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Attachment 19 - Roster of Employees Requiring Suitability Investigations

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Sheet1

ROSTER OF EMPLOYEES REQUIRING SUITABILITY INVESTIGATIONS
CAN:Contractor:
RFP/Contract #:Contractor Contact:
Contract Title:Contractor E-mail:
Project Officer:
Contract Specialist:
TO BE FILLED IN BY CONTRACTOR:TO BE FILLED OUT BY
PROJECT OFFICER and ISSO:TO BE FILLED OUT BY CONTRACTOR:
Suitability LevelInvestigation TypeQuestionaire RequiredQuestionaire Submitted
(mm/dd/yyyy)HHS Credit Release Submitted
(mm/dd/yyyy)OF 306 Submitted
(mm/dd/yyyy)Fingerprinting Completed
(mm/dd/yyyy)Existing Clearance or Application
Last NameFirst Namee-mailPositionNon-Disclosure

Agreement Submitted (mm/dd/yyyy) Security Awareness Training Completed (mm/dd/yyyy) 1, 5, 6 NACI, NACIC, MBI, LBI, BI Estimated Cost SF85 or SF85P Agency Clearance Level Date Comment

Page &P&R&Z&F

Sheet2

Sheet3

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