LEIN Request 23170.pdf
PDF 123 KB Posted
- Solicitation number
- RFQ - 171 - 240000000321
- Issued by
- Ionia County, Michigan
About this file
This document is a LEIN Request form from the Michigan Department of Corrections (MDOC). It is used to complete a criminal history check in the Michigan Law Enforcement Information Network (LEIN) for individuals who need to enter the secure perimeter/property of an MDOC facility to perform work, visit, or meet with MDOC offenders. The form collects the individual's personal information, including 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 applicable, check the individual's motor vehicle operator license record.
The related state and local contract opportunity is for the Bellamy Creek Correctional Facility's Food Service Flooring Replacement project, identified as File #472/23170.JGH. The project is located in Ionia County, Michigan. Bidders must submit questions via email to Richard Mann, and bid attachments must be uploaded to the SIGMA VSS system. The solicitation includes information about SIGMA VSS submission requirements, file size limitations, and the process for emailing proposals if there are technical issues with the SIGMA VSS system.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 472_23170_JGH_Appendix_V.pdf | ||
| 472_23170_JGH_Addendum1.pdf | ||
| 472_23170_JGH_Drawings.pdf | ||
| 472_23170_JGH_Specifications.pdf | ||
| Sign-In 23170.pdf | ||
| Addendum 2 Photos.pdf | ||
| 472_23170_JGH_DTMB0415 Advertisment.pdf | ||
| 472_23170_JGH_Addendum_2.pdf |
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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: Bellamy Creek CF - Food Service Flooring Replacement File # 472/23170.JGH
File details come from the government source that posted it. Updated .