W911SA-20-Q-3049 Attachment 6 - 88th RD FM Form 451.xlsx

XLSX spreadsheet 15 KB Posted Mar 20, 2020

Attached to: Custodial Services UT008 Helena, UT Federal contract opportunity
Solicitation number: W911SA20Q3049
Issued by: Department of the Army Materiel Command Mission and Installation Contracting Command Fort McCoy

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Other files for this federal contract opportunity

Other files attached to Custodial Services UT008 Helena, UT, newest first.
File	Type	Posted
W911SA-20-Q-3049 Attachment 4 - Sample Service Ticket.docx	DOCX document	Mar 20, 2020
W911SA-20-Q-3049 Attachment 5 - Sample Contractor Cleaning Sheet.docx	DOCX document	Mar 20, 2020
W911SA-20-Q-3049 Attachment 7 - 88th RD FM Form 452.xlsx	XLSX spreadsheet	Mar 20, 2020
W911SA-20-Q-3049 final solicitation.pdf	PDF	Mar 20, 2020
W911SA-20-Q-3049 Attachment 1 - Price Schedule.xlsx	XLSX spreadsheet	Mar 20, 2020
W911SA-20-Q-3049 Attachment 8 - SUS Trifold.pdf	PDF	Mar 20, 2020
W911SA-20-Q-3049 Attachment 2 - Drawing.pdf	PDF	Mar 20, 2020
W911SA-20-Q-3049 Attachment 3 ATOPSEC.pdf	PDF	Mar 20, 2020

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Sheet1

88th RD Installation Access NCIC-III Check Request V 1.6 (18 JAN 2019)

PRIVACY ACT STATEMENT AUTHORITY: The Privacy Act of 1974, Title 5 USC 552a. PRINCIPLE PURPOSE(S): To determine suitability of individual(s) requesting access to Military Installations. This information will be used to generate state and federal criminal history records checks. ROUTINE USE(S): Personal information may be disclosed to appropriate military and civilian emergency and investigation agencies to assist in determining suitability for access to Military Installations. DISCLOSURE: Voluntary; however failure to provide information will result in a refusal to grant access to Military Installations.

Legal Name as Appears on Driver's License or State ID. Example: John Edward Doe

29-Apr-64

F123-4567-8912-54

25-Jan-19

24-Jan-20

MON-FRI 0700-1700 HOURS

Bldg 100

Commissary / TCI

Example: Plumber / Bagger

Last Name

First Name

Middle name or "NMN" if none

SEX

(M/F)

DOB:

DRIVERS LICENSE NUMBER

DRIVERS LICENSE STATE

BEGIN DATE

END DATE

WORK ACCESS HRS

WORK AREA/ VISIT LOCATION

COMPANY NAME

EMPLOYEES POSITION/ EVENT

BELOW INFORMATION IS TO BE COMPLETED BY 88TH RD CONTRACTING OFFICER REPRESENTATIVE Remarks Block (At a minimum include Purpose for Access, Contract number and expiration date if Applicable)

Contract info: (Number, Exp Date)

Sponsor Name (first, MI, Last)	Sponsor Phone	mailto:usarmy.mccoy.imcom-central.list.des-physical-security@mail.mil
Sponsor Name Organization	Sponsor Email
* Note If Access is for Contract purpose Sponsor will be the COR* In all Cases Sponsor must be affiliated with 88th RD***
88th RD FORM 451 (ALL PREVIOUS VERSIONS ARE OBSOLETE)

&"-,Bold"FOUO

Page &P 88th RD FM Form 451 V 1.6 (18 JAN 2019) FOUO

File details come from the government source that posted it. Updated Mar 20, 2020.