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UNCLASSIFIEDHLAW ENFORCEMENT SENSITIVE (When Completed) <br />U.S. Department of Justice <br />United States Marshals Service <br />FACILITY FACTS <br />FACILITY OVERVIEW <br />Name <br />Address <br />Detention Facility Review <br />Phone Number <br />Fax Number <br />City <br />State Zip Code <br />County <br />District <br />Contract/Agreement Number <br />Contract/Agreement T re <br />(Private, IGA, LUA) Expiration Date <br />Closest USMS Office Name <br />Driving Time from Closest USMS <br />Driving Distance from Closest Date of Last USMS Detention <br />Office <br />USMS Office <br />Facility Review_ <br />minutes <br />= <br />miles <br />Points of Contact (Administrative, Facility, Intelligence, Medical, PREA, Restrictive Housing, Security) <br />(If needed, use "Other Notes Section" on last page to document more than one point of contact.) <br />Title Name <br />Tntact � Phone Number Exten� Email <br />Title Name <br />Type of Contact Phone Number Extension Email Address <br />I 11 177-11 1 <br />NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information <br />which is for the sote use of the intended reciplent(s). Any unauthorized review, use, disclosure, or distribution Is prohibited. If you are not the intended <br />recipient, please contact the sender and destroy all copies of this document. Any Protected Health Information contained in this document is to be used <br />only to aid in providing healthcare services to federal prisoners. Any other use is a violation of Federal HIPAA Law andfor the Privacy Act and will be <br />reported as such. <br />UNCLASSIFIEDI/LAW ENFORCEMENT SENSITIVE (When Completed) <br />Page 1 of 27 <br />Form USM-218 <br />Rev. 02126 <br />