DFM Contractor Security Clearance Form 10_16_2025.xlsx

This is a Contractor Security Clearance Form issued by the Colorado Division of Facilities Management (DFM) for the project "Install IP Cameras @ CMHHIP," which is associated with the state contract opportunity 2024-057M23 for installing IP cameras and infrastructure at the Colorado Mental Health Institute at Pueblo (CMHHIP) and the Southern Colorado Youth Services Center (SCYSC). The form requires submission of all contractor information including company name, project location, and detailed personal identifying information for all individuals who will work on the project. Clearance requests must be submitted no later than 1:00 PM on August 26, 2026, with a standard processing time of five business days. All individuals must obtain security clearance prior to beginning work at CDHS facilities and grounds.

The form mandates that all information be provided and typed, with incomplete submissions being rejected and not processed. The clearance form collects comprehensive contractor and employee data including full name, last four digits of Social Security Number, driver's license information, date of birth, place of birth, race, sex, and current place of residence. Aaron Shorter is identified as the DFM Project Manager and requestor responsible for coordinating the clearance process.