continued_background_data_information.docx

DOCX document 12 KB Posted

Attached to
Electrical and HVAC Work for the Memphis Division
Solicitation number
DJF-20-3440-PR-0001685
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File Type Posted
AMENDMENT 2.docx DOCX document
FD_816_Memphis_Division_Addendum.docx DOCX document
FD-484_2017_06_22_07_56_52_554.pdf PDF
Fd-816.pdf PDF
AMENDMENT 1.docx DOCX document
RFQ DJF-20-3440-PR-0001685 Electrical and HVAC Work for Memphis.pdf PDF
SOW DJF-20-3440-PR-0001685.pdf PDF

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CONTINUED BACKGROUND DATA INFORMATION

Contact phone number(s): ______________________________ (home) ______________________________ (cell) ______________________________ (pager)

Driver's Licence Number: __________________________________________

State of Issue: __________________________________

Specific Reason for Access: _______________________________________________________

One time visit or Multiple visits required: _____________________________________

Specific Location Where Work Is Performed: __________________________________________

Expected dates of access: _______________________________________

Estimated duration of work: ________________________________________________________

Employee submitting FD-816: _____________________________________

Extension: ______________________________________

****If candidate answered "YES" to any questions on page 1, please provide details, to include approximate date, offense charged, arresting agency, and disposition.

APPROVED: ___________ DATE: _____________________

DECLINED: ___________ DATE: _____________________

SECURITY OFFICER SIGNATURE: _______________________________________________

File details come from the government source that posted it. Updated .