Attachment 10 GSA Form 139.pdf

PDF 1015 KB Posted

Attached to
Level II Armed Security Guards / DR-4827-NC Federal contract opportunity
Solicitation number
70FBR426R00000001
Issued by
Federal Emergency Management Agency

About this file

Written by GovTribe AI ·

This is a GSA Form 139 (Revised 12/2006) for recording visitor arrival and departure times in federal buildings during security hours. The form is designed to track individuals entering and exiting a building, with columns for date, printed name, signature, agency or firm, room number, purpose of visit, and specific arrival and departure times. A special footnote indicates that Federal Protective Service and Contract Administration personnel must place an "X" in a designated column when conducting an investigation. The form provides space for multiple entries and is double-sided to accommodate extensive visitor logging, serving as an official security and visitor management document for government facilities.

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Other files for this federal contract opportunity

Other files attached to Level II Armed Security Guards / DR-4827-NC, newest first.
File Type Posted
Amendment 0001 - Solicitation - 70FBR426R00000001.pdf PDF
Solicitations Questions and Answers.pdf PDF
Proposal Attachment 2 Security Guard Roster and Weapons.xlsx XLSX spreadsheet
Attachment 21 Performance Requirement Summary (PRS).xlsx XLSX spreadsheet
Attachment 20 Section F Deliverable Schedule.xlsx XLSX spreadsheet
Attachment 11 Contractor DHS Fitness Form 11000 25.pdf PDF
Attachment 08 DHS Management Directive 11042.1.pdf PDF
Attachment 05 FEMA Directive 121 3 Facility Access.pdf PDF
Attachment 02 Federal Management Regulations (41 C.F.R. PART 102-74).pdf PDF
Attachment 1 PWS 20251208.pdf PDF
Attachment 18 SF 87 Fingerprint Chart.pdf PDF
Attachment 17 Standard Form 85P S Supplemental Questionnaire for Selected Positions.pdf PDF
Attachment 07 Homeland Security Presidential Directive 12.pdf PDF
Proposal Attachment 5 Pricing Schedule.xlsx XLSX spreadsheet
Proposal Attachment 4 Past Performance Questionnaire.DOCX DOCX document
Proposal Attachment 3 Determination of Finance Responsibility.pdf PDF
Attachment 24 1SCA WD 2015 4369 20251203 Rev 29 Henderson Buncombe.pdf PDF
Attachment 23 SCA WD 2015-4375 20251203 Rev 32 Durham.pdf PDF
Attachment 22 SCA WD 2015-4387 20251203 Rev 32 Catawba.pdf PDF
Attachment 19 Security Equities in Standing Up Responder Lodging Locations During Disaster Operations.docx DOCX document
Attachment 16 Standard Form 85P Questionnaire for Public Trust Positions.pdf PDF
Attachment 15 DHS Form 11000 9.pdf PDF
Attachment 14 DHS Form 11000 6 Sensitive but Unclassified Non-Disclosure Agreement.pdf PDF
Attachment 13 Lautenberg Amendment Statement.pdf PDF
Attachment 9 Security Guard Post Assignment Record Post Orders Template.pdf PDF
Attachment 03 American with Disabilities Act 9ADA) of 1990 (Pub L. 101-336).pdf PDF
2.2.1 70FBR426R00000001.pdf PDF
Proposal Attachment 1 Technical Factors Inset Offerors Name.docx DOCX document
Attachment 12 Optional Form 306 Declaration for Federal Employment OF306.pdf PDF
Attachment 06 FEMA Manual 121 3 1 FEMA Credentialing Access Manual.pdf PDF
Attachment 04 FEMA Directive 121 1 FEMA Personal Identity Verification Guidelines.pdf PDF
Attachment 1 Security Guard Roster and Weapons.xlsx XLSX spreadsheet
Show all 32

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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:

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