EAL_AXQD179651.pdf

PDF 81 KB Posted

Attached to
Extend Blast Wall Federal contract opportunity
Solicitation number
W912SV-17-B-0002
Issued by
Department of the Army Massachusetts Army National Guard

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EAL - Entry Authorization List

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Other files for this federal contract opportunity

Other files attached to Extend Blast Wall, newest first.
File Type Posted
ATTACHMENT_2_-_DRAWINGS_AXQD179651.pdf PDF
ATTACHMENT_1_-_STATEMENT_OF_WORK_(SOW)_AXQD179651.pdf PDF
ATTACHMENT_4_-_SPECIFICATION_01000_AXQD179651.pdf PDF
D01_W912SV-17-B-0002.pdf PDF

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104FW Security Forces Squadron

Contractor Entry Authority List

PRIVACY ACT STATEMENT

1. AUTHORITY: Title 50, Appendix, U.S.C., Title 10, U.S.C., Public Law 96-357 96th Congress, September 24, 1980 (Amendment to 10 U.S.C. 2107).

2. PRINCIPAL PURPOSE(S): The information provided on the application will be used to screen individual contractor employees for access to DoD facilities.

3. MANDATORY AND VOLUNTARY DISCLOSURE AND EFFECT ON INDIVIDUAL PROVIDING INFORMATION: Disclosure of information requested in this Entry Authorization List (EAL) is voluntary; however, the information must be furnished for the employee to be allowed access to the DoD facility.

Project:

Company/Contractor Name:

Project Manager and Phone:

104FW POC:

104FW POC Phone:

Contractor Employee Information:

Name Driver’s License / State DOB DATE START DATE END

NameRow1:
DOBRow1:
DATE STARTRow1: 8/15/2017
DATE ENDRow1: 8/15/2017
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Text1: Extend Blast Wall / AXQD179651
Text2:
Text3:
Text4: SMSgt Kyle Kiepke
Text5: 413.572.1593
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