Attach-5_Site_Visit_Reservation_Form.pdf

RFQ#: FA5270-15-Q-0077

Attach-5

SITE VISIT RESERVATION FORM

Date of Site Visit: 31 July 2015 Time: 10:00 a.m.

INSTRUCTIONS Please complete and EMAIL or FAX this form to shizuka.miyara.jp@us.af.mil by 28 July 2015, 10:00 a.m. Japan Time. If your company wishes to attend the meeting, it is the contractor’s responsibility to verify that this has been received by 18CONS/LGCB, Bldg 95.

Contact Name Shizuka Miyara/18 CONS/LGCB, Bldg 95, Kadena AB Email shizuka.miyara.jp@us.af.mil Phone 098-938-1111 ext 634-7737 (DSN 634-5837) Fax 098-938-1111 ext 634-4795 (DSN 634-4795)

NAME OF THE FIRM: _____________________________________________________________

ADDRESS: _____________________________________________________________

POINT OF CONTACT: _____________________________________________________________

E-MAIL ADDRESS: _____________________________________________________________

PHONE No: ____________________________ FAX No: ____________________________ MOBILE PHONE No: ____________________________

Meeting Place & Time: Bldg-950, Camp Kinser, Okinawa Japan at 31 July 2015, 09:50 a.m.

Due to the limited space in the parking lot, we would appreciate if you could carpool.

Name of the individuals to attend the site visit (Maximum of Two):

1._________________________________________________________________________________________ Name of Attendee Need Escort: YES NO.

2._________________________________________________________________________________________

Name of Attendee Need Escort: YES NO.

Name & Signature of Requester: ____________________________ Cell Phone: ____________________________ Date: ______________