ATTACHMENT 3 - Entry Authorization Listing (EAL).pdf

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Renovate Wellness Center, Bldg 12
Solicitation number
W50S8120Q0012
Issued by

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This document is a solicitation for renovation services at Wellness Center Building 12 at the 104th Fighter Wing. The solicitation seeks a firm fixed-price contract for project management, construction, and logistics support to remove and replace office furniture, flooring, lighting, HVAC, plumbing and electrical systems. The project size is between $100,000 and $250,000 and must be completed within 120 calendar days of the notice to proceed. The NAICS code is 236220 and it is a total small business set-aside for firms with average annual revenue under $36.5 million for the previous three years. A pre-proposal conference will be held on August 28th and proposals are due by September 11th. The award is expected to be made without discussions according to FAR Part 13. Interested parties must register in SAM and the solicitation is available on beta.SAM.gov. All inquiries must be submitted in writing to 104.fw.msc@us.af.mil.

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Other files

File Type Posted
Site Visit Sign-In.pdf PDF
RFI Log 20Q0012 20200908.pdf PDF
Solicitation W50S8120Q0012.pdf PDF
ATTACHMENT 2 - Drawings (Bldg12) 20200617.pdf PDF
ATTACHMENT 4a - JA Best Lock.pdf PDF
ATTACHMENT 4b - JA SNE Building Systems.pdf PDF
ATTACHMENT 1 - Specifications (Bldg12) 20200810.pdf PDF

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104FW Security Forces Squadron

Contractor Entry Authority List

PRIVACY ACT STATEMENT

1. AUTHORITY: Title 50, Appendix, U.S.C., Title 10, U.S.C., Public Law 96-357 96th Congress, September 24, 1980 (Amendment to 10 U.S.C. 2107).

2. PRINCIPAL PURPOSE(S): The information provided on the application will be used to screen individual contractor employees for access to DoD facilities.

3. MANDATORY AND VOLUNTARY DISCLOSURE AND EFFECT ON INDIVIDUAL PROVIDING INFORMATION: Disclosure of information requested in this Entry Authorization List (EAL) is voluntary; however, the information must be furnished for the employee to be allowed access to the DoD facility.

Project:

Company/Contractor Name:

Project Manager and Phone:

104FW POC:

104FW POC Phone:

Contractor Employee Information:

Name Driver’s License / State DOB DATE START DATE END kyle.kiepke Text Box

FOR OFFICIAL USE ONLY WHEN COMPLETED

NameRow1:
DOBRow1:
DATE STARTRow1: 28 August 20
DATE ENDRow1: 28 August 20
NameRow2:
DOBRow2:
DATE STARTRow2:
DATE ENDRow2:
NameRow3:
DOBRow3:
DATE STARTRow3:
DATE ENDRow3:
NameRow4:
DOBRow4:
DATE STARTRow4:
DATE ENDRow4:
NameRow5:
DOBRow5:
DATE STARTRow5:
DATE ENDRow5:
NameRow6:
DOBRow6:
DATE STARTRow6:
DATE ENDRow6:
NameRow7:
DOBRow7:
DATE STARTRow7:
DATE ENDRow7:
NameRow8:
DOBRow8:
DATE STARTRow8:
DATE ENDRow8:
NameRow9:
DOBRow9:
DATE STARTRow9:
DATE ENDRow9:
NameRow10:
DOBRow10:
DATE STARTRow10:
DATE ENDRow10:
NameRow11:
DOBRow11:
DATE STARTRow11:
DATE ENDRow11:
NameRow12:
DOBRow12:
DATE STARTRow12:
DATE ENDRow12:
NameRow13:
DOBRow13:
DATE STARTRow13:
DATE ENDRow13:
NameRow14:
DOBRow14:
DATE STARTRow14:
DATE ENDRow14:
NameRow15:
DOBRow15:
DATE STARTRow15:
DATE ENDRow15:
Text1: W50S8120Q0012 -- Renovate Wellness Center Bldg. 12 (Site Visit)
Text2:
Text3:
Text4: CMSgt Kyle Kiepke
Text5: 413.572.1593
Drivers License StateRow1:
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Drivers License StateRow4:
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Drivers License StateRow10:
Drivers License StateRow11:
Drivers License StateRow12:
Drivers License StateRow13:
Drivers License StateRow14:
Drivers License StateRow15:
Drivers License Row1:
Drivers License Row2:
Drivers License Row3:
Drivers License Row4:
Drivers License Row5:
Drivers License Row6:
Drivers License Row7:
Drivers License Row8:
Drivers License Row9:
Drivers License Row10:
Drivers License Row11:
Drivers License Row12:
Drivers License Row13:
Drivers License Row14:
Drivers License Row15:

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