ATTACHMENT 4 - - 1818 Pre-enrollment sample.pdf

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Attached to
Repair Sprinkler Pipe near Door 122 - Bldg 2001
Solicitation number
SP3300-24-Q-0040
Issued by

About this file

This document outlines a federal contract opportunity for repair work on a sprinkler system at a Defense Logistics Agency facility. The solicitation seeks a contractor to remove and replace an existing concrete floor slab and damaged cast iron sprinkler pipe near Door 122 of Building 2001 at the DLA Distribution Susquehanna site in New Cumberland, Pennsylvania. The work must be completed outside of normal business hours within 60 calendar days of receiving the notice to proceed. This acquisition is set aside exclusively for small businesses with a size standard of $45 million or less. The Defense Logistics Agency will issue the request for quote on or around January 5, 2024, conduct a pre-proposal site visit, and award a fixed-price contract to the lowest priced responsible offeror. All prospective contractors must register in the System for Award Management to be eligible for consideration.

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Text version

PRIVACY ACT STATEMENT

VISIT NOTIFICATION

1. ACTIVITY TO BE VISITED

AUTHORITY:

PRINCIPAL PURPOSE:

ROUTINE USES:

DISCLOSURE:DEFENSE LOGISTICS AGENCY

8725 JOHN J. KINGMAN ROAD

FT BELVOIR, VA 22060-6220

Section 21, 50 U.S.C. 781 et seq.; Executive Order 10450.

To control access to and movement on DoD installations, buildings, or facilities.

Used by General Services Administration Protective Service Personnel for access control and for any of the Blanket Routine Uses published by DLA.

Voluntary. However, failure to provide all the requested information may result in refusal to grant access to the installation, building, or facility.

DLA PRIVACY ACT SYSTEM NOTICE S500.50 DLA-I APPLIES

SECTION I

2. NAME OF REQUESTOR/PREPARER 4. TELEPHONE3. OFFICE CODE

5. DATE(S) OF VISIT 6. POINT OF CONTACT (at facility to be visited) 7. POC TELEPHONE

8. PURPOSE OF VISIT

SECTION II

9.

NAME(S) OF VISITOR(S)

(Last, First, MI)

10.

GRADE/RANK

11.

SSN

12.

DATE OF BIRTH

13.

STATE /COUNTRY OF

BIRTH

14.

CLEARANCE/DATE

GRANTED

15.

TYPE OF INVESTIGATION/

DATE

16. TYPED NAME OF SECURITY REPRESENTATIVE

SECTION III

18. ACTIVITY 19. TELEPHONE NUMBER 20. DATE17. SIGNATURE OF SECURITY REPRESENTATIVE

DLA FORM 1818, JUL 96 (EG)

FROM: TO:

PDF (DLA)

RequesterName: Mogen Gilson
OfficeCode: J7/AB
FacPOC: Tim Kielbowick
Phone: 717-770-4757
POCPhone: 717-770-6128
VisitedActivity: DLA DISTRIBUTION

Meet at PASS/ID

10:00 AM-11:00 AM

VisitPurpose: Site Visit: BLDG 2001 Sprinkler Repair

Visitor has registered utilizing the pre-enrollment website: https://dbids-global.dmdc.mil/enroll

DateTo: 1/30/2024
Visitor:
0: Doe, John M.
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