Attachment 4 Visitor Form.xlsx
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- Solicitation number
- 70Z08424QAA851300
About this file
This document is an Attachment 4 Visitor Form for USCG Base Elizabeth City, which outlines the process and requirements for visitors to gain access to the base. It provides details on the information required, such as visitor personal details, purpose of visit, sponsor information, and contact details. The form must be submitted no later than 3 working days prior to the visit, and foreign visitors must be submitted at least 30 days in advance.
The related federal contract opportunity is a Request for Quotation (RFQ) for Pest Control Services at USCG Base Elizabeth City, North Carolina. The contract has a base period starting on or about August 1, 2024, through July 31, 2025, with four 12-month option periods, for a total duration of up to five years. The solicitation is issued as a 100% Total Small Business Set-Aside under NAICS code 561710, with a size standard of $17.5M. Qualified small business sources are invited to submit quotations in accordance with the requirements stipulated in the solicitation.
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Text version
Sheet1
| Base Elizabeth City Visitor Request |
| For questions, contact your Command Security Officer or Base Coast Guard Police Dept. at (252) 335-6588. |
***All requests shall be submitted no later than 3 working days prior to visit.*** Reference BASEECITYINST 5512.1B for additional information and requirements.
LAST NAME FIRST NAME MIDDLE INITIAL SUFFIX DATE OF BIRTH DL STATE DL# CITIZENSHIP (US/FOREIGN)
| VISITOR ORGANIZATION: | |||
| PURPOSE OF VISIT: | |||
| PLACE OF VISIT: | |||
| ARRIVAL: | TIME: | DATE: | |
| DEPARTURE: | TIME: | DATE: | |
| SPONSOR'S NAME: | |||
| SPONSOR'S COMMAND/AFFILIATION: | |||
| SPONSOR'S CONTACT INFORMATION | PHONE #: | EMAIL ADDRESS: | |
| COMMENTS BELOW: |
| ***FOREIGN VISITORS MUST BE SUBMITTED NO LESS THAN THIRTY DAYS PRIOR TO AN OFFICIAL VISIT*** | ||
| For more information and/or guidance, contact your Tenant Command Security Officer | ||
| Base Elizabeth City and Tenant Command CSO's: | ||
| Base Elizabeth City: | MEC Kealiinohomoku, Brandonn | (252)335-6855 |
| Aviation Technical Training Center (ATTC): | ASTC Linehan, Michael | (252)335-6917 |
| Aviation Logistics Center (ALC): | Mr. Smith, Stephen | (252)384-7173 |
| Air Station Elizabeth City: | OSC Brancaleone, Paul | (252)335-6761 |
| Boat Station Elizabeth City: | BM1 Jordan, William | (252)335-6086 |
| USCG Aviation Projects Acquisition Center (APAC): | LT Cortez, Miguel | (252)355-6279 |
| ***ALL VISITOR REQUESTS SHALL BE SENT TO THE FOLLOWING EMAIL:*** | ||
| d05-smb-baseecityvisitors@uscg.mil | ||
| Instructions: Left click on the email address and an email will auto-populate. Once all fields are filled out in this visitor request, save to a safe place as this contains PII and attach this form to the email. Once you send off a visitor request you do not need to follow up, all visitor requests are monitored on a daily basis. If a member does not meet Base entry criteria as defined in BASEECITYINST 5512.1B and DCMS denial criteria, you will be contacted and the visitor request will be denied pending a follow up request. If you have any further questions please feel free to contact the CGPD. |
mailto:d05-smb-baseecityvisitors@uscg.mil image1.emf image2.emf image3.emf image4.emf image5.emf
File details come from the government source that posted it. Updated .