Be sure the Fire Name, Area and Fire Number, Unit Fire Number and Responsibility Center Number have been recorded and saved in the F1000 before starting a F1021.
This form will now be used exclusively to list fire costs and will replace the F-310. Use this form for all non-SABHRS costs.
The F1021 can be filled out partially by the person (the engine boss for instance), and "saved". Then the business person can fill in the rates for items being billed. When “prepare” is clicked from the main F1000 form the checking will be done for both the F1000 and the F1021.
The form is used when it is necessary to calculate costs for billable fires.The preparer fills out the electronic form and after the F1000 is approved, prints the F1021, gets necessary signatures and sends the original with the F1000 Fire Report and retains one copy for the unit files.
Part I is a worksheet utilized by initial attack personnel to record fire investigation information necessary for determining billing.
Click in the box to indicate “yes”.
Click in the box to indicate “yes”.
Click in the box to indicate “yes”.
Click in the box to indicate “yes”.
Enter the photographer's name.
Record the pole ID number and name of the power company who owns the pole from the pole ID tag, if present. Record this information from the pole nearest the fire's origin.
Record the number of the mile marker nearest the fire's origin. (Note—The railroad mile marker, not the nearest highway mile marker.)
In summary, write your opinions regarding the fire's cause based on the evidence available and information obtained from firefighters and other persons interviewed.
Write in this block either “witness statement will be attached to hard copy” or “no witness statement taken”.
This is really a voluntary witness statement. Usually the witness writes the witness statement out in his or her own words dates and signs it. You do not need to retype that information onto the electronic 1021 form.
This voluntary witness statement will be attached to the hard copy of the F1000 and F1021 report and sent in to the bureau. A copy should be kept at the unit.
Not entered on electronic report. (See Witness Statement)
Not entered on electronic report. (See Witness Statement)
This portion is to be completed by the unit or land office. Record the specific statute violated (see the "1000—Fire Follow-up Manual," section 1004.45, where the most common violations are listed). Call the Fire Training and Prevention Section of the Fire and Aviation Bureau if you require additional assistance.
Click in the box to indicate “yes”. (To be completed by the unit or Land Office)
Click in the box to indicate “yes” . (To be completed by the unit or land office)
Print your name in space provided.
Sign full name as investigator.
Part II is used to calculate the charges for a billable fire if a separate SABHRS responsibility center number has not been assigned for the fire, or to prepare a billing before a SABHRS report is available.
List the name of the employee or name/number of items of equipment. Include only those personnel and equipment actually used for fire suppression at the incident.
EFF and equipment rates are found in the blue pages of the Interagency Incident Business Management Handbook (IIBMH). DNRC engine rates are in the blue pages, Chapter 50, page 21 of 38. Contract rates are in Chapter 30. Any DNRC permanent or seasonal personnel rates will have to be obtained from their agency. Zero dollars can be put in for the rate if you want to suppress someone's hourly rate.
Units are the number of items (hours, days, etc.) the rate is applied to. For personnel, show the actual number of hours chargeable at the scene of the fire and travel to and from the fire. For equipment, show a minimum of one hour for each item listed or the actual number of hours the item was in use for fire suppression. Charge a reasonable number of hours for the situation.
Type of unit i.e. hours, lunches, dayrate.
The amount is automatically computed by multiplying the rate by the units.
The total is automatically calculated by totaling all the amounts. This is the total amount the State intends to collect for this fire. Note—At the discretion of the land office, other documented charges, i.e. foam concentrate used, meals, etc. may also be listed and included in the total amount.
Either check the “See F1000 narrative” or include a brief description of what took place (this narrative may refer to and expand on information contained in the F-1000 Fire Incident Report narrative). Explain any extenuating circumstances that might bear on billing actions taken by DNRC. This section is used to provide information when the billing letter is prepared and when questions are asked in regard to the billing letter. Include information on whom to bill and where to send the bill.
Type in the person’s name, date and title. When the form is printed, the unit Fire Supervisor should sign it .