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Step 1 - Provide Contact Info

Notice
Do not include any sensitive information on this form or (if applicable) files uploaded to this form. Sensitive information includes, but is not limited to, social security numbers, driver’s license numbers, bank account information, routing numbers, medical information, passport numbers, or passwords.
Introduction
This form is used if your agency/entity would like to register resources you may have that can be called upon during an emergency or disaster. RFPs for the private sector will still be done in a manner to promote a fair and open marketplace when practical. Emergency conditions may require expedient ordering of resources, which would be done from pre-developed lists, such as this one. Annual verification of items will be sent out annually via email. If an item is not confirmed, it will be removed from the list. This form is limited to one resource entry per submission. Look for the download template and upload links to submit multiple resources at the end of the form's steps.
Your Information
Provide the information of the person submitting this form below.
First Name*
Last Name*
Your Title*
Agency Type*
Specify Agency Type - Other
Phone Number*
Agency/Entity Name:*
Email Address*
Supervisor's First Name
Supervisors Last Name
Supervisor's Phone
Supervisor's Email
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Describe Your Resource
Enter resources you would like us to know about. This form is limited to entering one resource per submission. If you would like to bulk upload resources, use the download link to obtain the file template and then upload a filled out template. These templates are provided in the last step of the form.
Quantity*
Unit of Measure*
Resource Title*
Be as descriptive as necessary. Try to use the format: Internal ID Number, Model Year, Make, Model, Size, and Generic Description when possible. (Example: 1999 Honda EU2100 Portable 1600 watt Generator AC output only).
Step 3 NIMS Typing
If known, provide FEMA's NIMS Typing information below. You may visit Resource Typing Library Tool at: https://rtlt.preptoolkit.fema.gov/Public .
NIMS Category
NIMS Kind
NIMS Type
Confidence
How confident are you that you typed this resource properly?
1. 100% (I nailed it!)
2. 50% (I kind of think I did it)
3. 1% (I'm going to be honest, I just guessed!)
4. 0% (I didn't know what this was)
Operating Requirements
Describe any operating requirements that may be necessary, such as licensing.
Operating Limitations
Describe any limitations that may exist.
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Deployment Contacts
Please indicate the people who can be called to deploy the resource. List them in order preferred to be called.
Contact 1 (Name)*
Contact 1 24/7 Telephone*
Contact 1 Additional Info
Contact 2 (Name)*
Contact 2 24/7 Telephone*
Contact 2 Additional Info
Contact 3 (Name)
Contact 24/7 Telephone
Contact 3 Additional Info
Deployment Time
After you are notified, how long would it take you to get to an incident scene in Berrien County? (Tip for out of County entities: use Baroda, MI as your destination in a mapping internet page to estimate travel time) (Tip for in County: estimate the time it would take to get to the furthest County boarder community....ie if you are in New Buffalo, how long does it take to get to Watervliet, etc)
Hours*
Minutes*
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Actual Cost
Indicate the base estimated cost
Per (Qualifier)
Indicated it the "Actual Cost" is per hour, per gallon, per item, etc
Purchasing information or terms
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Additional Comments
Provide any additional comments you may think we may need to know.
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Download Bulk Template
Download (excel template)
Use this template to submit multiple resources.
Upload Template
Use this link to upload a template after you have downloaded it

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