US Citizen Pre_Bid or Site Visit Form JAN 2019.pdf

PDF 211 KB Posted

Attached to
Wolf Creek GSU Replacement Federal contract opportunity
Solicitation number
W912P524R0004
Issued by
Department of the Army Corps of Engineers Engineering District Nashville

About this file

This document is a US Citizen Pre-Bid Meeting or Site Visit Request Form for the Nashville District Corps of Engineers. It provides instructions for U.S. citizens to request approval to attend a pre-bid meeting or site visit for the Wolf Creek GSU Replacement contract opportunity (Solicitation # W912P524R0004). The form requires the visitor's full legal name, date of birth, last four digits of their social security number, the proposed visit date, and contact information. The form is to be submitted to the designated POC/COR at least 5 business days prior to the visit. The purpose is to verify the visitor's identification and conduct background checks to determine eligibility for access to the U.S. Army Corps of Engineers facility. Failure to provide the requested information may result in denied access.

The related federal contract opportunity is for the Wolf Creek GSU Replacement, solicited by the Department of the Army Corps of Engineers Engineering District Nashville. Interested parties must submit a completed Security/Site Visit Form to Alison Abernathy at Alison.T.Abernathy@usace.army.mil in order to view the associated plans, specifications, and drawings.

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Text version

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) / Contracting Officer Representative (COR) to be forwarded to the LRN Security Management Office (LRN-SM) at least Five

(5) full business days prior to the proposed visit.

Guidance for submitting pre-bid meeting or site visit requests is available at https://www.lrn.usace.army.mil/Business-With-Us/Contract-Security-Requirements/

LRN Meeting/Site Visit POC: __Alison Abernathy- WOL GSU_____ 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 Site) to be visited:

________Wolf Creek__________________________________________________

Date of Proposed Visit (mm/dd/yyyy) __10/09/2024__________________________

In Case of Questions, Please Provide Phone Number: __________________________

IMPORTANT: Submit form directly to COR. DO NOT submit the form directly to the Security Office Unless Directed. For questions regarding the site visit contact the COR.

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

Tracy Dorrough, Personnel Security Specialist, 615-736-7397 email: tracy.w.dorrough.civ@mail.mil John Carter, Security Specialist, 615-736-5567 email: john.h.carter@usace.army.mil Jay Klinger, District Chief of Security, 615-736-2185 email: jason.j.klinger.civ@mail.mil

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 tour of the facility, verify positive identification of visitor(s), and conduct background checks for determinations of the eligibility of 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.

Jan 2019 Version

W912P524R0004 WOL GSU

https://www.lrn.usace.army.mil/Business-With-Us/Contract-Security-Requirements/ mailto:tracy.w.dorrough.civ@mail.mil mailto:john.h.carter@usace.army.mil mailto:jason.j.klinger.civ@mail.mil

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