Attachment_6_SFS_Form_30.pdf
PDF 20 KB Posted
- Attached to
- Drop Arm Barrier Federal contract opportunity
- Solicitation number
- FA4897-19-R-A015
About this file
SFS Form 30
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Abstract_of_Offers.pdf | ||
| Abstract_of_Offers.pdf | ||
| Attachment_9_CRASHBEAM_TYPICALDRAWINGS_BARRIER1SYSTEMS_M50(K12)_20190226-01-PD.pdf | ||
| Attachment_8_Additional_QA.pdf | ||
| Solicitation_Amendment_FA489719RA0150003_SF_30_(1).pdf | ||
| Solicitation_Amendment_FA489719RA0150002_SF_30.pdf | ||
| Solicitation_Amendment_FA489719RA0150001_SF_30.pdf | ||
| Attachment_7_Q_and_A.pdf | ||
| Attachment_2_GateArm_Perimeter_SOW.pdf | ||
| Attachment_3_Environmental_Specs.pdf | ||
| Attachment_4_-_Wage_Determinations.pdf | ||
| Attachment_5_-_Certificate_of_Insurance.pdf | ||
| Solicitation_-_FA489719RA015.pdf | ||
| Attachment_1_Perimeter_Barrier_SitePlan.pdf |
Show all 14
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Text version
FOR OFFICIAL USE ONLY
MEMORANDUM FOR 366 SFS/S5B
FROM:
SUBJECT: Request for Installation Entry Pass (366 SFS Form 30)
1. The following individual is requesting issuance of a Base Access Pass for the reason/time period listed.
This letter is submitted IAW the 366 FW/Installation Defense Instruction.
TYPE/FILL OUT LEGIBLY OR APPLICATION WILL NOT BE PROCESSED
APPLICATION MUST BE FILED TWO WEEKS IN ADVANCE OF NEEDING BASE ACCESS
1. FULL NAME (FIRST, FULL MIDDLE NAME, LAST)
2. GENDER
M F
3. SSAN
4. DATE OF BIRTH (YYYY/MM/DD)
5. DRIVERS LICENSE NUMBER (OR PASSPORT NUMBER)
6. STATE
7. CONTRACT DATES / DATES OF VISIT
8. DUTY HOURS / TIME FRAME OF VISIT
9. DAYS REQUIRED (i.e. M/W/F)
10. EMPLOYED BY / SPONSORS NAME & EMAIL ADDRESS
11. SPONSOR’S PHONE #
2. Does the contractor require access to classified material: YES NO
3. Individual listed has been informed a background and local files check will be conducted. The individual has been informed that disclosure of the above information is voluntary; however, failure to do so could result in the individual being denied access to the installation.
Printed Name & Signature of Sponsor 1st Ind, 366 SFS/S5B Agency/Duty Title/Phone #
MEMORANDUM FOR:
Approved/Disapproved Authenticated on __________________ by (Date)
(Signature)
(Printed name & grade) 366 SFS/S5B
PRIVACY ACT STATEMENT: Authority: 50 U.S.C 797 and DOD Directive 5400 B
PRINCIPAL PURPOSES: To identify personnel requesting unescorted entry on to MHAFB who are Official Business Guests/ Students/Visitors/Houseguests/Designated Agents/MHSD Employees/FW-CC Sponsored Guests. ROUTINE USES: Information will be used to conduct a wants and warrants, criminal history check through the Air Force Law Enforcement Terminal System (AFLETS) and the local files check at the security police reports and analysis section (366 SPS/S5R).
DISCLOSURE IS VOLUNTARY: Failure to provide the information could result in the individual being denied base access. This letter of request will be sent to 366 SFS/S5B two weeks prior to the date the individual concerned requires the pass. 366 SFS FORM 30, Oct 2013
DISPOSITION: This document is for official use only once completed; if this document is no longer in use shred it for protection of the contents.
FOR OFFICIAL USE ONLY
MEMORANDUM FOR 366 SFS/S5B
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