Solicitation_Restricted_Access_Request_Mission_Erbil.docx

Restricted Access Request Solicitation Number SAQMMA17R0149 Local Guard Program U.S. Mission Erbil Iraq

THIS FORM MUST BE FILLED OUT IN ITS ENTIRETY*. ANY INFORMATION NOT SUPPLIED WILL RENDER THIS REQUEST INVALID.

1. Requester Information

2. My interest in this project is as a (please check one):

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 BE REGISTERED WITH SYSTEM FOR AWARD MANAGEMENT (SAM) AND FEDBIZOPS, 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 BIDDING DOCUMENTS ON THE INTERNET.

Printed Name:____________________________ Signature:______________________________________

Completed form shall be e-mailed to WilhelmNA@state.gov and Mukherjees1@state.gov by 16:00 March 2, 2017