87th_SECURITY_FORCES_SQUADRON_Appendix.docx

J-4 87th SECURITY FORCES SQUADRON (SFS)

APPENDIX TO ALL STATEMENTS OF WORK FOR

JB MDL, NEW JERSEY

INSTALLATION ENTRY CONTROL PROCEDURES FOR ALL CONTRACTORS

The following appendix provides information from Air Force Instruction 31-101 and local supplements on requirements for entering and conducting business while on JB MDL, New Jersey.

1. Contract Award.

1.1. Upon award of a contract, all contractors, including Small Purchase contractors, must initiate a criminal history record information/background check for non-criminal justice purposes on all personnel requiring access to JB MDL to the 87th Security Forces Squadron. This will be completed prior to any access credential for JB MDL being issued to the contractor personnel.

1.2. JB MDL requires all contractors to conduct a criminal history record information/background check WITH fingerprints. This check is done at the contractor's expense and not at government expense.

1.3. This check will require the completed criminal history record/background check results or report be sent by the Investigating Agency to the 87 SFS Entry Screening Facility (ESF).

1.4. All applicants are required to have a criminal history record information/background check for non-criminal justice purposes from BOTH the State of Residence and State of Employment.

1.4.1. General guidance for New Jersey on this process is provided by the NJ State Police and is found in 87 SFS Attachment 1 of this Contractor Security Appendix.

1.4.2. General guidance for Delaware on this process is provided by the DE State Police and is found in 87 SFS Attachment 2 of this Contractor Security Appendix.

1.4.3. General guidance for New York on this process is provided by the NY State Police and is found in 87 SFS Attachment 3 of this Contractor Security Appendix.

1.4.4. General guidance for Pennsylvania on this process is provided by the PA State Police and is found in 87 SFS Attachment 4 of this Contractor Security Appendix.

1.4.5. For guidance from any of the other state or US Territory (i.e. Puerto Rico), contact the state police of that particular state and follow the requirements of para 1.2. and 1.3. above.

1.5. The 87 SFS will not be used to conduct this criminal background check.

1.6. These results must be sent directly from the Investigating Agency to the 87 SFS at the above listed address. Forms sent from the contractor will no longer be accepted.

1.6.1. Contractors and sub contractors may contact the 87 SFS/ESF at 609-754-3197 to determine arrival of and verify status of Criminal History Record and Background Checks.

1.7. Failure to provide the completed check for each contractor individual requesting entry to the 87 SFS will result in that specific individual not being allowed access to JB MDL until the background check has been completed and provided.

1.8. The contractor will provide an initial Entry Authority List (EAL) (see 87 SFS Attachment 5 for EAL requirements) to the administrative contracting office (i.e. 87 CONS, US Army Corps of Engineers (USACE), NAS Lakehurst, 87 CES, etc.). The contracting office will provide a copy of the initial EAL to the 87 SFS ESF. The contracting office will maintain any required documentation until the contract has been completed or terminated for any reason.

1.9. Upon receipt of the results of the check, the ESF will review the results and determine whether personnel will be authorized to enter JB MDL. The ESF will maintain and file a copy of the original documents for future reference.

1.10. The ESF will notify the appropriate Administrative Contracting Office of those personnel from the initial EAL approved to enter JB MDL.

1.11. The ESF will also notify the appropriate Administrative Contracting Office of those personnel who are being denied access to the installation because of an issue with the individual’s criminal background investigation.

1.11.1. Any contractor found to have a criminal record which is not conducive to good order and discipline on JB MDL will not be allowed entry.

1.11.2. Personnel with outstanding warrants or personnel who are in the country in violation of immigration law will NOT be allowed entry to the installation in accordance with AMC Guidance.

1.11.3. US Citizenship, immigration status, or Social Security Account Number cannot be verified.

1.11.4. Barred from entry/access to any military installation or facility.

1.11.5. Wanted by federal or civil law enforcement authorities, regardless of offense/violation.

1.11.6. Any conviction of firearms or explosives violation within the past three years.

1.11.7. Incarcerated for 12 months or longer within the past three years, regardless of the offense/violation.

1.11.8. Any conviction of espionage, sabotage, treason, terrorism or murder.

1.11.9. Any conviction of sexual assault, armed assault/robbery, rape, child molestation, drug possession with intent to sell, or drug distribution within the past 10 years.

1.12. Upon notification of approved personnel, the contractor will provide a final listing of personnel on an Entry Authority List (EAL) in letter format to the requesting Administrative Contracting Office.

1.13. The administrative contracting office (such as the 87th Contracting Squadron, the US Army Corps of Engineers, etc.) will authenticate and forward the EAL to the ESF, NLT 72 hours prior to contract start date.

1.14. The ESF Supervisor will approve the EAL and file the package appropriately.

1.15. If EAL’s are not accurate or contain fraudulent information, contractor identification badges will not be issued.

1.15.1. Pen and ink changes for deletion purposes may be made to an EAL.

1.15.2. Pen and ink additions to an EAL will not be accepted. All additions must be made by initiating a new EAL.

1.16. The ESF will maintain a copy of the documents for future reference.

1.17. Contractor Criminal History Record and Background Checks will be valid for a period not to exceed 3 years.

1.17.1. At the 3 year mark, the contractor is required to complete a new check for each individual still employed and working at JB MDL.

1.17.2. Background checks older than 3 years will be updated through the NJ State Police or the State Police department for which they reside and/or are employed.

1.18. Contractors who are also required to do Criminal History Background checks for employment purposes and maintain the background per state laws are required to bring the original completed background check and a copy of the check to the 87 SFS ESF.

1.18.1. ESF personnel will verify the copy of the background check and will stamp both the original and copy.

1.18.2. ESF personnel will keep the copy of the background check.

1.18.3. Companies which maintain the original background check will be required to re-verify the status by bringing the original background checks to the ESF on a yearly basis.

2. Contractor Visitor Passes for Entry to JB MDL.

2.1. Contractors will be issued an AF Form 75 – Visitor Pass which identifies them as a contractor authorized to access to JB MDL.

2.1.1. Contractor visitor passes will be issued at the ESF or Checkpoint 9 for all contractors.

2.1.2. ESF and Checkpoint 9 personnel will issue AF Form 75 – Visitor Passes based on the Contracting Officer and ESF Supervisor approved EAL and completion of the criminal history check.

2.2. Contractor passes will be updated annually at the ESF or Checkpoint 9 for contracts lasting over 1 year.

2.3. Contractor passes will be issued for the duration of the contract, or the length of the option period not to exceed 1 year, whichever is less.

2.3.1. Any contractor whose driver’s license, car registration or car insurance expires sooner, will only be issued a pass up to the expiration time frame.

2.3.2. Upon providing proof of renewal, a new pass can be issued to comply with 2.3. above.

2.4. ESF personnel will review previously provided background investigations on all contractors prior to issuing/updating identification credentials.

2.5. NON U.S. CITIZENS: All non-U.S. citizens must provide original documents with immigration number the time badges are issued

2.6. Those contractors working under the AF Industrial Security program will provide an EAL to the ESF.

2.6.1. Those contractors under the AF Industrial Security program requiring access to the AF computer network may be issued a Common Access Card (CAC) in lieu of the normal contractor visitor pass.

2.6.2. Those contractors under the AF Industrial Security program who have not been issued a CAC will be issued a contractor visitor pass

2.6.3. Those contractors under the AF Industrial Security Program who maintain an active DoD security clearance shall provide a Joint Personnel Adjudication System (JPAS) printout in lieu of the required background checks.

3. Contractor Vehicle Passes for Entry to JB MDL.

3.1. Contractor vehicle passes will be issued at the ESF or Checkpoint 9.

3.2. All vehicles and drivers must have the following documentation prior to being granted access to JB MDL:

3.2.1. Valid state driver's license.

3.2.2. Valid vehicle insurance.

3.2.3. Valid vehicle registration.

3.2.4. Photo ID.

3.2.5. Bill of Lading (if available).

3.2.6. A JB MDL point of contact with a phone number.

3.3. Contractors will be issued AF Form 75, Vehicle Pass for entry to JB MDL provided the required documentation listed in 3.2 is valid.

3.4. Contractor vehicle passes will be updated annually at the ESF or Checkpoint 9 for contracts lasting over 1 year.

3.5. Contractor vehicle passes will be issued for the duration of the contract or 1-year, whichever is less.

4. Contractor, Commercial and Oversized Vehicles.

4.1. All contractor, commercial and oversized vehicles must enter JB MDL through Checkpoint-9 located on Fort Dix adjacent to Saylor’s Pond Road.

4.2. The following are considered “commercial and oversized” vehicles at JB MDL and these vehicles can only enter the installation IAW paragraph 4.1. above.

4.2.1. All vehicles registered and licensed with “commercial” license plates, regardless of state of issue.

4.2.2. All vehicles, regardless of type, license plate, or size, having more than two (2) axles.

4.2.3. All vehicles used to carry tools, machinery, equipment, or other commercial related equipment onto the installation.

4.2.4. All vehicles displaying a commercial plaque, logo or emblem.

5. Contractor vehicle and personnel processing requirements

5.1. Checkpoint - 9 is open for personnel and vehicle processing from 0700 – 2100 hours daily.

5.2. Contractor/Commercial vehicles requesting JB MDL entry from 2100 – 0700 will not be allowed entry. Unusual circumstances will be handled on a case by case basis. Contact the Security Forces Control Center at 609-754-2001/2002.

6. Subcontractors.

6.1. All subcontractors are required to follow the same instructions listed above for their subcontractor personnel.

6.2. Contractors with an immediate access requirement for a short-term subcontractor must coordinate with their Contracting Officer prior to authorization of access without following the normal procedures.

6.3. Short term Subcontractors will be issued a pass not to exceed 1 week.

7. Contractors working in USAF Restricted Areas will comply with the following:

7.1. All contractors working on the flight line and restricted areas are required to be established as a Visitor Group under the Air Force Industrial Security Program.

7.2. Each individual contractor (person) will be required to complete a Standard Form 85P - Questionnaire for Public Trust Position before accessing the Restricted Area. This is an investigation to determine the trustworthiness of the individual requiring access to the Restricted Area. This is not the same type of investigation as the NJ or other state background checks required to be conducted to access MAFB.

7.2.1. Each individual will work with the unit security manager the contractor is supporting to complete the SF 85P.

7.2.2. Upon completion, the contractor will submit to the unit security manager for review.

7.2.2.1. If the 85P package contains errors, the individual will work with the security manager to correct.

7.2.2.2. If unable to correct, the individual will not be allowed access to the restricted area and may be asked to leave the installation.

7.2.3. If the SF 85P package contains no errors, the unit security manager will complete an AF Form 2586 – Unescorted Entry Authorization Certificate for accessing the restricted area.

7.3. The unit security manager will make an appointment with 87 SFS/SFAI Personnel Security office for contractor processing and turn-in of SF 85P and AF Form 2586.

7.3.1. The contractor will meet SFAI personnel and submit the completed SF 85P. SFAI will review SF 85P for accuracy and completion.

7.3.1.1. If the 85P package contains errors, the individual will work with the personnel security office to correct.

7.3.1.2. If unable to correct, the individual will not be allowed access to the restricted area and may be asked to leave the installation.

7.3.1.3. If no issues with 85P, the Personnel security office will conduct a local files check on the individual.

7.3.2. Upon local files check completion (no issues), contractor will be directed to the Pass & Registration (Bldg 1911) where a restricted area badge can be issued on an interim basis based on submission of the SF 85P to SFAI.

7.3.2.1. SFAP will review AF Form 2586 for accuracy and completion.

7.3.2.2. If there are no errors, then an AF Form 1199 – Restricted Area Badge will be produced for the contractor.

7.3.2.3. If there are errors on the AF Form 2586, the contractor will be directed to return to the unit security manager for re-accomplishment of the form.

7.4. If there are problems found during the investigation process, access to the restricted area will be immediately revoked and the individual will not be allowed access to MAFB.

7.5. Any work on or near the flightline will be coordinated through the McGuire Installation Constable located in bldg 1738.

7.5.1. The Installation Constable will verify the need to access the restricted area and determine if a Free Zone can be established.

8. Flightline Driving.

8.1. Only authorized contracted or privately owned vehicles with colored cones are authorized on the flightline and/or flightline road unless driving a government vehicle or under authorized escort.

8.2. Contractor personnel who are authorized to drive on the flightline will be issued a colored cone from Base Operations.

8.2.1. This cone must be visible during operations of the vehicle when driving on the flightline and when parked on the flightline.

8.2.3. The cone must be secured (put away) upon departure from the flightline.

8.3. Restricted Areas: Defined as an area delineated by ropes, red lines or barriers that contain Protection Level resources (i.e. aircraft or equipment).

8.3.1. These areas require a certain level of protection, and entry is only allowed by authorized personnel wearing a restricted area badge or personnel under authorized escort.

8.3.2. Aircraft hangars are restricted areas when aircraft are present.

8.3.3. Signs are posted every 100 feet on the exterior of restricted area boundaries stating; "Deadly Force is Authorized."

8.3.4. Contractors will never enter restricted areas unless properly escorted or authorized by the installation commander or designee through the issuance of a restricted area badge.

8.4. If the Security Forces or a military member detains a contractor or contract employee at any time or for any reason, the contractor will comply with their request and will not become combative or argumentative.

9. Miscellaneous Requirements

9.1. All requests for additional contractor personnel must meet the same requirements listed in para A1 above before identification badges and vehicle passes will be issued.

9.2. The administrative contracting office will be notified when personnel leave the contractor company for any reason and provide that information to SFAP

9.3. The contractor company is responsible for the return of all contractor identification badges and vehicle passes at the end of the contract or when personnel depart for any reason. All badges and passes will be returned 87 Security Force Squadron Entry Screening Facility.

9.4. During increased Force Protection Conditions (FPCONs) there may be limited entry to the installation.

9.5. Retired military or government personnel whose vehicles display a valid DD Form 2220, DOD Registered Vehicle Decal, may be allowed to enter the installation through any gate providing the vehicle operator has a current and valid base entry ID card.

9.5.1. Retired military or government personnel who have been issued a DD Form 2220 must be listed on the company EAL.

9.5.2. All retired military or government personnel will be the subject of a Criminal History Record Information/Background Check regardless of their military/government retired status.

9.6. At no time will a contractor be issued a DD Form 2220 – DoD Registered Vehicle Decal.

9.6.1. This decal is used by all branches of service and will be honored for entry.

9.6.2. All vehicles entering JB MDL must have a valid DD Form 2220 or possess an AF Form 75 (visitor/vehicle pass).

9.7. Contractors ARE NOT AUTHORIZED to escort (vouch) for any personnel to enter JB MDL.

9.7.1. Exceptions to this rule will be addressed on an as needed basis through the Contracting Officer and the 87 SFS ESF Supervisor.

9.7.1.1. The contractor must work through the Contracting Officer who in turn will contact the ESF Supervisor.

9.7.1.2. In the event the ESF Supervisor is unavailable, the following personnel in the order listed may approve the contractor escort authority. The Chief, Administration & Reports Flight; the Operations Officer; Operations Superintendent; or the on-duty flight chief as necessary, may approve the contractor to escort.

9.7.2. Escorting onto the installation is a limited privilege for emergent requirements only and cannot be used as a routine to get subcontractors onto the installation.

9.7.2.1. Contractors with Installation Access vouching authority must contact the Entry Screening Facility Supervisor to coordinate each emergent requirement.

9.7.2.2. The escorting Contractor will be responsible for all individuals they escort onto the installation.

9.7.2.3. Contractor escort privileges will be revoked if is determined the contractor is attempting to supersede normal installation access requirements.

9.7.2.4. Contractors with Installation Access vouching authority will be authorized to vouch for personnel not to exceed 1 week.

9.8. Any contractor found in violation of this requirement will be escorted off the installation. They will be removed from the company entry authority list and will not be allowed to reenter JB MDL without the express written permission of the installation commander.

9.9. Contractors are required to obey all entry requirements, traffic rules and requirements of JB MDL. Failure to comply will result in barment from the installation.

9.10. Contractors are not authorized to utilize cell phones while operating a motor vehicle of any type while on JB MDL unless they can be operated hands free to include turning on, answering, speaking and turning off.

9.11. Headsets are not authorized for use while operating a vehicle on JB MDL.

10. Questions or problems.

10.1. Questions on entry onto the installation may be directed to any one of the following locations:

Entry Screening Facility (ESF) – (609) 754-3938 or (609) 754-3003

Checkpoint 9 – (609) 658-0425

10.2. If a contractor has any problems while on McGuire Air Force Base in any way related to base entry or security, the contractor should contact the Security Forces Control Center. (609)754- 2001/2002/2003/2004.

///Original Signed/// SCOTT G. ULRICH, Lt Col, USAF Commander, 87th Security Forces Squadron

87 SFS Attachment 1: General guidance for the NJ Criminal History Record Information/Background Check WITH fingerprints.

A1.1. Background checks are requested through the New Jersey State Police on an SBI Form 212B. (See sample located at the end of this attachment). This form was developed to provide these entities with the ability to request criminal history record information by submitting a subject's name, date of birth, social security number and other descriptive information. If an authorized SBI 212B Form requester elects to conduct a more thorough check, based on fingerprint comparison, they may submit a State Applicant Fingerprint Card to the SBI. A completed SBI 212B Form and the proper fee for a fingerprint card submission must accompany the fingerprint card.

A1.2. All forms, fingerprint cards, and payments will be submitted to:

A1.3. The state police response will be mailed to the 87th Security Forces Squadron (SFS) Entry Screening Facility (ESF) address listed in Section A of the form in 15 to 30 working days.

A1.4. Further questions regarding obtaining criminal history record background checks or non-criminal justice licensing/employment checks should be directed to the NJ Criminal Information Unit, (609) 882-2000, extension 2918.

A1.5. Additional information regarding this process can be obtained from the following:

http://www.state.nj.us/lps/njsp/about/serv_chrc.html#ncer

A1.6. The New Jersey State Police NJ 212B will be completed as follows:

A1.6.1. Section A (Complete Name and Address of Requestor) of the New Jersey State Police NJ 212B form will reflect the 87 SFS Entry Screening Facility.

A1.6.2. Section A (Additional Data Optional) will reflect the company address information. This information is use by ESF personnel to identify the company upon return of the record check.

A1.6.3. Section B – Subject of the Request.

A1.6.3.1. NAME (Including Maiden Name): (Last Name), (Maiden Name), (First Name), (Middle).

A1.6.3.2. ADDRESS: (Number), (Street), (City), (State).

A1.6.3.3. DOB (Date of Birth): (Month), (Day, (Year).

A1.6.3.4. SEX: Male or Female.

A1.6.3.5. RACE: White, Black, Chinese, etc.

A1.6.3.6. SBI NUMBER (If known): Leave Blank.

A1.6.3.7. FBI NUMBER (If known): Leave Blank.

A1.6.3.8. SOCIAL SECURITY NUMBER: Social Security Number will be furnished.

A1.7. Section C. Authority and Purpose of the Request.

A1.7.1. The first block is the only block which will be completed for all requests. (Non-criminal justice purpose by a governmental entity of this State, the federal government, or any other state for any official government purpose, including but not limited to employment, licensing, and the procurement of services).

A1.7.2. The second and third blocks are not used.

A1.8. Section D. Certification of Requestor.

A1.8.1. This section will be signed by 87 SFS ESF personnel only.

A1.8.2. The Contracting Officer will provide pre-signed forms to the contractor from the ESF.

A1.8.3. Contractors are not authorized to sign this section.

A1.9. Section E (Authorization by Subject of Request and Privacy Act Information). Supervisor, State Bureau of Investigation.

A1.9.1. I hereby authorize the release of any Criminal History Record Information maintained by your agency, meeting dissemination criteria, for the above indicated purpose to ____Insert Name of agency you authorize to receive this information____.

A1.9.2. The Name of the Agency you authorize to receive this information should read:

A1.9.3. The applicant (Subject of the Request) will sign and date the form.

A1.10. The company will submit a completed state applicant fingerprint card and the SBI 212B Form with a check for $25.00 to the NJ State Police.

Form SBI 212B (Rev. 06/02)

Please Note: The Form SBI 212B (Rev. 06/02), which is pictured below, is included for informational purposes only. The NJ State Police WILL NOT process photocopies/duplicates of this form. An original (processable) form is printed on bluish paper and can be obtained at any NJ State Police office.

87 SFS Attachment 2: General guidance for the DE Criminal History Record Information/ Background Check WITH fingerprints.

A2.1. The Delaware State Criminal History Record Check Authorization form will be used when requesting a Criminal History Background check through the state of Delaware. This form has been scanned into this document; it can be printed, and used for official requests. It can be found in this attachment.

A2.2. The Delaware State Bureau of Identification provides a Delaware Criminal History Record request for a fee of $30.00.

A2.3. This procedure is as follows:

A2.3.1. Complete the Delaware State Criminal History Record Check Authorization form filling out all the applicable areas (see below for detailed instructions).

A2.3.2. Sign the enclosed authorization/release form.

A2.3.3. Have fingerprints taken by person who has been formally trained to take fingerprints (poor quality fingerprints will be rejected and returned) A2.3.4. Provide brief explanation for reason fingerprinted. Use Company letterhead. See A2.8 below for details.

A2.3.5. Enclose $30.00 processing fee; money order or certified check only.

A2.3.6. Provide address for return of criminal history information.

A2.3.7. Send all items listed above to:

A2.4. Questions on completing the form can be directed to the Delaware State Police State Bureau of Identification at (302) 739 – 5882.

A2.5. The form will be completed as follows:

A2.5.1. LAST NAME

A2.5.2. FIRST NAME

A2.5.3. MIDDLE INITIAL

A2.5.4. SUFFIX

A2.5.5. ALIASES: MAIDEN/PREVIOUS LAST NAMES

A2.5.6. DATE OF BIRTH

A2.5.7. SOCIAL SECURITY NUMBER:

A2.5.8. SEX:

A2.5.9. RACE:

A2.5.10. HGT: (Height) A2.5.11. WGT: (Weight) A2.5.12. EYES: (Color Eyes) A2.5.13. HAIR: (Color Hair)

A2.5.14. PLACE OF BIRTH (STATE):

A2.5.15. CURRENT ADDRESS: Number, Street

A2.5.16. CITY/STATE:

A2.5.17. ZIP:

A2.6. * COMPLETE IF MAILING RESULTS TO DIFFERENT ADDRESS OTHER THAN YOURSELF. This block will read the address information for the 87th Security Forces Squadron (SFS) Entry Screening Facility (ESF).

A.2.7. AUTHORIZATION TO RELEASE INFORMATION:

A2.7.1. As applicant I authorize release of any and all information that you have concerning me, included CRIMINAL HISTORY RECORD INFORMATION and other information of a confidential or privilege nature. I hereby release you, your organization , the State of Delaware and other from any liability or damage, which may result from furnishing this information:

A2.7.2. SIGNATURE OF APPLICANT: Applicant signs form A2.7.3. DATE: Applicant dates form.

A2.7.4. SIGNTURE OF PARENT/GUARDIAN (IF UNDER 18): Parent or guardian signs if applicant is under 18 years of age.

A2.8. Item A2.3.4. above requires the individual to provide a brief explanation for reason fingerprinted. Companies should provide the following typed statement on Company letterhead to be provided with the request by the individual.

87 SFS Attachment 3 – General guidance for the NY Criminal History Record Information/Background Check WITH fingerprints.

A3.1. The New York State Office of Court Administration (OCA) Record Search for Conviction of Prosecution and Pending form will be used when requesting a Criminal History Background check through the state of NY. This form has been scanned into this document; it can be printed, and used for official requests. It can be found in this attachment.

A3.2. The New York State Office of Court Administration (OCA) provides a New York Statewide criminal history record search (CHRS) for a fee of $52.00. The search criteria is strictly based on exact match of Name and DOB (variations of Name or DOB are not reported.) The search includes data from all 62 counties pertaining to convictions and open/pending cases originating from City & County courts.

A3.3. This procedure is as follows:

A3.3.1. Complete the Criminal History Record Search (CHRS) Application Form.

A3.3.2. Indicate name, address, and phone number of the person or company submitting the form.

A3.3.3. Include the individual’s full name and date of birth (See Below) you want searched. A3.3.4. Applications with unclear or omitted information will be rejected.

A3.3.5. Each alias and each date of birth is counted as an additional search.

A3.3.6. The results of this process are NOT certified and should not be confused with a "Certificate of Disposition" which can only be issued by a court.

A3.4. PROGRAM FEE: The fee is $52.00 for Statewide search. Please make checks or money orders payable to the N.Y.S. Office of Court Administration (OCA). Cash will not be accepted. A $20.00 returned check charge will be imposed on items returned by the bank.

A3.5. You can contact the OCA at (212) 428-2973 between 10:00 and 4:00 pm for a copy of the Criminal History Record Search application or download the form at www.nycourts.gov.

A3.6. The form will be completed as follows.

A3.6.1. NAME/COMPANY: 87th Security Forces Squadron ATTN: Entry Screening Facility.

NOTE: Do not use your company address as the form must come from the state to the 87 SFS/SFAP.

A3.6.2. STREET ADDRESS: 1738 East Arnold Ave, A3.6.3. CITY, STATE, ZIP: JB MDL, NJ, 08641

A3.6.4. TELE./FAX NUMBER: This will be your company phone number not the 87th Security Forces Squadron phone number.

A3.6.5. CONTACT/EMAIL ADD.: Company POC and phone number.

A3.6.6. STATEWIDE SEARCH Page: _____ of _____: NOT USED

A3.6.7. E-MAIL: NOT USED

A3.6.8. MAIL: Place an X in this box.

A3.6.9. PICKUP: NOT USED.

A3.6.10. TYPE OR PRINT IN CAPITALS (Numbered 1 – 20 for up to 20 personnel)

LAST NAME, FIRST NAME & INITIAL

All information MUST by in CAPITAL LETTERS.

Information must be in the form of LAST NAME, FIRST NAME, INITIAL.

A3.6.11. D.O.B.: Type in individuals Date of Birth A3.6.12. For Your Use: NOT USED A3.6.13. The 87 SFS requests each company list no more than 15 personnel on one sheet. This is so there is space available using line 17 – 20 for your company information. We use your company information as listed on the form to identify your company personnel when the request is returned to our office. Please include the following information on each line.

87 SFS Attachment 4 – General guidance for the PA Criminal History Record Information/Background Check WITH fingerprints

A4.1. The Pennsylvania State Police Request for Criminal Record Check form will be used when requesting a Criminal History Background check through the state of Pennsylvania. This form has been scanned and can be printed for use. It can be found as part of Attachment 4.

A4.2. The PA State Police will provide a PA Criminal Record Check for a fee of $34.00. The fingerprint portion of this check costs $10.00 and the actual records check is $24.00.

A4.3. This procedure is as follows:

A4.3.1. Complete the Pennsylvania State Police Request for Criminal Record Check filling out all the applicable areas of Part I (see below for detailed instructions).

A4.3.2. Have fingerprints taken by a Law Enforcement agency.

A4.3.3. Enclose the $34.00 processing fee: money order or certified check only payable to the Commonwealth of Pennsylvania.

A4.3.4. Send all listed above to:

A4.4. Questions on completing the form can be directed to the PA State Police Central Repository at (717) 783 – 9973 during Business hours (8:15 – 4:15).

A4.5. PA has the capability to request a Criminal History background check through the CRIMINAL HISTORY (PATCH) System which is through the Internet. Use of this system is not authorized because fingerprints cannot be submitted in conjunction with the Criminal History Background check.

A4.6. The form will be completed as follows.

A4.6.1. DATE OF REQUEST: Day, Month, Year.

A4.6.2. REQUESTER NAME: 87 Security Forces Squadron, SFAP/Entry Screening Facility A4.6.3. ADDRESS: 1738 East Arnold Avenue

A4.6.4. CITY, STATE, ZIP: JB MDL, NJ, 08641.

A4.6.5. CONTACT TELEPHONE NUMBER: Type your company phone number here.

A4.6.6. REQUESTOR IDENTIFICATION: Mark an X in the Individual/NonCriminal Justice Agency A4.6.7. REQUESTOR IDENTIFICATION: Leave the Fee Exempt NonCriminal Just Agency box blank – this section is not used.

A4.6.8. NAME/SUBJECT of RECORD CHECK – LAST, FIRST, MIDDLE

A4.6.9. MAIDEN NAME AND/OR ALIASES

A4.6.10. SOCIAL SECURITY NUMBER (SOC)

A4.6.11. DATE OF BIRTH (DOB): Day, Month, Year

A4.6.12. SEX

A4.6.13. RACE

A4.6.14. REASON FOR REQUEST: Check OTHER. Type in the following statement: Requires access to JB MDL in performance of contract with (your company name and address information).

87 SFS Attachment 5 - Contractor Entry Authority List (EAL) Requirements

A5.1. The EAL must include the following information regarding the contractor:

A5.1.1. Company Name, A5.1.2. Company Address, A5.1.3. Company Point of Contact (POC), A5.1.4. Company POC Phone number, A5.1.5. Company On Site Contact name, A5.1.6. Company On Site Phone number, A5.1.7. Contract Number A5.1.8. Purpose of contract, A5.1.9. Duration of contract (Start and End Dates) A5.1.10. Location where contract is to be performed.

A5.1.11. JB MDL Unit POC Name and Grade, A5.1.12. JB MDL Unit of Sponsor A5.1.13. JB MDL Unit POC Phone number A5.1.14. Administrative Contracting Officer POC A5.1.15. Administrative Contracting Officer POC Phone Number A5.1.16. Alphabetical listing of all contractor personnel to include full name (LAST, First Middle Initial).

A5.1.17. Social Security Number of all contractors.

A5.1.18. Driver’s license number and state of all contractors.

A5.1.19. Immigration number or passport number for all Non-U.S. legal immigrants.

A5.2.. Subcontractors must be processed in the same manner as a prime contractor.

A5.2.1. Subcontractors require all the above listed information and the following additional information which must be submitted:

A5.2.1.1. Sub contractor company Name, A5.2.1.2. Sub contractor company Address, A5.2.1.3. Sub contractor company Point of Contact (POC), A5.2.1.4. Sub contractor company POC Phone number, NOTE: Any retired military or government personnel working as a contractor must be included on the EAL.

EAL SAMPLE - YOUR COMPANY LETTERHEAD HERE

DATE

FROM: (Your Company Address Information)

MEMORANDUM FOR 87th Security Forces Squadron Entry Screening Facility

SUBJECT: Entry Authority List (EAL)

1. The (Your Company Name) will be working on Contract Number (Example: F12958-06-C-0092) for the purpose of building the new Temporary Lodging Facility near bldg 2717 from 1 May 2006 through 31 May 2008.

2. My onsite POC will be (Example) John J. Johnson, and his on site phone number is (Example: (123) 456-7890).

3. The JB MDL Unit POC is (Example: Lt Tom T. Thompson) from the (insert unit name Ex: 87 SFS, 819 GRS, (87 CES), his phone number is (Example: (456)789-0123).

4. The Procurement/Administrative Contracting Officer is (Example: Mrs. Joan J. Jett) and her phone number is (Example: (789) 012-3456).

5. The following personnel will be required to access JB MDL on a daily basis for the length of the contract.

LAST, First, MI SSAN Driver’s License

EXAMPLES:

6. If there are any questions, please contact me at (098) 765-4321.

1st Endorsement, Contracting Officer

END OF SECTION 01000

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