Section L Appendix 6 - Badging Request Form (Secure Area).docx

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Attached to
Modify Vehicle Assembly Building High Bay-3 Platforms for Block 1B Federal contract opportunity
Solicitation number
80KSC021R0020
Issued by
National Aeronautics and Space Administration Kennedy Space Center

About this file

This document contains a federal contract opportunity solicitation for modification work at NASA's Kennedy Space Center in Florida. The solicitation seeks a contractor to fabricate and erect new platforms and construct new floors, rooms, walls and ceilings in the Vehicle Assembly Building at heights ranging from approximately 280 to 450 feet above ground. The contractor must provide all necessary resources including welding and bolting steel structures weighing around 300,000 pounds to the facility columns. In addition, the contractor must modify and extend building systems such as fire suppression pipes and valves, fire alarms, gaseous nitrogen and helium tubing operating at over 5,000 PSI, and electrical power. The work must be completed during operational downtimes between launches while allowing for dual occupancy of the work space.

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Text version

Badging Request

Name (First, Middle, Last) *Please specify if no middle name (NMN)

SSN

Date of Birth

Place of Birth (City, State, or Country)

Country of Citizenship

Naturalization Number *Must submit scanned copy of Naturalization Certificate or U.S. Passport with request

Legal Permanent Resident (LPR) Card Number *Must submit scanned copy of LPR card with request

LPR Expiration Date

Employee’s Home Address *Include City, State, and Zip Code

Date(s) of Visit *Must include start date and end date

Agreement Number

Position Title

Driver’s License Number *Must submit a scanned copy with request Issuing State

State ID Card Number
Issuing State

E-mail Address

Home Phone (Include Area Code)

Cell Phone (Include Area Code)

Company Name/Mailing Address/Phone Number

Is IT Access Required (Y/N) – Please be specific *Requires access to KSC system (i.e. SharePoint, internal Web sites, or applications)

N

Justification for IT Access – What role/work requires the request for IT access?

N/A

Is Temporary Area Access (TAA) needed? (Y/N)
Y
Escorted or Unescorted TAA?
Escorted
Area(s) to be Accessed (Provide Area Number[s])
1 and 2
Purpose for Access (Detailed)
Site Visit for Modify VAB HB-3 Platforms construction project. Solicitation No. 80KSC021R0020

Date(s) of Access

File details come from the government source that posted it. Updated .