Town/City of MUNICIPALITY STREET ADDRESS MUNICIPALITY, VT ZIP The Emergency Management Plan (LEMP) must be (re)adopted annually, after town meeting day, and submitted to the appropriate Regional Planning Commission (RPC) by May 1st. At a warned public meeting (regular selectboard/city council meeting), the municipality adopted the Local Emergency Management Plan (LEMP) on the date shown at right. Municipality At a warned public meeting (regular selectboard/city council meeting), the municipality adopted the National LEMP Adoption Incident Management System (NIMS) on the date shown Date at right. NIMS Adoption Date EMD Name If Vermont Emergency Management to contact EMD Position municipal leaders to determine status and support Primary Phone requirements during an emergency, the Emergency Management Director (EMD) and two other local Points Alternate Phone Of Contact (POCs) who should have authoritative local information are listed at right. POC 2 Name Position Mark this block if a readopted plan has no changes since the previous year. Primary Phone Alternate Phone I hereby certify that the LEMP meets Vermont National Email Incident Management System (NIMS) requirements and POC 3 Name current LEMP Implementation Guidance as on page 2: Position Primary Phone Alternate Phone Signed* Email Printed Name; certifying individual must have taken, at a minimum, ICS402 or ICS100/IS-100 training I hereby attest that the municipality has adopted NIMS and the LEMP as stated above: Signed* Printed Name, Selectboard / council member Once completed, send adoption form (2 pages) and copy of Local Emergency Management Plan to Regional Planning Commission. *A typed name is acceptable as an electronic signature if it represents an act of that person in accordance with 9 V.S.A. § 278. Check boxes below indicating the plan has the required elements and, if not using a template, fill in page numbers to report completion of required elements.
Town/City of MUNICIPALITY STREET ADDRESS MUNICIPALITY, VT ZIP Municipality LEMP Adoption Date NIMS Adoption Date EMD Name Position EMD Primary Phone Alternate Phone POC 2 Name Position Primary Phone Alternate Phone Email POC 3 Name Position Primary Phone Alternate Phone Email The Emergency Management Plan (LEMP) must be (re)adopted annually, after town meeting day, and submitted to the appropriate Regional Planning Commission (RPC) by May 1st. At a warned public meeting (regular selectboard/city council meeting), the municipality adopted the Local Emergency Management Plan (LEMP) on the date shown at right. At a warned public meeting (regular selectboard/city council meeting), the municipality adopted the National Incident Management System (NIMS) on the date shown at right. If Vermont Emergency Management to contact municipal leaders to determine status and support requirements during an emergency, the Emergency Management Director (EMD) and two other local Points Of Contact (POCs) who should have authoritative local information are listed at right. Mark this block if a readopted plan has no changes since the previous year. I hereby certify that the LEMP meets Vermont National Incident Management System (NIMS) requirements and current LEMP Implementation Guidance as on page 2: Signed* Printed Name; certifying individual must have taken, at a minimum, ICS402 or ICS100/IS-100 training I hereby attest that the municipality has adopted NIMS and the LEMP as stated above: Signed* Printed Name, Selectboard / council member Once completed, send adoption form (2 pages) and copy of Local Emergency Management Plan to Regional Planning Commission. *A typed name is acceptable as an electronic signature if it represents an act of that person in accordance with 9 V.S.A. § 278. Check boxes below indicating the plan has the required elements and, if not using a template, fill in page numbers to report completion of required elements.
2019%20LEMP%20Municipal%20Adoption%20Formv2.docx