Foreign National Security Form.pdf
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- Attached to
- Pre-Solicitation Notice for W912P524R0001 Chickamauga Lock Replacement Approach Wall and Decommissioning
- Solicitation number
- W912P524R0001
About this file
This document contains a pre-solicitation notice and foreign national security form for a federal construction contract opportunity. The U.S. Army Corps of Engineers Nashville District intends to issue a request for proposal for a firm fixed-price contract to construct the downstream approach walls and decommission portions of the existing dam spillway and lock at the Chickamauga Lock Replacement site in Chattanooga, Tennessee. The estimated value is between $100-250 million. The solicitation is expected to release on March 25, 2024 with a pre-proposal site visit scheduled for April 8, 2024. The foreign national security form provides instructions for foreign nationals to request and receive approval for site visits 30 days in advance by submitting identification documents to the Corps of Engineers Security Office.
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| File | Type | Posted |
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| US Citizen Security Form.pdf |
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Text version
Feb 2019 Version
Nashville District Corps of Engineers Foreign National Site Visit Request Form
Foreign Nationals (FNs): All non-U.S. Citizens, including permanent residents wishing to request a site visit at a
Nashville District (LRN) project must be approved 30 days in advance. FNs requesting a site visit ( includes: pre-bid meeting) must complete a LRN FN Pre-Bid Meeting Request Form and submit any two (2) legible color copies of the following documents: Passport (unexpired or expired), Certificate of U.S. Citizenship (INS Form N-560 04 N-561), Certificate of Naturalization (INS Form N-550 or N-570), unexpired foreign Passport with I-551 stamp or attached INS
Form I-94 indicating unexpired employment authorization, an Alien Registration Receipt Card with photo (INS Form I-
151 or I-551), unexpired Temporary Resident Card (INS Form I-688), unexpired Employment Authorization Card (INS
Form I-688A), unexpired Reentry Permit (INS Form I-327), unexpired Refugee Travel Document (INS- Form I-571), or unexpired INS issued Employment Authorization Documentation that contains a photograph (INS Form I-688B).
Documents must not expire on or before visit. Submit requests to your LRN pre-bid/meeting POC, they will forwarded it to LRN Security Management Office (SM) mailbox (dll-celrn-sm@usace.army.mil) for approval. All documents must be received 30 days in advance of the site visit of pre-bid meeting. FN requests require approval from Headquarters U.S.
Army Corps of Engineers (HQUSACE). Exceptions will be considered on a case by case basis but will be limited.
Date of submission to LRN POC (mm/dd/yyyy) _______________________
Name of Site _______________________________ LRN Site POC _____________________________
Requestors FULL 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., this must be indicated
Date of Birth (mm/dd/yyyy) _______________ Citizenship (Country) _________________________
Place of Birth (City/Town/Providence/County etc.) _________________________________________
Date(s) of Requested Site Visit (mm/dd/yyyy) ____________________________
Passport # (Include a scanned color copy) _________________________________________
VISA # (Include a scanned color copy) _____________________________________________ *Unless the country of citizenship participates in the VISA Waiver Program (VWP).
Nashville District Corps of Engineers Security Office Contact Information:
Tracy Dorrough, Personnel Security Specialist, 615-736-7397 email: tracy.dorrough@usace.army.mil John Carter, Security Specialist, 615-736-5567 email: john.j.carter@usace.army.mil Jay Klinger, Chief of Security, 615-736-2185 email: jason.j.klinger@usace.army.mil Fax Number: 615-736-7145
Mailing Address: USACE, Nashville
110 9th Ave S, Room A-450
ATTN: CELRN-SM
Nashville, TN 37203
PRIVACY ACT STATEMENT
AUTHORITY: Information is solicited pursuant to Title 10, U.S. Code, Section 3013 and E.O. 9397.
PRINCIPAL PURPOSE: To provide information necessary for preparation of a scheduled visit of the facility, verify positive identification of visitor(s), and conduct background checks for determinations of the eligibility of individuals for access to U.S. Army Corps of Engineers facilities.
ROUTINE USES: Used by the U.S. Army Corps of Engineers to accompany a request for a scheduled tour of the facility.
MANDATORY OR VOLUNTARY DISCLOSURE AND EFFECT OF NOT PROVIDING INFORMATION: Providing the solicited information, including Social Security Number, is voluntary; however, failure to provide information may result in a denial of visitor access due to an inability to verify identification. The information provided to the U.S. Army Corps of Engineers will not be retained digitally or by hard copy after the scheduled visit.
https://www.cbp.gov/travel/international-visitors/visa-waiver-program mailto:tracy.dorrough@usace.army.mil mailto:john.j.carter@usace.army.mil mailto:jason.j.klinger@usace.army.mil
| Name of Site: |
| Date of submitted mm/dd/yyyy: |
| Site POC: |
| Name (Last, First Middle): |
| Date of Birth mm/dd/yyyy: |
| Country of Citizenship: |
| Place of Birth (City, Town, Providence, or County etc: |
| ): |
| Requested dat of Visit mm/dd/yyyy: |
| Passport Number: |
| VISA Number: |
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