Exhibit_16_(FPS_FORM_139).pdf
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- Attached to
- Protective Security Officer Services
- Solicitation number
- HSHQEC-16-R-00010
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EXHIBIT FOR HSHQEC-16-R-00010
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Text version
FPS
YEAR:
PRINT NAME SIGNATURE SIGNATURE
(Last - First - Initial) (IN) (OUT) ARRIVAL DEPARTURE
FEDERAL PROTECTIVE SERVICE FPS FORM 139 (Rev. 11-04)
US DEPARTMENT OF
HOMELAND SECURITY
DATE RELIEF
CAUTION: False entries on this document will be cause for removal from all Government Contracts.
POST
*Federal Protective Service and Contract Administration personnel, when conducting an investigation, must place an "X" in this column.
RECORD OF TIME OF ARRIVAL AND DEPARTURE
CONTRACT GUARDING DUTY REGISTER
BUILDING: MONTH:
*SEE
FOOT
NOTE
TIME OF
Sheet1
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