Vendor_Conference_Registration_Form.pdf
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- Solicitation number
- 2025-RFP-019
- Issued by
- Dane County, Wisconsin
About this file
This document is a Site Visit - Temporary 1 Day Access/Registration Form for the Dane County Purchasing Department, specifically related to RFP# 2025-RFP-019 for a Vendor Conference. The form is required to be completed and submitted to Megan Rogan (rogan.megan@danecounty.gov) no later than Monday, January 27th, 2025, to gain approval for attending the site visit. The form is part of a comprehensive background check process that requires 3-4 full business days to complete, with potential attendees required to provide detailed personal information including driver's license details, criminal history, and contact information.
The registration form is designed to conduct a thorough background screening for vendors interested in participating in a site visit related to a Jail Resident Communication Services contract. The form includes sections for personal identification, criminal history disclosure, and requires individuals to disclose felony and misdemeanor convictions. The document indicates a rigorous vetting process with multiple background check components including D.O.T. open tickets, C.I.B. jail records, F.B.I. local computer contacts, CCAP records, and warrant checks. The form will be processed by the Project & Program Assistant and reviewed by a Sergeant, suggesting a high level of security and access control for the vendor conference.
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Text version
SITE VISIT - TEMPORARY 1 DAY ACCESS/REGISTRATION FORM
Complete this form in its entirety and email to Megan Rogan in the Purchasing Department no later than Monday, January 27th, 2025 in order to be approved to attend the site visit.
rogan.megan@danecounty.gov
Today's Date Date of Access Company Name Position
Reason for Visit RFP# 2025-RFP-019 Vendor Conference Phone #
FIRST name Drivers License # MIDDLE Name State Issued LAST name
Current Address Other LAST names used
Date of Birth
States lived in, past 10 years Sex
Race
Felony Convictions? YES or NO If Yes, when?
Misdemeanor Convictions? YES or NO If Yes, when?
Representative's Signature
Printed Name
PLEASE ALLOW 3-4 FULL BUSINESS DAYS FOR THE BACKGROUND PROCESS TO BE COMPLETED.
THANK YOU.
OFFICE USE ONLY
D.O.T. OPEN TICKETS
C.I.B. JAIL RECORDS
F.B.I. LOCAL COMPUTER CONTACTS
CCAP
WARRANTS
Date Criminal History Run ___________
Project & Program Assistant: B. Xiong _____________________________ Sergeant: ___________________________
OFFICE USE ONLY
File details come from the government source that posted it. Updated .