Attachment D Notification and Access for PANG to S-24800-00010840~2.xlsx

XLSX spreadsheet 27 KB Posted

Attached to
C-24-2001 - PANG Basewide Pavement Repair
Solicitation number
S-24800-00010840
Issued by
Multnomah County, Oregon

About this file

This document is an attachment related to a state and local contract opportunity in Oregon. The attachment provides a form to be completed for PANG (Project Annual Notification Guide) access to a project site. The form requires information such as the type of activity, location, date/time, point of contact details, and personal details of attendees including name, date of birth, driver's license information, last four digits of social security number, company, DBIDS status, and DoD ID status. The completed form must be submitted at least 3 business days prior to the event. The related state and local contract opportunity is for C-24-2001 - PANG Basewide Pavement Repair in the state of Oregon.

The pricing terms, set asides, incumbents, funding requirements and sources, and other salient details are not provided in this attachment. The attachment focuses solely on the access requirements and process for attending the project site.

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Text version

Sheet1

Please fill in according to the instructions on the bottom of the form. If the requested information does not apply then leave blank.
Type of Activity:Event Location:
Time & Date:POC Phone #:
POC Name:POC Email:
If the requested information is not provided, this request will be returned and not processed until it is provided.
LAST NAMEFIRSTMIDDLEDOBDL StateDL#L4 SSNCOMPANYDBIDSDoD IDAgeFormatted Full NameFormatted DOB
123,18991231
123,18991231
123,18991231
123,18991231
123,18991231
123,18991231
123,18991231
123,18991231
123,18991231
123,18991231
123,18991231
123,18991231
123,18991231
123,18991231
123,18991231
Privately owned weapons, illegal narcotics and/or controlled substances (to include marijuana in all forms and derivatives) are not allowed on this installation.18991231
Return this form in Excel format only. Form will not be processed if returned in ANY other format.
Upon completion email this form to 142.WG.SFS.VendorPass@us.af.mil and include your sponsor as a courtesy.
This information is REQUIRED.• Return at a minimum of three (3) business days prior to event
NAME - Full Last name, Full First Name, Full Middle Name, if no middle name, leave blank
DOB - Date of Birth, two digit month / two digit day / four digit year (MM/DD/YYYY)• Requests received after 1500 (3:00 PM – Pacific) may not be processed until the following business day.
DL STATE - State of driver license issue
DL # - Full number of driver license
L4 SSN - Last four numbers of Social Security Number12/1/23• Requests from military members utilizing a non-DoD email will include military signature block.
COMPANY - Enter your business or company - If visit not business related leave blank
DBIDS - DBIDS is an acronym for Defense Biometric Identification System. Has the person being entered previously held a DBIDS badge or pass. - Yes, No, or Unknown
• Contact the Installation Access Office directly for last minute requests. (503) 335-4984
DoD ID - Does the person being entered currently hold a DoD ID: Active Duty, Reserve, Guard, Contractor, Retiree, or Disabled Veteran Privilege Card - Yes, No, or Unknown

mailto:142.WG.SFS.VendorPass@us.af.mil

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