Common Contracts
1 similar Emergency Facilities & Land Use Agreement contracts
EMERGENCY FACILITIES & LAND USE AGREEMENT rev. 05/2021Emergency Facilities & Land Use Agreement • May 21st, 2022
INCIDENT AGENCY (name, address, phone number)San Juan National Forest 15 Burnett CourtDurango, CO 81301970-247-4874 Page 1 of 3AGREEMENT NUMBER MUST APPEAR ON ALL PAPERS RELATING TO THIS AGREEMENTAGREEMENT NUMBER:1282X922K4002 EFFECTIVE DATESa. beginning: 05/19/2022 b. ending: End of incident OWNER (name, address, phone number-include day/night/cell)Archuleta, County Of 449 San Juan StPagosa Springs, CO 81147 970-389-0276POINT OF CONTACT (if applicable): Derek Woodman EMAIL: derek.woodman@archuletacounty.org PAYMENT ADDRESS: Same as above, or DUNS: UEI VPPBX1NQ4KH9REGISTERED IN SAM.GOV: Yes or No, Vendor Code Information Worksheet attachedEIN/SSN (only if not in SAM):County: State: Township: Range: Section: INCIDENT NAME: Plumtaw INCIDENT NUMBER: CO-SJF-000203 RESOURCE ORDER NUMBER: S-185 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
