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U.S.

Department of Homeland Security


500 C Street, SW
Washington, DC 20472

JUN 1 4 2006
Ms. Melanie Sloan
Citizens for Responsibility and Ethics in Washington
11 DuPont Circle
N.W., 2ndFloor
Washington, DC 20036

RE: Freedom of Information Act Request


FOIA Case Number: 05-263

Dear Ms. Sloan:

This letter is a partial response to your Freedom of Information Act (FOIA) request dated
September 7,2005. In your request you asked for the following records/information:

What portion of the $3.1 billion appropriated to DHS in fiscal year 2005 for
emergency preparedness to "support the Nation's ability to prepare for, mitigate
against, respond to and recover from natural and manmade disasters" was spent to
prepare for potential hurricanes on the Gulf Coast of the United States and on
potential flooding in New Orleans;
The amount of money diverted from emergency preparedness for and response to
natural disasters to emergency preparedness for and response to acts of terrorism
and the rationale behind any such diversion;
Studies, assessments, presentations, or scenarios of the potential devastation a
powerful hurricane could wreak on the Gulf Coast, including, but not limited to
the eight-day tabletop exercise conducted in July 2004 and intended to prepare
FEMA for a catastrophic hurricane in New Orleans;
Plans created regarding the federal government's response to any such scenarios;
The potential breaching of the levees that would lead to Lake Pontchartrain
flooding New Orleans and the response to such breaches; and
Communications from anyone employed by or associated with the Army Corps of
Engineers regarding the problems with and weakness of the levees surrounding
New Orleans, the potential breaching of the levees and the consequences of such
breaches, as well as proposed repairs or other construction to the levees.

In addition, your letter stated that "CREW further seeks all memoranda, communications
and records of any kind and from any source, regardless of format, medium, or physical
characteristics, from August 26, 2005 through the present, discussing or mentioning in
any way:

1. Requests for emergency assistance from local government officials in Mississippi


and Louisiana in response to Hurricane Katrina;
2. Requests from local government officials in'~ississippiand Louisiana for
assistance in preparing for Hurricane ~ a t n n aincluding,
, but not limited to
communications requesting assistance in evacuating residents of Mississippi and
Louisiana from the areas in the hurricane's path;
Communications between the White House and FEMA regarding the preparation
for and response to the damage caused by hurricane Katrina;
Communications regarding the conditions in the New Orleans Convention Center;
Communications regarding the need for transportation to evacuate victims of the
hurricane from the city of New Orleans as well as communications regarding the
need for food and water for victims stranded in New Orleans;
Communications from Congressman Charles W. Boustany Jr. (R-LA) requesting
federal assistance and any response to Congressman Boustany;
Communications regarding offers by corporations and foreign governments to
assist the victims of the Hurricane Katrina and FEMA's responses to such offers;
Communications between FEMA Director Michael Brown and cabinet officials
either before or after the hurricane regarding the potential and actual devastation
wrought by the hurricane and the federal government's response to the
devastation;
Communications regarding the plan to evacuate victims of the hurricane to
Charleston, South Carolina and the misrouting of the plane carrying the evacuees
to Charleston, West Virginia;
10. Communications regarding the deployment of the National Guard to New Orleans
to assist in evacuation and relief efforts;
11. Communications regarding the inclusion of Operation Blessing, a Virginia based
charity run by evangelist and Christian Coalition founder Pat Robertson, on
FEMA's primary list of charities to which people were asked to donate money to
assist hurricane relief efforts; and
12. Communications regarding the limitations placed on journalists and
photographers, including, but not limited to, efforts to prevent photographers from
taking pictures of the corpses of hurricane victims in Louisiana and Mississippi.

In responding to a FOIA request, the US Department of Homeland Security


(DHS)/Federal Emergency Management Agency's (FEMA) search will include
responsive records in its control on the date the search began. FEMA's search began
September 24, 2005.

Your request is granted in part at no cost to you. Enclosed are releasable portions of
documents that are responsive to item numbers 1 and 2 of the second part of your request.
After thorough legal review of these documents, I have determined that portions of them
are exempt from disclosure under exemptions 2 and 6 of the Freedom of Information Act
of 1974, 5 U.S.C. 552, (b)(2) and (6), as amended. We are releasing a total of 1,151
pages, all of which are released in part.

We are withholding Government cell phone numbers under FOIA Exemption 2 ("High
2"). FOIA Exemption 2 ("High 2") protects information applicable to internal
administrative and personnel matters, to the extent that disclosure would risk
circumvention of an agency regulation or statute, impede the effectiveness of an agency's
activities, or reveal sensitive information that may put the security and safety of an
agency activity or employee at risk.

We are withholding personal cell phone numbers, non-government phone numbers, and
non-FEMA email addresses under FOIA Exemption 6. Exemption 6 exempts from
disclosure records the release of which would cause a clearly unwarranted invasion of
personal privacy. The interest of the general public in reviewing these portions of
government documents does not outweigh the individuals' right to privacy. The release
of this information adds no detail about agency activities, the core purpose of the FOIA.

I am the official responsible for this determination. You may appeal this determination
within 60 days from the date of this letter. Your appeal should include copies of your
original request and this response, as well as a discussion of the reasons supporting your
appeal. The envelope should be plainly marked to indicate that it contains a Freedom of
Information Act appeal. If you decide to appeal, please send your appeal to:

Freedom of Information ActPrivacy Act Appeals


U.S. Department of Homeland Security
245 Murray Lane, SW, Building 410
Washington, DC 20528

FEMA will continue to search for additional documents that may be responsive to your
request. Because of the broad scope of your request, responsive records may be located
at various offices within FEMA. Each office will respond via separate correspondence
with their respective records.

For your information, your FOIA request including your identity, the information made
available, is releasable to the public under subsequent FOIA requests. In response to
these requests, FEMA does not release personal privacy information, such as home
address, telephone numbers or Social Security Numbers all of which are protected from
disclosure under FOIA exemption 6.

Thank you for your interest in FEMA's programs and policies.

Sincerely,

4 +*,
Michael W. Lowder
Deputy Director
1 Response Division

Enclosures
ourcing tlpg Request - ~ c v i e w / ~ o & d i n n t i o nation ions Section Only)
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Diitc/'f%nc Assiancd:
N:Statement
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of Work (Operations section Only)
OF'A Action Offiiccr: 24 hour Phone:

p. Action T s k m (Operations ~ e c x o nOnly) - -- -

1
' r- ACTION REQUEST FORM OMB No. 1660.0047

----
Exprlcr Nownrlcr 30,2007
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Requestor C)~.gmizarion: C ~ f zh ir LA-- I .i.d:.dt ? I 1 . b ~ ( ~1 ,%:)
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11. Requested Assistance (Completed by Requestor) k c A&ncnfd
Description oC Assiutunct: Rrqucstcd:
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L
o m NO. 1660-0047

11.I
AC'WON REQUEST F O R M
.' FikpAcs Nowmbar 30,2007
Who is Requesting Assistance? ( ~ o m ~ l c k by
e d Requestor)
Narnr/Tidc'/Sli~tl;:
l~c~uc?Lc.tP Chcvlas Parent. ~ u ~ c ~ n t e n d cLa.
nt. 'Ikmpomry I1hnnc/Fax 4:

ricqucslor Orgnnimtion; New Orleans FLrc Department E-mid: .- -

11. Requested Assistance lcomgleted by Requestor) U S~?P~tuchcul

I>escripr.ion o f Asxjskmcr R c q ~ ~ e s t e d :

W E I STRIKE TEAM 7ENC)IXS. Thcsc R Y S L " nre4nccd


~~ for (he rrotlsportotidn of wa(cr for fucflghting cnpabilitica am1 for
T S victims Lhar hnvc hean cxpcposcd Lo hwardous wasrc in the water aruund rhc New Orlcans nrca.
decontaminution L I ~ ~ C S C U ~ und
Currrntl~tl~ercis no wntcr due tn thc lack of clvctricity in the urcu.
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IiI. Sourcing tbe Reqmest ~ d u i c r a / ~ ~ o r d i n a t l(Opera~oils
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Irnmcdiah?Action Required: IJ v a No Action request E!! r :
Qulc/T;me Assifpal: n?&ljned to: 0th~

v:Statement of Work (OpcmtionsSection Only)


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PEMA Pmjccr Oficcr: 24 hour Phone: .FAXI
.rustincation / Statement at.Work:

Estirrtnied Compktion Date: 1 Cosl Estimate: /, 5-&J 000


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a Acww
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Action Request I1 Received by (Nanie qnd Oqnni7adonj:

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Iky,ri.un Code/ Event H: Smtr: I~ntel~im Suebmirtcd: In OdglrWted x W~DB
ACTION REQUEST FORM O ~ N O1660.0047
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&prier Nouemkr 3 0 , 2 0 0 7
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Datc/Tirrrc: Assigncti:
IV: Statement of Work (Operations Section Only)
OFA Acrion OfCiccr: 24 hour Phanc: FAX^
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FEMA Project Officer: 24 hour Phone: FAX#
.Jusrification / Sttttcmenl of Work: .,... ; :I
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Estlrnutcd Cornplcxion Dace: I Cost Escirnatc:


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TRACKING XNINFORMATION (FEMA USE ONLY):. L:. '. i' '


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o Ar<CMed aR ~ M C U propetty
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ACTION REQUEST FORM O ~ N ~
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Exprirs Novcrnbcr 30. 2007
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i Priority: 1~ f ~ u v ~ n g ;JjrZ e1: sustaioiru~~, D;-rw/Tinic Nccd~:d:
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OFA hctwn OIficer: 24 h o w Phnnc: finXt1

Iv. Action Taken (Operations Section O d v l I


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ACTION =QUEST FORM OMB NO. 1 GGO-0047
Xxprics Novcmbor 30. 2007
1. Who is Requesting ~ s s i s t a n c c ? (Completed by Requestor)
)<ec,uc:i~orNr:~mit/'Tirlc/Sta~te: /i
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1111. Sourcing the IZaquest - Rcvicw/Coordination (OperationsSection Only)

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V: Statement of Work (OperationsSection Only)

Complc~lonDale:
Est~n~art:cl ( Cr~srEs~~rnnre:
V. Action Taken (Operations Section Only)
AcrrDtCd flRc\Jccf+YI

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FEMA Form 90- 136. NOW 04


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ACTION REQUEST FORM o m NO. 1660-0047
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111. Sourcing the Request - Review/Coordination (Operations Section Only)


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IV: Statement ofWork (Operations Section Only)


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ustifica lion / Swtcmcnc o i Work:

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'ENLA Form 90-136. NOV 04

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'03/04,!2005 06: 05 F A X

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ACTION REQUEST FORM OMU NO. 1~1ci0.0047
i h p d c s Navr~nhor30. 2007
I. Who is Roqucsting Assistance? (Completed by Requestor) A06 $+Xi3

St.at.t Approvirlg Officiul si#ilacurt::

111. Sourcing the Request - Review/Coordination (Operations Section Only)

I nsigncd to: n 0th~:

:Statement of Work (OperationsSection Only)

iktirnntecl Cornplction Dlc(s.: h i t Ellmate:

V. Action Taken (Operations Section Only)


ACWCLJ a Rrjcctod I
3 ~ccountaile~mpcrlv
~i:qmsition: C ' t v ~ r1111;tict1
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Exprlea No~ouem&r 30, 2007
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E-mail.
III. Requested Assistance
7

lCompleted by Rcsuestorl

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IlXI, Sourcing the Request ~evfcw/~ooh%nation
(Operations Section Only)

a OthuJ~mdla~~on ny:
Other Conrdtnauon by:

immediate Action KecpAred: U No


DateJTimt A:;s&ned:
IV: Statement of Work (Operations Section Only)
OFA Action Officer: 24 hour f'bone: FAXk
FEMA Projec~Urficer;
Jus~ific:hon / Sraterncnc of Work:
24 hour Phone: FAX#
1

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r~ezcivcdby (Name arid Orgvnizarion):
SIRLC: [ ~ a r e / l i m cS~brr~itted: Iu Ollfjii\JlM r l vwni~J
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FEMA Form 90-136, ROV 0 4


7 .

Rcqucsror Organization: ,y-bq fi ,.. ~7 (:../.-\ :, 1.A.; (- f> ,;I({ , E-mail: .-* .

11. Requested Assistance (Completed by ~equestor)' 13 54'A[tXhed ,

Description oZ Aysis[nr\cc l i c q ~ ~ c r i ~ c d :

Dare:

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~Reviaw/Coordination
112. ~ ~ r c i n g . k t T , F ~ ~ ~ uest (Operatione Saction Only)
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a R@ql1l5iUonS a ~ i ' * i l o n&$lpnn~ec~t

Action reqlcst FJF a:

- - - - -
W :Statement of Work (Operations Scct3on Only)
OFA hctcnn Ofiiccr: 24 h a w Phot~c; FLY I1
FRMA Project Olficcr: 21 hour Phonc: FAXH
l u s t i f i c a l ~ v n/ Stntcrncnt of Work:

; ~ [ i ~ n n t cCornpletirm
d 1htc: Cost E s h s i c :
7. Action Taken (Operations Section Only]
2Actontcd 0Rqectcd l] AccarntirWr?CrDpCrty
lispoxitia~i: dwtdinatc~lw11h A M )

M A Form 9 0 -136, NQV 04


'04/2005 19:23 FAX 2 2 5 9 2 5 7501

---
1 ' .

ACTION REQUEST FORM

--
OMB NO. 1660-004 7
Expries Nowrnber 30, 2007
- Who is Requestin8 Assistance? iCoinpleted by Requestor) E6C 'C% 257
kquesror Narne/Tlrlc/Statc (3 c @ f i d 5 dZ~c\sk
06 P Temporary Phone/ Fax #'

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FAX #
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[II. Sourcing t , Requqqt ~e6iew/~ej;/rdination
(Operations Section Only)
~ / O P S RWIW by: O ~onanons 0~rocurernent
d Log Review by: 0 orher (explain) 0 Interagency Agreement
7 Other Coordlnatloo by: 0 Requlsitlcru 0Mlaion Assignment
3 Other Coccdinanon by:
3 Other CoardlnaUan by:

.mmediate Achon Requ~red: U YES 0 NO Action request €SF #:


Date/Tirne Assigned: assigned to: 0 Oeher:

N:Statement of Work (Operatione Section Only)


OFA Action Officer: 24 hour Phone: FAX#
- - -- - - -
- -- --- -- - - -- - -

FEMA Project Off'cer: 24 hour Phone: FAX#


Justification / Statement of Work:

Estimated Completion Date:


V. Action Taken (Operatiox
- -
UAccepted UReJected
pmpercy
Disposition: 1 with APO

b&

9ction Request #
'rogram Code/Evcnt #:
t Originated as verbal

'EMA Form 90-136,NOV 09


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ACTION =QUEST FORM o m NO. ~ 6 1 5 0 - 0 ~ 7
Pxprlcs N o v o n r b w 30. 2007
I. W h o is Requesting Assistnrncc? ( C p ~ g l e t e d
by Requestor)

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----09/05/.2005 19,:03 FAX 225 925 7501

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F . ACTION REQUEST FORM o m NO. 1660-0047
Expries November 30, 2007
I. W h o is Requesting Assistance? (Completed by Requestor) EOC-Z X - $ 7 z
Requestor Name/TitlclSlele: $4 TA/IIAV -<> BP Temporary Phone/ Fax #:

Permanent Phone: FAX #:

Quantity: Priority: 1~fesaum 2 Life wstainlng Date/Tirne Needed:


@3 High a 4 Medium . i 5 Normal

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Delively Site L o c a t i o t x ~
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site POC: {JP A , * * : e:?? p-7


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State Approving Official signature:.?

Date/Time Assigned: I assigned to: 0 Other:

IV: Statement of Work (Operations Section Only)


OFA Action Omcer: 24 hour Phone: FAX#

Estimnrcd Completion Date: Cost Estimate:


V. Action Taken (Operations Section Only)
0Accepted 0Rejected Accountable Propew

f@ && ddd !P-- Coordinated with APO

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ACTION REQUEST FORM o m NO. 1660-0047


Erprfes November 30, 2007
I. who is Requesting Assistance? (Completed by Requestor)
Requestor Name/Title/Statc: A
,d
j , &e,f.nfl Tem~poraryPhone/Fax #:

Permanent Phone: F a #:
Requestor Organization: E-mail:
11. Requested Assistance (Completed by Requestor) 0 see Anached
Descrlptlon of Ass~stanceRequcsted-
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i-tri,l~- LSiQri &c pfi-p<ofine./,

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Site POC: /,& jrr 24 Hour Phone: " FAX#
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State Approving Official signature:

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1111. Sourcing the R a p e s $ ~e6iew)go~dinatton(Operations Section Only)
0 Procurement
a InteragencyAgreement
M W O ~blgnmcnt

I
Other Coordlnatlon by:
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- u~e~ No Action request 0 Ev #:
Datc/Timc Assigned: I assigned to: 0 Other:

N.Statement of Work (Operations Section Only)


(OFA Action Ofictr: 24 hour Phone: FAX#
- - --

FEMA Project Officer: 24 hour Phone: FAX#


Justification / Statement of Work:
I

Estimated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)
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ACTION REQUEST
- FORNI O M B No. 1660-0047
Expries Nouember 30,2007
. W h o i s Requesting Assistance? (Completed by Requestor)
Cequcstm Narne/?'itle/Stale: .G ri-' -2- rf Temporary Pl-ronejFax #:

'el-manent Phonc: FAX H: -


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~ccluesto-orOrganization: ,&$ bd., CP,fl,h I
E:cc, E-mail:
I. Requested ~ssistance(Completed by ~equestor) - See Attached
)escription of Assistance Requt'.shd:
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111. Sourcing the Request - Raview/Coordination (Operations Section Only)
a OPS Revlew by. &!! ]/:p,&*& ,* -3 0 DonaUons 0 Procurement
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3 Other Coordmatkx by.

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[V:Statement of Work (Operations Section O n l y )
3FA Action Officer. 24 hour Phone: FAX#

Estmated Completion Date: -J,-> - G+.,f -42- I Cost Estimate:


V. Action Taken (0perationdSection Only)
0Accepted Rejected Accountable property
Disposlhon. Coord~natedwith APO

6630

-CAFS/NEMIS Task ID:


fiction Request # l ~ e c e i v e dby (Name and Organization):
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ACTION REQUEST FORM OMB NO. 1660-0047
Expries November 30,2007
I. who is Requesting Assistance? (Completed by Requestor)

Rec]uesto~-Organizc~uoll: E-mail:
11. Requested Assistant& (Completed by Requestor) 0 See Attached.

Description of Assistance Requested:


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3 High . a 4 Medim 5 Norn~al /7,22!7°.

Stale Appioving Official signature: . .--

111. Sourcing the Request - ~e:iew/~ook/dination (Opexations Section Only)


j$'.OPS Review b~:/h,)Ah .,>cz? 0 DonaUwc; Pmcurement

-
0
-
Other (explain)
- Interagency Agreement

U Other ~oordlnatl&,by: URequlsRlons I_)


MlSiM Assignment

Olher Coordination by:


0 Other Cowdlnatlm by:

Immediate Action Recpired: !d Yes fl No Action request #: ?

: Statement o f Work (Operations Section Only)


24 hour Phone: PAX#
5 / 2 0 0 5 0 3 : 5 5 14AA LL., .- .

9
ACTION IWQUEST FORNL
ho i s Requesting Assistance? (Completed by Requestor)

l~rrrnancnfPhone: FAX ft:

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Quantity: ~~~~~~ity: 0 Lifesavi~lg 2 Life sustaining Date/Tiine Needed:
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Date: 9 7 63-
111- Sourcing the Request - ~ h i e w / ~ ~ r d i n a t i(Operations
on Section Only)
0o w ~ t l o n ~ a ~mctrrernent

00mer (explain) Intmgency Agreement


0~equldtions Mlssion Assignment
0 Gther Qordinatbn by.
0 Other Coordinabn by:
Immediate Action Required: Byes 0 No Action I-equest ESF IT:
DatelTirne Assigned: ?/ 7 assigned to: .B Other: d - 5 &
r *
rV: Statement of Work (Operations Section Only)
OFA Action Officer: 24 hour Phone: FAX#
PEMA Project Officer: 24 hour Phone: FAX#
/ Statement of Work:
Justification

, {- 01,6J. ,,e/,'k~, +, f chy419

eCAPS/NEMIS Task ID:


Action Rerprsl: H Received by (Name and Organization]:

A
Program Code/Event #: State: I~ate/~in
Submitted:
~e Ia Orlglnated as vcrt

FEMA Form 90-136,NOV 04


-
S e p 07 0 5 0 8 : 0 7 p St. L u c i e C o u n t y 703.321. 1 1 1 1 P- 2

._ 2 335-Lw c - o e - g a s
ACTION REQUEST FORM OMB NO. 1660.0047
Expries Nowmber 30,2007
Who is Requesting Assistance? (Completed by Requestor)
;Requestor Narne/T~tle/State Or lea f a pi5& Temporaw Phone/Fax #

Permanent Phone: FAX #:

-
l ~ e a u e s t o rOreanization:
.. - - -- --..
E-mail.
11. Requested Assistance (Completedby Requestor) - 0 see Attached

111. Sourcing the Request - ~eviewj~oordination


(OperationsSection Only)

0
0PS Review by:

~ e v k wtry:
, .S
r-
1
- 0M a -
0 Other (exphk)
Prauement

0 Interagency Agreement
Other CcordlnaUan by: Requlsltlcms 0Mission Aswgnrnent
Other Coordlnatlon by:
Other Coord~nationby:

Immediate Action Required: U Yes No Action request ESF #:


Date/Time Assigned: assigned to: 0 Other.

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 2 4 hour Phone: FAX#

I
Justification / Statement of Work:

Estimated Completion Date: ) Cost Estimate:


V. A c t i a n Taken (Operations Section Only)
5Accepted 0 Rejected 0 Accountable Propefty
Disposition: Coordinated w h APO

Action Request # Received by (Name and Organization):


Program Code/Event #: State: I~ate/~im Submitted:
e I Onginated as verbal

FEMA Form 90-136, NOV 04


I 2 1 Hour P h a Ne.
~ 8. Fax No.

I I
4. FEMA Pmjmd ORlwc 16.24 Hour Phona No. 18. Fax No.
I 1
7. Just#icaUonI Shtem6mtol Work:

~CAPSMEMISTeak ID: ~ R . ~ U ~ N O . ~mgmmco~~vrnl~t:


Um a c e
Racelvtd by (Uamo and Olganiuciorl): 8bW: W b n e Subdkd:
09/10/2005 1 2 : 3 8 FAX

Jm-ar
ACTION REQUEST FORM OMB No. 1 6600047
Expricrs Nonmbar 30.2007
I. W h o is Requesting Assistance? (Completed by Requestor]
z

.'.
I- Permanent Pho
(~eouestorOremnization:
-
FAX #:
E-mail:
-
-

Assistance (Completed by Requestor) 13 k e ~ l t . d t d

State Approving Official signature:


1111. Sourchg the Request - Rcvicw/Coordination (Operations Section Only) . I

0 munons 0P m c l t m
0 Log Revtew by: 0 Other (explain) Interagenry Agreement
a Other Coordlnatlon by:
3
Cl RequlslUons 0 MBIW ansignrnm
0 Other Caadlnatbn by:
Other Cwdlnatlon by:

Immediate Action Required: IJ Y" No Action request @'?ESF C: 3 6-.c h


-IV:Datc/Time Assigned:
Statement of Work (Operations Section Only)
assigned to: 0 O k

OFA Action Officer: 24 hour Phone: FAX#


~ F E M AProiect Officer: 24 hour Phone:

I Justification / Statement of Work:


I
Estimated Completion Date: Cost Estimate:
V. Action Taken (Operations Section Only)
a Accepted Rejected 10 Accountable Propew
Disposition:

-CAPS/NEMIS Task ID:

LMA Form 30-136.ROV 04


I.

Requestor NamelT~tlelState:

Permanent Phone:

Requestor Organization:

Descr~ptlonof Assistance Requested:


-
A
/ 0 --

VOY e. L&
11. Requested Assistance (Completed by Requestor)
ACTION REQUEST FORNI
W h o is Reauestine Assistance? fcom~letedbv Reauestorl

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Temporary Phone/Fax #:

FAX #:

E-mail:

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OMB No. 1660-0047
Expries November 30,2007

see Attached

SI4k-L.i-W

Il11. Sourcing the Request - ~ev%/~oordination (Operations Section Only)


~ P ~ e v i e Swby: Lc3 - L>aF0 ~aations Procurement

O ~ o Review
g by: a Ofher (explain) 17InteragencyAgreement
0 Other Coordlnahon by: 0Requnihons ~iaron
Assignment

Other Coordrnation by.


13 Other Coordtnatlon by.
/

Immediate Action Required: m e s - 0 No Action request 0 ESF #:


DatelTlme Assignpd. $ -/3- OJ ass~gnedto:w r : L o ~ r J t f i ~

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work: soh-f OT-
/YqK?)(S VILLC / 3 .3S n7 4 =r

Estimated Completion Date: I Cost Estimate:


V. Action Taken (OperationsSection Only)
0Accepted C f Rejected Accountable Propetty
D~sposlt~on: Coordinated with APO

- - -
Actmn Request # Received by (Name and Organization).
Program Code/ Event #: State: I~atef~im
Submitted:
e I Orlglnated as verbal

FEMA Form 90-136.AOV 04


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L f i p r l a s November 30.2007
E, Who irP Requesting Assistrmcc? /Completed by Requestor)

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-
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~evlcr*by: --$!...&, :_.:,.-, - .
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0 0therCoardIMllonby:
lrnmediate Action Required: U Yes a No Action request C) ESF U:
Dace/Time Assigned: I ansigned to: othrr:
nr: statement of Work (Operations Section Only)
24 hour Phone: FAX#
24 hour Phone; FAX#
1~ustificadon/ Smrement of Work;

ttimatcd Complcdon Dote; I Cost Estimate:


J. Action Taken (Operations Section Only)
~ A C C C P L ~ 0~ 4 ewe0 AcSPunLlDle ~ r o m
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TMCKING:INFORMATION (FEMA USE ONLY):. 'o -, ' r'.. .; . . . .. - ..


cCAPS/NEMIS Task ID:
ccion Rcquesr I I ~ c c e i v c dby (Nemeand Orghnimrion):
rogram CodelEvent H: 1 ~ tta~ : 1~arejTimcSubmitted: I0 originated aver

FEMA Form 90-136, NOV 04


sep ZO 05 0 5 2 5 3 ~ JFO BflTON ROUGE
= -1
ACTION REQUEST FOFW OMB NO. 1~60-0047
Exprles N o n m k t 30.1007
, Who is Requesting Assistance? (Completed by Requestor)

crrnanent Phone: 2
m- FAX I: X
wuestor Organization: ~ q - k ~ ~ u ~Pd&c bhe E oc E-mail:
I. Requested Assistance (Completed by Requestor) 0 seemached

, -,
luantity: I 2 ~ t sustarnmg
e I ~ a t e / ~ i mNeeded:
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I - I 0 3 H~gh 04 M e d ~ m 5 Normal I

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FAX #
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3 LqRevlewby: C] Other (explaln) a Interagency Agreement
3 OtherCoOrdlnatlm by: 0 Requlsitlons ~ t s i c n~ q n m e n t
7 other cootdlnatton by:
3 other Coordlnatlon by:
r
mmediate Action Required: U Yes NO Action request 0 €SF I :
>ate/Time Assigned: assigned to: Cr) Other:
IV: Statement of Work (Operations Section Only)
3FA Action Offker: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

Estlrnated Completion Date: 1 Cost Estimate:


V. Action Taken (Operations Section Only)
I

Disposition: Coordinated with AF'O

eCAPS/NEMIS Task ID:


Action Request # (Received by (Name and Organization):
Program Code/ Event #: 1state: I~ate/~im Submitted:
e ( 0 Originated as verbal
F E U Form 90- 136. NOV 04
I -
ACTION REQUEST FORM OMB NO. 16600047
kprlcr N o w m b e r 30.2007
I. W h o is Requesting Assistance? (Completedby Requestor)

Requestor Organization: LQ&V<L c E-mail:


11. Requested Assistance (Completed by Requestor)

Est~matedCompletion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)
a Accepted 0Rejected 1
0 Accountable Property

I
Disposition: Coordmated with APO

eCAPS/NEMIS Task ID:


~ c t i o nRequest # Received by (Name and Organmtion):
l~rogramCode/ Event #: State: I ~ a t e / ~ i r nSubmitted:
e I[] Orlglnated as verbal .
F E U Form 90- 136, NOV 04
I -
ACTION REQUEST FORM
Who is Requesting Assistance? (Completedby Requestor)
. -
o m NO. 16600047
Exprier November 30,2007 1
7
\Requestor Narne/Title/S*ale. ,kc ., 4, < ,L/, Temporary Phone/ Fax #.

[Permanent Phone: .
,
-
b FAX #: '%

11. Requested ~ssistance'(Completed by Requestor) See Attached

Description of Assistance Requested:

Quantity:
C
',
2 -7-
- .:
Prior]ty:
,
E; ~~fesawng
04 Medlum
2 ~ ~susta~n~ng
f e
a 5 Normal
Date/Time Needed.
~9f-F'
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-
/
L I ~ ~ ~ $ J / ~ A 7 6 7s-.f
SltePOC IAGr/y r
,M,/A 24 Hour Phone: - F-AX #

111. Sourcing the Request - Review/Coordination (Operations Section Only)

L 0DOnaDOnS 0Procurement
0 Log Revtew by. 0Other (explain) Interagency Agreement
Other Coordmation by. 0Requlsitlons Mlsston Assignment

Other Cowdtnahon by:


Other Coordinabon by:

Immediate Action Required. U Yes 0 No Action request 0 €SF L:


DatelTime Assigned: asslgned to: 0 Other:

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
24 hour Phone: FAX#

Estimated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)
- - -
I UAccepted URejected IU Accountabk property

I
Disposition: Coordinated with APO

eCAPS/NEMIS Task ID:


Action Request # Received by (Name and Organization):
Program Code/Event #: State: I ~ a t e / ~ i mSubmitted:
e 1 Origlnated as verba

FEMA Form 90- 136,NOV 04


r- ACTION REQUEST FORM OMI) No. 1660-0047
E x p i e s Noocrr~bcrYO. 2007

i
I. W h o is Requesting Assistance? (Completed by Rcqucstor) ';. ,:;cf^ iAx. ~ 2 ,
,y
Requestor Name/Titlc/Statc: L : /# Tern- Phonc/Fax #:

permanent Phone: F A X A i-

Requestor Organkation: Jk K l Y A E-mail:


-
11. Requested Assistance (Completed by Requestor) . . C] See-
Description of Assistance Requested:
&AIM. do -
Loo kh/

Esumated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)
o
~ o
cep
~ dc l ~ e f e c o d
e lo Accountabk Rcocm
Disposition: Coordinated with AW

eCAPS/NEMIS Task ID:


Action Request # Received by (Name and Organ~zatlon):
Program Code/ Event #: State: j ~ a t e / ~ i mSubmitted:
e 1 0 ~ t n a t r asd wrt
FEMA Form 90-136, ROV 04
I ACTION REQUEST
- FORl
*P*S
=J&X iamm47
30,2007
I. Who is Requesting Assistance? (Completed by Requestor)
pquestor Nnme/Title/State: st Jam&.,,,
, LoC T&:
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Pemuncnt phone: -mJ /

Requestor Organization: w#f Eo5 . 7 >/11 c -. -


11. RePuested Assistance (Corn~ lete dby Re' Puestor) mmuap

tion (OperationsSection Only)


0-tlars OPmcurement
0 (oc~la~ / Interasencv 4 r - w
0 oa#coocalnaam b,: 0 m- " OMISWIASSIQ~~~~.
a WlcrCoadlnatlonb,:
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Immediate Action Required: Uy e a No Action request €SF I :


I~ate/~irn Assianed:
e 1 assimed to: 0
IV: Statement of Work (Operations Section Only)
OFA Action Officer: 24 hour Phone: FAX#
FEW Proiect OScer: 24 hour Phone: FAX#

t' ustification / Statement of Work:

Estimated Completion Date: 1 Cost Estimate:


V. Action Taken (Operations Section Only)
CI/rccepted O~qeded 10 rccarn~~operty
Disposition: Coordinated with APO

-- ~ --- - -

Action Request # l~eceivedby (Name and Organization):


Program Code/ Event #: Istate: I ~ a t e / ~ i mSubmitted:
e 1
0~rlpi~tedaswrbal
,
FEbU Form 90-136, HOV 04
ACTION REQUEST FORM o m NO. 1660-0047
Expries November 30,2007
I. Who is Requesting Assistance? (Completedby Requestor)
Requestor Name/Title/State: &C CC~& T e m p o w Phone/Fax #:

(Permanent- FAX b:
( ~ e q u e s t oOrganization:
r <&7-a )vl M ~ I/w E OL E-mail:
(11. Requested Assistance (Completedby Requestor) 0 See Attached
Descrrpt~onof Assistance Requested:
-
6utcdCor 100kp
FU C(
At\ #dt*ww-
Quant~ty Priority. a 1 hfesavlng a 2 Life sustalnmg Date/T~meNeeded.
3 3 H~gh Medium a 5 Normal

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Delivery Si* ~oeatio*S+
-
T A A A O~C
--T,fa i#,St.
L ~ ~ LA; ~ + ~ ~ -
--
Slte POC. iX#
State Approving Official slgnatur - .- - Date:

111. Sourcing the ~ e ~ u e s ~ ~ e ~ e w / ~ ~ o r d (Operations


i n a t i o nSection Only)
a' OF5 Review by:
' /&&&
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0 Donations Rocvrernent

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Review by: / 0 other (explain) C] InteragencyAgreement
IC]
-
Other Coadinatlon by: 1 Requisitions Mlsslon Assignment

I
Other Coordlnatlon by:
0 Other Coordination by:

Immediate Action Required: U yes fl No Action request C] ESF I:


l~atej~im Assigned:
e assianed to: 0 Other:

IN: Statement of Work IO~erationsSection Onlvl


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: 3 - w
Justification / Statement of Work: #
-

Estimated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)
0 Accepted 0Rejected 0 Accountabk Property
Disposition: Cwrdmated wth AW
I

eCAPS/NEMIS Task ID:


Action Request # l~eceivedbv [Name and Oraanizationk
In
- - -- - pp -

rograrn Code/ Event #: State: I ~ a t e / ~ i mSubmitted:


e ~rlginatedas verb;

FEMA Form 90-136,NOV W


68; )*f<
Y
[Jr
ACTION IZEQUEST FORM OMB NO. 1660-0047
expries November 30, 2007
I. Who is Requesting Assistance? (Completed by Requestor)

Requestor Name/Tltle/State. 4&r~-~/


7&uGf fl.u~,flckn
fii/5~~em~oraryPhone/Fax#-
I
/
Permanent Phone:
Requestor Organization: 0gF E-mail:
111. Requested Assistance (Completed by Requestor) CI seemed

(
State Approving Off~cialsignature:

Interagency Agreement
MIS- Assignment
Other Coordlnatlar by:
c#hertaordlnatlon by:

ediate Action Required: U Yes 0 No


DatefTime Assigned: I assigned to: 0 ofhs

N:Statement of Work (OperationsSection Only)


-s,
OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:
/

Action Request # Received by (Name and Organization):


Program Code) Event #: State: I~ate/~im Submitted:
e . 10 Oiiglnated as verbal

FEJUA Form 90-136,NOV 04


-
EJ4i~ :
- - NOW^ 30,2007
I. Who is Requesting Assistance? (Completedby Requestor)
Requestor Narne/Title/State. fij&~a& & /5'c' Tern- PhonelFax #:

Rmuncnt Phone: F A
Requestor Organization: ~ / t:u
/~p 4~~ l ~ 'goc E-mail:
11. Requested Assistance (Completed by Requestor) -. 0 S~~AUXJE~

Descripuon of Assistance Requested: -(so k t - . f


BUeAfis -- ~
.z ~ D L L /

111. Sourcing the Request y&view/~oordination (Operations Section Only)


I

g&f-- 10 ~~ O Pmamment

10-
Rcvlcrv by:
0 OmaCoordlflatlonby:
Omacxxxdlmtlonby:
0 otfwCoordk#~by:
Ilrnmediate Action Required: U Yes u No .]&tion request ff I:
Date/Time Assigned: I assigned to: 0 Oms:

IV: Statement of Work (Operatioru Section Only)


OFA Action Off~cer: 24 hour Phone: FAXU
FEMA Project Oficcr: 24 hour Phone: FAX#
Justification / Statement of Work:

Eshmated Completion Date: Cost f?,stimatc:


V. Action Taken (OperationsSection Only)
-

I Disposition:
rYzr-Coordmated with APo

FEMA Form 90-136,NOV 04


r
ACTION REQUEST FORlh
.I. Who i s Requesting Assistance? (Completed by Requestor)
QIIB* 1~600047
Expdes N o a e m k r 30,2007

Requestor Name/Title/State: 7n
L 4.1* A p ~or to^ 0--
06:

, 111. Requested h i s t a n c e (Completed by Requestor) *-


(~escriptlanof Assistance Requested:

Quantity:
.. I -:--
Delivery Site bZati&&
hh-ity:
d317ns1 ~fesavng
0 4 -turn
02 ~e susta~nlng
0 SNamal
Date/Tunc Needed:
3 SaOS
206 C , ~ z b - r 25h1
.-- ( ~ ~ u h~o u- r te &w+
.-J
-
--
site POC: &+I /(cr/' e : - m . FAX R
State Approving Official signature: /",G/T
/
Date: 3&@

/Action request 0 YF #:
ate/Time Assigned: 1 assigned to: Omb: ,

:Statement of Work (Operations Section Only)


LOFA Action Officer: 24 hour Phone: FAX#
FEMA Rojtct Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

Estimated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)

Coordinated with AW

TRAC4Ng n O P O w p O E (PE116A USE OmY): *-~PW&:-5 - ., . -


A;--- +!a ., . < , .
eCAPS/NEMIS Task ID:
Action Request # l~eceivedby (Name and Organzation):
Program Code/ Event #: State: l ~ a t e / ~ i mSubmitted:
e [amgmwaswta
FEMA Form 90- 136, NOV 04
I ACTION REQUEST
- FORM OMB No. 16600047
a p r f e r N o a m b e r 30,1007
I. Who is Requesting Assistance? (Completed by Requestor)

Requestor Name/Title/State: Tern- Phone/Fax #:

Permanent Phone: - FAXk:&


Requestor Organization: gaC /rA&
f {:&&a E-mail:
11. Requested Assistance (Completedby Requestor) - 0 ~ e Attached
e
Description of Assistance Requested:
6Mu& logk(,/ fi<&(cd {J rcshr--e-p3wo f u Corn

f ,
[9/2 Lfe sustaining I ~ a t e / ~ i mNeeded:
e

111. Sourcing the Request -ew/~oordination (Operations Section Only)


O~~latlcns 0 -remem.
0 Other (explain) Interagency Agreement
0 c ~ h ~mrdinattm
a by: 0 O M ~ M W W ~ ~
0 Other~stlonby:
Other Coordlnatlon by:
Immediate Action Required: U Yes 0 No Action request 0 €9I:
Date/Timc Assigned: 1 assigned to: W

TV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
-
FEMA Project Oficer: 24 hour Phone: FAX#
Justification / Statement of Work:

Estimated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)
0Accepted 0Refeded 0 kzountable Roperty
Disposition: Coordmeted wth APO

Action Request # Received by (Name and Organization):


Program Code/ Event #: State: I~atef~im Submitted:
e

PEMA Form 90-136,NOV 04


f- ACTION REOUEST FORM-- OIYB NO. 16600017
* p d e ~ N ~ m b r 30.2007
r
I. Who is Requesting Assistance? (Completed by Requestor)
. .

Requestor Name/Titlc/State; T c m m Phonc/Fax W:

Permanent Phone: . FAX&%


Requestor Organization: Ta E-mail:
11. Requested Assistant ted by Requestor) - 0 *ma=he‘i

6 01c d o * -fl o oSkJ W


Descripuon of Assistance Requested:

J~U
q-0 O~rfp'
Quantity: Pnonty: 0 1 bf- C] 2 bfe susetn~ng Date/T~meNeeded:
-- 0 3 Ugh 0 4 wbrm 0 s~ormdl
o - * ~ ~$d4h
Deliven s i t e - + ~.--- ~ A /)w h c 0 EP
-- ~ O g G A,,f/hccy sf- 3
-
Site POC: ,
+- 24 Hourmon/
-- -
i
- FAX#

(state approving 0 f i d signature: /


/
// -
Date:

bg <
.

the Request - ~ e w / ~ o o r d i n a t i o
<
n
(Operatiolu Section Only)

I-'=
-by:
0 WlaCocrdlmtknby:

Immediate Action Required: U Ya a NO . Action request Ey r:


Date/Time Assigned: I assigned to: 0 m*.

OFA Action Officer: 24 hour Phone: FAX#


FEMA Project Officer:
-
Justif~cation/ Statement of Work:
24 hour Phone: FAX#

Estimated Completion Date: 1 Cost Estimate:


V. Action Taken (Operations Section Only)
O-P~Y C 7 ~ e - d IJ ~ ~ ~ a r n t a~* o p d l
Disposition: Cwrdmated with APO

Action Request W l~eceivedby (Nameand Organization):


Program Code/ Event #: I~tate: I ~ a t e / ~ i mSubmitted:
e

FEMA Form 90-136, NOV 04


ACTION REQUEST FORb OMB NO. 1~60.0047
Expries Nouembtr 30,2007
I. Who is Requesting Assistance? (Completedby Requestor)

I--
Requestor Name/Title/State

Permanent Phone.

-
l ~ e a u e s t o rOrganization:
0j ~ k

L4 f 0 u r m 2
I. Requested Assistance (Completed b y Requestor)
S Tempo

FAX &
E-mail:
Phone/Fax #.

Ir

El see~twhed

(Operations Section Only)


111. Qeurcing the ~e~ues$/f6view/~oordination
OK ~evtewby: 0 ~aratlons 0 Procurement
(3 L o p l h d m b y : flGUW (explain) 0Interagency Agreement
Other Coordlnatlm by:
0 0 t h cmrdlnatlan by:
Mtwr Coadlnatian by:

Immediate Action Required: U Yes 0 No 'IAction request 0 SF #:


Date/Time Assigned: 1 assigned to: 0 Omer:

IW Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
/-
-- 24 hour Phone: FAX#

Estimated Completion Date: 1 Cost Estimate:


V. Action Taken (OperationsSection Only)
~ccepted Rejected Accountable RoPertV
Disposition: Cdordmated with APO

eCAPS/NEMIS Task ID:


Action Request # Received by (Name and Organization):
Program Code/ Event #: State: ) ~ a t e / ~ i r Submitted:
ne Ia Originated as W!SI
i
F E U Form 90- 136, FlOV 04
N$ Lnr-LA

-
1 ACTION REQUEST
- FORM OMB NO. 1660.0047
Expries Now& 30. 2007
I. Who is Requesting Assistance? (Completedby Requestor)
Requestor Name/Trrl~/State: Temporpry Phone/ Fax #:

IReqvestar Organk~tion: ~ ~ P P T E OC.


S m E-mail:
p. ~ e ~ u ~AssEance
t e d (Completedby Requestor) -

State Approving Official signature:


/fA& Date:
~ I I Sourcing
. the ~ c ~ u e ~ ~ ~ o o r d i n@perations
a t i o n Section Only)
0 ~onauons 0 Procurement
0 ~ o Review
g by: 0 0 t h (eqkin)
~ Interagency Agreement
0 other-tionby: 0Regums W a n Assignment
0 Other CoordlnaUm by:
Other Cwrdlnatlon by:

lmmediate Action Required: U Ye No Action request €SF t :


DateITime Assigned: assigned to: other:

IV: Statement of Work (OperationsSection Only)


OFA Action Officer: - hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
"
Justification / Statement of Work:

Estimated Completion Date: I Cost Estimate:


V. Action Taken (Operations S e c t i o n Only)

1 Coordinated with APO

eCAPS/NEMIS Task ID:


I
Action Request # Received by (Name and Organization):
Program Code/ Event #: State: If)ate/~imeSubmitted: I0orlgrnated as wrbd
I FEMA Form 90- 136, NOV 04 A
r ACTIOH REQUEST M)RM QYB* 1-7

t
I. Who is Requesting Assistance? (Complcted by Requestor)
& P ~ Sm m k r 30,9007

State Approving Offidal signature:


Y

D Loo-bY: 01-w-
a :yb-
0 Wwcoadh.tbnbv:
C1 ~Corrdruumby:
Immediate Action Required: UY e 0 No

:Statement of Work ope rat lo^ 15ectlon Only)


24 hour Phone: FA-
24 hour Phone: FAXI
useif~cation/ Statement of Work:

Estimated Comvktion Date: . I


I
Cost Estimate:
V. Action Taken (Operatiom Section Only)
- - I

E
U ~ c ~ c p o s dU ~ ~ ) c c t e d
Disposition: Coordinated with AW

PS/NEMIS Task ID:


Action Request # l~eceivedby (Nameand Organization):
I
Ragram Code/ Event W: Iskite: I ~ a t e / ~ i mSubmitted:
e 10 OIlglnat@j*-.
L
I ACTION REQUEST FORM m~o. 1640.0047
e * p d e ~NolWmkr 30,3007
I. Who is Requesting Assistance? (Completed by Requestor)
equestor Narnc/Title/State: '$& - ir; Tern- Phone/Fau W:

Requestor Organization: r / c 46 +c /3, $fitvrr'-/[r (3gGc


E-mail:
11. Requested Assistance (Completed By Requestor) - 0 sec~famed
Descriphon of Assistance Requested:
ag 6ac.a$~t - K O ~ L3 /
, ,
~ k r/ 2~0~/ 2 4 o I ? o *yf
~
r/r&rr s d 5 c~+Kr:k
~ opvail,l>sc rnd L Q I I L J r r rf f ~ f c y

Quantity: 1
0 2 l,fe fesustammg Date/T~meNeeded.

-
- / - --- 0 sM M ~ U ~ Cj s ~onnal 06
DeLi'i~ !LVCc
W ~ W ~ TI S
&A ~ A 1 <hefp,& Q#\
--32.3
3 kc+ 6-b E&fl~<fi~~ --
~ 4 " LA
I
24 Hour Phone: FAY

State Approving Official signature:


-
IIII. Sourcing the Request - ~ v i e w / ~ o o r d l u t i o(Operations
n Suction Only)

Date/Time Assigned: 1 assigned to: 0 0mer:

N:Statement of Work {Operationr Section Only)


'
OFA Action Officu: 24 hour Phone: FAX%
FEMA Roject Oficer: vc- 24 hour Phone: FAX#
Justification / Statement of Work:

Estimated Completion Date: ( Cost Estimate:


'v. Action Taken (Operations Section Only)
O-WJ Ur~eaed C] A c m n t W m
Disposition: Coordtnated with

(m
'CRAC~~IMI ~ Q ~ T I O R USE ornu)..:G~:~C.& * -3- . :4:-.Ta +. .. . s .
eCAPS/NEMIS Task ID:
Amon Request # Received by (Name and Organization):
Program Code/ Event U: State: I ~ a t e / ~ i mSubmitted:
e 10 w n a t e d as vm
FEMA Form 90-136, ROV w
ACTION REQUEST FORM NO. 16600047
Erprles Nouambar 30,2007
I. Who is Requesting Assistance? (Completed by Requestor)

Permanent Phone: FAX r):


Requestor Organization: J!& $40%A E-mail:
11. Requested Assistance (Completedby Requestor) - C] SeeACtaChed

I
Description of Assistance Requested:
Grrc~=far 7 5 0 kW

6-t-d-fiu L4 -

State Approving Official signature: Date:

1111. Sourcing the R e q u e s ~ y i e w f l o o r d i n a t i o n(Operations Section Onlyf


0Pmamnent
Interagency Agreement
Mlalon Assignment

I Immediate Action Required:


Date/Time Assigned:
U Yes U f~ction
1
request
assigned to: fl
Ew t :
Other-

IV: Statement of Work (OperationsSection Only)


OFA Action Officer: FAX#
FEMA Project Officer:
l~ustification/ Statement of work: ' 4
a

Estimated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)

Coordinated with APO

eCAPS/NEMIS Task ID:


Action Request # l~eceivedby (Name and Organization):
Program Code/ Event #: J~tate: I ~ a t e / ~ i mSubmitted:
e ( 0 Originated as wba
F E U Form 90-136,NOV 04
ACTION REQUEST FORM QBZB NO. 16600047
Expries November 30,2007
I. Who is Requesting Assistance? (Completed by Requestor)

Requestor Organization: 0P J E-mail:


11. Requested Assistance (Completedby Requestor) seemached
I
Description of Assistance Requested:
6 m ~ r a t o r - *;th Cutp:'f

likiI.@sustaining l~ate/~im
Needed:
e

-
d -
Sltc POC: vd$, f l c I)crmo f t ,/ 24pour phone-. - FAX #
State Approving Official signature: Date:

111. Sourcing the Request (Operations Section Only)


a OPSReWew by:
,$- 0 Pmcwement
0 Log-by: a other (scplaln) ~nteragmcy
0 ~ e r ~ a o r d i n a t l oby:
n 0 ~qu~sltions El MW ~gnmmt
0 Other(bordlMtl0nby:
0 Other~oadtnatianby:

Immediate Action Required: U yes 0 No Action request 0 €SF t:


Date/Tirne Assigned: assigned to: 0 Wler:

N: Statement of Work (Operations Section Only)


OFA Action Oficer: 24 hour Phone: FAX#
FEMA Project Officec )( 24 hour Phone: FAX#
-

I Justification / statement of Work:

L
Estimated Completion Date: ) Cosr Estimate:
V. Action Taken (Operations Section Only)
o~ c c e p t ~ ~ejecw 10 Accountable ~operty
Disposition: I Coordinated with AW

'Action Request # Received by (Name and Organization):


Program Code/ Event #: State: I ~ a t e / ~ i mSubmitted:
e
F E U Form 90-136,BOV 04
I'
I.

- -
Requestor Organlzahon: OR&& ---
questor Name /Title/S tate:

Permanent Phone:

G~t=k.
ACTION REQUEST FORM
Who is Requesting Assistance? (Completedby Requestor)

11. Requested Assistance (Completed by Requestor)


Descriphon of Ass~stanceRequested

0 7 I . UYC W -00
R m r
&
Dfinl~T
O R m S L G ~ S

PI.!~CU

y5ACLs OE&fS
m @ € D d M
c
Temporary Phone/Fax #:

FAX#:

E-mail.

#7/SSY*/
D
o m NO. 1660-0047
Expties November 30, 2007

~d-~E;s+d&aa
-- *

u
,
See Attached

-
1111.- Sourcing the Request ~ e v i e w / ~ o o r d h a t i o n ~ ~ e r a tsectioudnly)
ions
@ OR RWI- Procurement

0 LOg~e\neW&: Interagenq Agreement


0 other~oordinatlon~
O Other ~omiinationby: -
0 Other Cowdination by:

Immediate Action Required:


DateJTirne Assigned: ( assigned to:
IW Statement of Work (Operations Section Only)
OFA Action Officer: 24 hour Phone: FAX#
Project Officer:
~FEMA 24 hour Phone:

I
Justification / Statement of Work:

Estimated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)
Accepted Rejected 10 Accountable Property
Coordinated with APO

--

eCAPS/NEMIS Task ID.


Act~onRequest # Received by (Name and Organlzatlon)
Program Code/ Event #: State: l~ate/~irn S eu b m tted.
~ 1 Ong~natedas verb2

F E U Form 90-136.NOV 04
@ 9/9
IACTION -
REOUEST FORM ' OMB No. 1660-0047
Expries November 30, 2007
I
I. Who is Requesting Assistance? (Completedby Requestor)
p q u c s t o r Narne/Title /State: LbF+ica H Temporary Phone/Fax #: u
1
-
-Permanent Phone:I - f FAX #:
Requestor Organization. &~'.ttS= PAWW
W t 4 - 7 E-mail:
XI. Requested Assistance (Completedby Requestor) See Attached

Description of Assistance Requested: &GMG~TI~&6~ h%~tfr*ldij


~ Z S ~ & RWV&
I D

?&szI$~ tJ1oG.

Quantity: I~ate/~im
Needed:
e

24 Hour Phone:

State Approving Offichl e: Date: I Ca,&m5


t
Y

-
111. €@urcing the ~ e ~ u e $~eview/~oordinkbon
&raons sectiog~nl~)
Donations

0 Requkltlons
Other Coordination by:
--
Other Coordination by:

Immediate Action Required: U Yes U :No Action request €SF t: g .f=- 3


Date/Time Assigned: I assigned lo: 0 Other:
r
IV: Statement of Work (Operations Section Only)
OFA Action Officer: - 24 hour Phone: FAX#
FEMA Proiect Officer: 24 hour Phone: FAX#
l~ustification/ Statement of Work:

Estimated Completion Date: Cost Estimate:


V. Action Taken (Operations Section Only)
Accepted Rejected 10 Accountable Prcperty'
I Coordinated with APO

eCAPS/NEMIS Task ID: -

Action Request # R~ceivedby (Name and Organization):


Program CodeJEvent #. State: /~ate/~im
Submitted.
e I Or~gmatedas verb;
i

FEh¶A Form 90-136.NOV 04


-
t
ACTION REQUEST F'ORM OMB No. 1660-0047
Expries November 30, 2007
I. Who is Requesting Assistance? (Completed by Requestor)
<
lRequestar Narne/Title/State: ~ ~ DEILDuE
/ & Temporary Phone/Fax #:

IPermanent Phone. ._
!
I- FAX#:

11. Requested Assktance (Completed by Requestor)


Description of Assistance Requested:
K c q u e n d q USACOG D a i z i S Mi s X / o ~ / , . . qfin
~ ~ ~ A / P&/54.
A / &

Quantity: Priority: &; ufesavlng


4 Medium
2 tife sustatning
5 Normal

. -- -- +-
-
Site POC:
--
A .
24 Hour Phone: :
- FAX_# -- %
State Approving Official signature: - .- - Date:Sm&y
r
-
III. S9urcing the Request ~eddewl~oordination
(Operations Section Only)
Donations 0Procurement

I-
U
0 Log Revlew by:
Other Coordination by:
M
OMer (explain)

Requisitions

I
Other Coordlnatlon by:
-
Other Coordlnatkm by:
/

Immediate Action Required: U . No ction request JZI' EY #: q


I ~ a t e l ~ i r Assianed:
ne 1 a s s i ~ n e dto: Wer:
J

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

Estimated Completion Date: Cost Est~mate:


V. Action Taken (OperationsSection Only)
0 Accepted 0Relected Iu Accountable Propem
Coordinated wtth APO

eCAPS/ NEMIS Task ID: - --


Received by (Name and Organzation)
I U Originated as verb?
-

Program Code/ Event #: ]state: I ~ a t e / ~ ~Submitted:


me
FEMA Form 90-136,
NOV 04
as--
i7i
ACTION REQUEST FORM
expries N o w s t b e 30.2007
:ho (a Requesting Assistance? (Completedby Requestor) &jPnxn~ g S dU]a& &

limmediate Action Required: ,U,yes 0 No /Action request a W *: 9


IV: Statement of Work (Operations Section Only)
OFA Action Oflicer 24 hour Phone: FAXU
FEMA Project Oficer.
*
2 4 hour Phone: FAX#
Justification / Sta~emenrof Work:

Est~rnaledCornpletlon Darc Cost Estzmate:


L I
V. Action Taken (Operations Section Only]
O~\creptpd 0 ~ q e a c - c ~

I
Disposition:

eCAPS/h'EMIS Task ID.


Acr~onRequest # l~eceivedby (Namc and Organization):
hogram Code/Evcnt a: State- I ~ a t e / ~ i r nSubmitted:
e

FEMA Form 90- 136. NOV 04


K&Z;P'LA& a F O -(\ 19
I ACTION REOUEST FOIU,
- - - - odd^ No. 1660404 7
&pries November 30,2007
I. Who is Requesting Assistance? (Completed by Requestor]

rmanent Phone: FAX #: S& A=-


l~equestor~rganization:?&q 06- &). E-mail: AZff
- - - -
PI. Requested Assistance (Completed by Requestor)

N:Statement of Work (Operations Section Only)


OFA Action Officer: - 24 hour Phone: FAX#
~FEMAProject Officer: - - -. 24 hour Phone: FAX#

I
Justification / Statement of Work:

Estimated Completion Date: ( Cost Estimate:


V. Action Taken (Operations Section Only)
0 Accepted 0Rejected Accwntable Property
Disposition. Conrdriated wth APO

FEMA Form 90-136,NOV 04


CQE-unVb - 21
-
"LC. I - L V V J V.LV,UII I

L
U.S. Department of Homeland ~aourlty oMB No. 2660-0047
Federsl Emergenay Management Agency See Reverse for Bpims Navember 30,2007

. ACTLGN REQUEST
I. REQUESTWIG ASSISTANCE (Tobe camplmd by Requeetor)
PaperworkDlsciosure
Notice
1' Requestor's Name (Please Print) Bllly Short 12.Title Warden Orleans Crlminal S h o d 13. Phone
I I
. Requeetofs Organlzatlon Orleans Criminal Shewa Offlce 15. Fax No. 8. Email Addross
,.
I I
(I. Requested Asslstanco (Completed by Requestor) 1
. Descriptionof Requaeted Asslbtana: -
I
Pmvlde an servrces desarlbed under para 3.0 SOW for the Houocr of Detention (HOD): including paras 3#1,3.2;'3.3, 3.4,3.6,3.6,3.7,
and 3.10. see attached. 5 0 l e held odjvrfuurb be e y w y d 4 C r-d rd S k v kn: ~ d#6ce6
3.8.3.9,

I
-
13.Priority: Ufcsaving Ufe uzta~ning ~aml 14. Date and Tlme Needed
Defined In SOW I
5. Delivery Site Location: New Orleans Houae of betentian
Hlsh 0 nedurm 3 Oct 2006
6. Site Point of Contaat (POU) Warden Billy Short
2735 Perdido Gtreet
Newarleans, LA193 19,-7
-
- ----- 7.24 H QPhone
~ M-8.
I
Fax No.

4. FEMA Pmject OMoer. Jack Rose PAC 5.24 Hour Phone No. 703-483-1243 e ==VN~

- -r
7 . Justification I Statement of Work:
The Orleans Crimlnal Sheriff's Oflice has criHcal need for the services hated above to transfer prisoners from a temporary fscillty In the
Qrayhound Bue terminal (Closing of this temporaryfacllity has been ordered by AMTRACK b vacate the facllity so they osn resume sewice to
New Orleans). The Louisiana Department of Comctions end Attomy General have stated In a IetteCdatrd Sep 14,2005. (Attached) the
importance of reestablishingdetention tacllltles for the Orleans Parish Criminal Shariff'a Office (OPCS) as won as posaible. The Misslon
Assignment services listed above In conjunction with other emergency and permanent mtaratfon sewices dsacrlhed in PWs 84 and El are
critlcal to reestablishing the New Orleane crtminal justiae ~yatem.
8. Estimated Completion Date:

TRACKINGTINFORMATION (FCMAUSE ONLY) /


ECAPSINEMIS Task ID: Actlon Request Na. Program CoddEvent #:

Received by (Name and Organi;5allon)! State: bate~TimeSubmitted:


I I I

'FEMA Form 90-136. NOV 04 (ThD partlculsr form has bean updatedfar compaiibilly with DART)
'

- -- ...-
EON W Q U E S T FOXV- O K .VC.
~ I ~ ~ G -i O O ~

-equestiag
-. .
Assistance? ( C o i n p k t e d by Reqnestor) -.
F x p r i e s 3%~cl."rr.5e.-30,2007

~ I I Sourcing
. -
the Request ~ e v i e w / ~ & d i n s t i o n (Operations Section Only) --

~ O P R e Sw w Sy: bations C] Procursmen!


:?Inr~:?)~nc.,, q i z e m t x
&s,prneci ~ S ~ C L -

IJ ~ : h ~owjinafioi,
s by: a e 0 ~ ~ ~ ~ 3 - 2 1
0 Other Coorcination by:

!mxedmte Actior? Xequir-d:. !A -IY%s No P.ction reqcesi a,i EES F=: 3 (-A<( !LfiC 47;
b-5
Dzte/Time Assigned: assigned to: Other:

IV: Statement of W o r k (Operations section Only) - -.


PF.4ficficr? Ofiker: 2G hour Thoze:
FEMA Project Officer: 2Ghour Phsnc: F.4?(=

- ..
-sz2a;xI Com?ie:!oii DE'LC:
V. A c t i o ~Takep-
. (Operations Section C
-- -
;
L
.
I-.:-
-
- r.z;5::+;
: -

-
51>2 -" >;;. ..,"L..
c .
ACTION REQUEST FORM

briorlty: 0 1 i~eravirq 0 z Ute sustaining l ~ a t e / ~ i r nNeeded:


e
.. --
-- I 3 HQh a 4M P ! 5 Normal 1
. tWhery-0fla - ,.b0,- A fieL
- $1 3rd S f r e d ( t r o ~t;'ee+r
~ ~ T~Loup;fir<,lard F e-
~ c.i. t ~ ) -
1VZl.l Op/euvlsr 7013 0
fi pot: Q-ff.;c<,c 5%;f.i., - ' 24 Hour Phone/Fax #s:
State Approving OK~cialsignature: - --.-

m.Action Request Radew/Coordtnatlan (FEMA UBE ONLY)


U WSRevlewbY:
0 Log-by:
O k < h o r d l M l k n bv:

lo (XhgCcadnaQn by:
I~ate/%e Assign& f~mmediateAction Rcquircd: 0 Yes No
~dgned
to: i.2 UfJux I I
- -. P ? W n g ~ n d a ~ - #i Ishot-t Description 6fMk.
124 hour Phonc/Fax U s :
124 hour PhoncfFax 1Ys:
Justification / Statement of Work:

L I

NEMlS Task ID: Estimated completion date: Cost estimate: O ~~countabfe


property
Coordine~edwith APO

CKING INFORMATION (FEMA USE ONLY)


Action Request # l~eceivedby (Name and Organization]:
Program Code/Event #: Istate: I
Date/Time Submitted: 10 Otiginatd as verbal
4

Copy of Action Request Form-1x1s at 1 1:06 PM


dF8-324
ci3/--6C7'
'pbo b Requesting Assistance? (Completed by ReqmestorJ
,mstor Nam./Tiie/Sfate: S t &qrnn& Ho
#hp ;sh sfl; fqll ~ c r n ~ o r Pbone/Fax
ar~ I:
-rmanent Phane/Fax I: &mail.

Wstate O m O R O C D m Elm C ~ E R T ~ ~O F A O~ther

NEMlS Task ID: Estimated completion date: C o s t estimate: C Aa.m&~t~pen~


Cooniinated aim APO

' A Request i? IRccdvcd by (N-c and Organkatik]:


ram CodelErent I: 1state: 1Lkte/~irncSubmitted: 19 Orlgh7afedasverbat

Copy of Action Rquest Form-1 .XIS


1. Who is Requesting Assistance? (Completed by Requestor)
pk q
1.

Requestor Nnme/Ticle/Stare: ;e, s Temporary Phone/ Fax W .


, .
Permanent Phone: FAX
1- I :#

.11.
Requestor Organization: E-mail: -
Requested Assbtance (Completed by Requ88tor) C] kc Altached
Description of Assistance Requested:
A

Quantity: DatejTime Needed:

--
d3~JloCha sse ,U 70037 e a-
-
Site POC: ; r e s S e -1 st, /
f. 24 Hour Phone: sA psd;d RAX #
w

Date/Time Assigned: ) assigned to: 0 Othv:

N:Statement of Work (Operatiom Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project OIIiccr: 24 hour Phone: FAX#
Justificatron 1 Statement of Work:

Estimated Completion Date: Cost Estimate:


V. Action Taken (OperationsSection Only)
0Accepted 0 Rejected 0 Accountable Pmpetty
Xsposlt~on: Coordtnated wlh APO

74-05 9

stion Request #
.rogram Code/ Event #:

EMA Form 90-136, IOV 04


Received by (Name and Organization):
State: I ~ a t e l ~ i r nSubmitted:
e

- 10 Orlglnated as verbal
1111. Sourcing the ~ c ~ u e ~ ~ e v i e r / ~ o o r d i n(Operations
ation Section Only)
WOPS
Review by: 0% /
Log Renew by:
- C Y
F.
Donations

0Other (erpla~n)
Procurement
[? Interagency Agreement
0 Other Coordmatlon by: a Requlsltlons 0Misslon Assignment

I
0 Other Coordination by:
Other Coord~nationby:
Immediate Action Required: U Yes No
Date /Time Assigned: I assigned to:
IV: Statement of Work (Operations Section Only)
OFA Action Officer: 24 hour Phone:
FEMA Project Officer: 24 hour Phone:
Justification / Statement of Work:

Estimated Completion Date: I Cost Estimate:


(v. Action Taken (Operations Section Onlvl

I
Disposition: Coordinated APO
w~th

TRACKING INFORMATION (FEMA USE ONLY)


eCAPS/NEMIS Task ID:
Action Request # Rzceived by f9arr.e and 0rganiza:ion):

r
Program Code/Event #: State: I ~ a t e / ~ i mSubmitted:
e I:I
Orlg~natedas vero;

FEMA F o r m 90-136,NOV 04
09/11/2005 02:58 FAX
-*

ACTION REQUEST FORM


, Who la Requesting Aesistancs? (Completedby Requestor)
Lequestor Name/Titlc/St l ~ e r n ~ o rPhone/Fax
ar~ 1:
'ermanent Phone/Fax #: E-mail.
'equestor State u cm*~ u ROC U E n 3 ERT-A 0 ERVDFO 0 OFA a other 0,')c4m t pk dr r, F k
kganiza tion:
I. What Need6 to be Done? (Completed by Requestor) ", see ~trached
)escription of Assistance Requested:
A i r c o nd ; + ; m $ o r o-;?.F;cas iq /,'ad 5r l ~ c - ~ d s ;+y C i-f.nl/,
.G, ~ h b l e '"4
.. q h - fi a c , d ~ .
2uantity: 1 each I Priority: 17 1Lifesaving 2 ufe sustaining I ~ a t e / ~ i mNeeded:
e

iite POC: f i 4 y ~
a'(, !/ ;, , , , 4 2 4 3 0 ~Phone/FeK-:
;tare Approving Officialrsignn&e: ,,yf,,+q y& c-- - .-- Date: r;//l/h<;'
1 I !

XI. Action Request Review/Coordination (FEMA USE ONLY)


I
Accept l ~ e a s o nRejected: @ OPS ~evlewby: ,&./J/.,9 &&'1~../,+=* 1
c Rele 1 6 Cog Revkw by: 7
G Omrr Cwrdlnatlon by:
0 Other Coordination by.
Other Cmrdinatlon by:
ictlon request ESF #: 7 DatejTirne Assigned: Immediate Actlon Requlred 5 Yes 0 No
ossrgned to C Other:
1 Tasking Under Exlmng MA U l ~ h o r Descnptlon
t of MA.
)FA Action Olficcr: 124 hour Phone/Fax #s.
'EMA Project Officer. I24 hour Phone/Fax #s:
lustification / Statement of W o r k

37. Action Taken (FEMA USE ONLY)


Mututal Aid C matlons C! Requlsltlcn C; Procurement Interagency Agreement 2 Mlss{onAsggnment Other (describe)
Cequest fa-
r~ca-A (FF 60-I
(FF 40-1 attached) (FF 40-3attachcdl (attach ARF to M A )
Zesults: attached)

{EMIS Task ID: Estimated completion date: Cost estimate: [I] Accountable Propem
Courdtuarcd rmth ,\PO

Program Code/Event f!. State. DateiT11ne Submitted.

Copy of Action Request Form- 1 XIS


/'
ACTION REQUEST FORM --OM 7
Expries November 30, 2007
I. W h o is Requesting Assistance? (Completed by Requestor)

(Permanent ~ h o n . u FAX #:

. .

Miiion Assignment

FEMA Project Officer: 24 hour Phone: FA);#


Justification / Statement of ~ o r k / a

Estlmated Complenon Dare: I Cost Estimate:

-
V. Action Taken (Operations Section Only)
Accepted Rejected C] Pccounrabl* Propem
D~sposit~or,. Coord~nareaulth A?O

TRACKING INFORMATION [FEh'lli USE ONLY) - -

eCA?S/ VEMIS Task ID


.4cnan Reauest F - ,m g m n
qeCP!,,p_dbl. - --
-L.U --
7 - - -6G".&aLlJLl)
4d - . - e l

Program CodelEveni -Y.


.State
- ( ~ a r t--i ~ l m e
Subrnl~red. 1 orsglnaieo 3s veroa'
+ 2%- 037
ACTION REQUEST FORM ~ d NO.d 1660-004
~ 7
Ewpries November 30,2007
I. W h o is Requesting Assistance? (Completedby Requestor)
Requestor Name/Title/State: - ~7-
4-
~ ~ A D I \ OEC
C Temporary Phone/ Fax #:

IPennanent Phone: -- \ FAX #:


Requestor Organization: _'-i-t%~~$~s
et~c$ZC E-mail:
11. Requested Assistance (Completed by Requestor) - 0 see Attached

Quantity: 8 - Priority: a 1~ e s a v ~ n g IJ 2 ble sustatnlng Date/T~meNeeded:


A - I2
--1- 4-
0 3 High 4 Medium 5 Normal

Delivery Site W&o-&;


- ~ W - Fkr25b* E ~ C [LI~D D W
b 7 U ~ S P ~ ~ A L
\ % S T AMCS k - v ~ . 102 f.mcDc;ktsr.
-
--
M~~;LCLW G a t 7 ~ d; : -
Site POC: 0 b~7- RE^^^^ -, , 24 Hour Phone: @ ! - .-.- t # ~
State Approving Official signature: Date:

1111. Sourcing the ~ e ~ u c s t ~ e r / ~ o o r d i n a(Operations


tion Section Only)
Review by: Procurement

Log Review by: C] Interagency Agreement


Other Coord~natfonby: 0M l m Ass!gnrnent
Other Coordination by:
Other Coordination by:

Immediate Action Required: U 0 No Action request €SF +:


DatejTime Assigned: I assigned to: Gther:

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

Estimated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)
- -
( UAccepted U Rejected
I
10 Accountable Property
Disposition: Coordinated with APO

TRACKING INFORMATION (FEMA USE ONLY) ::.$":;. .-'' . -2


- - - ,

e C A P S / N E M I S Task ID:

Program Code/Event #: State: ]~ate/~im


Submitted:
e I Ortgmated as verbal

FEMA Form 90-136,NOV 04


I.

- ACTION REQUEST FORM


Who b Requesting Assistance? (Completed by Requestor)

l ~ r m a n e n rPhone:
Requestor Organization:
11. Requested Assistance (Completed by Requestor)

I &La.uesf 2 ,ocR~le~ d
Description of Assistance Re tstcd:
e ~ j r c~
a Pr [ e o.fBumpin$
q bk ~
FAX I:
E-mail:

~OOO-TOOO
-
2'Fid &-7
OIQI NO. 1660-0047
30.2007
Expr(ss M1~8mb.r

0 see~ttvt~d

.--
/)pabe LA d
.---. -
Site POC af -7p"m
e 24 Hour Pho .AX#
State Approving Official signature:

u-nt
aInterage~y Agreement
(0 Other Cmrdl~t10flby: JJMW wnment
IJ Olher~tlonbv:
fJ Other CoardlnatIon by: -
Immediate Action Required: U No Action request ESF I:
Date/Time Assigned: assigned to: 0 Other:
N:Statement of Work (Operations Section Only)
OFA Action Officer: 24 hour Phone: FAXI
FEMA Project Ollicer. 24 hour Phone: FAX#
Justification / Statement of Work:

I J
Estimated Completion Date: Cost Estimate:
V. Action Taken (OperationsSection Only)
0 Accepted Rejected 10 Accountaae Properr,
Coordinated with APO

L__-I

C A P S / N E M I S Task ID
,ction Request #
LC '
rRACKING INBORMATlON ( F E U USE ONLY):;.X$~.' . . . ...- :.- .:'.
"

l~eceivedby (Name and Organization]:


E; .: c. ' -- ,g .
e -, - . '. , I ,

I
'rogram Code/Event #: State: (~ate/~im Submitted:
e I Originated as v d l

EMA Form 90-136,HOV 04


09/1.1/2005 02: 5 8 FAX

ACTION REQUEST FORM JFct 06g


I. Who is Requesting Assistance? (Completed by Requeetor)
Requestor Name/Title/Stat~:( 1 ~ fiS I ~ e r n ~ o r aPhonelFax
m #:
'Permanent Phone/Faxa #: - 1 - C e j : m- q -
Requestor
Organization:
state LJ EMAc LI KW ;- E5r s ERT-A a ERTIW LI oFA w Other =plea PI r; &%P r~
--

11. What Needs to be Done? (Completed by Requestor) see~ttadred

a Log Rwlew by; f

Other Gmdinatton by:


0 Other Cmrdinatlon by!
0 omm coordination by:
Action request 7 Assigned:
]~ate/~im e I
Immediate Action Required: a Yes [7 No
assigned to: a Other: 1
0 TasMng Under ExiWng MA U Short Description of MA:
OFA Action Officer: 24 hour Phone/Fax #s:
FEMA Project Oliicer: 24 hour Phone/Fax #s:
Justification / Statement oi Work:

IV. Action Taken (FEMA USE ONLY) e

Request
Mutual Ald
IRea-A form
Donatlmr RequiMon
(FF60- 1
rocurement a InteragencyAgreement
(FF40-3 attached)
5(attach
Mission k l g n m e n t
ARF to M A )
Other (dexrlbe)
IFF 40- 1 attachedl
Results: attadled) attached)
Disposlt~on. k@kff v ~ ~ - ~ / n
D J
--
NBhllS Task ID. I Estimated completion date: I Cost estimate: l I ~1 1 1 o Coordinated
Accountable property

I I I with APO

Copy of Action Request Form- l .As


1

I.

I
Requestor Name/Title/ State:

lPermanenf Phone:
Requestor Organization:
-
Who is Reauestinn Assistance? lCom~ktedbv Reaaestorl

Xf B
11. Requested Assistance (Completed by Requestor)
Description of Assistance Requested:
geed2 lie blackberries
E~PW~
ACTION REQUEST FORM

Temporary Phone/Fax #:

FAX #:

E-mail: -
OXE No. 1660-0047
e*p&~N o ~ m k 30.2007

,
r

0 SeCAaadd

.- Quantity:
(-fo-=- Priority: C] IW
- a2 ~ i f urnamng
e Date/Time Needed:
-,

- .LA.
p - 3
@ 3 Hklh 4 Medium 5 Normal
Delivery Site ~ o c a t i o - ~ =6ephc& SO - .
2 Cou r f house S I
v v
.-

Gal*e e, L - -
Site POC: C a pq mc/&b 24 Hour Phone: -- Fw#
tate Approving Official signature:

I
0 OtherCoordlnatlon by:
a oulerCoa&uuon~:

Immediate Action Required: U Yes a NO Action request @ €SF #: ? / /VM+*CU 05


Datc/Time Assigned: 7-/O-0 S- ( assigned to: 0 aha: I

fV: Statement of Work (Operations Section Only)


OFA Action OfIicer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#

Estimated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only]
Accepted x~e~ected +/&-- 0 Accountable PmpertV
Dis~os~tlon: Coordmated w ~ t hAPO

IRACIUNG. INFORMATION (FEMA USE ONLYJ.(: >. 4,:. a > 8 > 1 , . I

,CAPS/NEMIS Task ID:


. c t i o n Request # Received by (Name and Organization):
'rograrn Code/ Event #: State: I~atel~im e
Submitted: 1 Originated as verbal

EMA Form 90-136, ROV 04


ACTION REQUEST FORM
I. Who L Requesting a b t a n c e ? (Completed by Requestor)
Requestor Name/Title/State: O P!&A M C. l ~ e r n ~Phone/Fax
o r ~ #:
Permanent PhonefFax # E-mail:
Requestor
Organization:
o
stare u EMAC u ROC 0 EST 0 ERT-A 0 ERT/DFO CI OFA B Pa r i s h
~ t h e r0 r 1 e c r r . l ~

XI. What Needs to be Done? (Completed by Requestor) - 0 see~teched


Description of Assistance Requested:

IV. Action Taken ( F E U USE ONLY)


Action MututalAld DonatlOns Ihwisim 0 Procurement IntewAgrrement 3 Missionmgnment Other(desaibe1
IRequest IRea-A t o m (FF60-1 (FF40-3 attached) (attach ARF to MA]
attached) attachedl
(FT40-1 attached]

NEMlS Task ID: Estimated completion date: Cost estimate: a AcwuntaMe Property
Coordmated wth APO

TRACKING INFORMATION (FENLA USE ONLY)


Action Request # 1
Received by (Name and Organization):
10 Origmated as verbal
Program Code/ Event #: !state: I~ate/~im c
Submitted:
-
Copy of Action Request Form- 1.As
. . ,09/1.! / 2 0 0 5 0 2 : 5 7 FAX

ACTION REQUEST FORM T ~ 067


J
1. Who is Requesting Assistance? (Completed by Requestor)
Requestor Name/Title/Statc: or f l l af i 3 l ~ e m ~ o r aPhone/Fax
ry #:
Permanent Phone/Fax11: E-mail:
I
Requestor
Organlzat~on:
State 3 MAC J n u ~3 a ERT-A ERTIDM C OFA a
- Other O PI P $ J I S ?a r ;3

11. What Needs t a be Done? (Completed by Requestor) / fi See AttMhed

Description of Assistance Requcstcd:


w
IOJ* 1:on+~*~e.pc;clt-c,/45c t,j&~el'l~ c_vtd de5h.r-3ep<rr ~ r -teq s e
[ ? o o , d ! ~ ~k
~p$ e/m.~ phg:n-3 ope4 f Q p +ha d e r a n OC G o
(bhtq f;er q a r ,
Quantity;
- Priority: 0 1 Ufesavtng 0 2 Ufe urstaintng
/
Date/Tirne Needed:
.- . - --
- -z&S C . C ~ B 3 High 4 Medium a
Delivery ~ i t k L o ;- ~ o ~ F;c(L
a i i o G ~{and ~ / , E & ~ s Q f 3 ; v ? g d*eq
910-3 ~eod(4md

Lcg Revlew by: /


Other Coordinallon by.
GWmr CoordinaUon by:

- 0 Other CoordinaWon by:


Action request ESF 7 I~atelTuyk~ssigned: 1
~mmediateAction Required: 0 Yes 0 NO
assigned to: a Wet: / I
Tasking Under Existing MA # i oMA:
~ h o g ( ~ e s c r i ~ t of n
OFA Action Officer: 2 f i o ~ h o n c / ~ a#s: x
FEMA Project Officer:
Justification / Statement of Work:

I /
(FF40-1 attached)

I
Disposition:

Coordinated with APO

Copy of Action Request Form- l .XIS


ACTION REQUE8T FORM
/

I. wpe is Requesting Assistance? (Completed by Requestor)

Requestor
Organization:
O - UEW UROC urn d m OERTIDM O ~ F A ~ ~ t h a ~ ~ ~ u ~ v s f i

11. What Needs to be Done? (Completed by Requestor) 0 !knttached


Description of Assistance Requested:
VwJ-ides r e p d d ' fop damq3e ~ s s e s s ~ ~ pk o+ ~l ~ mIo w m e a f
o n n o and
supply dal:ver,Y- ~/ehiCJ@s-'6 - ~ u h c c l $ r ; ~ ~ ~ & ~ s , ~ - 4 / c ~ h u / C ; ~ ~ , % f r . P ~ * * ~ s

Other Caordinam by:

I assigned to: Other: 1 1


0 T a n g Under Usting MA Short Description of MA:
OFA Action Offkee 24 hour Phone/Fax #s:
FEMA Project Officer: 24 hour Phone/Fax Us:

,-
IV. Action Taken (FEMA USE ONLY)
fl Mututal Aid 0 DoMtions Requisition Pmawement 3 MlssjonAssignment
ImeragencvAgr€e~~~t Other (desmbe
Request IRW-A (FF60- 1 (FF40-1 attached) (FF40-3 attached) (attach ARF to MA)
Results: attached] attached)
Disposition:

NEMlS Task ID: Estimated completion date: Cost estimate: 0 Amountabie property
Coordinated w i t h APO
1

RACKING INFORMATION (FEMA USE ONLY)


Action Request # 1Received by (Name and Organization):
1
Program Code/ Event #: ]state: Date/Time Submitted: 1 10 Orig~natedas verbal

Copy of Action Request Form- 1.xls


r
- 9-m -073
ACTION REQUEST FORM OMB No. 1660-0047
Expries Norember 30, 2007
I. Who is Requesting Assistance? (Completedby Requestor)
Requestor Narne/T~tle/Statc: 5 F& r s -,J f i $I( &f Temporary Phone/Fax #:

Permanent Phone: FAX #:

ye

-
Requestor Organization: Pro fi i E-mail:
11. Requested Assistance (Completedby Requestor)
Descr~ptionof Ass~stanceRequested:
- See Attached

J ~ O ~ C I JG - e n e d o r
-
I o { r o v : d e eL-6 + b f h e f fiu:&.
ybh flc&

Quantity:
I Priority: 8 3 High
1 Ufesavlnp
0 4 Med~um
02 Life sustaining
I3 5 Normal

-.
pII. Sourcing the Request - Q&ew/~oGdination (Operations Section Only)
-
1 Donations ~rocurement

0 Log Review by: 0Other (explain) 0Interagency Agreement


Reqtrisitions %Ion Assignment
0 Other Coordinatm by:
Other Coordination by:
/

U
Immediate Action Required:
_2
(2
Yes No Action request -SF t:
Date/Time Assigned: I assigned to: % Other:
m

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Proiect Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

Estirnared Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)
0Accepted 0Rejected Accountable Property
D~sposttion: Cnordlnated w ~ t hAPO

leCAPS/NEMIS Task ID:


Action Request # /Received by (Name and Organization):
Program Code/ Event #: State: /~ate/~im Submitted:
e 10 Orlglnated as verb

FEMA Form 90-136,


NOV 04
- .
ACTION REQUEST FORM Od53 No. 1660-0047
Expries November 30, 2007
I. Who i s Requesting Assistance? (Completed by Requestor)
Temporary PhonefFax #:

FAX #:
Requestor Organization: dew-$+ E-mail:
11. Requested Assistance (Completedby Requestor) - See Attached
,
G t ~ a t TokeR
D e s c r ~ p t ~ oofn Assistance Requested:
lbk%nA b ~
H a \ ~ \ - i a & 1- 3 ~ - n ~ t + P a ~ ~ -
Quantity: Priority: 1 Ufesadng a 2 ~ f sustaining
e Date/Time Needed:
3 High 0 4 Medtum 5 Normal

Delivery Site --
L u e f & p i 5--~ c - C - t R a pact 6- 0k-e
--I%%\ A,rn~sBdo -
-*A-atz,TLo
site POC: WS - C~ ~ R O U 24 Hour P h o n e - ! &
- .-,-
X

State Approving Official signature: Date-

111. Sourcing the Request -/Review/~oordhation(Operations Section Only)


OPS Review by: Donations C] Procurement
0 Log Reblew by: aOther (explain) Agreement
C] Requisitions Assignment
a Other Cmdinabon by: L'
0 Other Coordination by: A
Immediate Action Required: U Yes 0 No Action reques-
Date/Time Assigned: assigned to: Mer:
---- -- -- - - - -- - - - -

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Just~ficatlon/ Statement of Work:

Estimated Completion Date: 1 Cost Estimate:


-
V. Action Taken (OperationsSection Only)
0Accepted Rejected 0 Accountable Property
,Disposition: Coordinated ivitt~APO

eCAPS/NEMIS Task ID:


Action Request # Received by (Name and Organization):
I
Program Code/ Event #: State: (~atef~im
Submitted:
e ( 0 Originated as verbal
,
FEMA Form 90-136,NOV 04
JY.0
ACTION FWQUEST FORM
or- 8
I. Who is Requesting Assistance? (Completed by Requestor)
Requestor Narne/Title/State: d 0 I= P / OR LA;^^ O W ( ~ e m ~ o r aPhone/Fax
ry #:
Permanent Phone/Fax #: -q E-mail:
Requestor
j ? 8 State U EMAC ROC C ] ES 0 ERT-A ERTJDFO OFA Other
Organization:

Quantity: &ah

Deliver~SiteLocation:
Priority: 0 1Ufesaving
3 High
EYLME-LT(L;S. M O R I ~bL n ~ r = - N ~ ~ ~ ~ \ C ~ ~ ~
0 4 Medium
0 z Life susia~ntng
U 5 Normal 1Date/ ime Needed:
~ J ~ / O S

-. - 1 "10 ~ ~ ~ v L = $ u T ~CL=N=
o&J RLVD

-
.- ;-F f i k - ~DRLC-A,~..
s i t e POC:CP b i i ~ ~ 4 - 24 Hour Phone/Fax #s: .
-' --
State Approving OfficiarSiiature: A
=/ Date:
/ r -
111. Action Request ~ e v i e w / ~ o # b t i o n(FEMAUSE O W ) / - ..,-
U Reason Rejected: 1\YO%

Y
Review by:
0 Re- 0 Log Revlew by:
Othw Cowdtnabonby:
0 Other Coordinationby:
0 t h Coordination by:
Action request ESF #: 7 Date/Time Assigned: Immediate Action Required: Yes 0 NO
assigned to: Other:

Short Description of MA:


OFA Action Officer: 24 hour Phone/Fax #s:
FEMA Project Officer: 24 hour Phone/Fax #s:
Justification / Statement of Work:
+o LT~-(
tt--du

NEMIS Task ID: Estimated completion dater Cost estin

TRACKING INFORMATION (FEMA USE ONLY)


- I
.- . - -- - - - -
Program Code/Event #: I~tate: .DI

Copy of Action Request Form- 1.As


. w e - @ - -&G-o /(6
I ACTION REOUEST FORM - OMU NO. 166aoo17
e*prlar Nowmber 30,9007
I. W h o is Requesting Assistance? (Completed by Requestor) op-,
> n I

Temporary Phone/Fax #:

FAX I:
-
Requestor Organization: E-mail:
--
11. Requested Assistance (Completed by Requestor) 0 Sec~ttad#d

Quantity: Priority: 0 1w a n g z ufe msudar~ng Date/Tirne Needed:

-- - a 3 High a 4 Medium 0S t 9 - d Y/ ? / o r
, .
10-3.
Delivery Site Locabo=

State Approving Oficial signature: Date:


s /a<
-
Sourchg the Request Revlew/Coordination (Operations Section Only)
. OPS Revlew by: - o-tjorn 0Prcarernent
Log Rwmv by: w (7 other (explain) 0InteragencyAgreement
Other Coordlnatlon by: RequlJUons a Mkslon Asskmrnent
a Other Coordlnatlon by:
0 outer toordtnath by:
Immediate Action Required: Yes No Action request EY I :

-nr: Statement of Work (Operations Section Only)


DatejTirnc Assigned: I assigned to:

OFA Action Officer: 24 hour Phone: FAX#


24 hour Phone: FAX#
-FEMA Project Officer:
Justilkation / Statement of Work:

Estimated Complehon Date: I Cost Estimate:

hL -
V. A c t i o q Tbken (Operations Section Only)
a~ccepted 1);21~elenea , - 10 &countable pmpertl
Disposition: Y\ Coordinated with APO

d o n Request #
'rogram Code/ Event #:
l~eceivedby (Name and Organization):
IS tate: ] ~ a t e / ~ i r Su
n e brnitted: 10 o,igmated a verbd
II
EMA Form 90-136.AOV 04
ACTION REQUEST FORM
[. W h o is Requesting Assistance? (Completed by Requestor) OF-'f
Requestor Name /Tit.e/St l~ern~orary
Phone/Fax #:
Permanent PhonelFax #: E-mail:
Requestor
&te u EMnc u ROC u EST o ERT-A CI E R T ~ o om o Other
3rganization.

[I. What Needs to be Done? (Completed by Requestor) 0 SeeAttached


3escnption of Assistance Requested'
PQIJ o#f r e L < J~u r n p ~ ~ i c ~ dp\ot,:!
(r/,'Jlb\ S<cr:ci_ +Lrcc -LI'R~~

Other Coordrnatm by.


Other Coordlnabon by.

1 Tasking Under E~15tmg.MA # Short Description of MA:


)FA Actlon Officer: 24 hour Phone/Fax #s:
?EMA Project Officer 24 hour Phone/Fax Us:
Justtficahon / ~iatementof Work.

[V. Action Taken /FEMA USE ONLY1


iction 10 Mututal A d 10 Donat~ons lo Regu~ut~on 1~ procurement 1o Interagency Agreement b Mission Assignment 1 0 Other (dexrte)
I (FF 60-1
attached,
I ' (FF40- 1 attached) I (FF 10-3attached)
I (attach ARF to MA)

-/TSC L ~ G t r : / u
lEMIS Task ID: Estimated completion date: Cost estimate: C Acmuntable Property
Coordinated with APO

Copy of Action Request Form- 1.xls


ACTION REQUEST FORM @ 134
. Who i s Requesting Assistance? (Completed by Requestor) 0p-3
estor Name/Title/State 0 u I-/, ( pa r I'S k l ~ e m ~ o r aPhone/Fax
ry #:
anent Phone/Fax #: E-mail:

11. What Needs to be Done? (Completed by Requestor) 0 See Attached

Description of Assistance Requested: flrll 0


:
$ q m p ~ ~ s n&e ~e d P o 6 f r u 9 A
~ C C Q W ,a c 0 0 6 ~ : c ' s { C ~ ,

b/~L%!~ICB-
Quantity: 1 each Priority: 0 1 Ufesav~ng 0 2 bfe sustaming Date/Time Needed:
d 6 ~ 1 g h 4 Medium 0 5 Normal
~ e t i--~Site
e r ~ Lo.otie~~~~~ , : G
& A
95 ~0 14
3.3 R r a o)d: r, La,
M
q1cr J , -
~ I ~ ~ P O C . Lv1-y finrgi~~ /
24 H-Phonc/Fax Xa: , - '
State ~ p p r o v Official
6~ signature /ys./// Date.
III. Action Request ~ e v i e w ~ ~ a o f l ~ n a t(FEMA
i o n USE ONLY)
"Cept Reason Rejected. / W O P S Rewew by
0 Re]& 0 Log Revrw by
0 Omer Coordination by
0 Other Coord~nahwcby.
0 Other Cocrdmahon by
Action request €SF # 7 Date/Tlme Assigned: 'lmmedlate Achon Requ~red. C! Yes No
ass~gnedto 0 Other
-OFA Actlon Officer.
Taslong Under Ex~shngMA # Short Descnptlon of MA.
24hourPhone/Fax#s
FEMA Project Officer 24 hour Phone/?= #s.
Justlficat~on/ Statement of Work.

CV. Action Taken (FEMA USE ONLY)


IChon Mututal Ad C Omahons 0 RequistUon Kpmurement Interagency Agreement
?equest form
(~eo-A (FF60-l (FF 40- I attached)
Zesults: attached) attached)

!EMIS Task ID: Estimated completion date: Cost estimate: 0 4ccountable property
Coordinated with APO

Copy of Action Request Form- 1.As


'09/12/2005 12: 13 FAX
r

ACTION REQUEST FORM 0- NO.1660-0047


Expries November 30,2007
I. ~ l i o Requesting ~ s s i s t a n c e ? (Completed by Requestor)
> is

R~q~-~etnrRarns/Ti+Je/State-?$LL*ANJ Mfl,~i( Temporaq- PPhtw/Fax


,

fk

Requestor C)rgarlization: ~ ~ & , I L < A A J . f~ a k ~ f ~ L E-md: - .

a
11. Requested Assistance (Completed b y Requestor)
Doscription of ~ c s i s t a n ' c eRequested: ,
a i ~ u * ; L ~ . ~F, I+
F
. .*,,p, .,J CL,/8
, c ~ ~ . , L ~ + - +, Qo
pu
L : ~ O ~ /w
~~
LJ' c C.yL:d c+(XI
3
- r v . x i C-.-.C c . L i < + N
.'
/&,.
-
J
I-

i ' v b r
see Attached

~-.h,-

CiZ Ctic4 . j7 / d /'~S pt 4 . L~ A'- U. -SpW .< 7 . /--P.(, (4 L ~ .A

Slle POC: 24 H o u r P11one:

State A p p r o v i n g Official signature: 13a te:

[IX. Sourcing the Request - Review/Coordination (Operations Section Only)


e w , _-
v i ~j
~ / b ~ ~ ' ~ c by: . -- - ..- --- C) ~orwt~r?ns U~loc~rrement
. / -
--
,-I l n g Revlew by: ,
C -
i..-' 0Other (explain) 0Interagency Agreement
-I.--.
7 0lh~r
~oorlllnatiorrb,: 0Requtsitlons Flisslo~aA%ignrnent

3 0tIw1-Cw~.dlnabnr~
by:
3 Olher Cmrdinatlon hy:
I
mmediate Action Required: U Yes U No Action reqursl D--'~F
t: ,f L; .S 4 /' I-:
> n t e / T ~ r n cA s s ~ g n e t l : I a s s i g o e ~ lt o @ 0tm.

IV: Statement of Work (Operations Section Only)


)FA Actmn C)fficcr: 2 4 hour F'l~one: FAX*
XA4A Project Ofhcer: 21 hour JJhonc: FIIXII
Just.ilication / Statement or W o r k p , p ,AJ e 12 A- ' 7 , L ~ Y I.. f.c...,
4
.L '3' h.-,
/
L-<:-c; --

p;.vl_f dlCk q cc\ii:,ny


~ L.=/=/=c.-;?-~;
Coinplctto~~
SsL~~natec l Dale:.' Cost Estimate:

V. Action Taken (Operations Section Only)


2 Acceptrd a Rej~cted 1
0 Acccuntable FfCpe*

1 Coordinated with A f O
,
VU, A&,

1)
e""" Lh. *-. 1 M

Jfi- I?-3 )fa-


OMB NO.1660-0047
,-&
J. , , , VV"' "A"

ACTION REQUEST FORM


-I. '

W h o i s Requesting Assistance? (Completed by Requestor)


E x p i a s November- 30, 2007

. .

Rcrlucsto~-Namc/Tttle/St:ile: <
; &, <P & Temporaiy Phonc/Fax tr :

Fermancnt Phone: FAX #:

Requestor Organization:

Description of Assistaure Requested:


LL'H &IS f k f l t ~ f l
11. Reqixested Assistance (Completedby Requestox)
B L j T c L>,~/ C
, f=,Qp-
E-mail:

~0 PA - -
(A. YL 1 u.+,- @
See Attached

Quan tlty Priority: i Uresavlng a 2 Life sustalnlng I)ate/Tirnc Needed:


GIJ=
3 High 4 Medurn 05 Normal
~ 2 ; v e n -SIk-Iac&-oi

Y
- .---
Stale Approving Oflicial signature: Date:

C Jntxagency Agreement.
0Iqlsslon
n Other Ccordloallon by:

[mmecliate Aclion Required: Yes 0 No


Date/Time Assigned: I assigned to: other:

IV: Statement of Work (Operations Section Only)


:'>FA Ac ticrn 0llic.r.r: 24 hour Phone: FAX#
FEhlA Project Uilicer: 24 hour Phone:

Estimated Conlpletjon Date: ( Cost Estimate:


V. Action Taken (Operations Section.Only)
n Accepted Rejected 10 Accountable Property

:CAPS/NEMIS Task ID:


I c t i o i i Reclucst i: Reccived by (Name and Organization):
71.0gra~nCock/ Even[ #: State: ]~ate/~im Submitted:
e 1 r]Orlglnated as verbal

FEMA Form 90-136,N O V 04


ACTION REQUEST FORM
o-.a - 3- ,
I. Who is Requesting Assistance? (Completed by Requestor)
Requestor Narne/Title/Stnte f i , ) 7 (.
, r o t , \ ~ . h fTemporaryPhone/Fax #:
Permanent Phone/FaxDti - U ; E-mail:
Requestor
&state EEMAC u RWL J EST ERT-A U ERTIDFO 0 OFA
Organization.
11. What Needs to be Done? (Completed by Requestor) - 0 SeeAteched
Description of Assistance Requested: I\ c? ct P,- FeSS \ 0e c o h C) F F:y.c ~ o m k c ~ r \ r \ c ~ ~ J l ; s h ~

1 w ~ i g h 4 Medlum 0 5 Nonnal
-.
Delivery Site Locati-mu::_
- =--T ,o, m C i ' r e u r e a ~ ~ m f l ~ l u n r ' c ~ & ; t , ' o n _ (
,
Site POC:
- - --y o / h s c d & k ,Vfd & j Y k f l J
-
State Approving Official signature:
III. Action Request ReviewICoo
N 24 now p40ne/Fax #a:!
-
d
- .- --
-us-.

Reason Rejected:
0 Rep3
0 Other Coordinabm by:
Other Coordinabon by:
0 Othercwrdl~by:
Action request #: 7 Date/Time Assigned: Immediate Action Required: Yes No
assigned to: fl Other:
0 Tasking Under Exiing MA # Short Description of MA:
OFA Action Officer: 124 hour Phone/Fax #s:
FEMA Project Off~cer: 124 hour Phone/Fax #s:
l~ustification/ Statement of Work:

N. Action Taken (FEMAUSE ONLY)


Mututal Ald C] Omations Requisition hocurement 0 Interngem Agrremeot 3 mgn-t Other (describe)
Request IRea-A form (FF60-1
(FF40-1 attached) (FF40-3 attached) (attachARF to MA)
Results: attached) attached)

I
Disposition:

NEMiS Task ID: Estimated completion date: Cost estimate: Acmuntable PmpenV
Coordinated with APO

TRACKING INFORMATION ( F E U USE ONLY)


Action Request # l~eceivedby (Name and Organization):
I
Program Code/Event #: I~tate: 1Date/Time Submitted: 1 Originated as verbal

Copy of Action Request F o m - 1.XIS


ACTIOH REQUEST FORM
. Who Q ~ e ~ n e s Aesistance?
t G (Completed by Requestor)

I. What Needs t o be Done? (Completed by Requestor) 0 see~ttached

)escription of Assistance Requested:


Re &E
prfble d o ~ e r s T a c f ; r s )S u f i n e ', f bemb-.
b'
)uantity: )sash I~iority: C) 1Ufesvlng $82,uk sustalnlng l~ate/~im
Needed:
e
_-&each I U 3 ~igh 4 Medium 0 sN ~ I I
1eli"ery ~itFii&I% ftc ,.p
- -I)lacArfC\ar
cTory "
+ t-ecrcdes -.
w O d e a n s LA
Ete POC: C a p + Jefq u;nn 24 Hour Phone/Fax #s
;tate Approving Official signature:
11. Actbn Request Review/Coordination (FEMA USE ONLY)
l ~ e a s o nRejected: Ops Rev& by: ,&h/u &k&?-
~eieb 1 ~og~eviewby:
I

OtherCowdinatlonby:
0 OtherCoordinatkMby:
0 OtherCOordinatbnby:
rction request fl SF#: 7 I~atej~im
Assigned:
e 1~rnmediateAction Required: Yes No
assigned to: Othec I
1 TasMrg Under ExistingMA # Short Description of MA:
)FA Action Officer: 24 hour Phone/Fax Its:
EMA Project Officer: (24 hour Phone/Fax #a:
btifrcation / Statement of Work

V. Action Taken (FEMA USE ONLY)


'tion 10 MUhltal Ald 10 DoMtlons lo ReglJisitlon 1 0 Pmammmt 1 Inmagenq Agreement b M- ASQ,-,,,,~-,~1 0 Other (describe)

lEMIS Task ID: Estimated completion date: Cost estimate: 0 Writable PrwW
Cidinated with APO
.TRACKING INFORMATION (-MA USE ONLW f
Action Request # l~eceiveaby [Name and Organization):
Program Code/ Event #: (state: I~ate/~im Submitted:
e I Originated as verbal

As of 9/10/2005
Copy of Action Request Form-1x1s at 10:33 PM
Arn-Yr;; P- a.r
I -
ACTION REQUEST FORM o m NO.1660-0047
ibprlas November 30,2007
I. Who is Requesting Assistance? (Completed by Requestor)
n /I

Permanent Phone. per &jo v,,,,,%h


4
FAX #:

l~equestorOmanization: E-mail:

P?rlT; W L F %R, m u ~ . $ ~ , G a q r ~d .-/

.>.
.
,

(Xher Coordlna

Other Coordinatlm by:

Justification / Statement of Work:

D~sposition: Coordhw.ted w ~ t hAPO

~ ~ C A P S / N E M I STask ID:
A ~ ~ i uKcqucst
n # I~cceivcdby (Name and 01-ganization):
Program Code/Event t : Israte: Date/Tirne Submitted: f @ Orcqlnated as verbal
PEMA Form 90-136,NOV 04
.' S o - 2r3

--
4
r.p-.2&
ACTION REQUEST FORNI OMU NO. 1660.0047
Expries November 30, 2007
I. Who is Requesting Assistance? (Completed by Requestor)
Requesior- t\'anle/'Sille/Skile: -.J -
,-T, L- .i 14 WC, Temporary Phone/Fax #:

Permanent Phone: FAX #:


-
Requestor Organization: &Iicr:&~-m.?il:
11. Requested Assistance (Completed by Requestor) - 'J See Attadled
Descriplion of Assistance Iiequested:
I(3- L - ~ Q ~ & u , * I E ) U , ~ SCWL
H . ~ J ~ t > i ~a~>. , W ~ L F T Sm e
O ~ Dk ~ ~ ~ P C Z

.*.. ,

Log R e v l w by: heragency Agrcen~ent

0 Other Cowdlnation by: C F.llssimAsslgl~rner#t


Other Cmdination by:
Other Coordination by:
Immediate Action Required: U Yes U 140

Date/Time Assignecl: 1 assigned to: QFOther: Ehl


i
q 5&
IV: Statement of Work (Operations Section Only)
OFA Action Officer: 2 4 hour Phone: FUR
FEMA Proiect Officer: 24 hour Phonc: FAX*

Esl~laatedConzplelion Date:
w
V. Action Taken (Operations Section Only)
9Accepted u Rejected
Disposition:

eCAPS/NEMIS Taslc
-.
ID:
Action Requesi n! Received by (Name a d Organization]: --
P
P I - o ~ I . : ICocle/Event
I~ #: State: Date/lTrne Submitted: I Originated as verbal

FEMA Form 90-136,NOV 0 4


- -,- ) ~ F o 2389 &,@/- 33
.
- ACTION REDUEST
" FORM o m NO. 1660.0047
Expries November 30,2007
1. Who is Requesting Assistance? (Completed by Requestor)
k dC ~ ~ ~ - ' n
Requestor ~ a r n e / ~ l t l~e / t a t z C Temporary Phone/Fax #

- FAX #:

E-mail: ..
-.

11. Requested Assistance lcompleted by Requestor) see Attached

[State Approving Official signature: Date:

-
k11. Sourchig the Request If&iev/~o&dination (Operations Section Only)
OPS Review by: /??
,
~2
7d;fl ,
h ~ona~loos Procurernest

0 Log Review by: Other (explain) lnteragencf ~greement


O . ?her Coordination by: Requisitions Mlsslon Assignment . , . . .

0 Other ~ k r d l n a t i o nby: .. .
.. .
G 0th- Coordination by:
.
.-..
~

a
.L..

ImrnediateAztion Required: U Yes 0 No Action request €SF 11:


h.

Date/Tirnc-&signed: assigned to: Other:

IV: stattiwent of Work (Operations Section Only)


OFA A-fficer: 24 hour Phone: FAX#
FEMA- Projict -Officer: 24 hour Phone: FAX#

IReceived by (Name and Organization):


Program Code/Event #: 1state: ) ~ a t e / ~ i r nSubmitted:
e ] a Or~inatedas verbal
FEMA Form 90-136,NOV 04
09/13/2005 2 0 : 4 6 FAX 225 925 7501

C' S. Department of Homeland Security Scc Rcvene for Papcrnork OMB No. 1660-0047
Federal Emergency Management Agency Disclosure Notice Expira November 30,2007
Action Request
I. Who i s Requesting Assistance? (Completed by Requestor)'
Requestor NameTitluState:Orleans Psrlrh Tempomy PhondFAX #:
Pennaamt ~ h o n m --! FAX#:
RequestorOrga~zatlon:Orlcans NOFD E-mall:
11. Requested Assistance (Completed by Requestor) See Anached

-
Dcscnptionof Assistance Rcqucrted:
Shigh pressure washers with hot water
8-noxious weed under carriage cleaners

-
- --
Quantitpr & e v e Priority: 0 1 Lifesaving 2 Life sustaining OateKme Needed:
@ 3 High 0 4 Medium 5 Nonual - --09/12/05 13:OOCDT
Delivery Site Ld&: -
Woo~nrrdBase Csmp -NOFD --
4 103 Woodland Dr. . ...--
New Orleans,LA

-
Ill. ~ourcirkthe Reauest - ReviewlCoor
F-0ps Review by: /A,$'$> /
&,-,;yCS1

0 Log Review by: OUler (explain) ....-.agency Agreement


Other Coordination by: Requisitions Mission Asslgnmenl

Other Coordination by: 'i


Other Coordination by: I

Immediate Action Required: I Yes No Action request ESF#:


DateKlme ~ s s ~ ~ n e d : ! 1 assigned to: . Other:
IV: Statement of Work (O~erationsSection Onlv)
24.- 2 4 - b a u r #:
m t Officer: 24-hour Phone #. - 24-hour FAX #:
Jusaficat~on/Statcanent
of Work

V: Action ~ a k e n(Omrations Section Onlv)


[Zj Accountable Property
Disposmon Coordinated with APO

NEMlS Task ID:


Action Rquest #: Received by (Name & Organization):
Program C o d e X v e ~ #:
~t Stars Datc'Tilnc Suhlnilrcd :
1 Chiginard as Va-bal .
FEMA Form 90-136 Nov 04
0~!13/2005 2 0 : 4 4 FAX 225 925 7501
d

I. who is Requesting ~ 8 8 l s t a n c e(Completed


~ by Requestor)
Requestor Name/Title/State: 6 I ,. r c rn 4' I\ i A l~ern~ora
Phone/Fax
r~ #:
Permanent Phone/Fax E-mail:
Requestor
$/state u EmAC ~1 ROC 3 ;
1 EST ST-A D ERTIDK) o QFA o m r
Organization:
XI. What Needs t o be Done? (Completed by Requestor)
- See AltddWd

Description of Assistance Requested: Pro6Cssl'cjnCL\ / I


'C)&~sh ~ V . CC0 ~ ~ 7 1 h ( , i f l ~ r l ~ ~ ~ l , ~ , \ ~

7 0 ; ) < o ~ c d K l c -e~l n
~ c / c c f i ~ ~ o,-+J
F ~ ~C ~V f E Pol,.
~

h* 1d
Quantity: 1 each Priority: 0 L Ufesaving G 2 Uk sustalnlng Date/Time Needed:
-.
- MHW 0 4 ~edlwn 5NMmal /q
_s 3 ,P
---
-- --
Delivery S i t e L o j e N.o, *Fire ly,v e', ( z e m."lu 61 r‘c..;+-,o': S.

I
Other Coordination by:
0 Other toordination by:
10 OMerCoOrdlnation by:
Action request SF#: 7 I~ate/TikneAssigned: 1~mrnediateAction Required: [3 Yes C! NO
assigned to: 0 Other: 1
Tasklng Under Erdstlng MA ff Short Description of MA:
OFA Action Officer: 24 hour Phone/Fax #s:
FEMA Project Officer: 24 hour Phone/Fax #s:
Justification / Statement of Work:

NEMIS Task ID: Estimated completion date: Cost estimate: C] Accountable property
Coordinated wth APO
I

TION (FEMA USE ONLY)


(~eceivedby (Name and Orqanizatinn):
I~tatc: 1Date/Time Submitted: 1
0 Originated as verbal

Copy of Action Request Form- 1.xls


Requestor Narne/Title/State:
permanent Phone/Fax #:
-. .

-
I. Who is Requesting Assistance? (Completed b y Requestor)
1 . p.4

11. What Needs t o be Done? (Completed b y Requeigtor)


Description of Assistance Requested:
B, ,Sf-z

d+$vT7T
Email:
l ~ e m ~ o r aPhpne

Y b sL
ry /Fax #:

~ L 4 &l&w
U
f
See Attached

Quantity: 1 each , 2 Life sustaining l~ate/~im


Needed:
e

-.. >-
I - .---
State Approving Official signature: Date:
111. Action Request Review/Coordination (FEMA USE ONLY)
U Accept Reason Rejected: U OPS Review by:
0 ~elea LO^ Revlew by:

IU Other Coordlnatton by:


(0 Other Coordination by:
iction request E s #: ,& I Date/Time Assigned: l~mmediateAction Required: Yes No
assigned to: Other: I&. Y
7 Tasking Under Existing MA # Short Description of MA:
)FA Action Officer: 24 hour Phone/Fax #s:
?EMA Proiect Officer: 124 hour Phone/ Fax #s:

V. Action Taken (FENLA USE ONLY)


- - 8 -
ction 117 M u t u t a l ~ l d l O Donationslu ~equlstionl [rl Procurement 10 Interagen

I (FF60-1
attached) I (FF40-1 attached)
I (FF40-3r

iEMIS Task ID: Estimated completion date: Cost estimate:

TRACKING INFORMATION (FEMA USE ONLY) I


Action Request # IReceived by (Name and Organization):
IX. Action Reauest

I U WPt
0 R e M I
I
Reason Rejected:

0 Othercoadlnatlonby: I
J

0 Other Coordination by:


Other CoordinaUon by:
Action request ESF *: 7 1~ a t e / ~ i mAssigned:
e Ilmrnediate Action Required: Yes No
I assigned to: 0 Other: I I I
0 Tasking Under Wdlng MA # Short Description of MA:
OFA Action Officer: 24 hour Phone/Fax #s:
FEMA Project Officer: 24 hour F%one/Fax #s:
Justification / Statement of Work:

I
Disposition:

@&#mu#
NEMIS Task ID: Estimated completion date: Cost estimate: 0 ~ccountablepropert~
Coordinated with APO

.
.I
TRACKING 1BM)RMATION (FEMAUSE ONLY)
Action Request # l~eceivedby (Name and Organization):
Program Code/Event #: (state: I~ate/~irneSubmitted: (OOriginated as verbal
5

Copy of Action Request Form- 1 .As


Permanent Phone: UD FAX #:

Requestor Organization: .A c:
tyd4wL0 "r- a-9 E-mail: -
11. Requested Assistance (Completed by Requestor) a See Attached

~ e s c r i p t i o nof Assistance Requested: ( 7a,,ce"-fu&,v C31h(mau-r


L\uh<at+
/- z TeJYbE -W M I C ~S V~L ‘L FUAL-\+Y
-~

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

Estimated Completion Date: 1 Cost Estimate:


V. A c t i o n Taken (Operations Section Only)
D Accepted Rejected
Accountable property
Disposition: Coordinated w i t h
ACTION REQUEST FORM J F ~ W ~
11. Who is Requesting Assietance? (Completed by Requestor)

Requestor
0 state €MAC u ,-.. EST 0 ERT-A ERT/DFO OFA . 17 Other

-
Organization:

11. What Needs to b e Done? (Completed by Requestor] 0 see Attached


Description of Assistance Requested:
R O-lc ba I r . r f e r r \ o t ; o n a j ( ~ t f c r e ~ cbyd f k o r&I; )o
S
9 proporSY
P a t ~ i e ~ e + $ram & r ; ~ e . H 4 , n / e d o p l r a s a
~ Q ; & W C L
C i t v has to con?-r~cTfiridate eomdah;es.
Quantity: 1 each 0 2 Ufe sustaining Date/Time Needed:

-- --
-@ad 00rleaas, L/q ?o//S - -
sitepoc: C C . T
. ~ ~~ Ssrr\saQ7
State Approving Oficial signature:
.
a
A& -
24 Hour PhoneIFax #s:
w- -
Date: y/,ddsy
I t .
I

III. Action Request Review/Coordination WEMA USE ONLYl


- .-.-
Accept Reason Rejected: WOK ~evw by:

e p -
-
0 LogReViewby: C -i

Othw Coordinabon by:


Other Coordination by:
Other Coordination by:
kction request a #: 7 I ~ a t e / ~ i mAssigned:
e l~rnmediateAction Required: O Yes 0 NO
assiened to: 0 Other: I I

IV. Action Taken (FEMA USE ONLY)


" 0 0 Other (dewbe)
Mututal Aid DoMtions Requisition Procurement IntwagencyAgreement 3 Mislm&fgnment
Request IRea-A form (FF-0.1 (FF 40-3 attached) (attachARF to MA)
attached) (FF 40-1 attached)
Results: attached)

Dlspos~Qon: t - b . & e g b ; ) . ~ . + ' @ ~ r b A ~ & d4 ,6rC


~o5w A+ 0 r h r P $ ~ , - -
I(
f- .a ,,,,d J ~ QC
NEMIS Task ID: Estimated completion date: Cost estimate: U - Accountable Property
Coordinated with APO

TRACKING INFORMATION ( F E U USE ONLY)


Action Request # ( ~ k e i v e by
d (Nameand Organization):
--
Program Code/ Evenr #: /~rate: 1
DatelTime Submitted: 1 Orrgmted as verbal
*

Copy of Action Request Form- 1.As


-.
I ACTION REQUEST FORM
-
(,/A
,
dr. A
l
.,

/ Who L Requesting Assistance? (Completed by Requestor)


Rcquastor Name/Title/Statc: _Z_hsra ,'
It Permanent Phone/ Fax #: --
I -
E-mad:
Phone/ Fax #:
l~ern~orary

/
Action request a EsF #: mmediate Action Required: Yes 0 No
assigned to: a Other:
0 TaSldng under wsang MA # riphon of MA:
OFA Action Oificer: one/Fax #s:
FEMA Project Officer: (24 hour Phone/Fax #s:
Justification / Statement of Work:

NEMIS Task ID: Estimated completion date: Cast estimate: Accountable Property
Coordinated with AP(I

Copy of Action Request Form- 1x1s


eoo/zoo g
Ref: 1-tent1

Requestor Name/Title/State:

Permanent Phone/Fax,- a FAX(


-
ACTION REQUEST FORM

-
I. Who is Requesting Assistance? (Completed by Requestor)

Jessc St. Amant, Plaquemines Parish


Office of Emergency Preparedness
3m
Temporary PhoneJFax #:

Email: john.c.robertmdhs.mv
473
fax - 1

Requestor
Organization:
UState OEMAC UROC UEST U E R T - A o~/DFO
Plaquemines Parish Govt (viaPlaquemines Parish Lmson Team)
a-
Plalquemnes Pansh Pres
11. What Needs to be Done? (Completed by Requestor) a see
Description of Assistance Requested:

ORE tentcity base camp: Provide a base camp sufficient to support long term disaster workers b i t i n g to include FEMA, federal agency
workers. contractors, and emergency responders working within the Parish. Minimum time frame is 90 days. Facilities should include support for
500 disaster workers including showers. feeding kitchen, laundry,and biUetings (lodging). All self sustaining for initial setup capability, includmg
werator power, fuf:C
---
----m -
related support

Quantity 1 camp for_-500 people Priority: a


I ~ifesaving
t w sustaining
- .-
Date/Time Needed:
- -
0 3Hii 0 4 Medium -=Tekmal 19th of September 2005
Delivery Site Location: - ---

-
Adjacent to parish government building a t Belle Chasse Feny Landing approx 2 blocks from Highway 23 at Belle Chasse in
northern Plaquemines Par.

Site POC: 1. Chris Brassard, FEMA Liaison 24 Hour IJhone/Fax #s: cell*- FEMA office Belch 678-547-287;
l~dditonalContact: Jesse St. Amant, Office of Emergency Preparedness Director (Plaq Parish)
State Approving Otlicial signature: rte:

-
III. Action Reauest Review/Coordination IFEMA USE ONLYI
U Accept Reason Rejected:
0- 0 LogRevkwby:
0 ~~~~oordmatmnby:
0 mr~oonlinabonby:
CI Otherlzomdhhby:
Action request e*: 7 I~ate/~im
Assigned:
e Ilmmediate Action Required: Yes NO

a ~ ~ s k i n g m ~ d s t i #n g ~ ~ Short Description of MA-


--

OFA Action OfIicer: 24 hour Phone/Fax Us:


FEMA Project Officer: 24 hour Phone/Fax Us:
Justification / Statement of Work:
CAMP #I. Parish emergency workers and federal response (S recovery workers are now sleeping (k eating in austere conditions at
the high school at Belle Chasse. Parish government wants to release all Parish schools for restoration of school services. (Note: BUS
8b industries in Pansh may move out if schools are not restored).

I
Disposition:

-. --
NEMIS Task ID: Estimated completion date: Cost estimate: ~ccountaMePropertV
As Wf3f-4W-
~ ~ / , ~ w o ~ e n t ~ a m ~ s . x l s at 4:41 PM
Ref: 1-tent1
1

-
I. Who is Requestiag hiatance? (Completed by Requestor)
Requestor Name/Title/State: Temporary Phone/ Fax #:
Jesse S t Amant, Plaquemines Parish
. Office of Emergency Preparedness
Director, LA
Permanent Phone/Fax B- Axf Email:
john.c.robert@,dhs.gov

I.
Requestor
Organization:
O = CIEpAc q R c c 0 . m O F - A OfRTm O O F A
Plaquemmes Pansh Govt (ma Pktquenunes Parish Lmson Team)
_D-~ther
-- PhIquemines Pansh R e s
0
I
What Needs to be Done? (Completed by Requestor) see~uadled

IDescription of Assistance Requested:

ONE tent-city base camp: Provide a base camp sufliaent to support long term disaster workers billeting to include FElWl federal agency
I
workers, contractors, and emergency responders working within the Parish. Minimum time frame is 90 days. Facilities should include support for
500 disaster workers in-duding showers, feeding kitchen, laundry, and billetings (lodging). AU self sustaining for initial setup capability, including
generator power, fyelaf&elated support.
- - . .--
-- ---
6
--
-
d
El 2 ~ i f m
e ining
---
Quantity: 1 camp for-- !%I0 people Priority: a
I ufesaving Date/Tirne Needed:
-
0 4 ~edium
A

3Htgh -+&i~Normal 19th of September 2005


Delivery S ~ t eLocation: - .--
l~djacentto parish government building at Belle Chasse Ferry Landing approx 2 blocks from Highway 23 at Belle Chasse in I
Site POC: 1. Chris Brassard, FEMA Liaison 24 Hour Phone/Fax #s: *
'-lcel
Additonal Contact: Jesse S t Amant, Office of Emergency Preparedness Director (Plaq Parish; .
State Approving Oflicial signature: Date:
m. Action Request &vlevlCoordination ( F E U USE ONLY)
U Reason Rejected: u OPSRevlewby:
O~efed 0 Log-by:
m c o o d w n by:
a :yb-
0 OtherCoordlMtfonby:
Action request li( IP: 7 Date/Time Assigned: Immediate Action Required: Yes 0
assigned to: Ctkc

Tasklng Under Odstlng MA # Short Description of MA:


A

OFA Action Offtcer: 24 hour Phone1Fax #s:


FEMA Project Officer: 24 hour Phone/ Fax #s:
JustX~cation/ Statement of Work:
CAMP #l. Parish emergency workers and federal response 8a recovery workers are now sleeping & eating in austere conditions at
the hi&-' school at Belle Chasse. Parish government wants to release all Parish schools for restoration of school services. (Note: Bu
& industries in Parish may move out if schools are not restored).

IV. Action Taken (FEMAUSE OHLY)


Action I I I I I 1 1

I
Disposition:
U N C E&p.pl,~nJe-
L- o c Jj% f7C/
'>,IP*CL
NEMIS Task ID: Estimated completion date: ()&st estimate: El AaoowltabfePropwty

As i 3 @ E 3 j f 4 ~ Q # b . B o i
U ~ O 0
, o en
09/17/2005 13:45 FAX
.. '.
r i
ACTION REQUEST FORM ?
-
I. W h o is Requesting Assistance? (Completed by Requestor) -
-

I Requestor
Organization:
State u cmNL ,,
,; fi EST ERT-A ERTIDFO D OFA - Other
-
11. What Needs to be Done? (Completedby Requestor) 0 See Attached
-

-
Quantity: 10 act, Priority: Cl l Lifesaving 0 2 Ufe sustalFJog Date/Time Needed:
F
@ 3 Hlgh 4 Medrum ,5
; Normal -
Delivery Site Location: Ch-1 r?s.f?-er. P;ec
-
-
--
-
7

-
0 Other Coordination by:
-
Other Cwrdimation by:
-
Other foordmatlon by. -
Action request 3 7 *: Date/Time Assigned: Immediate Action Required: Yes No
assigned to: a Other: - -
3 Tasldng Under EusMng MA # Short Description of blA: -
OFA Action Officer: 24 bow Phone/Fax #s: -
FEMA Project Officer: 24 hour Phone/Fax #s: -
Justification / Statement of Work:

& PA.

-
IV. Action Taken (FEMA USE ONLY)
Action Mututal Aid Donattons a Requ~simn !J Procurement a lnteragenw Agreement &ion mgn-t 3 Other (dexnbe)
-
Request 1Reo-ACorm (FF 60-1
attached) 40-1 attached)
@T /FF 40-3 attached)
Results: attached)
I I 1 I 1 I -
Disposition:

-
NEMIS Task ID: Estimated completion date: Cost estimate: a Accountable Property
Coordinated with APO

k
TRACKING INFORMATION ( F E U USE ONLY)
Action Request # (~eceivedby (Name and Organization): -. -.
t'rograiil Ooc;c/tvent #: I state: ~ a t e / ~ ~ S;lwni
r n e tted: 1iJ ~r~y:r.a:ec'as vcioa,

As .of 91 l7/2OO5
Copy of Action Request Form- l.xls at 5:19 AM
I. W h o is Requesting Assistance? (Completed by Requestor)
Requestor Name/Title/State: Sf &+ ns cd l ~ e m ~ o r a Phone/Fax
ry #:
Permanent Phone/Fax #: if
-y E-mail:

I Requestor
Organization:
0 State EMAC ROC

11. What N e e d s to be Done? (Completed by Requestor)


EST ERT-A 0 ERTIDFO 0 OFA 0 Other

0 See Attached

(Priority: 1 Wesaving 0 2 Life s&Ining I~ate/~irn


Needed:
e
I a 3 High 4 Medium 5 Normal
Delivery Site Location:

. -

1 Other Coardinatbn by:


tion request ESF *: I~ate/TimeAssigned: l~mmediateAction Required: 0 Yes CI] No

IV. Action Taken (FEMA USE ONLY)


Action Mututal Aid 0 Donations Requisition Proulrement IntersgqAgreement 3 ~ i&signment
~ ~ Other
l (describe)
~ ~
Request IRea-A form (FF60-1
(FF40-1attached) (FF40-3attached) (attachARF to MA]
Results: attached) attached,
Disposition:
&weQ&,y 2 W ~ k b g L t z*S.

NEMIS Task ID: I Estimated completion date: I Cost estimate:


I I I Coordinated with APO

Copy of Action Request Form- 1.xls


% J" W@/7
I ACTION REQUEST FORM Pm-oo9i
I. Who is Requesting Assistance? (Completed by Requestor) -
p q u e s t o r Name/TiUelState: Scott Rouselle Temporary Phone/Fax #: --
Permanent Phone: 7 FAX #:
l~equestorOrganization:
- Plaquemine Parish OEP E-mail:
II. Requested Assistance (Completedby Requestor) -
l ~ e s c r i ~ t i oofnAssistance Requested:

1500 utility coveralls @33WT, 400 utility wk boots, 2,000heavy duty rubber gloves, 2,000 light wieght disposable cchemical
resistant suits, various sizes see attached for additional request information

-
Quantity: Priority: 0 1 ufesaving 2 Life sustaining Date/Time Needed:
see above 3 High 4 Medium 0 5 Normal
Delivery Site Location:
Plaquemine Parish - OEP, 107 Main Street, Belle Chase, LA 70037
(Perry Boat L a n d i t i i
Site POC:
&A. -
S C - ~ ~ o u s s e l lor
eJ f i o u r Phone: -!!~
-
State Approving Officidd&gnttture: w- -
1111. Sourcbq the Request -Ike&s&ootdination (Operations Section O d y )
O- 0Procurement
I
~ l h e(explain)
r Interagency Agreement
Other Coordination by: 0 Requisttions C] ~ ~ s s l oAssignment
n
other COOrdiMth by:
Other Coorchnabon by:

Immediate Action Required: U Yes NO Action request ESF #:


e/Time Assigned: I assigned to: Other:

lW Statement of Work (Operations Section Only)


JOFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
I~ustification/ Statement of Work:
Needed to support responders and Parish UtilityjPublic Works in response to Hurricane Katrina.

Estimated Cornpietion Date: I Cost Estimate:


V. Action Taken (OperationsSection Only)
o~aept
e d a~ejected 1 Atcountable Property
I~is~osition: I Coordinated with APO

Action Request # (~eceivedby (Name and Organization):


Program Code/Event #: State: I~ate/~im Submitted:
e I Originated as verbal

Plaq. utility coveralls DFA


U.S. Dcpartmcnt of Hornland Security See Reverse for Paperwork OMB No. 16604347
Federal Emergency Managanent Agency Diclosurt Notice Expires November 30,2007
Action Request
I. Who is Requesting Assistance? (Completed by Requestor)
Requestor Name/Title/State: St Tammany EOC Temporary PhonedFAX #.
-
Permanent Phone 4 FAX*
Requestor Organization S t Tammany EOC E-mail.
II. Requested Assistance (Completed by Requestor) See Attached
Dscnptlon of Asststance Raguated.
The Red Cross requests mobile office or trailer to be used as moblle clinic with office space

Quantity: 1- _ 0 1 Lifesaving
Priority: C] 2 Life sustaining Date/Time Needed:
-- ---
-
-;---- I8 3 High 4 Medium 0 5 Nonnal ASAP
~divay"Siteiti ion:
St TammanyEarish Office, Coop Drive, Mandevilla, LA ----
- -
--
- ..&--

Site POC: C h i Knbs


. . 24-hour phone:- 24-hourFAX #: .
State Aoorovim Officialsiwturc: -6 / 1 ,
Ill. Sourcing the ~ e q u e s tReviewICoordination
t (Operations Section Only)
~eview
by: 0 - /if -4y 0 Donations Procurement

Log Review by: Other (explain) 0 Interagency Agreement

Other Coordination by Requisitions Mission Assignment

Other Coordrnation by.


Other Coordination by:
Immediate Action Required: 1 [3 Yes No Action request 17 €SF#:
assigned to: Other:
IV: Statement of Work herations Section Onlv)
24- #: 24-hour-
FEMA Pmiect Officer 24-hour Phone #: 24-hour FAX #.
JustificatiodStatementof Work: -

Estimated Comaletion Date: Cost Estimate:


V: Action Taken fo~erationsSection Onlv)
Accepted
Disposition
0 Rejected a Accountable Propaty
Coordinated with APO

NEMIS Task ID: - - -- --- -- -- -

Action Requst #: I Received by (Name &Organization):


FEMA Form 90-136 Nov 04
I. W h o is Requesting Aseiatance? (Completed by Requestor)
. Requestor Name/Title/ State: Orleans Parish l ~ e r n ~ o rPhone/Fax
ar~ #: - -
Permanent Phone/Fax #: E-mail:
Requestor
Organization:
state a O EMAC G ROC EST Cl ERT-A C ERTIDFO OH r] Other-

11. What Needs to b e Dome? (Completed by Requestor) - U See Attached

Description of Assistance RCqucsted: Structural Assessment Team

Quantity: 0 2 tik sustaining Date/T~meNeeded:

.* -
-Delivery SiKb-ga:
. LA.
--
New Orleans Fire Department Headquarters
-
---I
Woodland and General Degaulle
New Orleans - --
Site POC: Chief BruceS/lartin _14
State Approving Oficial signature:
- .-.-
Date: /7 J@a C

(FEMA USE ONLY)


111. Action Request ~eview/~odrdinati'on

'
,&,,fit <? &&-4,Ltz.,
Ci Log Rwlew by. f
a Other Coordlnatlm by
O other Coordination by:
0 Other towdinatlon by:
7 Date/Time Assigned: Immediate Action Required: Yes 0 No

0 Tasking Under Wstlng MA# Short Description of MA:


OFA Action Officer: 24 hour Phone/Fax Us:
FEMA Project Officer: 24 hour Phone/Fax Us:
Justification / Statement of Work:
The Rre Chief of New Orleans is requesting a comprehensive structural assessment and report of all 34 firehouses. If found to be
structurally sound then complete environmental assessment and reme&ation ii necessary. Structural assessment is to Include
complete evahation of electrical, water, and gas utility systems.
- G-rr Co
, l= I\ p e 6 L &,&pjgla a -&Arc CLas-
, +c.rb 6ri:ct

u.e\, (C b-4 kG~e*;e- i, & : c-&.


i
IV. Action Taken (FEMA USE ONLY)
Action
Request
a
Mutotal Ald Donations 3 Requisition
(Req-A farm
Procurement '3 Interagency Agreement 7
J M~.~~ ~ ~ Other
~ (dwrlbe)
, ~
(FF60-1 (FF 40-1 attached) (PF 40-3 attached) (atteclr ARF to MA)
Results: attachedl nttachcd)

I
Disposition:

NEMIS Task ID: Estimated completion date: Cost estimate: a Accountable Property
Coordinated with APO
..
1.m n c w n r c . l v v p. m r. - rnyn.r,a ONLY\
--
.-.-.-. . -

Action Request ff l~eccivedby (Name and Organization):


Program Code/Event #:

Copy of Action Request Form- 1


0!?/20/2005 0 8 : 4 4 FAX @002/004
.' B13!4 8/2005 20: 32 504-865-0538 ELECTRIC SHOP PAGE 03

.. @-//'r3Ft> wc
OlUB No. 166WO-W
ACTION REQUEST FORM -ear November 30,2007
I. Who h Requesthg Aw&i&auce? (Completed by Raqueetor) -

qucstor Organization: j\lm


Requested Mststanoe W R e q u e u
- SeMsched

@2 ru~nlng I ~ a t e / ~ u nNeeded!
e
-
--- 1 @J3 nlgl~ 4Medhrm iNormal
!
~eliwry-

Immediate Achon Required 0yes No Action request a f3F P:


Date/Thc Awignsd: sssigned to: OMer:

N:Statement of Work (CBperatiane Section Only]


OFA Acdon Officlcr. 24 hour Phone: FAX#
- -

FEMA Projcct Officer; 14 hour Phove: FAX#


,Justification/ Statement of Work:

Pmgram CodeJEvent I : Istare:


FEMA F o m 90-136,NOV 04
ACTION REQUEST FORM f OMB NO. 1660-0047
Expdes November 30, 2007
11. Who is Requesting Assistance? (Completed by Requestor)
l ~ e ~ u e s t NarneJTitleJ
or State: MIKE DEQpwE Temporary PhoneJFax #: .-

-
IPermanent Phone: - \ FAX#: - -

Requestor Organization: T Z ~~ R / J
11. Requested Assistance (Completed by Requestor)
SA/ ~ f $ & t f @ / ~ E-mail:
s w e Attached

&;
I

Quantity: Prioriq: LI~MVI~~ 0 2 ~ f sustaining


e DateJTime Needed:
4 Medium 5 Normal S@ 2% WS/D 9a-1
' ~ e l i v eSite
r ~ Location: 5 00 p u tx&5 5 r-
-
-- - - ---
- H ~ H A ,LA 70-
-
& &

- -
Site POC:
-- A .
24 Hour ~hoF
n'-%
c.X- - -
State Approving ~fficial&n&re: -=-a& -- Date:S&U&y J as
(111. S9urcing the Request - ~e&w/~oordhation(Operations Section Only)

ate/Time Assigned: I assigned to: other


N: Statement of Work (Operations Section Only)
OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

Estimated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)
0- n~efeded (0 Acan~ntabkPro@y
3isposition: -- Coordinated with APO -
- --

~CAPS/NEMISTask ID:

P E W Form 90-136, HOV 04


I
- .
equestor Name/Title/State:

l ~ e r m a n e nPhone:
t
Requestor Organization:
- ACTION REQUEST FORM
I. W h o is Requesting Assistance? (Completedby Requestor)
City of Slidell

City of Side11
11. Requested Assistance (Completed by Requestor)
Description of Assistance Requested: 100 Pillows
Temporary Phone/ Fax #:

FAX #:
E-mail: -
1
(Interim draR t+ of 6/02

a see Attacbed

1 100 Cots -
I 100 Blankets

Quantity: 1OOeach Priority: 1wesaving 2 We sustai?lng Date/Time Needed:


a 3 High a 4 Medium 5 Nonnal
Delivery Site Location: EOC Airport
1325 Bayou Ln.
.. -. - ;aidell, La
-
-
&A.

Site POC: May-%%oms/~~~ 24 Hour Ph- FAX_ #


- *
-
State Approving Officids@nabure: - Date:
III. Sourcing the Request - ReviewICoordination (OperationsSection-Only)
OPS Review by: 0 Donations 0 Procurement
0 Log Review by: 0Other (explain) Interagency Agreement
[7 Other Coordination by: 0 Requisltionr [7 Mssion Assignment
Other Coordwation by
a other Coordination by:

Immediate Action Required: ye No Action request ESF #:


Date/Tirne Assigned: assigned to: Other:

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: ' FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:
To be used to house law enforcement personnel, essential for maintaining law and order.

Estimated Completion Date: 1 Cost Estimate:


V. Action Taken (OperationsSection Only)
0 Accepted Rejected 1 Accountable Propetty
Disposition: Coordinated with APO

Action Request # /Received by (Name and Organization):


Program CodejEvent #;
,
State: ] Datc/Time Submitted: 1 Orlglnated as verbal

Katrina: arf43.xls
1'

--
I. Who is Requesting ~ s s itame?

3
s
Requestor NarnclT~dclStarc: i .-EM

Permanent Phone:

Requestor Organirstion: pb
QU
ACTEON REQUEST FORM
(Completedby Requestor)

c5
1 ~ 6(CDL
s S ! M \ ~ L + ~ Temporary

11. Requested Assistance (Completed by Requestor)


,
A ) Phone/Fax

FAX #:
E-mail:
mc-3-40

-
0-

Y:
No. 1660-0047
Ewprics November 30,9007

El see &ached

'Action Request L Received by (Name and Organization):


Program CodeIEvent #: State: l ~ a t e / ~ i mSubmitted:
e
FEMA Form 90-136,NOV 04
. W h o is Requesting Assistance? ICompleted by Requestor)

krrnanent Phone:

tequcstor Organization:

)elivcry Site Location:--

site P O ~ :

f i t 5

2
LW
.\m a 5
-. -
v ~ Q
e mu
(h( el
I. Requested Assistance (Completed by
lescription or Asslstancc Requested-

-.
) ~ ~ city:
an
-gzz
-
--

;tate Approving Officlal signatur

~ e v l e wby:

-1 - ~eviewby:
Wher Cnordlnatbn by:

rnmcdiate Action Required:


3atelTime Assigned:
pevL
-

'6
,--.

--
1
L012h I ea=a.

11. Sourchg the ~ e ~ u e g f Review/Coordination


,,
(-
, //
-
- 2
,

U Yes

W: Statement of Work (OperationsSection O d y )


3FA Action Ofiicer:
W M A Project Olficerr
Justilication / Statement of Work:
,
C'bhorr7

Priority:

---

No
a
0 3 High
+
ACTION REQUEST FORM

Requestor)

1 ~caving
5-

24 Hour ~hon-

(Operations Section Only)

Action request
assigned to:

24 hour Phone:
24 hour Phone:
A 7 T4cue0

0
a
F a W:

E-mail:

a 2 tile sus(a~nhg
4 Medium

EK #:
Omer.
-
--
-L
E3C-340

5 Normal
.

FAX 1

FAX#
FAX#
-
-
OM8 No. 16600047
E ~ p r i e sNovember 30. 3007

- ,

OezC

Date:
a ~ee
Y Z ~LC;, . ~

Date/Ttme Needed:
Attached

cA-#+2& L
(L
&
,, t5c G- 8 - XkN"

Estimated Completion Date: 1 Cost Estimate: .


V. Action Taken (Operations Section Only)
Accepted 0 Rejected 1
0 Accauntabie Property

Disposition: Coordinated with A m

UQtn5

eCAPSjNEMIS Task ID:


Iction Request # l~eceivedby (Name and organization):
'ragram CodeiEvent #: Istate: I ~ a t e / ~ i r nSubmitted:
e

rEMA Form 90-136, NOV 04


I -,
Requestor Organvation c,T~&~.,'G //C-+f' s r OC E-mall
11. Requested Assistance (Completed by Requestor) 0 see Attack4

- A

site POC: &)GI / ! / @ X C & [ ~ ~ - R 24 Hoilr Phone: FAX #

State Approving Official signature: Date:


I

n a t i o n Section Only)
111. Sourcing the ~ e ~ ~ s $ ~ p i c w ~ ~ o o r d i(Operations
OPS Rev~ewby: T&&G
?&
,o~~&&&&
#, 0Donations a ~rocurement
./ - I
3 Log Revhew by. //
i/
Other (explain) 0Interagenw Agreement
0 Other Coordlnatron by [7 Reqwsillons 0 MtsSlon Assrgnment
0 Other Coordlnat~onby.
Other Loordlnation by

Irnmedlatc Action Required. U Yes 0 NO Actlon request n €SF a:


Date / T ~ m eAssigned.
"
ass~gnedto. a Other.

IV: Statement of Work (OperationsSection Only)


OFA Actmn Officer: 24 hour Phone: FAX #
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work.

st~rnatedCompletion Date: Cost Estimate:

V. Action Taken (Operations Section Only)


C] Accepted 0Rqected Accountable Prcperty
D~sposctlon APO
Cwrdmated w ~ t h

RACKING INFORMATION (FEMA USE ONLY): - '-:S$. . . . .L>.


b , -
6 - .;%<':-
eCAPS/NEMIS Task ID:
Received by (Name and Organzation]: / I

Program Code/Event #: State: I~ate/~irne


~ubmittedffl//& yz/&do 0 n ~ i ~ t e d
1
as verbal

FEMA Form 90-136, NOV 04


I ACTION REQUEST FORM No. 1660-0047
t Expries Nouember 30,2007
I. Who is Requesting Assistance? (Completed by Requestor)
bequestor Name/Title/ State:. -- ST-. L- dlRO 0\r"c Temporary Phone/Fax #:

Permanent Phone: - 1 FAX It:


\

Requestor Organizauon: 57. a m =T


' , E-mail:
...

I
11. Requested Assistance (Completedby Requestor) - 0 ~ e Attached
e

I
Description of Assistance Requested:
flc-ue

L
Quantity: Priority: 1 Ltfesavtng C] 2 L~fesustalnmg Date/Time Needed:
.- - \ - 3 Htgh 04 Medium 0 5 Normal
Delive~ySite J x ~ & ~ f i ~ ~ ,--
- xt72Nnab
xg
--

111. Sourcing the ~e~ue/Keview/~oordfnation (Operations Section Only)


Review by: 10DmUons C] Procurement
Log Review by: 0 Other (explain) InteragencyAgreement

Other Coordmation by: 0 Requisitions Misslon Assignment

Other Coordination by:

I Other Cmrdination by:

Immediate Action Required:


I ~ a t/e~ i r n eAssiened:
U Yes 0 No I ~ c t i o nrequest L
/ assimed to: C
IV:Statement of Work (Operations Section Only)
OFA Action Officer: 24 hour Phone:
FEMA Project Officer: 24 hour Phone:
Justification / Statement of Work:

Estimated Completion Date: ( Cost Estimate:


V. Action Taken (Operations Section Only)
[IIlAccepted a Rejected
L Coordinated with APO

TRACKING INFORMATION (FEMA USE ONLY)- ' L .- : 1


eCAPS/NEMIS Task ID.
- - - - - -- - -

A c t ~ o nRequest # P.ecelved by (Name ar.d 9rgani~;:i~ii)

r
Program CodeIEvent #. State: Date/Tme Subrn~tted. ( Onglnated as v e
--
FEMA Form 90-136.N O V 04
expdss ffovcncber 30.2007
I. Who is Requesting Assistance? [Completed by Requestor]
Rcqucstor ~ a m a / ~ i t l c , ' ~ * -1 . - - ~ ~ 0kT Temporary Phonc/Fax #:

p m a n e n t Phone: -\ $- FAX #:
-
Requestor Organization: I am E-mail:
11. Requested Assistance (Completed by Requestor) 0 see ~ t ~ h e d
Description of Assistance Requested:

State Approving Official signature: Date:

US. Sourcing the Request -&&w/~oordination (Operations Section Only)


, I
J

" -,A
0 Procurement
LW Revie* bv: 0Interagency Agreement
0 Mher Coordination by: 0 RequlslUons MIssIan Asslqnment
Other Coordlmlon by:
0 Other C m d b U o n by:

Immediate Action Required: UY e No Action request a S F D:


Date/Tirne Assigned: 1 assigned to: a Other:

W:Statement of Work (Operations Section Only)


OFA Action Oflicer: 24 hour Phone: -- --
FAX#
-- - -- -- -
1
FEMA Project Oflicer: 24 hour Phonc: FAX#
Justification 1 Statement o f Work:

Estimated Completion Date: Cost Estimate:


V. Action Taken (Operations Section Only)
0 Accepted 0 Re]med hccountaMe Prop-
Disposition: Coordioatcd w(h APO

:CAPS/NEMIS Task ID:


4ction Request (f l~eceivedby (Name and Organization).
'rogram Code/Evcnt 8: I~tate: I ~ a t e / ~ i mSubmitted:
e 10 Originated as verbal
-
%MA Form 90-136. NOV 04
Pqrmanent Phone: FAX #:
(L
Rquestor O~gankation: F@k#3 E-mail: --

U. Ruquertad Adataaee (Ocrmp1ete.dby Reqpestor) tl see~ttxhd

Pcscyiplion of Assisttmce Iicquestd: @ ~ , ~ , ~ . o o


Enginrering & conrrtructionsupprt U, pmvide, ctmtltnK~and/or repair critical public F a d i s t~ include edumtion,judicial, h v
miwc.crnml,fit?, billeting, corr&tional, governmental and Mhcr fecilitks aa directed by FEMA.{ F e c t d Optratiahs Suppurl)

Quantity: Rioriy: 1U t m l n g 0 2 ufe sustaining


Date/ T i e Needed:
8 3~igh a 4 w i m 0 s m d 9/7/2005

state Approving Official &nature: Date.

Coordmatcd with hPO

NEMlS Task 10:


;Actio~\Request # Received hy (Name and Urgaxzat~on):
Program Cnde/Event #: State: ] Date/Tlnie Submrtted.
I
Rcqucstor Nemc/Titlf-/State: Mickey Fountain, Tern Lotldar, LA Tempor-py Phonc/Fax H C

Site KK: Miokcy Fountain FA


State Apprcrving Officid aignatuw: Date:

0 Other Cordtnation by.


O
g ~Goardmtionby:

Imrne6iaie Action Required: U No &(ton rrqueet EK#:


DatejTimc Assigqed: I asmdt~: other: a
Stxtement ofWbtk (Opetationr. Seation Only)
OFA Action Oficar: 24 hour Phonc: FAXU
FEMA Rojeut Oflicxr
Justification / Statement of Work
24 hour Phone: FAX# -

A c t ~ o nRequw # IRr.cetveb by (Namc and Organi7ationJ:


Rogram Code/Kvent #: [state: I ~ a t e / ~ i mSubmitted:
e 1 (7 OPiqnated as verb
ARF # 1, 10,000,000
ACTION REQUEW' FORM (Tattrimaft
aa of 1/03j
t. Wba fa Requeetkrg wistanoe? (Completed by Raqru~rstar)
iequestot N&me/Title/Statc: Mickcy Fountain, T e r n Laadex, LA Tcmp~raryh u m / Fax I:
/
iequcstor Organization: @F#3 E-mail: I

U. Requested Auietanca (GempUbd by Raqueutar) 0 seewadled


3escription of Assistance Requested:

-
JUAHTER BOAT FUI?KESPONSE CRFW (Federal Operations Supporl] 1603-RR-LA-COE-MVD-10
~rnendmentNtqincrease
O of$4.2M.
&y ~ , W ~ , O Ototal
Juantity. Priority: 0 l u h n g 2 ~ i f wstalninp
e Datcfhrne Needed:
- -* 3 Hgh Cf 4ner~vm 0 S~m"al 9/7/2005
Dc1ivet-y Sits I
&=:

Stat12 Approving Ofticid signalure: Date:


tLI. Sourslag the Request - Review/Coordination ~Opmatlom86ctbn Only)

7 OtherCoor'n~ty:
7 wlffOoMdl*by:
CJ Otherfoordrmby:
mrnrdiatc:Action Required: yes NO
Uatc/Tirne &simcd
tV: Statemapt of Work (Operatiom Section Only)
DFA Action Officer: 24 hour Phone FAX#
i.'t:MA,Projcct Off~cer: 24 hour Phone: FAX#
Jusdficsuonf Stmment of Work.
I, , &LL-L
I ACTION REQUEST FORM (Interim draft as of 1/02
. Who is Requesting Assistance? (Completed by Requestor)
- - -- - --

Requestor Name/T~tle/State: Paul Krebs Temporary Phone/F A


-
Permanent Phone: F4X. # --- - -
Requestor Orgamzation: ESF #3 E-r -
-

111. Requested Assistance (Completed by Requestor) See Attached


( ~ e s c r i ~ t i of
o nAssistance Requested:
EMERGENCY POWER (Direct Federal Assistance) - 1603-DR-LA-COE-MVD-03Amendment 04 to change verbage on ammendment .
Ifrorn "purchase up to 50 generators" to "purchase up to 90 generators."
There is no change to the amount of the M~ssionasslghment.
Quantity: Prlorlty: 1 ~lfesavtng El 2 Life sustamg Date/Tlme Needed:
--*9i 3 High 4 Medurn 0 5 Normal 9/7/2005
A--

Delivery S ~ t eLocatipn?
J A directed
~ by FEMA

Site POC: Pete Navesb 24 Hour T


b
e
- .'AX #

State Approving Officid signature: Date:

111. Sourcing the Request - Review/Coordination (Operations Section Only)


OPSRevlewby: Donabons Procurement

a
1.09 Review by:
Other Coordination by:
~ c C Obl: O
a ~ ~ ~ ~
#
a
Other (explain)
RequbWns
Interagency Agreement
Mwon Ass~gnment

n Other toordinathn by: \

/ImmediateActlon Requtred: Yes No Action request ESF #:


DateJTime Assigned: I assigned to: mr:
1
TV: Statement of Work (Operations Section Only)
I
OFA Action Oflicer: 24 hour Phone: FAX#
I
FEMA Project Officer: 24 hour Phone: FAX# I
l~ustification/ Statement of Work: I

Estimated Completion Date: I Cost Estimate:


V. Action Taken.(Operations Section Only)
Accepted 0 Rejected fl Accountable Propetty
Disposition:
-- ...
. Coordinated with APO
- . $ : - ;

. -.1 .
,<-.
6. 5 ?
,

NEMIS Task ID:


Action Request # Received by (Name and Organization):
Program CodejEvent #: State: I~ate/'l'ime Submitted: ) [7 Orynated as verbal
i
l r r ~ ~ r w d i a Ar:liun
ic Rt.-rltirccl: Yr. n tj,
Acuon rccptcai ts+ a: I
l J / ~ i i I- 1 ; y/7,/cj- ~wai&18vd
lu: U 0th~~.

IV: Statcmcnt of Work (Operations Section only)


OF;\ Ac'rion O r f i ~ p ~ : '-'.'IIUJUI. P l ~ o n e : FAX I/
FEMtI F'u I J ~ : II )l'Iit:c:r
14 hour Phonc: FA S 1:
*li~!;r~i~~..:.~r:t,~r~ C-A1L6t.
S I ~ I I ~ I I I ~ I I I \I~,~,.I~: '7.J&(: .d1(:~(6$5 yo^;^,^ ',,,.CJ
,. L ~ - " r T / d l - ; 7&,~(;
2.A-
>; i7- /:Ti G.+I 6 2 0 L',v.J ILL 0~$ 7 1 ~c q 706~t K 5 7.dw3; d ~ w5,.,a--.~]-T~L!Ch~
C:d uJ,25- C f i r ' c u C b ~ ~ b ( . 1 1 12~ )i c) ( ~ T ~ Y ,,?J/$-(.TG,;7 (a>,-/e, ,
~ L L D ? 1.v / J d ~ ~ d ~ . ~ h ~ . ~ d ; ' p;,."J , dj-/c.j-.,j.Z.,C~
Y .
:
~J~~~ O f ( f . ~ ~ I<(-[ r c f ~ .c,~c ikrr o v c ~+ w ~ ~ ( - ~ , , +c,l , - r -.,.)? + ~
(- r C
L>;, L, ,xL , ,
f ' -/Lj ..jf.^r.& Td,y
p ~ ? ? i l wd Y C fo
/OCt
V - Action Taken (Operations Section o d y l
!J~cr.r,11.*1 Li icq:-x~c~l
UI:<~>~I:;II,I~~II:
n A~NUIIWIC Proyuty
l ' ~ ~ r w t l ~ ~willt
~ ; ~ AIV-)
twl
h p ( , ( y ~ j ( ~ ( i <,r~e(
-- icbtdc?'

I -
, -.,.:
IjyF;:l:3ii!<$>T",iyx$i?$3p'.
. \.._,.,.-;,,,,,,,..--...,--~,.:;!<~,"a
PP$j
ir;T,...,*
;.,... p
.. ,:. ..'- "':;::~~+~:>:;.
- e3-7;..2'"'''--.lij!:.'-:--+
... ,,,,.
fi5"'r3~;-~;~g~&&$&;Pi:jI;;~~;ijl<24iIS~g:+3i5;
=?, .
. :.<, .I. .-..:)..+."- .
. .... .....

Actiun Hc.qi~c:;iI/ I)? I N : I ~ Canrl


I?I:I.x:Iv~!~ . ~ ~ ~ ~ ~ ~ ~ l ~ ~ ~ ~ - l ~ ~ o l l ~ ~
PI o & ;url
~ Cutlc/Evc.rll Smrc:: ,
] ~.l;l~c:/'~.irnc$11 i~:nittcd:. 1W ~cqrtmrntia< vpfis~

FEMA t'orm 90-136,NOV 04


1
ACTION BEQUEST FORM (Interim draft as of 1/03]
. ' Who is Requesting Assistance?
equestor Name/Title/State:
(Completed by Requestor)
Mickey Fountam Temporary Phone/:
1
Permanent Ph( FAX #. --- I
Requestor Organization: ESF #3 E-mail:
--
11. Requested Assistance (Completed by Requestor) See Attached

Description of Assistance Requested:


Four 3OOKW generators.

Quantity: 4 Priority: 0 I ufesawng 0 2 we sustmng Date/Tme Needed:


03 nigh 4 Mcddum 0 5 Normal 9/9/200:
Debvery Slte h e : Harnrnond Municipal Airport, Hammond, LA, Emt 42 off 1- 12

Site POC: Steve Sansone 24 Hour Phc..,. FAX#

State Approving O f f i c d signature: Datc;

-
III. SymAng the Request ReviewJCoordination(Operations Section Only)

I" OPSReviewby:

0 Log Review by:


0 other cooranam by:
L
J
el---
A
oona~ons

o other (explain)
Procurement

IntefagewAgreement

C] Othw Coordlnatlonby:
Other Cwrdiition by:

Immediate Action Required: U Ye5 17 No Action request 0 €SF#:


Date/Tirne Assigned: I assigned to: 0 Other:
N: Statement of Work (Operations Section Only)
OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justificntion / Statement of Work:

-V.Estimated Completion Date:


Action Taken (Operations Gection Only)
Cost Estimate:

0 Accepted
~spmition:
Rejected
& m- doK & JFQ 0 Accauntable Properly
Cwrdmated w ~ t hAM
Pcrmanenr Phone: FAX . --- L
I
Rgludror Or&anitatios: FSF*3 Email& - -
II. Rcqlrested Assistance (Compfct-edOby Requestor) 0~ ~ Ie u
Dtsoription of Assistance Ucquested;
=GINtERING S CONSTRUCTION SUPPORT FCDR DEMOKT ( F e d 4 O p e d o n s Support) - 1603-DR-LA-COGMVD-
19
Amendment 01 t6 inirtasc by $10,000.000 totaJ&of $1 1M. --

m,
-~erlwby:

0
n
LogopRHiatey:
otlw-stonby.
Otwr(;aa&bl:
-*+
the Request - Mew/Cdmrdinabion ( O p e x a t J o ~SectEon
0 amstlirrw
Daha,ccer4m)
D~apl~trorn
~ Ody)
OfLulmm

ofl=nA=W-

R ower-rocisrlk
hamediareAction Reguirtd: a yes a Action mqucst n &SF s:
DatefTimc Assigned: a s p i ~ e d z o : C] Othg:

W: Statement of Work lOaeratioas &tion O d ~ 1 - - -


>FA kdon Ofiiier: 24 hour Phone: WCtr
%MA hojtct OAim: 24 hour Phonk: FAX#
Iqs*aticm / Statemcar-ofWork

Mmatcd CcmpIetion Datc: ] Cmr,5i%imat.e


I . Action Taken (Operations &&om Qk?y)
1-6 ~JWU~Q lo ~rcountabIePro~rhl
mus Task ID:
iaiM Request # jj~eceivedbz (Namnmnd Organizadon):
h g a m Code(Event 8: ]state: ) ~ a t e / T i i cSubmjtred:

ARF # l , 2,000,000
I ACTION REQUEST FORM
Exudes
-- -o m NO.
.- - - ..
November
. ....
1 660-004 7
- -0
-- 3 > 2007

. W h o is Requesting Assistance? (Completed by Requestor) me dw@257


keauestor NamelTitlelState: Mickev Fountain, USACE T e m p o r a ~Phone]
, FA #:
Permanent Phone: FAX #:
.I
Requestor Organization: E-mad:
11. Requested Assistance (Completed by Requestor) - See Attached

l ~ e s c r i ~ t i oofnAssistance Requested:

I
Need helicopter tomorrow 8 / 3 1/05 for transport of two (2) USACE personriel to inspect levees. Depart from LA EOC at 9:OOa

L
Quantity. Priority. 1 ufesavmg 2 m e sustain~ng Date/ im Needed:
- --
->
El 3 HQh 04 M e d m 5 Normal xA/L5- /W/N
Delivery Site L o c ' i t 5 n i / /
Iland a t LA EOC 8/31/05 in time for 9:OOarn departure.

-.
Site POC: 24 Hour Phone: FAX #
State Approving Official signature: Date:

0Interagency Agreement
0M~ss~onAsslgnrnent
Other Coordtnation by:
Other Coordmat~onby

]Action request U ESF #:


Date/Time Assigned: 1 assigned to: Other:

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
IFEMA Project Officer: 24 hour Phone:
Justification / Statement of Work:

~ s ~ ~ m a tComplct~on
ecl Date Cost Estimate
V. Action Taken (Operations Section Only)
~ccepted 0Rejected Accountable Property
D~sposlt~on Coordinatcd iclth APO

- - - - - - - - -

Actron Request # Received by (Name and Organlzat~on).


Program Code/Event #: State: I ~ a t c / ~ i msubmitted:
e g * / ~&sa$a Ongmated as verb1
I .

FEMA Form 90-136,NOV 04


ACTION REQUEST FORM (Interim draft as of 1/03,
I.
r
Who i s Requesting Assistance? (Completed by Requestor) m c b??"fw

FAX #:
Requestor Organlzatlon: ESF # 3 E-mad:
11. Requested Assistance (Completed by Requestor) see Attached
Descriptmn of Assistance Requested
TEMPORARY ROOFING (Direct Federal Assistar e) $75M (See attached )

Quant~ty 1 PIlorlty 1 Lifesaving 0 2 L~fesustalnmg Date/Time Needed


I
3 3 High 4 Medium 0 5 Normal

. -
Dellverq Site L o ~ a t m n ~ ~ D e c l a countles
red In Lou~sana.

Mickey Fountain 24 Hour Phone: FAX #

State Approvtng Offic~alsignature: , lG Date:

111. Sourcing t h e Request - Redew/Coordination (Operations Section Only)


0 Donatims 0 Procurement
0 other (explain) Interagency Agreement

0 Other CoordfnaUon by: 0 Requisitions a Misslon Assignment


Other CaordinaUon by:
Other Coordination by:

Immediate Action Required: I-) a No Acbon request ESF #:


Date/Time Assigned: assigned to: 0 Other:

N:Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justificatton / Statement of Work:

Estimated Completion Date: ( Cost Estimate:


V. Action Taken (Operations Section Only)
nAccepted Rejected Amontable hoperty
Disposition: Cmrdinated w ~ t hAPO

NEMlS Task ID:


Action Request # Received by (Nameand Organization):
Program Code/ Event #: . State: I~ate/~im Submitted:
e 9//&
I I
&/yd 0 Originated as ve&
I

ARF - Roofing - 75M


I ACTION REQUEST FORM (Interim draft as of 1 /03)i
. Who is Requesting A s s i s a n e? (Completed by Requestor) FA& odclk>?
Requestor Name/Title/State: Mickey Fountain

Permanent Phone:b- FAX #.

Requestor Organization: ESF #3 E-mail:


11. Requested Assistance (Completed by Requestor) See Attached
Description of Assistance Requested: ...
DEBRIS (Direct Federal Assistance).$l,500,000,000.00
(See attached Verbal Tasking)

Quantity: 1 Priority: 0 i Lifesaving 2 Life sustaining Date/Time Needed:


I
3 High 4 Medium 0 5 Normal
Dehvery Site Lqati63- Prlsendentally declared counties in Louisana.
<

Site POC: Mickey Fountain 24 Hour Phone: - FAX#

State Approving Official signature:

111. Sourcing the Request - Review/Coordination (Operations Section Only)


Date:
I
uc,- Donations Procurement

Log Review by:


J
0 Other (explafn) Ci Interagency Agreement
Other Coorciinatlon by: 0 Requlwtlons Misslon Assignment
other Coordinatlon by:
Other Coordination by:

Immediate Action Required: U Yes 0 No Action request 0 ESF X:


Date/Time Assigned: assigned to: Other:

Ilk Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of W o r k

Eshnated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)
0 Accepted a ~ejectei 10 Accountable Property

I
Disposition: Coordinated with APO

NEMlS Task ID: -


Action Request # Received by (Nameand Organization): I

Program Code/Event #: State: I~ate/~im


Submitted:
e $,$///afl 0 Originated as verbal
! I I r
ARF - Debris
ACTION REQUEST FORM (Interim draft as o f 1/03
I. Who is Requesting Assistance? (Completed by Requestor) foe &?-/77

Permanent Phone: - FAX #:

Requestor Organization: ESF #3 E-mail:


11. Requested Assistance (Completed by Requestor) - a See Attached
Uescr~ptionof Assistance Requested: -
Power (Direct Federal Assistance)- $10,000,000.00 (See attached Verbal Tasking)

I
Quantity:
I Priority: 0 1 Lifesaving
0 3 High a 4 Medlum
2 ,Life sustaining
' a 5 Normal IDate/Time Nccded:

I Dellvery Site L O L ~ D . ~ ~ $

Site POC: Mickey Fountain


Prisendentally declared counties in Louisana.

24 Hour Phone: - FAX#

State Approving Official signature: Date:

111. Sourcing the Request - Review/Coordination (OperationsSection Only)


El~onatims 0Procurement
Log Review by: 1
L -
L - 0Other (explain) l ]Interagency Agreement
a Other Cwrdlnation by: 0 Requisitions 0 Mlsslon Asstgnrnent
0 Other Coordination by:
0 Other Caordlnation by:
Immediate Action Required: U Yes No Action request €SF I:
DatejTime Assigned: assigned to: Mhec

W:Statement of Work (Operations Section Only)


FA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

Estimated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)
1 Q Accepted 0Rejected 0 Accountable Properly
~Dispositron: Coordinated with APO

i ~ c t i o nRequest # I~eceivedbv [Name and Organization):


ACTION REQUEST FORM (Interim draft as of 1/03
I. W h o is Requesting Assistance? (Completed by Requestor) fEoc ' 8 R - X b

FAX # : 225-925-750 1

Requestor Organlzat~on ESF#3 E-mail 19 )


11. Requested A'asistance (Completed by Requestor) See Attached

Lkscrlptlon of A m s t a n c e Requested
-

IREGIONAL ACTIVATION (Direct Federal Assistance) - L ~ ~ ~ - D R - L A - C O E Amendment


- M V ~ - O ~01 to increase by $1,000,000 total
of $!!M.
Quantity: Priority: 1 Ufesaving 0 2 Life sustaining Date/Time Needed:
I
3 3 High 4 Medium , 5 Normal 9/4/200
l ~ c l i v Site
e ~ Locatio?
-. .-

S ~ t ePOC' M~ckeyFountam

State Approving Official signature: Date:

111. Sourcing the Request - Review/Coordination (OperationsSection Only)


MS
Review by:
// '&-
0 ~anatlons 0~ m m e n t
/
~ o Revlew
g by: 0Other (explain) C] Interageno/ Agreement
C] Other Coordlnat~onby: 0 Requlsctlons Mission Assignment
Other Coordlnatlon by:
Other Coordmatm by.

irnrnedlate Achon Required: Yes No Action request ESF #:


Date/Time Assigned: assigned to: Other:

N.Statement of Work (Operations Section Only)


O F A Act~onOfficer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#

Est~rnatedComplet~onDate: Cost Est~rnate.


V. Action Taken (Operations Section Only)
Accepted Rejected Accountable Pmperty
Disposltlon: Coordinated with APO

.NEMIS Task ID:


l ~ c t i o nRequest # l~eceivedbv (Name and Or~anizationl:
e o g r a m Code/ Event #: State: I~ a t e l ' r i m eSubmitted: I Originated as verb

AFU? #2,1,000,000
i
I
536
I ' ACTION REQUEST FORM (Interim draft as of 1/03)
W h o is Requesting Assistance? (Completed by Requestor) Goc . ;f(> .. && <a
xluc~tcrtN;irni=/'l'~~lr/Stittc.: Mickey Fountain, Team Leader, LA 'rc~npoii11y l'lionr/ F;lx tt
I

q u e s t o r Organ~zat~on: ESF#.? E-mad r


[. Requested Assistance (Completed by Requestor) - See Attached
escrlptlon of Assrstance Requested. $2OO,O0O,OOO.O0 -

ngineering & construction support to provide, construct and/or repair critical public facilities to include education, judicial, la&
for cement, fire, billeting, correctional, governmental and other facilities a s directed bv FEMA. (Federal Operations Support]

uantrty. PI IOrltY: a 1 L~fesavrng 0 2 ~ t f esusta~n~ng IIate/'l'rm~Needed:


3 Hlgh 4 Med~urn 5 Normal 9/7/200!
elivery Site 1 , o c g t i ~ 6 ~
e

~ t POC.
e MI( key Fountmn 24 Hour ~hon- FAX # - ' l )

tate Approving Official signature: Dale:

[I. Sourcing the Request - Review/Coordination (Operations Section Only)


, ,. 1

0 ona at ions hocurernent'


-
:.,+A;

1 ~og
Rev~ewby: Other (explam) Interagenq Agreement
1 Other Coordrnabon by: Requisibons El ~ m o %srgnment
n
1 Other Cmdrnatron by:
1 Other Coordination by:

nmediate Action Required: 0 Yes NO Action request 0 EY #:

atefl~rnt-Ass~gned: I assigned to: a Other:

V: Statement of Work (OperationsSection Only)


F A Action Officer: 24 hour Phone: FAX#
EMA Project Officer: 24 hour Phone: FAX#
ustification / Statement of Work:

ktimated Complet~onDate: I Cost Estimate:


r. Action Taken (Operations Section Only)
3 Accepted Relected Accountable Property
)isposlt~on: Coordinated w ~ t hAPO

JEMIS Task ID:


ictlon Request # Received by (Name and Organrzation):
'rogram Code/ bvent #. State: (~ate/~im
Subrnltted:
e ,

M A Pub Fac, 200,000,000


L'c,

-
cl 33 1
1 ACTICNV REQWEST FORM (Interim draft as of 1/03}1
I. Who la Requesting Assistance? (Cbmpleted by Rasquestod
rrprsror Narne/l'~tlc/Srate M~ckeyFounttam, Tcam Leadcr. I I A Temporary Phone/ Fax #
I
Permanent P h o n ~ FAX B . -----..IIc!
Requestor Orga~uzat~on ESPItR E-mall: .--- .'I
11. Requested Assistance (Completedii by Requestor) El see 4mached
Drxr~prronof Ass~stancrRcqurstrd
EKGINEERING Rc CONSTRUCTION SUPPOWT FQ)R DEMORT (Federd Oprrat~onsSupport) - 1603-DR LA COE M V D 19
.4mcndrncnt 01 to lncrcnse by 510,000,000 totall of $1 1M

Quantity: , IPrinritv: a Mesaving 0 2 life sustaining r)nte/Time Needed:


a QI ~ l u m a5 Normal 9/7/200

Site POC: Mrckey Fountam 24 Hour Phonn: FAX # \ h


State Approving OffiiaI sagnature: - Date:
I

I
0 Otlw Coordination by:
0 Other Ccordinaton Oy:

Imniediate Action Required: 0 Yes fl Acuonmquest a ESf 3:


Date/Tirne Assigned: 1 a-siegncd to: other:

W : Statement of Work (OperationsSeactton Only)


OFA Actaon Ofiicer. 24 hour Phone: FAXI
FEMA Project Onicer: 24 hour Phone: FAX#
Justification / Statement of Work-

Est~matedCompletion Date: 1 ~ost;~stimate:


V. Action Taken (OperationsSection U b d y )
u~cceobed ORe~eacd
Cmd~aatedulth APO

NEMlS Task ID:


Action Request # f k u i v e d by (Name:md Organization):
I
Program Code/Event #i: #state: I~ate/~im e
Submitted: 117 Ortghaads-d
ARF # I , 10,000,000
_/--,

-
1 ACTION REQUEST FORM (Interim draft as of 1 / 03)
b. Who is R c q u e s t h ~Assistance? ICcnmpleted by Re~questor) 1
FAX #:

Kcquestox Organimban: SF13


11. Requested Assistance (Completed b y Requestor)
l ~ e s c r ~ ~ t of
i o Assistance
n Requested:

IQUARTER BOAT FOR RESPOKSE CREW (Fedrrakl Ope,eratjonuSuppart) - 1603-DR-LA-COE-MVD-


10 Amendment 02 to increase

State Approvmg Official s i g n a t u ~ c Datc:

III. SourgAng the Request - Review/Cooordinatio~(qPanatbns Sectism Onty)


D-J&~- by RL%-- .-A- Uo~na~ D ~ocurement
O laguewtv
' /-+
[TJ~thermmdaHl) 13 rnterasency ~ g r e e r n r n
0thercoordhatm by Req-s MkslMl ASSlg-t

O OUW-~UO~W:
0 ~ ~Cmlnatton
e r by:

Immediate Action Required: a Ye5 0 NO Act~onrntqumt fl MS:


Datc/Time Assigned: I assigpled to: 0 Qther:

IV: Statement of Work (Operations Seclrt3on Only)


OFA Action Oflicer: 24 hour Phone: FAX#

EstimatedCompletion Date. 1 ~osmstimate:


V. Action Taken (Opttatfons Section Q)nly)
I ?
r

Action Request it )t~cceivcdby (Nameand Org~nization):


Program Code/Event U : I{~tatc: I~atef~im c
Submitted: 10 ~edasvefti

A R F #1, 2,000,000
. . ACTION REQWEST FORM llntctim draft as of 1/03d

t.'sc;mi~r.mlC'nmpJcJnrr L);tit-: 1 ~ ~ K Y.SI;IMAII?:


J I

V. Action Taken (Oprations Section €Only)


---
..

-
'I

ACTION REQUEST FORM (Interim draft as of 1/03)


I. Who is Requesting Assistance? (Completed by Requestor)
1
Requestor Narne/Title/Statc: Mickey Fountan 1-4
Temporary PhoncIFax

Permanent Phonc. - FAX #:


Requestor Organization: ESF #3 E-mail:
a
-
[I. Requested Assistance (Completed by Requestor) See Attached
Description of Assistance Requested: 2YP''E~~-'E
, Ff.rf.) Fop
~ r m 3r 0 0 m generators- c 6 r- f e e s
s.5+-44.?. ,, +- opI "
f

Ouantitv: 4 I~rioritv: - I ~esavlno a 2 Ufe sustaining I~ate/~im


Needed:
e
- -i I a 3 HIgb 4 Medkmm 0 5 Nwmal
I 9/9/200t
Delivery Site = a s : Hammond Mumcipal Airport, Hammond, LA, E d t 42 off 1-12

Steve Sansone , 24 Hour Phon b A. PAS#

State Approving Oficial signature: Date.

tion (Operations Section Only)


I
0 00natbns 0 ~murement
other (expiah) Interagency Agreement

I
0 Other CoordlnatkJn W :

I
Immcdiate Action
Datc/Time Assigned:
-
Action rcqucst
1 assigned to:
[7 €9SFC:
0 other:

:Statement of Work (OperationsSection Only)


OFA Action Officer: 24 hour Phone: FAX#
-

FEMA Project Officer: 24 hour Phone: FAX#


Justificntion / Statement of Work

Estimated Completion Date: 1 Cost Estimate:


V. Action Taken (OperationsSection Only)
Onccepted OR=-d krmnteble~r*

Coordinated wth APO

- --- -- In.
INEMIS- Task --
l~eccivcdby (Name and Organization):
Program CodeJEvent #: Jstate: I~atel~im e
Submitted: - 10 Odglnated as verw

ARF - Power 1OM


Who is Requesting Assistance? (Completed by Requestor)

emanent Phonc FAX #.


equestor Organization. ESF #3 E-mail:
I. Requested Assistance [Completed by Requestor) - See Attached

)escripoon of Assistance Requested: eFForf-,


bur XJOW generators. I. e r w 6 rq f B k -f~.
~ ~ ~ ~ ~ f ~0 ~, f-5 *n ~~~ * * c' c n V J * ~ ~
I

luantlty- 4 Pnonty: I Ufesav(ng DateITime Needed:


9/9/200
)ellvery S~te_Loca_t:
-i

Steve Sansone

Date.

N: Statement of Work (Operations Section Only)


3FA Action Officcr: 24 hour Phone: FAX# - -

:EM/\Project Oficer: 24 hour Phone: FAX#


JusWicntion / Statement of Work:

Estimated Completion Date: 1 Cost Estimate:


V. Action Taken (Operations Section Only)
- -

OWepted 0 Rejected
Disposition: Coordinated with APO

NEMlS Task ID:


Action Request # Rcccivcd by (Name and Organization):
Program Code/Event t : State: l ~ a t e / ~ i mSubmitted:
e

ARF - Power 10M


I.
-afl.3
rd;2% .V

- ACTION REQUEST
Who is Requesting Assistance? lcorn~letedbv Reauestorl
- FORM

Requestor Name/Title/State: Tom Porter / ESF #3 Team Leader / Mississippi Temporary Phone/Fax 703%6$%-7427

Permanent Phone: ,

Description of Assistance Requested:


AMENDMENT # 2 for MISSION ASSIGNMENT 1604-DR-MS-COE-MVD-15(TechnicalAssistance)
BY INCREASING FUNDING BY $730,000.00. CUMULATIVE TOTAL :$lM.
-
AMEND COMPLETlON DATE TO
FAX -
NOVEMBER30,2005.
-
Quantity: Priority: I ufesavlng 2 ufe sustaining
1 a 3 Hlgh 4 Med~wn 5 Normd
Delivery Site Location:
Various locations throq&e-ut the State of Mississippi c
-- - 6

FEMA will assign all requEd actions through the use of Mission Specification Forms. -
Site POC: William Brown 24 Hour Phone: FAX # -
State Approving Official signature Date:
-
III.$3ourcing the Reqyest rReview~Coordination
O K Revlew by:
(OperationsSection Only)
0oombons procurement
-
0 Lag Rewewby: / @ m(scplain) 0In-3WW m t
0 Other coordlnabon by: C RequsOons MI& Aa~gnment
0 Other toord~mtmby:
Other Coordinabon by:
f -
Immediate Action Required: Ld yes No Action request €SF#:
Date/Time Assigned: 1 assigned to: Other:
-
IV: Statement of Work lomerations Section Onlvl

-- .
I

OFA Action Officer:


-. I 24 hour Phone: FAX# -
FEMA Project Officer: 've b4+
,
24 hour Phone: FAX# -
Justification / Statement of Work

Provide technical assistance to the State of Mississippi and /or local jurisdictions to aid in the

accomplishment of priority missions, as directed by FEMA.

Estimated Complehon Date:


v
30-Nov-05 I Cost Estimate: $730,000
V. Action Taken (Operations Section Only)
0Accepted (a Rejected ~ccwn~ehopecty
Disposition: Coordinated anth APO

e\k J
TR#CKING IIOFORMATIOBI(FEMA USE ORLY)
NEMIS Task ID:
Action Request # Received by (Name and Organization):
Program Code/ Event # :
L
State: I ate / ~ i m eSubmitted: 1 ~ r ~ ~astV e ~d ~ I

,Y
TFCH A C q T AMli'Nn 3
08/30/2005 1 1 : 2 0 FAX
I

ACTION REQUEST F ~ R M OMII NO. J 660,004 7


-r 4 s 7 mpr1c.r Ivozwnbi?r 30, 2007

11. Requested Assistance (Completed by Requestor) - L_I sw AII~CII~~

Ut::icription 01 hss.:i~:mlic':ttRcquC!:rctl~

111. Sourcing the Reqncst - Rcyiew~Coordination(Operations Section Only]


]M Up< RNICI* by: $f,&,& r ononiolv, i-JP ~ ~ , ~ ~ ~ ~ ~ ~ . ~ ~

I I
f h t c f'l'imc A...:!siji;~wd: ;l::::i~ncd r,o: C: Wlw:

IV: Statement of Work (Operations Section Only)

-V. Action Taken (Operations Section Only) I


E:iti~rr:.~~c!cl (:cr~~jplctiotiDale: ~s
CI.I:<~ ~ixnie:

I:[ ~cccplcd ltcirx:(xi I!,-1 A ~ C O l I ~ ~ : ~ l~J,O(Wli)'


~h!
-
-
ACTION REQUEST FORM (Interim draft as of 1/03)
--

[I. m o is Requesting Assistance? (Completed by Requestor) -

Requestor Name/Title/State: Paul Krebs Temporary Phone/ Fax #:

Permanent Phone:
-
FAX#:
Requestor Organization: ESP #3 E-mad. J -R , -

11. Requested Assistance (Completedby Requestor) see ~ttached


-.
Description of Assistance Requested:
l ~ e c h n i c aAssistance
l (Direct Federal Assistance) - 1603-DR-LA-COE-MVD-09Amendment 01 & c r e a s e by $800,000 totd of $1M.
e increase in mission requirements to launch a management team to locate a site for RFO and to provide
l ~ u to
8 parrish liaison oflicers
Quantity: Priority: 0 I L~fesaving 0 2 Me susta~nmg Date/Time Needed:
fl 3 High 4 Medium 5 Normal 1 8/30/2005
Delivery Site Location: -
-
- 9.

t
Baton Rouge, LA 1.Z= Z
I
Site POC: Kerri Stark 24 Hour Phone: FAX #
-
State Approving Official signature: Date:

111. Sourcing the Request - Review/Coordination (Operations Section Only) 1


OPS~evieviby: f h ubw Donations 0 Rocu~ment
0 ~ o ~evlew
g by: 0 W r (explain) 0 InteragencyAgreement
Other Coordination by: ~equtsttiom a M~sslonAsagnrnent
a Other Coordination by:
Other Coordrnabon by:

Imrnedmte Actmn Requ~red: yes No Action request €SF #:


Date/Time Assigned: assigned to: Other:

Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA FToject Officer: 24 hour Phone: FAX#
Jushfication / Statement of Work:

Estimated Complehon Date: I Cost Estimate: '

V. Action Taken (Operations Section Only)


Accepted Relected a Accountable Property
Disposition: Coordinated wth APO

- -- -
l ~ c t i o nRequest # l~eceivedbv (Name and Oreanizationl: -- - -

1 rowa am Code /Event # : )state: ID&


l ~ i m Submitted:
e 1 n ae;td0ir as verbal
ACTION REQUEST FORM (Interim draft as of 1/03;
I. Who is Requesting Assistance? (Completed by Requestor)
Requestor Narne/Tltle/State:

Permanent Phone:
Paul Krebs /a Tcrnporaq Phone/F-ax -# - \

FAX #: - f

I Description of Assistance Requested:


REGIONAL ACTIVATION (Direct Federal Assistance) - 1603-DR-LA-COE-MVD-01Amendment 01 to increase by $800,000

Quant~ty: Pnorlty: 1 Lifesaving 0 2 ufe sustaining Date/Time Needed:


3 High 4 Medium 5 Normal 8/30/200:
Delivery Site Location:
- -. -----
-.
-r

Site POC: Kerri Stark FA:


-7

State Approving Offlcii signature: Date:


."
111. Sourcing the Request - Review/Coordination (Operations Section Only)
f?f OPS R e w w by: r ) ? d bMm , Donabons Prncurement

~ o ~g e v ~ eby:
w Other (explain) Interagency Agreement
Other Ccord~natbnby: 0 Requisitions Mmon Assignment
omer Cwrdination by:
Other Coordination by:
-
Immediate Action Required: 0 Yes No Action request ESF #:
Date/Time Assigned: I assigned to: Other:

TV: Statement of Work (Operations Section Only)


FA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
(~ustification/ Statement of Work:

Estimated Completion Date: I Cost Estimate:


V. Action Taken (OperationsSection Only]
Accepted Rejected Accountable Propem
Disposition: Coordinated anth AW

Action Request # Received by (Name and Organization):


Program Code/Event #: State: l~ate/~im
Submitted:
e I aOriginated as verbal
-
I ACTION REQUEST FORM (Interim draft as of 1/03]
. Who is Requesting Assistance? (Completed by Requestor) &&c bk?jw 1
Permanent Phone. FAX ti.
-.

TEIvIPOTWRY ROOFING (Direct. Fcdcral A s s i s r x eel $75M (See attached ]

Quantity 'I Pr~or~ty' D 1 L~fesavmq I


3 2 ~ l f esustarning D a t e / T m x Needed.
rn 3 High a 4 Medlurn 0 5 Normal
Deliveq S ~ t he & t G Declared countles in Louisana.

Site POC: Mlckey Fountain 24 Hour Phone: A. . FAX #

S t a t e Approving Official signature: 7-


0 id> Date:

111. Sourcing t h e Request - Review/Coordination (Operations Section Only)


DonaUons Procurement

~ o ~ge v i e wby: / 0Other (explain) 0Interagency Agreement


0 Olher Cwrdlnatlon by: Requisitions Mission Assignment
0 Other Coordtnation by;

0 Other Coordination by:

Immediate Action Required: 0 Yes 0 No Action request C ESF f:

D a t e / T ~ m eAssigned: assimed to. 0 other:

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer; 24 hour Phone: FAX#
Justification / Statement of Work:

timated Completion Date: Cost Estimate:


Action Taken (Operations Section Only)
a Accepted 0 Rejected Accountable Property
Disposition: Coordinated with APO

INEMS Task
- In: -

Action Request # Received by (Name and Organization):


Program Code/Evcnt #: Statc: I~atc/TxncSubmitted: 9//D9
r I
& T , ~ oOnglnated as verb
I

ARF - Roofing - 75M


MFR for Verbal Tasking

Memorandum for Record

SUBJECT: FEMG Verbal Tasking

1. On 1 Septe~nber2005, verbal tasking authority for the following mission assignment


has been ordered by Wayne Fairley at FEMA Region VI for the U S . A m y Corps of

Mmsion.: Temporary Roofing

Tasking: Provide temporary roofing support, as directed by-FEMA. Implement


the Advanced Contracting Initiative (ACI), other contracting processes or other sources
to provide temporary r o o h g . Coordinate the roofing activities of all organizations
performing portions of this roofing mission (e.g. National Guard and voluntary
organizations). This may include supplies, equipment, materials, and logistics support
necessary to provide temporary roofing to homes, hospitals, public facilities, and other
structures (real estate support necessary for Rights of Entry and leasing authorization may
be necessary). Orders for roofing quality plastic sheeting will be placed through or by
FEh4A Logistics.

FEMA Program Code; 1603-DR

Mission Assignment Number: COE -MVD-05

Event and Name Description: Ilumcane Katrina

Disastm State (2 letter designation): LA

Estimated Completion Date: 3 December 2005

U7CI,
w a tF
- d y b ,
FEMA Approving Official u.s.%~ Corps of Engineers
-
. . - .
I ACTION REQUEST FORM (Interim draft as of 1/03]
. Who is Requesting Assistance? (Completedby Requestor)
Requestor Name/Tltle/State: Charhe Tobln/ESF#3 ATLjLA Temporary Phone/ - *

Permanent Phone: FAX #.

Requestor Organizat~on: ESF 113 E-mm1:FEMA-KG-ROC-ESF3


11. Requested Assistance (Completed by Requestor)
,
. - a See Attached'
Description of Assistance Requested:
TEMPORARY ROOFING (Direct Federal Assistance)- $75,000,000. ($75M)Scope of work on attached sheet.
Ammend Mission Assigment (MA) li 1603DR-LA-COE-MVD-05,dated 8 / 3 0 / 2005, action request # 1509-31859

Quantity: hority: I ~ifesavmg a 2 L~fesustamng Date/Time Needed:


3 High 4 Medium 5 Normal As Soon As Poss~ble
Dellvery Site ~ocaack?$he Greater New Orleans metropolitan area and Southeast Louisiana
--

Site POC: Mickey Fountain 24 Hour Phone: 251-802-0551 -. FAX # 225-925-7501

Slate Approving Official signature: Date:

111. Sourcing the Request - Review/Coordination (OperationsSection Only)


. 17mations Procurement

Other (explain) Interagency Agreement


0 Other Coord~nationby: 0Requisitions Missron Ass~gnment
Other Coordination by:
0 Other Coordinaton by:
. t

1 C 0
lrnmediate Action Required:
Date/Tirne Ass~gned:
Y
NO
IAction request
assigned to:
€SF #:
Other:

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

Estlrnated Complet~onDate:
V. Action Taken (Operations Section Only)

[TRB-G rWPoRadATIQN (FEMA USE ONLY)


b E -Mv'Q-05
Cost Estimate.

7f;:o00,oo0.a-
.cis d 5 0 L h
& Akd
k u
- Accountable Property
Coordmated w ~ t hAPO

NEMIS Task ID: f f

Action Request # Received by (Name and Organization):


Program Code/ Event #: State: jDate/Time Submitted:
09/01/2005 1 8 : 3 2 FAX

R'IFR for Verbal Taskiug

Memorancluxn for Record -


SUBJECT: FEh4A Verbal Tasking

1. On 1 September 2005, verbal tasking authority for the following mission assigmerit
has been ordered by Wayne Fairley at FEMA Region VI for the U.S. Army Corps of
- :. W-n e e r s . f *.

Mission: Temporary Roofing

Taskin Provide t e m p m y roofing support, as directed b y FEMA. Implement


-+!?
the Advance ontracting Initiative (ACI), other contracting processes or other sources
to provide tenlporary roofing. Coordinate the roofmg activities of all organizations
performing portions of this roofing mission (e-g. National Guard and voluntary
organizations). This may inclnde supplies, equipment, materials, and logistics support
necessary to provide temporary roofing to homes, hospitals, public facilities, and other
structures (real estate support necessary for Rights of Entry and leasing authorization may
be necessary). Orders for roofing quality plastic sheeting will be placed through or by,
FEMA Logistics.

FEMA Program Code: 1603-DR

Mission Assignment Number: COE -MW-05

Event and Name Description: H~micaneKatrina

Disaster State (2 letter designation): LA

Estimated Completion Date: 3 December 2005

-7z=T/=
waheF A - \
FEMA Approving Official ~ . ~ . - k Carps
&m~ of Engineers
A

I ACTION REQUEST FORM (Interim draft a s of 1/03)

11.
Who is Requesting Assistance? (Completed by Requestor) 1
Requestor Name/Title/ State: Charlie Tobin/ ESF#3 ATL/LA Temporary phone/
, - - F

I ~ e r r n a n r n Phone:
t
Requestor Organization:
4
'-
ESF #3
FAX #:

E-~~II:FEMA-R~-ROC-ESF~
I
11. Reauested Assistance lComoleted bv Recruestorl-
See Attached
Descripuon of Assistance Requested:
DEBRIS (Direct Federal Assistance)- $1,500,000,000. ( $ 1 3 3 ) Scope of work on attached sheet. -

I Ammend Mission Assigment (MA) ff1603DR-LA-COE-MVD-07,dated 8/30/2005, action request #1509-31863

Quantity: Pnonty: lhfesawng 0 2 Life sustalning Date/T~meNeeded:


3 High 0 4 Medtum 0 5 Normal As Soon As Possible

-
Delivery Site Location: The Greater New Orleans metropolitan area and Southeast Louisiana
. - 9.
* A . -.
-r
--
--

S ~ t POC:
e Mickey Fountain 24 Hour Phone: FAX -# a
. .
State Approving Official signature: Date:

In. Sourcing the Request - Review/Coordination (Operations Section Only)


5 OPS Review by: Donations ~rocurernent
Log Revlew by: Cj Other (explain) 0Interagency Agreement
0&er Coordination by: Requisitims 0Mission Assignment
Other Coordination by:
C] Other Coordination by:

Immediate Action Required: Yes C] No Action request 0 EK #:


Date/Time Assigned: assigned to: Other:

N:Statement of Work (OperationsSection Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

Action Request # Received by (Name and Organization):


Program Code/ Event # : State: I~ate/~im
Submitted:
e - 1 Origmated as verbal

ARF AM 1
ACTION REQUEST FORM (Interim draft as of 1/03)
. Who i s Requesting Assistance? [Completed by Requestor) F R , ~L2&*K??
Tempo1 -xy Phorx/Fa;

Prrmanent Phone: FAX t?.


Requestur- Orqamzat~on. ESF # 3 E-inml
PI. Requested Assistance (Completed by Requestor) - a See Attached
Description of Assistance Requested:
DEBRIS (Direct Federal Assistance ).$1,500,000,000.00 (See attached Verbal 'Tasking)

Quant~ty 1 Pnon@ 1 ~~fesavlng 2 ~ ~sw~atnicg


f e Date/Txtne Needed:
a3 Hlgh 4 Medium G 5 Normal

Dehvery Site L o c a t e : Pi~sendentallydeclared counties in Lou~sana.


e

Mickey Fountain 24 Hour Phone:

(state Approving Official signature: Date:

111. Sourcing the Request - Review/Coordination (Operations Section Only)


J
\ - ~onationi Procurement

0 Log Revlew b y Other (explain) Interagency Agreement


0 Other Coordinatron bq: Requis~tions C! Mission Assignment
0 Other Cwrdination by.
0 Other Coordination by

Imrned~nteActlon Requ~red. U Yes [7 No AcL~onrequest a ESF #:


Assigned:
I~ate/~irn e I assigned to: Other:

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#

Estimated Completion Date: Cost Estimate:


V. Action Taken (Operations Section Only)
0Accepted Rejected lo Accountable Pmperty
Disposition: Coordinated with APO

Acixon Request # by (Name and Organization]:


[~eceived
Program Code/Event #: /state: I~ate/~im e
Submitted: Y//&$ 9udBJ
f D r
Onglnared as vetba

ARF - Debris
ACTION REQUEST FORM (interim draft as of 1/03)
I. Who is Requesting Assistance? (Completed by Requestor)

Requestor Name/Title/State: Mickey Fountam Temporary Phone/Fu #:

Permanent Phone.
Requestor Organization:
-'

ESF #3
FAX #.
E-mail:
I
XI. Requested Assistance [Completed by Requestor) See Attached

f ~ e s c r i ~ t i of
o nAssistance Requested: I
I Four 300KW generators.
I
Ouantity: 4 I~riority:. - i tifesavlng 2 Life sustaining 1Date/Time Needed:
Il ~- e l i v Site 3 n@h C] 4 Med~um 5 Normal I 9/9/2005
q Location: Hammond Municipal Airport, Harnmond, LA, Exit 42 off 1-12
I

'
Site POC:

(state
Steve Sansone

Approving Official signature: VI


24 Hour Phone: 901-409-9542

Date:
II
- --

III. S9urcing the Request - Review/Coordination (OperationsSection Only)


a
"Ia 0
OPSWewby:

Log Review by:


Other Gwrdlnamn by:
? -
f
Donaljons

0 Other (explain)
0 ReqUlSlUOns
0 Procurement
0Interagency Agreement
0 Mission Assignment
0 Other Coordinathm by:
13 Other Coordination by:
-
Immediate Action Required: U Yes No Action request 0 ESF #:
DatclTime Assigned: ( assigned to: 0 Other:
-
N: Statement of Work (Operations Section Only)
OFA Action Oflicer: 24 hour Phone: FAX#
-
-
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:
-

Estlrnated Completion Date: 1 Cost Estimate: -


V. Action Taken (Operations Section Only) -
-
Mcepted
mp~~,tlon:
Rejected
$skd Jlu - do(K a+ JFO 0 Accountable Property
Caord~natedwith AM
-

?-

-2

A c t ~ o nRequest # Recelved by (Name and Organlzat~on).


-
-
Program Code/Event t . State I ~ a t e / ~ ~Submitted.
me 10 Onginat~das v s r ~Ia
1
3
RRF - Power 1OM
l
11. Who is Rec~uestineAssistance? (Comdetedbv Reauestorl
l ~ e a u e s t o Name

IPermanent Phone:
r

-
l~eauestorOrganization:
/Title /State: Kem Stark

ESF #3
)

FAX #:
E-mail:
-
--
-
Tem~orarvPhone / Fax #:
1
yai
t
(Interim draft s: of 1/03)
I

>
111. Reauested Assistance lcom~letedbv Reauestorl see Attached
Requested:
Air transportation for 6 people to DMORT site and to Cameron City Hall .

Quantity: Priority: El I Lifesaving a 2 Ufe sustaining Date/Time Needed:


3 High 0 4 Medium 5 Normal
Delivery Site Location: --
, and-CarkCyTbn
I ~ a r v i l bLA .-- City Hall

h t e POC: Kerri Stark --


24 Hour P h o n e
--
-- FAX-#
!State Approving O6dd signature: Date:

-
111. Sourcing the Request Review/Coordination (Operations Section Only)
OPS Review by: ‘)M. $La' Donations 0procurement
0 Log Review by: 00ther (explain) InteragencyAgreement
Other Coordinationby: 0Requisitions Mission Pssignment
Other Coordination by:
Other Coordination by:

Immediate Action Required: 46 yes No Action request 0 €SF #:


Date/Time Assigned: f o// /o 3 assigned to: Other:
N:Statement of Work (Operations Section Only)
OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
l~ustification/ Statement of Work:

Estimated Completion Date: 1 Cost Estimate:


V. Action Taken (Operations Section Only)
0Accepted 0 Rejected Accountable Property
Disposition: Coordinated wth APO

TRACKING INFORMATION (FEMAUSE ONLY)


NEhlIS Task ID:
Action Request # Received by (Nameand Organization):
Program CodeIEvent #: State; DateITime Submitted: ] Originated as v e r b

ARF - Aerial for DMORT mtg.xls


h45-r- n3
@ OOS/OOg
08/30/2005 11'20 F A X

ACTION REQUEST F ~ R M OM^ NO. J 660,0047


1
IZrprlc?sNovcmnbcr 30, 2007
I. Who i s Requesting Assistance? (Completed by Requestor) ,G&C mf-&~7

I-!i:ip~:w?r(:lrg:'~iizuiion: E--1nici1:

11. Requested Assista~lcc (Completed b y Req,ucstor)


C3t::ii:ription nl Awisrmrct: Rcqilc!:tcd:

Dnrc/'l'imi A&:ncd: . icm~df.0:


a,.... wlm:

IV: Statcrnent' of Work (Operations Section Only)


O17A Aruttrl Olliccr: :?4 h 1 1 1 I-l l w ~ c . :

I~:~~.itij:~tccl QILG;
C;i~~npkticm I ~ I . I : :K:;I.I::I~Ic:
L

V. Action Taken (OperationsSection Only)


~cccplcd l<q:icc:i.cl -
i I ~v;pcrly
nrm~mt:.~~~t~

I ~ I :
e k hpr, w1tt1 h1'0
(.:rr?rtli~~;tct.~l

%MA Form c30..13b, NOV 04


h'.- ACTION REQUEST FORM (Interim draft as of 1/03

I
f

I. Who is Requesting Assistance? (Completed by Requestor)

Requestor Name/Tltle/Sratc: Paul Krebs Temporary Phone/ Fax it:

FAX #: .- I
Requestor Orgamzation: ESF #3 E-mail:
11. Requested Assistance (Completedby Requestor) See Attahed
Description of Assistance Requested: -
EMERGENCY POWER (Direct Federal Assistance) - 1603-DR-LA-COE-MVD-03
Amendment 0 1 to increase by $4M total of $5M.

..
L
Quanc~ry: Prlorlt~: 01 l~fesavlng 2 ~ l f susta~nrng
e Date/Time Needed.
83~lgh 0 4 Med~um 0 5 Normal 8/30/2005
Delivery Site Location:

State Approvmg Official signature: Date:

-
III. Sourcing the Request Review/Coordination (Operations Section Only)
,
I fl OPS Review by: 131a2/3A
&- 9 - 30- Donations Procurement
0 tag m e w by: Other (expla~n) Interagency Agreement
Other Coordrnahon by: Reqursitions Mlsslon Awgnrnent
Other Coordtnabon by:
Other Coordinatton by

Immediate Achon Requxed: 0 Yes 0 No Action request ESF #:


DateITime Assigned: 1 assigned to: Other:

IV: Statement of Work (Operations Section Only)


FA Action Oficer:
F E U Project Officer:
24 hour Phone:
24 hour Phone:
FAX#
FAX#
I
Justification / Statement of Work

Estimated Completion Date: Cost Estimate:


V. Action Taken (OperationsSection Only)
Accepted 0Rejected IE Accountable Property
1 Coordinated with APO I

Actian Request # 1Received by (Name and Organization):


Program Code/Event #: State: Date/Time Submitted: I C] Orig~naredas verbal
[.

iequestor Name/T~tle/State

'ermanent Phone.
3equestor OrganlzaQon:
ACTION REQUEST FOFW
W h o is Requesting Assistance? (Completed by Requestor)
Peter Navesky, ESF 3 Team Leader, LA

US Army Corps of Engineers


[I. Requested Assistance (Completedby Requestor)
lescription of Assistance Requested:
Temporary Pnone/Fax

FAbX 8-:
E-mad
*

Request delivery of 4 each FEMA generators in the 500 (mm) to 600 (rnax]KW size
=
P. -
(Interim draft as of 1/03)

0 See Attached
-.-

1
-ange dehvered to the Generator Staging Area at Esler Field. Request expeditims delivery please. Also ship fuel tanks for these
f not integral to the generator

2uantity: 4 each Priority: 1 Lifesaving


3 High
'

4 Medium
0 2 Life sustaining
5 Normal
Date/Time Needed:
4-Se~-05
1
Esler Field Generator Staging Area
Camp Beauregard, Alexandria, LA

Site POC: Steve Sansone 24 Hour Phone: -FAX# '

State Approving Official signature: Date:


- -- - -

-
111. Sourcing the Request ~ e G e w / ~ o i d i n a t i o(Operations
n Section Only)
1 Donabons IJprocurement
1
1 I

m e r (explain) Interagency Agreement


3 Other Coordlnatton by: Requlsltlons Mialon kisignment
7 Other Cmrdination by:
3 Gther Ccnrdinatlm by:
rnmediate Action Required: U Yes NO Action request S F #:
DateITime Assipned: assigned to: 0 Other:

W:Statement of Work (Operations Section Only)


3FA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

Estimated Complehon Date: Cost Estimate:


V. Action Taken (Operations Section-
- -- - - - -
Only) -
- - -
Accepted Rejected Accountable Property
Disposition: Coordinated wth APO

UEMIS Task ID:


a
ACTION REQUEST FORM (Interim draft as of 1/03)(
I. Who is Requesting Assistance? (Completed by Requestor)
equestor Name/Title/State: Meegan Nagy Temporary Phone/Fax #:
I
Permanent Phone:
Requestor Organization: ESF #3
FAX #:
E-mail:
.
'

11. Requested Assistance (Completed by Requestor) See ~ttached'

Description of Assistance Requested: -


(TEMPORARY ROOFING (Direct Federal Assistance) - 1603DR-LA-COE-MVD-05

I
Amendment 03 to change end date from 9-30-05 to 12-3 1-05.

Quantity: Priority: 0 i Lifesaving n 2 Life sustaining Date/Time Needed:


- -
3 High
--
n 4 Medium
- --
5 Normal

I~TiverySite ~ocation:

Site POC: 24 Hour Phone: - FAX #

l ~ t a t Approving
e Official signature: Date:

111. Sourcing the-Request - Review/Coordination (Operations Section Only)


Donatiom 0 ~rocurement
0 Log Review by: aOther (explain) 0Interagency Agreement
0 Other Coordinationby: Requisitions @%&on Assignment
0 Other Coordinationby:
Other Coordination by:

Immediate Action Required: U Yes No Action request SF #: 3


Date/Time Assigned: I assigned to: Other:

IV: S t a t e m e n t o f Work (Operations Section Only)


FA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

1
Est~matedCompletion Date: I Cost Estimate,
V. Action Taken (Operations S e c t i o n Only)
ilAccepted nRelected Ir-
- Accountable property
Disposition: Coordinated with APO

--

RACKING INFORMATION (FEMA USE ONLY)

Action Request # ( ~ c c e i v e dby (Namc a n d Orgmization):


Proeram CodcJEvcnt #: ]state: I~ a t c l ~ i r Submitled:.
ne I [ -1 Or~qinatedas verb,

ARF - Temp Roofing Amd to changt: datexls


I. . Who-is Requesting Assistance? (Completed by Requestor)
Requestor Name/Title/State: Mickey Fountain I F%I
Temporary - '

Permanent Phone: FAX #:


Requestor Organization: ESF #3 Email:
11. Requested Assistance (Completed by Requestor) 0 see ~ttachec
Description of Assistance Requested:

I
Temporary Roofmg (Direct Federal Assistance). $100,000,000.00

-
- -----
.
Site POC: Mickey ~ i i k t a i n 24 Hour Phone: FAX #
State Approving Official signature: --- Date:

-
III. Sourcing the Request RevSew/Coydination (Operations Section Only)
0 ~ps~evlewby: D ~ w 0 ~roamment
0 LogRRliewby: // a~w(ex~laln) ~greement
0 Other~ination
by: 0 Requlsitlons &&on wgment
0 OtherCoordinattonby:
Other Coordlnatlon by:

Immediate Action Required: 0 No Action request €SF I:


Date/Time Assigned: assigned to: Other:
N: Statement of Work (Operations Section Only)
OFA Action O f f i s 24 hour Phone: FAX#
FEMA Proje-40
/ KI -
+ -24hourPhone: FAX#
Justification / stateLent of Work: The initial estimaie of 18,000 roofs was based on a Wlnd Model that used
population with strength and path of the hunicane. A fly over coupled with remote sensing data indicates

approximately 28,000 damaged roofs. Some areas have not been over flown. Bawd on ground truthing the number

I
of damaged roofs to be repaired will increase signficantly.
I
I
Estimated Completion Date: 1 Cost Estimate:
V. Action Taken (Operations Section Only)
wepted ReJected Accountable Property
Disposition: Coordinated mth APO
-
7

ACTION REQUEST FORM (Interim draft as of 110:


I, .who is Requesting Assistance? (Completed by Requestor)
Requestor Name/Title/State: Charlie Tobin/ESF#3 ATL/LA Temporary Phone/Fax

Permanent Phone: FAX #:


questor Organization: ESF #3 E-mai1:FEMA-R6-ROC-ESF3
111. Requested mistance (Completed by Requestor) See Attached
l ~ e s c r i ~ t i of
o nAssistance Requested:
/TEMPORARY ROOFING (Direct Federal Assistance)- $75,000,000. ($75M) Scope of work on attachid sheet.

I
Ammend Mission Assigrnent (MA) #1603DR-LA-COE-MVD-05,dated 8/30/2005, action request # 1509-31859

Quantity: I~riority: 1 ufesaving 2 Life sustaining IDate/Time Needed:


3 High 4 Med~um 5 Normal As Soon As Possible
Delivery Site Location: %-.Greater New Orleans metropolitan area and Southeast Louisiana

State Approving Official signature: Date:

UI. Sourcing w e Request - Review/Coordination (Operations Section Only)


Donations fl Procurement
Qther (explain) Interagency Agreement
~ t h e Coordination
r by: 0Requisitions 0Mission Assignment
Other Ccordlnation by:
Other Cmdinatlon by:

Immediate Action Required: -p!6Gn- Action request 0 €SF #:


Date/Time Assigned: assigned to: C] Other:
N: Statement of Work (Operations Section Only)
OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

Eshmated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only)
Accountable Property
&E -MQ-05 4 Coordinated w ~ t hAPO

7 ~ 0 0 0 , o o o .-(a
~
c is & S O c*-rdSd~&B,
TRACKING INFORMATION (FEW USE ONLY)
NEMlS Task ID: , C ~ O ? - 3<'f53
Act~onRequest # Received by (Name and Organization):
Program Code/ Event #: State. Date/Time Submitted: I Orcqnated as verba

A R F AM 1
?
ACTION REQUEST FORM (Interim draft as of 1/03
I. Who is Requesting Assistance? (Completed by Requestor)
equestor Narne/Title/State: Meegan Nagy Temporary Phone/Fax #:

Permanent Phone: FAX#: * h a


-
h e a u e s t o r Organization: ESF #3
11. Requested Assistance (Completed by Requestor)
E-mail: - - ' -
- -
See Attached
Description of Assistance Requested: -
DEBRIS (Direct Federal Assistance) - 1603DR-LA-COE-MVD-07
Amendment 02 to change end date from 9-30-05 to 12-31-05.

Quantity: Priority: 0 1 Lifesaving 2 Ufe sustaining Date/Tjme Needed:


3 High El 4 Medium 5 Normal
Delivery Site Location:

-
-
. - -.
--
1

Site POC: 2 4 Hour Phone: FAX #


-
-
l ~ t a t Approving
e Official signature: IC Date:

an (Onerations Section Onhl


Donations Procurement

Other (explain)

Requisitions
Other Coordination by:
Other Coordination by:

Immediate Action Required: U Yes No Action request ESF #: 3


Date/Time Assigned: I assigned to: Other:

IV: Statement of Work (Operations Section Only)


OFA Action Oficer: 24 h o w Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#

Estimated Completian Date: Cost Estimate:


V. Action Taken (Operations Section Only)
r Accepted 11
Relected
--,
Accountable Property
Disposition: Coordinated with APO

N E M I S Task ID: 4
Action Rcaucst #
09 51 - 38
TRACKING INFORMATION ( F E W USE ONLY)
b3
T ~ e c e i v e dI>\. [Name and Orranization):
Program Code/Evcnt # : State: 1Date/Ti~neSubmitted: I L;
Originated a i verbi

ARF - Debris Amd to change date.xls


ACTION REQUEST FORM [Interim draft as of 1 / 0 3
I. Who is Requesting Assistance? (Completedby Requestor)
(I

Requestor Name/Title/State: Charlie Tobin/ ESF#3 ATLILA Temporary Phone/ Fax-

Permanent Phone--
FAX #:
E-mail:FEMA-R6-ROC-ESF3
nce (Completedby Requestor) I3 see ~ttached

DEBRIS (Direct Federal Assistance)- $1,500,000,000. ($1.5B] Scope of work on attached sheet. -
Ammend Mission Assigment (MA) #1603DR-LA-COE-MVD-07, dated 8/30/2005, action request #1509-31863

Quantity: Priority: 1 bfesav~ng 2 ~ i f sustaning


e Date/Time Needed:

-
0 3~1sh , 4 Medlurn sNormal As Soon As Possible
Delivery Site Location: The Greater New Orleans metropolitan area and Southeast Louisiana

--
Site POC: Mickey Fountain 24 Hour Phone: FAX #
-
-
State Approving Official signature: Date:

-
In. Sourcing the Request Review/Coordination (Operations Section Only)
0 OPSReviewby: 1 Donations Procurement

n mw
le
w v
e
iwb
y: 0Other (explain) nInteragencyAgreement
0 Wler Coordlnatlon by: ulsltions Mlsslon kis@nment
Other Coordlnatloo by:
0 other toordination by:
- -
Immediate Action Required: 0 Yes 0 No l ~ c t i o nrequest fl E Y #:

-
Date/Time Assigned: 1 assigned to: 0 Wer:

IV: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Justification / Statement of Work:

- -

Estimated Completion Date: Cost Estimate:


YYAction Taken (Operations Section Only)
Accepted
m4IficfmcQE-MVD-07 by Accountable Property

TRACKING INFORNLATION (FEMA USE ONLY)


NEMIS Task ID I ~ o g5-4
?---3%
l ~ c t i o nReauest #
- - - - -
1 ~eceivcdbv (Name and Oreanization):
- -

Program Code/Event #: State: (llate/'lTme Submitted: 10 Or~gnatedas verb'


x
Oct 05 05 0 6 3 3 2 ~ FEMR 228-769-5196

3fo- roq3 p.2


+t

I.

Requestor Name/Title/State: Kerri Stark

ESF#3
ACTION REQUEST FORM
Who Is Requesting Assistance? (Completed by Requestor)
Temporary PhoneJFax #:

FAX y#: - t
E-mail:
-
(Interim draft as of 1/03

Requestor Organization:
11. Reauested Assistance (Com~letedbv Reauestorl
' ---.-
- See Attached
- --

f ~ e s c r i p i o nof Assistance Requested:


[HURRICANE KATRINA TECHNICAL ASSISTANCE (TechnicalAssistance).

hmendrnedt 03 to increase mission bv $3 to total $7M.

I Quantity:
I3 3 High 0 4 Med~wn 5 Normal IDate/Time Needed

--
I Delivery Site L o c + F e
-

Site POC: p/ / /d4 $ou#~hone: - FAX #

*-
State Approving Official signature: Date: 7c cF$hJ-
-
111. Sourcing the Request & & v / ~ o o ~ n a t i o n (OperationsSection Only)
WPS
~evlewby: DOM~IO~S 0merit
0 ~ o Review
g by. 0other (explain) interagency Agreement
Other Coordlnabon by: at. ulwtions GbMd510n ktignment
U Other Coordlnatlon by:
Other Cmrd~natkmby:

Immediate Action Required: U Yes 0 No Action request m~~3 #: -


DateJTime Assigned: ( assigned to: Other:

IV: Statement o f Work (Operations Section Only)

I Tasker received to provide 60 preservation architects or architectural historians. The amount of this mission is $3M.

I This amount will fund 30 days of service.

Estimated Completion Date: / Cost Estimate:


V. Action Taken (Operations Section Only)
0Aaepted Rejected @ Accountable Property
Disposition: Coord~natedwith APO

TRACKING INFORMATION jFE;MA USE ONLY)


NEMIS Task ID /!*o 7'-
Actlc~nKeaucst # I ~ e c e w e dbv (Name and Orrranizat~on)
Program Cock/ Ever11 U : State: l~atej~im
Submitted:
e [ fl Originated as verb

ARF - Tech Asst increase mission to 4M.xls


-
C 4 4
i ACTION REQUEST FORM (Interim draft as of 1 / 0 3
1. who is Requesting Assistance? (Completed by Requestor)
Requestor Name/T~tle/State: Kern Stark ESF #3 Temporary Phone/Fax # 4
Permanent Phone. FAX#.
Requestor Organzation. USACE / ESF #3 E-maxl: a
-'
11. Requested Assistance (Completed by Requestor) See Attached
Description of Assrstance Requested -
HURRICANE affA STRUCTURAL SAFETY ASSESSMENT
wt
w - lLS k ~ ~ a J b
Quankty. Prlorlt~ 0 1 Ufesavmg
a 3 High
Delrvery Srte Locatron: City of New Orleans and surroundrng environs

--
t
-- -
Crty of New Orleanq a&surroundmg Parlshes

Site POC: 24 Hour Phone: FAX #


-
l ~ t a t Approving
e Official signature: Date:

/ L
-
1111. Soyrcing the Request Review/Coordhation (Operations Section Only)
Procurement
-
U 2 U Other (explain)
I
Log Review by:
Other Coordination by: G Requisitions

I
Other Coordination by:
0 Other Coordination by:
Immediate Action Required: Yes 0 No Action request -F #: 3
Date/Time Ass~gned: I assigned to: W r :

IV: Statement of Work (Operations Section Only)

Estimated Completion Date: 30-Nov-05 Cost Estima


V. Action Taken (Operations Section Only)
Accepted r!Rejected
Disposition:

TRACKING INFORMATION lFElMA USE ONLY\

Action Request # Received by {Name and Organization):


Program Code/Event #: State: Date/Time Submitted: -, Or~ginatedas verb?
Activate and deploy SSA PRT to provide rapid evaluations of buildings in [identify 3
statellocal government jurisdiction(s)] to determine whether damaged, or potentially
damaged, buildings are safe for use or if entry should be restricted or prohibited. The
communities identified above,will designate the specific buildings to be evaluated and
will coordinate access. This mission may include logistical and other supp61-tnecessary
to perform the evaluations. This mission may be expanded, by an amendment issued by
FEMA, to include detailed evaluations and/or to add additional local jurisdictions.
O c t 0 4 0 5 04:07p FE

-
.

-
.
spo-Wa
ACTION REQUEST FORM (Interim draft as of 1/03

-
. Who i s Requesting Assistance? (Completed by Requestor)
Requestor Name/T~tle/State: K c r n Stark Temporary Phone/Fax #:
Pcrrnanent Phone. FAX#:
Requestor Organization: ESF It3 E-mail:
11. Requested Assistance (Completed by Requestor) I3 ~ee~ttached
Description of Assistance Requested:
HURRICANE KATRINA TECHNICAL ASSISTANCE (Technical Assistance).

nt 02 to increase mission by $3 to total $4M. See attached justification


1~riority: 0 1 Lifesaving 0 2 Life sustaining j ~ a t e / ~ i r nNeeded:
e
I GI 3 High 4 Medium o 5 Noma! 1
Delivery Site ~ o w ~ i p =
z
--

0InteragencyAgreement
0Requisitions . 0Miwion Assignment
Other Coordination by:

Eslirnatrd Complctiori Date: I Cost Estirndie:


V. Action Taken (Operations Section Only)
3 Accepted Rejected 0 nccounrable Properly
Disposi tioti: coot Jinatcd with APO

RACKING INFORMATION (FEMA USE ONLY)


N E M I S Task ID: -.
Action Recprest # IReceived by (Name and Organization): . -
Progran~C o d c / E v r ~ ~
i t :t State: D a k / T i r n e Submitted: 1 Originated as vcrb,

A R F - Tech Asst increase mission to 4M.xls


Activate and deploy SSA PRT to provide rapid evaluations of buildings in [identify
stateAoca1 governmentjurisdiction(s)] to determine whether damaged, or potentially
damaged, buildings are safe for use or if entry should be restricted or prohibited. The
communities identified above will designate the specific buildings to be evaluaTed and
will coordinate access. This mission may include logistical and other support-necessary
to perform the evaluations. This mission may be expanded, by an amendment issued by
FEMA, to incl~tdedetailed evaluations andlor to add additional local jurisdictjons.
R
Los*bq
Z
. ,/ ACTION REQUEST FORM (Interim draft as of 1/03
.2

I. Who i s Requesting Assistance? (Completed by Requestor)


Requestor Narne/Title/State: Paul Krebs Temporary Phone/ Fax #: C L

Requestor Organization: ESF #3 E-mail: b-a


II. Requested Assistance (Completed by Requestor] See ~ttacheh
Description of Assistance Requested: -
l~echnicalAssistance (Rc - 1603-DR-LA-COE-MVD-09
r Amendment 01 to increase by $800,000total of $1 M.
L'.
e increase in miss~onrequirements to launch a management team to locate a site for RFO and to provide
l ~ u to

I8 parrish liaison officers


Quantity:

Delivery Site Location:


Priority: 0 I ufesavlng
3 High a
- -
0 4 Medlum
2 Ufe sustaining

-
5 Normal
DatejTime Needed:
8/30/200E

Baton Rouge, LA - 1
- -. ,
-- --

Site POC: Kerri Stark 24 Hour Phor - -


- FAX #
State Approving Offlcial signature: Date:

ination (Operations Section Only)


Dcnations 0 hocurernent
n
othec (ma

Other CoordlnaUon by:

Immediate Action Required: Yes No Action requc


Date/Time Assigned: I assigned
IV: Statement of Work (Operations Section Only)
1,- CCC-0-1 I
OFA Action Officer: 24 hour Phone:
Y' r2'
[ I
--I
FEMA Project Officer: 24 hour Phone:
Justification / Statement of Work:

Estimated Completion Date: Cost Estimate:


V. pction Taken (Operations Section Only)
Wccepted Rejected lo Accountable Propetty

I
Disposition: Coordinated with APO

TRACKING INFORMATION (FEMA USE ONLY)


NEMIS 'Task ID \sbq- 3 ~ \ s a
hct~onRequest # Received by (Name and Organization):
Program Code/Event #: State: I~ate/~irn Submitted:
e 1 0 Origmated as verbal
-
Oct 0 4 05 0 4 : 07p FENA

ACTION REQUEST FORM [Interim draft as of 110311


I. Who i s Requesting Assistance? (Completed by Requestor)

Requestor Name/T~tlc/Statc. Ker ri Stark Temporary Phone/Flu I; /


'cimanenl Phor~c F M
irquestor 01ganlration [r;SF #3 E -b
m d- *
-
- -- -
[I. Requested Assistance (Completed by Requestor) a See ~ttached
3escrlptlon of Asslstancc Requcstcd
WRRICANE KATRINA TECHNICAL ASSISTANCE (Technical Assisrancc)

Zst~motcdCornplction Dare:
V. Action Taken (Operations Section Only)
Cost Estlrnatc:
-
5 A<cFP:& Rejected nccounwb* P~UWCY
3isposicion: Coodinatcd wiulrh npo

4 H I ; - Tech Asst increase nnssion to 4M.xls


O c t 0 4 05 0 4 : 0 7 p FEMR

Activate and &ploy SSA PRT to provide rapid evaluations of buildings in [identify
state/local government jurisciiction(s)] to determine whether damaged, or potentially
damaged, buildings are safe for use or if entry should be restricted or proliibited. The
connmunities identified above will designate the specific buildings to be evaluated and
will coordinate access. This mission may include logistic?l and other support necessary
to perform the evaluations. This mission may be expanded, by an amendment issued by
., -E&lA, to ~ncl~ide detailed evaluations andor to add additional locd jurisdictiorts.
& -,
---
-C_
I
Requestor Name /Title/ State:

Permanent Phone:
Requestor Organizat~on:
Meegan Nagy

ESF #3
ACTION REQUEST FOW!
I. W h o is Requesting Assistance? (Completed by Requestor)
Temporary Phone/ Fax #:

FAX #:
E-mail:
-
(Interim draft as of 1/03)

1
I
11. Requested Assistance (Completed by Requestor)
Description of Assistance Requested: -
QUARTER BOAT FOR RESPONSE CREW (Federal Operations Support) - 1603DR-LA-COE-MVD-10

I
Amendment 03 to change exid date from 9-30-05 to 12-31-05.

Quantity: Priority: a 1 Lifesaving 2 Life sustaining Date/Time Needed:


I

3 High 0 4 Medium 5 Normal


l~eliverySite Location:
I
Site POC: 24 Hour Phone: -FAX#
e.

State Approving Official signature: - Date:

111. Sourcing thesequest - Review/Coordination (Operations Section Only)


hations 0Procurement
Other (explain) 0Interagency Agreement
Other Coordination by: 0Requisitions s o n Assignment
n Other Coordination by:
M&
0 Other Coordination by:
Immediate Action Required: U yes 0 No Action request €SF #: 3
Date/Time Assigned: assigned to: Other:

IV: Statement of Work (Operations Section Only)


OFA Action Officer:
-
24 hour Phone:
- -
FAX#
FEMA Project Officer: 24 hour Phone: FAX#
Just~fication/ Statement of Work:

Estimated Complet~onDate Cost Est~mate


V. Action Taken {Operations Section Only)
I - I Accountable Property
Dtspositlon Coordmated wlh APO

-I
TRACKING INFORMATION (FEMA USE ONLY)
NEhlIS Task ID
Action Rcqucst #
-
, 5 04 3 8 /& 3
Rcceirccl by (Ndrnc and Oig,tnizat~on]
Program Code/ Event #: State D a l e f T ~ r n eSubmitted I CJ
.a
Orlg~natedas verbal

=
ARF - Quarter Boat Amd to change date xis
ACTION REQUEST FORM (Interim draft as of 1/03)
I. Who is Requesting Assistance? (Completed by Requestor)
iequestor Name/Title/State: Mickcy Fountain,Team Leader, LA Temporary Phone/Fax #: -
'
3
I
'ermanent Phone: Ipt

tequcstur Organization: ESFI3


[I. Requested Assietance (Completed by Requestor)
E-mail: b - *
- 0
--
~ e e ~ t t a ~ h e d-
Iescnpuon of Assistance Requested:

5
JUAKTER BOAT FOR RESPONSE CREW (Federal Operations Support) - 1603-DR-LA-COE-MVD-
10 ~ m e n d m e n t N t oIncrease
)v $2,000,000 total of $4.2M.
2uantlty: Pnorily: 0 I ~afesaving 0 2 LJe sustaming Datc/T~rneNeeded
a 3 nigh 0 r Medlvm 0 s~amai 9/7/20C
) c ~ ~ v c r ?~lteh.&2$:
/
-

inr POC: Mickcy Fountain 24 Hour hone.-


--.
- FAX R ..-- I
;tale Approving Ofiicial signature: Date:

-
[[I. Souy_cingthe Request Review/Coordination [Operations Section Only)
0Pmxwernent
InteragencyAgreement
0wssion ~ r a n e n t

Action request ESF 1:


)atc/Time Assigned: I assigncd to: other.

V: Statement of Work (Operations Section Only)


)FA Action Ofliccr: 24 hour Phone: FAX#
:I-;MA Projjcct Officer: 24 hour Phonc: FAX#
usrification / Statement of Work:

; s t h a t e d Completion Date: 1 Cost Estimate:


r.- Action Taken (Operations Section Only)
-
_I Accepted 0Rejected
hqmsition: Coordinated with A P O

'RACKING INFORMATION ( F E U USE ONLY)


EMIS Task 1~:+/5/09->3//37
c l w n Request # Rcceivcd by (Name and Organ~mr~on):
rogrnln Code/Evcnt #: Scatr: Datr/T~mcSubmitted: ( Ortg~natedas verba

ARF $1, 2,000,000


Jatc/Tbc Assigned: I ~ s i g g m dto: Ober
lW Stabtarept of Work (Opemtioas stcrtioD 0-
>FA Action Oficer: 24 hour Phone: FAX#
'EMA Raj& Ooicer: 24 how Pho~e: FAXE
tust&=&m strucmcnt 0 f W ~
1
Ia?(o

-
3Fb
ACTION REQUEST FORE (Interim draft as of 1/03

(I. Who is Requesting Assistance? (Completedby Requestor)


Requestor Name/T~tle/State: Meegan Nagy Temporary Phone/Fax #: I
Permanent Phone: FAX #: -.

Requestor Organization: ESF #3 E-mail: L


-
-

111. Requested Assistance (Completed by Requestor) .. ,El see~ttached


l~escri~tio ofnAssistance Requested:
t State of Louisiana by performing and or contracting for the un-watering of the City of New Orleans and the
l ~ s s i s the
lgreater metropolitan area.
Amendment 04 to increase funding by $200K. MA total $85,200,000.00
Quantity: IPriority: 1 ufesaving 2 tife sustalnlng ~ate/~irn I
Needed:
e
IDelivery Site Location: I 3 High 0 4 Medlum 5 Normal
I
I
- -- - -
-.-
-
Site POC: 24 Hour Phone: FAX#
IState Approving Oficial signature: -
- Date:

111. Sourcing t h Request - Review/Coordination (Operations &&ion Ohly)


/o/lgLJJ DMmr ~murement

I0 (-\
I
Log Review by: other (explain) Interagency Agreetnent
Other .toordination by: 0Requisitions m ~ o Mng m n t

I0 &rCoordinationby:
Other ~oordinationby:

Action request PESF


#: 3
-
Date/Time Assigned: I assigned to: Ozher:

N: Statement of Work (Operations Section Only)


OFA Action Officer: 24 hour Phone: FAX#
FEMA Project Oficer: 24 hour Phone: FAX#
l~ustification/ Statement of Work:

The estimate given to me by LTC. Berczek (HQ) is $200k to fund shipment of equipment for the Foreign Forces back to their home countries.

Estimated Completion Date: I Cost Estimate:


V. Action Taken (Operations Section Only}
Accepted nRejected 1 Accountable Propefty
Coordinated with APO

Action Request # 1Received by (Name and Organization):


Program CodeIEvent #: /state: I Date/Time Submitted: 1 C' Originated as verb
, IF0 b 3 5
I -. ACTION REQUEST FOR. (Interim draft as of 1/03
I. Who is Requesting Assistance? (Completed by Requestor)
Requestor Narne/Title/State: Mickey Fountain Temporary Phon

IRrrnanent Phone: e
-' FAX #:
Requestor Organizabon: ESF #3 E-mail: .. 4

11. Requested Assistance (Completed by Requestor) 0 see Attached


v
Description of Assistance Requested:
Unwatering (Direct Federal Assistance). $35,000,000.00

Quantity: 1 I~riority 0 1 Wesavi~~ fl 2 Ufe sustaining I ~ a t e l ~ i r Needed:


ne
3 High 4 Medium 5 orm mall
-
Delivery Site Location, Prisendentally declared counties in Louisana.
- --

-
Site POC: Mickey Fountain 24 Hour Phone: --
-
FAX #
State Approving Official signature: Date:

-
111. Sourcing the Request ReviewICoordination (Operations Section Only)
[7 Donations hocurernent

a Other (explain) Interagency Agreement


Other Coordination by: 0 Requ~slions M~ssionAssignment
Other Coordination by:
Other Coordlnatton by:

Immediate Action Required: yes No Action request ESF #:


DatefTime Assigned: I assigned to: Other:

W:Statement of Work (Operations Section Only)

redicted and will require over t

Estimated Completion Date: Cost Estimate:


tion Taken (Operations Section Only)
Accountable Property
Coordinated w ~ t hAPO

USE;O~~W)
TRACKING"INFOR$%ATZ~N'(FEMA &

NEMIS Task ID: /s&9 3 6 2 )7


Action Request # I~eceivedby (Name and Organization):
Program Code/Event #: State: Date/Time Submitted: I Originated as v

Unwatering ARF $120,000,000.00

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