Form must be filled out completely and legibly (must be reproducible by a copy machine). No plan of operations is approved until signed by both Authorized Contract Holder and DNR Representative. If you have questions, contact the DNR Geoduck Program staff at: (360) 902-1100. HARVEST AREA NAME: GEODUCK HARVEST AGREEMENT #: QUOTA #: PURCHASER/CONTRACT HOLDER: ADDRESS: TELEPHONE #: PURCHASER UBI #: WORKERS COMPENSATION COVERAGE ACCT #: INITIAL PLAN OF OPS ADDITION TO PLAN OF OPS CHECK or CIRCLE ONE: HARVEST VESSELS VESSEL INFORMATION: Name: Vessel Length: Registration No.: WDFW Geoduck Hrvst No.: Owner/Operator: Telephone No.: Address: Moorage Phone No.: Vessel Moorage Location: Relationship to Purchaser: Company Name: UBI Number: Workers Compensation: Yes No Account Number: VESSEL INFORMATION: Name: Vessel Length: Registration No.: WDFW Geoduck Hrvst No.: Telephone No.: Address: Moorage Phone No.: Vessel Moorage Location: Relationship to Purchaser: Company Name: UBI Number: Workers Compensation: Yes No Account Number: VESSEL INFORMATION:
Form must be filled out completely and legibly (must be reproducible by a copy machine). No plan of operations is approved until signed by both Authorized Contract Holder and DNR Representative. If you have questions, contact the DNR Geoduck Program staff at: (360) 902-1100. HARVEST AREA NAME: GEODUCK HARVEST AGREEMENT #: QUOTA #: PURCHASER/CONTRACT HOLDER: ADDRESS: TELEPHONE #: PURCHASER UBI #: WORKERS COMPENSATION COVERAGE ACCT #: CHECK or CIRCLE ONE: INITIAL PLAN OF OPS ADDITION TO PLAN OF OPS HARVEST VESSELS VESSEL INFORMATION: Name: Vessel Length: Registration No.: WDFW Geoduck Hrvst No.: Owner/Operator: Telephone No.: Address: Moorage Phone No.: Vessel Moorage Location: Relationship to Purchaser: Company Name: UBI Number: Workers Compensation: Yes No Account Number: VESSEL INFORMATION: Name: Vessel Length: Registration No.: WDFW Geoduck Hrvst No.: Telephone No.: Address: Moorage Phone No.: Vessel Moorage Location: Relationship to Purchaser: Company Name: UBI Number: Workers Compensation: Yes No Account Number: VESSEL INFORMATION:
aqr_planofops_vessels.docx