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<br />ATTACHMENT 5 <br /> <br />PRODUCT AND SERVICE PROVIDERS FORM <br /> <br />Department Heads are responsible for maintaining records of essential <br />products and services used within their departments. This form can be used for <br />gathering and maintaining this information. <br /> <br />PRODUCT I SERVICE PROVIDER <br />Company Name: <br />Address: <br />Telephone: <br />Fax: <br />E-mail: <br />Primary contact: <br />Alternate contact: <br />Account I contract: <br />Materials provided: <br />Frequency of delivery: <br />Notes: <br />If this company is unable to provide materials/services they can be obtained from the following organization(s): <br />Company Name: <br />Address: <br />Telephone: <br />Fax: <br />E-mail: <br />Primary contact: <br />Alternate contact: <br />Notes: <br /> <br />[Copy and attach additional forms as needed) <br /> <br />Pandemic 11ifluenza Continuity of Operations Plan <br /> <br />31. <br />