Attatchment_3_VETTING_SPREADSHEET.xlsx

XLSX spreadsheet 36 KB Posted Nov 30, 2018

Attached to: USSTRATCOM Bldg. 1000 Facility Clean Up Federal contract opportunity
Solicitation number: FA4600-19-R-0001
Issued by: Department of the Air Force Air Combat Command

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Vetting Information

Other files attached to USSTRATCOM Bldg. 1000 Facility Clean Up, newest first.
File	Type	Posted
Q&A_Round_3.pdf	PDF	Feb 1, 2019
Solicitation_Amendment_FA460019R00010003_SF_30.pdf	PDF	Feb 1, 2019
PWS_v3_2019_01_30_-_STRAT_Post_Construction_Clean.pdf	PDF	Feb 1, 2019
PWS_v2_2019_01_23_-_STRAT_Post_Construction_Clean.pdf	PDF	Jan 23, 2019
FA4600-19-R-0001_Amendment_3.pdf	PDF	Jan 23, 2019
Q&A_Round_2.pdf	PDF	Jan 23, 2019
Solicitation_Amendment_FA460019R00010001_SF_30.pdf	PDF	Jan 2, 2019
Attachment_4_Q&A_Round_1.docx	DOCX document	Jan 2, 2019
FA4600-19-R-0001_Amendment_1.pdf	PDF	Dec 6, 2018
J4._DODM_5200.01,_Vol._4.pdf	PDF	Nov 30, 2018
Attatchment_1_PWS_-_STRAT_Post_Construction_Clean.pdf	PDF	Nov 30, 2018
FA4600-19-R-0001.pdf	PDF	Nov 30, 2018
J0_-_How_to_obtain_Government_Furnished_Information.pdf	PDF	Nov 30, 2018
J5._Contractor_Validation.xls	XLS spreadsheet	Nov 30, 2018
J3._DODI_8582.01.pdf	PDF	Nov 30, 2018
Attatchment_2_Wage_Determination_Standards.pdf	PDF	Nov 30, 2018
J1._Certificate_Pertaining_to_Foreign_Interests_SF328.pdf	PDF	Nov 30, 2018
J2._NDA_Agreement.pdf	PDF	Nov 30, 2018

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	Name Last, First, Middle Initial	Social Security # 000 00 0000	Gender Male/Female	DOB (1980 Jan 31)	Drivers License Number	State of Issue	Company Name / Unit	Nationality/Passport #/Visa #/INS # (if non us citizen)	Place of citizenship /Place of Birth	Citizenship 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 &D

Authorized Escort List

55 SFS CONTRACTOR/VENDOR/DV PASS REQUEST SPREADSHEET
Personally Identifying Information (PII) being collected by this form is authorized for collection under provisions of 10 U.S.C. 8013, Secretary of the Air Force, DoD 5200.2R, DoD Personnel Security Program; AFI 33-202, Computer Security, Information will be maintained by local Security Forces Authority while access requirements exist. Information access is restricted to personnel responsible for contract administration, or otherwise needed in the performance of official DoD duties. Information will be properly disposed of when its required use has been concluded. Providing this information is voluntary; however, failure to provide all of the required data shown on the spreadsheet will result in denial of entry to the installation. This information is exempt from OMB licensing under provisions of AFI 33-324, Information Collections and Reports Management Program; Controlling Internal, Public, and Interagency Air Force Collections, paragraphs 3.16.11 and 3.16.16.3.
Sponsoring Unit:					Company Name:
Sponsor's Name:					Address:
Phone #: (Work/Cell)					Phone Number:
Request Date:
Full Name	Date of Birth					Work Schedule		Effective	Escort	Mission Critical Access
Last, First, MI	Year	Month	Day	Drivers License/ID #	State	Days	Hrs	Dates	Yes / No	FPCON: A, B, C, D

Gregory.Derkatch: Cannot exceed 1-year

Gregory.Derkatch: Escort Limitations: Privileges are limited to 3 per every 10 contractors

Gregory.Derkatch: Insert one of the following ID numbers: State drivers license, state ID card, passport, or immigration card

Gregory.Derkatch: Mon-Fri Mon-Sat Mon-Sun

Gregory.Derkatch: Use 24 hr clock format 24 Hr access requests must be coordinated through the 55 SFS/S-3 or S-3S for approval

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