Contractor's Release Form.doc

DOC document 49 KB Posted

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RESTROOM REMODEL at Barksdale AFB near Shreveport, LA
Solicitation number
DTFAAC-17-R-00088
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Contractor's Release Form (doc)

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Text version

U.S. Department of Transportation

Federal Aviation Administration

CONTRACTOR POSITION RISK / SENSITIVITY

LEVEL DESIGNATION RECORD

Contractor Name / Subcontractor

Organization Code or Cost Center

Purpose of Contract

Contract / Solicitation Number

Position Title

If the position is a national security position (security clearance required) Sections I, II and III are optional.

RISK DESIGNATION SYSTEM

I. Program Placement

Impact on efficiency of service

Major Substantial Moderate Limited

FORMCHECKBOX

FORMCHECKBOX

Scope of Operations for efficiency of service

World Wide Gov’t Wide Multi-Agency Agency

FORMCHECKBOX

Placement

Major Substantial Moderate Limited

FORMCHECKBOX

II. Position Risk Points

a. Degree of public trust (7-1) - - - - - - - - - - - - - - - - - - - - -

b. Fiduciary responsibilities (7-1) - - - - - - - - - - - - - - - - - - - - -

c. Importance to program (7-1) - - - - - - - - - - - - - - - - - - - - -

d. Program authority level (7-1) - - - - - - - - - - - - - - - - - - - - -

e. Supervision received (7-1) - - - - - - - - - - - - - - - - - - - - - TOTAL POINTS:

III. Risk/Sensitivity Level

High Risk – 6 Critical-Sensitive – 3

Moderate Risk – 5 Noncritical-Sensitive – 2

Special-Sensitive – 4 Low Risk – 1

RISK LEVEL:

IV. Final Adjustment Factor(s), Including AIS Risk Criteria

Level of Security Clearance Required (To be filled in by the SSE)

TOP SECRET FORMCHECKBOX

SECRET FORMCHECKBOX

CONFIDENTIAL FORMCHECKBOX

NONE

V. Final Risk / Sensitivity Level

Final Risk/Sensitivity Level - Comments:

Level of Investigation Required (To be filled in by the SSE)

FP Check FORMCHECKBOX

NACI FORMCHECKBOX

NACIC FORMCHECKBOX

MBI FORMCHECKBOX

LBI FORMCHECKBOX

BI FORMCHECKBOX

SBI

Operating Office/CO (providing input) and Code

Signature of Operating Office/CO (providing input) Date

Approving Security Official (Type or Print name)

Signature of Approving Security Official

Date

FAA Form 1600-77 (6-00) Local Reproduction Authorized OMB Control No. 2120-0595 _1008748476.bin

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