Attachment 2 NSWCPD ENTRY SCREENING ASSESSMENT 01 Apr 20.pdf
PDF 145 KB Posted
- Attached to
- NSWCPD Engineering and Support Services for Code 33 Federal contract opportunity
- Solicitation number
- N6449821R4011
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| N6449821R4011U0002.pdf | ||
| N6449821R4011U0001.pdf | ||
| Encl 17g - CDRL A007 - Systems Security Plan.pdf | ||
| Encl 17h - CDRL A008 - Counterfeit Prevention Plan.pdf | ||
| Encl 17d - CDRL A004 - Other Direct Costs Report (ODCs).pdf | ||
| Encl 17i - CDRL A009 - Technical Report.pdf | ||
| Encl 17e - CDRL A005 - GovtPropertyInventoryReport.pdf | ||
| Attachment 3 -NSWCPD SBPCD August 2018.xlsx | XLSX spreadsheet | |
| N6449821R4011.pdf | ||
| Encl 17j - CDRL A010 - Unauthorized Supplier Purchase Report.pdf | ||
| Encl 17b - CDRL A002 - Travel Trip Report.pdf | ||
| Encl 17c - CDRL A003 - Contractor Personnel Roster.pdf | ||
| Encl 17f - CDRL A006 - Small Business Utilization.pdf | ||
| Attachment 1 List of Key Personnel N6449821R4011.docx | DOCX document | |
| Encl 17a - CDRL A001 - Contract Status Report.pdf |
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Text version
01 Apr 2020 Revision 2
NSWCPD COVID-19 SCREENING & SELF-ASSESSMENT QUESTIONNAIRE
1. Have you traveled internationally (to include Canada) or within the New York City Metropolitan Area in the last 14 days? YES NO
2. Have you had close personal contact, as defined below, with anyone who has been diagnosed with COVID 19 (lab or clinical diagnosis)? YES NO
a. Within 6 feet for prolonged period (~10 minutes)
b. In a confined space (car, small room, shared stateroom, berthing proximity, office, etc.)
c. Had direct contact with infectious secretions (been coughed, sneezed on, etc.)
3. Are you currently experiencing any of the following symptoms?
a. Fever YES NO
b. Chills YES NO
c. Cough YES NO
d. Sore Throat YES NO
e. Shortness of Breath YES NO
f. Body Aches YES NO
Seek medical advice by calling your insurance provided health line number and/or:
• Pennsylvania Department of Public Health: 1.877.724.3258 or visit, health.pa.gov
• New Jersey Department of Public health: 1.800.962.1253 or text, NJCOVID to 898-
211 or visit, NJ.gov/health
• Delaware Department of Public Health: 1.866.408.1899 or email, DPHcall@delaware.gov
In an effort to limit any possible exposure of COVID-19, if you have answered YES to any of the above questions, it is highly recommended that you telework if eligible or take appropriate leave.
mailto:DPHcall@delaware.gov
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