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HomeMy WebLinkAboutR10-138 Emergency Operations Plan, Appendix F Commissioner 51 ■JL - E—` — 't moved adoption of the following Resolution: BOARD OF COUNTY COMMISSIONERS COUNTY OF EAGLE, ST ATE OF COLORADO D Resolution No. 2010- l () RESOLUTION ADOPTING EAGLE COUNTY EMERGENCY OPERATIONS PLAN, APPENDIX F WHEREAS, Section 24 -32 -2107 of the Colorado Revised Statutes states each political subdivision shall be within the jurisdiction of and served by the division and by a local or inter - jurisdictional agency responsible for disaster preparedness and coordination of response; WHEREAS, Section 24 -32 -2107 of the Colorado Revised Statutes states each county shall maintain a disaster agency or participate in a local or inter jurisdictional disaster agency that otherwise has jurisdiction over and serves the entire county; WHEREAS, Section 24 -32 -2107 of the Colorado Revised Statute states each local and inter jurisdictional disaster agency shall prepare and keep current a local or inter jurisdictional disaster emergency plan for its area; WHEREAS, the Eagle County Emergency Operations Plan was adopted by Resolution No. 2010 -072 on June 29, 2010; and WHEREAS, it is desirous to update and supplement the Eagle County Emergency Operations Plan through the adoption of various appendices. NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF EAGLE, ST ATE OF COLORADO: THAT, the Eagle County Emergency Operations Plan, Appendix F be adopted in the form attached hereto as Exhibit "A" and incorporated herein by reference. THAT, the Eagle County Emergency Operations Plan, Appendix F set forth herein shall be effective as of November 16, 2010. THAT, should any section, clause, provision, sentence or word in this Resolution be declared by a court of competent jurisdiction to be invalid, such decision shall not affect the validity of this Resolution as a whole or any parts thereof, other than the part so declared to be invalid. For this purpose, this Resolution is declared to be severable. i I THAT, the Board hereby finds, determines and declares that this Resolution is necessary for the health, safety and welfare of the citizens of Eagle County. h' g tY . MOVED, READ AND ADOPTED by the Board of County Commissioners of the County of Eagle, State of Colorado, at its regular meeting held the 16th day of November, 2010. COUNTY OF EAGLE, STATE OF COLORADO, By and Through Its ATTEST: pf " . • ARD OF COUNTY COMMISSIONERS .. ��I � .yam r ,T � �ja/La–L`' Clerk to the Bo • g of poi Sara J. Fisher County Commissioners Chairman Iii` -1 ; t u z ' Jo Stavney Co 0 issioner / di o" . I' Peter F. Runyon Commissioner Commissioner " '� `-, seconded adoption of the foregoing resolution. The roll having been called, the vote as as follows: • Commissioner Fisher 0' " Commissioner Stavney V Commissioner Runyon V""` w This Resolution passed by ` vote of the Board of County Commissioners of the County of Eagle, State of Colorado. f ,, i Appendix F Eagle County Y Damage Assessment Plan Damage Assessment Purpose: Da age assessment is the process of identifying and quantifying damages that occurs as a result of a isaster. The objective of damage assessment is to provide situational awareness to the EOC abo t the state of critical (must be in place for recovery to begin) and essential (must be in place for recovery to continue) functions to help facilitate the EOC move from response into recovery and decisions to appropriately direct resources and teams. Additionally, the damage assessment results are used as the initial basis to justify or determine state or federal assistance. Scoi$e: Immeediately following, and even while a disaster or major emergency is occurring, it will be necessary to quickly and as accurately as possible assess the damages and impacts. Situation Reports: Immediately following a disaster (within 8 hours), it will be the responsibility of the Eagle County Emergency Manager to develop a local situation report. 1 Situation reports provide an overview of areas within the County that have sustained damage and will need to be surveyed to determine the extent of damage. 0 Situation reports shall include at a minimum; names of jurisdiction(s) involved, casualty estimates, areas of reported damage, probable extent of damage, category of damages (residential, business, public infrastructure), impacts to critical facilities /services, local and mutual aid resources deployed, and outside assistance needed and/or anticipated. 1 Critical facilities (e.g., hospital, airport) and special needs populations should be contacted directly to determine degree of damage. + Situation reports provide a "footprint" of locally damaged areas to that will need to be prioritized and assessed in more detail. Situation reports shall be posted on WEBEOC (a statewide web base information sharing tool) to keep the State Division of Emergency Management (CDEM) and surrounding counties informed on the current Eagle County situation. Larger, more severe disasters require less detail to support a disaster declaration than smaller situations. • Damage assessment is conducted in three phases: Windshield Damage Assessment (WDA): This assessment begins immediately after the incident occurs. It is conducted by first responders (EMS, fire service, law enforcement, public works, etc.) and helps to determine life safety issues and identify the hardest hit areas. Responding resources should report type, extent and general location of damage to the Vail Public Safety Communications Center (VPSCC). It will usually be the •ispatcher who first recognizes a disaster situation and begins the assessment process by ' 0 requesting activation of the Eagle County EOC. The EOC activation will relieve the VPSCC of the responsibility for resource management and it will begin the process of damage assessment with the goal of quickly initiating a disaster declaration when applicable. Initial Damage Assessment (IDA): The initial damage assessment focuses on damages to residences, businesses and public infrastructure. This is the first attempt to assign a dollar amount to a disaster situation. Following the determination that a disaster situation exists, and the identification of affected areas, the damage assessment team(s) will respond into the disaster area armed with address maps and/or GPS units to conduct the initial damage assessment. The initial damage assigns a simple percentage of damage to affected infrastructure at a 10 %, 20 %, 30 %, 40 %, 50 %, 60 %, 70 %, 80 %, 90% or 100% threshold based upon what can be observed from a safe location. This assessment information shall be provided to the Assessor's Office for assignment of dollar values and to the GIS Department (towns and county will work cooperatively) for damage mapping purposes. This assessment also determines whether more detailed damage assessments are necessary and identifies those areas where further efforts should be concentrated. Preliminary damage assessment (PDA): This PDA is done to verify the initial damage assessment (especially for state /federal assistance) and gather additional information on areas or functions that are going to require additional resources so recovery can be prioritized. Engineering departments shall be the key resources in order to provide more detailed assessment which guides the recovery process. Damage Assessment Teams: A Damage Assessment Coordinator (Assessor's Office ?) shall be appointed by the EOC Manager. The Damage Assessment Coordinator shall appoint teams to perform the initial damage assessment. Suggested candidates for these teams include building officials, parks and recreation employees, public works employees, utility providers, real estate appraisers, American Red Cross, chamber of commerce, facility managers and other volunteers. Each Damage Assessment Team shall have a leader who is responsible for team safety, assignments and overall team coordination as well as reporting results to the Damage Assessment Coordinator. Each team should include assessment specialist (2 -3) who are responsible for evaluations at each site to determine damage levels and a data recorder who is responsible for recording damage data on forms and compiling summary reports which are included in the damage assessment kits. Damage Assessment Teams will: • Conduct site by site assessments, unless otherwise instructed by the Damage Assessment Coordinator. • Report any unsafe conditions to the EOC. • Report severe damage with no emergency services on site. • NOT discuss the damage assessment with the public or the media. • NOT comment on possible assistance. • Maintain communications and keep the EOC informed. Majr Disaster Declaration usually follows these steps: • Local Government Responds, supplemented by neighboring communities and volunteer agencies. If overwhelmed, turn to the state for assistance; • The State Responds with state resources, such as the National Guard and state agencies; • Damage Assessment by local, state, federal, and volunteer organizations determines losses and recovery needs; •1 A Major Disaster Declaration is requested by the governor, based on the damage assessment, and an agreement to commit state funds and resources to the long -term recovery; FEMA Evaluates the request and recommends action to the White House based on the disaster, the local community and the state's ability to recover; • The President approves the request or FEMA informs the governor it has been denied. This decision process could take a few hours or several weeks depending on the nature of the disaster. Further details regarding the Disaster Declaration process can be found in Appendix H. Damage Assessment Team Guidelines Damage Assessment Teams will be deployed to assigned sites /areas to perform damage assessment as prescribed in the operations briefing. • Each Damage Assessment Team shall have a leader who is responsible for team safety, assignments and overall team coordination as well as reporting results to the Damage Assessment Coordinator. • Teams shall maintain communications with the Eagle County EOC and keep the Damage Assessment Coordinator apprised of progress. • Team Leaders shall make contact and coordinate activities with the Incident Commander operating in that area. • Assessments will be conducted street -by- street and property -by- property unless otherwise instructed by the Damage Assessment Coordinator. • If teams encounter conditions that will make it unsafe to perform their assigned damage assessments, the team leader will report these conditions to the Damage Assessment Coordinator and await instructions on how to proceed. • If areas of severe damage are encountered and public safety personnel are not on scene, the team leader shall report the situation to the EOC immediately, so that emergency personnel can be dispatched to protect life and property. • Teams that encounter members of the public or media should not discuss potential or anticipated damage assessment outcomes. Teams should not volunteer commitments to the public concerning disaster response or assistance. • Upon completion of assigned inspections, teams will report to the local EOC and provide all data collected to the Damage Assessment Coordinator. Estimating Damage: • With different individuals assessing damage and different agencies applying the information to their own needs, it is important to establish consistent standards in estimating damage. Estimating damage costs, as described in these guidelines, will generally relate to residential dwellings, small business facilities and other smaller structures. These procedures will usually not be appropriate for estimating damage costs to public facilities. • A ten level damage scale will be used to estimate the level of damage to a particular property. 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Least most severe severe • 100% is the most severe damage, and 10% is the least severe. This scale provides specific guidance in determining damage levels and was compiled using resources from federal, • state and private agencies. It is designed to help make a somewhat subjective process more objective and consistent across different assessors. The ten level scale can be used to provide: o a damage description o guidance concerning the structure's habitability o things for damage assessors to look for in evaluating a structure o water level assessments when flooding is involved. (Note: water levels are general guides. Flood damage intensifies with the force of the water, duration of the flood and the degree of contaminants and sediments in the water.) o an indication of how FEMA and the ARC would categorize the damage to a structure in each damage level (i.e. Destroyed, Major, Minor, Affected Habitable) and given definitions four these four damage categories. In general do not enter a building. It should not be necessary to enter a building in order to assess the damage level. Assessors must consider all areas of damage to a structure in deciding an overall damage level for the elitire property. If a damaged area appears to border between two levels, choose the higher or more severe level. Estiiiating Dollar Amount of Damage: Estimated Dollar Damage = [Damage Level x .1] x [Pre- Disaster market value x 1.1] 1. Multiply the pre- disaster market value of structure by 1.1 or 110% of pre- disaster value. 2. Multiple the percent of damage by 110% of pre- disaster market value. Example: Pre- disaster market value is $100,000 and damage is estimated at 70% $100,000 x 1.1 = $110,000 Estimated Dollar damage is .7 x $110,000 or $77,000 Estimating Damage to Contents: Estimating damages to contents will assist the family service caseworkers as well as increase the total damage cost estimates. Contents will include food, clothing, furniture and major appliances. An estimation of probable damage to contents is obtained from asking occupants of the property, if at all possible. Damage Assessment Team Briefing Checklist General: ❑ Provide current update concerning the disaster event ❑ Review purpose and importance of damage assessment mission ❑ Designate team members and assign designated team leader ❑ Outline geographic areas affected by the event and designated for IDA ❑ Distribute prioritized list of sites /areas to be assessed ❑ Assign sites /areas to specific teams ❑ Anticipate degree of damage and destruction the should be encountered ❑ Designate level of detail needed for damage assessment ❑ Stress importance of expediting the process (objective is to obtain information as accurately as possible with as little delay as possible) ❑ Refer to IDA guidelines Safety and Maneuvering: ❑ Unstable/Unsafe buildings, structures (identify know areas) ❑ Weather forecast (any potential for weather hazards) ❑ Potential hazards that may be encountered and how to handle (downed wires, etc.) Equipment: ❑ Assign vehicles, if appropriate ❑ Assign team equipment kits ❑ Review damage assessment forms and guidelines ❑ Procedures for obtaining additional supplies if needed Communications: ❑ Radios, cell phones (operations Check and establish check -in time frames) ❑ Guidelines for interacting with the public and media ❑ List of emergency shelters, recovery centers, mobile feeding sites ❑ Contact Eagle County EOC to clarify questions, instructions Team Equipment Checklist 0 Photo identification badges for each team member 0 Hard hat for each team member 0 Rubber pull -over boots (if necessary) for each team member 0 Protective gloves for each team member Reflective traffic vests for each team member 0 Insect repellent 1 C Protective eyewear for each team member 0 Hearing protection for each team member Rain gear (if necessary) for each team member O First aid kit 1 Cl Trash bags (to store personnel equipment) for each team member O Vehicle, 4WD (recommended) 1 o Full tank of fuel O Shovel 1 O Sand/Rock Salt (if necessary) 50# bag O Road flares 12 O "CAUTION" tape 1 roll O "DO NOT ENTER" tape 1 roll O Binoculars C� DTR Radio 1 o Spare battery (charged) 1 o Perform operational check 0 Cellular telephone 1 o Vehicle charger 1 o Perform operational check O Duct tape 1 roll • Maps (highway, assigned area) 1 each O Note pads 3 0 Pens 6 0 Clip boards 3 Whistle for signaling 1 Flashlights (w /extra batteries) 2 Safety Checklist General: 9 - 1 - 1 EOC telephone number: Electricity: Holy Cross Energy (all areas of Eagle County EXCEPT Hwy 24 South of Dowd Jct.) (970) 949 -5892 or (970) 945 -5491 Xcel Energy (Hwy 24 South of Dowd Jct., including Minturn and Red Cliff) (800) 847 -4970 Transmission or (800) 895 -2999 Distribution o Notify EOC o Do Not attempt to remove a tree limb or other object from power lines. Do Not attempt to use a branch, board fiberglass etc. These can conduct electricity. o If you are in a vehicle and a power line fall on it, STAY IN THE VEHICLE. If for some life- threatening reason, you must exit the vehicle, jump. Do Not touch both the vehicle and the ground at the same time. Natural Gas: Source Gas (all areas of Eagle County West of Miller Ranch Road and Hwy 6) (800) 563 -0012 Retail or (866) 477 -1190 Transmission Xcel Energy (all areas of Eagle County East of Miller Ranch Road and Hwy 6) (800) 308 -3978 • If you Smell Gas: o Immediately extinguish all open flames o Prohibit smoking o DO NOT operate electrical switches or machinery, use telephones, ring doorbells, use flashlights or two way radios o Avoid any actions that could produce sparks o Notify the EOC • If you discover a broken Natural Gas Line: o Immediately extinguish all open flames and turn off all machinery o Avoid all actions that could produce sparks o Alert everyone in the area of the potential danger and evacuate the area o Cordon off the area with CAUTION or DO NOT ENTER tape o Notify the EOC o Wait for professionals. NEVER attempt to fix a gas line • Anirkials — Avoiding Dog Bites: • When Dogs Might Bite: o They feel threatened, are afraid, are protecting their territory /food/family /pups o They don't know you o Their chase response is triggered o They are in pain or irritated • Warning Signs a Dog Might Bite: o Dog stands stiff and still, hair may be up o Dog stares at you o Dog's tail is stiff and wagging very fast, ears erect. o Dog growls, snarls, shows teeth • What to do if Threatened by a Dog: o Do not trigger the natural instinct to chase o Stand still, remain calm, don't run or turn your back to the dog. Wait until the dog leaves, then back away slowly o If a dog comes to sniff you, let it. Don't try to pet it o Don't make any fast or jerky movements o Don't stare into the dogs eyes. This is a challenge to fight o Speak in a loud, calm, low voice, "GO HOME ", "NO ", or "STAY" • If the Dog Attacks: o Shield yourself by keeping something between yourself and the dog o Feed the dog your jacket, anything that will give it something else to bite o If you get knocked down, curl into a ball with hands over your head and neck. Don't scream or roll. "Play Dead" o Report the incident and get medical attention 0 2/ § 0 `� 2 f f/ ■_ E / § zN ■ \ S 1- § ) - z 0 UJ §® k— _0 N e , . @ 2 U) s § CO § §gts o ¢ � _ 0 z 7 , cs a ® 4 © w. M , 2 . . X co i a § Z \ - 2 � UJ 1-/ . CO §_ g� CO . U) � ° / 2 ! w UJ < ,-E, ƒ E !/ O 03 � • p UJ . p @ bo � z u. 0 1 12 z B � . d ( $ ( . co 0 0211E / & §£f= o § §B§ . § c I.L. 0 §0 - • 2 CA RI 6 k k z z co = a u. to- Co Cr Instructions - Initial Damage Assessment - Housing Losses A. General Information 1. County - The term "County" refers to the name of the county where the reported damages occurred. Information repo ed on the Initial Damage Assessment - Housing Losses form is a composite of all such damages incurred within the ted "County". 2. M nicipality" Indicate the name of the municipality there these damaged houses, living units, or manufactured homes are I *sated. 3. In ident Flood ( ), Tornado () Hurricane () Other ( ) 'The term "Incident' refers to the tomado, hurricane, flood, fire, the ical spill, etc., which caused the need to ), this report in the first place. Check the appropriate incident. If 'Other" is the ed, specify the incident by name. 4. ssment Team - Indicate the last name, first initial, of those individuals responsible for conducting the damage a sment and for reporting the damages as shown. 5. I 'dent Period" The "incident Period" refers to the time span from when the incident occurred to when there is no Ion r a threat to people or their property. In the case of a hurricane, flood, or even a fire, the "Incident Period" may en pass several days. In the case of a tornado, the "Incident Period- is usually only one day. However, there are ex tions. 6. Date of Survey - The term "Date of Survey" refers to the date the damage assessment was conducted. This mayor may not be the date the incident occurred. 7. Page of - Pages should be numbered in consecutive order with the total number of pages indicated on each page, i.e., 1 of 5, 2 of 5, 3 of 5, etc. B. Damage Assessment Information" Housing Losses 8. Reif. No. - The term "Ref. No." is an abbreviation for "reference number". Each affected house, living unit or manufactured home are to be numbered in consecutive order for ease in identification, totaling, etc. 9. Name of Occupant. Indicate, if known, the name of the owner / renter occupant of the affected house, living unit or mobile home. However, if the occupant is a renter, then you must also enter the name of the owner of the building on the Initial Damage Assessment Business Losses form .. 10. Street/Route/SR/Mobile Home Park/Bldg, Name /Development/Etc. - Indicate the affected property's site address, i.e., street address, route, road, mobile home park, building same, development, etc. 11. PRI (Home) - The term "PRI" is an abbreviation for primary home. If the occupant lives in the home 50% or more of the year the home is considered their primary dwelling. Indicate, by a check mark, if the damaged home in question is the rrimary dwelling unit for the occupant. If unknown, check "PRI". 12. (home)" The term "Sec" is an abbreviation for secondary home. If the occupant lives in the home less than 50% f the year the home is considered their secondary dwelling. Indicate, by a check mark, if the damaged home in ques ion is a secondary dwelling unit for the occupant. If unknown, check "PRI". 13. SS��' (type of home) The term "SF" is an abbreviation for a single- family type of home. Unless known otherwise, consider all stick - built, wood -frame and pre- fabricated housing units as "SF ". Indicate, by the use of a check mark, that t e home in question is a single - family type of home. 14. IMF (type of home) "The temr "MP is an abbreviation for multi- family type of home. Mufti - family dwelling units inclu e all duplexes, apartments and condominiums. Indicate, by the use of a check mark, that the home in question is a ulti- family type of home. 15. MH (type of home) "The term "MH" is an abbreviation for manufactured or mobile home. Indicate, by the use of a check mark, that the home in question is a manufactured (mobile) type of home. 16. (status) - The term "Own" refers to ownership status of the home in question, i.e., whether or not the home is own or rented. Indicate, by the use of a check mark, that you consider the hone in question to be owned by the occu ant. 17. nt (status) - The term "RN, refers to the ownership status of the home in question, i.e., whether or not the home is own or rented. Indicate by the use of a check mark, that you consider the home in question to be rented by the occu ant. If rented, then you must also consider the home to count as a business and enter the name of the owner and othe appropriate information on the Initial Damage Assessment - Business Losses form. 18. in (damages/uninhabitable) - The term "MIN" is an abbreviation for "minor" damage. "Min r" damages, when considering housing damages, are defined as physical damages which make the impacted horn uninhabitable and have damages of 10% or less of the home's replacement cost or fair market value. "Min" dam es are those which will require minimal repairs to doors, windows, floors, utilities, etc, to make the structure hat)" le again. 19. N.aj ( damages/uninhabitable) - The term "MAJ" is an abbreviation for "major" damage. "Major" damages are defined as physical damages which make the impacted structure or facility uninhabitable and have damages between 11% and 74% of the home's replacement cost or fair market value. A home with extensive damages to its foundation, roof and wallslwould indicate "MAJ" damages. 20. st ( damages/uninhabitable) - The term "DEST", is an abbreviation for "destroyed ". "Destroyed" is defined to mea those homes which have been made uninhabitable as a result of the incident and have damages in excess of 75% f their replacement cost or fair market value. If reconstruction or relocation are the only options to restoring the horn to its original use, then "DES" should be checked. HINT: Consider older manufactured homes which have been flood d or overtumed manufactured homes as being destroyed. 21. Iso." "ISO" is an abbreviation for "isolated ". Even though the home may not have sustained any physical damages, the structure is considered unusable if the home is no longer accessible or if there is a lack of essential utilities such as electricity, water, etc. 22. Water Level In structure" In the event that flood waters entered the home, indicate, in feet, the height of the water within the structure. 23. Replacement Cost or Fair Market Value" Obtain from the owner or occupant or estimate from existing tax records, or give your best estimate of the fair market value or replacement cost of the damaged, destroyed or otherwise uninhabitable home, to include contents. However this does not include land value. 24. Est. Dollar Loss" Obtain from the owner or occupant or give your best estimate, as to the estimated total dollar loss incurred as a result of the incident. Include contents. 25. HO (insurance) - The term "HO" is an abbreviation for homeowners (insurance). Indicate to the best of your ability, or not the owner/occupant has homeowners insurance coverage. Put a "check" in the column if the answer is yes. Leave blank if the answer is no. If unknown, leave blank. 26. NFIP (Insurance) • Indicate, to the best of your ability whether or not the owner / occupant has flood insurance coverage. Put a "check" in the column if the answer is yes. Leave blank if the answer is no. If unknown, leave blank. 27. Low (estimate income) "Based upon guidance received from the local tax office, indicate, to the best of your ability, whether the owner / occupant has a low medium or high average annual income. Indicate by the use of a check mark, your particular choice. In the absence of any guidance utilize the following table as a general guide as to income levels: Income (per year) Rank Less than $15.000 LO $15,000 - $50,000 MED Greater than ssn nfln 1-11 , 28. Mad (estimate Income) "Based upon guidance received from the local tax office, indicate to the best of your ability whether the owner 1 occupant has a low medium or high average annual income. Indicate, by the use of a check mark your particular choice. In the absence of guidance utilize the above table. 29. HI (estimate Income) • Based upon guidance received from the local tax office indicate, to the best of your ability whether the owner / occupant has a low medium or high average annual income. Indicate by the use of a check mark, your particular choice. In the absence of guidance utilize the above table. • 1 - F igieg— I. �rxio f I 1 N W H 7 I o W O 1 zm - p a e, $ 1 Tit m 6 N N N . I a OUt, FZ O Q ? U m 4444 N N N ..... N..... N N N N N N N N N N N N N 0 � W S- . N g Z {- ....... N N N N N N N N N N N N N N N N N N ... Z .. .. .. y .. .. .. .. . p. .. .. W W OW M K GIIINGGLII F W ZF W OK S W ZK W ZKy W S W x 5'w�5 0 Cr .a. �O LL> N N HU . NU yU 4. p W y v 2 > LL7 O m } LL Sm V y W Z u4, W �i O_ O S c O W> o~Q S d K o z U F p J GF W N ?� Q W O w m 0 E o S o 0 0 8 2 ° o o o 0 0 M : m 1 ! m co W s _ co N w 0 a w a 8 2 • W _ • NZz c _ g W m n a Z � , a Q z v W O W lz lz • 0 2 LL • j 0 Instructions: Initial Damage Assessment - Business Losses A. General Information 1. County - The term "County" refers to the name of the county where the reported damages occurred. Information reported on the Initial Damage Assessment - Business losses form is a composite of all such damages incurred within the stated "County". 2. Municipality - Indicate the name of the municipality where these business or industrial losses were incurred. 3. Incident: Flood ( ), Tornado (), Hurricane ( ), Other ( ) - The term "Incident refers to the flood, tomado, hurricane, fire, chemical spill, etc., which caused the need to file this report in the first place. Check the appropriate incident. If "Other" is checked, specify the incident by name. 4. Assessment Team - Indicate the last name, first initial, of those individuals responsible for obtaining the information contained on the form. 5. Incident Period - The "Incident Period" refers to the time span from when the incident occurred to when there is no longer a threat to people or their property. In the case of a hurricane, flood, or even a fire, the "Incident Period" may encompass several days. In the case of a tomado, the "incident Period" is usually only one day. However, there are exceptions. 6. Date of Survey - The term "Date of Survey" refers to the date the information being reported is assessed. This may or may not be the date the incident occurred. 7. Page_of - Pages should be numbered in consecutive order with the total number of pages indicated on each page, Le., 1 of 5, 2 of 5, 3 of 5, etc. 8. Ref. No. - The term "Ref. No: is an abbreviation for "reference number". Each affected business or industry are to be numbered in consecutive order for ease in identification, totaling businesses and industries, etc. 9. Name of Business/Site IocationITetephone Number - Indicate the name of the business or industry which incurred physical damages as a result of the incident. If more than one building or facility was affected per business or industry, summarize and report damages on one line only. Also enter the site location of the affected business or industry. For example, the site location would include the street, route, road, industrial park, etc, where the impacted structure is located. Also enter the business telephone number. 10. Tenant/Owner (circle choice) & Type of Bus. - Circle whether the damaged structure and contents being assessed is owned by the business occupant (circle O) or rented/leased by the business occupant, and thus a tenant (circle T). IF THE BUSINESS OCCUPANT IS A TENANT, ADD TO THE FORM A SECOND BUSINESS FOR THE OWNER OF THE BUILDING. Enter the kinds of products manufactured, stored, shipped, treated, sold, etc., by the affected entity. If services are provided, indicate the type of service, e.g., catering, landscaping, legal financial, etc. 11. Estimated Days out of Operation - Estimate the number of days the affected business or industry will be inoperable as a result of the incident. 12. Number (Employees) - Obtain from the owner or other officials the number of people employed by the business or industry. If not readily available, give best estimate. 13. Covered by U.I. (Employees) - Obtain from the employer or appropriate officials the number of employees covered by Unemployment Insurance. If the infonnation is not readily available, give best estimate. 14. Replacement Cost or Fair Market Value - Obtain from the employer or other appropriate officials, or estimate from tax records the total replacement cost or fair market value of the damaged business' land, structure and contents. 15. Estimated Dollar Loss - Obtain from the owner or other appropriate officials the estimated total dollar loss incurred as a result of the incident. If the information is not readily available, give a best estimate. Include losses to inventory, equipment, furnishings, etc. 16. Dollar Amount Insurance Coverage - Obtain from the owner or other appropriate officials the estimated total dollar amount of insurance coverage. If unknown, enter "unk ". 17. % Unins. Loss Bus. Value - The "% Unins. loss Bus. Value" is an abbreviation for the percent uninsured loss to the value of the business. This value consist of the relationship between the businesses' total losses, its insurance coverage, and the replacement cost or total fair market value of land, structure and contents. The percentage is calculated by subtracting column 16 from column 15 and dividing that number by the dollar estimate listed in column 14. The entire result is then multiplied by 100 %. For example, if the: Estimated Dollar loss = $325,000 Dollar Amount of Insurance Coverage = $100,000 Total Fair Market Value: Land = $120,000 Structure = $675,000 Contents = $200,500 . Then, uninsured Toss to the value of the business is: ($325,000 - $100,0001 ($120,000 +$675,000 +$200,500) X 100% = 22.6% If the ins rance information required under column number 16, "DOLLAR AMOUNT INSURANCE COVE GE ", is not known, then do not attempt to calculate the percentage to be entered under column 17. Simp�y, leave this column blank. 18.1f Co 17 is <40% Min -If the percentage calculated and entered under column number 17, "% UNINS. LOSS B S. VALUE, is less than 40 %, check "MIN ". Column number 17 must have been filled have been filled out n order to complete this entry. If column 17 is left blank, also leave columns 18, 19 and 20 blank. 19. If Col 17 is: 40% - 75% Maj -If the percentage calculated and entered under column number 17, "% Unins. Less Bus. Value ", is between 40% and 75% (inclusive), check "Maj ". Column number 17 must be filled out in order to complete this entry. If column 17 is left blank, also leave columns 18, 19 and 20 blank. 20. If Co 17 Is: >75% Dest -If the percentage calculated and entered under column number 17, "% Unins. Loss Bu Value ", is greater than 75 %, check "Dest ". Column number 17 must have been filled out in order to complete) this entry. If column 17 is left blank, also leave columns 18, 19 and 20 blank. •