Attachment%20J%20Part%201-%20FPO%20Request%20Form.pdf
PDF 95 KB Posted
- 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 used by the State of Tennessee Department of General Services and the Department of Safety and Homeland Security to request armed Facility Protection Officers for assignment to state-owned or state-leased facilities. The form serves as the initial documentation mechanism for agencies seeking FPO services and requires approval from the requesting agency head, the DGS FPO Contract Administrator, and the TDOSHS FPO Manager. The form collects essential information including facility ownership status, specific facility location details, incident history that may have prompted the request, and a detailed explanation of the need for protection services along with the number of FPOs required. The form must be completed and signed by the agency head before routing through the approval chain, with space provided for all required signatures and dates from approving officials.
The FPO Request Form is the foundational administrative document that initiates the process for deploying Facility Protection Officers under the state's comprehensive facility protection services contract. Requesters must indicate whether the facility is state-owned or leased, describe any security incidents that necessitate the request, and provide justification for the services needed. The form requires signatures from the requesting agency head, the DGS FPO Contract Administrator, and the TDOSHS FPO Manager, establishing a clear approval hierarchy to ensure that FPO deployment decisions are made through proper state channels and documented for audit and accountability purposes.
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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: |
| Text2: |
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