AMENDMENT 0002 - NCIC Screening and Pass Request (Field House).pdf

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Attached to
Field House Child Play Area Fence Upgrade
Solicitation number
FA460024Q0026
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This document is an amendment to a contract for NCIC screening and pass requests at Offutt Air Force Base. It provides a spreadsheet template for contractors to submit information on their personnel who require access to the base, including name, date of birth, driver's license details, social security number, work schedule, and citizenship status. The information collected is authorized under U.S. law and is exempt from certain reporting requirements. The document specifies that all listed personnel must present a REAL ID Act-compliant ID upon arrival at the Visitor Control Center. The related federal contract opportunity is for the upgrade of a child play area fence at the Field House, requiring removal of the existing enclosure and installation of upgraded acrylic panels, protective padding, and new gates with a latching system.

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Amendment 0003 - CPA Fence - Q_A Responses - 6.3.24.pdf PDF
AMENDMENT 0002 - CPA Fence - Combined Synopsis_Solicitation - 5.28.24.pdf PDF
AMENDMENT 0001 - CPA Fence - Combined Synopsis_Solicitation - 5.20.24.pdf PDF
AMENDMENT 0001 - NCIC Screening and Pass Request (Field House).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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Company Rep 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: 3 June 2024
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