FMT RFP Attachment 02 Security Self Vetting Form.pdf

464 KB Posted

Attached to
FMT DRAFT RFP Request for Feedback
Solicitation number
W900KK25RA0003_Draft
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This is a Security Self-Vetting Form (Attachment 02) for solicitation W900KK25RA003, designed to collect security-related information from potential contractors. The form requires contractors to provide their organization name, CAGE code, SAM registration status, details about any previous government work, Facilities Clearance (FCL) status and level, and information about foreign ownership or Foreign Owned, Controlled, or Influenced (FOCI) status.

The form includes additional questions about potential mergers or purchasing discussions with foreign companies and requires detailed information about any foreign-owned or FOCI companies, including company names, CAGE codes, and countries of origin. The document is marked as Source Selection Sensitive and For Official Use Only, requiring certification by signature that all provided information is accurate and up to date.

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RFP DRAFT - W900KK25RA003 08 JAN 25.pdf PDF
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Attachment 02 Solicitation #: W900KK25RA003

Security Self-Vetting Form Page 1 of 1

Source Selection Sensitive – See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY

SECURITY SELF-VETTING FOR CONTRACTORS

To facilitate the security vetting procedures required to support your participation on FAR based contracts, please provide the following information and certify (sign) and date your responses.

1. Full Organization Name:

2. Organization Cage Code:

3. Is your organization registered in the System for Award Management (SAM) database (Yes or No)?

4. If you answered “No” to question #3, please provide information regarding any previous contracts or government work your organization has performed.

5. Does your organization have an active Facilities Clearance (FCL) (Yes or No)? If you answer “Yes,” what is the nature of the FCL (security level, possessing or non-possessing)?

6. Is your organization (or your subcontractors) foreign owned or under USA Foreign Owned, Controlled, or Influenced (FOCI) status (Yes or No)?

7. Is your organization in merger and/or purchasing discussions with a foreign company or a USA FOCI company (Yes or No)? No

8. If you answered “Yes” to question #6 or #7, please provide the following information on each foreign owned or under USA FOCI company.

a. Full Company Name:

b. Cage Code:

c. Identify Country or Origin:

I certify the information I have provided on behalf of my organization is accurate and up to date.

Printed Name Signature Date

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