Form 16016 Form 16016 Limited Facility Report

Limited Facility Report
Limited security exhibitions need a minimal amount of environmental control,
supervision, and art-handling experience. Requires a climate-controlled, limitedaccess display space with minimal temperature, humidity, and lighting controls.

National Archives
Traveling Exhibits Service

Name of Institution:
Mailing
Address:

Shipping
Address:

Contact Person:
Phone #:

Title:
ext.

Email:

Institutional Information
Does your organization hold 501(c)3 status?

Yes z No z

Gallery/Museum Open Hours: Mon __________ Tues ___________ Wed __________ Thurs ___________
(e.g. closed, 10am-5pm, 10am-7pm)
Fri ____________ Sat ____________ Sun __________
Do you open/close seasonally? Yes z No z If yes, please explain:
Does your facility meet accessibility criteria of the Americans with Disabilities Act? Yes z No z
What is your annual attendance? _________
Type of Institution:

z Museum:
z
z Art
z Natural History/Science
z History
z College/University
z Historic House/Site
z Children’s
z Other (Specify): _____________
NATES - Limited Facility Report

Cultural Institution:
z Archives
z Library
z Community/Civic Center
z Religious Facility

NATIONAL ARCHIVES AND RECORDS ADMINISTRATION

z Other:
z Fair Building
z Commercial/Retail

(Specify): _____________________
z Other
(Specify): ____________________

Please continue on next page
NA FORM 16016 (09-16)
Required by NARA 1612

Facility Information
Is your building/facility locked and secure after viewing hours?

Yes z No z

Does your facility have fire systems and fire protection devices according to local ordinances?

Yes z No z

Does your facility have an electronic security control system?

Yes z No z

Is your temporary exhibition gallery/space limited-access (no exterior doors)?
If no, please explain:

Yes z No z

Is your temporary exhibition gallery/space locked after public hours?

Yes z No z

Can you provide exhibition supervision by volunteer, receptionist, or guard during public hours?

Yes z No z

Size of your temporary exhibition gallery/space? Square Feet _______ Linear Feet _______
On what floor of your building is your temporary exhibition gallery/space located? _________
Do you have a freight or passenger elevator that can handle crates up to 600lbs?

Yes z No

Do you have a climate-controlled, pest-free crate storage area?

Yes z No z

Environmental Information
Does your gallery have a temperature and humidity control system active at all times?

Yes z No z

Does your temporary exhibition gallery/space maintain a temperature between 68-72 degrees?

Yes z No z

Does your temporary exhibition gallery/space maintain relative humidity between 45-55%?

Yes z No z

Are all sources of sunlight in temporary exhibition gallery/space blocked by UV filters or shades?

Yes z No z

What type of lighting system do you use in the temporary exhibition gallery/space? Check all that apply.

z Artificial Light:
z Fluorescent Lighting
z Fluorescent Lighting with UV Filters
z Incandescent Lights, Stationary
z Incandescent Lights, Track
z Halogen Lights, Stationary
z Halogen Lights, Track

z Daylight Windows:
z Shades or Draperies
z UV Filters

z Skylights:
z Shades or Draperies
z UV Filters

Are you able to adjust the light levels in your temporary exhibition gallery/space?

Yes z No z

Do you allow eating and drinking in the temporary exhibition gallery/space or during packing/unpacking?

Yes z No z

Have you had any pest/insect problems in the building within the past 6 months?

Yes z No z

NATES - Limited Facility Report

NATIONAL ARCHIVES AND RECORDS ADMINISTRATION

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NA FORM 16016 (09-16)
Required by NARA 1612

Shipping and Handling Information
Who handles exhibition objects? Check all that apply.
z Trained Staff
z Volunteer Staff:
z Professional
z Trained
z Technical
z Untrained with trained supervision
z Clerical
z Other (specify): _______________________
Are you able to provide 3-4 people to assist in loading, unloading, installation and de-installation?

Yes z No z

Do you have staff or volunteers able to handle exhibit crates up to 600 lbs in weight?

Yes z No z

Do you have a raised loading dock?

Yes z No z

If no, please explain your loading area:
If yes, can your loading dock accomodate a 53’ tractor trailer?

Yes z No z

Contact person for shipping and installation issues:
Name:

Title:

Phone #:

Email:

ext.

Please attach a building floorplan and photographs of your temporary exhibition gallery/space.

Name

Title

Signature

Date (mm/dd/yyyy)

Mail to:
---or---

National Archives Traveling Exhibits Service
400 W. Pershing Road
Kansas City, MO 64108

Email to:

NATES@nara.gov

Contact NATES at:

816.268.8088

PRINT

NATES - Limited Facility Report

NATIONAL ARCHIVES AND RECORDS ADMINISTRATION

National Archives
Traveling Exhibits Service
RESET

SAVE

Thank you!

NA FORM 16016 (09-16)
Required by NARA 1612