Resource Request Questions


Incident Name:

Priority

• When do you need this request fulfilled?
o 0-4 hours
o 4-8 hours
o 8-12 hours
o 12-36 hours
o Longer than 36 hours

Justification
• Does the county or local jurisdiction have the ability to contract for these resources?
o Yes
o No

Have you exhausted all mutual aid options in the surrounding counties?
o Yes
o No

Additional justification for the requested resource(s):
Justification Examples:
Local jurisdiction does not have this resource...
All existing resources have been contracted out...
Surrounding counties are also impacted...
No mutual aid is available...

Requesting Jurisdiction
• Requester Agency:
• Operational Area:

Requested Resources
• Resource Name:
• Quantity Requested (ea):
• Detailed Resource Description: (Vital characteristics, brand, specs, experience, size, etc.)
• Is an operator needed for this resource?

Request Summary (Why is this resource needed and what will it do):

Actions taken on this request so far (what have you done to obtain the resource on your own)?

Requester Information
• Requester First & Last Name:
• Requester Email:
• Requester Phone:
• Requester Title:

Delivery Information
• Recipient First & Last Name:
• Delivery Recipient Email:
• Delivery Recipient Phone:
• Delivery Recipient Title:
• Delivery Recipient Entity Name:
• Delivery Location:
• Delivery Notes:

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COASTAL REGION RESOURCE REQUEST

 

REQUESTING JURISDICTION INFORMATION
Incident Name:    Request Date/Time:   
Priority

When do you need this request fulfilled?
 0-4 Hours 4-8 hours
8-12 hours 12-36 hours longer than 36 hours
Justification
Does the county or local jurisdiction have the ability to contract for these resources? Yes   No
Have you exhausted all mutual aid options in the surrounding counties? Yes    No

Additional justification for the requested resource(s)

     Examples:   : Local jurisdiction does not have this resource...  All existing resources have been contracted out...
       Surrounding counties are also impacted..  No mutual aid is available...

Requesting Jurisdiction

Requesting Jurisdiction Name:   

Operational Area:
Requested Resources
 Resource Name  Quantity Requested (ea)  Detailed Resource Description (Vital characteristics, brand, specs, experience, size, etc.)  Is an operator needed ?
Yes   No
Yes   No
Yes   No

Request Summary (Why is this resource needed and what will it do):

Actions taken on this request so far (whathave you done to obtain the resource on your own)?

Requester Information
Requester First & Last Name:    Requester Email:  
Requester Phone:   Requester Title:
Delivery Information
Recipient First & Last Name:: Delivery Recipient Email:
Delivery Recipient Phone: Delivery Recipient Title:  
Delivery Recipient Entity Name:  
Delivery Location:
Delivery Notes:
                                       Coastal Region Resource Request  v1.0