FA4861-17-R-A020_Pass_Template_Attachment_2.xlsx
XLSX spreadsheet 21 KB Posted
- Attached to
- Fire Suppression System Maintenance Federal contract opportunity
- Solicitation number
- FA4861-17-R-A020
About this file
Pass Template
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| FA4861-17-R-A020_Questions_&_Answers.pdf | ||
| FA4861-17-R-A020_PWS_Updated_18_January_2017.pdf | ||
| Jan_6_Revised_Draft_Fire_Suppression_System_PWS.pdf | ||
| FA4861-17-R-A020_PWS_Dated__14_December_2016_Attachment_1.pdf | ||
| FA4861-17-R-A020_WD_2015-5593_Attachment_3.pdf |
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Text version
Sheet1
| Sponsor Name: | |||||||||||
| Sponsor signature: | |||||||||||
| Contact Number(s): (Primary/Alternate) | |||||||||||
| Company | Last Name | First Name | MI | Country of Citizenship | Permanent Resident Card# | DOB | SSN | State AND DL#/ID# | Location(s) | Valid Dates(s) | Valid Day(s) & Hrs |
JUSTIFICATION:
Note 1: Specify in detail justification requesting the person(s) listed above having unescorted access. (i.e. requires access 3 times a week to service vending machines on Nellis AFB) Note 2: If you are using a Driver’s License from California, Colorado, Connecticut, District of Columbia, Illinois, Maryland, Utah, Vermont and Washington states an additional form of government issued ID is required (i.e. US Passport, original Birth Certificate with raised seal, original Social Security Card, etc. Note 3: If individuals are listing another country other than the US for residency please include a copy of their permanent resident card or work permit.
I certify, in accordance with FAR 52.222-54 "Employment Eligibility Verification" that I have performed checks on all above listed employees through the E-Verify system.
Printed Name Signature
(PRIMARY CONTRACTOR NAME)
(PROJECT NAME)
INFORMATION MUST BE TYPED
The individuals listed below have been thoroughly briefed on entry procedures and conconduct while on Nellis/Creech AFB.
Sheet2
Sheet3
File details come from the government source that posted it. Updated .