Agenda 07/24/2012 Item #16F27/24/2012 Item 16.F.2.
EXECUTIVE SUMMARY
Recommendation to approve the submittal of a Federal Emergency Management Agency
Assistance to Firefighter's Grant Application in the amount of $81,400 for the purchase of
new mobile and portable radios for the Ochopee Fire Control District
OBJECTIVE: To obtain an after - the -fact approval of a Federal Emergency Management
Agency Assistance to Firefighters Grant (AFG) application for the purchase of mobile and
portable radios for continued protection of the Ochopee Fire Control District.
CONSIDERATIONS: Ochopee Fire Control District has received this type of grant from the
Federal Emergency Management Association (FEMA) in past years. At this time the District is
in need of replacing its mobile and portable radios. Radios have reached their life expectancy and
are no longer compliant with FCC Regulations and new digital infrastructure therefore new
equipment is necessary. The replacement of this equipment will increase personnel safety and
improve firefighting resources in the District.
The AFG grant program typically provides only a month for development and submittal of grant
applications. This application period was opened in June with a week notification. A 30 day
application period is allowed for application. Unfortunately, in the rush to get the application
materials together and submit the application on -time, Ochopee Fire Control District will need to
submit the grant via the electronic submittal process prior to getting proper BCC approval to
submit. The Ochopee Fire Control District has received County Manager approval that will be
documented by the grant deadline. This approval follows standard practice as outlined in CMA
#5330 for after - the -fact approval of grant applications.
FISCAL IMPACT: The total cost of the equipment is $81,400. This is a 95/5 matching grant
split between FEMA and the Ochopee Fire Control District with FEMA providing 95% of the
costs at $77,330. If awarded, the District's share of 5% in the amount of $4,070 will be funded
from Capital Outlay in Ochopee Fire Control District MSTU Fund 146. Following the award a
grant agreement will be presented to the Board of County Commissioners along with budget
amendments to recognize grant funds in Fund 713, Bureau of Emergency Services Grants and to
transfer matching funds from Fund 146 to Fund 714, Bureau of Emergency Services match in
Project.
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated
with this Executive Summary.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney, is
legally sufficient, and requires majority vote for approval. -JAK
RECOMMENDATION: That the Board of County Commissioners approve the after - the -fact
submittal of a grant to Federal Emergency Management Agency's Assistance to Firefighters
Grant (AFG) for the purchase of a new mobile and portable radios.
Prepared by: Alan McLaughlin, Fire Chief
Packet Page -3066-
7/24/2012 Item 16.F.2.
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.F.2.
Item Summary: Recommendation to approve the submittal of a Federal Emergency
Management Agency Assistance to Firefighter's Grant Application in the amount of $81,400 for
the purchase of new mobile and portable radios for the Ochopee Fire Control District
Meeting Date: 7/24/2012
Prepared By
Approved By
Name: KlatzkowJeff
Title: County Attorney
Date: 7/6/2012 8:41:03 AM
Name: SummersDan
Title: Director - Bureau of Emergency Services,
Date: 7/6/2012 9:17:30 AM
Name: Joshua Thomas
Title: Grants Support Specialist,
Date: 7/6/2012 3:19:15 PM
Name: GreenwaldRandy
Title: Management/Budget Analyst,Office of Management & B
Date: 7/6/2012 3:34:10 PM
Name: KlatzkowJeff
Title: County Attorney
Date: 7/6/2012 3:35:50 PM
Name: OchsLeo
Title: County Manager
Date: 7/10/2012 3:41:16 PM
Packet Page -3067-
TO: Leo Ochs, County Manager
CC: Alan McLaughlin, Ochopee Fire Control District
FROM: Joshua Thomas, Grants Support Specialist
DATE: June 27, 2012
7/24/2012 Item 16.F.2.
Grant Application Reviewed and
AppzQved by County Manager or
After the fact approval by the BCC
is required at the July 24, 2012
BCC meeting.
SUBJECT: County Manager review and approval of an.Assistance to Firefighters Grant Application
to the Federal Emergency Management Agency in the amount of $81,400.
The Ochopee Fire Control District is applying for an Assistance to Firefighters Grant in order to purchase
mobile and portable radios for the continued protection of the district. The Ochopee Fire Control District
has received this type of grant in past years and at this time, is in dire need of replacing its mobile and
portable radios. The radios have reached their Iife expectancy and are no longer compliant with FCC
regulations and new digital infrastructure therefore, new equipment is necessary. The replacement of this
equipment will increase personnel safety and improve firefighting resources in the district. There is a
95/5 matching requirement with FEMA providing 95% of the costs in the amount of $77,330. If
awarded, the district's share of 5% in the amount of $4,070 will be funded from Capital outlay Fund 146.
This grant program typically provides only a month for development and submittal of applications. The
application opened on June 11, 2012 with a deadline of July 6, 2012. Furthermore, due to the BCC
summer schedule, your review and approval of the application is requested followed by after -the -fact
approval at the July 24, 2012 BCC meeting.
This application is submitted online and does not require the submittal of any signed documents. Your
approval will allow Alan McLaughlin to submit the application via the FEMA online application portal.
Once you have reviewed the proposal, please sign in the box above and call me for pickup at 239 -252-
8989. Thank you and please let me know if you have any questions regarding this request.
3299 Tamiami Trail East, Suite 201 • Naples, Florida 34112-5746, 239 -252 -8973 • FAX 239 -252 -8828
Packet Page -3068-
Preparer Information
Overview
Did you attend one of the workshops conducted by DHS's regional fire program
specialist?
No, I have not attended workshop
~Was a workshop offered within 2 hours drive?
UM
*Are you a member, or are you currently involved in the management, of the fire
department or non - affiliated EMS organization applying for this grant with this
application?
Yes, I am a member /officer of this applicant
7/24/2012 Item 165.2.
If you answered No, please complete the information below. If you answered Yes, please skip the Preparer
Information section.
Fields marked with an • are required.
Preparer Information
Preparer's Name
Address 1
Address 2
• City
-State
Zip -
Need help for ZIP +4
In the space below please list the person your organization has selected to be the primary point of contact for
this grant. This should be a Chief Officer or long time member of the organization who will see this grant
through completion. Reminder: if this person changes at any time during the period of performance please
update this information. Please list only phone numbers where we can get in direct contact with the POC.
Title
Prefix (check one)
First Name
Middle Initial
Last Name
Business Phone (e.g. 123 -456 -7890)
Home Phone (e.g. 123 -456 -7890)
Mobile Phone /Pager (e.g. 123 -456 -7890)
Fax (e.g. 123 - 456 -7890)
Email (e.g. user @xyz.org)
Primary Point of Contact
Chief
Mr.
Alan
M
McLaughlin
239 -695 -4114 Ext.
239 -825 -9074 Ext.
239 -285 -3726
239 - 695 -3473
alanmclaughlin @colliergov.net
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Alternate Contact Information
Contact Information
* Title
Prefix
First Name
Middle Initial
• Last Name
• Business Phone
,Home Phone
Mobile Phone /Pager
Fax
-Email
Title
Prefix
First Name
Middle Initial
Last Name
Business Phone
*Home Phone
Mobile Phone /Pager
Fax
*Email
Alternate Contact Information Number 1
Captain
Mr.
Caleb
Morris
239 -695 -2902 Ext.
239 -695 -2418 Ext.
239- 825 -5079
239 -695 -3473
calebmorris @colliergov.net
Alternate Contact Information Number 2
Administrative Assistant
Mrs. ,
Linda
Swisher
239 - 695 -4114 Ext.
239 - 280 -9070 Ext.
239 -695 -3473
lindaswisher@colliergov.net
7/24/2012 Item 16.17.2.
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Applicant Information 7/24/2012 Item 16.17.2.
Applicant Information
• Organization Name
• Type of Applicant
• Type of Jurisdiction Served
If other, please enter the type of Jurisdiction
• Employer Identification Number
• What is your organization's DUNS Number?
Headquarters or Main Station Physical Address
Physical Address 1
Physical Address 2
City
State
• Zip
Mailing Address
Mailing Address 1
Mailing Address 2
Ochopee Fire Control District
Fire Department/Fire District
Other (explain)
County created MSTU for Fire Rescue services
59- 6000558
076997790 (call 1- 866 - 705 -5711 to get a DUNS
number)
201 Buckner Ave North
Everglades City
Florida
34139-0070
Need help for 2IP +4*7
P.O. Box 70
City Everglades City
State Florida
Zip 34139-0070
Need help for ZIP +4?
Please describe all grants that you have received from DHS, for example, 2008 AFG grant for a vehicle or
2010 HSGP grant for exercises. (Enter N/A if Not Applicable).
2004 AFG Breathing apparatus and compressor.
Account Information
Type of bank account Checking
Bank routing number - 9 digit number on the bottom 067091719
left hand corner of your check
Your account number 1138577
Additional Information
r For this fiscal year (Federal) is your organization
receiving Federal funding from any other grant No
program that may duplicate the purpose and /or scope
of this grant request?
If awarded the AFG grant, will your organization
expend more than $500,000 in Federal funds during No
your organization's fiscal year in which this AFG grant
was awarded?
* Is the applicant delinquent on any Federal debt? No
If you answered yes to any of the additional questions above, please provide an explanation in the space
provided below:
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Fire Department Characteristics (Part 1)
Department Characteristics (Part I)
• Are you a member of a Federal Fire Department
or contracted by the Federal government and
solely responsible for suppression of fires on
Federal property?
What kind of organization do you represent?
If you answered combination, above, what is the
percentage of career members in your
organization?
If you answered volunteer or combination or paid
on -call, how many of your volunteer Firefighters
are paid members from another career
department?
What type of community does your organization
serve?
Is your Organization considered a Metro
Department?
. What is the square mileage of your first -due
response area?
* What percentage of your response area is
protected by hydrants?
k In what county /parish is your organization
physically located? If you have more than one
station, in what county /parish is your main station
located?
No
Combination
75%
0
Rural
Yes
1180
1%
Collier
Does your organization protect critical
infrastructure of the state? No
. How much of your jurisdiction's land use is for
agriculture, wildland, open space, or undeveloped 96 %
properties?
• What percentage of your jurisdiction's land use is 1 %
for commercial and industrial purposes?
• What percentage of your jurisdiction's land is
used for residential purposes? 3 °
�O
How many occupied structures (commercial,
industrial, residential, or institutional) in your
jurisdiction are more than three stories tall? Do not 4
include structures which are not regularly
occupied such as silos, towers, steeples, etc.
What is the permanent resident population of
your Primary /First -Due Response Area or 3970
iurisdiction served?
R Do you have a seasonal increase in population? Yes
7/24/2012 Item 16.F.2.
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Fire Department Characteristics (Part I)
If "Yes" what is your seasonal increase in
230
population?
How many active firefighters does your
24
department have who perform firefighting duties?
How many ALS level trained members do you
1
have in your department/organization?
How many stations are operated by your
2
organization?
. Is your department compliant to your local
Emergency Management standard for the
Yes
National Incident Management System (NIMS)?
• Do you currently. report to the National Fire
Yes
Incident Reporting System (NFIRS)?
If you answered yes above, please enter your
640411
FDIN /FDID
What percent of your active firefighters are
100%
trained to the level of Firefighter I?
• What percent of your active firefighters are
100%
trained to the level of Firefighter II?
If you answered less than 100% to either question
above, are you requesting for training funds in this
application to bring 100% of your firefighters into
compliance with NFPA 1001?
7/24/2012 Item 16.F.2.
If you indicated that less than 100% of your firefighters are trained to the Firefighter 11 level and you are
not asking for training funds in this application, please describe in the box below your training program
and your plans to bring your membership up to Firefighter II.
What services does your organization provide?
Structural Fire Suppression Emergency Medical Responder Haz -Mat Operational Level
Wildland Fire Suppression Basic Life Support
Airport Rescue Firefighting (ARFF) Rescue Operational Level
Occasional Fire Prevention Program
Maritime operations /Firefighting
. Please describe your organization and/or community that you serve. We recommend typing your
response in a Word Document outside of this application, then copying and pasting it into the written
field. There is a 4000 character limit.
The Ochopee Fire Control District is a dependent fire district located in Eastern Collier County Florida
established for fire and rescue services as an MSTU. The Fire District protects 1180 square miles of
rural county, State, and Federal Lands, The Fire Department is made up of one chief officer, a battalion
captain, three lieutenants, nine full time fire fighters, three part time firefighters and six volunteers. There
is one rural city within the jurisdiction which the district provides service for and four other areas of rural
population. Only 1 % of the district has an established water supply system, which is within the two major
population areas. The District has two stations that respond to 600 calls on average. The district also
provides coverage for two airports and 32 miles of 1 -75. The District serves the Big Cypress National
Preserve and the Everglades National Park through an MOU. The District provides marine rescue and
fire response to Collier Seminole State park and Everglades National Park. The district responds to 35
miles of 1 -75 and 46 miles of U.S 41.1 -75 is the major east/west route in south Florida as well as U.S
41.Both roadways are in the remote part of Everglades and Big Cypress: On average 50% of the district
incidents are on these roadways. Types of calls the district responds to include structure fires, brush
fires, aircraft incidents, vehicle fires, commercial vehicle fires, marine incidents, water rescue, and
hazardous materials incidents.
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Fire Department Characteristics (Part I)
7/24/2012 Item 16.F.2.
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Fire Department Characteristics (Part II)
Fire Department Characteristics (Part II)
• What is the total number of fire - related civilian fatalities in
your jurisdiction over the last three years?
* What is the total number of fire - related civilian injuries in
your jurisdiction over the last three years?
What is the total number of line of duty member fatalities in
your jurisdiction over the last three years?
- What is the total number of line of duty member injuries in
your jurisdiction over the last three years?
. Over the last three years, what was your organization's
average operating budget?
- What percentage of your TOTAL budget is dedicated to
personnel costs (salary, overtime and fringe benefits)?
* What percentage of your annual operating budget is derived from:
Enter numbers only, percentages must sum up to 100%
7/24/2012 Item 16.17.2.
2011 2010
0 0
0 0
0 0
1 0
1818833
74%
Taxes?
69 %
EMS Billing?
0%
Grants?
0
Donations?
0 %
Fund drives?
0
Fee for Service? .
0%
Other?
31 %
2009
1
1
0
0
Property assesment depreciation has
If you entered a value into Other field (other than 0), please reduced the Ad valorem tax for operating
explain budget. Loans from County General
Fund are necessary to maintain salaries
to prevent loss of service.
* Please describe your organization's need for Federal financial assistance. We recommend typing your
response in a Word Document outside of this application, then copying and pasting it into the written
field. There is a 4000 character limit.
The Ochopee Fire Control District has seen a 46% reduction in property values which has translated into
an average 24% loss of the Ad Valorum revenue for the operating budget. The revenue loss has
resulted in a loan from County General fund in the amount of $434,600 in FY12. These monies were
needed to continue salaries without reduction of services. The Ochopee District is $431,100 defecit in
FY13. A loan from General Fund is requested but only covers salaries, so local funding for capital
projects is not available.
How many vehicles does your organization have in each of the types or class of vehicle listed below?
You must include vehicles that are leased or on long -term loan as well as any vehicles that have
been ordered or otherwise currently under contract for purchase or lease by your organization
but not yet in your possession. (Enter numbers only and enter 0 if you do not have any of the vehicles
below.)
Number of Number of Number
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Fire Department Characteristics (Part I1)
Type or Class of Vehicle
Engines or Pumpers (pumping capacity of 750 gpm or greater
and water capacity of 300 gallons or more):
Pumper, Pumper/Tanker, Rescue /Pumper, Foam Pumper, CAFS Pumper,
Type I or Type II Engine Urban Interface
Ambulances for transport and/or emergency response
Tankers or Tenders (pumping capacity of less than 750
gallons per minute (gpm) and water capacity of 1,000 gallons
or more):
Aerial Apparatus:
Aerial Ladder Truck, Telescoping, Articulating; Ladder Towers, Platform, .
Tiller Ladder Truck, Quint
Brush /Quick attack (pumping capacity of less than 750 gpm
and water carrying capacity of at least 300 gallons):
Brush Truck, Patrol Unit (Pick up w/ Skid Unit), Quick Attack Unit, Mini -
Pumper, Type III Engine, Type IV Engine, Type V Engine, Type VI Engine,
Type VII Engine
Rescue Vehicles:
Rescue Squad, Rescue (Light, Medium, Heavy), Technical Rescue Vehicle,
Hazardous Materials Unit
Additional Vehicles:
EMS Chase Vehicle, Air /Light Unit, Rehab Units, Bomb Unit, Technical
Support (Command, Operational Support/Supply), Hose Tender, Salvage
Truck, ARFF (Aircraft Rescue Firefighting), Command /Mobile
Communications Vehicle,
7/24/2012 Item 161.2.
Front Line Reserve of Seated
Apparatus Apparatus
Riding
Positions
2 1 8
0 0 0
1 0 2
0
2
L
3
0 0
0 4
0 2
0 5
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Fire Department Call Volume 7/24/2012 Item 16.F.2.
Department Call Volume
2011 2010 2009
How many responses per year by category? (Enter whole numbers only. If you have no calls for any of the categories,
enter 0)
Working Structural Fires
4
2
5
False Alarms /Good Intent
189
196
226
Calls
Vehicle Fires
10
15
40
Vegetation Fires
23
36
46
EMS -BLS Response Calls
91
85
79
EMS -ALS Response Calls
0
0
0
EMS -BLS Scheduled
0
0
0
Transports
EMS -ALS Scheduled
0
0
0
Transports
Vehicle Accidents w/o
183
179
212
Extrication
Vehicle Extrications
9
8
7
Other Rescue
11
2
2
Hazardous
5
14
3
Condition /Materials Calls
Service Calls
10
1
2
Other Calls and Incidents
19
3
1
Total
554
541
623
How many responses per year by category? (Enter whole
numbers only. If you have
no calls for any of the categories,
enter 0)
What is the total acreage of all
4700
2700
1900
vegetation fires?
" }low many responses per year by category? (Enter whole
numbers only. If you have
no calls for any of the categories,
enter 0)
In a particular year, how many
times does your organization
15
1
1
receive mutual /automatic aid?
In a particular year, how many
times does your organization
provide mutual/automatic aid?
6
1
2
(Do not include first -due
responses claimed above).
Total Mutual / Automatic Aid
21
2
3
Out of the mutual /automatic
aid responses, how many
3
1
1
were structure fires?
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Request Information 7/24/2012 Item 16.F.2.
Request Information
. ................... .
1. Select a program for which you are applying. If you are interested in applying under both Vehicle
Acquisition and Operations and Safety, and /or regional application you will need to submit separate
applications.
Program Name
Operations and Safety
2. Will this grant benefit more than one organization?
No
If you answered Yes to Question 2 above, please explain.
3. Enter Grant - writing fee associated with the preparation of this request. Enter 0 if there is no fee.
$0
eGiPacket Page J3078-
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Fire Operations and Firefighter Safety Request Details
Request Details
7/24/2012 Item 16.F.2.
The activities for program Operations and Safety are listed in the table below.
Activity Number of Entries Total Cost Additional Funding Action
Equipment 2 $ 81,400
Modify Facilities 0 $ 0
Personal Protective Equipment 0 $ 0
Training 0 $ 0
Wellness and Fitness Programs 0 $ 0
" Total Funding for all EMS requested in this application
Grant- writing fee associated with the preparation of this request.
$ 0 View Additional Funding
Narratives
$ 0 View Details
$ 0 View Details
$ 0 View Details
$ 0 View Details
$0
$0
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Firefighting Equipment - Narrative 7/24/2012 Item 16.F.2.
Firefighting Equipment - Narrative
* Section # 1 Project Description: In the space provided below include clear and concise details
regarding your organization's project's description and budget. This includes providing local statistics to
justify the needs of your department and a detailed plan for how your department will implement the
proposed project. Further, please describe what you are requesting funding for including budget
descriptions of the major budget items, i.e., personnel, equipment, contracts, etc.? *3000 characters
Our grant request is to purchase mobile and portable radios that meet the most current standard of FCC,
State, and Local requirements. Presently our radios were bought between 1996 and 2001 and are no
longer serviceable. They cannot be rebanded to meet new FCC requirements and are not upgradable to
new P -25 digital standards. They will not be capable of interoperability with any surrounding agencies or
regional response teams. In addition, the radios we are requesting will allow the department to
implement an accountability system via two -way radio tracking through the digital system. This will
provide an increased level of safety during incidents as software for monitoring of personnel locations
will be implemented in the digital radios. The units will be compliant to interoperate with surrounding
agencies and regional response teams. The units will also be equipped to operate in mutual and auto aid
instances. This grant request will enhance the department's ability to protect the health and safety of our
personnel and citizens as well as a large transient population served through the interstate system. The
grant will address the ability to respond to all hazardous incidents (CBRNE) and become compliant with
regional response teams. This grant will also allow for interagency operability during disaster events. All
personnel have been trained in the use of portable radios.
* Section # 2 Cost/Benefit: In the space provided below please explain, as clearly as possible, what will
be the benefits your department or your community will realize if the project described is funded (i.e,
anticipated savings and /or efficiencies)? Is there a high benefit for the cost incurred? Are the costs
reasonable? Provide justification for the budget items relating to the cost of the requested items. `3000
characters
The funds requested in this application will allow for the replacement of existing radios, which are not
compliant with new digital upgrades and State and Local requirements. Present radios will no longer
interoperate with any surrounding agencies or regional response teams. The request will benefit the
District by outfitting 100% of the apparatus and active seated positions. The grant will provide a fire
fighter safety benefit by a real time accountability system that monitors personnel. The grant will also
provide a reduced maintenance cost benefit. Present radios cannot be serviced as parts and are no
longer availible. Service agreements for present radios are no longer valid and costs for service are
hourly. New digital portable radios will provide the benefit of integration with local and regional response
teams.
Section # 3 Statement of Effect: How would this award affect the daily operations of your department
(i.e., describe how frequently the equipment will be used or what the benefits will provide the personnel
in your department)? How would this award affect your department's ability to protect lives and property
in your community? "3000 characters
If awarded the grant through the assistance of the Office of Domestic Prepardness and the U.S. Dept of
Homeland Security, the Ochopee Fire Control District will be able to assure 100% of seated firefighters
are equipped and protected by the most up to date and compliant communications system as outlined by
new FCC, State, and Local requirements, Communications will also be afforded to all firefighters as
outlined in NFPA. In addition we will be able to incorporate a firefighter accountability system that will
monitor in real time the location of personnel in fire fighting, and rescue incidents. The grant will allow for
radios that will integrate into local and regional response teams and allow for interoperability on mutual
and auto aid incidents. The grant will provide communications that is effective to stay in compliance with
present standards.
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Firefighting Equipment - Narrative
7/24/2012 Item 16.F.2.
' Section # 4 In the space provided below include details regarding your organization's request not
covered in any other section. "3000 characters
The Ochopee Fire Control District budget is funded through ad- valorem taxes for fire suppression
activities and medical responses. The district has experienced a reduction in property values in the last
three years, The loss of Ad Valorum tax revenue from depreciated property values has severely
impacted the operating budget and eliminated capital outlay projects. At this time, the budget does not
allow us to fund this project for replacement of portable radios.
Ochopee is only requesting radios for active seated positions. Two front line engines carries 4 positions
and two command vehicles which seat one position each are utilized in the majority of incident
responses. However,Ochopee often reponds in varied unit configurations utilizing two engines, one light
attack truck, one water tender,two brush trucks, and one fire boat. This is due to the size and varied
structure of the district. However, only ten seated positions are staffed in any configuration depending on
manning, and call type.
v
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Budget
Budget
Budget Obiect Class
a. Personnel
b. Fringe Benefits
c. Travel
d. Equipment
e. Supplies
f. Contractual
g. Construction
h. Other
i. Indirect Charges
j. State Taxes
Federal and Applicant Share
7/24/2012 Item 16.F.2.
$0
$0
$0
$ 81,400
$0
$0
$0
$0
$0
$0
Federal Share $ 77,330
Applicant Share $ 4,070
Federal Rate Sharing ( %) 95/5
Non- Federal Resources (The combined Non - Federal Resources mast equal the Applicant Share of $ 4.070)
a. Applicant $ 4070
b. State $ 0
c. Local $ 0
d. Other Sources $ 0
If you entered a value in Other Sources other than zero (0), include your explanation below. You can
use this space to provide information on the project, cost share match, or if you have an indirect cost
agreement with a federal agency.
Total Budget $ 81,400
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Assurances and Certifications
Assurances and Certifications
FEMA Form SF 4248
7/24/2012 Item 16.F.2.
You must read and sign these assurances. These documents contain the Federal requirements
attached to all Federal grants including the right of the Federal government to review the grant activity.
You should read over the documents to become aware of the requirements. The Assurances and
Certifications must be read, signed, and submitted as a part of the application.
Note: Fields marked with an * are required.
O.M.B Control Number 4040 -0007
Assurances Non - Construction Programs
Note: Certain of these assurances may not be applicable to your project or program. If you have any
questions, please contact the awarding agency. Further, certain Federal awarding agencies may require
applicants to certify to additional assurances. If such is the case, you will be notified.
As the duly authorized representative of the applicant I certify that the applicant:
1. Has the legal authority to apply for Federal assistance and the institutional,
managerial and financial capability (including funds sufficient to pay the non - Federal
share of project costs) to ensure proper planning, management and completion of
the project described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if
appropriate, the State, through any authorized representative, access to and the right
to examine all records, books, papers, or documents related to the award; and will
establish a proper accounting system in accordance with generally accepted
accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a
purpose that constitutes or presents the appearance of personal or organizational
conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of
approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. Section
4728 -4763) relating to prescribed standards for merit systems for programs funded
under one of the nineteen statutes or regulations specified in Appendix A of OPM's
Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all Federal statutes relating to nondiscrimination. These include but
are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88 -352) which
prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended (20 U.S.C. Sections 1681 -1683, and
1685 - 1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the
Rehabilitation Act of 1973, as amended (29 U.S.C. Section 794), which prohibits
discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as
amended (42 U.S.C. Sections 6101- 6107), which prohibits discrimination on the
basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92 -255), as
amended, relating to nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and
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Assurances and Certifications
7/24/2012 Item 16.F.2.
Rehabilitation Act of 1970 (P.L. 91 -616), as amended, relating to nondiscrimination
on the basis of alcohol abuse or alcoholism; (g) § §523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. § §290 dd -3 and 290 ee -3), as amended, relating to
confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil
Rights Acts of 1968 (42 U.S.C. Section 3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i) any other
nondiscrimination provisions in the specific statute(s) under which application for
Federal assistance is being made; and 0) the requirements of any other
nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Title 11 and III of the
Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970
(P.L. 91 -646) which provide for fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal or federally- assisted programs.
These requirements apply to all interest in real property acquired for project purposes
regardless of Federal participation in purchases.
8. Will comply, as applicable, with provisions of the Hatch Act (5 U.S.C. § §1501 -1508
and 7324 -7328) which limit the political activities of employees whose principal
employment activities are funded in whole or in part with Federal funds.
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C.
§ §276a to 276a -7), the Copeland Act (40 U.S.C. §276c and 18 U.S.C. §874), and the
Contract Work Hours and Safety Standards Act (40 U.S.C. § §327 -333), regarding
labor standards for federally- assisted construction subagreements.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102
(a) of the Flood Disaster Protection Act of 1973 (P.L. 93 -234) which requires
recipients in a special flood hazard area to participate in the program and to
purchase flood insurance if the total cost of insurable construction and acquisition is
$10,000 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the
following: (a) institution of environmental quality control measures under the National
Environmental Policy Act of 1969 (P.L. 91 -190) and Executive Order (EO) 11514; (b)
notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance
with EO 11988; (e) assurance of project consistency with the approved State
management program developed under the Coastal Zone Management Act of 1972
(16 U.S.C. § §1451 et seq.); (f) conformity of Federal actions to State (Clean Air)
Implementation Plans under Section 176(c) of the Clean Air Act of 1955, as
amended (42 U.S.C. § §7401 et seq.); (g) protection of underground sources of
drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-
523); and, (h) protection of endangered species under the Endangered Species Act
of 1973, as amended (P.L. 93 -205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. Section 1271 et
seq.) related to protecting components or potential components of the national wild
and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the
National Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593
(identification and protection of historic properties), and the Archaeological and
Historic Preservation Act of 1974 (16 U.S.C. 469a -1 et seq.).
14. Will comply with P.L. 93 -348 regarding the protection of human subjects involved in
research, development, and related activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89 -544, as
amended, 7 U.S.C. 2131 et seq.) pertaining to the care, handling, and treatment of
warm blooded animals held for research, teaching, or other activities supported by
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Assurances and Certifications
7/24/2012 Item 16.F.2.
this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. Section
4801 et seq.) which prohibits the use of lead based paint in construction or
rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in
accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A-
133, "Audits of States, Local Governments, and Non -Profit Organizations."
18. Will comply with all applicable requirements of all other Federal laws, executive
orders, regulations and policies governing this program.
Signed by Alan McLaughlin on 06121/2012
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Assurances and Certifications
Form 20 -16C
You must read and sign these assurances.
7/24/2012 Item 16.F.2.
Certifications Regarding Lobbying, Debarment, Suspension and Other Responsibility Matters and Drug -
Free Workplace Requirements.
Note: Fields marked with an * are required.
O.M.B Control Number 1660 -0025
Applicants should refer to the regulations cited below to determine the certification to which they are
required to attest. Applicants should also review the instructions for certification included in the
regulations before completing this form. Signature on this form provides for compliance with certification
requirements under 44 CFR Part 18, "New Restrictions on Lobbying; and 44 CFR Part 17,
"Government -wide Debarment and Suspension (Non - procurement) and Government -wide
Requirements for Drug -Free Workplace (Grants)." The certifications shall be treated as a material
representation of fact upon which reliance will be placed when the Department of Homeland Security
(DNS) determines to award the covered transaction, grant, or cooperative agreement.
1. Lobbying
A. As required by the section 1352, Title 31 of the US Code, and implemented at 44 CFR Part 18 for
persons (entering) into a grant or cooperative agreement over $100,000, as defined at 44CFR Part 18,
the applicant certifies that:
(a) No Federal appropriated funds have been paid or will be paid by or on behalf of the
undersigned to any person for influencing or attempting to influence an officer or employee
of any agency, a Member of Congress, an officer or employee of congress, or an
employee of a Member of Congress in connection with the making of any Federal grant,
the entering into of any cooperative agreement and extension, continuation, renewal
amendment or modification of any Federal grant or cooperative agreement.
(b) If any other funds than Federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any agency,
a Member of Congress, an officer or employee of congress, or an employee of a Member
of Congress in connection with this Federal grant or cooperative agreement, the
undersigned shall complete and submit Standard Form LLL, "Disclosure of Lobbying
Activities ", in accordance with its instructions.
(c) The undersigned shall require that the language of this certification be included in the
award documents for all the sub awards at all tiers (including sub grants, contracts under
grants and cooperative agreements and sub contract(s)) and that all sub recipients shall
certify and disclose accordingly.
2. Debarment, Suspension and Other Responsibility Matters (Direct Recipient)
A. As required by Executive Order 12549, Debarment and Suspension, and implemented at 44CFR Part
67, for prospective participants in primary covered transactions, as defined at 44 CFR Part 17, Section
17.510 -A, the applicant certifies that it and its principals:
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible,
sentenced to a denial of Federal benefits by a State or Federal court, or voluntarily
excluded from covered transactions by any Federal department or agency.
(b) Have not within a three -year period preceding this application been convicted of or had
a civilian. judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain or perform a public (Federal, State, or local)
transaction or contract under a public transaction; violation of Federal or State antitrust
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Assurances and Certifications 7/24/2012 Item 16.F.2.
statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction
of records, making false statements, or receiving stolen property.
(c) Are not presently indicted for or otherwise criminally or civilly charged by a government
entity (Federal, State, or local) with commission of any of the offenses enumerated in
paragraph (1)(b) of this certification: and
(d) Have not within a three -year period preceding this application had one or more public
transactions (Federal, State, or local) terminated for cause or default; and
B. Where the applicant is unable to certify to any of the statements in this certification, he or she shall
attach an explanation to this application.
3. Drug -Free Workplace (Grantees other than individuals)
As required by the Drug -Free Workplace Act of 1988, and implemented at 44CFR Part 17, Subpart F,
for grantees, as defined at 44 CFR part 17, Sections 17.615 and 17.620:
(A) The applicant certifies that it will continue to provide a drug -free workplace by:
(a) Publishing a statement notifying employees that the unlawful
manufacture, distribution, dispensing, possession, or use of a controlled
substance is prohibited in the grantee's workplace and specifying the actions
that will be taken against employees for violation of such prohibition;
(b) Establishing an on -going drug free awareness program to inform
employees about:
(1) The dangers of drug abuse in the workplace;
(2) The grantees policy of maintaining a drug -free workplace;
(3) Any available drug counseling, rehabilitation and employee
assistance programs; and
(4) The penalties that may be imposed upon employees for
drug abuse violations occurring in the workplace;
(c) Making it a requirement that each employee to be engaged in the
performance of the grant to be given a copy of the statement required by
paragraph (a);
(d) Notifying the employee in the statement required by paragraph (a) that,
as a condition of employment under the grant, the employee will:
(1) Abide by the terms of the statement and
(2) Notify the employee in writing of his or her conviction for a
violation of a criminal drug statute occurring in the workplace no
later than five calendar days after such conviction.
(e) Notifying the agency, in writing within 10 calendar days after receiving
notice under subparagraph (d)(2) from an employee or otherwise receiving
actual notice of such conviction. Employers of convicted employees must
provide notice, including position title, to the applicable DHS awarding office,
i.e. regional office or DHS office.
(f) Taking one of the following actions, against such an employee, within 30
calendar days of receiving notice under subparagraph (d)(2), with respect to
any employee who is so convicted:
(1) Taking appropriate personnel action against such an
employee, up to and including termination, consistent with the
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Assurances and Certifications 7/24/2012 Item 165.2.
requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a
drug abuse assistance or rehabilitation program approved for
such purposes by a Federal, State, or local health, law
enforcement or other appropriate agency.
(g) Making a good faith effort to continue to maintain a drug free workplace
through implementation of paragraphs (a), (b), (c), (d), (e), and (f).
(B) The grantee may insert in the space provided below the site(s) for the performance of
work done in connection with the specific grant:
Place of Performance
Street City State Zip Action
If your place of performance is different from the physical address provided by you in the Applicant
Information, press Add Place of Performance button above to ensure that the correct place of
performance has been specified. You can add multiple addresses by repeating this process multiple
times.
Section 17.630 of the regulations provide that a grantee that is a State may elect to make one certification
in each Federal fiscal year. A copy of which should be included with each application for DHS funding.
States and State agencies may elect to use a Statewide certification.
Signed by Alan McLaughlin on 06/2112012
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Assurances and Certifications
7/24/2012 Item 165.2.
FEMA Standard Form LLL
Only complete if applying for a grant for more than $100,000 and have lobbying activities. See Form 20-
16C for lobbying activities definition.
This form is not applicable
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