Base_Access_18Q0136_Fire_Pump.docx

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REPLACE FIRE PUMPS, ENGINES AND CONTROLS Federal contract opportunity
Solicitation number
W912JB18Q0136
Issued by
Department of the Army

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SELFRIDGE AIR NATIONAL GUARD BASE ACCESS FORM

Pre-registration is MANDTORY for access to the base. Email Access Form.

Email to tami.L.mckenney.civ@mail.mil

Add to the Subject Line: W912JB18Q0136 Fire Pump

Authorized Visitor Information complete for each person who will be attending:

Full Name: Last, First, Middle: __________________________________________

JR/SR: _______________________________________________________________

Date of Birth:__________________________________________________________

Driver’s License (State of issue and number)_________________________________

Gender and Race_______________________________________________________

Country of Citizenship/Passport Number____________________________________

Destination on base: 127 MSC Contracting Division, Bldg 105

Full Name: Last, First, Middle:___________________________________________

JR/SR: _______________________________________________________________

Date of Birth:__________________________________________________________

Driver’s License (State of issue and number)_________________________________

Gender and Race_______________________________________________________

Country of Citizenship/Passport Number____________________________________

Destination on base: 127 MSC Contracting Division, Bldg 105

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