US Citizen Pre-Bid or Site Visit Form MAR 2025 1 (1).pdf
PDF 250 KB Posted
- Attached to
- JPP Regulatory Office - HVAC Units Replacement
- Solicitation number
- W912P526QA015
About this file
This is a Site Visit Request Form for U.S. Citizens seeking approval to visit Nashville District Corps of Engineers field locations. The form must be submitted to the Nashville District Meeting or Site Visit Point of Contact (POC) and forwarded to the LRN Security Management Office at least five (5) full business days prior to the proposed visit. The form requires submission of personal identification information including full legal name, date of birth, last four digits of social security number, driver's license number and state, the specific LRN field location to be visited, the proposed visit date, and a contact phone number for questions. The POC is identified as Kenyanna Jennings of the Nashville District.
The form establishes specific restrictions and requirements for site visits, including that only confirmed and approved visitors are permitted with no substitutions or additions allowed, visitors may not carry packages or backpacks, photography and video recording of power plant interiors is strictly prohibited, and dress code requirements prohibit high-heeled or open-toe shoes. The form notes that increased threat conditions may result in cancellation of approved tours with minimal notice. Information provided is voluntary but failure to supply requested data may result in denial of access due to inability to verify identification. The information will not be retained digitally or in hard copy after the scheduled visit. For assistance, visitors may contact Tracy Dorrough, Personnel Security Specialist (615-736-7397) or Jay Klinger, District Security Chief (615-736-2185).
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Text version
Nashville District Corps of Engineers
U.S. Citizen
Site Visit Request Form
This Request Form is for U.S. Citizens requesting approval to attend a meeting or site visit at one of the
Nashville District (LRN) Corps of Engineers field locations. The form should be submitted to the
Nashville District Meeting or Site Visit Point of Contact (POC) to be forwarded to the LRN Security
Management Office (LRN-SM) at least Five (5) full business days prior to the proposed visit.
LRN Meeting/Site Visit POC: _____________________________________
Nashville District (LRN) Contact Person)
Date the Request is Being Submitted to LRN (mm/dd/yyyy) ___________________
FULL LEGAL Name _______________________________________________________
(Last, First Middle)
If you have only initials in your name, use them and state (IO). If you have no middle name, enter
“NMN”. If you are a “Jr.,”Sr.,” “II,” etc., indicate your status (Do not list a Nickname)
NOTE: Failure to provide FULL LEGAL name will delay approval
Date of Birth (mm/dd/yyyy) ___________ Last Four Digits of Social Security Number ____________
Driver’s License Number and State ________________________
LRN Field Location (Project Site) to be visited: _______________________
Date of Proposed Visit (mm/dd/yyyy) ____________________________
In Case of Questions, Please Provide Phone Number: __________________________
IMPORTANT: Submit form directly to Site Visit POC (contracting representative or Corps POC). DO
NOT submit the form directly to the Security Office Unless Directed. For questions regarding the site visit contact the Site Visit POC.
Only confirmed/approved visitors will be permitted on the tour. No substitutions or additions are allowed.
Visitors may not carry packages, backpacks, or other containers during the tour.
Photographs and video recording of the interior of the Power Plant is strictly prohibited.
No high-heel, open toe shoes, including clogs and Crocs or bare feet will be allowed on a tour.
NOTE: Any increase in threat conditions may result in an approved tour being cancelled with little notice. We regret any inconvenience this may cause.
For questions regarding completing the form, contact one of the individuals listed below:
Tracy Dorrough, Personnel Security Specialist, 615-736-7397 (Primary Security POC)
Jay Klinger, District Security Chief, 615-736-2185
PRIVACY ACT STATEMENT
AUTHORITY: Information is solicited pursuant to Title 10, U.S. Code, Section 3013 and E.O. 9397.
PRINCIPAL PURPOSE: To provide information necessary for preparation of a scheduled tour of the facility, verify positive identification of visitor(s), and conduct background checks for determinations of the eligibility of individuals for access to U.S.
Army Corps of Engineers facilities.
ROUTINE USES: Used by the U.S. Army Corps of Engineers to accompany a request for a scheduled tour of the facility.
MANDATORY OR VOLUNTARY DISCLOSURE AND EFFECT OF NOT PROVIDING INFORMATION: Providing the solicited information, including Social Security Number, is voluntary; however, failure to provide information may result in a denial of visitor access due to an inability to verify identification. The information provided to the U.S. Army Corps of Engineers will not be retained digitally or by hard copy after the scheduled visit.
03/25/2025 mailto:tracy.w.dorrough@usace.army.mil mailto:john.j.carter@usace.army.mil mailto:jason.j.klinger@usace.army.mil
| Drivers License Number and State: |
| Contracting Representative or Corps POC: Kenyanna Jennings |
| Date of Request: |
| LEGAL Name: |
| Birthday mm/dd/yyyy: |
| Last Four #s of SSN: |
| Project Site your visiting (e: |
| g: |
| Barkley Dam): |
| Date of arrival mm/dd/yyyy: |
| Contact number if we have questions: |
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