LEIN Request 17400.pdf

PDF 25 KB Posted

Attached to
SAIF - Perimeter Fence Enhancements 472/17400. SMD
Solicitation number
RFQ 171 180000000415 2
Issued by
Washtenaw County, Cheboygan City, Michigan

About this file

This is a LEIN (Law Enforcement Information Network) Request form issued by the Michigan Department of Corrections (MDOC) for vendor and contractor criminal history clearance related to a Special Alternative Incarceration Facility Perimeter Fence Enhancements project (File #472/17400.SMD). The form serves as a prerequisite document for individuals seeking approval to visit or conduct business within MDOC facilities. Vendors and contractors must complete the form by providing personal identification information including driver's license number or state ID number, social security number, date of birth, race, and sex. At least two of the three specified identification types must be provided to enable MDOC to conduct the required criminal history check through the LEIN system.

The LEIN clearance process is mandatory for all potential entry into MDOC facilities and must be completed and cleared before vendors or contractors can be approved to meet with persons confined in the facility. The form includes spaces for staff to document the reason for the LEIN check, the staff member requesting it, the individual conducting the check, and the clearance status (Yes/No). Individuals may obtain copies of their Michigan criminal history through www.michigan.gov/ichat for a fee. This document represents an administrative prerequisite rather than a pricing or service delivery agreement, focusing solely on security and compliance requirements for facility access.

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Other files

File Type Posted
Specifications 17400.pdf PDF
Plans 17400.pdf PDF
Advertisement 17400.pdf PDF
Addendum 1 17400.pdf 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: Special Alternative Incarceration Facility - Perimeter Fence Enhancements File # 472/17400.SMD

File details come from the government source that posted it. Updated .