BASE Elizabeth City Visitor Request Form.xlsx
XLSX spreadsheet 107 KB Posted
- Solicitation number
- 70Z05024R43000004
About this file
This document is a Visitor Request Form for accessing USCG Base Elizabeth City in Elizabeth City, NC. The form collects visitor information such as name, date of birth, driver's license, citizenship, organization, purpose of visit, arrival/departure dates, sponsor details, and contact information. All visitor requests must be submitted no less than 3 working days prior to the visit, and foreign visitors must be submitted no less than 30 days prior. Visitor requests should be emailed to d05-smb-baseecityvisitors@uscg.mil. The form references BASEECITYINST 5512.1B for additional information and requirements. This request form is related to a federal contract opportunity for Design-Build services to perform major renovations of Building #3, the Rescue Swimmer Training Facility, at USCG Base Elizabeth City. The contract is available only to successful offerors in the NMACC III Pool 1.
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Sheet1
| Base Elizabeth City Visitor Request |
| For questions, contact your Command Security Officer or Base Coast Guard Police Dept. at (252) 335-6588. |
***All requests shall be submitted no later than 3 working days prior to visit.*** Reference BASEECITYINST 5512.1B for additional information and requirements.
LAST NAME FIRST NAME MIDDLE INITIAL SUFFIX DATE OF BIRTH DL STATE DL# CITIZENSHIP (US/FOREIGN)
| VISITOR ORGANIZATION: | |
| PURPOSE OF VISIT: | Rescue Swimmer Training Facility Pre-Proposal Site Visit (Contracting Office: CEU Cleveland) |
| PLACE OF VISIT: | Building #3 |
| ARRIVAL: | 6/17/24 |
| DEPARTURE: | 6/17/24 |
| SPONSOR'S NAME: | |
| SPONSOR'S COMMAND/AFFILIATION: | |
| SPONSOR'S CONTACT INFORMATION | |
| COMMENTS BELOW: |
| ***FOREIGN VISITORS MUST BE SUBMITTED NO LESS THAN THIRTY DAYS PRIOR TO AN OFFICIAL VISIT*** | ||
| For more information and/or guidance, contact your Tenant Command Security Officer | ||
| Base Elizabeth City and Tenant Command CSO's: | ||
| Base Elizabeth City: | MEC Kealiinohomoku, Brandonn | (252)335-6855 |
| Aviation Technical Training Center (ATTC): | ASTC Linehan, Michael | (252)335-6917 |
| Aviation Logistics Center (ALC): | Mr. Smith, Stephen | (252)384-7173 |
| Air Station Elizabeth City: | OSC Brancaleone, Paul | (252)335-6761 |
| Boat Station Elizabeth City: | BM1 Jordan, William | (252)335-6086 |
| USCG Aviation Projects Acquisition Center (APAC): | LT Cortez, Miguel | (252)355-6279 |
| ***ALL VISITOR REQUESTS SHALL BE SENT TO THE FOLLOWING EMAIL:*** | ||
| d05-smb-baseecityvisitors@uscg.mil | ||
| Instructions: Left click on the email address and an email will auto-populate. Once all fields are filled out in this visitor request, save to a safe place as this contains PII and attach this form to the email. Once you send off a visitor request you do not need to follow up, all visitor requests are monitored on a daily basis. If a member does not meet Base entry criteria as defined in BASEECITYINST 5512.1B and DCMS denial criteria, you will be contacted and the visitor request will be denied pending a follow up request. If you have any further questions please feel free to contact the CGPD. |
mailto:d05-smb-baseecityvisitors@uscg.mil image1.emf image2.emf image3.emf image4.emf image5.emf
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