LEIN Request 26287.pdf
PDF 160 KB Posted
- Solicitation number
- RFP 171 260000002211 3
- Issued by
- Oakland County, Michigan
About this file
This is a LEIN (Law Enforcement Information Network) Request Form CAJ-1037 issued by the Michigan Department of Corrections for the Muskegon Correctional Facility HVAC Controls Upgrades project (File #472/26287.HJD). The form is used to collect personal identification information and authorize criminal history background checks for individuals requiring access to the secure perimeter or property of MDOC facilities. The form requests standard identifying information including driver's license or state identification number, date of birth, race, and sex. Requestors must indicate their affiliation with the agency, such as employment, contractor, visitor, or volunteer status, and declare whether they will be entering the secure perimeter of an MDOC facility.
By signing the authorization, individuals consent to the MDOC conducting a criminal history check through the Law Enforcement Information Network to determine eligibility for facility access. For MDOC Human Resources and Employment purposes, the Department is further authorized to review motor vehicle operator license records to assess whether the individual may operate a motor vehicle while conducting Department business. The LEIN clearance determination (Yes/No) is completed by designated MDOC personnel, with optional notation of conviction records and comments. This screening requirement applies to all contractors and personnel involved with the Muskegon CF HVAC Controls Upgrades project.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| RFP Billable Rate 26287.pdf | ||
| RFP_ADDENDUM 1_26287.pdf | ||
| RFP_Attachments_26287.pdf | ||
| SAMPLE Billable Rate Contract (Rev 04-25).pdf | ||
| RFP_Project Statement_26287.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: Muskegon CF - HVAC Controls Upgrades File # 472/26287.HJD
File details come from the government source that posted it. Updated .