Attachment 10 - NSSC Contractor Access Request.docx
DOCX document 92 KB Posted
- Solicitation number
- W911QY25QAP05
About this file
This is a Contractor Access Request Form for entry to the Natick Soldier Systems Center (NSSC). The form requires contractors to provide company information, building/area of work, NSSC point of contact details, and personal information including name, date of birth, driver's license details, current address, and states of residence for the past 5 years.
The form must be submitted at least 24 hours before visitor arrival, either via encrypted email to usarmy.natick.imcom.list.nati-policevistoraccess-ssc@mail.mil or by fax to (508) 206-4009. Visitor vetting is valid for 90 days, and successful vetting results in placement on the Daily Access Roster at the Main Gate. If derogatory information is found during vetting, the POC will be notified and access will be denied, though a waiver request process is available through the USAG Natick Police Desk. Questions can be directed to the Police Desk at 508-206-4007.
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Text version
NSSC Contractor Access Request Form
Company Name: __________________________ Bldg/Area working: ____________ NSSC Point of Contact (POC): _________________ POC Phone #:__________________
| Last Name |
| First Name |
| Date of Birth |
| State ID or Drivers License # |
| DL |
State
| Current Address |
| States Resided In |
During Past 5 Years
· Per U.S. Army Directive-Type Memorandum (DTM) 09-012, all of the above information is required for unescorted access. The POC will only be notified if the visitor is not authorized entry onto the installation.
· All U.S. visitors 18 years of age and older must be vetted prior to entry to NSSC. Foreign visitors (both official and unofficial) must be vetted through the appropriate Foreign Disclosure Officer based on the organization he/she is coming to see.
· To protect PII, there are two methods of submitting this form. This form can be emailed encrypted to “USARMY Natick SSC IMCOM List NATI-PoliceVistorAccess-SSC” at email address usarmy.natick.imcom.list.nati-policevistoraccess-ssc@mail.mil Alternatively, this form can be faxed to (508) 206-4009.
· Requests must be received by USAG Natick Police at least 24 hours prior to the visitor’s arrival. Upon successful vetting, the visitor will be added to the Daily Access Roster for the date of the visit. The Daily Access Roster is maintained at the Main Gate.
· If a visitor has been vetted within the last 90 days, their information will be on the appropriate Visitor Access Roster. For those personnel not on the Visitor Access Roster or who have recently expired, then send an email request to the above address at least 24 hours prior to the visitor’s arrival. Include the visitor’s full name, date of visit, time of visit and POC.
· If a visitor has derogatory information found when vetted, a call will go to the POC only and not allowed on Installation.
· Contact the USAG Natick Police Desk at 508-206-4007, to verify whether or not a visitor has been vetted within the last 90 days.
· Please direct any questions regarding this process to the USAG Natick Police Desk at 508-206-4007.
· Note: If individual has been denied access a Waiver Request and instructions can be obtained from USAG Natick Police Desk.
FOUO
In compliance with the Privacy Act of 1974, this information is Personal Data and must be protected from disclosure.
USAG Form 402 image1.gif
File details come from the government source that posted it. Updated .