Captain Uniform Outfitting Form Description/Specificat Logistics Brigade Chief Item Item # Quantity Size Captain Initials Date Issued ion Initials Initials Dress Uniforms J-5 Gold 2 1/4" x 1/2" Name Tag Blackinton 130270 2 Double Clutch Back Serving Since Blackinton 130271 2 YEAR in Gold American Flag Pin Blackinton J 143 2 American Flag Pin Gold Breast Badge Blackinton B1449 2 Hi Glo - GOLD Hat Badge for Dress Blackington BC076 1 Hi Glo - GOLD Hat Snake Strap for Dress Snake Style Cap 1 Gold Hat Strap Gold, Galls Wreath with EMS, One Collinson CINS510 Star, 7/8", Die Struck, Collar Devices 2 sets Gold Clutch Back, (Gold) Finish 1/2" letter, Custom "VB" Pin for Dress Blackinton Style # 5 2 Combination "VB", Gold Coat Lapel Plate Emergency Medical Services on White Officer Dress Coat Galls, Item # CB1288 2 Outer Ring, Blue Star of Lapel Pin Life on Gold Background 1 3/4 Inch wide BLACK Belt Duty Man 1611U 2 Leather / Gold Buckle Law Pro/ Hero's Tie Clip Pride Item# 1 Gold Tie Clip QM4007G Flying Cross Dress Men's: JA 380; 38800 Jacket w/ Gold P Officer Dress Blouse Women's: JA 009; 1 Buttons & Sleeve 38833 striping Flying Cross Men's: 38200 Flying Cross Plain Front Dress Uniform Pants 1 Women's: 38260, Men / Women Galls Horace Small New Men's: ZR024 Dimension Long Sleeve Dress Shirt L/S Women's: SR682, 2 Shirt / Gold P Buttons / White Shirt w/Patches and rockers Horace Small, New Men's ZO743 Dimension Short Sleeve Dress Shirt S/S Women's: ZM149, 2 Shirt / Gold P Buttons / White Shirt w/Patches and rockers Work Uniforms Description/Specificat Logistics Brigade Chief Item Item # Quantity Size Captain Initials Date Issued ion Initials Initials Corner Stone Hi Performance Polo / Men's: CS-412 Short Sleeve w/ Gold Polo Shirts 6 Women's: CS-413 Embroidery of Badge, Name & Rank. No Screen Print on Back. Job Shirt / Heather Gray / 1/4 Zip / with 5.11 Tactical Style Gold Embrodiery of Job Shirt 3 72314 Badge, Name & Rank. No Screen Print on Back. Elbeco 4 pocket Every Day Work Pants Men's: TR593 4 Trousers Women's: TR590 Cavalier Sportswear, Virginia Beach EMS in Baseball Cap Trucker Style, Mesh 1 Gold Backing Virginia Beach EMS in EMS Beanie Cavalier Sportswear 1 Gold Turnout Gear / PPE Description/Specificat Logistics Brigade Chief Item Item # Quantity Size Captain Initials Date Issued ion Initials Initials Tan Jacket w/ Yellow Honeywell First Heat Sealed Letters Honeywell Responder Turnout 1 "VIRGINIA BEACH Jacket USR-21XJ EMS" Tan Pants -- Incl: EMS Honeywell First pocket R and semi- Honeywell Responder Turnout 1 bellows pocket L, Belt Pants USR-21XJ w/belt loops Bullard USRX Helmet Helmet USRX 1 w/ ESS Goggles / White 5.11 Sabre 2.0 Tactical JA 935 1 Tactical Jacket Jacket Helmet Crescents 2 Rank Appropriate Department Shield Helmet Shield Decal 1 decal for front of helmet / Rank appropriate Logistics Name (Printed):____________________________________________________________________________ Date of Signature: ______________ Logistics Signature:_________________________________________________________________________________ Brigade Chief Name (Printed):__________________________________________________________________________ Date of Signature: ____________________ Brigade Chief Signature:__________________________________________________________________________ Captain's Name (Printed):_____________________________________________________________________ Date of Signature: ____________________ Captain's Signature:___________________________________________________________________________.