SOW Exhibit B.xlsx
XLSX spreadsheet 38 KB Posted
- Solicitation number
- 20156798
About this file
This file is a CBP Contractor Information Sheet template used for short-term contractor and visitor access management at U.S. Customs and Border Protection facilities. The form collects comprehensive information from contract companies requesting to bring visitors or contractors to CBP locations, including the contractor's company details, point of contact information, and CBP site specifics such as location and building assignment. The form requires detailed personal information for each visitor, including full name, date of birth, citizenship status, place of birth, occupation, address, and government-issued identification details (visa, passport, driver's license, and social security number).
The template establishes mandatory security procedures requiring submission 72 hours prior to visitor arrival to the Office of Professional Responsibility via email (SMDSECURITYSERVICESBRANCH@cbp.dhs.gov) or fax (202-344-1860). All visitors must present U.S. Government-issued photo identification upon arrival and check in/out at the Security Desk. Visitor escorts are responsible for constant supervision, with a ratio of one escort per four visitors required, or one-to-one escort depending on vetting status. The form accommodates up to 84 individual visitors and is governed by the Privacy Act of 1974, with failure to provide required information resulting in access denial.
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| Attachment 1 - Provisions and Clauses.docx | DOCX document | |
| SOW Exhibit A.pdf |
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Text version
Short Term Contractors Template
| CBP Contractor Information Sheet | |
| Date Submitted: | From: |
| Contract Company Information | CBP Agency Information |
| Contract Company Name | CBP Location Address (Location, Building, Floor, Room #) |
Contract Company Address Visitor Escort Full Name (DHS/CBP Employee Only)
Contract Company POC (First & Last Name) Phone Number Email
On Site Contractor POC (First & Last Name) Phone Number Phone Office Mobile Office
| Date(s) and | |||||
| Time(s) of Visit | From Date | Time | To Date | Time |
| Purpose of Visit: | ||||||||||||||||||
| Provide all below information | ||||||||||||||||||
| # | Last Name(s) | First Name | Middle Name | DOB MM/DD/YYYY | U.S. Citizen (Y/N) | POB (City, State/ Country) | Occupation | Address | A Number | Exp Date | Visa Number | Exp Date | Passport Country | Passport # | Exp Date | Social Security Number | DL State Issued | Drivers |
License #
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| 7 |
| 8 |
| 39 |
| 40 |
| 41 |
| 42 |
| 43 |
| 44 |
| 45 |
| 46 |
| 47 |
| 48 |
| 49 |
| 50 |
| 51 |
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| 56 |
| 57 |
| 58 |
| 59 |
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| 61 |
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| 63 |
| 64 |
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| 66 |
| 67 |
| 68 |
| 69 |
| 70 |
| 71 |
| 72 |
| 73 |
| 74 |
| 75 |
| 76 |
| 77 |
| 78 |
| 79 |
| 80 |
| 81 |
| 82 |
| 83 |
| 84 |
| SUBMISSION: The Office of Professional Responsibility requires a mandatory submission of 72 hours prior to arrival of visitor(s) in order for any visitor to be considered for approval. Email request to SMDSECURITYSERVICESBRANCH@cbp.dhs.gov or fax to the Office of Professional Responsibility, ATTN: Security Management Division at 202-344-1860. |
NOTICE: All visitors must present a U.S. Government issued Photo Identification Card. All visitors must check in at the Security Desk upon arrival and check out at the desk upon departure. Visitor escorts are responsible for constant escort of visitors. The designated escort must accompany visitors at all times, to include returning visitors back to the front desk upon departure. Any visitors found in U.S. Customs and Border Protection space without an escort will be immediately reported to security and escortedout of CBP space. One escort must be provided for every four visitors (1-4), depending on Vetting status one escort may be required for evey person (1-1).
PRIVACY ACT NOTICE: This information is provided to PL 93-579 (Privacy Act of 1974). The purpose of this document is provide information necessary for a minimum security check prior tolimited authorized access to U.S. Customs and Border Protection facility. Failure to provide this information may result in denial of access.
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