LEIN Request 23158.pdf
PDF 689 KB Posted
- Solicitation number
- RFP - 171 - 230000003146
- Issued by
- Ionia County, Capac Village, Michigan
About this file
The document is a LEIN (Law Enforcement Information Network) Request form from the Michigan Department of Corrections (MDOC). This request is for a criminal history check to approve an individual to enter the secure perimeter/property of an MDOC facility to perform work, visit, meet with, or work with MDOC offenders. The form collects 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 sign the form to authorize the MDOC to conduct the criminal history check and, if for employment purposes, to check the individual's motor vehicle operator license record.
The related state and local contract opportunity is for the Carson City Correctional Facility Cell Door Lock Control Upgrades project, which is located in Ionia County and Capac Village, Michigan. The project details, timeline, and other specifics are not provided in the given documentation.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| SAMPLE Billable Rate Contract (Rev 221207).pdf | ||
| Project Statement 23158.pdf | ||
| RFP Billable Rate 23158.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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: Carson City CF - Cell Door Lock Control Upgrades File # 472/23158.TYC
File details come from the government source that posted it. Updated .