Atch_10,_HAFB_Site_Visit_eVAR.PDF

HOLLOMAN AFB

VISIT ACCESS REQUEST

(VAR)

MEMORANDUM FOR: 49 SFS/S5AV (49 SFS Pass and Registration)

(UDG_49SFS_VARandEAL@us.af.mil)

FROM:

SUBJECT: Contractor Visit Access Request (VAR) References:

a. Contract Number: ______________ Contract Title: ______________

b. Start Date: ____________________ End Date: __________________

c. Requesting Office: _______________________

d. Requesting Office Phone: _________________

e. HAFB Point of Contact:

Name______________________________________________ Telephone #_________________________________________ E-mail address _______________________________________

VAR's may be used for multiple contracts for the same company and may take up five (5) days to process.

Request that a visitor pass be issued to the contractor(s) listed below. All employees will be briefed on and shall comply with HAFB security requirements. All employees have signed the government provided consent form authorizing the U.S. Government (United States Air Force) to conduct a background check to confirm their eligibility to be granted access to HAFB, NM. Contractors denied unescorted entry as a result of their background check may be approved for escorted entry by the 49 SFS/CC. Escort authority will ONLY be granted to the project manager or project superintendent (maximum of three (3) three escorts per VAR designated by asterisk on a VAR and has completed a Escort Responsibility Form), or a contractor with a valid DoD Common Access Card (CAC) may also escort employees approved for escorted entry. Contractor escort authority is limited to ONLY those employees approved for escorted entry. EXCEPTION: The project manager or project superintendent, or a contractor with a valid DoD CAC may escort non-routine pickups and deliveries. Pickup/delivery drivers will provide a bill of lading at the time of pass issuance; passes will not exceed six (6) hours. Routine pickups and deliveries require the contractor add the driver(s) to a VAR to undergo the appropriate background check. All VARS must be typed and emailed to the Welcome Center.

Contractors shall report to the 49 SFS Welcome Center (Bldg. 1) with photo identification issued by a federal/ state activity. Employees requesting to operate a company or privately owned vehicle on the installation shall provide a valid driver’s license, current vehicle registration, and proof of current vehicle insurance or car rental agreement.

All Foreign Nationals requesting access to HAFB (for official and unofficial visits) must provide three

(3) valid forms of ID consisting of: A state issued drivers license/ID card, Social Security card, Resident alien card, Employment Authorization Document, or Passport/Birth certificate.

NCIC

Current as of 26 JUL 16 The information herein is For Official Use Only (FOUO) which must be protected under the Freedom of Information Act of 1966 and Privacy Act of 1974, as amended. Unauthorized disclosure or misuse of this PERSONAL INFORMATION may result in criminal and/or civil penalties.

The requestor will ONLY request access for job duration not to exceed one year or contract end date. The requesting company/organization will retrieve all credentials from employees when job is completed or employee is terminated. The requesting company/organization will then return collected terminated access credentials to sponsoring agency in turn the sponsoring agency will return all credentials to the issuing office, 49 SFS/S5AV.

1039059181C Typewritten Text

1039059181C Typewritten Text

SFS USE

ONLY #

FULL LEGAL NAME

LAST, FIRST, MI AND

ISSUING STATE OF ID

OR DL

SSN DOB

(DD MMM YYYY)

CITIZENSHIP/

PERM RESIDENT

#(REQUIRED)

STATUS NAME SSN DOB CITIZENSHIP

1 NAME SSN DOB

2 NAME SSN DOB

3 NAME SSN DOB

4 NAME SSN DOB

5 NAME SSN DOB

6 NAME SSN DOB

7 NAME SSN DOB

8 NAME SSN DOB

9 NAME SSN DOB

10 NAME SSN DOB

11 NAME SSN DOB

12 NAME SSN DOB

13 NAME SSN DOB

14 NAME SSN DOB

15 NAME SSN DOB

16 NAME SSN DOB

17 NAME SSN DOB

18 NAME SSN DOB

19 NAME SSN DOB

20 NAME SSN DOB

21 NAME SSN DOB

22 NAME SSN DOB

23 NAME SSN DOB

24 NAME SSN DOB

25 NAME SSN DOB

26 NAME SSN DOB

27 NAME SSN DOB

28 NAME SSN DOB

29 NAME SSN DOB

30 NAME SSN DOB

31 NAME SSN DOB

32 NAME SSN DOB

33 NAME SSN DOB

34 NAME SSN DOB

35 NAME SSN DOB

36 NAME SSN DOB

37 NAME SSN DOB

Company Name:_____________________________________

2 Current as of 26 JUL 16 The information herein is For Official Use Only (FOUO) which must be protected under the Freedom of Information Act of 1966 and Privacy Act of 1974, as amended. Unauthorized disclosure or misuse of this PERSONAL INFORMATION may result in criminal and/or civil penalties.

HOLLOMAN AFB

VISIT ACCESS REQUEST

(VAR) cont.

CONTRACTOR VISIT INFORMATION:

* Visitor passes will NOT exceed contract performance period or 1 year, whichever is less. Badges will only be issued within three (3) duty days prior to the start date.

Period of visit: ___________________ to ___________________ (Dates Requested)

Visiting hours: ___________________ to ___________________ (ex. 0600-1730)

Reason for visit: ________________________________________ (Brief description of work)

Visit location: ______________________________________ (Be specific; bldg/room(s), etc.)

Sponsoring Organizations WILL return ALL issued access credentials to 49 SFS/S5AV once the contract has been completed and/or the individual no longer requires access.

Please direct any questions to me (company official) at _________________.

By selecting "YES" you certify the attached information is true and correct.

Signature of Company Official _________________________ Date _____________

Typed/Printed Name _________________________

Job Title/Company Name _________________________

I have reviewed and approved this visit access request.

Signature of Sponsoring Unit __________________________ Date _____________

CC/Unit Security Manager/

Designated Contracting Official

Typed/Printed Name __________________________

Duty Title __________________________

Current as of 26 JUL

The information herein is For Official Use Only (FOUO) which must be protected under the Freedom of Information Act of 1966 and Privacy Act of 1974, as amended. Unauthorized disclosure or misuse of this PERSONAL INFORMATION may result in criminal and/or civil penalties.

SPONSORING UNIT PLEASE READ BELOW

All civilian contractor identified on a VAR are going to be issued a Defense Biometric Identification System (DBIDS) credential from the Holloman AFB Welcome Center. All credentials issued will not exceed Force Protection Condition (FPCON) Bravo. If the sponsoring unit that has reviewed and approved a VAR and finds it necessary for a civilian contractor to have access at a higher FPCON not to exceed Charlie, the sponsoring unit commander will need to complete, sign and submit a FPCON Charlie access memorandum to the Holloman AFB Welcome Center. The memorandum must contain the civilian contractor’s name, duty title and a brief description of his/her specific duties that require access during FPCON Charlie. At no time will a civilian contractor listed on a VAR be eligible for FPCON Delta Access.