LEIN Request 22180.pdf
PDF 123 KB Posted
- Solicitation number
- RFQ - 171 - 230000000011
- Issued by
- Jackson County, Michigan
About this file
The document provided is a LEIN (Law Enforcement Information Network) Request form from the Michigan Department of Corrections (MDOC). This form is used to request a criminal history check for individuals who need to enter the secure perimeter or property of an MDOC facility to perform work, visit, or meet with offenders. The form requires the individual's personal information, such as name, address, date of birth, sex, race, and driver's license or state ID number. The individual must authorize the MDOC to conduct the criminal history check and, for MDOC employment/HR purposes, a motor vehicle operator license record check.
The state and local contract opportunity related to this document is for the Southern Region Business Office - Phase I Powerhouse High Voltage Switchgear project, with the file number 472/22180.RWG. The project is located in Jackson County, Michigan. The document provides limited information about the contract opportunity, and further details would be needed to summarize the key aspects of the project, such as the scope of work, timeline, bidding requirements, and any set-asides or funding sources.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Specifications 22180.pdf.crdownload | CRDOWNLOAD file | |
| Advertisement 22180.pdf | ||
| 472.22180.RWG Jackson Powerhouse - Replace Switchgear_Addendum No 1.pdf.crdownload | CRDOWNLOAD file | |
| Plans 22180.pdf.crdownload | CRDOWNLOAD file |
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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: Southern Region Business Office - Phase I Powerhouse High Voltage Switchgear File # 472/22180.RWG
File details come from the government source that posted it. Updated .