Attachment 4 - Pass Request.docx

Attachment 4 – Pass Request Mission Training Complex, JBSA-Camp Bullis-High-Speed Internet Service

RFQ - FA301623U0039

Please fill out the form below and submit to aja.lynch@us.af.mil and gary.beck@us.af.mil.

Due to additional security vetting requirements and associated processing timelines non-US contractor pass requests will require added information and additional delays. Please ensure personnel have no outstanding traffic warrants or other legal issues that would disqualify them from base access.

(Please ensure the D.O.B info is in the format provided). If individual does not have a Driver’s License, please provide the type of ID document and Number.

Since Pass requests contains PII information, please password protect this document and submit password to both the Contract Specialist and Contracting Officer for processing. Confirm Government receipt of your pass request documents.

Contractor 1

Company Name:

Last Name, First Name, MI

Cell Phone Number

Email Address:

DOB: (DD/MMM/YY)

Country of Birth:

Driver’s License Number:

State of Issue:

Contractor 2

Company Name:

Last Name, First Name, MI

Cell Phone Number

Email Address:

DOB: (DD/MMM/YY)

Country of Birth:

Driver’s License Number:

State of Issue:

COPY AND ADD ADDITIONAL INFORMATION BLOCKS FOR ADDED REQUESTS