N4019220R1800_AAFB_Base_Access_List_Form.pdf
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- Solicitation number
- N4019220R1800
About this file
This document includes a base access list form and details of a federal contract opportunity for environmental services. The base access list form requests personal information such as names, dates of birth, and social security numbers from individuals seeking access to Andersen Air Force Base for a one-day pre-proposal site visit related to solicitation N40192-20-R-1800.
Solicitation N40192-20-R-1800 is a small business set-aside for environmental services including hazardous waste management, hazardous material management, and spill response at Joint Region Marianas under the Department of the Navy Naval Facilities Engineering Command. Services will be provided through an indefinite delivery indefinite quantity contract with a base period of one year and four one-year options for a total of five years. The contract value shall not exceed $20 million. Interested small businesses can view the full solicitation on FBO.gov starting October 25, 2019. A pre-proposal conference and site visit is scheduled for November 8, 2019 at Naval Base Guam.
AAFB Base Access List Form
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ANDERSEN AAFB ACCESS LISTING REQUEST
The information herein is For Official Use Only (FOUO) which must be protected under Title 5, U.S.C. 552a - The Privacy Act of 1974, as amended. Unauthorized disclosure or misuse of this PERSONAL INFORMATION may result in criminal and/or civil penalties.
Base Access List (BAL) Authority: AFI 31-113, Chapter 4 Identity Vetting and Fitness Determination Purpose: Installation Access Listing for personnel requesting access to Andersen AFB (AAFB).
SSN and DOB: Are used for further proofing and vetting of an individual requesting base access.
Routine Use(s): The Visitor Control Center/Base Access Office will use NAME, DOB and FULL SSN to perform fitness determination on all individuals listed in this document and issue an AF Form 75 / Visitor Pass.
Disclosure: Disclosure is voluntary. Failure to disclose all required information will result in that person not being allowed to enter Andersen AFB property.
TRACKING NUMBER
DATE
REQUESTOR:
SCHEDULED DATES: One-Day Only 11/12/2019 - 11/12/2019 ACCESS/TIME: One-Day Only □ Su □ Mo □ Tu □ We □ Th □ Fr □ Sa TIME 0800-1600hrs PURPOSE: Pre-Proposal Site Visit for Solicitation N40192-20-R-1800, Environmental IDIQ Services for Hazardous Waste, Hazardous Material, Other Regulated Waste, and Spill Response at Joint Region Marianas
***ACCESS TO ANDERSEN AFB RESTRICTED AREAS IS PROHIBITED***
BLOCK I. Personal Data
# Last Name First Name MI. Date of Birth (yyyymmdd)
FULL Social Security Number
Please contact the undersigned at (671) 333-3171 or teresa.aguon@fe.navy.mil for any questions.
TERESA F. AGUON,
Contracting Officer, NAVFAC Marianas mailto:teresa.aguon@fe.navy.mil
File details come from the government source that posted it. Updated .