Description
This combined synopsis/solicitation is amended to add the following clauses and attachments: 52.204-09, Personal Identity Verification of Contractor Personnel, Sep 2007; 52.228-05, Insurance-Work on a Government Installation, Jan 1997; 1452.228-70, Liability Insurance-Department of the Interior, July 1996; 1452.237-80, Security Requirements-Bureau of Reclamation, Oct 2006; PIV Instructions, Application Form, and List of Acceptable Identity Source Documents. The PIV documents will be sent to the winning quoter. These are for information only. STATEMENT OF INFORMATION Personal Identity Verification (PIV) Homeland Security Presidential Directive-12 (HSPD-12), Office of Management and Budget (OMB) guidance M-05-24, and Federal Information Processing Standards Publication 201 (FIPS Pub 201) activated contract clause GP-7 (Site Security), paragraph (b) whereas the Government will perform background checks on any or all contractor workers on contract which meet the criteria as specified in HSPD-12. Performance of this contract requires prime contractor personnel, and its subcontractors, to have background investigation before being allowed unsupervised access to the Bureau of Reclamation facility Big Thompson Power Plant and Big Thompson Waste Way where the work will be performed under this contract. The prime contractor (and subcontractors) is required to complete the attached Application Form with the identify of all contractor (and subcontractor's) employees who will require physical access to the facility to perform the requirements of the contract and return a copy to the Contracting Officer within 5 calendar days after issuance of the Notice to Award and submit to the Contracting Officer the same information for any new employee working on this contract. The employee will be contacted by the Great Plains Region Security Specialist through the email address provided on the form and/or telephone number and requested to complete the necessary forms electronically (on-line) through a program titled "Eqip." The Security Specialist will provide instructions to each applicant on how to proceed through this process. All personnel will be required to produce two forms of identification, one of which must be a Federal or State-issued photo ID and the other from the List of Acceptable Identity Source Documents. Fingerprinting is also required and fingerprint cards will be provided by the Government. Contractor (and subcontractors) employees are required to give, and to authorize others to give, full, frank, and truthful answers to relevant and material questions needed to reach a suitability determination. Refusal or failure to furnish or authorize provision of information may constitute grounds for denial or revocation of credentials. Government personnel may contact the contractor personnel being screened or investigated in person, by telephone, or in writing, and the contractor agrees to make them available for such contact. Alternatively, if an individual has already been credentialed by another agency and that credential has not yet expired, further investigation may not be necessary. Provide the Contracting Officer with documentation that supports the individual's status with another Government Agency. During the performance of the contract, the contractor will keep the Contracting Officer apprised of changes in personnel to ensure that performance is not delayed by compliance with credentialing processes. Cards that have been lost, damaged, or stolen must be reported to the Contracting Officer and Security Specialist within 24 hours. Replacement will be at the contractor's expense. If reissuance of expired credentials is needed, it will be coordinated through the Contracting Officer. At the end of the contract performance, or when a contractor employee is no longer working under this contract, the contractor will ensure that all identification cards are returned to the Contracting Officer. Before starting work under this contract, a National Agency Check (NAC) will be conducted to verify the identity of the individual applying for clearance. Upon successful completion of the NAC process, an identification card will be issued and access granted. Simultaneously, a NAC with Inquiries (NACI) will be initiated to determine the individual's suitability to have unsupervised access to Reclamation facilities. If the NACI adjudication is favorable, nothing more needs to be done. If the adjudication is unfavorable, the credentials will be revoked. In the event of a disagreement between the contractor and the Government concerning the suitability of an individual to perform work under this contract, the Department of the Interior shall have the right of final determination. This requirement must be incorporated into any subcontracts that require subcontractor personnel to have routine and regular unsupervised access to a Federally-controlled facility for more than 180 calendar days. References: Information about this Federal Government program can be found at: HSPD-12 can be found at www.fas.org/irp/offdocs/nspd/hspd-12.htmlOrwww.whitehouse.gov/news/release/2004/08/20040827-8/html FIPS PUB 201 can be found at http://www.itl.nist.gov/fipspubs/by-num.htm OMB M-05-24 can be found at http://www.whitehouse.gov/omb/memoranda/2005/html Attachment: Application FormList of Acceptable Identity Source Documents PERSONAL IDENTITY VERIFICATIONAPPLICATION FORMApplicant's Personal Information(All fields are mandatory) Legal First Name(Must match name on legal documents) Legal Middle Name(Must match name on legal documents) Use "No Middle Name" only IF NO middle name is on legal documentsLegal Last Name(Must match name on legal documents) Suffix(Sr., Jr., III) Use only if it appears on legal documents to be used for enrollmentSocial Security Number (SSN) Date of Birth (DOB) Email (Home) addressIf applicant does not have a home email, please provide the work email address Home Address 1 Address 2 City State and Zip Code Country Citizenship Country Birth Country Birth State Birth City Affiliation (i.e., Owner, employee, associate) Contractor Company Name(or subcontractor Company Name) Contract Number Contract Start Date / Contract End Date Business Phone Cellular Phone I, __________________________________hereby certify the information above are correct. (signature) List of Acceptable Identity Source Documents List A List B List CU. S. Passport (unexpired or expired) Driver's license or ID card issued by a state or outlying possession of the United States provided it contains a photograph or information, such as name, date of birth, gender, height, eye color, and address U.S. social security card issued by the Social Security Administration (other than a card stating it is not valid for employment)Certificate of U.S. Citizenship (Form N-560 or N-561) ID card issued by Federal, State, or local government agencies of entities, provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address Certification of Birth Abroad issued by the Department of State (form FS-545 or Form DS-1350)Certificate of Naturalization (Form N-550 or N-570) School ID card with a photograph Original or certified copy of a birth certificate issued by a state, county, municipal authority, or outlying possession of the United States bearing an official sealUnexpired foreign passport, with I-551 stamp or attached Form I-94 indicating unexpired employment authorization Voter's registration card Native American tribal documentPermanent Resident Card or Alien Registration Receipt Card with photograph (Form I-151 or I-551) U.S. Military card or draft record U.S. Citizen ID Card (Form I-197)Unexpired Temporary Resident Card (Form I-688) Military dependent's ID card ID Card for Use of Resident Citizen in the United States (Form I-179)Unexpired Employment Authorization Card (Form I-688A) U.S. Coast Guard Merchant Mariner Card Unexpired employment authorization document issued by DHS (other than those listed under List A)Unexpired Reentry Permit (Form I-327) Driver's license issued by a Canadian government authority Unexpired Refugee Travel Document (form I-571) For persons under age 18 who are unable to present a document listed above: Unexpired Employment Authorization Document issued by DHS that contains a photograph (Form I-688B) School record or report card Clinic, doctor, or hospital record Day-care or nursery school record