Attachment 4 Request form for Site Visit.pdf

ATTACHMENT 4 –Site Visit Form Grounds Maintenance Service for Army Installation, Okinawa, Japan

RFQ NO. FA527020Q0002

SITE VISIT FORM RESERVATION FORM

Site Visit Date and Location: 7, 8 and 9 July 2020. See page 2 for the site visit schedule.

Name of Company:

Address:

Point of Contact:

E-mail Address:

Phone No.:

Cell Phone No.

Fax No.:

*Name of individuals to attend the Pre-proposal conference/ Site Visit: (Maximum of two (2) personnel) Please check the block, if you need escort or not.

Name Need escort /Phone No. NO escort

1.

2.

NOTE: It is the contractor's responsibility to verify if this has been received by 18 Contracting Squadron.

INSTRUCTIONS: Please complete & email this form to POC below by 2 Jul 2020, 10:00 a.m., (JST) if your company wishes to attend the site visit. Page 3 Questionnaire Checklist shall be fill out for each individaul.

Site Visit are scheduled for 3 consecutive days on 7, 8 & 9 July. See page two for detail schedules.

Transportation will be provided by the Government from the departure location and back.

Be aware of weather heat conditions, recommend to bring enough water for the day.

Wearing of Mask are mandatory during bus transportation.

POC: Ms. Norie Moromizato or Mr. Ken Kuresaki Email: norie.moromizato.2.jp@us.af.mil or ken.kuresaki.jp@us.af.mil mailto:norie.moromizato.2.jp@us.af.mil mailto:ken.kuresaki.jp@us.af.mil

ITINERARY OF PRE-PROPOSAL SITE VISITS FOR GROUNDS MAINTENANCE SERVICES:

7 JUL 20:

Meeting location for idividauls will meet at Torii Station Gate 3 by 0815 Hrs, Individauls do not require escort will meet at Torii Station Bldg 100/105 by 8:45 am on 7 Jul 2020.

Depart from Torii Station – 0900 Hrs.

Arrive at Bolo Point – 1030 Hrs.

Arrive at Patrol Road – 1130 Hrs.

Lunch Break – 1200 Hrs.

Arrive at White Beach – 1330 Hrs.

Arrive at Torii Station / Adjourn – 1530 Hrs.

8 JUL 20:

Meeting location will at parking area beside Kadena Gate #1 visitor center - 0815Hrs

Depart from Kadena Gate 1 – 0830 Hrs Arrive at Chimuwan Tank Farm #1 – 0930 Hrs.

Arrive at Chimuwan Tank Farm #2 – 1030 Hrs.

Arrive at Chimuwan Tank Farm #3 – 1130 Hrs.

Lunch Break – 1200 Hrs.

Arrive at Tengan (Camp Courtney) – 1300 Hrs.

Arrive at Kadena Gate #1 / Adjourn– 1500 Hrs.

9 JUL 20:

Meeting location will at parking area beside Kadena Gate #1 visitor center - 0815Hrs

Depart from Kadena Gate 1 – 0830 Hrs Arrive at Naha Annex – 0930 Hrs.

Arrive at Naha Port – 1030 Hrs.

Arrive at Lunch Time – 1200 Hrs.

Arrive at Kuwae Tank Farm #1 – 1300 Hrs.

Arrive at Kuwae Tank Farm #2 – 1400 Hrs.

Arrive Kadena Gate #1 / Adjourn– 1500 Hrs.

1. Have you (visitor requesting base access) traveled to/through any location outside Japan in the last 14 days?

ビジターは過去14日以内に国外に滞在または乗り継ぎ等で通過したか？

Yes – please proceed to fill out the box below and DENY ENTRY onto the installation

はい – 下記の項目を記入し、施設への立ち入りを拒否してください。 No

Non-Japanese Citizen Visitors must presents a Passport to verify entry date into Japan and ask for a flight itinerary if the date of arrival was within the past 14 days.

日本国籍以外のビジターは日本入国日の確認の為に必ずパスポートを提示し、到着日が過去１４日以内であった場合は旅程を確

認する。

For Japanese Citizens, flight itinerary is not needed as they will provide a Japanese ID card for entry. Simply ask them question #1 and take their word.

日本人が日本国の身分証を提示する場合、旅程の確認は必要はないが、口頭で１番の質問をする。

2. Do you have a close personal relationship with anyone that has traveled outside Okinawa in the last 14 days?

過去14日以内に沖縄県外に旅行に行った人が家族内にいるか？

はい - 下記の項目を記入し、施設への立ち入りを拒否してください。

3. Have you been in close proximity to someone that has been diagnosed with COVID-19.

COVID-19（新型コロナウィルス）と診断された人の近くにいたことはあるか？

4. Do you currently or within the past 14 days have you had a fever over 100.4 degrees AND the following symptoms?

現在、または過去１４日以内に３８度以上の発熱と下記の症状があったか？

☐ Cough ☐ Fatigue ☐ Diarrhea ☐ Chest Tightness/Pain ☐ Sore Throat ☐ Shortness of Breath ☐ Muscle Aches ☐ 咳 ☐ 倦怠感 ☐ 下痢 ☐ 胸の圧迫感/痛み ☐ のどの痛み ☐ 息切れ ☐ 筋肉痛

No - issue base pass and allow base entry いいえ – パスを発行し、入域を許可してください。

NAME:______________________________

1.