AF103.pdf
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- Attached to
- RFP- $999M RDI #2 UNR IDIQ MATOC Federal contract opportunity
- Solicitation number
- W9128F19R0043
About this file
This document contains a Base Civil Engineering Work Clearance Request form and information on an upcoming federal contract opportunity.
The Work Clearance Request form is used to coordinate required construction or utility work that may disrupt base operations with key base activities. It identifies the type of work, location, required clearance date, and requires approval signatures from base security, safety, communications and other units. The form provides instructions for describing precautions to be taken before and during the work.
The federal contract opportunity is an $999 million Rapid Disaster Infrastructure Response Multiple Award Task Order Contract to provide time-sensitive disaster, infrastructure and construction services for federally funded customers on an as-needed basis over eight years. Services include security and defense mission support, disaster response support like roads and bridges, and infrastructure construction support. Task orders may be firm-fixed price or cost-plus fixed fee. The primary NAICS code is commercial and institutional building construction. Mobilization is required within three days for emergency recovery actions. The solicitation is expected to be issued on July 5, 2019.
Base Civil Engineering Work Clearance Request
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Text version
I. ZONE
J. OTHER (Specify)
BASE CIVIL ENGINEERING WORK CLEARANCE REQUEST
(See Instructions on Reverse)
AF FORM 103, 19940801 (EF-V3) PREVIOUS EDITIONS ARE OBSOLETE.
DATE PREPARED
1. Clearance is requested to proceed with work at on Work Order No. , Contract No. , involving excavation or utility disturbance per attached sketch. This area has has not been staked or clearly marked.
2. TYPE OF FACILITY/WORK INVOLVED
A. PAVEMENTS
B. DRAINAGE SYSTEMS
C. RAILROAD TRACKS
D. FIRE DETECTION & PROTECTION SYSTEMS
E. UTILITY
F. COMM
G. AIRCRAFT OR VEHICULAR TRAFFIC FLOW
H. SECURITY
I. OTHEROVERHEAD UNDERGROUND
OVERHEAD UNDERGROUND
3. DATE CLEARANCE REQUIRED 4. DATE OF CLEARANCE
5. SIGNATURE OF REQUESTING OFFICIAL 7. ORGANIZATION6. TELEPHONE NO.
15. OTHER (Specify)
16. REQUESTED CLEARANCE APPROVED DISAPPROVED
TELEPHONE
GAS
ELECTRIC
14. COMMERCIAL UTILITY COMPANY
17a. DATE SIGNED
8.
B A S E
C I V I L
E N G I N E E R I N G
A. ELECTRICAL DISTRIBUTION
B. STEAM DISTRIBUTION
C. WATER DISTRIBUTION
D. POL DISTRIBUTION
E. SEWER DISTRIBUTION
F. ENVIRONMENTAL
G. PAVEMENTS/ GROUNDS
H. FIRE PROTECTION
REMARKS (Use Reverse for additional comments) REVIEWER'S NAME AND INITIALSORGANIZATION
9. SECURITY POLICE
10. SAFETY
11. COMMUNICATIONS
12. BASE OPERATIONS
13. CABLE TV
17. TYPED NAME AND SIGNATURE OF APPROVING OFFICER (Chief of Operations Flight or Chief of Engineering Flight)
The BCE work clearance request is used for any work (contract or in-house) that may disrupt aircraft or vehicular traffic flow, base utility services, protection provided by fire and intrusion alarm system, or routine activities of the installation. This form is used to coordinate the required work with key base activities and keep customer inconvenience to a minimum. It is also used to identify potentially hazardous work conditions in an attempt to prevent accidents. The work clearance request is processed just prior to the start of work. If delays are encountered and the conditions at the job site change (or may have changed) this work clearance request must be reprocessed.
INSTRUCTIONS
18. REMARKS. (This section must describe specific precautionary measure to be taken before and during work accomplishment. Specific comments concerning the approved method of excavation, hand or powered equipment, should be included.)
AF FORM 103, 19940801 (EF-V3) (REVERSE)
File details come from the government source that posted it. Updated .