Contractor Staffing Access Questionnaire J-4.pdf

OMB Control No. 2120-0595

Paperwork Reduction Act Public Burden Statement:

A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB Control Number for this information collection is 2120-0595. Public reporting for this collection of information is estimated to be approximately 25 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Aviation Administration, 10101 Hillwood Parkway, Fort Worth, TX 76177-1524.

CONTRACTOR STAFFING ACCESS QUESTIONNAIRE

Purpose: The purpose of this questionnaire is to identify the access needs of a potential contractor’s employees so the FAA may determine the appropriate investigation requirements and badging needs for the contractor in the event of contract award.

INSTRUCTIONS: Please complete and return

1. What is the estimated number of employees (both full and part-time including subcontractor personnel)anticipated to support this contract throughout the life of the contract? If available, attach a list of personnel proposed to work on the contract.

2. Please provide the following information for each labor category anticipated on this contract. Where the labor categories are specified in advance by the FAA, these labor categories must be used. Where the labor categories are not specified in advance, use contractor labor categories:

Labor Category 1

Position Title(s)

Estimated number of employees in this category

Will employees in this category require routine (defined as more than (1) day per week), access to an FAA facility for more than 180 days?

Yes No

Will employees in this category require access to FAA computer systems or FAA networks (i.e., computer access, etc.)?

Yes No

Will employees in the category require access to FAA Sensitive Unclassified Information (SUI) (e.g., building or land designs, drawings, research and development material, operations plans, etc.)?

Yes No

Page 1 of 2FAA 4400-48 (01/23)

OMB Control No. 2120-0595

Labor Category 2

Estimated number of employees in this category

Will employees in this category require routine (defined as more than (1) day per week), access to an FAA facility for more than 180 days?

Will employees in this category require access to FAA computer systems or FAA networks (i.e., computer access, etc.)?

Position Title(s)

Will employees in the category require access to FAA Sensitive Unclassified Information (SUI) (e.g., building or land designs, drawings, research and development material, operations plans, etc.)?

Labor Category 3

Position Title(s)

Estimated number of employees in this category

Will employees in this category require routine (defined as more than (1) day per week), access to an FAA facility for more than 180 days?

Will employees in this category require access to FAA computer systems or FAA networks (i.e., computer access, etc.)?

Will employees in the category require access to FAA Sensitive Unclassified Information (SUI) (e.g., building or land designs, drawings, research and development material, operations plans, etc.)?

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Page 2 of 2FAA 4400-48 (01/23)