W911SA21Q3073 Attachment 6 (88th RD FM Form 451).xlsx
XLSX spreadsheet 15 KB Posted
- Attached to
- Custodial Services IL073; Urbana, IL
- Solicitation number
- W911SA-21-Q-3073
View the file
Other files
| File | Type | Posted |
|---|---|---|
| W911SA-21-Q-3073 Amendment 1.pdf | ||
| W911SA21Q3073 Attachment 2 (Drawings IL073).docx | DOCX document | |
| W911SA21Q3073 Attachment 7 (88th RD FM Form 452).xlsx | XLSX spreadsheet | |
| W911SA21Q3073 Attachment 4 (Sample Service Ticket).docx | DOCX document | |
| W911SA21Q3073 SOLICITATION.pdf | ||
| W911SA21Q3073 Attachment 5 (Sample Contractor Cleaning Sheet).docx | DOCX document | |
| W911SA21Q3073 Attachment 1 (Price Schedule-blank).xlsx | XLSX spreadsheet | |
| W911SA21Q3073 Attachment 3 (AT-OPSEC).pdf |
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Text version
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 | M | 29-Apr-64 | F123-4567-8912-54 | WI | 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 .