Attach 5_1_MCASO 5500.2V Appendix D_Restricted Area Access Request.pdf

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N4008424R0074 INDEFINITE DELIVERY INDEFINITE QUANTITY MULTIPLE AWARD CONSTRUCTION FOR SMALL MAGNITUDE SIZE DESIGN-BID-BUILD (DBB) REQUIREMENTS (MINI MACC) FOR THE U. S. MARINE CORPS AIR STATION, IWAKUNI, JAPAN
Solicitation number
N4008424R0074
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This document is a restricted area access request form for Marine Corps Air Station Iwakuni in Japan. It requires submission of personnel names, ranks, identification numbers, rotation dates, and whether they require vehicle access or escorts to access restricted areas including flight lines, port facilities, and specific buildings and rooms. Justification must be provided for any vehicle access requests. Signatures are required from the requester, security manager, airfield operations, harbor operations, and physical security to approve or not approve the access requests.

The related federal contract opportunity is a solicitation for an indefinite delivery indefinite quantity multiple award construction contract for small magnitude design-bid-build construction requirements at Marine Corps Air Station Iwakuni. Services sought include replacement of an underground steam double pipe. A pre-proposal conference and site visit will be held. The solicitation package contains attachments and offerors must submit required documents through the System for Award Management to participate. The issuing agency is the Department of the Navy Naval Facilities Engineering Command.

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Other files

File Type Posted
N4008424R0074 Amend 0003.pdf PDF
N4008424R0074 Amend 0002.pdf PDF
N4008424R0074 Amend 0001.pdf PDF
Exhibit B SAFETY NARRATIVE.docx DOCX document
Exhibit C PAST PERFORMANCE QUESTIONNAIRE.docx DOCX document
Exhibit D PRICE PROPOSAL FORM.docx DOCX document
Exhibit A CONSTRUCTION EXPERIENCE PROJECT DATA SHEET.docx DOCX document
Attach 1_Pre-Bid_Inquiry_Form.xlsx XLSX spreadsheet
Attach 5_2_MCASO 5500.11B Acknowledgement of Flight Line Regulations_EN_Sample.pdf PDF
Attach 5_3_MCASO 5500.11B Acknowledgement of Flight Line Regulations_SHEET_Sample.pdf PDF
Attach 5_2_MCASO 5500.11B Acknowledgement of Flight Line Regulations_JP.pdf PDF
RFP N4008424R0074.pdf PDF
Attach 5_3_MCASO 5500.11B Acknowledgement of Flight Line Regulations_SHEET.pdf PDF
Attach 5_4_1-Day Official Entry-Exit Request.pdf PDF
Attach 5_2_MCASO 5500.11B Acknowledgement of Flight Line Regulations_EN.pdf PDF
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THIS FORM SHALL BE SUBMITTED WITH COMPLETED RESTRICTED AREA ACCESS REQUEST

APPENDIX D MCASO 5500.2V

MCAS IWAKUNI RESTRICTED AREA ACCESS REQUEST

D-1

MEMORANDUM Date: __________

From: _____________ _____________ ________ ___________ __________________

Last Name, First Name Rank Unit Work Phone

To: Provost Marshal

Subj: RESTRICTED AREA ACCESS REQUEST

Ref: (a) MCO 5530.14A

(b) MCASO 3710.3X

(C) MCASO 5500.2V

1. Per the references, it is requested that the following personnel be authorized access to the indicated restricted area for the performance of their duties. Personnel that also require vehicle gate access will receive additional approval with justification written below.

□ FLIGHT LINE □ PORT FACILITY □ BUILDING______ □ ROOM______

NAME (LAST,FIRST) RANK

DODID #

or DBIDS

ROTATION DATE

DD MMM YYYY

AVOC LICENSE

(YES/NO)

AVOC

EXPIRATION

DD MMM YYYY

ESCORT NAME

OR N/A

LN, FN, RANK

Note: If the listed personnel do not have Unescorted RESTRICTED AREA access an escort is required at ALL TIMES.

2. Justification of Vehicle Access (if applicable, provide copies of AVOC

License, US/SOFA/Japanese Drivers License and GME License):

3. A copy of this authorization letter must be provided to the PMO

Physical Security Section.

Requester (Department Head/CO/XO/SGTMAJ or CIV Equivalent):

Signature of Requester Requester Print & Date

APPENDIX D MCASO 5500.2V

MCAS IWAKUNI RESTRICTED AREA ACCESS REQUEST

D-2

Security Manager: Approved - Not Approved

Signature of Security Manager Security Manager Print & Date

Airfield Operations (If Applicable): Approved - Not Approved □ N/A

Signature of Airfield Operations Airfield Operations Print & Date

Harbor Operations (If Applicable): Approved - Not Approved □ N/A

Signature of Harbor Operations Harbor Operations Print & Date

Physical Security: Approved – Not Approved

Signature of Physical Security Physical Security Print & Date

NAME (LAST,FIRST) RANK

DODID #

or DBIDS

ROTATION DATE

DD MMM YYYY

AVOC LICENSE

(YES/NO)

AVOC

EXPIRATION

DD MMM YYYY

ESCORT NAME

OR N/A

LN, FN, RANK

Encl(6)_Escort Request Form_Entry-Exit 1
Encl(3)_MCASO 5500.2V Appendix D_Restricted Area Access Request
Date: Leave Blank
Last Name: Leave Blank
First Name: Leave Blank
Rank: Leave Blank
Unit: Leave Blank
Work Phone: Leave Blank
flight line: Yes
port: Off
build: Off
receive additional approval with justification written below:
room: Off
undefined:
NAME LASTFIRSTRow1:
RANKRow1: CTR
DODID or DBIDS Row1:
ROTATION DATE DD MMM YYYYRow1:
license1: [NO]
AVOC EXPIRATION DD MMM YYYYRow1:
ESCORT NAME OR NA LN FN RANKRow1:
NAME LASTFIRSTRow2:
RANKRow2: CTR
DODID or DBIDS Row2:
ROTATION DATE DD MMM YYYYRow2:
license2: [NO]
AVOC EXPIRATION DD MMM YYYYRow2:
ESCORT NAME OR NA LN FN RANKRow2:
NAME LASTFIRSTRow3:
RANKRow3: CTR
DODID or DBIDS Row3:
ROTATION DATE DD MMM YYYYRow3:
license3: [NO]
AVOC EXPIRATION DD MMM YYYYRow3:
ESCORT NAME OR NA LN FN RANKRow3:
NAME LASTFIRSTRow4:
RANKRow4: CTR
DODID or DBIDS Row4:
ROTATION DATE DD MMM YYYYRow4:
license4: [NO]
AVOC EXPIRATION DD MMM YYYYRow4:
ESCORT NAME OR NA LN FN RANKRow4:
NAME LASTFIRSTRow5:
RANKRow5: CTR
DODID or DBIDS Row5:
ROTATION DATE DD MMM YYYYRow5:
license5: [NO]
AVOC EXPIRATION DD MMM YYYYRow5:
ESCORT NAME OR NA LN FN RANKRow5:
License USSOFAJapanese Drivers License and GME License 1: Project Number: N4008424R0074

Project Title: REPLACE UNDERGROUND STEAM DOUBLE PIPE BETWEEN SP1-1-3 AND B#6010 (ID#4946145) Flight Line Access are required for site visit on DD MMM 2024 (HHHH-HHHH).

Requester Print Date: Leave Blank
undefined_2: Leave Blank
security1: Off
security2: Off
Security Manager Print Date:
undefined_3:
AOPS1: Off
AOPS2: Off
AOPS3: Off
Airfield Operations Print Date:
Not Approved:
HOPS1: Off
HOPS2: Off
HOPS3: Yes
Harbor Operations Print Date:
Not Approved_2:
PSY1: Off
PSY2: Off
Physical Security Print Date:
undefined_4:
NAME LASTFIRSTRow1_2:
RANKRow1_2:
DODID or DBIDS Row1_2:
ROTATION DATE DD MMM YYYYRow1_2:
license: [NO]
AVOC EXPIRATION DD MMM YYYYRow1_2:
ESCORT NAME OR NA LN FN RANKRow1_2:
NAME LASTFIRSTRow2_2:
RANKRow2_2:
DODID or DBIDS Row2_2:
ROTATION DATE DD MMM YYYYRow2_2:
license7: [NO]
AVOC EXPIRATION DD MMM YYYYRow2_2:
ESCORT NAME OR NA LN FN RANKRow2_2:
NAME LASTFIRSTRow3_2:
RANKRow3_2:
DODID or DBIDS Row3_2:
ROTATION DATE DD MMM YYYYRow3_2:
license8: [NO]
AVOC EXPIRATION DD MMM YYYYRow3_2:
ESCORT NAME OR NA LN FN RANKRow3_2:
NAME LASTFIRSTRow4_2:
RANKRow4_2:
DODID or DBIDS Row4_2:
ROTATION DATE DD MMM YYYYRow4_2:
license9: [NO]
AVOC EXPIRATION DD MMM YYYYRow4_2:
ESCORT NAME OR NA LN FN RANKRow4_2:
NAME LASTFIRSTRow5_2:
RANKRow5_2:
DODID or DBIDS Row5_2:
ROTATION DATE DD MMM YYYYRow5_2:
license10: [NO]
AVOC EXPIRATION DD MMM YYYYRow5_2:
ESCORT NAME OR NA LN FN RANKRow5_2:
NAME LASTFIRSTRow6:
RANKRow6:
DODID or DBIDS Row6:
ROTATION DATE DD MMM YYYYRow6:
license10-2: [NO]
AVOC EXPIRATION DD MMM YYYYRow6:
ESCORT NAME OR NA LN FN RANKRow6:
NAME LASTFIRSTRow7:
RANKRow7:
DODID or DBIDS Row7:
ROTATION DATE DD MMM YYYYRow7:
license11: [NO]
AVOC EXPIRATION DD MMM YYYYRow7:
ESCORT NAME OR NA LN FN RANKRow7:
NAME LASTFIRSTRow8:
RANKRow8:
DODID or DBIDS Row8:
ROTATION DATE DD MMM YYYYRow8:
license12: [NO]
AVOC EXPIRATION DD MMM YYYYRow8:
ESCORT NAME OR NA LN FN RANKRow8:
NAME LASTFIRSTRow9:
RANKRow9:
DODID or DBIDS Row9:
ROTATION DATE DD MMM YYYYRow9:
license13: [NO]
AVOC EXPIRATION DD MMM YYYYRow9:
ESCORT NAME OR NA LN FN RANKRow9:
NAME LASTFIRSTRow10:
RANKRow10:
DODID or DBIDS Row10:
ROTATION DATE DD MMM YYYYRow10:
license14: [NO]
AVOC EXPIRATION DD MMM YYYYRow10:
ESCORT NAME OR NA LN FN RANKRow10:
NAME LASTFIRSTRow11:
RANKRow11:
DODID or DBIDS Row11:
ROTATION DATE DD MMM YYYYRow11:
license15: [NO]
AVOC EXPIRATION DD MMM YYYYRow11:
ESCORT NAME OR NA LN FN RANKRow11:
NAME LASTFIRSTRow12:
RANKRow12:
DODID or DBIDS Row12:
ROTATION DATE DD MMM YYYYRow12:
license16: [NO]
AVOC EXPIRATION DD MMM YYYYRow12:
ESCORT NAME OR NA LN FN RANKRow12:
NAME LASTFIRSTRow13:
RANKRow13:
DODID or DBIDS Row13:
ROTATION DATE DD MMM YYYYRow13:
license17: [NO]
AVOC EXPIRATION DD MMM YYYYRow13:
ESCORT NAME OR NA LN FN RANKRow13:
NAME LASTFIRSTRow14:
RANKRow14:
DODID or DBIDS Row14:
ROTATION DATE DD MMM YYYYRow14:
license18: [NO]
AVOC EXPIRATION DD MMM YYYYRow14:
ESCORT NAME OR NA LN FN RANKRow14:
NAME LASTFIRSTRow15:
RANKRow15:
DODID or DBIDS Row15:
ROTATION DATE DD MMM YYYYRow15:
license19: [NO]
AVOC EXPIRATION DD MMM YYYYRow15:
ESCORT NAME OR NA LN FN RANKRow15:
NAME LASTFIRSTRow16:
RANKRow16:
DODID or DBIDS Row16:
ROTATION DATE DD MMM YYYYRow16:
license20: [NO]
AVOC EXPIRATION DD MMM YYYYRow16:
ESCORT NAME OR NA LN FN RANKRow16:
NAME LASTFIRSTRow17:
RANKRow17:
DODID or DBIDS Row17:
ROTATION DATE DD MMM YYYYRow17:
license21: [NO]
AVOC EXPIRATION DD MMM YYYYRow17:
ESCORT NAME OR NA LN FN RANKRow17:
NAME LASTFIRSTRow18:
RANKRow18:
DODID or DBIDS Row18:
ROTATION DATE DD MMM YYYYRow18:
license22: [NO]
AVOC EXPIRATION DD MMM YYYYRow18:
ESCORT NAME OR NA LN FN RANKRow18:
NAME LASTFIRSTRow19:
RANKRow19:
DODID or DBIDS Row19:
ROTATION DATE DD MMM YYYYRow19:
license23: [NO]
AVOC EXPIRATION DD MMM YYYYRow19:
ESCORT NAME OR NA LN FN RANKRow19:

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