Attachment_A_Base Access Memo.pdf

PDF 161 KB Posted Oct 21, 2026

Attached to: P210 ELECTRIC POWER PLANT AND ELECTRICAL DISTRIBUTION SYSTEM AT CHABELLEY AIRFIELD, DJIBOUTI
Solicitation number: N6247027R0001
Issued by: Department of the Navy Naval Facilities Engineering Command

About this file

Written by GovTribe AI · Oct 21, 2026

This is a Base Access Request form for contractor personnel requiring temporary access to Camp Lemonnier (CADJ). The request is sponsored by LCDR Adam Smith of NAVFAC ROICC Camp Lemonnier under contract number N6247027R0001. The purpose of the access is to conduct a site visit for project P210 (CADJ 21001) involving the Power Plant and Electrical Distribution System.

The form accommodates up to 30 contractor personnel and requires completion of standard information including individual names, passport identification numbers, and dates of birth. All individuals must be escorted by military personnel at all times while on the base and are subject to biometric enrollment upon initial entry if directed. The sponsoring organization must verify that the Office of Special Investigations (OSI) has conducted a review of the Identity Intelligence Analytical Resource (12AR) database for each individual with no derogatory material found. Authorization for base access is granted in accordance with ACI 3203.15A, Enclosure 2, paragraph I.a., and requires signatures from the requester, sponsor, OSI representative, and Squadron Commander or equivalent.

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Email:

Contract Number:

Per ACI 3203.15A, Enclosure 2, para. I.a., I authorize the above listed individuals access to CADJ. They must be escorted by a military member at all times while on the base. Please facilitate the entry and exit of these individuals during this period.

TO: (SQ/CC) TYPE OR PRINT NAME AND GRADE

DATE (DDMMMYY)

Signature

DATE (DDMMMYY)

(Requester) TYPE OR PRINT NAME AND GRADE Signature

No.

TO BE COMPLETED BY CONTRACTOR GOV

Phone #:

Organization: Start

Expires

Bio-Enrollment Required

DOB

ID of Passport # Name

Request Number:

Sponsor Name:

Hours

DDMMMYY

Signature

DATE (DDMMMYY)

OSI EDET 2505 conducted a review of the Identity Intelligence Analytical Resource (12AR) database for the above listed individuals; no derogatory material was found. Upon initial entry to CADJ, the individuals will be required to complete biometric enrollment, if so directed.

TO: (OSI) TYPE OR PRINT NAME AND GRADE

FOR GOVERNMENT USE ONLY

TO: (Sponsor) TYPE OR PRINT NAME AND GRADE

Purpose of Base Access Request

BASE ACCESS REQUEST

Email:

Contract Number:

BASE ACCESS REQUEST

Organization:

Sponsor Name: Phone #:

Request Number:

No. Name ID # DOB Bio-Enrollment

Required

DDMMMYY

ADDITIONAL NOTES

Sheet1

Sponsor Name: LCDR Adam Smith

Phone:

Email: Andrew.T.Smith36.mil@us.navy.mil

Organization: NAVFAC ROICC Camp Lemonnier

Start:

Contract Number: N6247027R0001

Expires:

Request Number:

Hours:

Name1:

ID of Passport 1:

DDMMMYY1:

BioEnrollment Required1:

Name2:

ID of Passport 2:

DDMMMYY2:

BioEnrollment Required2:

Name3:

ID of Passport 3:

DDMMMYY3:

BioEnrollment Required3:

Name4:

ID of Passport 4:

DDMMMYY4:

BioEnrollment Required4:

Name5:

ID of Passport 5:

DDMMMYY5:

BioEnrollment Required5:

Name6:

ID of Passport 6:

DDMMMYY6:

BioEnrollment Required6:

Name7:

ID of Passport 7:

DDMMMYY7:

BioEnrollment Required7:

Name8:

ID of Passport 8:

DDMMMYY8:

BioEnrollment Required8:

Name9:

ID of Passport 9:

DDMMMYY9:

BioEnrollment Required9:

Purpose of Base Access Request: Site visit for P210 (CADJ 21001) Power Plant and Electrical Distribution System

DATE DDMMMYYRow1:

Supporting Agency TYPE OR PRINT NAME AND GRADERow1:

SignatureRow1:

TO Sponsor TYPE OR PRINT NAME AND GRADERow1:

SignatureRow1_2:

DATE DDMMMYYRow1_2:

TO OSI TYPE OR PRINT NAME AND GRADERow1:

SignatureRow1_3:

DATE DDMMMYYRow1_3:

TO SQCC TYPE OR PRINT NAME AND GRADERow1:

SignatureRow1_4:

DATE DDMMMYYRow1_4:

Sponsor Name_2:

Phone_2:

Email_2:

Organization_2:

Contract Number_2:

Request Number_2:

Name10:

ID 10:

DDMMMYY10:

BioEnrollment Required10:

Name11:

ID 11:

DDMMMYY11:

BioEnrollment Required11:

Name12:

ID 12:

DDMMMYY12:

BioEnrollment Required12:

Name13:

ID 13:

DDMMMYY13:

BioEnrollment Required13:

Name14:

ID 14:

DDMMMYY14:

BioEnrollment Required14:

Name15:

ID 15:

DDMMMYY15:

BioEnrollment Required15:

Name16:

ID 16:

DDMMMYY16:

BioEnrollment Required16:

Name17:

ID 17:

DDMMMYY17:

BioEnrollment Required17:

Name18:

ID 18:

DDMMMYY18:

BioEnrollment Required18:

Name19:

ID 19:

DDMMMYY19:

BioEnrollment Required19:

Name20:

ID 20:

DDMMMYY20:

BioEnrollment Required20:

Name21:

ID 21:

DDMMMYY21:

BioEnrollment Required21:

Name22:

ID 22:

DDMMMYY22:

BioEnrollment Required22:

Name23:

ID 23:

DDMMMYY23:

BioEnrollment Required23:

Name24:

ID 24:

DDMMMYY24:

BioEnrollment Required24:

Name25:

ID 25:

DDMMMYY25:

BioEnrollment Required25:

Name26:

ID 26:

DDMMMYY26:

BioEnrollment Required26:

Name27:

ID 27:

DDMMMYY27:

BioEnrollment Required27:

Name28:

ID 28:

DDMMMYY28:

BioEnrollment Required28:

Name29:

ID 29:

DDMMMYY29:

BioEnrollment Required29:

Name30:

ID 30:

DDMMMYY30:

BioEnrollment Required30:

ADDITIONAL NOTESRow1:

File details come from the government source that posted it. Updated Oct 21, 2026.