Preliminary assessment of storm impact on cultural facilities in Florida. SURVEY DEADLINE: Friday, November 3, 2017 Organization Name * Address Line 1 * Address Line 2 City * State * Zip Code * Main Contact Person Name * Title * Email * Phone * FLORIDA COUNTY: * - Select -AlachuaBakerBayBradfordBrevardBrowardCalhounCharlotteCitrusClayCollierColumbiaDeSotoDixieDuvalEscambiaFlaglerFranklinGadsdenGilchristGladesGulfHamiltonHardeeHendryHernandoHighlandsHillsboroughHolmesIndian RiverJacksonJeffersonLafayetteLakeLeeLeonLevyLibertyMadisonManateeMarionMartinMiami-DadeMonroeNassauOkaloosaOkeechobeeOrangeOsceolaPalm BeachPascoPinellasPolkPutnamSanta RosaSarasotaSeminoleSt. JohnsSt. LucieSumterSuwanneeTaylorUnionVolusiaWakullaWaltonWashington DESCRIPTION OF FACILITY DAMAGEBriefly describe any physical damage to your facility and/or equipment, materials, etc. Describe facility damage: * EXPENSES - Hurricane Irma Pre and Post StormPlease note: to input a value of zero, enter only “0” with no decimals. PRE-Storm Preparation Expenses - Emergency Work $ Emergency protective measures are measures taken before, during, and after a disaster to save lives, protect public health and safety, and prevent damage to improved public and private properties. POST-Storm Clean-up Expenses - Emergency Work $ Debris Removal: Debris removal activities, such as clearance, removal and disposal of debris that is in the public best interest, based on whether the work: eliminates immediate threats to lives, public health and safety; eliminates immediate threats of significant damage to improved public or private property; ensures economic recovery of the affected community to the benefit of the community at large; or mitigates the risk to life and property by removing substantially damaged structures. Facility or Equipment Damage Expenses - Permanent Work $ Work required to restore or repair damage to its pre-disaster design, function, and capacity, in accordance with certain codes and standards (i.e., repair or replacement of structural and non-structural building components, including mechanical, electrical and plumbing systems, contents and equipment within the building, and furnishings; and repair or replacement of vehicles and construction equipment) POST-Storm Service Interruption Costs $ Income loss due to operational interruption and/or program/event cancellation including lost ticket/admission revenues. TOTAL $