Attachment 14 - Contractor Employee Separation Clearance Checklist - template.pdf

INSTRUCTIONS

This checklist applies to the separation of contractor employees. This checklist SHALL be completed PRIOR to the separation date by the ICE Point of Contact (ICE/POC) (i.e., Contracting Officer (CO), or Contract Officer’s Representative (COR)).

1. The ICE/POC shall complete all parts of this checklist for the separating contractor employee, including Contractor Company Name or Subcontract or Company Name.

2. The ICE/POC shall ensure the departing contractor employee’s FULL name (including middle name) is deactivated in the ICE on-line telephone system ("TELE") and his or her Voice Mail account is removed from the local phone system and local telephone lists.

3. The ICE/POC shall send an electronic mail (email) message to "Voice, Communications", IF the contractor employee was issued a calling card, providing the contractor employee’s card number. The ICE/POC shall destroy (shred the card) the calling card after notification has been made.

4. The Local Property Officer (LPO) shall ensure the return of any Government Furnished Property (GFP), is returned for disposition to include but not limited to:

a. all computer equipment (desktops, notebooks, palm PC, etc.)

b. media and publications (CD’s , DVD’s, etc.)

c. official credentials, and official passports

d. smart cards and associated readers, cameras, mobile devices, pagers, phone calling cards

e. any other government owned item(s) to the Local Property Officer (LPO) for disposition.

The LPO shall take possession of all accountable GFP issued to the departing contractor employee, if the government maintains the official government property records. (Example: Complete form G-570, for all property issued to a contractor.) The LPO shall notify the ICE /POC if the contractor employee did not return all GFP. The LPO shall complete Part II and return the signed form to the ICE/POC. Email/facsimile is acceptable.

5. The LPO shall complete an “ICE Service Catalog” then the Personnel Exit Request” to close out all user accounts (LAN access and all related system (all systems that contractors had access to should be spelled out in this request with user ID's if known/application user accounts, this can include VPN access, IRMNET domain access (normal and administrative), FFMS, Blackberry/iPhone accounts to be deactivated. Requests are submitted via https://servicedesk.ice.dhs.gov/ServiceDesk/ServiceDesk.aspx.

6. Office Chief of Information (OCIO). The OCIO shall suspend the contractor employee's access to all systems authorized access, such as TECS, ACS, and others. OCIO will send an email "Separation Confirmation” message to the ICE/POC and all ICE LAN Administrators and Systems Control Officers confirming that the individual's access to all systems has been suspended.

7. The ICE/POC shall annotate any additional instructions for clearance in Part III (e.g., mailroom, parking permit, library, and passport).

Separate local instructions may be attached.

8. The ICE/POC is responsible for destroying the Personal Identity Verification (PIV) card AND turning it into ICE Physical Security.

PIV cards must be rendered inoperable prior to being sent to Physical Security. To render the PIV card inoperable: Using a standard hole punch, make three holes in the card: one through the integrated circuit chip; one through the upper left of the facial image, making sure to destroy part of the photograph as well as the magnetic stripe on the back of the card; and one through the expiration date found in the top right corner of the card; then mail to PSU at the address listed under Security Requirements.

DEPARTMENT OF HOMELAND SECURITY

U.S. Immigration and Customs Enforcement

CONTRACTOR EMPLOYEE SEPARATION CLEARANCE CHECKLIST

Page 1 of 4ICE Form 50-005 (7/13)

SECURITY REQUIREMENTS:

The ICE/POC shall ensure:

• Keys (e.g.,building, and office) are turned in/collected by ICE/POC or local Resource Management (administrative) Division.

• Return PIV* and Access control badge ID cards to:

Immigration & Customs Enforcement OPR/SMU/Physical Security 950 L’Enfant Plaza, SW, MS 5501 Washington, DC 20536-5501 https://servicedesk.ice.dhs.gov/ServiceDesk/ServiceDesk.aspx

• Contractor employee name and reason for leaving ICE is included in email notification.

• Destroy Classified Courier Card - retain card number and date destroyed.

• Contractor employee with SCI Access is terminating employment with ICE.

Send email to ICE Departure Notification (mailto:ICEDepartureNotification@fins3.dhs.gov) that will notify the following groups OPR, ADSEC, SSO, and ICE Personnel Security); and retain a copy in the contract file.

9. ADDITIONAL CLEARANCE PROCEDURES

Annotate any special clearance instructions. The applicable office shall complete the form and return it to the CPOC.

Passports issued by the Office of International Affairs must be returned to:

Immigration & Customs Enforcement Washington, DC 20536

10. The ICE/POC shall email that the following has been completed along with a scanned copy of the completed checklist:

ICE Form 50-005 (7/13) Page 2 of 4

The ICE/POC (i.e., Contracting Officer or Contract Officer's Representative (COR)) shall complete this form for all departing U.S.

Immigration and Customs Enforcement (ICE) contractor employees prior to departure.

PART I - TO BE COMPLETED BY THE ICE POC

1. Contractor Employee's Type/Printed Name:

2. Company Name and Address:

3. Contract Number/Task Order:

PART II - TO BE COMPLETED BY THE LOCAL PROPERTY OFFICER (LPO) AT YOUR LOCATION

Laptops, PEDS (includes mobile devices & mobile chargers, blackberries, etc.), air cards, mobile computing devices (thumb drives, external hard drives, etc.), PDAs, voice mailboxes, Secure ID tokens, online reference subscription services, and Government Emergency Telecommunications (GETS) Card are deactivated and recovered.

I certify to the best of my knowledge that I have returned all government furnished property and information.

4. Departure Date:

5. Departing Contractor Printed Name & Employee Signature:

6. Printed Name & Signature of LPO (i.e., Contracting Officer Representative (COR) and/or Contracting Officer (CO)):

7. Date of Signature:

Submit request through “ICE Service Catalog,” then “Personnel Exit Request” at https://servicedesk.ice.dhs.gov/ServiceDesk/ServiceDesk.aspx to close out all user accounts (LAN access and all related system (all systems that contractor had access to should be spelled out in this request with user ID’s if known/application user access accounts, this can include VPN access, IRMNET domain access (normal and administrative), Blackberry/iPhone accounts to be deactivated.))

Submit request to be removed from systems (FFMS, PRISM, WebView, ePMO, etc.) that OCIO service desk is not responsible for to the system owner. List systems below:

DEPARTMENT OF HOMELAND SECURITY

U.S. Immigration and Customs Enforcement

CONTRACTOR EMPLOYEE SEPARATION CLEARANCE CHECKLIST

ICE Form 50-005 (7/13) Page 3 of 4

PART IV - TO BE COMPLETED BY THE ICE/POC

E-mail notification sent to ICE Departure Notification (this will notify the following groups OPR, ADSEC, SSO, ICE Personnel Security, and ICE Physical Security) at mailto:ICEDepartureNotification@fins3.dhs.gov.

The ICE/POC shall e-mail that the following has been completed along with a scanned copy of the completed checklist:

• Contractor employee name and reason for leaving ICE is included in email notification.

• Destroy Classified Courier Card - retain card number and date destroyed.

• Contractor employee with SCI Access is terminating employment with ICE.

ICE POC shall retain a copy of the completed checklist and email from OCIO service ticket # completion confirmation in the contract file; as well as email a copy to your local Resource Management (administrative) Division for removal from mail groups, office rosters, etc.

8. ICE/POC (Point of Contact) (i.e., Contracting Officer Representative (COR) and/or Contracting Officer (CO)) Type/Printed Name & Email Address:

9. Phone Number:

10. Date:

ICE Form 50-005 (7/13) Page 4 of 4

PART III - TO BE COMPLETED BY THE ICE/POC

Physical Security:

Keys (building/office) recovered. Turned into Resource Management (administrative) Division.

PIV Card/Access control badge ID cards recovered and rendered inoperable.

Administrative Security:

Classified Courier Card destroyed.

Kline, Jill

INSTRUCTIONS

This checklist applies to the separation of contractor employees. This checklist SHALL be completed PRIOR to the separation date by the ICE Point of Contact (ICE/POC) (i.e., Contracting Officer (CO), or Contract Officer’s Representative (COR)).

1. The ICE/POC shall complete all parts of this checklist for the separating contractor employee, including Contractor Company Name or Subcontract or Company Name.

2. The ICE/POC shall ensure the departing contractor employee’s FULL name (including middle name) is deactivated in the ICE on-line telephone system ("TELE") and his or her Voice Mail account is removed from the local phone system and local telephone lists.

3. The ICE/POC shall send an electronic mail (email) message to "Voice, Communications", IF the contractor employee was issued a calling card, providing the contractor employee’s card number. The ICE/POC shall destroy (shred the card) the calling card after notification has been made.

4. The Local Property Officer (LPO) shall ensure the return of any Government Furnished Property (GFP), is returned for disposition to include but not limited to:

a.

all computer equipment (desktops, notebooks, palm PC, etc.)

b.

media and publications (CD’s , DVD’s, etc.)

c.

official credentials, and official passports d.

smart cards and associated readers, cameras, mobile devices, pagers, phone calling cards e.

any other government owned item(s) to the Local Property Officer (LPO) for disposition.

The LPO shall take possession of all accountable GFP issued to the departing contractor employee, if the government maintains the official government property records. (Example: Complete form G-570, for all property issued to a contractor.) The LPO shall notify the ICE /POC if the contractor employee did not return all GFP. The LPO shall complete Part II and return the signed form to the ICE/POC. Email/facsimile is acceptable.

5. The LPO shall complete an “ICE Service Catalog” then the Personnel Exit Request” to close out all user accounts (LAN access and all related system (all systems that contractors had access to should be spelled out in this request with user ID's if known/application user accounts, this can include VPN access, IRMNET domain access (normal and administrative), FFMS, Blackberry/iPhone accounts to be deactivated. Requests are submitted via https://servicedesk.ice.dhs.gov/ServiceDesk/ServiceDesk.aspx.

6. Office Chief of Information (OCIO). The OCIO shall suspend the contractor employee's access to all systems authorized access, such as TECS, ACS, and others. OCIO will send an email "Separation Confirmation” message to the ICE/POC and all ICE LAN Administrators and Systems Control Officers confirming that the individual's access to all systems has been suspended.

7. The ICE/POC shall annotate any additional instructions for clearance in Part III (e.g., mailroom, parking permit, library, and passport). Separate local instructions may be attached.

8. The ICE/POC is responsible for destroying the Personal Identity Verification (PIV) card AND turning it into ICE Physical Security.PIV cards must be rendered inoperable prior to being sent to Physical Security. To render the PIV card inoperable: Using a standard hole punch, make three holes in the card: one through the integrated circuit chip; one through the upper left of the facial image, making sure to destroy part of the photograph as well as the magnetic stripe on the back of the card; and one through the expiration date found in the top right corner of the card; then mail to PSU at the address listed under Security Requirements.

DEPARTMENT OF HOMELAND SECURITY

U.S. Immigration and Customs Enforcement

CONTRACTOR EMPLOYEE SEPARATION CLEARANCE CHECKLIST

ICE Form 50-005 (7/13)

SECURITY REQUIREMENTS:

The ICE/POC shall ensure:

Keys (e.g.,building, and office) are turned in/collected by ICE/POC or local Resource Management (administrative) Division.

Return PIV* and Access control badge ID cards to: Immigration & Customs Enforcement OPR/SMU/Physical Security 950 L’Enfant Plaza, SW, MS 5501 Washington, DC 20536-5501 Contractor employee name and reason for leaving ICE is included in email notification.

Destroy Classified Courier Card - retain card number and date destroyed.

Contractor employee with SCI Access is terminating employment with ICE.

Send email to ICE Departure Notification (mailto:ICEDepartureNotification@fins3.dhs.gov) that will notify the following groups OPR, ADSEC, SSO, and ICE Personnel Security); and retain a copy in the contract file.

9. ADDITIONAL CLEARANCE PROCEDURESAnnotate any special clearance instructions. The applicable office shall complete the form and return it to the CPOC.

Passports issued by the Office of International Affairs must be returned to: Immigration & Customs Enforcement Washington, DC 20536

10. The ICE/POC shall email that the following has been completed along with a scanned copy of the completed checklist:

ICE Form 50-005 (7/13) The ICE/POC (i.e., Contracting Officer or Contract Officer's Representative (COR)) shall complete this form for all departing U.S. Immigration and Customs Enforcement (ICE) contractor employees prior to departure.

PART I - TO BE COMPLETED BY THE ICE POC

1.

Contractor Employee's Type/Printed Name:

2.

Company Name and Address:

3.

Contract Number/Task Order:

PART II - TO BE COMPLETED BY THE LOCAL PROPERTY OFFICER (LPO) AT YOUR LOCATION

Laptops, PEDS (includes mobile devices & mobile chargers, blackberries, etc.), air cards, mobile computing devices (thumb drives, external hard drives, etc.), PDAs, voice mailboxes, Secure ID tokens, online reference subscription services, and Government Emergency Telecommunications (GETS) Card are deactivated and recovered.

I certify to the best of my knowledge that I have returned all government furnished property and information.

4.

Departure Date:

5.

Departing Contractor Printed Name & Employee Signature:

6.

Printed Name & Signature of LPO (i.e., Contracting Officer Representative (COR) and/or Contracting Officer (CO)):

7.

Date of Signature:

Submit request through “ICE Service Catalog,” then “Personnel Exit Request” at https://servicedesk.ice.dhs.gov/ServiceDesk/ServiceDesk.aspx to close out all user accounts (LAN access and all related system (all systems that contractor had access to should be spelled out in this request with user ID’s if known/application user access accounts, this can include VPN access, IRMNET domain access (normal and administrative), Blackberry/iPhone accounts to be deactivated.)) Submit request to be removed from systems (FFMS, PRISM, WebView, ePMO, etc.) that OCIO service desk is not responsible for to the system owner. List systems below:

DEPARTMENT OF HOMELAND SECURITY

U.S. Immigration and Customs Enforcement

CONTRACTOR EMPLOYEE SEPARATION CLEARANCE CHECKLIST

ICE Form 50-005 (7/13)

PART IV - TO BE COMPLETED BY THE ICE/POC

E-mail notification sent to ICE Departure Notification (this will notify the following groups OPR, ADSEC, SSO, ICE Personnel Security, and ICE Physical Security) at mailto:ICEDepartureNotification@fins3.dhs.gov.

The ICE/POC shall e-mail that the following has been completed along with a scanned copy of the completed checklist:

Contractor employee name and reason for leaving ICE is included in email notification.

Destroy Classified Courier Card - retain card number and date destroyed.

Contractor employee with SCI Access is terminating employment with ICE.

ICE POC shall retain a copy of the completed checklist and email from OCIO service ticket # completion confirmation in the contract file; as well as email a copy to your local Resource Management (administrative) Division for removal from mail groups, office rosters, etc.

8.

ICE/POC (Point of Contact) (i.e., Contracting Officer Representative (COR) and/or Contracting Officer (CO)) Type/Printed Name & Email Address:

9.

Phone Number:

10.

Date:

ICE Form 50-005 (7/13)

PART III - TO BE COMPLETED BY THE ICE/POC

Physical Security:

Keys (building/office) recovered. Turned into Resource Management (administrative) Division.

PIV Card/Access control badge ID cards recovered and rendered inoperable.

Administrative Security:

Classified Courier Card destroyed.