Attachment 6C_ Security_SelfCertificationContinuousService.pdf
PDF 102 KB Posted
- Attached to
- Y1DA--VISN 5 - MULTIPLE AWARD TASK ORDER CONTRACT CONSTRUCTION 2022 Federal contract opportunity
- Solicitation number
- 36C24522R0056
About this file
This document outlines a multiple award task order contract solicitation from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 5. The solicitation seeks offers from contractors to provide general construction services for maintenance, repair, alteration, and renovation projects at VA medical centers on an as-needed basis. Offerors would be eligible to compete for both small- and large-scale task orders for work such as carpentry, electrical, plumbing, roofing, drywall, painting, and site work. Task orders issued under the contract would have firm-fixed pricing and incorporate prevailing Davis-Bacon wage rates. The multiple award contract would be in effect for one year and provide each awardee a fair opportunity to compete for task orders valued over the simplified acquisition threshold, except under statutory exceptions for urgency, sole-source logical follow-ons, minimum guarantees, and Congressionally mandated sources.
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Text version
DEPARTMENT OF VETERANS AFFAIRS
SECURITY AND INVESTIGATIONS CENTER
Self Certification of Continuous Service
I hereby certify my break in service from my last federal employment is indicated by the block checked below.
I have NOT had a break in service.
My break in service was less than 60 days.
My break in service was greater than 60 days, but less than 2 years. (You are required to submit the OF 306, Declaration for
Federal Employment, with this form.)
My break in service is greater than 2 years or; I have never had employment through the federal government.
Print Name: Social Security Number:
Signature: Date:
VA Personnel Security/HR Use Only:
Current Investigation in PIPS: Date:
Risk level of current position: Verified by:
(Check One)
Federal employment is defined as any branch of the United States military (Active, Guard or Reserve), federal government civilian employee (any federal government agency), or a contractor working for the federal government.
Self Certification of Continuous Service Form Revised February 14, 2017
Previous Versions are Obsolete
| I have NOT had a break in service: Off |
| My break in service was less than 60 days: Off |
| My break in service was greater than 60 days but less than 2: Off |
| My break in service is greater than 2 years or I have never worked: Off |
| Print Name: |
| Social Security Number: |
| Date: |
| Current Investigation in PIPS: |
| Date_2: |
| Risk level of current position: |
| Verified by: |
File details come from the government source that posted it. Updated .