WASHINGTON STATE RESOURCE REQUEST MESSAGE    (ICS 213RR WA)     Vers 8.4 .3                    

 * REQUESTOR *
1. Mission # & Incident Name:   {var IncName}  
2. Requesting Agency: {var AgName}
3. Date & Time  (mm/dd/yy - 0000) :   {var DateTime}  
 
4. Requester Tracking #  {var ReqTrackNum}
5. Resource Request
SHADED AREAS TO BE FILLED BY LOGISTICS/FINANCE SECTIONS
a. Qty     b. Kind  c. Type  d. Detailed item description and/or of task to be accomplished: (Vital characteristics, brand, specs, experience, size, etc.) and, if applicable, purpose/use, diagrams and other inf    Needed Date/Time    
e. Requested
f. Estimated
g. Cost
{var Qty1} {var Kind1} {var Type1}
{var Item1}
{var ReqDateTime1} {var EstDateTime1} {var Cost1}
6. Personnel/Support Needed:  (Driver/Fuel Etc.)
{var SupNeed}
 7. Duration Needed:  
   {var Duration}  
8. Requested Delivery/Report Location
{var ReqLoc1}    
9. Delivery/Reporting Location POC   (Name and Contact Info) 
{var ReqLoc}  
10. Suitable Substitutes &/or Suggested Sources  
{var Sub}
11. Priority : {var Priority}
12 . a. Have all commercial resources been exhausted: {var B12a}
       b. Have all local resources been exhausted:      {var B12b}
       c. Have all mutual aid resources been exhausted: {var B12c}


 
13. Requester willing to provided funding : {var B13}
if "No" Explain:

{var Explain}
14. Requested by Name/Position & phone/email:    
  {var ReqName}
15. Request Authorized by: 
{var ReqAuth}
 * LOGISTICS *
16. EOC/ECC Logistics Section Tracking # 
{var EocNum}
17. Name of Supplier/POC  (Phone/Fax/Email) 
  {var SupName1}
18. Notes (Be Brief)    
{var Notes}                
Approval Signature of Authorized Logistics Representative
{var LogRep}
  20. Date & Time: (mm/dd/yy - 0000)
  {var DateTime1}
21. Order Placed by:   {var OrderBy}   {var Other}
 
22. Elevate to State? {var Elevate}  23. State Tracking # {var StateNum}      24. Mutual Aid Tracking #    {var MATracking}      
 * FINANCE *
25. Reply/Comments from Finance  
{var FinComm}
26. Finance Section Signature:     {var FinRepName} 27. Date/Time (mm/dd/yy - 0000)  {var DateTime2}
 
Original to Documentation Unit    Copies to Logistics Section, originating ESF/Agency, & Finance & Administration Section.