Attachment%20J%20Part%201-%20FPO%20Request%20Form.pdf
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- Attached to
- Facility Protection Services - UPDATED State and local contract opportunity
- Solicitation number
- RFP 32110-22726
- Issued by
- Davidson County, Tennessee
About this file
This is a Facility Protection Officer Request Form utilized by state agencies in Tennessee to request armed Facility Protection Officers and related personnel to be stationed at state-owned or state-leased facilities. The form serves as the initial request mechanism for agencies seeking facility protection services and requires approval from the requesting agency head, the DGS FPO Contract Administrator, and the TDOSHS FPO Manager before processing. The form captures essential information including the facility name and address, whether the request is the first for that facility, the reason for the request (whether incident-based or preventative), and the number of FPOs needed.
The form functions as part of the broader Facility Protection Services contract opportunity, which encompasses multiple regions across Tennessee including Nashville, Knoxville, Chattanooga, Memphis, Jackson, Lawrenceburg, and Cookeville. The request form requires agencies to provide detailed explanations of their need for protection services and allows for documentation of incidents that may have prompted the request, while maintaining security and confidentiality protocols. Completion and submission of this form initiates the formal approval process through the designated state officials responsible for facility protection resource allocation and contract administration.
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Text version
Facility Protection Officer Request This form should be utilized to request Facility Protection Officer(s) to be stationed in a state-owned or state-leased facility. The form may require prior approval of other state officials, as applicable.
4-6-2017
SW RDA 25
Request FPO
GS-1127
Requesting Agency
Is this the first request for Facility Protection Officers for this facility?
Yes
No
Is the facility State owned or leased?
Facility Name/Address
Is this request being made because there is/was there an incident? If 'Yes', provide brief details of the incident without compromising security or confidentiality.
You may be contacted for additional details if needed.
Yes
No
Brief Description of Incident
Explanation of need for these services. If there was not an incident (See Item 4.), please explain the need for these services and how many FPOs are being requested.
Print Name of Agency Head:
Title:
Date:
Signature of Agency Head
APPROVED APPROVED
FPO Contract Administrator (DGS) sign above TDOSHS FPO Manager sign above
Print Name: Date: Print Name: Date:
| Requesting Agency: |
| undefined: Off |
| Yes NoIs the facility State owned or leased: |
| Yes NoFacility NameAddress: |
| Brief Description of Incident: Off |
| Yes No Brief Description of IncidentExplanation of need for these services If there was not an incident See Item 4 please explain the need for these services and how many FPOs are being requested: |
| Print Name of Agency Head Title Date: |
| Text1: |
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