Attachment 6 - Base Access Request Form.docx

DOCX document 84 KB Posted

Attached to
Paint and Protective Coating IDIQ - Shaw AFB Federal contract opportunity
Solicitation number
FA480324B0003
Issued by
Department of the Air Force Air Combat Command

About this file

This memorandum requests base access for an individual to visit multiple sites on Shaw Air Force Base in relation to the Paint and Protective Coating IDIQ solicitation issued by the Department of the Air Force Air Combat Command. The contractor shall provide all personnel, equipment, tools, materials, supervision, and other items and services necessary to perform interior and exterior painting and protective coating services, as well as sign fabrication, as defined in the statement of work. Paint and protective coating requirements will be awarded through individual task orders on an as-needed basis to the standards outlined in the contract.

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Text version

DEPARTMENT OF THE AIR FORCE

20th FIGHTER WING (ACC)

SHAW AIR FORCE BASE SOUTH CAROLINA

DATE: 5 December 2023

MEMORANDUM FOR 20 SFS/S-5V (email to:20 SFS/EAL 20SFS-EAL@us.af.mil or fax 803-895-5337 803-895-9085 or 803-895-9086)

FROM: Mr. Darrel Ford

SUBJECT: Request for Base Access

WHO:

WHAT FOR: Paint Indefinite Delivery Indefinite Quantity Site Visit

WHERE: 321 Cullen Street, 20th Contracting Squadron

If base wide give justification: Will look at multiple possible sites for contract

WHEN:

SPONSOR: Mr. Darrel Ford

CONTACT INFO: 803-895-5381

The information below is protected under Privacy Act 1974 and will only be used to process Criminal Background History Checks to grant or deny access to Shaw AFB. It is further understood that anyone abusing approved privileges could, at a minimum, lose said privilege and possibly face criminal charges.

Full Legal Name (Last, First MI) Date Of Birth (Year/Mo/Day) Social Security Number

ST-DL #
U.S.

Citizen (Y/N)

I UNDERSTAND THAT AS THE SPONSOR I AM RESPONSIBLE FOR THE PERSON(S) LISTED ON THIS FORM, AND FOR ENSURING THE ABOVE NAME INDIVIDUAL(S) TURNS IN THE DBIDS PASS OR RETRIEVE THE PASS ONCE THE INDIVIDUAL(S) ARE TERMINATED, QUIT, OR NO LONGER REQUIRES ACCESS. IF I AM NOT ABLE TO RETRIEVE THE PASS I WILL NOTIFY SECURITY FORCES TO HAVE THE INDIVIDUAL(S) PASS DEACTIVATED IN DBIDS.

This form must be sent by the sponsor from their government email and received at the email addresses/fax number listed above in the 20 SFS/S-5V section.

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File details come from the government source that posted it. Updated .