Attachment 4 - Base Access Request Form.docx
DOCX document 76 KB Posted
- Attached to
- Asbestos Abatement - B1411 Barbershop
- Solicitation number
- FA480324QB069
About this file
This document is a Base Access Request Form from the Department of the Air Force 20th Fighter Wing at Shaw Air Force Base. The form is being submitted by SrA Cesar Tapia-Caballero of the 20th Contracting Squadron to request access to Building 1411 and other support agencies for a site visit related to the 20 CONS Annual Multiple Award Construction Contract. The site visit is scheduled for April 25, 2024. The form includes personal information about the individuals requiring base access, such as full legal name, date of birth, social security number, and driver's license number. It also states that the sponsor, SrA Tapia-Caballero, is responsible for ensuring the individuals turn in their DBIDS passes when no longer required.
This Base Access Request is related to a federal contract opportunity with Solicitation Number FA480324QB069 for Asbestos Abatement services in Building 1411 at Shaw AFB. The contractor will be required to provide asbestos abatement services in accordance with the Performance Work Statement provided as Attachment 1.
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Text version
DEPARTMENT OF THE AIR FORCE
20th FIGHTER WING (ACC)
SHAW AIR FORCE BASE SOUTH CAROLINA
DATE: 15 April 2024
MEMORANDUM FOR 20 SFS/S-5V TSgt Kolby Davis kolby.davis.1@us.af.mil, Ms. Jacqueline Hernandez-Sears jacqueline.hernandez-sears.1@us.af.mil or fax 803-895-5337 803-895-9085 or 803-895-9086) FROM: 20CONS/PKA SrA Cesar Tapia-Caballero
SUBJECT: Request for Base Access / Mead Hunt background request
WHO: 20th Civil Engineering, 20th Contracting Squadron and AFCENT
WHAT FOR: 20 CONS Annual Multiple Award Construction Contract
WHERE: BLDG 1411
Allow access to bldg. 1411 and other support agencies to attend site visit for bldg. 1411.
WHEN: 25 April, 2024
SPONSOR: SrA Cesar Tapia-Caballero 20th Contracting Squadron
CONTACT INFO: cesar.tapia-caballero@us.af.mil 803-895-5499
The information below is protected under Privacy Act 1974 and will only be used to process Criminal Background History Checks to grant or deny access to Shaw AFB. It is further understood that anyone abusing approved privileges could, at a minimum, lose said privilege and possibly face criminal charges.
Full Legal Name (Last, First MI) Date Of Birth (Year/Mo/Day) Social Security Number
| ST-DL # |
| U.S. |
Citizen (Y/N)
| Doe, John |
| 2000/01/01 |
| 111-11-1111 |
| SC - 000000000000 |
| Yes |
I UNDERSTAND THAT AS THE SPONSOR I AM RESPONSIBLE FOR THE PERSON(S) LISTED ON THIS FORM, AND FOR ENSURING THE ABOVE NAME INDIVIDUAL(S) TURNS IN THE DBIDS PASS OR RETRIEVE THE PASS ONCE THE INDIVIDUAL(S) ARE TERMINATED, QUIT, OR NO LONGER REQUIRES ACCESS. IF I AM NOT ABLE TO RETRIEVE THE PASS I WILL NOTIFY SECURITY FORCES TO HAVE THE INDIVIDUAL(S) PASS DEACTIVATED IN DBIDS.
This form must be sent by the sponsor from their government email and received at the email addresses/fax number listed above in the 20 SFS/S-5V section.
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