Att_19_EAL.xlsx

XLSX spreadsheet 21 KB Posted

Attached to
Building 500 (LeMay Complex) Maintenance and Repair Services Federal contract opportunity
Solicitation number
FA4600-16-R-0012
Issued by
Department of the Air Force Air Combat Command

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Attachment 19 - EAL

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EAL Blank Template

Last, First, Middle InitialGender M/FDOB (year month day)Drivers License Number/StateState of IssueCompany NameNationality/Passport #/Visa #/INS # (if non us citizen)Place of citizenship /Place of BirthCitizenship date (if naturalized citizen)Foreign continuous or routine contacts (name, country, relationship/method of contact) (list all)
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PRIVACY ACT STATEMENT Authority: 10 U.S.C. 8013 and Executive Orders 13478 and 9397 as amended (SSN). Purpose: Information collected by PMO Security will be used to authorize
installation entry to persons shown on the entry authority listing for the specific purpose provided by the sponsor. Information will also be used to notify person(s) designated as the visitor
sponsor of arrival and other pertinent information relating to entry on the installation. Routine Uses: Records may be disclosed to applicable Federal, State, or local agency charged with the
responsibility of investigating or prosecuting a violation or enforcing/implementing a statute, rule, regulation, order issued pursuant thereto.
Disclosure: Disclosure of requested information is voluntary. Failure to provide all or parts of information requested can result in denial of installation entry. System of records number
F031 AF SF B, applies. Security Forces Management Information System (SFMIS)

CONTRACTOR PERSONAL INFORMATION LIST FOUO FA4600-16-R-0012

Attachment 19

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