2a._Gate_Pass_Request.pdf
PDF 117 KB Posted
- Attached to
- Refuse Collection, Transportation and Disposal Services at Akizuki Ammunition Depot, Hiroshima, Japan
- Solicitation number
- FA5209-18-Q-0052
About this file
2a. Gate Pass Request Form
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Other files
| File | Type | Posted |
|---|---|---|
| 3.__RFQ_(18Q0052).pdf | ||
| 1._Business_w_US_Government.pdf | ||
| 2._Notice_to_Offerors.pdf | ||
| 4._Atch_1_PWS_(FBO).pdf |
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Text version
Attachment 1 to Notice to Offerors
ONE TIME/MULTIPLE ACCESS ROSTER (Information for Form USAG-J 1529)
RFQ No. (入札書番号) FA5209-18-Q-0052
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
Japan
* 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 offeror, 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.
**Vehicle License
Plate No.
(車両ナンバー)
Kanji（漢字）
(例) 横田太郎 (Ex) x-x, XX-cho, XXXX-shi, Kanagawa, Japan, xxx-xxxx xxx-xxx-xxxx SAGAMI 30x XX xx-xx1 XXXXXXXXX
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