IGA- Oak Brook Park District & VOB- Temporary Shelter Agreement 11-13-1988 VILLAGE OF OAKBROOK - EMERGENCY SERVICES AND DISASTER AGENCY (ESDA)
TEMPORARY SHELTER AGREEMENT
It is the intent of the Village of Oak Brook through it's
Emergency Services and Disaster Agency (ESDA) , to arrange
temporary shelter for victims of a declared disaster who
have been identified and registered as such by the Village of
Oak Brook ESDA. Because local government itself does not
have adequate facilities for this purpose, the Village of Oak
Brook ESDA hereby enters into the following agreement with
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(entity)
(hereafter known as "the provider") , through it's undersigned
agents, in order to make available temporary shelter in the
event of a disaster.
All temporary shelter areas, supplies and provisions herein
referred to shall be specifically stated in Addendum A of
this agreement. The provisions contained herein shall remain
in effect until such time as either party informs the other
in writing, of the desire to modify or dissolve this
agreement.
1. The provider of temporary shelter shall do so only to the
extent that the designated areas, supplies or provisions
(Addendum A) , are readily available and uncommitted for the
period requested.
2. only out-of-pocket expenses incurred by the provider which
are in direct relation to the shelter operation as stated in
Item 4, shall be reimbursed by the Village. Such expenses
shall not exceed $2500. 00 (twenty-five hundred dollars) per
declared disaster, unless consent to exceed that amount is
given by the Oak Brook ESDA Coordinator, pursuant to Article
VI, Section 2-204 (b) , of the Village of Oak Brook Code of
Ordinances.
3 . Village personnel or their designees shall be responsible for
the operation and control of temporary shelter activities as
outlined in Item 4 of this agreement. They shall coordinate
all such activities with a designated representative of the
provider.
4 . The provider agrees to permit any lawful associated activity
in conjunction with the temporary shelter operations. Such
activities shall include, but are not limited to; eating,
sleeping, the conducting of religious services, the use of
any sanitiary facilities, and making provisions fdr any of
the above.
5. once the temporary shelter is to be closed, the Village of
Oak Brook ESDA is responsible for returning the facility to
its pre-shelter condition (except for ordinary wear and tear)
before leaving, unless specifically relieved of that
responsibility by the provider.
This agreement is established according to the provisions of
the Illinois Emergency Servises and Disaster Agency Act of
1975, as contained in Chapter 127, par. 1101 thru 1126 of
the Illinois Revised Statutes.
Signed this 3t` day of � c�meT_ ,1988.
Village P s nt
Village ESDA Co dinator
AGENT(S) OF THE PROVIDER;
game title/position
e
name title/position
ADDENDUM A
The provider will make available the following specified
areas, supplies, and/or provisions, according to the ac-
companying guidelines, if any.
AREAS;
# Shelter facility at 1500 Forest Gate Road,
and
# Indoor Racquet Club Facility at 1300 Forest Gate Road,
with attention given to the following:
- Indoor tennis court surface. Provide proper
protective covering to court surface so as not to
damage cushioned surface.
- Racquet ball wooden court flooring. Proper care so
as not to scratch 'or cause warpage of floors.
SUPPLIES / PROVISIONS;
i
ADDENDUM A
The provider will make available the following specified
areas, supplies, and/or provisions, according to the ac-
companying guidelines, if any.
AREA
# Shelter facility at 1500 Forest Gate Road,
and
# Indoor Racquet Club Facility at 1300 Forest Gate Road,
with attention given to the following;
- Indoor tennis court surface. Provide proper
protective covering to court surface so as not to
damage cushioned surface.
- Racquet ball wooden court flooring. Proper care so
as not to scratch or cause warpage of floors.
SUPPLIES / PROVISIONS;
VILLAGE f OAK BROOK 1vsDA MASS CARE FACILITY SURVEY
F
Survey Completed:
1
����`�� Survey Update:
Site Name: L I
Address: �s�d �o����CT�
C�c�sz-
Main Telephone:
Directions to the Facility From the Village Commons
.�d tTz-c-E-1 o ;� av� �' S�z�-�°_'TT �rc.1 .�oczc'E l.�,t�.• � `�a�s�"
_mod
-T-0-r-�^ Rw cc -C
�Sct+z�2�
To Open the Facility`Call: Person Who Opens the Facility: Alternate to Open the Facility:
Name---n8 u` S Name:7ANM14 TEA
Name: � T'
Titls: ' C-�rtZGr_Q tZ
Title: 'iPt�Crilt O�c �R ► Title: U ��
Business Telephone: t5Z- ?ft-W33 Business Telephone: (3t2 ) 9a-t123'S Business Telephone: (3+2-1T � �Z
Home Telephone: (�- I�(t(s-�}y/aS Home Telephone: (312 ) �l Home Telephone: LIZ I �Sd>3
Village personnel authorized to ooen shelter
Address: 1200 Oak Brook Road - Oak Brook Village Hail
Oak Brook IL
Telephone: ( 312 I 990-3000 general govt OR 990-2121 police emergency line
Contact: Oak Brook ESDA Coordinator OR ESDA sta£f in charge
NOTE: Those requesting use of the facility as a temporary shelter
must be able to give the code word(s) to the appropriate facility
personnel.
i
Site Name: County
`jG7G �'a2CS-t- vk-ti= -• City/Community::t -y— r)tSr
Street Address
31;::%__ &dSZ-1 School District:
City State Zip Code
-42
Telephone:
Please cotttpletc the following section ns thoroughly as possible,
Irtcliciali; numbers, space dinrctnslons, elc.,jwhere applicable.
check applicable boxes for this specific facility.
CONSTRUCTION `` FOOD PREPARATION SANITATION
Year constructed: L Type of Service: Total number of individual
Wood frame k''Full kitchen SMr44 F(ctiti r%(P0 units (do not include urinals):
LJ Concrete ] Warming oven kitchen Toilets:
tid')vtasonry ❑ None . No.male_No. female 2'
❑ Metal
D Prefab ,E��uiprnenC Wash basins:
❑ Bungalow li�RofrIgeratortsf t No. rnsel_No. female
O Trailer O Walk-in refrigeratorts)
r] Other (specify): Freezer(sl Showers:
Handicapped access: 17,Walk-in rfreezerts) No. male No. tamale
I
VBuildings J; iurners: number: _
�YReatrooms O Griddlels). number: Laundry:
Q10ven(s). number: No. washers No.dryers
❑ Convection oven(s). number:—7—
CLASSROOMS tiZ Iicrowava events), (number).
(Not libraries.shops. labs. or equi ment Number of individual servings that can be WATER SOURCE
rooms) C%&%.) to'G w 4M
d :� A tutee prepared per meal:
Number: 1`t,.lO Qoc�C-tS - O✓L+ � -- — W-M-unicipal
."ts4a 600 well(s)
Average size: _
(sq. it.) t:;Other:
Total area, all classr9omms: FOOD SERVING (sq. ft.) L7 Trapped water,drinkable.in gallons:
{i ft.l LJ Cafeteria 1)Trapped water,nondrinkable.In gallons:
t�t1r/'005L- tZH. ❑ Catetorium
Homemaking and other rooms with u Other joint use 0 Swimming pool
cooking equipment Inol kitchen): (specify)
❑Snack bar t� --
(number) O Other COMMUNICATIONS
(specify) Transrr�t r f�rToYb@Ot.r4
OTHER ROOMS/NON-FOOD (sq. It.) -1 None / rgceiv r,
:f .0 F3 Orto
Maximum sealing capacity: (frequency) (type)
❑Auditorium Number indoor t�umber outdoor__
•Permanent seating On C.1�1 O -044ACe ❑Additional tolophgnes:
•Sloped floor l
•Gymnasium UTILITIES
• Multipurpose Nat. LP Electric Water 0 Pay telephones:
t�iSE.F•tew r r
� oG� Gas Gas
❑ Cooking 0 C.
Heating ❑ CJ r GENERATOR
OUTDOOR SPACES Cooling ❑ '
CJ Yes
tX-A-11',Ietic field(sl M Mme_ Specify use:
0 Other: HEALTH CARE
No.of rooms: _ Operator:
O Fenced court(s) Total area of
(number) health rooms: Telephone; i 1
Parking lot(s) too (sq. It)
pnaximum number) No. of beds:
I
I
y
A.Limitations an Facility Use (Update yearly) 8 � rq i "t-tC
1. Availability
This facility should be available at any time during the yeay
This facility will not be available during the following time period without obtaining special permission of
the owner(s):
to
to
to
Note: Never open this Mass Care facility without obtaining proper authorization from persons listed on
page 1 of this form.
2. Accessibility
This facility may not be accessible during the followi ypes of disasters:
(List type of disaster and reason for inaccessibilit
Note: If one/o( the above-listed disasters has occurred, check with the building representative before
sending a Mass Care team to activate the facility.
B. General Information
1. Groups associated with the facility:
— Fire auxiliary .Church
auxiliary _ Paid staff _Paid feeding persons
Other (specify):
2.Does the Red Cross have a written agreement with these groups to use them in providing mass care services
in the facility? .
Yes No
If "yes;' has the group been trained to perform its assigned function? _Yes No
3. Is a written agreement for use of the facility attached? J&Yes No
Q.Recommended for use as a Red Cross Mass Care fa`cil�ity? + _Yes . No
5. Facility survey completed by: Name: S t-te-G "'
F
Title: Gk��Gl T -L✓C:. !fit TC[Z
Date:
MASS CARE FACILITY SURVEY
VILLAGE OF OAK BROOK ESDA
Survey Completed:
Survey Update:
Site Name:
Address: T �tdTi�
Main Telephone:
Directions to the Facility From the Village CommonsG�
[prAv-emxxaK.7,ACWZ�L 0
R 4'-c --r °i`L.Lt d tittc Eck l+l o CEE +� �c �i� c Sr t ?
tt N
64T'E Tv tt c= L�tZtVL=LtJ u4 U 141v t`.s T'o
E
To Open the Facility, Call: Person Who Opens the Facility- Alternate to Open the Facility:
Name:. tJ .S'"'1-t _ Name:�ttticuZC �t >�Ftr��t�''1 _ Name: tO �� S
Title:e r, �, -tai !Jt t� Title:JGC�4ET CLu(e tAt4"' Title: iQ t77fZ 6 FJ 11*�
Business Telephone: OM r O'q?-13 Business Telephone: 1311- )q f6-q,9460 Business Telephone: 1-312 i r�--y233
Home Telephone: (36 1�//!n'� �5 Home Telephone:_L3V )528"141,1.8 Home Telephone: 13(t )425-2815
71
Village personnel authorized to Oren shelter
Address: _ 1200 Oak Brook Road - Oak Brook Village Hall
Oak Brook,IL
Telephone: 1 3121 990-3000 general govt OR 990-2121 police emergency line
Contact: Oak Brook� ESDA Coordinator OR ESDA si-Aff in charge
NOTE: Those requesting use of the facility as a temporary shelter
must be able to give the code word(s) to the appropriate facility
personnel.
I
Site Name: C}( k -�iLt2 �kltSz�tGt > [ ttt=T ��-�47�County:. ��t•-���
pt,�tc 3 �,mr,C
City/Community:
Street Addres
Zn5 ZI School District: r-
City � State �^, Zip Code
Telephone: AL) <q'1�r O please Complete the following section as thoroughly as possible,
inclicating numbers, !space cl1nien5101115, etc.,j where applicable.
Check tpplIcible boxes for this specific facility.
CONSTRUCTION FOOD PREPARATION SANITATION
Year constructed! Type of Service: Total number of individual
0 Wood frame Full kitchen units (do not include urinals):
Ptoncrete C Warming oven kitchen Toilets;
it?''titasonry 0 None , No. male, No. female--"L
0 Metal
7 Prefab Equipment: Wash basin
C7 Bungalow I]Refrigerator(s) No. male No. female
Ei Trailer 0 Walk-in refrigerator(s)
(] Other (specify): u I'mezeris) Showers:
Ilandicapped access: (.l Walk•in freezer(s) No.male► ,No.famale-3—
VBuildings 0 Burners: number:
1y liesirooms 0 Griddle(s),number: Laundry:
CO Oven(s), number: No, washers No. dryers
0 Convection oven(s), number: _
CLASSROOMS C Microwave oven(s), (number):
(Not libraries, shops,tabs, or equipment Number of individual servings that can be WATER SOURCE
rooms) prepared per meal:
Number J _� lunlcipal
Weil(s)
Average size:
i�] Other:
Total area,all classrooms: FOOD SERVING (sq. ft.) L7 Trapped water,drinkable,in gallons;
(sq. It.) 0 Cafeteria 0 Trapped water,nondrinkabic in gallons:
0 Catetorium
Homemaking and other rooms with 0 Other joint use GG�inw++jnq pool
cooking equipment (not kitchen): (specify) Wit4imL
0 Snack bar joor4rLv3tte
inumber) 0 Other COMMUNICATIONS
(specify) ransmitterreceiver: �tjOTtJ�cK-�?
OTHER nOOMSlNON-FOOD (sq, It.) C None 159. ams- 4T-,q
Maximum seating capacity: (frequency) (type)
0 Auditorium Number indoor Number outdoor
0 Permanent seating Additional telephones: A
0 Sloped floor (�
0 Gymnasium UTILITIES
C7 Multi urpose Nat. LP Electric Water ay telephones:
Ik�par� TEytfli5 CTS• Gas Gas
Cooking 0 C. L1
d HrcCQ3 ^ltriayGCSS Heating n O c GENERATOR
OUTDOOR SPACES Cooling L; 0 E:
e,l 0 Yes PA.
Alhletie ficid(s) Specify use:
C3 Other, HEALTH CARE
No. of rooms: _ Operator:
(3 Fenced court(s) Total area of
{number) health rooms: Telephone; I )
Parking lot(s) Inn (sq. ft)
(maximum number) No. of beds:
I�
A.Limitations on Facility Use (Update yearly) Q p
1. Availability C7GT "1*AJ1 j0 &I Vt0UC-c- A•T
This facility should be available at any time during the year,14S art O X N
1 his facility will not be available during the following time period without obtaining special permission of
the owner(s):
to
to
to
Note: Never open this Mass Care facility without obtaining proper authorization from persons listed on
page 1 of this form.
2.Accessibility
This facility may not be accessible during the following types of disasters:
(List type of disaster and reason for inaccessibility)
i
y�
Note: If one of the abovi),efis' ted disasters has occurred, check with the building representative before
sending a Mass Care team to activate the facility.
8. General Information
1. Groups associated with the facility:
_Fire auxiliary _ Church auxiliary Paid staff Paid feeding persons
Other (specify):
2. Does the Red Cross have a written agreement with these groups to use them in providing mass care services
in the facility? ,
Yes X No
If "yes;' has the group been trained to perform its assigned function? —Yes _No
3. Is a written agreement for use of the facility attached? , Yes No
4.Recommended for use as a Red Cross Mass Care facility? —Yes . No
5.Facility survey completed by: Name: a '� ---
Title: t.c- Ct^t TuCrc (/t'
Date: