Foregin National Contractor Security Access Form.pdf
PDF 89 KB Posted
- Solicitation number
- W912P5QA018
About this file
The document is a Foreign National Security Form for the Nashville District Corps of Engineers, requiring detailed information for non-U.S. citizens working on Nashville District contracts or task orders. The form mandates approval from the Headquarters U.S. Army Corps of Engineers Foreign Disclosure Officer at least 30 days in advance of contract work, with specific requirements including full name, date of birth, citizenship, passport and visa details, work description, work location, site access dates, job title, and payment method.
Additional requirements include furnishing documentation to verify legal admission to the United States, with special provisions for non-U.S. citizens who have lived in the country for at least three years. They must obtain a favorable background investigation in accordance with Homeland Security Presidential Directive 12 (HSPD-12). The form provides contact information for the Nashville District Corps of Engineers Security Office, including security technician and specialist contact details, and is dated March 2024.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
COMPANY NAME / ADDRESS / MAIN PHONE #
Nashville District Corps of Engineers Foreign National Security Form
All non-U.S. Citizens, including permanent residents who work on Nashville District (LRN) contracts or task orders must be approved by the Headquarters U.S. Army Corps of Engineers (HQUSACE) Foreign Disclosure Officer before beginning any contract/task order work. Must be submitted 30 days in advance.
NOTE: At no time will a Contractor or Subcontractor be permitted to access the site until approved by the Nashville District Security Office and the Contractor Official has been notified.
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., you must include this
Date of Birth (mm/dd/yyyy): _________________ Citizenship (Country): ______________________
Passport # (Include copy scanned in color): _____________________________________________
Visa # (Include copy scanned in color if applicable): _______________________________________
* Visa information must be included unless country of citizenship is in the Visa Waiver Program
Work to be performed: (e.g. Plumbing, electrical) ________________________________________
Corps of Engineers Location (Project Office/ Work Site) Where Work is to be performed:
From & To Dates for Requested Site Access: ____________________________________________
Expected Arrival Date: ___________________ Job Title: ___________________________________
Method of Payment (U.S. Dollars, Euros etc.): ___________________________________________
Primary Company POC Name/Phone: _________________________________________________
Primary Company POC Email Address: _______________________________________________
In addition to the information above, the Contractor shall furnish documentation to verify he/she was legally admitted into the United States and has an employment or immigrant Visa (unless in the Visa Waiver Program). This includes, individuals living and working in the United States but are not U.S.
Citizens, such as permanent residents.
In addition to the requirements above, all non-U.S. Citizens who have lived in the United States for at least three years must also have or obtain a favorable background investigation in accordance with Homeland Security Presidential Directive 12 (HSPD-12) (guidance provided separately).
Nashville District Corps of Engineers Security Office Contact Information:
*Tracy Dorrough, Security Technician, 615-73-7397 email: tracy.dorrough@usace.army.mil Jay Klinger, Security Specialist, 615-736-2185 email: jason.j.klinger@usace.army.mil
* Primary - Personnel Security Investigations
March 2024 https://travel.state.gov/content/travel/en/us-visas/tourism-visit/visa-waiver-program.html mailto:tracy.dorrough@usace.army.mil mailto:jason.j.klinger@usace.army.mil
| COMPANY NAME ADDRESS MAIN PHONE: |
| FULL Name: |
| Visa Include copy scanned in color if applicable: |
| Corps of Engineers Location Project Office Work Site Where Work is to be performed: |
| Expected Arrival Date: |
| Job Title: |
| Method of Payment US Dollars Euros etc: |
| Primary Company POC Email Address: |
| Birthday format mm/dd/yyyy: |
| Country of Citizenship: |
| Passport Number: |
| What is your job?: |
| Begining and End dates for Site Access: |
| Primary Company POC Name Phone: |
File details come from the government source that posted it. Updated .