Attachment 4 - Base Pass Request.pdf

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Attached to
Fire Break Maintenance BPA
Solicitation number
FA483024Q0047
Issued by

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This document is a Request for Quotation (RFQ) for Fire Break Maintenance Services at Moody Air Force Base in Georgia. The RFQ is set aside 100% for small businesses under NAICS code 115310. It will result in the award of a Blanket Purchase Agreement (BPA) with a period of performance from July 29, 2024 to July 28, 2029. Interested vendors must submit their quotes by July 17, 2024 at 2:00 P.M. EST to joseph.bruno.9@us.af.mil. A site visit will be held on July 10, 2024 at 10:00 AM EST. Vendors must complete the Base Pass Request form, Attachment 4, by April 19, 2024 at 5:00 PM EST. The RFQ includes a Statement of Work detailing the required fire break maintenance services, a Price List, a Wage Determination, and Insurance Compliance requirements.

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FOR OFFICIAL USE ONLY

DEPARTMENT OF THE AIR FORCE

23D CONTRACTING SQUADRON (ACC)

MOODY AIR FORCE BASE GEORGIA

Attack ∙ Rescue ∙ Prevail The information herein is For Official Use Only (FOUO) which must be protected under the Freedom of Information Act of 1996 and Privacy Act of 1974, as amended. Unauthorized disclosure or misuse of this PERSONAL INFORMATION may result in criminal and/or civil penalties

MEMORANDUM FOR 23 SFS/SFOXI

FROM: 23 CONS

SUBJECT: Request for Installation Access Personnel Pass

1. Request pass for the following person(s) to Moody AFB:

2. If you have any questions or concerns, please contact the undersigned:

Contract Number:

Prime Contractor:

Duration of Pass:

(NTE 1 Year)

Purpose:

Full Name Organization/CompanySSN/DOB*

*Write N/A if contractor declined to provide information. Be advised that SSN/DOB information is required for base access.

Security Forces will ask for it at the Visitor's Center if not detailed in this form.

Sponsor Info: GS-09, Amanda Grover, Contract Specialist, amanda.grover@us.af.mil, 229-257-4917

Date1_af_date:
Contract #:
Contractor Name:
Duartion of Pass:
Contract Purpose:
FullName1:
FullName2:
FullName3:
FullName4:
FullName5:
SSNDOB1:
SSNDOB2:
SSNDOB3:
SSNDOB4:
SSNDOB5:
Org1:
Org2:
Org3:
Org4:
Org5:
SponsorInfo:
Clear Form:

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