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EMERGENCY MANAGEMENT AGENCY
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0MB NO. 1860-0047
Expires January 31, 2011
See Reverse for Paperwork
Burden Disclosure Notice
MISSION ASSIGNMENT (MA)
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DEPARTMENT OF HOMELAND SECURITY
FEDERAL
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TRACKING INFORMATION (FEMA Use Only)
I.
State
NEMIS Number
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DC (D’stnct of Columbia) Incident 201 1082201-Hurncane Irene
Program Code Event Number
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3337EM-DC. HURRICANE IRENE
See Attached
ASSISTANCE REQUIRED
II.
DateIT me Received
0828/2011 2229
Assistance Requested
Post-Declaration-activate United States Forest Service (USFS) and Department of Interior to the FEMA National Response Coordination Center
(NRCC) to perform duties of Emergency Support Function (ESF) #4 in support of disaster operations in response to Humeane Irene
Delivery Location
Date/Time Required
0828/2011
Internal Control Number
FEMA NRCC
.
tnitiatorlRequestor Name
Robert Fenton
24 Hour Phone Number
(202) 646-2828
Email Address
Date
08 28/2011
Site POC Name
DEBROT. MARJORIE L
24 Hour Phone Number
12021 646-3493
Email Address
Marjorie Debrotdhs.gov
Date
08/28i201 1
Date
State Approving Official Required for DFA and TA)
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III,
INITIAL FEDERAL COORDINATION (Operations
ESF It
Other
.
Action to
4
Section)
Date/Time
08/28/2011 21.30
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Priorit’
1 Lifesaving
2. Life sustaining
3. High
4. Medium
See Attached
DESCRIPTION (Assigned Agency Action Officer)
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Statement of Work
to perform the functions of ESF #4 in the NRCC
Post-Declaration activation for appropriate USFS personnel and, as appropriate, DOI personnel,
supporting National-level coordination efforts and Regional response activities at the direction and coordination of FEMA, beginning August 27. 2011
This activation may include overtime and administrative costs
more than
Your agency s responsible for submitting a Mission Assignment Quarterly Progress Report to FEMA to include cost data when Mission Assignment takes
and submitted on-line at wwfema. gov/maprogress
30 days to complete including billing. The Mission Assignment Quarterly Progress Report can be accessed
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New or
Projected End Date
J27/2011
Projected Start Date
08/27/2011
Assigned Agency
USFS (U.S. FOREST SERVICE)
Total Cost Estimate
Amendment to MA It:
$110000.00
Phone
ESF/OFA Action Officer
Email
No.
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(540)265-5122
GORDYSACHS
COORDINATiON (FEMA Use Only)
V.
Direct Federal Assistance
State Cost Share (0% 10% 25%)
T ‘p e of MA’
0.0
State Cost Share Percent
State Cost Share Amount
%
Fund Citation
Mission
2011-06-3337EM-9034-XXXX-2501-D
Assignment Manager (Preparer)
ARNIE GONZALEZ
Federal Operations Support
State Share (0%)
Technical Assistance
State Share (0%)
S 0 00
Appropriation code. 70X702
Date
08/28/2011
Date
FEMA Project Manager/Branch Director (Program Approval)
.
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Comptroller/Funds Control Funds
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VI.
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MARLQR1E0EBRQT_
Date
Review)
APPROVAL
Date
‘State Anproving Official -equired r DFA ann TA
rDate
“Federal Approving Official irequired for a11
08/29/2011
STEVEN WOODARD
VII,
OBLIGATION (FEMA Use Only)
Mission Assignment Number
3337EM DC-USFS-01
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Arnendmnt Number
00
Amount Ths Action S 110 00000
Date/Time Obligated
-
Cumulative AmountS 110.000 00
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Signature requtred for Direct Federal Assestance and Technical Assstance MM
•* Signature required for all MM.
PREVIOUS EDITIONS OBSOLETE
FEMA Form 90.129, JAN 08
Region 3. State DC, 3337EM. MA#1 509 143363 (Open) as of 08/29/2011
Print Time 08/29/201116 30
Financial Program: 3337EM
RFA #15O9143363
Additional Mission Statement
Equipment purchases are not authorized under this Mission Assignment.
MA task orders will be issued for specific personnel requirements. location(s), dates, and duration of assignment(s).
Region 3. State DC, 3337EM. MA#1 509143363 (Open) as of 08/29/2011
Print Time: 08/29/2011 1630