Att_8_--_Contractor_Information_Spreadsheet.xlsm
XLSM spreadsheet 195 KB Posted
- Attached to
- Integrated Logistics Support (ILS) Services for te Transporation Security Administration
- Solicitation number
- HSTS04-17-R-CT3014
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Attachment 8 - Persec Documentation
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Sheet1
| Contractor applicant personal identifiers -- please submit in format provided below | Fingerprint requirement | Contract Information | Subcontract Information | Other Agreements (MOA, IAA, OTA) | Level and type of vetting | ||||||||||||||||||||||||||||||||||||
| SSN* | Gender* | Last* | First* | Middle Initial Only | Suffix | Date of Birth* | City of Birth* | County of Birth | State of Birth | Country of Birth* | Country of Citizenship* | phone | If subject is not local to TSA HQ in Arlington, VA please provide location of nearest major airport to subject for fingerprinting purposes. | Contract Company Name and address | DUNS Number | Contract Number* | Contract Start Date | Contract End Date | Task Order Number | Task Order Start Date | Task Order End Date | Full legal name of COR | COR e-mail address (address must be entered as @tsa.dhs.gov) | COR phone number | Full legal name of CO | CO e-mail address (address must be entered as @tsa.dhs.gov) | CO phone number | If classified contract, Cage Code | If classified contract, Facility Clearance | If classified contract, Safeguard Level | If classified contract, CSO | If classified contract, FSO name | Contract Company Name and address | Name of agreement and parties involved. | Expiration date of agreement. | Type of Vetting* | If classified contractor, clearance level required for contract support | PIV request for unescorted access to TSA facilities (including leased spaces). | Access to DHS/TSA IT systems (to include TSA e-mail accounts) or assist in the development, operation, management or maintenance of DHS/TSA IT systems? | Access to TSA Sensitive but Unclassified Information which may include Sensitive Security Information. | |
| 123-45-6789 | Female | Gale | Dorothy | 1/1/11 | Prairie City | Emerald County | KS | United States | United States | dorothygale@gmail.com | 1234567890 | DCA | WilsonCo. 1222 Valley Drive, Arlington, VA 22202 | 1234567 | HSTS02-10-D-CT1234 | 1/1/11 | 1/1/15 | 15 | 1/1/14 | 1/1/15 | Dorothy Gale | DorothyGale@tsa.dhs.gov | 5711234578 | Wizard Ozzey | WizardOzzey@tsa.dhs.gov | 5711234578 | 1A2B3 | Secret | None | DSS | Auntie Em | Classified Contractor | Secret | Yes | Yes | Yes |
mailto:dorothygale@gmail.commailto:DorothyGale@tsa.dhs.govmailto:WizardOzzey@tsa.dhs.gov Sheet2
| Male |
| Female |
| United States |
| United States |
| Afghanistan |
| Akrotiri |
| Albania |
| Algeria |
| American Samoa |
| Andorra |
| Angola |
| Anguilla |
| Antarctica |
| Antigua and Barbuda |
| Argentina |
| Armenia |
| Aruba |
| Ashmore and Cartier Islands |
| Australia |
| Austria |
| Azerbaijan |
| Bahamas |
| Bahrain |
| Baker Island |
| Bangladesh |
| Barbados |
| Belarus |
| Belgium |
| Belize |
| Benin |
| Bermuda |
| Bhutan |
| Bolivia |
| Bonaire |
| Bosnia and Herzegovina |
| Botswana |
| Bouvet Island |
| Brazil |
| British Indian Ocean Territory |
| Brunei |
| Bulgaria |
| Burkina Faso |
| Burma |
| Burundi |
| Cambodia |
| Cameroon |
| Canada |
| Cape Verde |
| Cayman Islands |
| Central African Republic |
| Chad |
| Chile |
| China |
| Christmas Island |
| Clipperton Island |
| Cocos (Keeling) Islands |
| Colombia |
| Comoros |
| Congo, Democratic Republic of the |
| Congo, Republic of the |
| Cook Islands |
| Coral Sea Islands |
| Costa Rica |
| Côte d'Ivoire |
| Croatia |
| Cuba |
| Curaçao |
| Cyprus |
| Czech Republic |
| Denmark |
| Dhekelia |
| Djibouti |
| Dominica |
| Dominican Republic |
| Ecuador |
| Egypt |
| El Salvador |
| Equatorial Guinea |
| Eritrea |
| Estonia |
| Ethiopia |
| Falkland Islands (Islas Malvinas) |
| Faroe Islands |
| Fiji |
| Finland |
| France |
| French Guiana |
| French Polynesia |
| French Southern and Antarctic Lands |
| Gabon |
| Gambia |
| Georgia |
| Germany |
| Ghana |
| Gibraltar |
| Greece |
| Greenland |
| Grenada |
| Guadeloupe |
| Guam |
| Guatemala |
| Guernsey |
| Guinea |
| Guinea-Bissau |
| Guyana |
| Haiti |
| Heard Island and McDonald Islands |
| Holy See |
| Honduras |
| Hong Kong |
| Howland Island |
| Hungary |
| Iceland |
| India |
| Indonesia |
| Iran |
| Iraq |
| Ireland |
| Isle of Man |
| Israel |
| Italy |
| Jamaica |
| Jan Mayen |
| Japan |
| Jarvis Island |
| Jersey |
| Johnston Atoll |
| Jordan |
| Kazakhstan |
| Kenya |
| Kingman Reef |
| Kiribati |
| Kosovo |
| Kuwait |
| Kyrgyzstan |
| Laos |
| Latvia |
| Lebanon |
| Lesotho |
| Liberia |
| Libya |
| Liechtenstein |
| Lithuania |
| Luxembourg |
| Macau |
| Macedonia |
| Madagascar |
| Malawi |
| Malaysia |
| Maldives |
| Mali |
| Malta |
| Marshall Islands |
| Martinique |
| Mauritania |
| Mauritius |
| Mayotte |
| Mexico |
| Micronesia, Federated States of |
| Midway Islands |
| Moldova |
| Monaco |
| Mongolia |
| Montenegro |
| Montserrat |
| Morocco |
| Mozambique |
| Multiple |
| Namibia |
| Nauru |
| Navassa Island |
| Nepal |
| Netherlands |
| New Caledonia |
| New Zealand |
| Nicaragua |
| Niger |
| Nigeria |
| Niue |
| Norfolk Island |
| North Korea |
| Northern Mariana Islands |
| Norway |
| Oman |
| Pakistan |
| Palau |
| Palmyra Atoll |
| Panama |
| Papua New Guinea |
| Paracel Islands |
| Paraguay |
| Peru |
| Philippines |
| Pitcairn Islands |
| Poland |
| Portugal |
| Puerto Rico |
| Qatar |
| Reunion |
| Romania |
| Russia |
| Rwanda |
| Saba |
| Saint Barthelemy |
| Saint Helena |
| Saint Kitts and Nevis |
| Saint Lucia |
| Saint Pierre and Miquelon |
| Saint Vincent and the Grenadines |
| Saint-Martin |
| Samoa |
| San Marino |
| Sao Tome and Principe |
| Saudi Arabia |
| Senegal |
| Serbia |
| Seychelles |
| Sierra Leone |
| Singapore |
| Sint Eustatius |
| Sint Maarten |
| Slovakia |
| Slovenia |
| Solomon Islands |
| Somalia |
| South Africa |
| South Georgia and the South Sandwich Islands |
| South Korea |
| South Sudan |
| Spain |
| Spratly Islands |
| Sri Lanka |
| Sudan |
| Suriname |
| Svalbard |
| Swaziland |
| Sweden |
| Switzerland |
| Syria |
| Taiwan |
| Tajikistan |
| Tanzania |
| Thailand |
| Timor-Leste |
| Togo |
| Tokelau |
| Tonga |
| Trinidad and Tobago |
| Tunisia |
| Turkey |
| Turkmenistan |
| Turks and Caicos Islands |
| Tuvalu |
| Uganda |
| Ukraine |
| United Arab Emirates |
| United Kingdom |
| Uruguay |
| Uzbekistan |
| Vanuatu |
| Venezuela |
| Vietnam |
| Virgin Islands, British |
| Virgin Islands, U.S. |
| Wake Island |
| Wallis and Futuna |
| Western Sahara |
| Yemen |
| Zambia |
| Zimbabwe |
| AK |
| AL |
| AZ |
| AR |
| CA |
| CO |
| CT |
| DE |
| DC |
| FL |
| GA |
| HI |
| ID |
| IL |
| IN |
| IA |
| KS |
| KY |
| LA |
| ME |
| MD |
| MA |
| MI |
| MN |
| MS |
| MO |
| MT |
| NE |
| NV |
| NH |
| NJ |
| NM |
| NY |
| NC |
| ND |
| OH |
| OK |
| OR |
| PA |
| RI |
| SC |
| SD |
| TN |
| TX |
| UT |
| VT |
| VA |
| WA |
| WV |
| WI |
| WY |
Sheet3
File details come from the government source that posted it. Updated .