SOW Attachment 5 - PIV Request Form.pdf
PDF 293 KB Posted
- Attached to
- Z2GZ-- 402-23-002 Abate and Renovate B67
- Solicitation number
- 36C24124B0036
About this file
The document appears to be a PIV Request Form for the Department of Veterans Affairs VA Maine Healthcare System Police Department. The form requires various personal information to be submitted, such as name, address, social security number, date of birth, and occupation title, in order to obtain a PIV (Personal Identity Verification) or FLASH badge. The form indicates that all highlighted information must be provided, or a badge cannot be issued. The form also includes sections for VISTA, VAPS, and local records checks to be completed.
The related federal contract opportunity is for the abatement and renovation of Building 67 at the Togus VA Medical Center in Augusta, Maine. The work includes the removal and abatement of lead paint, the removal and abatement of mold-contaminated surfaces and fixtures, the investigation and repair of a steam leak issue, and the demolition and replacement of the existing doors and windows. The contract is being solicited by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 1.
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Other files
| File | Type | Posted |
|---|---|---|
| Wage Determination 05242024.pdf | ||
| 36C24124B0036 0004.docx | DOCX document | |
| 36C24124B0036 0003.docx | DOCX document | |
| First Floor-Lead Layout1.pdf | ||
| 36C24124B0036 0002.docx | DOCX document | |
| 36C24124B0036 0001.docx | DOCX document | |
| SOW Attachment 2 - Togus Campus Map.pdf | ||
| SOW Attachment 1 - Seasonal Influenza with Vaccines.pdf | ||
| SOW Attachment 6 - Specifications Complete.pdf | ||
| SOW Attachment 3 - ICRA.pdf | ||
| SOW Attachment 7 - Photo Package.pdf | ||
| SOW Attachment 4 - PCRA.pdf | ||
| SOW - Abate and Renovate B67 - revised 5-2-24.docx | DOCX document | |
| Wage Determination.pdf | ||
| 36C24124B0036.docx | DOCX document |
Show all 15
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Text version
Project Name: Type of Badge Requested: PIV NON-PIV FLASH
Circle one
Departmentof Veterans Affairs
VA Maine Healthcare System
Police Department
1 VA Center 07B
Augusta, ME 04330
207 623-5796
Last Name First Name Middle
Physical Street Address City State and Zip Code
Social Security Number
Gender (M) (F)
Service Line or Company Name Company or Cell Phone Number
Date of Birth
Place of Birth Occupation Title
Personal email for activation of badge process
For Engineers to fill out:
Contract end date:
Service Line Official Date
All highlighted info must be submitted, or a badge cannot be issued
FOR TOG US POLICE USE ONLY
VISTA RECORDS:
DATE CHECKED BY RECORDS FOUND TYPE
VAPS RECORDS:
DATE CHECKED BY RECORDS FOUND TYPE
LOCAL RECORDS:
DATE CHECKED BY RECORDS FOUND TYPE
STATUS F YES NO ADVANCED TO HR
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File details come from the government source that posted it. Updated .