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GSA Requesting Official: Contract/TO/DO/RWA # Office Symbol:

Phone: Vendor Prime:

E-Mail: Prime POC: Version Date:

POC E-Mail:

Last Name First Name Middle Name Suf. Position Title

Projected Dates on

Project (Start-Finish)

Date Removed from

Project Subcontractor Name Name of Escort Start Date End Date Investigation Type

Full Legal Name Individual Specific Escorting Credentialing

GS-xx-xx-xx-xxx-xxxx

The names provided below are contractors proposed by the vendor to work on the contract listed above. The GSA Requesting Official will submit this list to the Zonal Help Desk, as approval to begin the investigation process for each person listed, upon receipt of a

CIW. This list is not an indication that these individuals have completed the required investigation process, and is not to be used for building access.

Completed by Prime Vendor Completed by RO

Requesting Official Contractor Approval List

(Rev. 5/17)

GAC/PIV

Credentialing

The names provided below are contractors proposed by the vendor to work on the contract listed above. The GSA Requesting Official will submit this list to the Zonal Help Desk, as approval to begin the investigation process for each person listed, upon receipt of a

CIW. This list is not an indication that these individuals have completed the required investigation process, and is not to be used for building access.

Completed by RO

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