MARB_Contractor_Base_Pass_Request__-_Blank.pdf

243 KB Posted

Attached to
IFB No. 130797 March ARB Annual Backflow Testing and Certification, March Air Reserve Base (ARB)
Solicitation number
0000040236
Issued by
Riverside County, Lake Riverside CDP, Riverside City, California

About this file

Written by GovTribe AI ·

This is a Contractor Base Pass Request form issued by the 452nd Security Forces Squadron Visitor Control Center at March Air Reserve Base (MARB), California, in conjunction with the IFB No. 130797 for Annual Backflow Testing and Certification services. The form serves as a blank template for contractors and their personnel to request base access credentials prior to conducting work at the facility. Prospective bidders attending the optional pre-bid job walk on October 22, 2026, at 9:00 AM, or contractors awarded the contract must complete and submit this form to gain entry to March ARB. The form requires submission of personal identification information, driver's license details, date of birth, and Social Security number for each individual requesting access. List submissions of 10 or more personnel must be submitted a minimum of 10 duty days prior to the visit, while lists of 9 or fewer require a minimum of 5 duty days' notice. All submissions must be directed to the Visitor Control Center at 452SFS.March.VCC@us.af.mil via digitally signed and encrypted email from a .mil address, with hard copies delivered in person to the Visitor Control Center.

Individuals must bring a Real ID Driver's License (or secondary valid identification if not Real ID-compliant), vehicle registration, and proof of insurance to the Visitor Control Center upon arrival. The form must be sponsored and signed by a Department of Defense Common Access Card (CAC) holder who serves as the individual's on-base sponsor. The document contains Controlled Unclassified Information protected under the Freedom of Information Act and Privacy Act of 1974, with disclosure limited to authorized personnel with direct need-to-know. Unauthorized disclosure or misuse of personal information may result in disciplinary action or criminal and civil penalties. The form is controlled by Air Force Reserve Command and the 452nd Security Forces Squadron.

View the file

Other files

File Type Posted
130797_IFB_Packet.pdf PDF
130797_IFB_Packet_Rev1.pdf PDF
130797_Addendum_01.pdf 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
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

DATE SUBMITTED:

NAME (Last, First, MI)

FULL SSN

(no dashes)

DRIVER LICENSE #

Ensure individuals bring the following items to the Visitor Control Center (1) Real ID Driver’s License (if not a REAL ID, need second form of valid ID), (2) Registration and (3) Proof of insurance

***THIS FORM IS TO BE FILLED OUT AND SIGNED BY SPONSOR (DoD CAC HOLDERS ONLY)***

Privacy Act Statement PRIVACY ACT-1974 as Amended applies – This memo may contain information which must be protected IAW DOD 5400-11, and it is For Official Use Only (FOUO)

AUTHORITY: 10 U.S.C. 8013; 44 U.S.C. 3101; and EO 93397 PRINCIPAL PURPOSES: Used to record information and details of criminal activity which may require investigative action by commanders, supervisors, police, special agents, etc. ROUTINE USES: Information may be disclosed to Pass and Registration to determine base access. DISCLOSURE IS VOLUNTARY: SSN is used to positively identify the individual as a conduit to check past criminal activity records. Failure to provide the request information will affect your ability to gain access to

March Air Reserve Base, CA.

DL STATE

DOB

MMDDYEAR

This document contains CONTROLLED UNCLASSIFIED INFORMATION (CUI) that must be protected under the Freedom of Information Act (5 U.S.C. 552 and/or the Privacy Act of 1974 (5 U.S.C. 552a). Unauthorized disclosure or misuse of this PERSONAL Information may result in disciplinary action, criminal and/or civil penalties. Contents not be disclosed, discussed, or shared with individuals unless they have direct need-to-know in the performance of their official duties.

Deliver this document directly to the VCC in person or e-mail the VCC ORG e-mail box. Only digitally signed and encrypted e-mail's from a .mil e-mail address will be accepted. E-mails from personal e-mail addresses will not be accepted.

**LISTS OF 10 OR MORE MUST BE SUBMITTED A MINIMUM OF 10 DUTY DAYS PRIOR TO VISIT**

**LISTS OF 9 OR LESS MUST BE SUBMITTED A MINIMUM OF 5 DUTY DAYS PRIOR TO VISIT**

Visitor Control Center Org e-mail: 452SFS.March.VCC@us.af.mil

452nd Security Forces Squadron Visitor Control Center March ARB Contractor Base Pass Request Sheet

TO

LOCATION:

COMPANY NAME:

START DATE:

VALID DAYS: M T W TH F SA SU

VALID TIMES:

EXPIRATION DATE:

Sponsor (DoD CAC Holder) Rank, Name, Unit/ORG:

Sponsor Contact Numbers (On-base & cell):

Sponsor E-Mail Address (.mil):

Date:Signature:

Controlled by: AFRC Controlled by: 452 SFS/S3L CUI Category: PRVCY Distribution/Dissemination Controls: FEDCON POC: MSgt Mark Estorga, DSN 447-3791

CUI

1073267516V Rectangle

Text20:
Text21:
Text22:
Text23:
Text28:
Text25:
Text29:
Text30:
Text26:
Check Box3: Off
Check Box4: Off
Check Box5: Off
Check Box6: Off
Check Box7: Off
Check Box8: Off
Check Box9: Off
Text24:
Text1:
DL state 1:
0:
0:
0:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
DL NUMBER 1:
0:
0:
0:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
DOB 1:
0:
0:
0:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
name 1:
0:
0:
0:
0:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:
SSAN 1:
0:
0:
0:
0:
0:
0:
1:
2:
3:
4:
5:
6:
7:
8:
9:
10:
11:
12:
13:
14:
15:
16:
17:

File details come from the government source that posted it. Updated .