_7 _Site_Visit_Registration.doc

ATTACHMENT 7

CONTRACTOR SITE VISIT REGISTRATION FORM

INSTRUCTIONS: Please complete and return this form to 2Lt Megan VanHorn by no later than 1400 Central Standard Time on 08 May 2015, if you wish to attend the site visit. Completed forms may be submitted to the following address. Completed forms may also be sent via e-mail to megan.vanhorn.1@us.af.mil

Address:

7th Contracting Squadron

Attn: 2Lt Megan VanHorn

381 Third Street

Dyess AFB TX 79607

Name & Address of Firm:

Point of Contact: _______________________________________________________

E-Mail Address: ________________________________________________________

Phone No.: _________________________ Fax No.:_________________________

Number of individuals to attend the contractor site visit: ____________

CONTRACTOR/VENDOR LIST

Name of Prime Contractor:

Name of Sub Contractor:

Contract For/or Type of Service:

Contract Number:

Start Date:

Completion Date:

Duty Phone:

Vouch

Y or N

YY/MM/DD

N

N

N

N

N

N

N

N

N

The above information is correct to the best of my knowledge. The contractor or designated employee must sign, date and print name in signature block below.

Printed Name:

Signature:

Date:

SPONSOR INFORMATION ONLY:

NO

HOURS

By signing below I certify that I have a DD Form 557 (Signature Card) on file at Pass & Registration. (Ext 696-3088)

Printed Name:

Signature:

Date:

Privacy Act Statement

Information contained herein is personal and will not be disclosed to the public without permission of the individual, IAW AFI 37-312. DYESS FORM 173