Section L Appendix 1 KSC Form 28-889 Visitor Badge Request.pdf
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- Solicitation number
- 80KSC02R0022
About this file
This document contains a federal contract solicitation and related visitor badge request form. The solicitation is for modifying Mobile Launcher 1 at Kennedy Space Center to support Artemis II and install an emergency egress system. Key work includes adding platforms and systems for emergency egress, ground cooling, fire detection and suppression. It also involves relocating a restroom, modifying critical system cables, and other incidental work. Interested vendors must be Defense Logistics Agency Joint Certification Program certified and request controlled documents from listed points of contact by email, including their CAGE and JCP numbers. Documents will then be sent via an approved file transfer service. The badge request form provides visitor details for a May 25, 2021 site visit related to contract number 80KSC021R0022 for the Mobile Launcher 1 modifications.
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KSC Visitor Badge Request (Multiple)
NRRS 1620.105.A
Page of KSC FORM 28-889 NS (PI) 08/13 (1.1) PREVIOUS EDITIONS ARE OBSOLETE. Validate prior to use.
Fax No. 867-4854 Mail Code: KSC Badging Office Phone No. 867-7763 Through signature above I attest to the validity and purpose of this visit.
FULL NAME (Last, First, MI)
COUNTRY OF CITIZENSHIP
SSN/Passport/Naturalization # or Alien Reg. # (Green Card) COMPANY NAME and ADDRESS
DATE OF BIRTH
PLACE OF BIRTH
START DATE
END DATE
To Be Escorted Y/N WARNING. When filled in, this form contains Personally Identifiable Information (PII) that is subject to Federal law and regulation. PII may be used only as authorized, which includes securing it in accordance with NASA policy and procedural requirements. Penalties for misuse apply.
Report suspected misuse immediately to Security Operations Center at 877-NASA-SEC (627-2732).
05/05/14 05/05/14 05/05/14 05/05/14 05/05/14 05/05/14 05/05/14 05/05/14 05/05/14 9.0.0.2.20101008.1.734229 KSC Visitor Badge Request (Multiple) KSC FORM 28-889 Rev 08/13, Created 08/13 Version 1.1 08/13 KSC Forms KSC Visitor Badge Request (Multiple) 08/13 1.1
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| ContstructionContractNum: 80KSC021R0022 |
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| BadgingAuthority: Jesse Berdis, NASA-LX, email: jesse.e.berdis@nasa.gov |
| TelephoneNum: (321) 861-5412 |
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| Purpose: ML-1 Modifications Site Visit on May 25, 2021 |
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File details come from the government source that posted it. Updated .