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Resource Request Form - Hard Goods (ICS 213-HG)

1. Incident Name: 2. Date of Request: 7/28/2020 3. Section/Branch/Department Making Request:


COVID-19 Response 4. Time of Request: 10:30 AM HREEO
5. Section/Branch/Department P.O.C. 6. POC Phone Number 7. POC E-Mail Address
Andrea Ledger 651.266.6422 andrea.ledger@ci.stpaul.mn.us
8. Resource Request:
Qty Item Make/Model/Description Requested
Delivery Date
washable masks per the citywide distribution
240 flexible
Request

9. Notes (Please detail the resources provided to the requests listed above):
Response

10. Requesting Sect/Brch/Dept Approval 11. Date 12. Planning Approval 13. Date 14. Logistics Approval 15. Date
Valerie Jensen 7/28/2020
16. Additional Approval (only as needed: HR, Operations, etc.) 17. Date

a. Download a copy of this form to your local computer for use and save a blank copy or download a copy as needed.
b. Fill out, then "Save As" with the original file name PLUS your department name AND date of submission.
c. Email the completed form to EOCLog@ci.stpaul.mn.us and Procurement@ci.stpaul.mn.us.

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