LEOP Contractor Selection

Section I: Community Information
The completion of this form will serve notice to the State of New Hampshire as to how our community wishes to update our Local Emergency Operations Plan (LEOP). Please note if this form was accessed through the EMPG Application that once it has been submitted, you must return to the Application and submit that as well.
Community Name*
Town/City of
Primary Point of Contact Name:*
First Last
Title*
Address*
Street Address City State ZIP Code
Email*
Phone*

Section II: Planning Commission/Contractor Update
Our community chooses to utilize the services of:*
Private Consultant: By choosing a private consultant, we (the community) agree to enter into a grant agreement with the State of NH, and will be solely responsible to maintain all documentation and invoicing of paperwork.*
- I Agree and Understand
Regional Planning Commission: By choosing a Regional Planning Commission, we (the community) understand that the Commission will enter into a grant agreement, on our behalf, and will be responsible for maintaining all documentation and invoicing of paperwork.*
- I Understand and Agree
By updating the plan ourselves, we agree to enter into a grant agreement with the State of NH, and will be solely responsible to maintain all documentation and invoicing of paperwork.*
- I understand and Agree
Please enter the Name of the Private Consultant which your community is contracting with:*
Please select the Regional Planning Commission*
Please enter your DUNS Number*
Click here to locate your DUNS number and enter only the number in the space below.
Please enter an additional email to send a notification to.
Example: the email of the contractor that you selected.
Thank you for your information. This information will be considered in part with your EMPG Application Submission.
If you have any questions, please do not hesitate to contact us at 603-271-2231.

Section I: Community Information