CLEARANCE VISITORS FORM revised 012423.pdf
PDF 135 KB Posted
- Solicitation number
- 2137934
- Issued by
- Orange County, New York
About this file
This is a Visitor's Form for Building Clearance issued by the Orange County Sheriff's Office in Goshen, New York, designed to control access to Orange County facilities. The form requires visitors to provide personal identification information including name, address, date of birth, driver's license number, and contact details. Visitors must indicate which department they intend to visit—including Corrections, Food Service, Medical, Mental Health, Programs/Education, Department of Public Works, or other departments—and state the reason for their visit. The form specifies that submission must occur prior to facility entry and requires both the completed form and a copy of the visitor's driver's license for approval before access is granted.
This clearance mechanism applies to the Orange County Sheriff's facility located at 110 Wells Farm Road in Goshen, New York, and serves as a security control measure for the county's operations. Contact information for inquiries is provided through the Orange County Sheriff's Department via phone at 845-291-4033 or email at OCNYSheriff@OrangeCountyGov.com. The form contains no pricing information, contract terms, or service specifications, as it functions solely as an administrative access control document rather than a procurement instrument.
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Text version
110 Wells Farm Road • Goshen, NY 10924 • P: 845-291-4033 • E: OCNYSheriff@OrangeCountyGov.com
ORANGE COUNTY NEW YORK Sheriff Paul Arteta
VISITOR’S FORM FOR BUILDING CLEARANCE
NAME:_______________________________/__________________/_____________________________
(FIRST) (MIDDLE) (LAST)
ADDRESS:_______________________________________________________________________
EMAIL ADDRESS:________________________________________________________________
SEX: MALE__________ FEMALE__________ DATE OF BIRTH:_________________
DRIVER’S LICENSE NUMBER:__________________________________ STATE:__________
PHONE NUMBER:______________________________________________
DATE OF SUBMISSION: ________________________________
DATE OF VISIT: _______________________________________
DEPARTMENT TO BE VISITED: (CHECK ALL THAT APPLY)
CORRECTIONS________ FOOD SERVICE________ MEDICAL________
MENTAL HEALTH________ PROGRAMS/EDUCATION________ DPW________
OTHER________________________________________________________________________
(PLEASE PRINT DEPARTMENT OR EMPLOYEE TO BE VISITED IF NOT LISTED)
REASON FOR VISIT: ___________________________________________________________________
VISITOR MUST SUBMIT THIS FORM AND A COPY OF DRIVER’S LICENSE FOR APPROVAL PRIOR TO
ENTERING THE FACILITY
File details come from the government source that posted it. Updated .