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N62742-16-C-1309 RONWH Nov 2022 Submit Signed1
N62742-16-C-1309 RONWH Nov 2022 Submit Signed1
(1) Specific date/time of work (note: times need to be specific, not "24/7") November 05, 12, 19 and
26, 2022 (Saturdays) (0600 hrs. to 1800 hrs.)
(2) Was an Activity Hazard Analyses (AHA) reviewed, approved and discussed with all concerned?
YES
(3) Work to be performed: (Specific Crews, Subcontractors, Location, Work Element, etc.) To
Perform Site Grading Activities, Exc./Backfilling/Compaction Works, Civil/Mech/Elec UG
Utilities and Rough-ins, Rebar & Forms Installation, Structural Steel Activities, Termite Control Barrier
Installation, Steel stud and drywall installation and Painting Activity.
(10) I understand that this request to work outside of the normal work hours is at no additional cost to
the Government. Digitally signed by ftechavez
NAME/SIGNATURE/DATE
Digitally signed by
RODRIGUEZ.ALBERTO. RODRIGUEZ.ALBERTO.MAURICIO.13963161
68
MAURICIO.1396316168
CME/AROICC APPROVAL/DISAPPROVAL: Date: 2022.10.31 23:53:18 +10'00'
NAME/SIGNATURE/DATE
CONTRACTING OFFICER
R APPROVAL/DISAPPROVAL:
APPROVAL/ CRUZ.JACQUELINE.C.13 Digitally signed by
CRUZ.JACQUELINE.C.1369380199
69380199 Date: 2022.11.01 08:58:09 +10'00'
NAME/SIGNATURE/DATE
SECURITY FORCES ANTITERRORISM: APPROVED / DISAPPROVED
REASON:
NAME/SIGNATURE OF AT REVIEWER:
Security Notification Form To Be Filled Out For Base Access
Contact your ET/CME/AROICC for any work related incident within 4 hours of the incident. If you are unable
to reach them, contact the Command Duty Officer (CDO) at 777-1809 or 339-7133. You are reminded that
you must physically speak to the person in the contact chain. We are again stressing “SAFETY FIRST”.
N62742-16-C-1309 P-3028 LOCCCRS PROJECT
Saturdays RONWH-November 2022
No. Name Company Tracking# FVR
1 Abalos, Gerard D. Pernix Guam LLC 09-17
2 Balatbat, Zosimo M. Pernix Guam LLC 09-17
3 Betito, Ronaldo E. Pernix Guam LLC 09-17
4 Buot, Reynaldo C. Pernix Guam LLC 09-17
5 Clemente, Ricardo C. Pernix Guam LLC 09-17
6 De Castro, Florita M. Pernix Guam LLC 09-17
7 Echavez, Ferdinand T. Pernix Guam LLC 08-259
8 Facun, Rolando N. Pernix Guam LLC 09-17
9 Fanayam, Darrel Pernix Guam LLC 10-164
10 Gimoto, Arnold G. Pernix Guam LLC 09-17
11 Gorre, Harold, P. Pernix Guam LLC 08-259
12 Guevarra, Eleazer F. Pernix Guam LLC 09-17
13 Hartman, John S. Pernix Guam LLC 09-17
14 Javellana, Benjamin C. Pernix Guam LLC 09-17
15 Laxamana, William L. Pernix Guam LLC 09-17
16 Landry Jr., Raymond A. Pernix Federal 09-17
17 Mariano, Christopher R. Pernix Guam LLC 09-17
18 Marquez, Danny P. Pernix Guam LLC 09-17
19 Medina, Edgardo G. Pernix Guam LLC 09-17
20 Muna II, Peter Paul Pernix Guam LLC 10-164
21 Quichocho, Jonathan S. Pernix Guam LLC 09-17
22 Reyes, Daunte J. Pernix Guam LLC 09-17
23 Velasquez, Donato S. Pernix Guam LLC 09-17
24 Villa, Enrique Pernix Federal 09-17
25 Dizon, Michael Del Rosario Pernix Guam LLC 10-72
26 Fagalyinug, John Pernix Guam LLC 10-72
27 Hainrick, Berson Dimson Pernix Guam LLC 10-72
28 Marathag, Jesus Tamag Pernix Guam LLC 12-172
29 Aiken, Kimura Smithbridge 01-60
30 Alvarez, Alfredo Mark Smithbridge 01-60
31 Hellwig, Roderick John Smithbridge 01-60 01-42
32 Sablan, Jason Roland Smithbridge 01-60
33 Claveria, Kyle B. Pernix Guam LLC 10-72
34 Aguilar, Amerson S. Kinden Corporation 01-206
35 Anderson, Franklin Anthony Smithbridge/Operator 01-60
36 Claveria, Lanz B. Pernix Guam LLC 10-72
37 Bernal, Willy Kinden Corporation 01-60
38 Cruz, Jereme Kyle S Smithbridge 01-60
39 Cunningham II, Clarance Victor Smithbridge/Operator 01-60
40 Evasco, Franklyn Kim Smithbridge/Operator 01-60