NEW Base Pass Template.pdf
PDF 345 KB Posted
- Attached to
- MXS Carpet Replacement
- Solicitation number
- FA483025Q0036
About this file
This document is a Department of the Air Force base access request form for a carpet installation project at Moody Air Force Base. The form is part of the solicitation FA483025Q0036 for the 23rd Maintenance Squadron (23 MXS), requesting installation access for contractors to conduct a site visit on Monday, April 7, 2025 at 09:00 AM EST. The form requires contractors to provide full names, last 6 digits of SSN/DOB, and company information for base access. The site visit is mandatory for vendors to inspect the carpet replacement location, with check-in required at the Visitor's Center by 8:30 AM EST. Completed base pass forms must be emailed to june.alba@us.af.mil by Friday, April 4, 2025 at 1:00 PM EST, with a contact phone number included. The carpet replacement project involves multiple carpet selections from manufacturers like Mohawk, Interface Americas, Mannington, Tarkett, Milliken, and Bentley Mills, to be installed in building 780 at Moody AFB.
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Text version
CCUI
DEPARTMENT OF THE AIR FORCE
23D SECURITY FORCES SQUADRON (ACC)
MOODY AIR FORCE BASE GEORGIA
MEMORANDUM FOR 23 SFS
FROM: 23 CONS
SUBJECT: Request for Installation Access
1. I am requesting a pass for the following people to Moody AFB for the purpose of a site visit for a carpet installation project at the 23 MXS. (RFQ #FA483025Q0036)
Full Name: as they appear on their valid state ID.
Last 6 of
SSN / DOB
Organization/Company Name:
Expiration Date:
(not to exceed 1yr)
JUNE ALBA, SSGT, USAF
23 CONS PKB, NCOIC
Attack · Rescue · Prevail
Unauthorized disclosure or misuse of this PERSONAL INFORMATION may result in disciplinary action, criminal and/or civil penalties.
**Write N/A if contractor declined to provide information. Be advised that SSN/DOB information is required for base access. Security Forces will ask for it at the Visitor's Center if not detailed in this form.
2. Request pass for the following person(s) to Moody AFB for SITE VISIT: 23 MXS - BLDG 780
| Text1: JOHN SMITH |
| Text2: 12-3456 / 1JAN1990 |
| Text3: ABCD LLC. |
| Text4: 7 APR - 7 APR 2025 |
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