SP451015Q0015Attachment_1.docx

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Temporary Replacement Nurse Services
Solicitation number
SP4510-15-Q-0015
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CAC card Attachment 1

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SF30_SP451015Q0015 1 .pdf PDF
SF1449_SP451015Q0015 1 .pdf PDF
SF1449_SP451015Q0015 1 .pdf PDF
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GOVERNMENT-ISSUED CONTRACTOR COMMON ACCESS CARD (CAC)

TURN-IN RECEIPT

The contractor shall complete the following information:

Contract Number:

Contractor:

Location:

The contractor shall identify the following information for each contractor CAC being turned-in:

Employee Name
Issue Date
Expiration Date

The contractor shall return the above identified contractor CACs to the Contracting Officer’s Representative (COR) for the contract for turn-in. The COR will enter the turn-in date for the contractor CACs. The contractor shall acknowledge turn-in of the contractor CACs and the COR will acknowledge receipt below:

Turn-in Date to COR
Contractor Acknowledgement of Turn-In
COR Acknowledgement of Receipt
Signature:
Signature:
Print Name:
Print Name:

The COR will hand-carry the above identified contractor CACs to the nearest Real-Time Automated Personnel Identification System (RAPIDS) office for turn-in. The RAPIDS office will enter the turn-in date for the contractor CACs. The COR will acknowledge turn-in of the contractor CACs and the RAPIDS office will acknowledge receipt below:

Turn-in Date to RAPIDS Office
COR Acknowledgement of Turn-In
RAPIDS Office Acknowledgement of Receipt
Signature:
Signature:
Print Name:
Print Name:

Attachment 1

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