Attachment 5 - BAL Request.pdf

CUI

DEPARTMENT OF THE AIR FORCE

17TH TRAINING WING (AETC)

GOODFELLOW AIR FORCE BASE TEXAS

CUI

DATE

MEMORANDUM FOR 17 SFS/S5

FROM: 17 CONS/LGCA

Subject: (CUI) Request Unescorted Base Access Pass

1. (U) I am sponsoring the following Non-ID card holding guest requiring Unescorted access to the base for Repair B3456 Water Lift Station

Company Type of Services Contract# Location Visiting Repair B3456 Water

Lift Station

2. (CUI) The following contractor or guest will need periodic access to perform the project.

Name DOB State/DL or ID# Last 4 SSN Date(s) of Entry Days/Hours

3. (U) I will ensure these individuals are briefed that only properly licensed visitors, appropriately covered by vehicle insurance, will operate a vehicle on Goodfellow AFB. Authorized vehicle operators will have in their possession a valid driver’s license, current vehicle registration and a valid insurance certificate at all times when operating a vehicle on the installation.

4. (U) Upon completion or termination of this visitor request, I will ensure his pass is returned to the Visitor Control Center.

5. (U) If you have any questions, please contact Robyn Moore at (325) 654-3282.

ROBYN E. MOORE

Contract Specialist