M67001-13-R-0001_Attachment_1.pdf

M67001-13-R-0001 Attachment 1

CONTRACTOR SECURITY REQUIREMENTS

BUSINESS ACCESS

VERIFICATION

The Contractor shall submit this notification to the Contract Administration Office as reflected in Section G of the contract upon completion of the Security Requirements reflected in Section C1 of the contract.

CONTRACTOR ACKNOWLEDGEMENT

In accordance with the Security Requirements in Section C1 of the contract, I acknowledge and certify that all personnel providing services under this contract have been processed for access to Marine Corps Base, Camp

Lejeune, North Carolina, and its' satellite activities and/or Marine Corps Air Station, New River, North Carolina, and have furnished the documentation reflected below to obtain personnel badges and vehicle decals.

_____ Proof of employee citizenship or legal alien status.

_____ Proof of a criminal records check.

_____ Proof of employment.

_____ An installation sponsor request forwarded to provost Marshall office.

_____ A valid form of Federal or state government identification.

_____ If driving a motor vehicle, a valid driver’s license, vehicle registration and proof of insurance.

I, also, acknowledge and certify in accordance with the contract, that I am responsible, upon completion/termination of this contract or an individual’s employment, to collect and turn in all personnel badges and vehicle decals.

CONTRACTOR NAME: ______________________________________

ADDRESS: _____________________________________________

CONTRACT NUMBER: ______________________________________

Contractor's printed name

Contractor's signed name Date