2b.__Gate_Pass_Request.pdf
PDF 64 KB Posted
- Solicitation number
- FA5209-15-T-0042
About this file
2b. Gate Pass Request for Site Visit
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Other files
| File | Type | Posted |
|---|---|---|
| 1.__Govt_Policy_Ltr.pdf | ||
| 5.__Atch_2_(PPI_List).pdf | ||
| 2a._Notice_to_Offerors.pdf | ||
| 4.__Atch_1_PWS_(Except_A-1_ _A-2).pdf | ||
| 3.__RFQ.pdf | ||
| 7.__Subcontractor_Consent.pdf | ||
| 6.__Atch_3_(PP_Survey).pdf |
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Text version
Attachment 1 to Notice to Offeror
ONE TIME/MULTIPLE ACCESS ROSTER (Information for Form USAG-J 1529)
RFQ No. (入札書番号):
Company Name (社名):
Name（氏名） 1* Driver's License No.
(運転免許証番号）
Nationality（国籍） 2* Passport No.
(パスポート番号）
(Ex) YOKOTA, Taro SAGAMI XXX
Japan HO XX-XX
* Select 1 or 2, and provide the information of your choice. (1か2を選び、選択した項目の情報を御記入ください。)
** Please come to the installations by car (1 vehicle per offeor, please). Please provide the vehicle license plate number.
(当日はお車でお越し下さい。但し1社1台でお願いします。車両のナンバープレート番号を御記入ください。)
SPECIAL ATTENTION FOR DRIVING IN THE U.S. FORCES JAPAN INSTALLATIONS:
1. Any vehicles driving in the U.S. Forces Japan installations must have a liability insurance that covers at least 30,000,000 yen for bodily injury and 3,000,000 yen for property damage. (在日米軍施設内を走行する車両は、対人保障3000万円以上、対物保証300万円以上の補償額の任意保険が必要です。）
2. The driver needs to present the certificates of (1) automobile inspection (original ), automobile liability insurance (original) and voluntary insurance (copy) of the vehicle.
(入門の際、車両運転者は車検証原本、自賠責保険証原本と任意保険証コピーの提示が必要になります。）
Address（住所） Telephone No.
(電話番号)
GATE PASS REQUEST FORM
FA5209-15-T-0042
**Vehicle License
Plate No.
(車両ナンバー)
(例) 横田太郎 (Ex) 1-1-1 Yokota, xxxxx-shi, Tokyo, Japan 111-xxxx xxx-xxx-xxxx １ 12345678XXXX
Kanji（漢字）
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