Attachment 0003 Notification and Authorization to Release Criminal Information for Entry....pdf

PDF 136 KB Posted

Attached to
Remote Weapon Systems (RWS) Federal contract opportunity
Solicitation number
W15QKN-21-Z-0H0U
Issued by
Department of the Army Materiel Command Contracting Command Picatinny Arsenal

About this file

Written by GovTribe AI ·

This notice announces an industry day for the Remote Weapon System special notice. The Department of the Army Materiel Command Contracting Command Picatinny Arsenal will host the industry day on June 8-10, 2021 at The Club at Picatinny to demonstrate two variants of remote weapon systems. Representatives from each company are limited to five attendees who must complete a criminal background check form and registration by April 30, 2021 to attend. The industry day will provide an opportunity for attendees to operate both weapon system variants and ask technical questions. A non-disclosure agreement is required. The notice aims to share information with industry partners but does not constitute a binding offer, and participation will not require the government to pay any costs or information.

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W15QKN-21-R-0025 DRAFT.pdf PDF
Attachment 0005 Non -Disclosure and Non-Use Agreement Program Manager Soldier Lethality.DOC DOC document
CCDC-AC FVS Exempt Visit Request Guidance_v8_09Apr2021.docx DOCX document
Attachment 0002 DD FORM 2345.pdf PDF
Attachment 0004 PM-SL Industry Day - RegistrationForm.pdf PDF
Attachment 0006 Use and Non-Disclosure Agreement between USG and XXX for CROWS SLA No 1 Type 2 Data.doc DOC document
Attachment 0001 AMSTA-AR Form1350.pdf PDF

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DEPARTMENT OF THE ARMY

UNITED STATES ARMY INSTALLATION MANAGEMENT AGENCY

PICATINNY ARSENAL, NEW JERSEY 07806-5000

Notification and Authorization to Release Criminal

Information for Entry

Notification

For the purpose of accessing Picatinny Arsenal I am required to consent to a criminal background check as a condition of being granted access. This check includes the following: Criminal history reference searches for felony and misdemeanour convictions at the county and federal levels of every jurisdiction where I currently reside or where I have resided; and sex offender registry searches at the county and federal levels in every jurisdiction where I currently reside or where I have resided. If I decline to submit to a Criminal background check I understand that I will be denied access to Picatinny Arsenal.

Authorization

I hereby authorize Picatinny Arsenal to conduct the criminal background check described above.

I also am aware that records of arrests on pending charges and/or convictions are not an absolute bar to entrance to Picatinny Arsenal.

Such information will be used to determine whether the results of the background check reasonably bear on my ability to enter in a manner which is safe for Picatinny Arsenal visitors, employees, and other community members.

Please print LEGIBLY (for identification purposes):

Full Legal Name:

First Middle Last

Date of Birth: Race: Gender: Female Male

Month/Day/Year

Place of Birth Social Security Number:

Driver’s License # State of Driver’s License

To the best of my knowledge, the information provided in this Notice and Authorization and any attachments thereto is true and complete. I understand that any falsification or omission of information may disqualify me for entrance and/or may serve as grounds for denial of entry to Picatinny Arsenal. By signing below I hereby provide my authorization to Picatinny Arsenal to conduct a criminal background check. In addition, I understand that I have a right to appeal an adverse decision made by Picatinny Arsenal based on my background check information.

Signature Date

Individual is cleared for entry to Picatinny Arsenal

Yes: No:

11.0.0.20130303.1.892433

Full Legal Name:
Date of Birth:
Race:
Gender: Female:
Male:
Place of Birth:
Social Security Number:
Driver’s License:
State of Driver’s License:
Signature:
Date:
Yes:
No:

File details come from the government source that posted it. Updated .