Attachment 1 - DoO Form 5-6.xlsx
XLSX spreadsheet 76 KB Posted
- Attached to
- INDUSTRY DAY - Mission Test Support Services Federal contract opportunity
- Solicitation number
- PANMCC23P0000010518
About this file
This document contains instructions for completing an extended pass request form for access to Yuma Proving Ground in Arizona. The form requires contractors to provide identification details such as name, date of birth, driver's license information, social security number, and signature authority. It instructs on selecting gates and dates for required access and obtaining proximity card and phone information. The related federal contract opportunity is a special notice for an industry day to support mission test services at Yuma Proving Ground issued by the Department of the Army Materiel Command Mission and Installation Contracting Command. It includes the solicitation number but no further opportunity details.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attachment 3 - Performance Work Statment DRAFT.pdf | ||
| Attachment 4 - Authorization Letter SAMPLE.docx | DOCX document | |
| Attachment 2 - Visitor Center_PublicRelease.pdf | ||
| Attachment 5 -MWR Lunch Menu Selection.xlsx | XLSX spreadsheet |
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Text version
Extended Pass Request
| COMPANY NAME | FULL LAST NAME | FULL FIRST NAME & MIDDLE NAME | DATE OF BIRTH | STATE DL | DRIVER LICENSE (DL) # | FULL SSN# | LOCATION OF BIRTH - CITY, STATE/COUNTRY | PROXIMITY CARD REQUIRED YES/NO | SIGNATURE AUTHORITY FROM FM 5-8 | PHONE # | ACCESS DATE FROM: | ACCESS DATE TO: | GATES: HCA/WCA/KCA/LAAF |
| (EXAMPLE) CORPORATION | SMITH RAMIREZ | JOHN DOE | MM/DD/YYYY | AZ | D12345678 | 123-45-6789 | NEW ORLEANS, LA, USA | NO | PLANT, ROBERT | 928-328-XXXX | MM/DD/YYYY | MM/DD/YYYY | HCA/LAAF |
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FOUO USAG YUMA PROVING GROUND UNCLEARED CONTRACTOR/ EMPLOYEE/ TEACHER REQUEST &D
DOO FORM 5-6 Confidentiality and Nondisclosure Notice: This document contains confidential/privileged information. Any unauthorized use, disclosure or distribution is strictly prohibited. FOUO
**Instructions for completing extended pass form as provided in example above:
Company Name: Name of Company employee represents Last Name: As it is written on the driver license First Name and Middle : As is it written on the driver license Date of Birth: Self-Explanatory State of Driver's License: Self-Explanatory Driver's License Number: Self-Explanatory Full Social Security Number: Self-Explanatory Location of Birth City and State or Country: Self-Explanatory Signature Authority from FM 5-8: Only personnel with a completed DOO FORM 5-8, authorizied signature card, can submit an Extended Access Request.
Proximity Card Required: Yes or No (Fill out by YPG Official only) Phone: Phone number of Company/Organizaton number Access From: Date access needs to be granted Access To: Date access is to be terminated. Passess will not be granted to contractors for longer than 365 days at a time.
Gates: gate(s) that need to be access (Fill out by YPG Official only)
Once the DOO 5-6 Form is filled out by the contractor, the contractor must email it to the Yuma Proving Ground (YPG) Point of Contact. The YPG Authorized Personnel will then email or forward the form to the Visitor Control Center Officials. Please provide the Visitor Control Center Officials at least a week noticed
Email completed form to the Directorate of Emergency Services, Visitor Control Center by Yuma Proving Ground Authroized Personnel:
usarmy.ypg.imcom.list.doo-vcc@army.mil
Office Number: 928-328-6668/ 6689/ 6691 Fax: 928-328-2681
File details come from the government source that posted it. Updated .