RESOURCE REQUEST FORM (ICS 213 RR), Adapted for Team Rubicon Incident Name: 2. Date/Time: Resource Request Number: OP/ SP Name Date / Time 4. Order (Use additional forms when requesting different resource sources of supply.): 5. Resource Status (Complete after resource received) Unit of Detailed Item Description: (Vital characteristics, brand, Qty. Type Cost Received Date/Time Assigned Date/Time Complete Issue specs, experience, size, etc.) by to $total Requestor 6. Resource Requested by: (RLM/SLC/LSC) Name/ Position: 7. Date/ Time: Date / Time Name / Position 8. Method of Payment : Cash Billing N/A PEX Petty Direct Other: 9. Name of Suppliers/POC’s: N/A 10. Priority: Purpose: SP/OP Name Urgent Routine Low 11. Reply/Comments from Approving Authority & Requestor: 12. Approving Authority: (Next Higher Level) Name/ Position: 13. Regional Logistics Manager (Requestor): Name/ Position: Name / Position 14. Reply/Comments from HQ Logistics Management Associate: National 15. HQ Logistics Management Associate Signature: 16. Date/Time: Updated by TR 04/2015
RESOURCE REQUEST FORM (ICS 213 RR), Adapted for Team Rubicon Incident Name: OP/ SP Name 2. Date/Time: Date / Time Resource Request Number: Requestor 4. Order (Use additional forms when requesting different resource sources of supply.): Qty. Unit of Issue Type Detailed Item Description: (Vital characteristics, brand, specs, experience, size, etc.) Cost 5. Resource Status (Complete after resource received) Received by Date/Time Assigned to Date/Time Complete $total 6. Resource Requested by: (RLM/SLC/LSC) Name/ Position: Name / Position 7. Date/ Time: Date / Time 8. Method of Payment : N/A PEX Petty Cash Direct Billing Other: 9. Name of Suppliers/POC’s: N/A 10. Priority: Urgent Routine Low Purpose: SP/OP Name 11. Reply/Comments from Approving Authority & Requestor: 12. Approving Authority: (Next Higher Level) Name/ Position: National 13. Regional Logistics Manager (Requestor): Name/ Position: Name / Position 14. Reply/Comments from HQ Logistics Management Associate: 15. HQ Logistics Management Associate Signature: 16. Date/Time: Updated by TR 04/2015
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