W911SA-19-Q-3068_Attachment_6_Form_451_dated_Sep_2018.xlsx

XLSX spreadsheet 14 KB Posted Feb 27, 2019

Attached to: Custodial, Pocatello ID
Solicitation number: W911SA-19-Q-3068
Issued by: Department of the Army Materiel Command Mission and Installation Contracting Command Fort McCoy

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Form 451

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File	Type	Posted
W911SA-19-Q-3068_Amendment_1_released.pdf	PDF	Mar 12, 2019
W911SA-19-Q-3068_Attachment_1_ID006_Custodial_Price_Schedule_(blank).xlsx	XLSX spreadsheet	Feb 27, 2019
W911SA-19-Q-3068_Attachment_5_Custodial_Contractor_Rest_Room_Cleaning_Sheet_V_1.6_(18_JAN_2019).docx	DOCX document	Feb 27, 2019
W911SA-19-Q-3068_Solicitation_Released.pdf	PDF	Feb 27, 2019
W911SA-19-Q-3068_Attachment_8_SUS_Trifold.pdf	PDF	Feb 27, 2019
W911SA-19-Q-3068_Attachment_7_Form_452_dated_Sep_2018.xlsx	XLSX spreadsheet	Feb 27, 2019
W911SA-19-Q-3068_Attachment_4_Custodial_Service_Ticket_Template_V_1.6_(18_JAN_2019).docx	DOCX document	Feb 27, 2019
W911SA-19-Q-3068_Attachment_3_ID006_Custodial_8_Feb_19_AT_OPSEC_Cover-Sheet.pdf	PDF	Feb 27, 2019
W911SA-19-Q-3068_Attachment_2_ID006_Custodial_Drawing_5_Feb_2019.docx	DOCX document	Feb 27, 2019

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Sheet1

88th RD Installation Access NCIC-III Check Request

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-15

24-Jan-16

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

Remarks Block (At a minamum include Purpose for Access, Contract number and expiration date if Applicable)

Contract info: (Number, Exp Date)

Sponsor Name (first, MI, Last)	Sponsor Phone
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

&"Arial,Bold"&10FORT MCCOY FORM 451 1 Jun 2017 &"-,Bold"FOUO

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