Attachment_5_Registration_Form_for_PreProposal_Conference.pdf

ATTACHMENT 5

GSA National Capital Region

Registration Form

Pre-Proposal Conference and Site Visit for Solicitation No. GS-11P-12-MK-C-0055 Potomac Annex Complex – Renovation of Building 1 for Department of State

A pre-proposal conference and site visit regarding this Solicitation is scheduled as follows:

Date: Friday, November 2, 2012 Time: 9:30 AM to 12 Noon

Location: Department of State, Harry S Truman Building, 2201 C Street, NW, Washington, DC 20520 in the East Auditorium of the George C. Marshall Conference Center (Use 21st Street Entrance)

Interested Offerors must submit this form to facilitate security pre-screenings in advance of the pre-proposal conference and site visit. Please scan form in pdf format and send via email to denise.avery-craft@gsa.gov.

Attendee information must be provided no later than 2:00 P.M. on Monday, October 29, 2012.

Attendee’s Full Name _____________________________

Attendee’s Date of Birth** __________________________

Attendee’s Place of Birth** _________________________

Attendee’s Social Security Number** _________________

**All personal information obtained will be used solely for the purpose of obtaining security clearance for this conference/site visit only. This information will be destroyed and not retained by GSA on our hard drives or in our files.

Any additional information or changes regarding the pre-proposal conference will be posted on FEDBIZOPPS. Only those parties who have notified the Contracting Officer and provided the necessary information in advance of the meeting will be allowed to attend. To request a reasonable accommodation due to a disability, contact the Contracting Officer at 202-205-5742.

301 7 th

Street, SW, Suite 2021

Washington, DC 20407