Common Contracts
1 similar Emergency Facilities & Land Use Agreement contracts
March 2015 EMERGENCY FACILITIES & LAND USE AGREEMENTEmergency Facilities & Land Use Agreement • March 10th, 2015
INCIDENT AGENCY (name, address, phone number) Page of AGREEMENT NUMBER MUST APPEAR ON ALL PAPERS RELATING TO THIS AGREEMENTAGREEMENT NUMBER EFFECTIVE DATESa. beginning b. ending OWNER (name, address, phone number-include day/night/cell/fax) DUNS:EIN/SSN:PAYMENT ADDRESS:[ ] Same as above, or INCIDENT NAME: INCIDENT NUMBER:RESOURCE ORDER NUMBER: JOB CODE (P#) AND OVERRIDE: TYPE OF CONTRACTOR ("X" APPROPRIATE BOXES)SMALL BUSINESS LARGE BUSINESS SMALL DISADVANTAGED OWNED WOMEN OWNED HUBZONE SERVICE DISABLED VETERAN PUBLIC ENTITY(Pursuant to FAR 31.6 & OMB Cir.A-87) The owner of the property described herein, or the duly appointed representative of the owner, agrees to furnish the land/facilities for use as _.DESCRIPTION OF LAND/FACILITIES: Address or specific location. If street or highway address is unavailable, use distance from nearest city, crossroads, or other significant landmark. The local description of how to get to the land/facilities is also acceptable. County: State: T
