SFRC Controlled Unclassified Information (CUI) Restricted Access Request Form.docx

Space Force Range Contract (SFRC) Restricted Access Request 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. Company CAGE Code: _________________________________________________

d. Company Unique Entity Identifier: ________________________________________

e. Point of Contact Name: _________________________________________________

i. Telephone No.: __________________________________________________

ii. E-mail Address: _________________________________________________

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

a. [ ] Prime Contractor

b. [ ] Joint Venture Participant

c. [ ] Subcontractor (please specify prime)_____________________________________

d. [ ] 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

SFRC Bidder’s Library distribution authorized to legitimate bidders only.

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 BIDDING DOCUMENTS ON THE INTERNET.

Printed Name: ____________________________ Signature: ___________________________________

Please email completed form to natalie.erdley@spaceforce.mil and charlene.thomas@spaceforce.mil