3. SFS ACL template.docx

DOCX document 35 KB Posted

Attached to
REPAIR RUNWAY 32 PAVEMENT PHASE 3
Solicitation number
FJXT220010
Issued by

About this file

This document is a memorandum requesting access to Dover AFB for a contractor site visit related to contract FA449724R0015. The request is made by TSgt Joshua Brooks, the Administrative Contracting Officer, and lists the required entry information for the individuals needing access on July 18, 2024 from 7am to 5pm.

The related federal contract opportunity is for a project to repair 2,100 linear feet of Runway 14/32 at Dover AFB. The project includes milling, repaving, crack sealing, and restriping the runway and shoulders. It is solicitation number FJXT220010 issued by the Department of the Air Force Air Mobility Command. The contract requires providing all labor, materials, and equipment necessary to complete the work in accordance with the Statement of Work.

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Text version

Date:

MEMORANDUM FOR: 436th SFS/S5B

FROM: 436 CONS/PKA

SUBJECT: Request for Dover AFB Access Control List

1. Sponsor’s Full Name and Grade: TSgt Joshua Brooks / PKA CO Sponsor’s Contact Phone # Military/Home 677-5232 Sponsor’s Military/Home Address: 639 Atlantic Street, Dover AFB Email Address: Joshua.brooks.14@us.af.mil Sponsor’s Affiliation with Dover AFB: Active Duty: X Reserve:

National Guard: Retired Military Member: DoD Civilian:

Will the sponsor be attending the event? Yes X No

2. Request the below listed individual/personnel be granted entry to:

Dover AFB, DE 19902 Location of event

Contractor Site Visit for work to be conducted on contract FA449724R0015 Reason for request

Access date/time: 18 July 2024; 7am-5pm daily Required access will be from (Inclusive dates and times)

3. The below personal information is provided for individuals requiring access.

All information contained below must be protected under the Privacy Act of 1974 (see AFI33-332). Do not release outside of DoD channels without the consent of the originator's.

LAST NAME, FIRST MI DATE OF BIRTH DRIVER’S LICENSE

//SIGNED//

JOSHUA J. BROOKS, TSgt, USAF
Administrative Contracting Officer

Revised: 3 November 2016 Page 1 of 1

File details come from the government source that posted it. Updated .