ASA Form 4 (Official base pass request).pdf

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Soto Cano Air Base, Honduras- Recreational Facility Repair and Construction
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W912QM-24-Q-0027
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This document is an official pass request for visitors to enter Soto Cano Air Base in Honduras. It outlines the process for requesting access, including submitting the request through the chain of command, obtaining approval from the Major Subordinate Command (MSC) Commander, and processing the pass through the Military Police Detachment and Honduran Intelligence Office. The form requires details such as the visitor's name, ID number, relationship, requested dates and times, purpose of the visit, and vehicle information. The document also references a related federal contract opportunity for repairs and upgrades to buildings at Soto Cano Air Base, including a site visit scheduled for July 23, 2024 and a planned solicitation posting on or about July 29, 2024. The contract opportunity is for a firm-fixed-price contract with a period of performance of 180 calendar days after the notice to proceed, and the estimated order of magnitude is between $250,000 and $500,000.

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ASA Form 4, Dec 2023 PREVIOUS EDITIONS ARE OBSOLETE

OFFICIAL PASS REQUEST

Date:_________________

(A photocopy of front and back of I.D. card or passport needs to be attached)

1. Request authorization for the following official visitor(s) to enter Soto Cano Air Base.

NAME ID NUMBER RELATIONSHIP

2. Requested Dates: from: to: Requested Time: from: to:

3. Purpose of visit (be specific): ________________________________________________________

4. The following vehicle will be used to enter Soto Cano Air Base. Make:

Model: Year: Color: License Plate:

5. Requester: Official visitor(s) will comply with all Honduran and ASA policies and regulations.

Name:Rank: Duty Phone:Unit:

Area & Quarters Number: Date: Telephone:

Signature:_______________________________________ Date:

6. Approval Authority: Major Subordinate Command (MSC) Commanders and their deputies, if on orders as commander, must approve both types of pass requests.

Name: Rank: Unit: Duty Phone:

Signature:_______________________________________ Date:

IAW ASA Policies: US military and DoD civilian personnel may apply for a base access pass for official and unofficial visitors by submitting a request form through their chain of command. Official Visitors (ASA request form 4) are those who are providing support to, or conducting business with, Installation units or personnel in an official capacity. Unofficial Visitors (ASA form 5) are all other guests. Major Subordinate Command (MSC) Commanders and their deputies, if on orders as commander, must approve both types of pass requests. Requests must be submitted to Military Police Detachment (ATTN:

Liaison Section) at least five (5) working days in advance of the visitor’s scheduled arrival to ensure timely processing.

The Military Police, will process the requested passes through the Honduran Intelligence Office, bldg A-2, for final approval. US Service members and DoD Civilians are not authorized to request base passes/access through any other channels except those specified in this directive.

Contact the Liaison National Officer’s (LNO) office if you have any questions at ext. 4116/4215.FOR OFFICIAL JSF USE ONLY

Received by MPD on: ____________________ Pass Number: ___

OFFICIAL PASS REQUEST
Received by JSF on: ____________________ Pass Number: ___
Date:
NAME 1:
NAME 2:
NAME 3:
NAME 4:
NAME 5:
NAME 6:
NAME 7:
ID NUMBER 1:
ID NUMBER 2:
ID NUMBER 3:
ID NUMBER 4:
ID NUMBER 5:
ID NUMBER 6:
ID NUMBER 7:
RELATIONSHIP 1:
RELATIONSHIP 2:
RELATIONSHIP 3:
RELATIONSHIP 4:
RELATIONSHIP 5:
RELATIONSHIP 6:
RELATIONSHIP 7:
2 Requested Dates from:
to:
Requested Time from:
to_2:
3 Purpose of visit be specific:
4 The following vehicle will be used to enter Soto Cano Air Base Make:
Model:
Year:
Color:
License Plate:
Name:
Rank:
Unit:
Duty Phone:
Area Quarters Number:
Telephone:
Date_2:
Date_3:
Name_2:
Rank_2:
Unit_2:
Duty Phone_2:
Date_4:
Received by JSF on:
Text1:

Text3:

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