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Lending Cooperative Mutual-Aid Form
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Lending Cooperative Mutual-Aid Form
Lending Mutual-Aid Form
If your cooperative is lending mutual-aid to a distressed cooperative. Please complete the form below.
Cooperative Lending Mutual-Aid Assistance
*
If your cooperative is lending mutual-aid to a distressed cooperative. Please complete the form below.
Contact's Name at the Cooperative
*
First
Last
Primary Contact's Phone Number
*
Primary Contact's Email
*
Cooperative Lending Mutual-Aid Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Radio Channel Used
Uniform Arc Rating
Gloving Voltages Crews Equipped for
Please upload the signed NRECA Mutual-Aid Agreement
Max. file size: 30 MB.
Are FEMA equipment rates used?
Yes
No
Please upload rates charged for man hours
If rates for man hours are not included in the Mutual-Aid Agreement, please upload.
Max. file size: 30 MB.
Please upload rates for equipment
If rates for equipment are different from FEMA rates or they are not included in the Mutual-Aid Agreement, please upload.
Max. file size: 30 MB.
Date crews are available
*
MM slash DD slash YYYY
Number of days crews are available
*
Are rotation crews available?
*
Yes
No
Crew 1
Type of Crew
*
Ranking person on the crew
*
First
Last
Phone number for the ranking person on the crew
*
Additional Crew Members
*
Please use the plus sign to add additional people.
Crew Member's Name
Job Classification
Cell Phone Number
Vehicle Type
Vehicle Number(s)
Emergency Contact
Emergency Phone Number
Special equipment en route with crew?
Yes
No
Description of specialty equipment
Crew 2
Only complete Crews 2-4 if you are sending multiple crews.
Type of Crew
*
Ranking person on the crew
*
First
Last
Phone number for the ranking person on the crew
*
Additional Crew Members
*
Please use the plus sign to add additional people.
Crew Member's Name
Job Classification
Cell Hone Number
Vehicle Type
Vehicle Number(s)
Emergency Contact
Emergency Phone Number
Special equipment en route with crew?
Yes
No
Description of specialty equipment
Crew 3
Type of Crew
*
Ranking person on the crew
*
First
Last
Phone number for the ranking person on the crew
*
Additional Crew Members
*
Please use the plus sign to add additional people.
Crew Member's Name
Job Classification
Cell Hone Number
Vehicle Type
Vehicle Number(s)
Emergency Contact
Emergency Phone Number
Special equipment en route with crew?
Yes
No
Description of specialty equipment
Crew 4
Type of Crew
*
Ranking person on the crew
*
First
Last
Phone number for the ranking person on the crew
*
Additional Crew Members
*
Please use the plus sign to add additional people.
Crew Member's Name
Job Classification
Cell Hone Number
Vehicle Type
Vehicle Number(s)
Emergency Contact
Emergency Phone Number
Special equipment en route with crew?
Yes
No
Description of specialty equipment
About Us
Board of Directors
Members
Staff
Directory
Cooperative Principles
Q & A
Resources
News
Events
Legislation & Regulatory
Louisiana Public Service Commission
Action Co-Op
Legislative Updates
ACRE
Public Relations & Education
Youth Tour
Energy Saver
Vendor Registration
Safety & Loss Control
Schools
Training Sessions
Federated Rural Electric Insurance Exchange
Zero Contacts
Emergency Assistance
Emergency Work Plan
Emergency Work Contractor Form
Storm Information
Emergency Assistance Request Form
Lending Cooperative Mutual-Aid Form
Publications
Co-op Monthly Magazines
Advertising Rates & Information
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