LEIN Request 16345.pdf
PDF 24 KB Posted
- Attached to
- 472/16345. TAP Chippewa CF - Freezer Replacement
- Solicitation number
- RFQ 171 180000000363 2
- Issued by
- Chippewa County, Kincheloe CDP, Michigan
About this file
This is a LEIN (Law Enforcement Information Network) Request form from the Michigan Department of Corrections used to conduct criminal history checks for vendors and contractors seeking access to MDOC facilities. The form is associated with a food service freezer replacement project at Chippewa Correctional Facility (File #472/16345.TAP). The document requires vendors or contractors to provide personal identification information including driver's license number or state identification card number, social security number, date of birth, race, and sex. Potential entry into MDOC facilities mandates completion and clearance of this LEIN check before vendors or contractors may visit or meet with confined persons. The form authorizes the Michigan Department of Corrections to conduct the necessary criminal history check as a prerequisite for facility access.
The LEIN request form does not contain pricing information, contract terms, funding details, or award dates. Instead, it serves as a prerequisite administrative requirement for vendor and contractor participation in MDOC projects. Vendors may obtain copies of their Michigan criminal history through www.michigan.gov/ichat for a fee. The form is completed by MDOC staff who document whether the LEIN check was cleared or resulted in disqualification, along with completion date and staff initials.
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Other files
| File | Type | Posted |
|---|---|---|
| Specifications 16345.pdf | ||
| Plans 16345.pdf | ||
| Advertisement 16345.pdf | ||
| Addendum 1.pdf |
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Text version
MICHIGAN DEPARTMENT OF CORRECTIONS
VENDOR/CONTRACTOR LEIN REQUEST
CAJ-1037
REV. 03/15
Please provide the information requested below. This information will be used to complete a criminal history check in the Michigan Law Enforcement Information Network (LEIN).
Your Driver’s License Number or State Identification Card Number and your Social Security Number is needed to complete this LEIN. Also needed are your date-of-birth, race and sex. Potential entry into MDOC facilities require that this LEIN check be completed and cleared.
Profession Vendor Contractor
Last Name (Please Print)
First Name Middle Name
Address
City State Zip Code
Date of Birth Sex Race
Please provide the number of at least two of the following three types of identification:
Driver’s License # State issued by
State ID # State issued by
Social Security #
I authorize the Michigan Department of Corrections to conduct a criminal history check, so that I may be approved to visit/meet with persons confined in a Michigan Department of Corrections facility.
Signature Date
Staff Use Only
Reason for LEIN Check
Staff requesting LEIN Check
LEIN Checked by
LEIN Clear Yes No, You may obtain a copy of your Michigan criminal history at www.michigan.gov/ichat. There is a fee for this service.
LEIN Check completed by Initials Date http://www.michigan.gov/ichat hallt2 Text Box Facility/Project Name: Chippewa Correctional Facility - Food Service Freezer Replacement File # 472/16345.TAP
File details come from the government source that posted it. Updated .