Attachment 5 - Base Pass Request.pdf
PDF 376 KB Posted
- Attached to
- Tree Trimming & Tree Removal Services
- Solicitation number
- FA483025Q0014
About this file
This is a base pass request template form for contractors requiring access to Moody Air Force Base, specifically related to RFQ FA483025Q0014 for Tree Trimming/Tree Removal Services. The form is a memorandum addressed to 23 SFS/S5 Pass and Registration, requiring contractors to provide company information, contract number FA4830-25-A-00, and employee details for base access authorization.
The document outlines key requirements including: submission of original criminal background consent forms for all listed employees, designation of a contractor point of contact (who must be from the prime contractor), and access duration not to exceed one year (specifically noting 15 Mar 2025 - 14 Mar 2026 for this contract). The form must be reviewed by 23 CONS for contracts they administer, or by the requesting base organization for other contracts. The document serves as Attachment 5 to the main solicitation and requires signatures from both company officials and base personnel for approval.
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Text version
NOTE: THE INFORMATION ON THIS LETTER MUST BE LEGIBLE
MEMORANDUM FOR 23 SFS/S5; PASS AND REGISTRATION DATE: .
FROM:
(YOUR FIRM’S/PRIME CONTRACTOR'S NAME/ADDRESS)
SUBJECT: Request for Personnel Passes, Contract Number FA4830-25-A-00
(INCLUDE COMPLETE CONTRACT NUMBER)
Or At the Request of 23 Contracting Squadron .
(NAME OF BASE ORGANIZATION REQUIRING CONTRACTOR’S PRESENCE ON BASE)
1. Project Title or Reason for Pass Request: Tree Trimming/Tree Removal Services .
2. Please issue passes for employees of:
(YOU FIRMR YOOR UR SUBCONTRACTOR)
Employees require access to Moody AFB through:
(NOT TO EXCEED 1 YEAR)
Contractor point of contact is: - (YOUR FIRM’S REPRESENTATIVE AND PHONE NUMBER, IF CONTRACT, MUST BE PRIME CONTRACTOR)
3. If there is a contract, whether written or administered by 23 CONS or by another agency, the address above, the point of contact listed, and the signature below are with the Prime Contractor to which the contract is written. This letter will be presented for review by 23 CONS for contracts written or administered by 23 CONS and for all others will be presented for review by the base organization requesting our presence.
4. Completed, original, consent forms (no copies) to conduct criminal background will be presented for the individuals listed below.
Reviewed:
(SIGNATURE OF COMPANY OFFICIAL) (SIGNATURE OF BASE PERSONNEL)
(TYPED NAME AND TITLE OF COMPANY OFFICIAL)
(TYPED/PRINTED NAME, PHONE NO. OF BASE PERSONNEL AND DATE)
(Format, Background Cover Letter, 02/2011) No. of Completed Consent Forms to be presented
15 Mar 2025 - 14 Mar 2026
/PKB Moody AFB, GA 31699
Attachment 5 - Base Pass
RFQ: FA483025Q0014
Title: Tree Trimming/Tree Removal Services
File details come from the government source that posted it. Updated .