FY19_Base_Access_Request_(1).pdf

PDF 139 KB Posted

Attached to
Install UPS NUWCDIVNPT Federal contract opportunity
Solicitation number
N66604-19-Q-2891
Issued by
Department of the Navy Naval Sea Systems Command

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Visit Request Information

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N66604-19-Q-2891-0002.pdf PDF
Amendment_0001_N6660419Q2891.pdf PDF
N66604-19-Q-2891.pdf PDF
19-023A01_Replace_UPS_System.pdf PDF

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NUWC NEWPORT DIVISION VISITOR REQUEST INFORMATION

• A visit request is MANDATORY for all visitors to NUWC Division Newport; government and civilian, regardless of the duration or classification of the visit. Access to NUWC Division Newport will not be granted under any circumstances without a valid visit authorization request (VAR) on file.

• If you can submit your VAR via JPAS, you do not need to send a VAR on company letterhead.

• Due to the number of visit requests received, please allow 3-5 business days for processing time, whether received by

JPAS or on Company Letterhead via FAX or EMAIL.

• Visitors who arrive prior to the 3-5 working day processing window may not be guaranteed access.

• Please note, all individuals not in possession of a common access card (CAC) or Teslin Card (Retired Military/Dependent

ID), will require a DBIDS card for access.

• No unescorted access will be granted without a valid DBIDs card or ID mentioned above.

NUWCDIVNPT VISITOR REQUE

ST INFORMATION NEEDED:

**Information must be on Company Letterhead**

1) Company/Organization Name, Address, Telephone, and FAX Number

2) Cage Code

3) Visitor(s) Full Name (As it appears on government issued ID – i.e. Driver’s License)

4) Visitor(s) Full Social Security Number

5) Visitor(s) Date of Birth

a. If born outside the U.S, you MUST provide a Naturalization Number or US Passport

6) Visitor(s) Place of Birth (City & State)

7) Visitor(s) Citizenship

a. SCI Level Access MUST be coordinated SSO to SSO

8) Level of Clearance: UNCLASSIFIED or as appropriate

a. Please specify which visitor(s) have CAC, Retired Military/Dependent ID, DBIDS, or NOT APPLICABLE

9) Do they possess a CAC, Teslin or DBIDs Card? (Yes or No)

a. MUST be a NUWC Government Employee

10) NUWCDIVNPT Point of Contact (Sponsor)

11) Specific Date(s) of Visit, to include Year

12) Purpose of Visit

13) Contract Number, if applicable

a. If NO Contract Number is provided, then the visit will be for 30 days at the UNCLASSIFIED Level

14) Authorized Signature:

a. Name, Title, Signature, and Date of Requesting Company/Organization Authorizing Official (MUST be a US Citizen)

b. Smaller companies that do not have a Security Officer to sign may use another Official or Secretary.

c. Individuals MUST NOT Sign their own request

Submit Visitor Request(s) via:

JPAS SMO CODE: 666045 (If no access to JPAS, use methods below)

EMAIL FORM TO: Please send to ALL email addresses listed below.

o Keith.P.Arnold@navy.mil o Deanna.L.Monell.ctr@navy.mil o Gina.Fleming.ctr@navy.mil

FAX FORM TO: (401) 832-4396

**ALL INCOMPLETE VISIT REQUESTS WILL BE DENIED**

https://safe.amrdec.army.mil/safe/ mailto:Keith.P.Arnold@navy.mil mailto:Deanna.L.Monell.ctr@navy.mil mailto:Gina.Fleming.ctr@navy.mil

SECNAV FORM 5512_1_ highlighted.pdf
28. Check the applicable box for WORK HOURS box or check the OTHER box and enter the work hours, then check the applicable for WORK DAYS:
PRIOR FELONY CONVICTIONS
29. Have you ever been convicted of a Felony?
REQUIREMENT TO RETURN LOCAL POPULATION ID CARD
LIST OF ACCEPTABLE DOCUMENTS - All documents must not be expired.
AGENCY DISCLOSURE STATEMENT:
PLEASE DO NOT RETURN COMPLETED FORM TO THE ABOVE ADDRESS.

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