FACILITIES REPORT FOR BORROWING INSTITUTIONS

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NAVAL HISTORY AND HERITAGE COMMAND CURATOR BRANCH 805 KIDDER BREESE STREET SE WASHINGTON NAVY YARD, DC 20374-5060 (202) 433-7886 (202) 433-2220 curegistrar@navy.mil FACILITIES REPORT FOR BORROWING INSTITUTIONS 1. To the Prospective Borrower: Completing this report on your buildings / facilities, insurance, security and handling capabilities will help us assess the feasibility of the loan you are requesting. a. If more than one building will house artifacts, a separate Facilities Report must be filed for each building. b. Please attach a copy of your plans for your buildings, prospective display area, insurance policy, and other relevant information, as detailed below. c. If you have an existing American Alliance of Museums Facilities Report that includes the information requested below, that report can be submitted in lieu of the NHHC report. 2. Borrowing Institution Profile: a. Name of Borrowing Institution: b. Mailing Address c. Shipping Address: d. Telephone Number: f. E-mail Address: g. Website: h. Point of Contact: Name: Title: Telephone number: E-mail address:

NAVAL HISTORY AND HERITAGE COMMAND CURATOR BRANCH 805 KIDDER BREESE STREET SE WASHINGTON NAVY YARD, DC 20374-5060 (202) 433-7886 (202) 433-2220 curegistrar@navy.mil 3. Loan Profile: a. Purpose of loan / exhibition title: b. Requested dates of loan: From: To: c. List of objects to be borrowed (attach additional pages as necessary): d. Describe the context and surroundings in which the borrowed objects will be displayed:

4. Institution Information: a. Is your institution currently accredited by the American Alliance of Museums? Y/N If Yes, date of most recent accreditation: b. Check the type(s) below that best describe your institution: Federal agency or institution Veteran s organization Nationally recognized war veteran s organization Museum Memorial Reunion group Soldier s Monument Association Museum (non-profit) State museum Municipal museum Incorporated museum State government Municipal Corporation University Museum Other (Specify): c. Establishment documentation: Please attach a copy of the following documentation: Institution s charter Mission statement Non-profit status Endorsement of national headquarters organization, if applicable 3

d. Staff: Please provide information on your key staff: POSITION NAME TELEPHONE E-MAIL ADDRESS EMPLOYMENT NUMBER STATUS (FULL TIME, PART TIME, VOLUNTEER) DIRECTOR CURATOR REGISTRAR CONSERVATOR e. Insurance. 1. Please list the company that provides insurance for your institution: Company Name: Address: City / State: Broker Name: Telephone Number: 2. Please indicate what coverage your policy provides for borrowed objects (check the applicable elements): All-risk museum coverage on a wall-to-wall basis (while on exhibit and / or in transit), subject st to andard exclusions on all collections, owned or borrowed. Legal liability for property of others in its care, custody and control. Coverage against burglary and theft. Coverage against fire. Coverage against rising water and water damage. Coverage against mysterious disappearance. Coverage against employee dishonesty. 3. Please list the deductible limits of coverage for borrowed objects: $ 4

e. Financial management: What is the institution s budget? Overall Current year CY+1 CY+2 CY+3 CY+4 CY+5 (CY 0) Collections Management f. Collections management. Please provide a copy of your collections management plan. This should include: Mission Statement Description and scope of collections Authority and responsibility regarding collections Access to collections Collections management activity - Documentation - Acquisition of Collections - Disposal of Collections - Risk management and insurance - Collections care and preservation - Collections control - Security - Inventory - Collections in Temporary Custody - Lending Collections - Outgoing loans - Incoming loans 1. How will borrowed objects be transported to and from your building (NHHC retains final approval on transportation arrangements.): 2. If transported by you, will the borrowed items be in weather tight, locked trucks properly secured and insured against damage in transit? Y/N 5

3. Do you have adequate, secure work space for unpacking, packing, and preparing objects for display or study? Y/N - If Yes, please indicate square footage: 4. Will you provide experienced, competent museum objects handlers? Y/N 5. Do you have a well-equipped and staffed conservation laboratory? Y/N 6. Describe how items are to be installed in the display area, including mounting techniques, materials, and type of display case (if proposed): 7. List other institutions you have borrowed from recently: INSTITUTION NAME OBJECT TYPE YEAR(S) 5. Facilities Information: a. Provide a brief description of the overall facility: 1. Number of buildings: 2. Type of building to be used for display (Check as appropriate): Type I - Fire resistive. Type II - Non-combustible (including concrete / masonry, etc.). Type III - Ordinary. Type IV - Heavy timber. 6

Type V - Wood Frame. Other. Please describe: 3. Square footage: - Display area: - Collections storage area: b. Is the facility Americans with Disabilities Act compliant: Y/N c. Life safety / fire protection: Please describe the systems in your facility: 1. Sprinkler System? Y/N If Yes, what type of piping is used Wet, Dry? 2. Gaseous/Clean Agent Fire Suppression? Y/N If Yes, what type of gas is used? 3. Fire extinguisher in exhibit, laboratory and storage areas? 4. Heat alarms? in exhibit: Y/N in laboratory: Y/N in storage area: Y/N in exhibit: Y/N in laboratory: Y/N in storage area: Y/N 5. Smoke alarms? in exhibit: Y/N in laboratory: Y/N in storage area: Y/N 5. Other detection/extinguishing system. Please specify: 7

d. Physical security: Please describe the systems in your facility: 1. Alarm systems: Is your institution equipped with: - Volumetric intrusion detection system? Y/N - Sensors in collections areas? Y/N - Sensors in exhibit areas? Y/N - Sensors on display cases? Y/N - Does the alarm sound at a central station? Y/N 2. Security / guard force: - Serviced by a full-time 24 hr. professional guard force? Y/N - How often are patrols made of the facility? - Is there an operating security camera system operating in the facility? Y/N If video recorded, for how long? 3. Locks: - Access doors equipped with double cylinder dead bolt locks? Y/N - Display cases are equipped with: Security screws: Y/N Locks: Y/N 4. Who is on your recall / access list in case of emergency? NAME TITLE 8

5. Do you have a disaster / emergency response plan? Y/N - Date of latest revision: - Frequency of staff training: e. Environmental controls / systems: Quarterly: Y/N Annually: Y/N Other: 1. Please indicate the type of environmental control system(s) in your facility: Centralized 24-hour temperature control system: Y/N Centralized 24-hour humidity control system: Y/N Centralized 24-hour filtered air system: Y/N Simple air conditioning (window units): Y/N Simple heating: Y/N 2. Describe the environmental conditions in your facility: POSITION TEMPERATURE (F) %RELATIVE HUMIDITY COLLECTION STORAGE AREAS EXHIBITION AREAS SPRING / SUMMER: FALL / WINTER: SPRING / SUMMER: FALL / WINTER: SPRING / SUMMER: FALL / WINTER: SPRING / SUMMER: FALL / WINTER: f. Lighting: 1. What type of lighting do you utilize in exhibition areas: Daylight: Y/N Skylights: Y/N Florescent: Y/N Artifact Lighting: Y/N 9

7. Verification and Responsibility: 2. Do you have a light meter? Y/N 3. What are the light levels (measured in Foot candles) in exhibition areas? 4. Are objects safeguarded against ultraviolet rays and heat buildup from interior lights? Y/N - If Yes, please describe: a. Report writer: The undersigned is a legally authorized agent for the subject institution and has completed this report. Signature: Typed or printed name: Title: Date: b. Supervisor: I certify that the information provided in this report is true and to the best of my knowledge. Signature: Typed or printed name: Title: Date: 8. Please complete, sign and return this report by email or US mail to: Associate Registrar for Loans Naval History and Heritage Command 805 Kidder Breese Street, SE Washington Navy Yard, DC 20374-5060 ATTN: Curator Branch curegistrar@navy.mil 10