Atch 2. Site visit request form_Updated.pdf

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Attached to
Lackland Faux Wood Blinds
Solicitation number
FA301624Q5067
Issued by

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This document is an unescorted access request form for a site visit related to a federal contract opportunity. The key details are:

The solicitation number is FA3016-24-Q-5067 for a requirement to replace window blinds at Lackland Air Force Base. It is a 100% small business set-aside with a NAICS code of 337920. A site visit is scheduled for June 21, 2024 at 1:00 PM Central time. Contractors must submit a completed access request form by June 17, 2024 at 3:00 PM to gain access to the site visit. Questions are due by June 26, 2024 at 2:00 PM, and RFQ responses are due by July 5, 2024 at 1:00 PM. The contracting agency is the Department of the Air Force, Air Education and Training Command.

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Other files

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Atch 6.Amendment 0002 FA301624Q5067 B2012 LAK Faux Wood Blinds.pdf PDF
Atch 4.Faux Wood Blinds Questions and Answers.pdf PDF
Atch 5.Site visit pictures.pdf PDF
Atch.1_Combined Synopsis Soliciation_ Faux Blinds_07.02.2024.pdf PDF
Atch 3. Blinds_Template SOW_Final_07.02.2024.pdf PDF
Atch 1.Combined Synopsis Solicitation_ Faux Blinds.pdf PDF
Atch 2. EAL Request Form.pdf PDF
Atch 3.Blinds_SOW v2.pdf PDF

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JBSANANTONIO Form 7, 20211020 (Prescribed by: JBSANANTONIOI 31-1131)

UNESCORTED ACCESS REQUEST

AUTHORITY: Title 10, United States Code 8012. PRINCIPAL PURPOSE: To assist security personnel in establishing a fitness determination through the identity proofing and vetting process. ROUTINE USES: To be utilized by personnel requesting to obtain guest installation access pass for unescorted access to Joint Base San Antonio (JBSA) installations or for special one-time events. DISCLOSURE: Disclosure of the requested information is voluntary; however, failure to provide information may result in denial of request or the refusal by the Security Forces Squadron, Installation Access Control Section to permit access to the installation.

"FOUO, This document contains information exempt from mandatory disclosure under the FOIA. Title 5 U.S.C. 552 (b) (6) applies.

This document also contains personal information that is protected by the Privacy Act of 1974 and must be safeguarded from unauthorized disclosure."

SPECIAL SECURITY REQUIREMENTS: : IAW DoDM-5200.08 Volume 3, AFMAN 31-101 Volume 3, paragraph 1.1.g.(1)(b), It is the sponsoring organization's responsibility to ensure the visit is properly recorded and documented in the FVS, and the local AFOSI unit is coordinated with in advance of the official foreign visitors' arrival and prior to their departure from the installation. On the day of visit and when the FOREIGN VISITORS visitors have departed the installation, email AFOSI, at AFOSI.Det403@us.af.mil indicating time of arrival and departure from the installation.

The following information has been provided to aid in the completion of the Unescorted Access Request.

Section I: Sponsor Information.

Block 1. Title The sponsors title (ie; Mr., Ms., Mrs., or associated rank of Military/GS employee).

Block 2. Last Name, First Name MI (Full name of sponsor, use format assigned).

Block 3. Duty Phone (Office number you can be reached at during business hours).

Block 4. Cell/Home Phone (Phone number you may be reached at during requested access times for your guests).

Block 5. DoD ID Number (Assigned number on your DoD ID Card-This is required to fully identify you in DBIDS).

Block 6. Organization/Home Address (If you are sponsoring for a government purpose use your organization. If it is for personal reasons use your home address).

Block 7. Email Address (email submissions will be sent encrypted utilizing a .mil email address).

Section II: Access Details.

Block 8. Category for Access (Check the category of your guest).

Block 9 Location (Check which location(s) in the JBSA area you are requesting your guests to have access to – Must be a valid need for entry to these locations. Contractor/Vendors must provide contract number stating access locations are required).

Block 10. Time Frame

From Date (Start date of visit/contract, etc…) To Date (End date of visit/contract, etc…)

From Time (Start time of visit or if continual access, start time each day) To Time (End time of visit or if continual access, end time each day)

Days of Week (Days of week entry is required - If visiting select day(s) visit will take place, if continual access is required – actual days of work required to be present)

Block 11. Reason for Access. Provide specific reason for access (ie; Meeting, Tow Truck, Pop-A-Lock, Taxi, Wedding, Family visit, etc…).

Block 12. Identify the Visiting Organization, Name of Event or if Contractor: Company Name (Prime and Sub Contractor), Contract Number and

Contract Period.

Block 13a, b, c: Sponsor completes each block. Must be legible when completed manually.

Section III: Visitor Center Use Only.

Section IV: Foreign Disclosure Office Use Only.

Section V: Guest Information.

FOREIGN VISITORS must be processed through the Foreign Disclosure Office. Email completed form to 502SRG.MAS.JBSA_ForeignRequest@us.af.mil

For more than 20 visitors [Special Event] use continuation sheets).

Block 16. Fill in the blocks [alphabetical order] for all visitors 18 years of age or older.

Last Name, First Name MI (Full name of visitor, use format assigned).

DOB: Date of Birth (Use format assigned).

Country (Country of birth for foreign visitors).

ID Type: Must be a valid form of photo ID. Below are acceptable forms. Use the corresponding number when making your selection.

1 = Driver's License 2 = State Identification Card 3 = Veteran's Identificat ion Card 4 = Passport/Visa 5 = Permanent Residence Card 6 = US Citizenship & Immigration Services 7 - Foreign Visitor

ID Number (The associated number assigned to the ID Type) Country of Issue (Country where identification was issued) State of Issue (State where identification was issued) If a tracking number is assigned, the sponsor will relay the number to their guest(s) for announcement at a visitor center. This will allow the Visitor Center Personnel to track completed paperwork for issuance of an access credential.

mailto:AFOSI.Det403@us.af.mil mailto:502SRG.MAS.JBSA_ForeignRequest@us.af.mil

UNESCORTED ACCESS REQUEST

I. SPONSOR INFORMATION

1. TITLE 2. LAST NAME, FIRST

Farrell,Thomas,A

NAME, MI 3. DUTY PHONE

512-994-0018

4. ALTERNATE CONTACT NUMBER 5. DOD ID NUMBER

6. ORGANIZATION/HOME ADDRESS 7. EMAIL ADDRESS

thomas.farrell.5@ us.af.mil 502 CONS/JBKAA 1655 Selfridge Ave JBSA-Lackland, TX 78236

II. ACCESS DETAILS

8. CATEGORY OF ACCESS

Contractor/Vendor

Personal Services

Delivery/Pick-Up (Ex: Pizza Delivery/.Non Driver Status)

Visitor/Volunteer

Special Event

Foreign National

9. LOCATION 10. TIME FRAME

JBSA-FSH From Date: Jun 20, 2024 Sunday

JBSA-SAMMC From Time: 12:00:00 PM Monday

Tuesday

JBSA-CB

Wednesday

To Date: Jun 20, 2024 Thursday

JBSA-LAK

To Time: 3:30pm Friday

JBSA-RND

Saturday

11. REASON FOR ACCESS (Be Specific)

BLDG 2012 Site Visit for RFQ FA301624Q5067

12. CONTRACTED COMPANY SPONSORED OR SPECIAL EVENT NAME

13a. DATE OF SIGNATURE 13b. NAME, GRADE/RANK, OFFICE SYMBOL, AND TITLE OF SPONSOR 13d. SIGNATURE

III. VISITOR CENTER USE ONLY

14a. TRACKING NUMBER

14b. RECEIVED DATE

NCIC III

SFMIS

ALERTS

TSDB

14c. VETTED DATE 14d. POSTED DATE (For EAL Use)

14e. ECP POSTED LOCATION (For EAL Use)

14f. DATE OF SIGNATURE 14g. NAME, GRADE/RANK, OFFICE SYMBOL, AND TITLE OF VERIFIER 14h. SIGNATURE

IV. FOREIGN DISCLOSURE OFFICE (FDO) USE ONLY

15a. CASE NAME 15b. VETTED DATE

Approved

Denied

15c. DATE OF SIGNATURE 15d. NAME, GRADE/RANK, OFFICE SYMBOL, AND TITLE OF VERIFIER 15e. SIGNATURE

UNESCORTED ACCESS REQUEST

V. GUEST INFORMATION

16. Enter information for all persons 18 years of age or older (in alphabetical order). Refer to page 1 for instructions.

TRACKING NUMBER

S O R T

Last Name, First Name, MI

DOB

(DD/MMM/YY)

Country of Birth

ID

Type

ID

Number

Country of Issue

State of

Issue VCC Use Only

+ 1 TX -

ContractorVendor: Off
Personal Services: Off
DeliveryPickUp: Off
Vis: Off
Special Event: Off
Foreign National: Off
9 LOCATION JBSAFSH JBSASAMMC JBSACB JBSALAK JBSARND:
JBSAFSH: Off
JBSASAMMC: Off
JBSACB: Off
JBSALAK: Off
JBSARND: Off
Sunday: Off
Monday: Off
Tuesday: Off
Wednesday: Off
Thursday: Off
Friday: Off
Saturday: Off
11 REASON FOR ACCESS Be Specific BLDG 2012 Site Visit for RFQ FA301624Q5067:
12 CONTRACTED COMPANY SPONSORED OR SPECIAL EVENT NAME:
13a DATE OF SIGNATURE:
13b NAME GRADERANK OFFICE SYMBOL AND TITLE OF SPONSOR:
13d SIGNATURE:
14a TRACKING NUMBER:
14c VETTED DATE:
14d POSTED DATE For EAL Use:
14b RECEIVED DATE:
NCIC III: Off
SFMIS: Off
ALERTS: Off
TSDB: Off
14e ECP POSTED LOCATION For EAL Use:
14f DATE OF SIGNATURE:
14g NAME GRADERANK OFFICE SYMBOL AND TITLE OF VERIFIER:
14h SIGNATURE:
15a CASE NAME:
15b VETTED DATE:
Approved: Off
Denied: Off
15c DATE OF SIGNATURE:
15d NAME GRADERANK OFFICE SYMBOL AND TITLE OF VERIFIER:
15e SIGNATURE:
State:
Last Name First Name MI:
DOB DDMMMYY:
Country of Birth:
ID Number1:
Country of Issue1:
VCC Use OnlyTX:
Last Name First Name MI_2:
DOB DDMMMYY_2:
Country of Birth_2:
1:
ID Number:
Country of Issue:
VCC Use OnlySelect:
Last Name First Name MI_3:
DOB DDMMMYY_3:
Country of Birth_3:
1_2:
ID Number_2:
Country of Issue_2:
Select:
VCC Use Only:
Last Name First Name MI_4:
DOB DDMMMYY_4:
Country of Birth_4:
1_3:
ID Number_3:
Country of Issue_3:
Select_2:
VCC Use Only_2:
Last Name First Name MI_5:
DOB DDMMMYY_5:
Country of Birth_5:
1_4:
ID Number_4:
Country of Issue_4:
Select_3:
VCC Use Only_3:
Last Name First Name MI_6:
DOB DDMMMYY_6:
Country of Birth_6:
1_5:
ID Number_5:
Country of Issue_5:
Select_4:
VCC Use Only_4:
Last Name First Name MI_7:
DOB DDMMMYY_7:
Country of Birth_7:
1_6:
ID Number_6:
Country of Issue_6:
Select_5:
VCC Use Only_5:
Last Name First Name MI_8:
DOB DDMMMYY_8:
Country of Birth_8:
1_7:
ID Number_7:
Country of Issue_7:
Select_6:
VCC Use Only_6:
Last Name First Name MI_9:
DOB DDMMMYY_9:
Country of Birth_9:
1_8:
ID Number_8:
Country of Issue_8:
Select_7:
VCC Use Only_7:
Last Name First Name MI_10:
DOB DDMMMYY_10:
Country of Birth_10:
1_9:
ID Number_9:
Country of Issue_9:
Select_8:
VCC Use Only_8:
Last Name First Name MI_11:
DOB DDMMMYY_11:
Country of Birth_11:
1_10:
ID Number_10:
Country of Issue_10:
Select_9:
VCC Use Only_9:
Last Name First Name MI_12:
DOB DDMMMYY_12:
Country of Birth_12:
1_11:
ID Number_11:
Country of Issue_11:
Select_10:
VCC Use Only_10:
Last Name First Name MI_13:
DOB DDMMMYY_13:
Country of Birth_13:
1_12:
ID Number_12:
Country of Issue_12:
Select_11:
VCC Use Only_11:
Last Name First Name MI_14:
DOB DDMMMYY_14:
Country of Birth_14:
1_13:
ID Number_13:
Country of Issue_13:
Select_12:
VCC Use Only_12:
Last Name First Name MI_15:
DOB DDMMMYY_15:
Country of Birth_15:
1_14:
ID Number_14:
Country of Issue_14:
Select_13:
VCC Use Only_13:
Last Name First Name MI_16:
DOB DDMMMYY_16:
Country of Birth_16:
1_15:
ID Number_15:
Country of Issue_15:
Select_14:
VCC Use Only_14:
Last Name First Name MI_17:
DOB DDMMMYY_17:
Country of Birth_17:
1_16:
ID Number_16:
Country of Issue_16:
Select_15:
VCC Use Only_15:
Last Name First Name MI_18:
DOB DDMMMYY_18:
Country of Birth_18:
1_17:
ID Number_17:
Country of Issue_17:
Select_16:
VCC Use Only_16:
Last Name First Name MI_19:
DOB DDMMMYY_19:
Country of Birth_19:
1_18:
ID Number_18:
Country of Issue_18:
Select_17:
VCC Use Only_17:
Last Name First Name MI_20:
DOB DDMMMYY_20:
Country of Birth_20:
1_19:
ID Number_19:
Country of Issue_19:
Select_18:
VCC Use Only_18:
Last Name First Name MI_21:
DOB DDMMMYY_21:
Country of Birth_21:
1_20:
ID Number_20:
Country of Issue_20:
Select_19:
VCC Use Only_19:
Last Name First Name MI_22:
DOB DDMMMYY_22:
Country of Birth_22:
1_21:
ID Number_21:
Country of Issue_21:
Select_20:
VCC Use Only_20:
Last Name First Name MI_23:
DOB DDMMMYY_23:
Country of Birth_23:
1_22:
ID Number_22:
Country of Issue_22:
Select_21:
VCC Use Only_21:
Last Name First Name MI_24:
DOB DDMMMYY_24:
Country of Birth_24:
1_23:
ID Number_23:
Country of Issue_23:
Select_22:
VCC Use Only_22:
Last Name First Name MI_25:
DOB DDMMMYY_25:
Country of Birth_25:
1_24:
ID Number_24:
Country of Issue_24:
Select_23:
VCC Use Only_23:
JBSANANTONIO Form 7 20211020:
Text1:

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