Common Contracts
2 similar Emergency Facilities & Land Use Agreement contracts
EMERGENCY FACILITIES & LAND USE AGREEMENTEmergency Facilities & Land Use Agreement • July 13th, 2020
INCIDENT AGENCY (name, address, phone number) 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) POINT OF CONTACT (if applicable):EMAIL:PAYMENT ADDRESS: Same as above, or DUNS:REGISTERED IN SAM.GOV: Yes or No, Vendor Code Information Worksheet attachedEIN/SSN (only if not in SAM):County: State: Township: Range: Section: INCIDENT NAME: INCIDENT NUMBER: RESOURCE ORDER NUMBER: S- MODIFICATION No/DATE: MODIFICATION CO Initials: TYPE OF CONTRACTOR ("X" APPROPRIATE BOXES):SMALL BUSINESS LARGE BUSINESS SMALL DISADVANTAGED OWNED WOMEN OWNED HUBZONE SERVICE DISABLED VETERAN PUBLIC ENTITY GOVERNMENT OTHER 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
EMERGENCY FACILITIES & LAND USE AGREEMENTEmergency Facilities & Land Use Agreement • March 23rd, 2018
INCIDENT AGENCY (name, address, phone number) 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) POINT OF CONTACT (if applicable):EMAIL:PAYMENT ADDRESS: Same as above, or DUNS:REGISTERED IN SAM.GOV: Yes or No, Vendor Code Information Worksheet attachedEIN/SSN (only if not in SAM):County: State: Township: Range: Section: INCIDENT NAME: INCIDENT NUMBER: RESOURCE ORDER NUMBER: S- MODIFICATION No/DATE: MODIFICATION CO Initials: TYPE OF CONTRACTOR ("X" APPROPRIATE BOXES):SMALL BUSINESS LARGE BUSINESS SMALL DISADVANTAGED OWNED WOMEN OWNED HUBZONE SERVICE DISABLED VETERAN PUBLIC ENTITY GOVERNMENT OTHER 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 dis
