Attachment 2 - Data Sheet and Project Narrative.docx

Agreement Details

TSA Law Enforcement Officer Reimbursement Agreement Program (LEORP)

Section 1: Participant Details

Airport Code:

Airport Name:

UEI Number:

Federal Tax ID Number (TIN)/Employer ID Number (EIN):

Applicant Information

Entity/Legal Name:

Address:

City:

State:

Zip Code:

Authorized Representative

Full Name:

Title:

Email Address:

Phone Number(s):

Section 2: Selection Information

1) Whether airport has a police department specifically dedicated to airport security and, if so, name of the entity providing Law Enforcement Services:

2) Total number of LEOs assigned to the airport:

3) Number of LEOs dedicated to provide support of the passenger screening checkpoint(s):

4) Operational Hours of the Passenger Screening checkpoint(s):

5) Number of checkpoints and lanes:

6) Total number of daily departure flights. Note: arrival flights are not considered for reimbursement. Banks of departure flights at a particular checkpoint will be treated as singular periods of time for reimbursement purposes, regardless of the number of departing flights during that bank. A break of more than 1 hour from departure release time to the next departure report time constitutes a new bank:

7) Daily number of hours LEO(s) are assigned to checkpoint(s); daily number of hours LEOs are in the vicinity/close proximity of the checkpoint(s):

8) Why the deployment of available resources cannot effectively fulfill airport security mandates, including any specific impacts the lack of program funding could have on security operations:

9) Type of security posture (select one): [Fixed/Flexible/Hybrid]

Section 3: Project Narrative

1) Supplemental Requirements – describe the specific LEO support to be provided under this Agreement which supports TSA screening activities. Such support, based on the specific characteristics and security requirements of the airport, could include (but is not limited to) LEO patrol of a particular area, or unique assistance to local TSA. Note that such additional activities should only include those which are being performed during periods of TSA screening operations, and which do not interfere with the LEOs’ ability to provide immediate response to incidents at the screening checkpoints. If utilizing Flexible or Hybrid Stationing, Participant must include specific LE response times to non-emergency/routine TSA calls for assistance and details of LEO support being provided in support of passenger screening:

2) Budget Request and Justification – provide details regarding the number of LEOs to support the project, salary & benefits of those supporting the project (include rank/position), number of shifts per officer and hours. A brief justification is required to support the requested budget. If additional supporting documentation is required, it may be included as an attachment to this document.

Signature from authorized official affirming that all terms and conditions of the Parent OTA will be met and that all information submitted within this document is complete and accurate.

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