LEIN Request 21302.pdf
PDF 123 KB Posted
- Attached to
- 472/21302. RWG; Cooper Street CF - VMS Upgrades
- Solicitation number
- RFQ - 171 - 220000000565
- Issued by
- Jackson County, Michigan
About this file
The document is a LEIN Request form from the Michigan Department of Corrections (MDOC) that is used to conduct a criminal history check through the Michigan Law Enforcement Information Network (LEIN) for individuals seeking to enter the secure perimeter/property of an MDOC facility to perform work, visit, meet with, or work with MDOC offenders. The related state and local contract opportunity is for the Cooper Street CF - VMS Upgrades project, with a file number of 472/21302.RWG. The project is located in Jackson County, Michigan. Bidders are instructed not to submit questions through the VSS system, but rather to email them to Bret Emerson at bids@commtechdesign.com. Bid attachments must be uploaded to SIGMA VSS, with individual attachments not to exceed 6 MB. If bidders experience any issues with the electronic submission, they are advised to contact the SIGMA Help Desk and notify the Office of Design and Construction, providing their SIGMA ticket number.
The document does not provide any details on pricing terms, set asides, incumbents, funding requirements and sources, or any other salient information related to the contract opportunity. The focus of the document is on the LEIN Request process for individuals seeking access to MDOC facilities.
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Text version
MICHIGAN DEPARTMENT OF CORRECTIONS
LEIN REQUEST
CAJ-1037.
REV. 09/19.
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, date-of-birth, race and sex is needed to complete this LEIN request.
Employment/Human Resources HR Personnel / Requesting
Contractor Visitor Contractor Agency Agency Representing
Volunteer Other Agency Representing Agency Representing
Are you entering the secure perimeter/property of a Michigan Department of Corrections (MDOC) facility? Yes No
Please print information below:
Last Name: First Name: Middle Name:
Address:
City: State: Zip Code:
Date of Birth: Sex: Race:
Please provide the number of one of the following types of identification:
Driver’s License #: State issued by:
State ID #: State issued by:
I authorize the MDOC to conduct a criminal history check, so that I may be approved to enter the secure perimeter/property of an MDOC facility to perform work, visit, meet with or work with MDOC offenders.
For MDOC HR/Employment purposes only: I further authorize the Department to check my motor vehicle operator license record for the purposes of determining if I will be allowed to operate a motor vehicle while conducting Department business.
Signature: Date:
LEIN Completed By: Name: Date:
LEIN Cleared: Yes No (Does not apply to Human Resources)
MDOC Employment/HR purposes: Indicate the # of convictions:
Comment (Optional):
hallt2 Text Box Facility/Project Name: Cooper Street CF - VMS Upgrades File # 472/21302.RWG
File details come from the government source that posted it. Updated .