Attch 5 - Pass Request Info Form.docx
DOCX document 28 KB Posted
- Attached to
- Universal Power Systems Battery Replacement
- Solicitation number
- 12217985
About this file
This is a Pass Request Information Form (Attachment 3) for contractors requiring base access. The form requires detailed personal information for each contractor including full name, company name, cell phone number, email address, date of birth, country of birth, driver's license number and state of issue, and US citizenship status.
The form notes that non-US contractors require additional security vetting and longer processing times. Contractors must be free of traffic warrants or legal issues that would disqualify them for base access. The completed form must be password-protected due to PII and submitted to Contract Specialist Jose A. Olmo-Rivera and Contracting Officer Umar Thomas at their provided Air Force email addresses. This form appears to be related to a battery replacement project for Universal Power Systems at an Air Force facility under solicitation number 12217985.
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Text version
CONTROLLED UNCLASSIFIED INFORMATION (CUI)
Pass Request Information Attachment 3
Please fill out the form below and return to Contract Specialist: José A. Olmo-Rivera, Email: jose.olmo_rivera@us.af.mil and Umar Thomas, Contracting Officer, Email: umar.thomas.1@us.af.mil.
NOTE: Due to additional security vetting requirements and associated processing timelines non-US contractor pass requests will require added information and additional delays.
ADDED NOTE: Please ensure personnel have no outstanding traffic warrants or other legal issues that would disqualify them from base access.
Contractor 1
Company Name:
Last Name, First Name, MI
Cell Phone Number
Email Address:
DOB: (DD/MMM/YY):
Country of Birth:
Driver’s License Number:
State of Issue:
| US CITIZEN |
| YES NO |
Contractor 2
Company Name:
Last Name, First Name, MI
Cell Phone Number
Email Address:
DOB: (DD/MMM/YY):
Country of Birth:
Driver’s License Number:
State of Issue:
| US CITIZEN |
| YES NO |
COPY AND ADD ADDITIONAL INFORMATION BLOCKS FOR ADDED REQUESTS
If individual does not have a Driver’s License then please provide the type of ID document and Number. Since Pass requests contains PII information, please password protect the above Base Pass information and submit password to both the Contract Specialist and Contracting Officer for processing. Confirm Government Receipt Of Your Pass Request Documents.
File details come from the government source that posted it. Updated .