Attachment 7 - Fort McCoy Form 452.pdf
PDF 1 MB Posted
- Attached to
- Custodial Services at IL079 Elwood, IL
- Solicitation number
- W911SA-22-Q-3111
About this file
This document is an installation access pass request form for Fort McCoy. The form collects personal information such as name, dates of required access, work hours and location, company and position to determine suitability for base access. Sponsors both internal and external to Fort McCoy are required, and a National Crime Information Center background check date will be completed by installation physical security specialists.
The related federal contract opportunity is a request for quotes for custodial services at facility IL079 in Elwood, Illinois. The requirement is being solicited by the Department of the Army Materiel Command Mission and Installation Contracting Command at Fort McCoy. Services include cleaning and maintenance tasks within the specified facility. Quotes are due based on the solicitation number and issuing agency provided.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 8 - Room Chart - Task and Frequency.xlsx | XLSX spreadsheet | |
| Attachment 7 - Fort McCoy Form 452.pdf | ||
| Attachment 6 - Fort McCoy Form 451.pdf | ||
| Attachment 6 - Fort McCoy Form 451.pdf | ||
| Attachment 1 - Price Schedule - CUI.xlsx | XLSX spreadsheet | |
| Attachment 5 - Restroom Cleaning Sheet.docx | DOCX document | |
| Attachment 2 - Drawing.docx | DOCX document | |
| Attachment 8 - Room Chart - Task and Frequency.xlsx | XLSX spreadsheet | |
| W911SA-22-Q-3111 - Solicitaton.pdf | ||
| Attachment 4 - Sample Service Ticket.docx | DOCX document | |
| Attachment 3 - AT_OPSEC.pdf |
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Fort McCoy Form 452 May 2021
AEM6.2 V 7.0
Page of Fort McCoy Form 452 February 2021 Obsolete Fort McCoy Installation Access Pass Request PRIVACY ACT STATEMENT AUTHORITY: The Privacy Act of 1974, Title 5 USC 552a. PRINCIPLE PURPOSE(S): To determine suitability of individual(s) requesting access to Fort McCoy. ROUTINE USE(S): Personal information may be disclosed to appropriate military and civilian emergency and investigation agencies to assist in determining suitability for access to Fort McCoy. DISCLOSURE: Voluntary, however failure to provide information will result in a refusal to grant access to Fort McCoy.
Legal Name as Appears on Driver's License or State ID: Example: John Edward Doe 25-Jan-15 24-Jan-16
MON-FRI 0700-1700 HOURS
Bldg 100 Commissary/TCI Example: Plumber/Bagger Last Name First Name Middle Name or NMN if non Begin Date End Date Work Access Hours Work Area/ Visit Location Company Name Employees Position/ Event Remarks Block (At a minimum include: purpose for access; contract number and expiration date) ** Note: If access is for contract purpose, Sponsor will be the COR. In all cases, Sponsor must be affiliated with Fort McCoy. ***NCIC-III Check Date, PS Specialist and PS Specialist Signature for DES USE ONLY**** When complete submit to: usarmy.mccoy.id-readiness.mbx.des-physical-security-iacs-form@mail.mil Legal Name as Appears on Driver's License or State ID: Example: John Edward Doe 25-Jan-15 24-Jan-16
MON-FRI 0700-1700 HOURS
Bldg 100 Commissary/TCI Example: Plumber/Bagger Last Name First Name Middle Name or NMN if non Begin Date End Date Work Access Hours Work Area/ Visit Location Company Name Employees Position/ Event 11.0.0.20130303.1.892433.887364 280-4222
DHR ASD
Trudy L. Ward FMF452_Fort McCoy Installation Access Pass Request 20210212 20210212
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