Attachment 0006 Security Clearance Validation Sheet.pdf
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- Solicitation number
- W56KGU26RC1MC
About this file
This is an RS3 Task Order Contractor Clearance Data form used to document personnel security clearance requirements for the RS-20-0018 Operations Support Task Order. The form is a template designed for contractors to submit employee clearance information to the Army Contracting Command - Aberdeen Proving Ground, MD.
The form requires contractors to list proposed contractor employees by name, Social Security Number, company affiliation, labor category, and proposed man-years (MY) of effort. It mandates that employees possess either a Top Secret/Sensitive Compartmented Information (TS/SCI) clearance—defined as an existing clearance on a current U.S. government contract or a TS Collateral clearance with an "in scope" investigation within the past five years—or a current valid SECRET or Interim SECRET clearance, depending on task requirements. For each employee, contractors must indicate the clearance type required, whether the employee possesses the required clearance, clearance issuance date, issuing agency, availability for work on the specific task, and work location (government onsite or contractor offsite). The form specifies that a "YES" answer to clearance availability is mandatory; if answered "NO," the offeror will not be awarded the task. If an employee is assigned to another task order, proposed for another contract, or working elsewhere, a Task Order Explanation Sheet detailing availability and workload impact is required. The form includes Privacy Act notification stating that Social Security Numbers are required under Public Law 104-134 and will be retained by Army Contracting Command per applicable DoD regulations and Executive Orders concerning personnel security and classified information access.
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Text version
RS3 Task Order Contractor Clearance Data RS3 Task Order Title: RS-20-0018 Operations Support Task Order Task Order# (Insert # Here) TBD
Total Labor MY: TS/SCI Req'd:
Contractor Employee Name Employee Social Security Number (SSN)*** Company Labor Category Proposed MY
Total Proposed MY 0.00
* TS/SCI Definition: The definition of an “acceptable” clearance shal clearance on a current U.S. government contract or alternately a TS Collateral clearance with an “in scope” investigation (within the past 5 years).
SECRET Definition: Current valid SECRET or Interim SECRET clea
** The answer for this block should be a "YES". If "YES" is answered and the employee is currently assigned to another Task Order, Proposed on another current TOR, or is on another contract, a TOR Explanation Sheet is required with details on how the proposed employee will be available to work this TO and how the other work the employee will no longer be performing will not be impacted.
NOTE: A "NO" answer in this block will mean the Offeror does not have the appropriate personnel with approprate clearance for this Task Order and will not be awarded the Task.
*** Social Security Number Privacy Act Statement Information
Public Law 104-134 (April 26, 1996) requires that any person doing business with the Federal Government furnish a social number. This is an amendment to Title 31, Section 7701. Furnishing the social security number, as well as other data, is v may delay or prevent action on the ability to work on subsequent Task Orders. Any information provided on this form will r the Army Contracting Command - Aberdeen Proving Ground, MD.
Authority: 10 USC 3013, Executive Order (SSN) 9397, as amended. 50 U.S.C., 401, Congressional declaration of purpose Personnel Security Program Regulation; DoD 5105.21-M-1, Sensitive Compartment Information Administrative Security, M for Government Employment; E.O. 10865, Safeguarding Classified Information Within Industry; E.O. 12333, United States National Industrial Security Program; and E.O. 12968, Access to Classified Information; and EEO 9397 (SSN), as amende
Routine Uses: The DoD Blanket Routine Uses that appear at the beginning of the Army's compilation of systems of record
SECRET Req'd:
TO Clearance Required*
Has Req'd Clearance (Yes/No)
Date of Clearance
Issued
Name of Agency Issuing
Clearance
Available for work this Sample Task?
Location:
Govt Onsite
/Cont Offsite ll be an existing with “in scope” TS/SCI rance.
Task Order Clearance Summary
File details come from the government source that posted it. Updated .