LEIN Request 25082.pdf
PDF 159 KB Posted
- Attached to
- 472/25082. RLO; Oaks CF - Emergency Generator
- Solicitation number
- RFP-171-250000001740-1
- Issued by
- Macomb County, Mcbride Village, Michigan
About this file
This is a LEIN (Law Enforcement Information Network) Request form from the Michigan Department of Corrections (MDOC) for the Oaks Correctional Facility, specifically related to an Emergency Generator, ATS, and Primary Switchgear Replacement project with File # 472/25082.RLO. The form is a standardized document designed to conduct criminal history checks for individuals seeking to enter secure MDOC facility perimeters, whether as contractors, visitors, volunteers, or other personnel. The form requires detailed personal identification information including name, address, date of birth, race, sex, and either a driver's license or state ID number.
The document authorizes MDOC to conduct comprehensive background checks, including criminal history verification and, for employment purposes, motor vehicle operator license record checks. The form is part of MDOC's standard security protocol for vetting individuals who may come into contact with or work in proximity to correctional facility offenders. While the form itself does not provide specific contract details about the emergency generator and switchgear replacement project, it represents a critical administrative step in personnel screening for the project's potential contractors or workers.
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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: Oaks Correctional Facility - Emergency Generator, ATS and Primary Switchgear Replacement File # 472/25082.RLO
File details come from the government source that posted it. Updated .