MCC Form 452 .pdf
PDF 1 MB Posted
- Attached to
- Transient Training Facility Support Services at Fort McCoy, WI Federal contract opportunity
- Solicitation number
- W912ES23R0005
About this file
This document is an installation access pass request form for Fort McCoy in Wisconsin. The form requests individual name, driver's license information, date range for required access, work hours, work area, company name, position, and remarks including purpose for access and contract details if applicable. It lists the Directorate of Emergency Services as the proponent and notes a voluntary National Crime Information Center background check will be conducted.
The related federal contract opportunity is a solicitation from the Department of the Army Corps of Engineers Engineering District St Paul for transient training facility support services at Fort McCoy. Services include ensuring full use of clean and stocked transient training facilities for scheduled customers, operating the service office daily from 0700 to 1630 including extended hours as required, and overseeing transient training facilities including issuing, receiving, inspecting facilities and furnishings as well as operational stock items. The solicitation number is W912ES23R0005 and responses are due by June 15, 2023.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Amendment 0002.pdf | ||
| Amendment 0001.pdf | ||
| Amendment 0001 Technical Exhibit 2 (revised) .pdf | ||
| Technical Exhibits 1 - 7.pdf | ||
| Solicitation Transient Training FSS.pdf | ||
| Past Performance Questionnaire .pdf | ||
| MCC Form 451 .pdf |
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Fort McCoy Form 452 December 2021
AEM6.2 V 8.0
Page of Fort McCoy Form 452 May 2021 Obsolete Fort McCoy Installation Access Pass Request Prescribing Regulation: Army Regulation 190-13, Proponent: Directorate of Emergency Services
PRIVACY ACT STATEMENT AUTHORITY: The Privacy Act of 1974, Title 5 USC 552a. PRINCIPLE PURPOSE(S): To determine suitability of individual(s) requesting access to Fort McCoy. ROUTINE USE(S): Personal information may be disclosed to appropriate military and civilian emergency and investigation agencies to assist in determining suitability for access to Fort McCoy. DISCLOSURE: Voluntary, however failure to provide information will result in a refusal to grant access to Fort McCoy.
Legal Name as Appears on Driver's License or State ID: Example: John Edward Doe 25-Jan-15 24-Jan-16
MON-FRI 0700-1700 HOURS
Bldg 100 Commissary/TCI Example: Plumber/Bagger Last Name First Name Middle Name or NMN if non Begin Date End Date Work Access Hours Work Area/ Visit Location Company Name Employees Position/ Event Remarks Block (At a minimum include: purpose for access; contract number and expiration date) ** Note: If access is for contract purpose, Sponsor will be the COR. In all cases, Sponsor must be affiliated with Fort McCoy. ***NCIC-III Check Date, PS Specialist and PS Specialist Signature for DES USE ONLY**** When complete submit to: usarmy.mccoy.id-readiness.mbx.des-physical-security-iacs-form@army.mil Legal Name as Appears on Driver's License or State ID: Example: John Edward Doe 25-Jan-15 24-Jan-16
MON-FRI 0700-1700 HOURS
Bldg 100 Commissary/TCI Example: Plumber/Bagger Last Name First Name Middle Name or NMN if non Begin Date End Date Work Access Hours Work Area/ Visit Location Company Name Employees Position/ Event 11.0.0.20130303.1.892433.887364 280-4222
DHR ASD
Trudy L. Ward FMF452_Fort McCoy Installation Access Pass Request 20210212 20210212
| CurrentPage: |
| PageCount: |
| TextField1: |
| TextField1: Solicitation W912ES23R0005 |
| DateField1: 2023-06-15 |
| DateField1: 2023-06-15 |
| TextField2: 1230 - 1700 |
| TextField2: DPW / Troop Facilities |
| TextField2: / Site visit |
| SPONSORNAME: Jay Kummer |
| SPONSORORG: Directorate of Public Works / Troop Facilities SB |
| SPONSORPHONE: 608-388-3746 |
| Button1: |
| SPONSOREMAIL: jay.a.kummer.civ@army.mil |
| TextField7: Site Visit for Fort McCoy, Transient Training Facility Support Services solicitation |
| NCIC-IIICHECKDATE: |
| PSSPECIALISTSIGNATURE: |
| PSSPECIALIST: |
| SignatureField1: |
| SPONSOREMAIL2: jay.a.kummer.civ@army.mil |
| SPONSORORG2: Directorate of Public Works / Troop Facilities SB |
| SPONSORPHONE2: 608-388-3746 |
| SPONSORNAME2: Jay Kummer |
| PSSPECIALIST2: |
File details come from the government source that posted it. Updated .