SOW Attachment - PIV Request Form.pdf
PDF 293 KB Posted
- Attached to
- Z2DA--402-24-007 B200E Lobby Flooring
- Solicitation number
- 36C24124Q0184
About this file
The provided document is a Request for Quotes (RFQ) for project 402-24-007 Building 200E Lobby Flooring at the Togus VA Medical Center in Maine. The project requires the removal and installation of new flooring in the lobby and corridors of Building 200E, approximately 4,650 square feet. The contractor will be responsible for field verifying all conditions and quantities. A site visit is scheduled for April 15, 2024, and questions must be submitted by April 24, 2024. Requests for Quotes are due by May 6, 2024, and the period of performance is 210 calendar days from the issuance of the Notice to Proceed.
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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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