AMENDMENT 0001 - NCIC Screening and Pass Request (Field House).pdf

PDF 207 KB Posted

Attached to
Field House Child Play Area Fence Upgrade
Solicitation number
FA460024Q0026
Issued by

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Written by GovTribe AI ·

This document is an Amendment to a contract for NCIC Screening and Pass Request at Offutt Air Force Base. It outlines the process for collecting personally identifiable information (PII) from contractors and vendor personnel who require access to the installation. The information to be provided includes full name, date of birth, driver's license/ID number and state, Social Security number, work schedule, and citizenship status. This information is collected under the authority of 10 U.S.C. 8013 and DoD regulations. Providing the information is voluntary, but failure to do so will result in denied entry to the installation. The information will be maintained by the local Security Forces and properly disposed of when no longer needed. The document includes a spreadsheet template for submitting the required personnel information.

The related federal contract opportunity is for upgrading the Child Play Area fence at Offutt Air Force Base's Field House. The current fence is degrading and requires the replacement of the plexiglass panels with upgraded acrylic panels, protective padding, and new gates with latching systems. This solicitation is being issued by the Department of the Air Force Air Combat Command.

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AMENDMENT 0002 - CPA Fence - Combined Synopsis_Solicitation - 5.28.24.pdf PDF
AMENDMENT 0002 - NCIC Screening and Pass Request (Field House).pdf PDF
AMENDMENT 0001 - CPA Fence - Combined Synopsis_Solicitation - 5.20.24.pdf PDF
CPA Fence - Statement of Work - 5.7.24.pdf PDF
CPA Fence - Combined Synopsis_Solicitation - 5.14.24.pdf PDF

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Contract#:

Contract Start/End Dates: Unit Commander or Security Manager Sig Block

Full Name Country of Last, First, MI Year Month Day Drivers License/ID # State SSAN Days Hrs Start Date - End Date (MMDDYYYY) Citizenship

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.

55 SFS CONTRACTOR/VENDOR NCIC SCREENING & PASS REQUEST SPREADSHEET

Date of Birth

Offutt AFB Sponsoring Agency / Unit:

Base Sponsor's Name:

Base Sponsor's Phone #:

Request Date:

Work Schedule

Company Name:

Company Address:

Company Representative Name:

Company Representative Phone Number:

NOTE:

Security Manager will ensure all listed personnel are briefed that they must present a REAL ID ACT compliant drivers license, or state ID, or an approved alternate form of photo identification upon arrival at Offutt AFB Visitor Control Center.

Contract Start/End Dates: Unit Commander or Security Manager Sig Block 55 WG/IP Sig Block - Needed For Non U.S. Visitors

Contract Start/End Dates: Unit Commander or Security Manager Sig Block 55 WG/IP Sig Block - Needed For Non U.S. Visitors

Sheet1

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Comapny Name:
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Sponsoring Squadron: Field House/55 FSS
Sponsor's Name: Daniel Luizzi
Sponsor's Phone Number: (402) 264-0644
Request Date: 23 May 2024
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