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DocuSign Envelope ID: 1B46502C-936F-4363-9309-A1593E81EB36 <br /> 2018 HAZARDOUS MATERIALS <br /> PREPAREDNESS PROJECT APPLICATION <br /> Instructions <br /> Please provide the information requested below. All fields are mandatory. Limit your response to <br /> the space allocated whenever possible. If this is not possible, please indicate on the form when <br /> additional pages are attached. Clear, complete, and concise information is required for the <br /> panel to make fair and equitable decisions. <br /> Applicant Information <br /> Organization: Durham City/ County Emergency Management <br /> Mailing Address: 2422 Broad St Durham NC 27704 <br /> Street, City, State, Zip +4 <br /> Physical Address: 2422 Broad St Durham NC 27704 <br /> Street, City, State, Zip +4 <br /> DUNS Number: 088564075 <br /> Tax ID Number: 56-66000297 <br /> Host County: Durham <br /> Local Emergency <br /> Planning Committee Chatham, Durham, and Orange <br /> LEPC : <br /> Is your organization Yes <br /> registered in SAM: <br /> Point of Contact: Leslie O'Connor <br /> Title: Division Chief— Emergency Management <br /> Email: LOConnor@DcoNc.Gov <br /> Phone Number: (919) 560-7273 <br /> Fax: (919) 560-0661 <br /> 2018 Hazardous Materials Preparedness Project Application <br /> Page 4 of 8 <br />