Foreign National Pre-Bid Site Visit Form.pdf

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Attached to
Williams Street Detention Structure, Mouse Creek Cleveland, Tennessee
Solicitation number
W912P525BA005
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About this file

The document is a Foreign National Security Form for the Nashville District Corps of Engineers, requiring comprehensive documentation for non-U.S. citizens seeking to work on Nashville District contracts or task orders. The form mandates that all non-U.S. citizens, including permanent residents, must obtain approval from the Headquarters U.S. Army Corps of Engineers Foreign Disclosure Officer at least 30 days prior to beginning contract work, with strict requirements for documentation including passport details, visa information, work location, and site access dates.

The form requires additional background investigation for non-U.S. citizens who have lived in the United States for three years, in accordance with Homeland Security Presidential Directive 12 (HSPD-12). Contractors must provide verification of legal U.S. entry, employment or immigrant visa status, and contact information for company representatives. The form includes contact details for the Nashville District Corps of Engineers Security Office personnel who will process and approve foreign national security requests, with a March 2024 revision date.

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Text version

COMPANY NAME / ADDRESS / MAIN PHONE #

Nashville District Corps of Engineers Foreign National Security Form

All non-U.S. Citizens, including permanent residents who work on Nashville District (LRN) contracts or task orders must be approved by the Headquarters U.S. Army Corps of Engineers (HQUSACE) Foreign Disclosure Officer before beginning any contract/task order work. Must be submitted 30 days in advance.

NOTE: At no time will a Contractor or Subcontractor be permitted to access the site until approved by the Nashville District Security Office and the Contractor Official has been notified.

FULL Name_______________________________________________________________________ (Last, First Middle)

• If you have only initials in your name, use them and state (IO). If you have no middle name, enter “NMN”

• If you are a “Jr.,”Sr.,” “II,” etc., you must include this

Date of Birth (mm/dd/yyyy): _________________ Citizenship (Country): ______________________

Passport # (Include copy scanned in color): _____________________________________________

Visa # (Include copy scanned in color if applicable): _______________________________________

* Visa information must be included unless country of citizenship is in the Visa Waiver Program

Work to be performed: (e.g. Plumbing, electrical) ________________________________________

Corps of Engineers Location (Project Office/ Work Site) Where Work is to be performed:

From & To Dates for Requested Site Access: ____________________________________________

Expected Arrival Date: ___________________ Job Title: ___________________________________

Method of Payment (U.S. Dollars, Euros etc.): ___________________________________________

Primary Company POC Name/Phone: _________________________________________________

Primary Company POC Email Address: _______________________________________________

In addition to the information above, the Contractor shall furnish documentation to verify he/she was legally admitted into the United States and has an employment or immigrant Visa (unless in the Visa Waiver Program). This includes, individuals living and working in the United States but are not U.S.

Citizens, such as permanent residents.

In addition to the requirements above, all non-U.S. Citizens who have lived in the United States for at least three years must also have or obtain a favorable background investigation in accordance with Homeland Security Presidential Directive 12 (HSPD-12) (guidance provided separately).

Nashville District Corps of Engineers Security Office Contact Information:

*Tracy Dorrough, Security Technician, 615-73-7397 email: tracy.dorrough@usace.army.mil Jay Klinger, Security Specialist, 615-736-2185 email: jason.j.klinger@usace.army.mil

* Primary - Personnel Security Investigations

March 2024 https://travel.state.gov/content/travel/en/us-visas/tourism-visit/visa-waiver-program.html mailto:tracy.dorrough@usace.army.mil mailto:jason.j.klinger@usace.army.mil

COMPANY NAME ADDRESS MAIN PHONE:
FULL Name:
Visa Include copy scanned in color if applicable:
Corps of Engineers Location Project Office Work Site Where Work is to be performed:
Expected Arrival Date:
Job Title:
Method of Payment US Dollars Euros etc:
Primary Company POC Email Address:
Birthday format mm/dd/yyyy:
Country of Citizenship:
Passport Number:
What is your job?:
Begining and End dates for Site Access:
Primary Company POC Name Phone:

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