Attachment 19. MARB Base Pass Request_2022_ v2.1 CUI_3.pdf
PDF 374 KB Posted
- Attached to
- Design/Build Repair by Replacement Elevator Bldg. 395 Air Traffic Control Tower Federal contract opportunity
- Solicitation number
- FA466422R0001
About this file
This document is a contractor base pass request sheet for March Air Reserve Base in California. It requires company information including name, start and expiration dates for base access, as well as individual visitor details such as full name, date of birth, driver's license information, and vehicle registration and insurance documentation. The base pass provides access to specific dates and times. Sponsors must have a Department of Defense Common Access Card and fill out contact information. It notes the Privacy Act of 1974 and requirements to protect controlled unclassified information. An attachment to the federal contract opportunity FA466422R0001, the opportunity is for a design-build project to remove and replace an elevator in the Air Traffic Control Tower building at March Air Reserve Base. The project scope includes disassembly and removal of the existing elevator and systems, furnishing and assembling a new elevator, and testing, commissioning, and providing training on the new elevator.
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Text version
Controlled by: AFRC
Controlled by: 452 SFS/S3L
CUI Category: PRVCY
Distribution/Dissemination Controls: FEDCON
POC: MSgt Jonathan Ortega, DSN 447-3791
This document contains CONTROLLED UNCLASSIFIED INFORMATION (CUI) that must be protected under the Freedom of Information Act
(5 U.S.C. 552 and/or the Privacy Act of 1974 (5 U.S.C. 552a). Unauthorized disclosure or misuse of this PERSONAL Information may result in disciplinary action, criminal and/or civil penalties. Contents not be disclosed, discussed, or shared with individuals unless they have direct need-to-know in the performance of their official duties.
Deliver this document directly to the VCC in person or e-mail the VCC ORG e-mail box. Only digitally signed and encrypted e-mail's from a .mil e-mail address will be accepted. E-mails from personal e-mail addresses will not be accepted.
**LISTS OF 10 OR MORE MUST BE SUBMITTED A MINIMUM OF 10 DUTY DAYS PRIOR TO VISIT**
**LISTS OF 9 OR MORE MUST BE SUBMITTED A MINIMUM OF 5 DUTY DAYS PRIOR TO VISIT**
Visitor Control Center Org e-mail: 452SFS.March.VCC@us.af.mil
452nd Security Forces Squadron Visitor Control Center
March ARB Contractor Base Pass Request Sheet
COMPANY NAME:
START DATE: EXPIRATION DATE:
DATE SUBMITTED:
LOCATION:
VALID DAYS: M T W TH F SA SU
VALID TIMES: TO
NAME (Last, First, MI) SSN DL STATE DRIVER LICENSE # DOB
Ensure individuals bring the following items to the Visitor Control Center (1) Real ID Driver’s License (if not a REAL ID, need second form of valid ID), (2) Registration and (3) Proof of insurance
***THIS FORM IS TO BE FILLED OUT AND SIGNED BY SPONSOR (DoD CAC HOLDERS ONLY)***
Sponsor (DoDCAC Holder) Rank, Name, Unit/ORG:
Sponsor Contact Numbers (On-base & cell):
Sponsor E-Mail Address (.mil):
Signature: Date:
Privacy Act Statement
PRIVACY ACT-1974 as Amended applies – This memo may contain information which must be protected IAW DOD 5400-11, and it is Controlled Unclassified Information (CUI)
AUTHORITY: 10 U.S.C. 8013; 44 U.S.C. 3101; and EO 93397
PRINCIPAL PURPOSES: Used to record information and details of criminal activity which may require investigative action by commanders, supervisors, police, special agents, etc.
ROUTINE USES: Information may be disclosed to Pass and Registration to determine base access.
DISCLOSURE IS VOLUNTARY: SSN is used to positively identify the individual as a conduit to check past criminal activity records. Failure to provide the request information will affect your ability to gain access to March Air Reserve Base, CA.
CUI
GS-12, Amy Crain, 452 MSG/PK
951-655-3227 amy.crain.1@us.af.mil
Bldg 2313 Ste 118
Attachment 19 to FA466422R0001 - Proposal Submission
0730 1600 mailto:452SFS.March.VCC@us.af.mil mailto:452SFS.March.VCC@us.af.mil
File details come from the government source that posted it. Updated .