Attachment G - RSA Badge Request Form.pdf
PDF 139 KB Posted
- Solicitation number
- 15F06723R0000050
About this file
This document contains a solicitation for lead cleaning and janitorial services at firing ranges and associated areas at the FBI Quantico Complex. The Federal Bureau of Investigation requires cleaning of firing ranges and associated areas on a frequency defined in the attached Scope of Work. Workers will have contact with lead-contaminated surfaces and may be exposed to airborne lead above the permissible limit, so contractors must have an OSHA-compliant lead safety plan and respiratory protection program. The total five-year contract value includes all required labor, equipment, and supplies to perform lead cleaning and janitorial services as specified. Qualified small businesses certified in firing range cleaning may submit proposals by April 28, 2023 for the award of a single contract set aside under NAICS code 562910 with a $22 million size standard.
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Text version
FBI Base Access Form
REV 1, 31 OCT 16
Form Provided by FBIHQ OSO Security
PLEASE PRINT LEGIBLY
CLASS NO: (If Applicable)
ORGANIZATION:
OFFICE SYMBOL: (If
Applicable)
SOCIAL SECURITY NUMBER:
(REQUIRED FOR ACCESS)
LAST
NAME:
FIRST
NAME:
MIDDLE
NAME:
PERSON TYPE
(CONTRACTOR, ETC)
CLEARANCE:
GRADE/RANK:
POSITION TITLE
PRIMARY CITIZENSHIP: DUAL CITIZENSHIP:
HAIR COLOR
EYE COLOR
HEIGHT (IN)
WEIGHT (LBS)
DATE OF BIRTH
(D/M/Y)
SEX
RACE
BIRTHPLACE
EMAIL ADDRESS:
DATE OF ARRIVAL:
DATE OF DEPARTURE:
HOME ADDRESS:
HOME PHONE:
CITY:
STATE:
ZIP:
SECURITY BADGE REQUEST
SCAN COMPLETED FORM TO HQ_DIV11_RSVS@fbi.gov
NOTES:
1. Bring your vehicle registration if you are driving.
2. Bring proof of insurance or department proof of liability, if applicable.
3. Bring driver’s license and credentials.
4. When you arrive at Gate 9 or Gate 1 your driver’s license will be entered into the system to pull your data – your photograph will be taken and you will be issued a badge and vehicle pass, if applicable.
File details come from the government source that posted it. Updated .