NCIC Screening Pass Request 2025.pdf

207 KB Posted

Attached to
Fire Alarm Maintenance
Solicitation number
FA460025Q0030
Issued by

About this file

Written by GovTribe AI ·

The document is a 55 SFS Contractor/Vendor NCIC Screening & Pass Request Spreadsheet for Offutt Air Force Base, specifically related to the Fire Alarm Maintenance contract (Solicitation Number FA460025Q0030). The spreadsheet is designed to collect personally identifying information (PII) for contractors and vendors who will be accessing the installation, with the base sponsor being Austin Palrang from the 55 CONS unit. The form requires detailed personal information including full name, date of birth, driver's license/ID number, work schedule, and country of citizenship. The document emphasizes that all listed personnel must present a REAL ID ACT compliant photo identification upon arrival at the Offutt AFB Visitor Control Center, and that providing the requested information is voluntary but necessary for base entry.

The contract opportunity itself involves replacing and testing fire alarm control panels and devices in three specific buildings (Buildings 123, 441, and 584) at Offutt Air Force Base, under the jurisdiction of the Department of the Air Force Air Combat Command. The spreadsheet provides multiple pages for listing contractor personnel, with additional signature blocks for the Unit Commander, Security Manager, and a special 55 WG/IP block required for non-U.S. visitors. The request date is set for 29 Apr 2025, indicating this is a future contract preparation document for managing contractor access and security screening.

View the file

Other files

File Type Posted
FA460025Q0030 Questions and Answers.pdf PDF
Combined diagrams_FA460025Q0030.pdf PDF
Solicitation Amendment FA460025Q00300001 SF 30.pdf PDF
Solicitation - FA460025Q0030.pdf PDF
PWS_ Fire Alarm Repairs_FY 2025.pdf PDF
Fire Alarm Standardization Memo JandA_Redacted.pdf PDF
SCA Wage Determinations.pdf PDF

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

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

Name1:
1:
0:
2:
3:
4:
1:
5:
0:
1:
2:
3:
4:
5:
6:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
0:
2:
1:
Year1:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
15:
16:
17:
18:
19:
20:
21:
22:
23:
24:
Month1:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
18:
19:
20:
21:
22:
23:
0:
1:
Day1:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
18:
19:
20:
21:
22:
23:
DriversLicense1:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
18:
19:
20:
21:
22:
23:
State1:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
18:
19:
20:
21:
22:
23:
Comapny Name:
Company Address:
Company Rep Name:
Company Phone Number:
Sponsoring Squadron: 55 CONS
Sponsor's Name: Austin Palrang
Sponsor's Phone Number: 232-6458
Request Date: 29 Apr 2025
SSN1:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
18:
19:
20:
21:
22:
23:
Days1:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
18:
19:
20:
21:
22:
23:
Hours1:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
18:
19:
20:
21:
22:
23:
Start Date - End Date:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
18:
19:
20:
21:
22:
23:
Citizenship:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
18:
19:
20:
21:
22:
23:

Text1: FA460025Q0030

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