RESTRICTED ACCESS FORM - MALAWI.pdf
PDF 208 KB Posted
- Solicitation number
- 19AQMM26R0391
About this file
This is a Restricted Access Request form for the Local Guard Program at the U.S. Mission in Lilongwe, issued as a pre-solicitation notice. The form is designed for firms interested in bidding on this contract opportunity to request access to restricted documentation containing technical and operational information.
Interested firms must complete the form in its entirety, providing company name, address, UEID number, point of contact information, telephone number, and email address. Requesters must indicate their interest category as either a prime contractor, joint venture participant, or other entity type. Upon completion, the form must be signed by an authorized representative and submitted via email to both Kerryn Finik (FinikK@state.gov) and Daniel Smith (Smithdd@state.gov) for government approval. All firms must register with SAM.GOV and agree to a restricted distribution agreement that prohibits duplication, secondary distribution, internet posting, or scanning of documents. Requesters are required to maintain documents in locked storage when not in use and destroy all hardcopy prints and electronic media upon termination of use by shredding and formatting, respectively.
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Text version
US Mission Lilongwe– Local Guard Program Restricted Access Request
Restricted Access Request Page 1
SBU - CONTRACTING AND ACQUISITIONS
RESTRICTED ACCESS REQUEST –
LOCAL GUARD PROGRAM U.S. MISSION LILONGWE
PRE-SOLICITATION NOTICE
THIS FORM MUST BE FILLED OUT IN ITS ENTIRETY*. ANY INFORMATION NOT SUPPLIED
WILL RENDER THIS REQUEST INVALID.
1. Requester Information
a. Company Name:
b. Company Address:
c. UEID No:
d. Point of Contact:
e. Telephone No:
f. E-mail Address:
2. My interest in this project is as a (please check one):
a. a. [ ] Prime Contractor
b. b. [ ] Joint Venture Participant
c. c. [ ] Other (please specify) ___________________________________________
3. I, the undersigned, agree that I will safeguard this information in accordance with the following distribution restriction statement:
RESTRICTED DISTRIBUTION AGREEMENT
Distribution authorized to legitimate bidders only, contains technical or operation information.
THESE RESTRICTED ACCESS DOCUMENTS MAY NOT BE DUPLICATED NOR IS ANY SECONDARY
DISTRIBUTION OF DOCUMENTS AUTHORIZED. ANY AND ALL FIRMS WISHING TO VIEW ANY
PART OF THESE DOCUMENTS MUST REGISTER WITH SAM.GOV, COMPLETE AND SIGN THIS
FORM, AND HAVE THEIR REQUEST APPROVED BY THE GOVERNMENT. DATA SHALL BE KEPT
IN A LOCKED DESK, LOCKED FILING CABINET, OR LOCKED ROOM WHEN NOT IN USE. UPON
TERMINATION OF USE, THE HARDCOPY PRINTS AND ANY ELECTRONIC MEDIA SHALL BE
DESTROYED BY SHREDDING THE PRINTS AND FORMATTING THE ELECTRONIC MEDIA. UPON
TERMINATION OF USE, ALL MEDIA SHALL BE REMOVED FROM ANY COMPUTERS.
DO NOT COPY, SCAN OR POST ANY PART OF THESE DOCUMENTS ON THE INTERNET.
US Mission Lilongwe– Local Guard Program Restricted Access Request
Restricted Access Request Page 2
SBU - CONTRACTING AND ACQUISITIONS
Printed Name: Signature:______________________________________
*Completed form must be e-mailed to Kerryn Finik at FinikK@state.gov AND Daniel Smith at Smithdd@state.gov.
File details come from the government source that posted it. Updated .