McAAP Presolicitation Site Visit - Visitor Access Request form AR-190-13.pdf

Army Regulation PDF 4 MB Posted

Attached to
Ammunition Demolition Shop, McAlester Army Ammunition Plant (MCAAP)
Solicitation number
W912BV23R0029
Issued by

About this file

This document is a visitor access request form for pre-solicitation site visits to the McAlester Army Ammunition Plant (MCAAP). The form collects personal information for security screening and assigns an escort. It requires submission to the Pass & ID Office at least 48 hours before the planned dates of June 23-24, 2023. The related federal contract opportunity is for design and construction of a new Ammunition Demolition Shop at MCAAP. Solicitation number W912BV23R0029 was issued by the Department of the Army Corps of Engineers Engineering District Tulsa. Responses are due by August 15, 2023 and work is to be completed by December 2025.

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MCAAP Site Visit Sign in Sheet.pdf PDF

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MCAAP FORM 190-20, MAY 2019

AEM 6X

PREVIOUS EDITIONS ARE OBSOLETE

PAGE OF

MCAAP VISITOR ACCESS REQUEST

(AR 190-13)

For Official Use Only (FOUO)/Contains Personally Identifiable Information (PII) (Please Read Privacy Act Statement & Instructions on Page Two) NOTE: Provide the following information to the Pass & ID Office at least 48 hours prior to visit (excluding weekends).

6. ACCESS REQUESTED:

7. VISITOR BE ESCORTED?:

8. HOSTING DIRECTORATE/TENANT:

a. LAST NAME

b. FIRST NAME

c. M/F

d. DATE OF BIRTH

(MM/DD/YYYY)

e. DRIVERS LICENSE NUMBER

f. STATE

g. U.S CITIZEN

(YES/NO)

h. CAC

(YES/NO)

10. PERSONAL INFORMATION:

11. PASS & ID USE ONLY:

MCAAP VISITOR ACCESS REQUEST - CONTINUED

(AR 190-13)

For Official Use Only (FOUO)/Contains Personally Identifiable Information (PII) Block 1 - Enter in Point of Contact (POC).

Block 2 - Enter the POC Phone Number.

Block 3 - Click inside the Date From and select the date.

Block 4 - Click inside the Date To and select the date.

Block 5 - Provide the purpose/reason for your visit.

Block 6 - Select Admin Area , Restricted Area, or Both if you are requesting to visit these areas.

Block 7 - Click on the drop down arrow and select Yes or No.

Block 8 - Click on the drop down arrow and select the Directorate/Tenant who is hosting/responsible for the visit.

Block 9 - Enter in the name of the individual who will escort the guest. Enter the division where the escort is assigned (example: Bob Smith/AO).

Block 10 - Provide Personal information in columns a through h.

a - Enter in Last Name.

b - Enter First Name.

c - Click on the drop down arrow and select a gender "M" for Male and "F" for Female.

d - Click inside the DOB block for the calendar drop down. Double click on the current month (appears in blue) to change the function to the Decades setting. Use the left scroll arrow to the correct decade that contains the year you were born. Select the year (example 1964 or 1967), followed by the month and day you were born.

e - Enter your Driver's License number as it appears on your card. You are required to have both a current driver's license and automotive insurance in order to operate a privately owned vehicle on the installation.

f - Click on the drop down arrow and select the state that issued your current driver's license.

g - Click on the U.S. Citizen drop down arrow and select Yes or No.

h - Click on the CAC Card drop down arrow and select Yes or No.

Block 11a through 11e to be filled out by Pass & ID personnel.

INSTRUCTIONS

(All fields are required to be completed)

PRIVACY ACT STATEMENT

DATA REQUIRED BY THE PRIVACY ACT OF 1974

1. Authority: 10USC 3012, EO 10450

2. Principle Purpose: Provide positive identification of all individuals who require access, with just cause, to McAlester Army Ammunition Plant and designed areas within McAlester Army Ammunition Plant.

3. Routine Users: To afford a means of identification of all individuals and to afford maximum control over areas to which access will be authorized.

4. Mandatory or Voluntary Disclosure and Effect on Individual Not Providing Information: Disclosure of personal information is mandatory.

Failure to disclose required information will result in the person(s) not being granted a pass and therefore, cannot be permitted entry/access into any given area.

FOR ADDTIONAL INFORMATION REGARDING PRIVACY PRACTICES SEE SYSTEM OF RECORD NOTICE (SORN) A0191-13 OPMG AT:

http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/ Article/569989/a0190-13-opmg/

6.2.0.20160331.1.924316.921890

AEM 6X

PREVIOUS EDITIONS ARE OBSOLETE

Text Field

PAGE OF

AEM 6X

PREVIOUS EDITIONS ARE OBSOLETE

AEM 6X

PREVIOUS EDITIONS ARE OBSOLETE

MCAAP VISITOR ACCESS REQUEST

(AR 190-13)

For Official Use Only (FOUO)/Contains Personally Identifiable Information (PII)

(Please Read Privacy Act Statement & Instructions on Page Two) NOTE: Provide the following information to the Pass & ID Office at least 48 hours prior to visit (excluding weekends).

1. MCAAP POINT OF CONTACT (POC):

5. PURPOSE OF VISIT:

FY23 Ammunition Demolition Shop pre-solicitation Site Visit - New Facility.

2. MCAAP POC PHONE NUMBER:

3. DATE FROM:

4. DATE TO:

6. ACCESS REQUESTED:

ADMIN ONLY

RESTRICTED AREA

7. VISITOR BE ESCORTED?:

YES

NO

8. HOSTING DIRECTORATE/TENANT:

Command (CO) Civilian Deputy (CD) Chief of Staff (CS) Command Initiative Group (CIG/CIG-P/CIG-R/PA/EE/IA) Community/Family Activities (CA/CAF/CAS/CAO/CAR) Environmental Management (EM) Quality Assurance (QA/QAI/QAE/QAT) Risk Management (DMP/DME) Logistics (DL/DLE/DLM/DLS/DLI) Engineering & Public Works (DE/DEE/DEO/DEB/DER) Depot Operations (DO/DOM/DOC/DOO/DOS) Information Management (IM) Ammunition Operations (AO/AOI/AOO/AOP/AOS) Legal (GC) Safety (SF) Business Development (BD) Resource Management (RM/RMM/RMI/RMF/RMC) Liaisons (USMC/USAF) Contracting (CCRC-IDM) Defense Ammunition Center (DAC) Civilian Personnel Health Clinic Post Exchange Credit Union Naval Surface Warfare Center Disposition Services (DEMIL) US Army TMDE Center JMC Office Engineering/Demil Technology

9. ESCORT NAME/DIVISION:

Justin Hargis, justin.l.hargis2.civ@army.mil

a. LAST NAME

b. FIRST NAME

c. M/F

d. DATE OF BIRTH

(MM/DD/YYYY)

e. DRIVERS LICENSE NUMBER

f. STATE

g. U.S CITIZEN

(YES/NO)

h. CAC

(YES/NO)

M F

AL

AK

AR

AZ

CA

CO

CT

DE

FL

GA

HI

IA

ID

IL

IN

KS

KY

LA

MA

MD

ME

MI

MN

MS

MO

MT

NC

ND

NE

NH

NJ

NM

NV

NY

OH

OK

OR

PA

RI

SC

SD

TN

TX

UT

VA

VT

WA

WI

WV

WY

YES

NO

YES

NO

M F

AL

AK

AR

AZ

CA

CO

CT

DE

FL

GA

HI

IA

ID

IL

IN

KS

KY

LA

MA

MD

ME

MI

MN

MS

MO

MT

NC

ND

NE

NH

NJ

NM

NV

NY

OH

OK

OR

PA

RI

SC

SD

TN

TX

UT

VA

VT

WA

WI

WV

WY

YES

NO

YES

NO

M F

AL

AK

AR

AZ

CA

CO

CT

DE

FL

GA

HI

IA

ID

IL

IN

KS

KY

LA

MA

MD

ME

MI

MN

MS

MO

MT

NC

ND

NE

NH

NJ

NM

NV

NY

OH

OK

OR

PA

RI

SC

SD

TN

TX

UT

VA

VT

WA

WI

WV

WY

YES

NO

YES

NO

M F

AL

AK

AR

AZ

CA

CO

CT

DE

FL

GA

HI

IA

ID

IL

IN

KS

KY

LA

MA

MD

ME

MI

MN

MS

MO

MT

NC

ND

NE

NH

NJ

NM

NV

NY

OH

OK

OR

PA

RI

SC

SD

TN

TX

UT

VA

VT

WA

WI

WV

WY

YES

NO

YES

NO

M F

AL

AK

AR

AZ

CA

CO

CT

DE

FL

GA

HI

IA

ID

IL

IN

KS

KY

LA

MA

MD

ME

MI

MN

MS

MO

MT

NC

ND

NE

NH

NJ

NM

NV

NY

OH

OK

OR

PA

RI

SC

SD

TN

TX

UT

VA

VT

WA

WI

WV

WY

YES

NO

YES

NO

M F

AL

AK

AR

AZ

CA

CO

CT

DE

FL

GA

HI

IA

ID

IL

IN

KS

KY

LA

MA

MD

ME

MI

MN

MS

MO

MT

NC

ND

NE

NH

NJ

NM

NV

NY

OH

OK

OR

PA

RI

SC

SD

TN

TX

UT

VA

VT

WA

WI

WV

WY

YES

NO

YES

NO

M F

AL

AK

AR

AZ

CA

CO

CT

DE

FL

GA

HI

IA

ID

IL

IN

KS

KY

LA

MA

MD

ME

MI

MN

MS

MO

MT

NC

ND

NE

NH

NJ

NM

NV

NY

OH

OK

OR

PA

RI

SC

SD

TN

TX

UT

VA

VT

WA

WI

WV

WY

YES

NO

YES

NO

10. PERSONAL INFORMATION:

11. PASS & ID USE ONLY:

a. NCIC DATE COMPLETED:

d. POC NOTIFIED (If Necessary):

YES

NO

c. AUTHORIZATION(S) ATTACHED:

YES

NO

b. ENTER BADGE IN SYSTEM:

YES

NO

e. NOTES:

MCAAP VISITOR ACCESS REQUEST - CONTINUED

(AR 190-13)

For Official Use Only (FOUO)/Contains Personally Identifiable Information (PII)

Block 1 - Enter in Point of Contact (POC).

Block 2 - Enter the POC Phone Number.

Block 3 - Click inside the Date From and select the date.

Block 4 - Click inside the Date To and select the date.

Block 5 - Provide the purpose/reason for your visit.

Block 6 - Select Admin Area , Restricted Area, or Both if you are requesting to visit these areas.

Block 7 - Click on the drop down arrow and select Yes or No.

Block 8 - Click on the drop down arrow and select the Directorate/Tenant who is hosting/responsible for the visit.

Block 9 - Enter in the name of the individual who will escort the guest. Enter the division where the escort is assigned (example: Bob Smith/AO).

Block 10 - Provide Personal information in columns a through h.

a - Enter in Last Name.

b - Enter First Name.

c - Click on the drop down arrow and select a gender "M" for Male and

"F" for Female.

d - Click inside the DOB block for the calendar drop down. Double click on the current month (appears in blue) to change the function to the Decades setting. Use the left scroll arrow to the correct decade that contains the year you were born. Select the year (example 1964 or 1967), followed by the month and day you were born.

e - Enter your Driver's License number as it appears on your card. You are required to have both a current driver's license and automotive insurance in order to operate a privately owned vehicle on the installation.

f -

Click on the drop down arrow and select the state that issued your current driver's license.

g - Click on the U.S. Citizen drop down arrow and select Yes or No.

h - Click on the CAC Card drop down arrow and select Yes or No.

Block 11a through 11e to be filled out by Pass & ID personnel.

INSTRUCTIONS

(All fields are required to be completed)

PRIVACY ACT STATEMENT

DATA REQUIRED BY THE PRIVACY ACT OF 1974

1. Authority: 10USC 3012, EO 10450

2. Principle Purpose: Provide positive identification of all individuals who require access, with just cause, to McAlester Army Ammunition Plant and designed areas within McAlester Army Ammunition Plant.

3. Routine Users: To afford a means of identification of all individuals and to afford maximum control over areas to which access will be authorized.

4. Mandatory or Voluntary Disclosure and Effect on Individual Not

Providing Information:

Disclosure of personal information is mandatory.

Failure to disclose required information will result in the person(s) not being granted a pass and therefore, cannot be permitted entry/access into any given area.

FOR ADDTIONAL INFORMATION REGARDING PRIVACY PRACTICES SEE SYSTEM OF RECORD NOTICE (SORN) A0191-13 OPMG AT:

http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/

Article/569989/a0190-13-opmg/

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FY23 Ammunition Demolition Shop pre-solicitation Site Visit - New Facility.

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August 21,2023 TimeField1:

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