CAJ-1037 DOC LEIN Request REV 04-2018.pdf

This is a criminal history check request form issued by the Michigan Department of Corrections (MDOC) for vendors and contractors seeking access to MDOC facilities. The form, CAJ-1037 (Revision 04-2018), is used to initiate a criminal background investigation through the Michigan Law Enforcement Information Network (LEIN) as a prerequisite for facility entry and contact with incarcerated individuals. The form applies to a project at Pugsley Correctional Facility involving wastewater treatment plant (WWTP) lagoon closure work (File #472/15085.GAG). Vendors and contractors must complete the form with personal identification information, including driver's license or state identification number, date of birth, race, and sex, and must authorize MDOC to conduct the criminal history check before approval to enter the facility is granted.

The form does not contain pricing information, contract terms, set-asides, or funding details. It serves solely as an administrative screening document to ensure facility security and safety by vetting individuals who will have access to MDOC premises. Applicants may obtain copies of their Michigan criminal history through www.michigan.gov/ichat for a nominal fee. The LEIN check must be completed and cleared before any vendor or contractor can proceed with work at the facility, with results documented and initialed by MDOC staff.