VA0710.pdf
PDF 693 KB Posted
- Attached to
- Replace Linear Accelerator at Greater Los Angeles VAHCS Federal contract opportunity
- Solicitation number
- 36C25821B0004
About this file
This document includes a federal contract opportunity solicitation for replacing a linear accelerator at a Veterans Affairs medical center. The solicitation seeks a contractor to demolish an existing linear accelerator, assist with installing a new linear accelerator provided by another vendor, and perform related construction work including renovating rooms, adding a mechanical room and data server room, replacing ceiling, flooring, and medical equipment. The work will occur at the Greater Los Angeles Healthcare System campus and must meet seismic requirements. The contractor must coordinate with the linear accelerator vendor, provide structural and electrical work for the medical equipment, and install ceiling-mounted patient lifting equipment. The contract is issued by the Department of Veterans Affairs Veterans Health Administration VISN 22.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sign in Sheet for 11 Jan Site Walk Linear Accelerator.pdf | ||
| 36C25821B0004 0002.pdf | ||
| 36C25821B0004 0001 RFI Amendment.pdf | ||
| Self Certification of Continuous Service.pdf | ||
| Fingerprint Record Prep Sheet BLANK.PDF | ||
| 36C25821B0004.pdf | ||
| Wage Rate Determination CA20200022.docx | DOCX document | |
| Atch 1 Self Performance Calculations.pdf | ||
| 6 4Radixact Full Set.pdf | ||
| Contractor Background Investigation Request Form (May 2019).pdf | ||
| 6 8Infection Control Permit_revised.pdf | ||
| of0306.pdf | ||
| 6 2 Drawings 2 of 2.pdf | ||
| 6 3Specification CSI 121.pdf | ||
| 6 1 Drawings1 of 2.pdf |
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Text version
AUTHORIZATION FOR RELEASE OF INFORMATION
PROTECTED UNDER THE FAIR CREDIT REPORTING ACT (TITLE 15, SECTION 1681)
STATEMENT OF AUTHORIZATION AND CLARIFICATION OF PURPOSE
I Authorize the Department of Veterans Affairs (VA), and authorized agents, to obtain my credit reports from any consumer or credit reporting agency for employment purposes.
The Fair Credit Reporting Act, as amended (15 U.S.C. § 1681, et seq.) allows VA to get one or more credit reports on you for employment. Should a decision to take any adverse action against you be made, based either in whole or in part on the credit report, you should know that the consumer or credit reporting agency that provided the report has played no role in the decision to take action.
VA is requesting an investigation to determine your fitness to work for, or on behalf of, the Federal Government. The information in this authorization will be given to the consumer or credit reporting agency so that the agency will release information about you and your credit history. This information may be disclosed to other Federal Agencies to fulfill official responsibilities, to the extent that the disclosure is permitted by law.
I Understand that the information released by records custodians and sources of information is for official use by the Department of Veterans Affairs, all affiliated agencies and departments, to determine suitability and/or fitness for employment on the behalf of the Federal Government.
Copies of this authorization that show my signature are as valid as the original release signed by me. This authorization is valid for (5) years from the date signed or upon the termination of my affiliation with the Department of Veterans Affairs, whichever is sooner.
SIGNATURE OF EMPLOYEE (Sign in ink) TYPE OR PRINT LEGIBLY FULL NAME DATE SIGNED
OTHER NAMES USED HOME TELEPHONE NUMBER (Include Area Code)
CURRENT ADDRESS (Include Street, City, State, and ZIP Code)
VA FORM
OCT 2017 0710
..\logos\VA Form Bar-04(NEW LOGO).jpg Department of Veterans Affairs
AUTHORIZATION FOR RELEASE OF INFORMATION
PROTECTED UNDER THE FAIR CREDIT REPORTING ACT (TITLE 15, SECTION 1681)
AUTHORIZATION FOR RELEASE OF INFORMATION PROTECTED UNDER THE FAIR CREDIT REPORTING ACT (TITLE 15, SECTION 16 81)
STATEMENT OF AUTHORIZATION AND CLARIFICATION OF PURPOSE
Statement of Authorization and Clarification of Purpose I Authorize the Department of Veterans Affairs (VA), and authorized agents, to obtain my credit reports from any consumer or credit reporting agency for employment purposes.
The Fair Credit Reporting Act, as amended (15 U.S.C. § 1681, et seq.) allows VA to get one or more credit reports on you for employment. Should a decision to take any adverse action against you be made, based either in whole or in part on the credit report, you should know that the consumer or credit reporting agency that provided the report has played no role in the decision to take action.
VA is requesting an investigation to determine your fitness to work for, or on behalf of, the Federal Government. The information in this authorization will be given to the consumer or credit reporting agency so that the agency will release information about you and your credit history. This information may be disclosed to other Federal Agencies to fulfill official responsibilities, to the extent that the disclosure is permitted by law.
I Understand that the information released by records custodians and sources of information is for official use by the Department of Veterans Affairs, all affiliated agencies and departments, to determine suitability and/or fitness for employment on the behalf of the Federal Government.
Copies of this authorization that show my signature are as valid as the original release signed by me. This authorization is valid for (5) years from the date signed or upon the termination of my affiliation with the Department of Veterans Affairs, whichever is sooner.
I Authorize the Department of Veterans Affairs (VA), and authorized agents, to obtain my credit reports from any consumer or credit reporting agency for employment purposes.
The Fair Credit Reporting Act, as amended (15 U.S.C. § 1681, et seq.) allows VA to get one or more credit reports on you for employment. Should a decision to take any adverse action against you be made, based either in whole or in part on the credit report, you should know that the consumer or credit reporting agency that provided the report has played no role in the decision to take action.
VA is requesting an investigation to determine your fitness to work for, or on behalf of, the Federal Government. The information in this authorization will be given to the consumer or credit reporting agency so that the agency will release information about you and your credit history. This information may be disclosed to other Federal Agencies to fulfill official responsibilities, to the extent that the disclosure is permitted by law.
I Understand that the information released by records custodians and sources of information is for official use by the Department of Veterans Affairs, all affiliated agencies and departments, to determine suitability and/or fitness for employment on the behalf of the Federal Government.
Copies of this authorization that show my signature are as valid as the original release signed by me. This authorization is valid for (5) years from the date signed or upon the termination of my affiliation with the Department of Veterans Affairs, whichever is sooner.
SIGNATURE OF EMPLOYEE (Sign in ink)
TYPE OR PRINT LEGIBLY FULL NAME
DATE SIGNED
OTHER NAMES USED
HOME TELEPHONE NUMBER (Include Area Code) CURRENT ADDRESS (Include Street, City, State, and ZIP Code)
VA FORM
OCT 2017
V A Form 0 7 1 0, OCTOBER 2017 VA Form 0710, AUTHORIZATION FOR RELEASE OF INFORMATION
PROTECTED UNDER THE FAIR CREDIT REPORTING ACT (TITLE 15, SECTION 1681)
0710, Authorization, Release, Information, Protected, Fair, Credit, Reporting, Act Missie Vaccaro-Palomaki
MAY 1998
OCTOBER 2017
Trish Moore (07)
| Signature of Employee Sign in ink: |
| TYPE OR PRINT LEGIBLY FULL NAME: |
| DATE SIGNED: |
| OTHER NAMES USED: |
| HOME TELEPHONE NUMBER (Include Area Code): |
| CURRENT ADDRESS (Include Street, City, State, and ZIP Code): |
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