W912QR20B0003-0001.pdf
PDF 2 MB Posted
- Attached to
- DFAS Overhangs in Columbus, Ohio
- Solicitation number
- W912QR20B0003
About this file
This solicitation is for construction services to build three entry overhangs at a Defense Finance and Accounting Service facility in Columbus, Ohio. The U.S. Army Corps of Engineers Louisville District intends to issue a firm-fixed-price invitation for bid for the construction of three overhangs extending over three entrance areas of Building 21 located at the Defense Supply Center. Two larger overhangs will be approximately 108 square feet, and one smaller overhang will be approximately 100 square feet. The overhangs will provide weather protection at the entrances and protect existing card readers. The contract duration is estimated at 180 calendar days. A pre-proposal site visit may be held. This is a 100% small business set-aside procurement with a magnitude between $500,000 and $1,000,000. Proposals will be evaluated based on low price, and pro forma requirements must be met. The Government intends to award without discussions but reserves the right to conduct discussions if deemed in its best interest. Offerors must be registered in the System for Award Management. The point of contact is provided.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Bid Opening Results - DFAS Overhangs.pdf | ||
| W912QR20B0003Specs-0000.pdf | ||
| W912QR20B0003Plans-0000.pdf |
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
CIVIL/OPS/ENVIRONMENTAL BR
ATTN: RENEE BOOTH
600 DR M L KING JR PL RM 821
LOUISVILLE KY 40202-2236
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.
15A. NAME AND TITLE OF SIGNER (Type or print)
30-105-04EXCEPTION TO SF 30
APPROVED BY OIRM 11-84
STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA
FAR (48 CFR) 53.243
Solicitation W912QR20B0003 for DFAS Overhangs is hereby modif ied as follows:
a. See summary of changes.
1. CONTRACT ID CODE PAGE OF PAGES
1 4
16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)
16C. DATE SIGNED
BY 20-Feb-2020
16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR
(Signature of Contracting Officer)(Signature of person authorized to sign)
8. NAME AND ADDRESS OF CONTRACTOR (No., Street , County, State and Zip Code) X W912QR20B0003
X 9B. DATED (SEE ITEM 11)
05-Feb-2020
10B. DATED (SEE ITEM 13)
9A. AMENDMENT OF SOLICITATION NO.
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer is extended, X is not extended.
Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:
(a) By completing Items 8 and 15, and returning 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;
or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN
REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.
12. ACCOUNTING AND APPROPRIATION DATA (If required)
13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.
A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE
CONTRACT ORDER NO. IN ITEM 10A.
B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
D. OTHER (Specify type of modification and authority)
E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.
14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
10A. MOD. OF CONTRACT/ORDER NO.
2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)
6. ISSUED BY
3.EFFECTIVE DATE
20-Feb-2020
CODE
U. S. ARMY ENGINEER DISTRICT, LOUISVILLE
600 DR. MARTIN LUTHER KING, JR. PLACE
ROOM 821
LOUISVILLE KY 40202-2239
W912QR 7. ADMINISTERED BY (If other than item 6)
4. REQUISITION/PURCHASE REQ. NO.
CODE W912QR
FACILITY CODECODE
EMAIL:TEL:
W912QR20B0003-0001
W912QR20B0003
SECTION SF 30 BLOCK 14 CONTINUATION PAGE
SUMMARY OF CHANGES
SECTION SF 30 - BLOCK 14 CONTINUATION PAGE (SF 30)
The following have been added by full text:
AMENDMENT 0001
a. This amendment adds FAR Clause 52.236-27, Alternate I, which adds an on-site meeting for Thursday, February 27, 2020 at 11:00 am ET (updated as Note 8 on the Bid Schedule).
b. The following DFAS forms are hereby incorporated into the solicitation:
- EQIP Process for Contract DFAS Projects
- Form 9035 CRI
- OF306
- Policy for Requesting Non-Sensitive-Facilities (Formerly IT-III) Access for Contractor Applicants
c. Updated Bid Schedule to reflect that only ONE entrance to be closed at any one time (updated as Note 7 on the Bid Schedule).
d. Acknowledgment of receipt of this amendment and bids are due by date of 9 March 2020 at 1:00 pm (ET).
52.236-27 SITE VISIT (CONSTRUCTION) (FEB 1995) – ALTERNATE I (FEB 1995)
(a) The clauses at 52.236-2, Differing Site Conditions, and 52.236-3, Site Investigations and Conditions Affecting the Work, will be included in any contract awarded as a result of this solicitation. Accordingly, offerors or quoters are urged and expected to inspect the site where the work will be performed.
(b) An organized site visit has been scheduled for--
Thursday, February 27, 2020 at 11:00 a.m. (ET)
(c) Participants will meet at--
West lobby of Building 21
*Must first report to Defense Supply Center Columbus Visitor Center, located at 401 N Yearling Avenue, Columbus, OH 43213 to obtain your visitor pass.
(End of provision)
SECTION 00 10 00 - SOLICITATION
The following have been modified:
BID SCHEDULE
OFFEROR'S NAME:
Line Item No. Description Unit Amount
BASE BID
0001. Construction: All work, materials, and labor required to construct two overhangs, one at Entrance 6 and one at Entrance 4 as referenced on the drawings.
Job
TOTAL BASE $
OPTIONS
0002.
OPTION 1: Construction: All work, materials, and labor required to construct one overhang at Entrance 5 as referenced on the drawings.
Job
TOTAL OPTIONS $ ____________________
TOTAL BID: $ ____________________
NOTES FOR CONTRACT LINE ITEM (CLIN) SCHEDULE
NOTE NO. 1. To better facilitate the receipt and bid process, all modifications to bids are to be submitted on copies of the latest Contract Line Item (CLIN) schedules as published in the solicitation or the latest amendment thereto. In lieu of indicating additions/deductions to line items, all Offerors should state their revised prices for each site.
NOTE NO. 2. Offerors must insert a price on all numbered items including options of the CLIN Schedule. Failure to do so may result in the offer being unacceptable.
NOTE NO. 3. The Offeror’s Base Bid and all Options will be evaluated. In accordance with 52.217-5, Evaluation of Options, the Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. Evaluation of options will not obligate the Government to exercise the option(s).
NOTE NO. 4. The target ceiling for contract award is $550,000 for Base Bid and all Options. The government cannot guarantee that funds exceeding this target ceiling can be made available for award. Offerors are under no obligation to approach this ceiling.
NOTE NO. 5. CLIN 0001 includes construction of entrance overhangs 4 and 6 as referenced on the drawings to include, but not limited to, all items associated within the building, utilities, sidewalks, site work, and all incidental related work as described in the plans and specifications provided in this Solicitation.
NOTE NO. 6. CLIN 0002 Bid Option 1 includes construction of entrance overhang #5 to include, but not limited to, all items associated within the building, utilities, sidewalks, site work, and all incidental related work as described in the plans and specifications provided in this Solicitation. This bid option may be exercised within 90 days of NTP. Award of this bid option will not extend the contract period of performance of 180 days.
AMDT 001******************************************************************************
NOTE NO. 7 Only one entrance to be closed at any one time for construction of an overhang.
NOTE NO. 8 On-site meeting scheduled for February 27, 2020, at 11:00 AM (ET)
AMDT 001******************************************************************************
--END OF CLIN SCHEDULE--
(End of Summary of Changes)
AMDT 001****************************************************************************
100% of the contractor's employees that work onsite will be required to obtain an IT-Level III badge.
Please be aware that effective April 15, 2019, all DFAS NS (IT-III) contractors must have their fingerprints already completed before the COR may submit the CRI and OF306 to Personnel Security for processing.
COR’s should ensure that all NS contractors and their companies are informed of this new requirement as soon as possible so that they have time to comply with it. A formal, more detailed policy memorandum regarding this requirement will be issued within the next week. All COR’s should be aware that this policy only applies to NS (IT-III) contractors at this time. CS (IT-I) and NCS (IT-II) positions are not affected by this change.
The first step in the process is to submit a Form 306 and 9035 to the COR. Upon favorable review of these forms the Government Security Agent will contact the individual to obtain fingerprints and complete the EQIP questionnaire. Once contacted the individual will be provided instruction to report to DSCC, 401 North Yearling Road, Whitehall, Ohio 3990 E. Broad Street, Building 11-12, Columbus Ohio 43218 within 5 days (or other time specified by the Security Agent). Fingerprinting takes approximately 2 hours to complete and the EQIP questionnaire takes approximately 5 hours to complete, per individual, but varies based on complexity of their job and personal history.
The EQIP is completed on the internet and provides instructions for submitting the forms. Upon favorable review of the individual's EQIP the individual will be contacted by DSCC and must obtain his badge from the Visitor Center within 10 days(or other time specified by the Security Agent). The badge is obtained at DSCC, 401 North Yearling Road, Whitehall, Ohio Visitor Center (Building 61). Obtaining the badge takes an average of 1 hour. Once the badge is received he/she may enter the building where the work is to be performed and will receive permissions from the security office for specific door access.
The average time for security personnel to process each individual's application is 45 calendar days from the receipt of the 306 & 9035 forms. It is highly encouraged that the contractor begin identifying his employees and get forms submitted as soon as possible. These directions are subject to change based on security levels because this work is on a DoD installation. This information is provided for the contractor to quantify the time commitment required to obtain badges.
Applicant's Driver License # and state will be required for access to site.
Formal Site Visit to be conducted on February 27, 2020, at 11 AM.
AMDT 001****************************************************************************
CONTRACTOR REQUEST FOR INVESTIGATION
P RIVACY ACT INFORMATION
In compliance with the P rivacy Act of 1974, this information is personal data and must be protected from public disclosure.
PURPOSE
This form is submitted to the HR Personnel Security Division by Contracting Officer's Representatives (CORs) and Trusted Agents (TAs) to initiate Personnel Security Investigations for potential contract employees or those persons requiring a Common Access Card (CAC) who are associated with Defense Finance and Accounting Services (DFAS) but are not a civilian employee or applicant.
INSTRUCTION
• When submitted to the HR Personnel Security Division, this form must be accompanied by the appropriate security forms to initiate a background investigation.
• Contractor reguests for investigation are onl� to be submitted b� CORs. CORs must be Federal emi;1lo�ees. Contractors are not authorized to reguest
P�rsonn�I S�!;;yri� lnv�stigatigns
SECTION 1 -SUBJECT DATA
1. LAST NAME 2. FIRST NAME 3. MIDDLE NAME 4. SOCIAL SECURITY NUMBER
5. PLACE AND DATE OF BIRTH
Sa. CITY OF BIRTH Sb. STATE OF BIRTH Sc. COUNTRY OF BIRTH 6. DATE OF BIRTH
7. HOME PHONE NUMBER 8. BUSINESS PHONE NUMBER 9. CELL PHONE NUMBER 10. E-MAIL ADDRESS
SECTION 2-CONTRACT DATA
11. CONTRACTOR NAME 12. SUBCONTRACTOR NAME (IF APPLICABLE)
13. CONTRACT NUMBER
14. CONTRACT EXPIRATION DATE
15. DUTY STATION
DSCC
16. PROPOSED DATES SUBJECT WILL WORK ON 17. ACCESS REQUIREMENTS
CONTRACT I REQUIRE ACCESS
a. FROM I
b. TO
a. LEVEL OF IT ACCESS REQUIRED O1T-I O1T-II IZ]IT-111
b. FACILITIES ACCESS/ ISSUANCE OF CAC REQUIRED IZI YES □ NO
18. PURSUE INVESTIGATION IF SUBJECT IS NOT WAIVER ELIGIBLE? □ YES IZI NO
*IF "NO", AND SUBJECT IS NOT WAIVER ELIGIBLE, SUBJECT'S FILE WILL BE DISPOSED OF WITHIN 60 DAYS /AW THE PRIVACY ACT OF 1974.
SECTION 3-COR DATA
19. COR LAST NAME 20. COR FIRST NAME 21. COR SIGNATURE
Campbell Charles
22. COR DUTY STATION 23. COR PHONE NUMBER 24. DATE SUBMITTED
DFAS COLUMBUS, OH 614-692-9319
MAINTENANCE -Completed form is filed in subject's Personnel Security file until investigation is adjudicated for fitness.
Form is destroyed upon expiration of contract. If requested investigation is not favorable, form is retained for 90 days and then destroyed.
Dr.;AS FORM 9035, SEP 2009 PREVIOUS EDITIONS ARE OBSOLETE
RESET FORM I .... I _P_ R_IN_ T_ F_O_R _M _ _,] 1 SUBMIT BY EMAIL
ADOBE ACROBAT
AMDT 001*****************************************************************************************************************************
AMDT 001*****************************************************************************************************************************
Declaration for Federal Employment* (*This form may also be used to assess fitness for federal contract employment)
Form Approved:
OMB No. 3206-0182
U.S. Office of Personnel Management 5 U.S.C. 1302, 3301, 3304, 3328 & 8716
Optional Form 306 Revised October 2011
Previous editions obsolete and unusable
Instructions
The information collected on this form is used to determine your acceptability for Federal and Federal contract employment and your enrollment status in the Government's Life Insurance program. You may be asked to complete this form at any time during the hiring process. Follow instructions that the agency provides. If you are selected, before you are appointed you will be asked to update your responses on this form and on other materials submitted during the application process and then to recertify that your answers are true.
All your answers must be truthful and complete. A false statement on any part of this declaration or attached forms or sheets may be grounds for not hiring you, or for firing you after you begin work. Also, you may be punished by a fine or imprisonment (U.S. Code, title 18, section 1001).
Either type your responses on this form or print clearly in dark ink. If you need additional space, attach letter-size sheets (8.5" X 11").
Include your name, Social Security Number, and item number on each sheet. We recommend that you keep a photocopy of your completed form for your records.
Privacy Act Statement
The Office of Personnel Management is authorized to request this information under sections 1302, 3301, 3304, 3328, and 8716 of title 5, U. S. Code. Section 1104 of title 5 allows the Office of Personnel Management to delegate personnel management functions to other Federal agencies. If necessary, and usually in conjunction with another form or forms, this form may be used in conducting an investigation to determine your suitability or your ability to hold a security clearance, and it may be disclosed to authorized officials making similar, subsequent determinations.
Your Social Security Number (SSN) is needed to keep our records accurate, because other people may have the same name and birth date. Public Law 104-134 (April 26, 1996) asks Federal agencies to use this number to help identify individuals in agency records. Giving us your SSN or any other information is voluntary. However, if you do not give us your SSN or any other information requested, we cannot process your application. Incomplete addresses and ZIP Codes may also slow processing.
ROUTINE USES: Any disclosure of this record or information in this record is in accordance with routine uses found in System Notice OPM/GOVT-1, General Personnel Records. This system allows disclosure of information to: training facilities; organizations deciding claims for retirement, insurance, unemployment, or health benefits; officials in litigation or administrative proceedings where the Government is a party; law enforcement agencies concerning a violation of law or regulation; Federal agencies for statistical reports and studies; officials of labor organizations recognized by law in connection with representation of employees; Federal agencies or other sources requesting information for Federal agencies in connection with hiring or retaining, security clearance, security or suitability investigations, classifying jobs, contracting, or issuing licenses, grants, or other benefits; public and private organizations, including news media, which grant or publicize employee recognitions and awards; the Merit Systems Protection Board, the Office of Special Counsel, the Equal Employment Opportunity Commission, the Federal Labor Relations Authority, the National Archives and Records Administration, and Congressional offices in connection with their official functions; prospective non-Federal employers concerning tenure of employment, civil service status, length of service, and the date and nature of action for separation as shown on the SF 50 (or authorized exception) of a specifically identified individual; requesting organizations or individuals concerning the home address and other relevant information on those who might have contracted an illness or been exposed to a health hazard; authorized Federal and non-Federal agencies for use in computer matching; spouses or dependent children asking whether the employee has changed from a self-and-family to a self-only health benefits enrollment; individuals working on a contract, service, grant, cooperative agreement, or job for the Federal government; non-agency members of an agency's performance or other panel; and agency-appointed representatives of employees concerning information issued to the employees about fitness-for-duty or agency-filed disability retirement procedures.
Public Burden Statement
Public burden reporting for this collection of information is estimated to vary from 5 to 30 minutes with an average of 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of the collection of information, including suggestions for reducing this burden, to the U.S. Office of Personnel Management, Reports and Forms Manager (3206-0182), Washington, DC 20415-7900. The OMB number, 3206-0182, is valid. OPM may not collect this information, and you are not required to respond, unless this number is displayed.
AMDT 001*******************************************************************************************W912QR20B0003-0001
Form Approved:
OMB No. 3206-0182
U.S. Office of Personnel Management 5 U.S.C. 1302, 3301, 3304, 3328 & 8716
Optional Form 306 Revised October 2011
Previous editions obsolete and unusable
GENERAL INFORMATION
1. FULL NAME (Provide your full name. If you have only initials in your name, provide them and indicate "Initial only". If you do not have a middle name, indicate "No Middle Name". If you are a "Jr.," "Sr.," etc. enter this under Suffix. First, Middle, Last, Suffix)
2. SOCIAL SECURITY NUMBER 3a. PLACE OF BIRTH (Include city and state or country)
3b. ARE YOU A U.S. CITIZEN?
YES NO (If "NO", provide country of citizenship)
4. DATE OF BIRTH (MM / DD / YYYY)
5. OTHER NAMES EVER USED (For example, maiden name, nickname, etc) 6. PHONE NUMBERS (Include area codes)
Day
Night
Selective Service Registration
If you are a male born after December 31, 1959, and are at least 18 years of age, civil service employment law (5 U.S.C. 3328) requires that you must register with the Selective Service System, unless you meet certain exemptions.
7a. Are you a male born after December 31, 1959? YES NO (If "NO", proceed to 8.)
7b. Have you registered with the Selective Service System? YES (If "YES", proceed to 8.) NO (If "NO", proceed to 7c.)
7c. If "NO," describe your reason(s) in item 16.
Military Service
8. Have you ever served in the United States military? YES (If "YES", provide information below) NO
If you answered "YES," list the branch, dates, and type of discharge for all active duty.
If your only active duty was training in the Reserves or National Guard, answer "NO."
Branch From (MM/DD/YYYY) To (MM/DD/YYYY) Type of Discharge
Background Information
For all questions, provide all additional requested information under item 16 or on attached sheets. The circumstances of each event you list will be considered. However, in most cases you can still be considered for Federal jobs.
For questions 9,10, and 11, your answers should include convictions resulting from a plea of nolo contendere (no contest), but omit (1) traffic fines of $300 or less, (2) any violation of law committed before your 16th birthday, (3) any violation of law committed before your 18th birthday if finally decided in juvenile court or under a Youth Offender law, (4) any conviction set aside under the Federal Youth Corrections Act or similar state law, and (5) any conviction for which the record was expunged under Federal or state law .
9. During the last 7 years, have you been convicted, been imprisoned, been on probation, or been on parole?
(Includes felonies, firearms or explosives violations, misdemeanors, and all other offenses.) If "YES," use item 16 to provide the date, explanation of the violation, place of occurrence, and the name and address of the police department or court involved.
YES NO
10. Have you been convicted by a military court-martial in the past 7 years? (If no military service, answer "NO.") If "YES," use item 16 to provide the date, explanation of the violation, place of occurrence, and the name and address of the military authority or court involved.
YES NO
11. Are you currently under charges for any violation of law? If "YES," use item 16 to provide the date, explanation of the violation, place of occurrence, and the name and address of the police department or court involved.
YES NO
12. During the last 5 years, have you been fired from any job for any reason, did you quit after being told that you would be fired, did you leave any job by mutual agreement because of specific problems, or were you debarred from Federal employment by the Office of Personnel Management or any other Federal agency? If "YES," use item 16 to provide the date, an explanation of the problem, reason for leaving, and the employer's name and address.
YES NO
13. Are you delinquent on any Federal debt? (Includes delinquencies arising from Federal taxes, loans, overpayment of benefits, and other debts to the U.S. Government, plus defaults of Federally guaranteed or insured loans such as student and home mortgage loans.) If "YES," use item 16 to provide the type, length, and amount of the delinquency or default, and steps that you are taking to correct the error or repay the debt.
YES NO
Form Approved:
OMB No. 3206-0182
U.S. Office of Personnel Management 5 U.S.C. 1302, 3301, 3304, 3328 & 8716
Optional Form 306 Revised October 2011
Previous editions obsolete and unusable
Additional Questions
14. Do any of your relatives work for the agency or government organization to which you are submitting this form?
(Include: father, mother, husband, wife, son, daughter, brother, sister, uncle, aunt, first cousin, nephew, niece, father-in-law,mother-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law, stepfather, stepmother, stepson, stepdaughter, stepbrother, stepsister, half brother, and half sister.) If "YES," use item 16 to provide the relative's name,relationship, and the department, agency, or branch of the Armed Forces for which your relative works.
YES NO
15. Do you receive, or have you ever applied for, retirement pay, pension, or other retired pay based on military, Federal civilian, or District of Columbia Government service?
YES NO
Continuation Space / Agency Optional Questions
16. Provide details requested in items 7 through 15 and 18c in the space below or on attached sheets. Be sure to identify attached sheets with your name, Social Security Number, and item number, and to include ZIP Codes in all addresses. If any questions are printed below, please answer as instructed (these questions are specific to your position and your agency is authorized to ask them).
Certifications / Additional Questions
APPLICANT: If you are applying for a position and have not yet been selected, carefully review your answers on this form and any attached sheets. When this form and all attached materials are accurate, read item 17, and complete 17a.
APPOINTEE: If you are being appointed, carefully review your answers on this form and any attached sheets, including any other application materials that your agency has attached to this form. If any information requires correction to be accurate as of the date you are signing, make changes on this form or the attachments and/or provide updated information on additional sheets, initialing and dating all changes and additions.
When this form and all attached materials are accurate, read item 17, complete 17b, read 18, and answer 18a, 18b, and 18c as appropriate.
17. I certify that, to the best of my knowledge and belief, all of the information on and attached to this Declaration for Federal Employment, including any attached application materials, is true, correct, complete, and made in good faith . I understand that a false or fraudulent answer to any question or item on any part of this declaration or its attachments may be grounds for not hiring me, or for firing me after I begin work, and may be punishable by fine or imprisonment. I understand that any information I give may be investigated for purposes of determining eligibility for Federal employment as allowed by law or Presidential order. I consent to the release of information about my ability and fitness for Federal employment by employers, schools, law enforcement agencies, and other individuals and organizations to investigators, personnel specialists, and other authorized employees or representatives of the Federal Government. I understand that for financial or lending institutions, medical institutions, hospitals, health care professionals, and some other sources of information, a separate specific release may be needed, and I may be contacted for such a release at a later date.
17a. Applicant's Signature: Date (Sign in ink)
17b. Appointee's Signature: Date (Sign in ink)
Appointing Officer:
Enter Date of Appointment or Conversion
MM / DD / YYYY
18. Appointee (Only respond if you have been employed by the Federal Government before): Your elections of life insurance during previous Federal employment may affect your eligibility for life insurance during your new appointment. These questions are asked to help your personnel office make a correct determination.
18a. When did you leave your last Federal job? DATE:
MM / DD / YYYY
18b. When you worked for the Federal Government the last time, did you waive Basic Life Insurance or any type of optional life insurance?
YES NO DO NOT KNOW
18c. If you answered "YES" to item 18b, did you later cancel the waiver(s)? If your answer to item 18c is "NO," use item 16 to identify the type(s) of insurance for which waivers were not canceled.
YES NO DO NOT KNOW
AMDT 001*******************************************************************************************
DEFENSE FINANCE AND ACCOUNTING SERVICE
8899 east 56th street
Indianapolis, in 46249-0201 www.dfas.mil Your Financial Partner @ Work
ZHSG August 9, 2019
MEMORANDUM FOR CONTRACTING OFFICER REPRESENTATIVES (CORs) AND
SITE SECURITY PERSONNEL
SUBJECT: Policy for Requesting Non-Sensitive/Facilities (Formerly IT-III) Access for Contractor Applicants
Effective August 19, 2019:
SOCIAL SECURITY NUMBER (SSN) VERIFICATION: CORs will initiate a Personnel Security review for a contractor applicant requiring nonsensitive/facilities/IT- III access by submitting the following documents to Personnel Security:
Contractor Request for Investigation (DFAS Form 9035) Declaration for Federal Employment (OF-306) Copy of either a Social Security card or other official government-issued document (Federal, State or Local) clearly displaying the contractor applicant’s SSN.
FINGERPRINTING: All fingerprinting must be completed prior to the submission of the Contractor Request for Investigation (DFAS Form 9035) and Declaration for Federal Employment (OF-306)
TIME LIMITATIONS ON SUBMISSION OF SECURITY FORMS
Contractor applicants have seven-days to complete a Questionnaire for Non-Sensitive Position (SF-85) via the OPM e-QIP website and the DFAS Personnel Security Office will deactivate records for contractor applicants that fail to complete their SF-85 after 14 days. Extensions beyond the 14-day deactivation period may be approved by the DFAS Personnel Security Office on a case-by-case basis but must be requested prior to deactivation of the contractor applicant’s records for non-compliance.
Contractor applicants who fail to complete and release their SF-85 within the allotted time-period will not be eligible for resubmission for another contractor position with DFAS for 90 days from the date of their original 14-day suspense date.
DFAS Personnel Security point of contact is Dan Grisham, Personnel Security Contractor Program Manager, (317) 212-4058 or email: daniel.r.grisham.civ@mail.mil.
Robert L. Berthiaume, Chief Human Resources, Personnel Security Division
AMDT 001********************************************************************************
AMDT 001*****************************************************************************************
| STANDARD FORM 30 |
| SUMMARY OF CHANGES |
| 52.236-27 SITE VISIT (CONSTRUCTION) (FEB 1995) – ALTERNATE I (FEB 1995) |
| BID SCHEDULE |
| EQIP PROCESS FOR CONTRACT DFAS PROJECTS |
| FORM 9035 CRI |
| OF306 |
| POLICY FOR REQUESTING NON-SENSITIVE-FACILITIES (FORMERLY IT-III) ACCESS FOR CONTRACTOR APPLICANTS |
File details come from the government source that posted it. Updated .