125_FW_Installation_BAL_Visitor.pdf
PDF 201 KB Posted
- Attached to
- PERIMETER FENCING Federal contract opportunity
- Solicitation number
- W911YN19R5003
About this file
Base Authorization List. Turn in to attend site visit. See solicitation for more information.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Site_Visit_Roster.pdf | ||
| Chain_Link_Fence_Drawings.pdf | ||
| W911YN19R5003.pdf |
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Text version
BASE AUTHORITY LIST (BAL)
#1. NAME: (Last, First, MI)
DESCRIPTION OF BUSINESS/FUNCTION:
VEHICLE DESCRIPTION:DRIVE LICENSE #: LICENSE PLATE :
LOCATION OF BUSINESS/FUNCTION INCLUSIVE DATES:
PRIVACY ACT STATEMENT: 1. AUTHORITY: USC Title 10, 8013 2. PURPOSE: Used to collect information needed for entry control to the 125th Fighter Wing. 3. ROUTINE USES: This information will not be disclosed outside the Department of Defense. 4. DISCLOSURE: Voluntary. However, failure to provide information results in the denial of entry to the 125th Fighter Wing.
The following individuals will be on the installation for the listed function/business and dates stated. All individuals listed will be escorted at all times by the Point of Contact for this BAL. This BAL is used for business/functions not associated with contracts.
#2. NAME: (Last, First, MI) DRIVE LICENSE #: VEHICLE DESCRIPTION: LICENSE PLATE :
POINT OF CONTACT: (Last, First, MI) PHONE #: UNIT: DATE SUBMITTED:
#3. NAME: (Last, First, MI) VEHICLE DESCRIPTION:DRIVE LICENSE #: LICENSE PLATE :
#4. NAME: (Last, First, MI) DRIVE LICENSE #: VEHICLE DESCRIPTION: LICENSE PLATE :
#5. NAME: (Last, First, MI) VEHICLE DESCRIPTION:DRIVE LICENSE #: LICENSE PLATE :
#6. NAME: (Last, First, MI) DRIVE LICENSE #: VEHICLE DESCRIPTION:
#9. NAME: (Last, First, MI) VEHICLE DESCRIPTION:DRIVE LICENSE #:
AUTHENTICATED BY SFS: (LAST, FIRST, MI) AUTHENTICATED BY SFS: (SIGNATURE) DATE:
LICENSE PLATE :
#10. NAME: (Last, First, MI) DRIVE LICENSE #: VEHICLE DESCRIPTION: LICENSE PLATE :
#11. NAME: (Last, First, MI) VEHICLE DESCRIPTION:DRIVE LICENSE #: LICENSE PLATE :
#12. NAME: (Last, First, MI) DRIVE LICENSE #: VEHICLE DESCRIPTION: LICENSE PLATE :
LICENSE PLATE :
#7. NAME: (Last, First, MI) VEHICLE DESCRIPTION:DRIVE LICENSE #: LICENSE PLATE :
#8. NAME: (Last, First, MI) DRIVE LICENSE #: VEHICLE DESCRIPTION: LICENSE PLATE :
125 FW EAL-02 03102018 PREVIOUS EDITIONS OBSOLETE
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