Attachment 3 CAC Turn-In Receipt.pdf

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Attached to
Guam MHE Preventative Maintenance and Remedial Services
Solicitation number
SP451022Q1003
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GOVERNMENT-ISSUED CONTRACTOR COMMON ACCESS CARD (CAC)

TURN-IN RECEIPT

The contractor shall complete the following information:

Contract Number:

Contractor:

Location:

The contractor shall identify the following information for each contractor CAC being turned-in:

Employee Name Issue Date Expiration Date

The contractor shall return the above identified contractor CACs to the Contracting Officer’s Representative (COR) for the contract for turn-in. The COR will enter the turn-in date for the contractor CACs. The contractor shall acknowledge turn-in of the contractor CACs and the COR will acknowledge receipt below:

Turn-in Date to COR Contractor Acknowledgement of Turn-In COR Acknowledgement of Receipt

Signature: Signature:

Print Name: Print Name:

The COR will hand-carry the above identified contractor CACs to the nearest Real-Time Automated Personnel Identification System (RAPIDS) office for turn-in. The RAPIDS office will enter the turn-in date for the contractor CACs. The COR will acknowledge turn-in of the contractor CACs and the RAPIDS office will acknowledge receipt below:

Turn-in Date to RAPIDS Office

COR Acknowledgement of Turn-In RAPIDS Office Acknowledgement of Receipt

Signature: Signature:

Print Name: Print Name:

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