Attachment 3 - Site Visit DLA Form 1818.pdf

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DDSP Refurbishment, Surface Preparation, and Painting of Six (6) Static Displays
Solicitation number
SP330026Q0261
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This is a DLA Form 1818, a Privacy Act Statement and Visit Notification form used by the Defense Logistics Agency to control access to and movement on Department of Defense installations, buildings, and facilities.

The form documents a site visit to DLA Installation Management at Susquehanna, Building 753, scheduled for August 5, 2026. The visit requestor is Christopher Chapman (Office Code: DJSP, Telephone: 614-693-4034), with the point of contact at the facility also being Christopher Chapman (POC Telephone: 614-693-4034). The stated purpose of the visit is to conduct a site visit of Building 753 for potential vendors interested in quoting boiler repair and maintenance requirements. Visitors must register using the pre-enrollment website at https://dbids-global.dmdc.mil prior to the visit. The form includes Section I for visit details, Section II for visitor information (including name, grade/rank, SSN, date of birth, state/country of birth, and clearance status), and Section III for security representative authorization. The disclosure of information is voluntary; however, failure to provide all requested information may result in denial of access to the installation, building, or facility. The form is based on the authority of Section 21, 50 U.S.C. 781 et seq. and Executive Order 10450, with routine uses coordinated through General Services Administration Protective Service Personnel and DLA Privacy Act System Notice S500.50.

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PRIVACY ACT STATEMENT

VISIT NOTIFICATION

1. ACTIVITY TO BE VISITED

AUTHORITY:

PRINCIPAL PURPOSE:

ROUTINE USES:

DISCLOSURE:DEFENSE LOGISTICS AGENCY

8725 JOHN J. KINGMAN ROAD

FT BELVOIR, VA 22060-6220

Section 21, 50 U.S.C. 781 et seq.; Executive Order 10450.

To control access to and movement on DoD installations, buildings, or facilities.

Used by General Services Administration Protective Service Personnel for access control and for any of the Blanket Routine Uses published by DLA.

Voluntary. However, failure to provide all the requested information may result in refusal to grant access to the installation, building, or facility.

DLA PRIVACY ACT SYSTEM NOTICE S500.50 DLA-I APPLIES

SECTION I

2. NAME OF REQUESTOR/PREPARER 4. TELEPHONE3. OFFICE CODE

5. DATE(S) OF VISIT 6. POINT OF CONTACT (at facility to be visited) 7. POC TELEPHONE

8. PURPOSE OF VISIT

SECTION II

9.

NAME(S) OF VISITOR(S)

(Last, First, MI)

10.

GRADE/RANK

11.

SSN

12.

DATE OF BIRTH

13.

STATE /COUNTRY OF

BIRTH

14.

CLEARANCE/DATE

GRANTED

15.

TYPE OF INVESTIGATION/

DATE

16. TYPED NAME OF SECURITY REPRESENTATIVE

SECTION III

18. ACTIVITY 19. TELEPHONE NUMBER 20. DATE17. SIGNATURE OF SECURITY REPRESENTATIVE

DLA FORM 1818, JUL 96 (EG)

FROM: TO:

PDF (DLA)

RequesterName: Christopher Chapman
OfficeCode: DDSP
FacPOC: Christopher Chapman
Phone: 614-693-4034
POCPhone: 614-693-4034
VisitedActivity: DLA Installation Management at Susquehanna,

Building 753 VisitPurpose: Site Visit of Building 753 for potential vendors interested in quoting boiler repair and maintenance requirements.

Visitor has registered utilizing the pre-enrollment website: https://dbids-global.dmdc.mil

DateTo: 8/5/2026
Visitor:
0: Doe, John M.
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