Contractor_Mass_Pass_Template.xlsx
XLSX spreadsheet 13 KB Posted
- Attached to
- Nellis AFB On-Base Restaurant Sources Sought
- Solicitation number
- Not on record
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| File | Type | Posted |
|---|---|---|
| Nellis_AFB_Restaurant_Sources_Sought.pdf |
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Sheet1
| Sponsor Name: | Lorali Herrell |
| Sponsor Signature: |
| Contact Number(s): | Nellis AFB Restaurant Sources Sought | ||||||||||
| Company | Last Name | First Name | MI | Country of Citizenship | Permanent Resident Card# | DOB | SSN | State AND DL#/ID# | Location(s) | Valid Dates(s) | Valid Day(s) & Hrs |
JUSTIFICATION:
Note 1: Specify in detail justification requesting the person(s) listed above having unescorted access. (i.e. requires access 3 times a week to service vending machines on Nellis AFB) Note 2: If you are using a Driver’s License from California, Colorado, Connecticut, District of Columbia, Illinois, Maryland, Utah, Vermont and Washington states an additional form of government issued ID is required (i.e. US Passport, original Birth Certificate with raised seal, original Social Security Card, etc.
Note 3: If individuals are listing another country other than the US for residency please include a copy of their permanent resident card or work permit.
I certify, in accordance with FAR 52.222-54 "Employment Eligibility Verification" that I have performed checks on all above listed employees through the E-Verify system.
Printed Name Signature
(PRIMARY CONTRACTOR NAME)
(PROJECT NAME)
INFORMATION MUST BE TYPED
The individuals listed below have been thoroughly briefed on entry procedures and conconduct while on Nellis/Creech AFB.
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