Attachment_(4)_Notice_2.pdf

PDF 2 MB Posted Apr 14, 2014

Attached to: INDEFINITE DELIVERY/INDEFINITE QUANTITY MULTIPLE AWARD CONSTRUCTION CONTRACT (MACC) FOR VARIOUS CLIENTS KANTO PLAINS OPERATIONAL AREA, JAPAN
Solicitation number: N4008414R0102
Issued by: Department of the Navy Naval Facilities Engineering Command

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NOTICE - 2

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Other files

File	Type	Posted
0002.pdf	PDF	May 6, 2014
0001.pdf	PDF	Apr 29, 2014
Attachment_(5)_EXHIBIT.pdf	PDF	Apr 14, 2014
Attachment_(1)_Main_Spec.pdf	PDF	Apr 14, 2014
N4008414R0102A.pdf	PDF	Apr 14, 2014
Attachment_(3)_Notice.pdf	PDF	Apr 14, 2014
Attachment_(2)_CRVVF-SD.pdf	PDF	Apr 14, 2014

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From: Hakozaki / Tsurumi Fuel Terminal Supervisor, FLCY

SECOND ENDORSEMENT

Signature

入門を許可します。警備隊により身分証明の確認を受けた後、バッチを受け取って下さい。

1. Your request is approved. The Fleet Activities Civil Police will issue a gate pass to your employees after verifying their ID card.

To: __________________________________________________________________________________

1. All names have been screened.

POINT OF CONTACT 連絡先

Tel: 電話番号

FIRST ENDORSEMENT

From: Industrial Security Officer, FAY

To: Hakozaki / Tsurumi Fuel Terminal Supervisor, FLCY

Date: ___________________________

E-mail Address （可能であれば）

REQUEST MUST BE SUBMITTED TO FACP AT HAKOZAKI OR TSURUMI 72 HOURS PRIOR TO YOUR VISIT!

この申請書は箱崎もしくは鶴見の警備隊宛に入門の72時間前に提出されなければなりません。

Signature

Name (Last) 氏

Signature （サイン）

Name (First) 名

箱崎 □/ 鶴見地区□への立ち入許可申請を御願いします。

Via Subj:

Ref:

Industrial Security Office, Fleet Activities, Yokosuka (FAY)

REQUEST FOR BASE ACCESS (HAKOZAKI □ TSURUMI □)

(a) FISCINST 5330.7B//(b) COMFLEACTINST 5530.3//(c) USFJINST 31-204

Date (日付):

From:

会社名

To: Hakozaki / Tsurumi Fuel Terminal Supervisor, Fleet Logistics Center Yokosuka (FLCY)

FACP FORM 5531/3 EJ (20070410) (EF)

REQUEST FOR FUEL TERMINAL ACCESS HAKOZAKI □ TSURUMI □

1. It is requested that the visitor listed on the back page be authorized access to HAKOZAKI □ / TSURUMI □.

DATE/TIME 日時

Date 訪問日Purpose for Visit 訪問の目的 Time (From) 入門時間 Time (To) 出門時間

Jiro.Tomikawa.JA Callout CFAY保安部用申請書 (契約者用：One-Day Pass 申請) 記載例

Jiro.Tomikawa.JA Typewritten Text 御社名 (例：元請会社が有る場合は、『御社名 (元請会社 : 元請会社名) 』と明記)

Jiro.Tomikawa.JA Text Box ○×◇工事の為

Jiro.Tomikawa.JA Text Box ○年×月◇日(予備日：×日)

Jiro.Tomikawa.JA Text Box

TSURUMI

Jiro.Tomikawa.JA Text Box Taro

Jiro.Tomikawa.JA Text Box 03-1234-5678

Jiro.Tomikawa.JA Text Box 上記の□印はチェックする欄です、必ず記入してください。

Jiro.Tomikawa.JA Line

Jiro.Tomikawa.JA Typewritten Text TSURUMI Taro

Jiro.Tomikawa.JA Typewritten Text 漢字またはアルファベットで自筆サイン

Jiro.Tomikawa.JA Line

Jiro.Tomikawa.JA Highlight

Toshiki.Hisasue.JA Text Box Attachment (4) - 1 RFP N40084-14-R-0102

Toshiki.Hisasue.JA Text Box Page 1 of Attachment (4)- 1

FACP FORM 5531/3 EJ (20070410) (EF)

REQUEST FOR FUEL TERMINAL ACCESS HAKOZAKI □ TSURUMI □

1. It is requested that the visitor listed on the back page be authorized access to HAKOZAKI □ / TSURUMI □.

DATE/TIME 日時

Date 訪問日Purpose for Visit 訪問の目的 Time (From) 入門時間 Time (To) 出門時間

Date (日付):

From:

会社名

To: Hakozaki / Tsurumi Fuel Terminal Supervisor, Fleet Logistics Center Yokosuka (FLCY) Via Subj:

Ref:

Industrial Security Office, Fleet Activities, Yokosuka (FAY)

REQUEST FOR BASE ACCESS (HAKOZAKI □ TSURUMI □)

(a) FISCINST 5330.7B//(b) COMFLEACTINST 5530.3//(c) USFJINST 31-204

箱崎 □/ 鶴見地区□への立ち入許可申請を御願いします。

Name (Last) 氏

Signature （サイン）

Name (First) 名

REQUEST MUST BE SUBMITTED TO FACP AT HAKOZAKI OR TSURUMI 72 HOURS PRIOR TO YOUR VISIT!

この申請書は箱崎もしくは鶴見の警備隊宛に入門の72時間前に提出されなければなりません。

Signature

1. All names have been screened.

POINT OF CONTACT 連絡先

Tel: 電話番号

FIRST ENDORSEMENT

From: Industrial Security Officer, FAY

To: Hakozaki / Tsurumi Fuel Terminal Supervisor, FLCY

Date: ___________________________

E-mail Address （可能であれば）

入門を許可します。警備隊により身分証明の確認を受けた後、バッチを受け取って下さい。

1. Your request is approved. The Fleet Activities Civil Police will issue a gate pass to your employees after verifying their ID card.

To: __________________________________________________________________________________

From: Hakozaki / Tsurumi Fuel Terminal Supervisor, FLCY

SECOND ENDORSEMENT

Signature

Jiro.Tomikawa.JA Text Box

Jiro.Tomikawa.JA Typewritten Text

Toshiki.Hisasue.JA

Page 2 of Attachment (4)- 1

氏名（漢字）生年月日国籍現住所（漢字）入門パス有効期限 Furigana SUZUKI, Ichiro

Furigana

*外国人（ＮｏｎＪａｐａｎｅｓｅ）：パスポート（Ｐａｓｓｐｏｒｔ），或いは外人登録書（ＡｌｉｅｎＲｅｇｉｓｔｒａｔｉｏｎＣａｒｄ）

1968年6月6日日本横浜市横浜区横浜町1-1-1 鈴木一郎

REQUEST FOR FUEL TERMINAL ACCESS HAKOZAKI □ TSURUMI □

身分証明書として認められている書類（Proper Identification forms)

*日本人（ｊａｐａｎｅｓｅ）：運転免許書（本籍入り）（Driver`s License ｗｉｔｈＰｅｒｍａｎｅｎｔＡｄｄｒｅｓｓ）パスポート（Ｐａｓｓｐｏｒｔ），

住民基本台帳（写真入り）（Resident Card ｗｉｔｈＰｉｃｆｕｒｅ）のいずれか

御社名 (元請会社：○×建設㈱)

記載例

チェックを忘れずに！

CFAY / FLCY 共通入門者名前リスト

西暦

空欄

Jiro.Tomikawa.JA Highlight

Toshiki.Hisasue.JA

Page 3 of Attachment (4)- 1

氏名（漢字）生年月日国籍現住所（漢字）入門パス有効期限 Furigana

Furigana

REQUEST FOR FUEL TERMINAL ACCESS HAKOZAKI □ TSURUMI □

*外国人（ＮｏｎＪａｐａｎｅｓｅ）：パスポート（Ｐａｓｓｐｏｒｔ），或いは外人登録書（ＡｌｉｅｎＲｅｇｉｓｔｒａｔｉｏｎＣａｒｄ）

身分証明書として認められている書類（Proper Identification forms)

住民基本台帳（写真入り）（Resident Card ｗｉｔｈＰｉｃｆｕｒｅ）のいずれか

Jiro.Tomikawa.JA Text Box

Jiro.Tomikawa.JA Typewritten Text

Jiro.Tomikawa.JA Typewritten Text イイダヤスミツ

Jiro.Tomikawa.JA Typewritten Text

Jiro.Tomikawa.JA Typewritten Text Fuji Xerox

Toshiki.Hisasue.JA

Page 4 of Attachment (4)- 1

年月日

登録番号下4桁車名形式色車検期限自賠責期限入門パス有効期限ドライバー

品川 100 た 1234 トヨタエスティマワゴン白

Shinagawa 100 ta 1234 Toyota Estima Wagon White 2010年10月30日 2010年11月30日鈴木一郎

Request for Fuel Terminal Access / Hakozaki □ Tsurumi □ 御社名(元請会社：○×建設㈱)

記載例

上記の□印はチェックする欄です、必ず確認して下さい。

左寄せ右寄せ

空欄

Toshiki.Hisasue.JA

Page 5 of Attachment (4)- 1

年月日

登録番号下4桁車名形式色車検期限自賠責期限入門パス有効期限ドライバー

Request for Fuel Terminal Access / Hakozaki □ Tsurumi □

Toshiki.Hisasue.JA

Page 6 of Attachment (4)- 1

1/24/2012http://www.autobacs-hamasen.jp/service/img_inspection/mot_sample.jpg

Jiro.Tomikawa.JA Typewritten Text

Jiro.Tomikawa.JA Typewritten Text 車検証コピー Copy of Automobile Inspection Certificate

Toshiki.Hisasue.JA

Page 7 of Attachment (4)- 1

1/24/2012http://kurumatouroku.com/img/jibai.jpg

Jiro.Tomikawa.JA Typewritten Text 自賠責保険証コピー Copy of vehicle insurance

Toshiki.Hisasue.JA

Page 8 of Attachment (4)- 1

Attachmehnt (4) - 2 RFP N40084-14-R-0102

PERSONNEL LIST

NMC EAD DET YOKOSUKA

TIME:DATE:

ORGANIZATION NAME

PURPOSE:

GATE PASS#

VEHICULAR LIST

From:

REQUEST PERMISSION TO ENTER

NMC EAD DET YOKOSUKA(SHORT TERM)

Your request is approved/disapproved

LICENSE PLATE# VEHICLE PASS#

Page 1 of Attachment (4) - 2

Attachment (4) - 2 RFP N40084-14-R-0102

PERSONNEL LIST

NMC EAD DET YOKOSUKA

From: ABC TRUCKING COMPANY

PURPOSE: Truck shipment to camp FUJI

DATE: 9 AUG 2010

VEHICULAR LIST

ORGANIZATION NAME GATE PASS# LICENSE PLATE#

SAMPLETIME:07:30~

VEHICLE PASS#

ABC trucking company YAMADA, Taro xxx1234 YOKOHAMA 100 Ka 1234 serial#12345 oneday vehicle pass

ABC trucking company YAMADA, Jiro oneday pass

ABC trucking company SUZUKI, Ichiro xxx5678 YOKOHAMA 100 Ka 5678

ABC trucking company SASAKI, Kojiro oneday pass

Your request is approved/disapproved

REQUEST PERMISSION TO ENTER

NMC EAD DET YOKOSUKA(SHORT TERM)

Page 2 of Attachment (4) - 2

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File details come from the government source that posted it. Updated Nov 14, 2017.