Attachment E - Request for Controlled Unclassified _CUI Building Information Form.docx
DOCX document 135 KB Posted
- Solicitation number
- 47PJ0023R0069
About this file
This document contains a request for proposal and related attachments for construction of a new National Science Foundation Ice Core Facility. The General Services Administration Public Buildings Service Region 8 is soliciting bids to design and build a new freezer space within Building 810 at the Denver Federal Center in Lakewood, Colorado to replace the existing ice core storage facility built in 1993. The proposed 19,058 square foot facility will include refrigerated warehouse spaces, refrigeration equipment space, shop/storage spaces, office and support spaces, and loading/shipping spaces. Construction must comply with GSA 2021 PBS P-100 standards. Interested offerors must complete Attachment E to request controlled unclassified building information and certify proper handling and disposal of such information. The solicitation number is 47PJ0023R0069.
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Attachment E - Request for Controlled Unclassified Information (CUI) Building Information.
Solicitation/Contract Number _____47PJ0023R0069____________________________ The requester shall complete the information below and return the entire Request for Controlled Unclassified Information (CUI)Building Information document to the Contracting Officer or Contract Specialist. By signature below, the requestor of CUI building information acknowledges the requirement to maintain controls, as stated herein, to safeguard the information, and shall return or destroy the CUI building information as required by this Agreement. The undersigned acknowledges that the requester shall abide by this Agreement and shall only disseminate CUI building information to other authorized users under the conditions set forth herein.
Company Name: _____________________________________________________ Name of Individual and Title: ____________________________________________ Signature: ___________________________________________________ Date: _______________________________________________________
(The Offeror shall attach copy of business license or formation document.)
DUNS Number: _________________________________________ DUNS Number Verified by Government Representative at: https://www.sam.gov/portal/public/SAM/#1 Yes: ___ No: ___ Employer ID Number/Federal Tax ID Number _______________________________ Offeror/bidder/contractor information and DUNS number has been verified and release of CUI building information is approved by:
| ________________________________________ | _____________________ |
| Joseph Dorsey | Date |
Contracting Officer
DISPOSAL STATEMENT FOR CONTROLLED UNCLASSIFIED INFORMATION BUILDING INFORMATION
Solicitation/Contract Number ________________________________________ I hereby certify that all Controlled Unclassified Information(CUI) building information relative to the referenced solicitation/contract not previously returned to the Government has been destroyed or disposed of by burning or shredding paper copies, physically destroying computer diskettes or permanently deleting/removing/erasing electronic files from computers.
I also certify that no unauthorized physical or electronic copies of such CUI building information were made or are being retained.
Company Name: ______________________________________________ Name of Individual: ____________________________________________ Signature: ___________________________________________________ Title: _______________________________________________________ Date: _________________ image1.png
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