APPENDIX C COVA ENTITY eVA DESIGNATION
COVA Entity eVA
Designation Form
COVA ENTITY NAME: ______Agency Code:______
Date:______
· As the Entity Administrative Head for the COVA Entity listed above, I am designating the individual listed below-as the:
q Primary Entity eVA Security Officer
q Backup Entity eVA Security Officer
· As the Entity Procurement Director for the COVA Entity listed above, I am designating the individual listed below-as the:
q Primary Entity eVA Lead
q Backup Entity eVA Lead
· The individual designated is: with no known disciplinary actions for security issues.
q An employee of my Entity
q Is not an employee of my Entity but is authorized to serve as the Entity eVA Security Officer for my Entity.
· I understand that it is recommended that the designated individual have passed a criminal background check.
Signature Date
Printed Name & Title
As the Entity eVA Security Officer/ Entity eVA Lead, I acknowledge that it is my responsibility to comply with the eVA Electronic Procurement System Security Policies and Standards.
Signature Date
Printed Name & Title
______(_____)______
eMail Phone Number eVA User ID
eVA Security designation submit electronically or by mail or fax: / Department of General Services, ATTN: eVA Global Security Officer, 1111 E. Broad St, 6th floor Richmond, VA 23219/ Fax: (804) 786-5712
Basic Level Security Delegation Granted / Advance Level Security Delegation Granted______
Date eVA Global Security Officer / ______
Date eVA Global Security Officer
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