G1529(SAMPLE).pdf
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- Solicitation number
- FA520922R0006
About this file
This document contains a solicitation notice for an Indefinite Delivery/Indefinite Quantity (IDIQ) Simplified Acquisition of Base Engineer Requirements (SABER) contract to provide maintenance, repair, and minor construction services at U.S. Army installations in Japan including Camp Zama, Sagamihara Family Housing Area, Sagami General Depot, and other locations. The services include a broad range of real property maintenance, repair, and construction tasks. The maximum contract value is $49 million over a potential seven-year ordering period.
The solicitation will be awarded as a single-award IDIQ contract. A pre-proposal conference will be held on June 24th, and proposals are due by July 15th. Interested parties must register in the System for Award Management and meet requirements for operating in Japan. The Department of the Air Force Pacific Air Forces is the contracting agency.
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PageONE TIME/MULTIPLE ACCESS ROSTER
JNL-SAZV2.90PREVIOUS EDITIONS ARE OBSOLETE.USAGJ FORM 1529, DEC 2020
1. INSTRUCTION
DATE OF REQUEST
of Pages
A "One Time/Multiple Access Roster" is valid for a single group visit for a specific date and time. It is the sole responsibility of the individual sponsor to include all information listed. Processing time can be reduced if each sponsor will take the time to legibly list the required information in both English and Kanji. This roster must be submitted to the Pass office at Camp Zama, SHA or SGD or HB four (4) working days might no be processed in time.
Any request that is submitted or the same day will not be processed. Sponsor must sign guest in at the gate.
The sponsor's signature services as an acknowledgment the sponsor is aware of his/her individual responsibilities as the sponsor and to exercise total control over his/her non-SOFA guests in accordance with the provisions contained in USAGJ Regulation 190-13.
a.
b.
a. TYPED NAME (Last, First MI)
e. DESTINATION/INSTALLATION
h. MULTIPLE ACCESS
EFFECTIVE DATE
f. PURPOSE
i. MULTIPLE ACCESS
EXPIRATION DATE
k. SPONSOR'S SIGNATURE
g. TYPE OF REQUEST
d. TELEPHONE NO.b. RANK c. DUTY TELEPHONE NO.
a. VISIT DAY
NATIONALITY NAME (Last, First MI) ADDRESS VEHICLE
PLATE NO.
GATE NO.
d. TOTAL (VEHICLE)c. TOTAL (PERSONNEL)
FROM
b. VISIT TIME
TO
ONE TIME MULTIPLE
2. SPONSOR INFORMATION & ACCESS DESCRIPTION
3. VISITORS INFORMATION
e. AREA(S) TO BE AUTHORIZED
ZAMA SGD SHA YND APC PIER6 TORII
PASSPORT NO.
TEL
DRIVER'S LICENSE NO.
j. SPONSOR'S ORGANIZATION
SEX DATE OF BIRTH EYE COLOR HAIR COLOR HEIGHT WEIGHT
NATIONALITY NAME (Last, First MI) ADDRESS VEHICLE
PLATE NO.
PASSPORT NO.
TEL
DRIVER'S LICENSE NO.
SEX DATE OF BIRTH EYE COLOR HAIR COLOR HEIGHT WEIGHT
NATIONALITY NAME (Last, First MI) ADDRESS VEHICLE
PLATE NO.
PASSPORT NO.
TEL
DRIVER'S LICENSE NO.
SEX DATE OF BIRTH EYE COLOR HAIR COLOR HEIGHT WEIGHT
NATIONALITY NAME (Last, First MI) ADDRESS VEHICLE
PLATE NO.
PASSPORT NO.
TEL
DRIVER'S LICENSE NO.
SEX DATE OF BIRTH EYE COLOR HAIR COLOR HEIGHT WEIGHT
GATE NO.
GATE NO.
GATE NO.
AUTHORITY:
PRINCIPAL PURPOSE:
ROUTINE USES:
DISCLOSURE:
DATA REQUIRED BY THE PRIVACY ACT OF 1974
Title 10 U.S.C., Code, Section 3013.
To provide information to officials of the Army responsible for monitoring/controlling visitor's status.
Information is used to record and assign authorized pass numbers to allow authorized visitors onto U.S. Army installations.
Voluntary. Failure to disclose the required information will result in authorized pass numbers not being issued; therefore, causing the applicants to have to meet and escort on and off the installation their visitors.
Japanese ZAMA, TARO
123412341234
046-407-00011-1-1 Zama Zama-shi, Kanagawa
F 5 May 1985 Black Black 170cm 65
Japanese ZAMA, HANAKO 080-1234-5678
123456789
2-2-2 Zama Zama-shi, Kanagawa
M 5 Dec 1975 Black Black 158cm 45 shigeru.akata Line shigeru.akata Line shigeru.akata Line shigeru.akata Line shigeru.akata Line shigeru.akata Line
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