EAL_Bldg_3_Carpet_Installation.pdf

PDF 94 KB Posted

Attached to
Bldg 3 Carpet Federal contract opportunity
Solicitation number
W912SV-19-Q-5016
Issued by
Department of the Army Massachusetts Army National Guard

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EAL Entry Access List

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AXQD192616_Drawings.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 kyle.kiepke Text Box

FOR OFFICIAL USE ONLY WHEN COMPLETED

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Text1: Replace Carpet Bldg 3 (DFAC)
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Text4: Sarah Sinclair, Sandra Woodin
Text5: 413-572-1549/413-568-9151 ext 698-1019
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