Registration_Form_Nov_2016_FINAL.pdf
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- Attached to
- Solicitation - Request for Proposal (RFP) Federal contract opportunity
- Solicitation number
- W52P1J15R0023
About this file
This document contains a registration form and related details for an Industry Day event regarding a solicitation to manage and operate the Scranton Army Ammunition Plant and produce 155mm and 120mm projectiles and shells. Attendees must pre-register by November 8, 2016 and provide company and attendee information for security screening and placement on the Federal Business Opportunities website to facilitate networking. The Industry Day will be held on November 15-16, 2016 at the Hilton Scranton hotel. Non-U.S. citizen attendees must have an approved Visitor Access Request. U.S. citizen attendees participating in the facility tour must provide additional personal information for a criminal background check. The Industry Day is associated with solicitation W52P1J-15-R-0023 to manage SCAAP and produce munitions, issued by the U.S. Army Contracting Command - Rock Island and New Jersey on behalf of Joint Munitions Command and Project Manager for Combat Ammunition Systems.
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Text version
REGISTRATION FORM
Scranton Army Ammunition Plant (SCAAP) Industry Day #2
Solicitation W52P1J‐15‐R‐0023
November 15‐16, 2016
Location:
Hilton Scranton & Conference Center
100 Adams Avenue, Scranton, Pennsylvania, 18503‐1826
Business Information:
Company Name: _______________________________________________________________________
Company Cage Code: ___________________
US or Foreign Owned (Name of Country): ___________________________________________________
Company Address: _____________________________________________________________________
Business Phone Number(s): ______________________________________________________________
Small Business: _____ Large Business: _____
ALL ATTENDEES MUST BE REGISTERED, THIS WILL BE STRICTLY ENFORCED.
This Industry Day is scheduled to start at 8:30 a.m. Eastern Time on the November 15, 2016.
You must pre‐register for this conference by e‐mailing your completed registration and information release form no later than November 8, 2016 to Ms. Katie Young at katie.m.young9.civ@mail.mil and
Ms. Mariah Hanko at mariah.l.hanko.civ@mail.mil.
NOTE: Save this as a word file and email to the above addresses.
Please see the attached release form for placing company information on FedBizOps at www.fbo.gov.
Please see the attached personal registration forms.
Would you like to schedule a One‐on‐One Meeting with the Government? (Y/N): ________
Release of names and information of the SCAAP Industry Day attendees:
We typically share company names and attendees list including: telephone numbers and email addresses with other attendees from the Industry Day to facilitate subcontracting and teaming arrangements.
Before releasing the above named information to all Industry Day attendees on FedBizOps at www.fbo.gov, we would like your authorization to do so. If you do not want such information to be distributed, perhaps there is a corporate or office email and telephone number that may be used instead. Whatever information you agree to release to FedBizOps will be information we provide to all attendees.
Please state whether we can release your name, title, telephone number and e‐mail address in association with your attendance at the SCAAP Industry Day in Scranton, PA on November 15‐16, 2016.
YES: _____ NO: _____
If you answered NO to the above, is there any information we can share with all attendees?
Signature to authorize release of information
Personal Information:
A Personal Information form must be completed for each Industry Day attendee.
Name of Representative (Last, First, Middle): _______________________________________________
Title: ________________________________________________________________________________
Work Phone: __________________________________________________________________________
Email: _______________________________________________________________________________
Citizenship: ____________________________
Participating in Facility Tour (Y/N): _________
Participating in Viewing of Sample Technical Library (Y/N): _________
If you will be participating in the facility tour or viewing the sample technical library, and you are a US
CITIZEN we need the following additional information. This information will be used to complete a criminal background history and a warrant search will be run for each individual participating in the facility tour. If an individual comes back with a criminal history they may be denied access.
Date of Birth (YYYYMMDD): _________________________
Sex: ________
Race: _________________________
Driver’s License Number/State: ______________________
SSN: __________________________
If you will be participating in the facility tour or viewing the sample technical library and you are NOT A
US CITIZEN you will need to submit or have previously submitted a Visitor Access Request (VAR) through your own embassy. Admittance on to SCAAP will only be granted to those who have received prior authorization from higher headquarters. All questions regarding this item should be directed to Mr.
Jason Shradnick at Jason.shradnick.civ@mail.mil.
File details come from the government source that posted it. Updated .