FRP Industry Day Security Info Sheet (SIS v. 4).pdf
PDF 196 KB Posted
- Solicitation number
- W91237-SN-0002
About this file
This is a Security Information Sheet required for site visits to U.S. Army Corps of Engineers properties, specifically for an Industry Day event at Robert C. Byrd Locks and Dam. The form requires personal information including full name, date of birth, SSN, place of birth, citizenship status, contact information, and contractor details. The completed form must be submitted via password-protected email to Stephen R. Curry at the Huntington District Security Office.
For non-U.S. citizens, additional documentation is required including passport, U.S. residency proof, and work visa. The form must include start/end dates and justification for the visit. The document specifies that all blocks outlined in red must be completed or the submittal will be rejected. The Corps of Engineers point of contact for this specific event is Eileen S. Hodges, whose contact information is provided on the form.
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| File | Type | Posted |
|---|---|---|
| Security Info Sheet (SIS v. 4).pdf |
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Text version
SECURITY INFORMATION SHEET - Site Visit Version
Full Name (Last, First, Middle)
Date of Birth (MM/DD/YYYY)
Full SSN
City and State of Birth
Country of Birth
US Citizen (check one) Yes ___ or No ___ *
Email Address
Phone Numbers Primary
Secondary
Contractor Name:
Contractor Website:
Contractor Phone Number:
Reason for Visit:
Corps of Engineers POC:
All blocks outlined in red must be filled out or submittal will be rejected.
* Non-citizens, see page 2 for additional documents required.
Instructions: Send to Huntington District Security Office via password protected email, with second email to Security Office containing the password.
Point of Contact for this action in Security Office is Stephen R. Curry, PERSEC Email: stephen.r.curry@usace.army.mil
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Non- U.S. Persons
| Blank Page |
| Untitled |
| Full SSN: |
| City and State of Birth: |
| Country of Birth: |
| Email Address: |
| Primary: |
| Secondary: |
| Full Name: |
| Date of Birth: |
| Citizenship: Yes |
| List Box1: [] |
| Check Box4: Off |
| Check Box5: Off |
| Check Box6: Off |
| Passport Data Page: Passport Attached |
| Proof of US Permanent Residency: U.S. Residency Proof Attached |
| Work Visa: Work VISA attached |
| Start: |
| End: |
| Justification: |
| Start Date Label: Start Date |
| End Date Label: End Date |
| Justification Label: Justification |
| Reason for Visit: |
| USACE POC: Eileen S. Hodges, eileen.s.hodges@usace.army.mil, Ext. 5632 |
| Contractor Phone Number: |
| Contractor Website: |
| Contractor Name: |
File details come from the government source that posted it. Updated .