Pickwick_U.S._National_Site_Visit_Registration_Form.pdf

Mooring Cell Construction - Barkley Lock & Dam and Pickwick Lock & Dam Return to Contract Specialist POC: Debra Barlow, (615) 736-7933, Debra.A.Barlow@usace.army.mil

Nashville District Corps of Engineers U.S. Citizen

Pre-Bid Meeting or Site Visit Request Form

This Request Form is for U.S. Citizens requesting approval to attend a pre-bid meeting or site visit at one of the Nashville District (LRN) Corps of Engineers field locations. The form should be submitted to the Nashville District Pre-Bid Meeting or Site Visit Point of Contact (POC) to be forwarded to the

LRN Security Management Office (LRN-SM) at least two (2) full business days prior to the proposed visit.

Guidance for submitting pre-bid meeting or site visit requests is available at http://www.lrn.usace.army.mil/BusinessWithUs/Contracting/Contract Security

Requirements/Pre-Bid Meeting or Site Visit Process

LRN Meeting/Site Visit POC: Debra Barlow Nashville District (LRN) Contact Person)

Date the Request is Being Submitted to LRN (mm/dd/yyyy)

FULL LEGAL Name (Last, First, Middle)

If you have only initials in your name, use them and state (IO). If you have no middle name, enter “NMN”. If you are a “Jr.,”Sr.,” “II,” etc., indicate your status (Do not list a Nickname) NOTE: Failure to provide FULL LEGAL name will delay approval

Date of Birth (mm/dd/yyyy)

Last Four Digits of Social Security Number LRN

Field Location (Project Sites) to be visited:

Barkley Lock & Dam and Pickwick Lock & Dam

Date of Proposed Visit (mm/dd/yyyy)

In Case of Questions, Please Provide Phone Number:

IMPORTANT: DO NOT Submit Form Directly to the Security Office Unless Directed

For questions regarding completing the form, contact one of the individuals listed below:

Tracy Dorrough, Security Technician, 615-736-7397 (Primary Security POC) Jay Klinger, District Security Chief, 615-736-2185

PRIVACY ACT STATEMENT

Information is solicited in accordance with Title 10, US Code Section 552 and is used to provide information necessary in preparation for a scheduled tour and/or briefing and to verify positive identification of visitor. Solicited information is voluntary; however, failure to provide information may result in denied visitor access. The information provided to the Nashville District will not be retained digitally or by hard copy after the scheduled tour date.

8/4/2016

Barkley - Aug 22, 2017 / Pickwick - Aug 23, 2017 mailto:anthony.carmona@usace.army.mil http://www.lrn.usace.army.mil/BusinessWithUs/Contracting/Contract