Attachment 1- PWS Appendix 14_GSA Form 139-Record of Arrival and Departure from Building.pdf
GSA Form PDF 1 MB Posted
- Attached to
- Western Ground Transportation Solicitation (RFP)
- Solicitation number
- 70CDCR24R00000007
- Issued by
-
Immigration and Customs Enforcement
About this file
This document is a template for recording visitor arrivals and departures from federal buildings. It includes fields for month, year, date, visitor name, signature, agency or firm, room number, purpose of visit, arrival and departure times. The instructions state that Federal Protective Service and Contract Administration personnel conducting investigations should place an "X" in the footnote column.
The related opportunity is a solicitation from U.S. Immigration and Customs Enforcement seeking offers for ground transportation services in the Western United States. Offerors should respond by the date listed to be considered for an award to provide vehicles, drivers, and transportation coordination for agency personnel and detainees/deportees in the region. The solicitation includes standard terms for pricing, insurance, vehicle specifications, driver requirements, and performance metrics.
View the file
Other versions and copies of GSA Form 139
Who attaches GSA Form 139
Other files
Show 40 more
Latest 50 of 54 listed here. See the rest on GovTribe.
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
TIME OFPRINT NAME
(Last - First - Initial)
(b)
SIGNATURE
(c)
RECORD OF TIME OF ARRIVAL AND DEPARTURE
FROM BUILDINGS (DURING SECURITY HOURS)
BUILDING MONTHYEAR
DATE
(a)
AGENCY OR FIRM
(d)
PURPOSE OF VISIT
(f)
ROOM
NUMBER
(e)
SEE
FOOTNOTE*
(g)
ARRIVAL
(h)
DEPARTURE
(i)
* Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column.
GENERAL SERVICES ADMINISTRATION GSA 139 (REV. 12/2006)(Continue on reverse)
GSA 139 (REV. 12/2006) BACK
TIME OFPRINT NAME
(Last - First - Initial)
(b)
SIGNATURE
(c)
DATE
(a)
AGENCY OR FIRM
(d)
PURPOSE OF VISIT
(f)
ROOM
NUMBER
(e)
SEE
FOOTNOTE*
(g)
ARRIVAL
(h)
DEPARTURE
(i)
* Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column.
TIME OF
PRINT NAME
(Last - First - Initial) (b)
SIGNATURE
(c)
RECORD OF TIME OF ARRIVAL AND DEPARTURE
FROM BUILDINGS (DURING SECURITY HOURS)
BUILDING
MONTH
YEAR
DATE
(a)
AGENCY OR FIRM
(d)
PURPOSE OF VISIT
(f)
ROOM NUMBER
(e)
SEE FOOTNOTE*
(g)
ARRIVAL
(h) DEPARTURE (i)
* Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column.
GENERAL SERVICES ADMINISTRATION
GSA 139 (REV. 12/2006)
(Continue on reverse)
GSA 139 (REV. 12/2006) BACK
TIME OF
PRINT NAME
(Last - First - Initial) (b)
SIGNATURE
(c)
DATE
(a)
AGENCY OR FIRM
(d)
PURPOSE OF VISIT
(f)
ROOM NUMBER
(e)
SEE FOOTNOTE*
(g)
ARRIVAL
(h) DEPARTURE (i)
* Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column.
| MONTH: |
| YEAR. Enter 4 digit year.: |
| BUILDING: |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 1 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 16 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 15 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 14 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 13 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 12 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 11 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 10 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 9 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 8 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 7 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 6 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 5 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 4 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 3 of 16. : |
| DATE (a). Enter 2 digit month, 2 digit day and 4 digit year. Line 2 of 16. : |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| PRINT NAME (Last - First - Initial) (b): |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| SIGNATURE. (c). This is a protected field. : |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| AGENCY OR FIRM (d): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| ROOM NUMBER (e): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| PURPOSE OF VISIT (f): |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| SEE FOOTNOTE* (g). * Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column. : 0 |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| TIME OF ARRIVAL (g): |
| TIME OF DEPARTURE (i): |
| SignatureField1: |
File details come from the government source that posted it. Updated .