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Backup Documents 02/12/2013 Item #16C 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTINGS WP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT 1N BOARD OF COUNTY COMMISSIONERS OFFICE FOR SI U THE O KIN; Print on pink paper.Attach to original document.Original documents should he hand delivered to the Board Office.The completed routing slip and original documents are to be forwarded to the Board Office only after the Board has taken action on the item.) ROUTING SLIP Complete routing lines#1 through#4 as appropriate for additional signatures,dates,and/or information needed.If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#4,complete the checklist,and forward to Sue Filson(line#5). Route to Addressee(s) Office Initials Date (List in routing order) 1.Joshua Thomas OMB r' G Zl I f 113 2.Scott Teach County Attorney's Office k2c �.rt 3.BCC Office Board of County Commissioners 4. Minutes and Records Clerk of Court's Office -m 2[(' 1(3 PRIMARY CONTACT INFORMATION (The primary contact is the holder of the original document pending BCC approval.Normally the primary contact is the person who created/prepared the executive summary.Primary contact information is needed in the event one of the addressees above,including Sue Filson,need to contact staff for additional or missing information.All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the item.) �,��,_p�� Name of Primary Staff Joshua Thomas c c v—c s. ',,"-�Cne Number 252-8989 Contact • Agenda Date Item was 02/12/13 Agenda Item Number 16 C 1 Approved by the BCC Type of Document Grant Application Number of Original 1 Attached \ Documents Attached CQ�c� CO VNCc z �4S�v \V10�cr�5 �,J INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney.This includes signature pages from ordinances, resolutions,etc. signed by the County Attorney's Office and signature pages from contracts,agreements, etc.that have been fully executed by all parties except the BCC Chairman and Clerk to the Board and possibly State Officials.) 2. All handwritten strike-through and revisions have been initialed by the County Attorney's Office and all other parties except the BCC Chairman and the Clerk to the Board 3. The Chairman's signature line date has been entered as the date of BCC approval of the document or the final negotiated contract date whichever is applicable. 4. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's si t nature and initials are required. 5. In most cases(some contracts are an exception),the original document and this routing slip w (1 should be provided to Sue Filson in the BCC office within 24 hours of BCC approval. \�J I x\\ Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified.Be aware of your deadlines! 6. The document was approved by the BCC on21 I ) 13 (enter date)and all changes w made during the meeting have been incorporated in the attached document.The County Attorney's Office has reviewed the changes,if applicable. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05 16C1 MEMORANDUM DATE: February 15, 2013 TO: Joshua Thomas, Grants Support Specialist Administrative Services Department FROM: Ann Jennejohn, Deputy Clerk Minutes and Records RE: A Florida Division of Emergency Management Grant Application for funding to retrofit doors at the Public Utilities Division's Operations Center Attached for further processing is the original document referenced above, (Item #16C1) approved by the Board of County Commissioners February 12, 2013. A copy will be held in the Minutes and Records Department for the Board's Official Record. If you have any questions, please contact me at 252-8406. Thank you. Attachment (1) DRAFT 16C1 STATE OF FLORIDA — HAZARD MITIGATION GRANT PROGRAM APPLICATION THIS SECTION FOR STATE USE ONLY FEMA-4068-DR-FL ❑ Standard HMGP ❑ 5%Initiative Application ❑Application Complete ❑ Standard FMA ❑ Initial Submission or ❑ Re-Submission Support Documents Eligible Applicant Project Type(s) ❑ Conforms w/State 409 Plan ❑ State or Local Government ❑ Wind ❑ In Declared Area ❑ Private Non-Profit(Tax ID Received) ❑ Flood ❑ Statewide ❑ Recognized Indian Tribe or Tribal Organization ❑ Other: Community NFIP Status:(Check all that apply) Reviewer Phone#: ❑ Participating Community ID#: Reviewer Fax#: ❑ In Good Standing ❑ Non-Participating ❑ CRS Reviewer E-Mail: Date Application Received: State Application ID: State Reviewer: Signature: Date: This application is for all Federal Emergency Management Agency(FEMA Region IV)Hazard Mitigation Grant Program(HMGP) proposals. Please complete ALL sections and provide the documents requested. If you require technical assistance with this application,please contact your State Emergency Management Division at(850) 922-5269. A. To Fill Out This Application:Complete all sections that correspond with the type of proposed project General Application Sections:All applicants must complete these sections Environmental Review: All applicants must complete these sections Maintenance Agreement: Any applications involving public property,public ownership,or management of property Damage Frequency Assessment Worksheet: Acquisition,Elevation,Floodproofing(if FIS and H&H are unavailable)--one worksheet per structure Flood-Drainage Improvement Worksheet: Acquisition,Elevation,Floodproofing(if FIS and H&H are available)--one worksheet per structure Tornado Worksheet: Safe Room Projects only Wind Retrofit Worksheet: Wind retrofit projects only--one worksheet per structure Request for Public Assistance Form: FEMA Form 90-49(Request for Public Assistance):All applicants must complete,if applicable. Acquisition Forms: If project type is Acquisition,these forms must be completed. (Only one of the two Notice of Voluntary Interest forms is necessary.) Model Statement of Assurances for Property Acquisition Projects Declaration and Release Notice of Voluntary Interest(Town Hall Version) Notice of Voluntary Interest(Single Site Version) Statement of Voluntary Participation FEMA Model Deed Restriction Language Application Completeness Checklist: All applicants are recommended to complete this checklist B. Applicant Information FEMA-4068-DR-FL DISASTER NAME: Tropical Storm Debby Ex.,FEMA-1609-DR-FL;Hurricane Wilma Title/Brief Descriptive Project Summary: Collier County,Public Utilities Operations Center/Wind Retrofit I. Applicant(Organization): Collier County Water Sewer District 2. Applicant Type: 0State or Local Government ['Recognized Native American Tribe ['Private Non-Profit Form No.HMGP 001,Eff.06/2012 DRAFT _ 16C1 3. County: Collier Cosmty 4. Stale Legislative House Dings) 31. State Legislative Senate District(s): Z Congressional House District(s): Z4� 5. Federal Tau LD.Number: 59-6000558 6. Data Universal Numbering System(DUNS): 076997790 7. FIPS Codes: 021-99021-0Q (*if your FIPS code s not known,please fill out FEMA Font 90-49(Rapes for Public Assistants)so that the Department may obtain a FIPS code for you) S. National Flood Insurance Program(NFIP)Community Identification Number(this number can be obtained from the FIRM map for your ate): LINE 9. NF1P Community Rating System Corm Number(if available):2 10. NFIP Last Community Assistance Visit Date(FMA ONLY): 11. Attach motet'aaeeat Flood Insurance Policy(FMA ONLY): 12. Point of Centaat OMs. ®Mr. OM's. First Name:lams_ Last Name: fries Title Sneer Address: 4370 Meese ve may: Naha State:fj Zip Code: 24101 Telephonic 239-252-6246 Fax: 239-2524413 Email Address:latoffiodailsolikusrust 13. Applicedast Prepared by DMs. ®Mr. 0Mrs. First Name:lamps Last Name:price. Mk:Technical Support ProfessiQal Telephone:Z39.25k--6246 Peat:239-252-6243 Email Addams:jamespriceecolliergov.net 14. Authorised Applicant Agent(p oaf of ertherloWitoss ember*reP 4 • OMs. OMr. Mn.® First Nam Std Last Nemec 1i Title. chissan Telephone:239-2524602 Sired - f'. Fast Sense 300 ATTEST r • �City:��.. ... 411W State: E Zip Code:24112 DWIGHT rw BROC+)C,CIERK Savanna yr, Dates *t :t t, , 11.15. AU proposed projects should be included in the county's Load Mitigation Strategy(LMS). '<1 , Attached is a letter of cndonememt for the project from the county's Local Mitigation Strategy Chairperson.afis ONo 16. Has this project been submitted and/or funded under a previous disaster eveott? If so please provide the disaster number sod project number if available.No Section 1. Project De scripiloe — ate tts M fens! - - A. Hazards to be Mitipled I Lead of Protection I. Select the type of hazards the proposed project will mitigate: &PAY Morse, ❑Flood ®Wind 0 Storm singe ❑Other(list): 2. Identify the type of proposed project ❑Elevation mid retrofitting of=idealist or non-residentiel structure ❑Acquisition and relocation ❑Acquisition and demolition Wind retrofit ❑Minor drainage project that reduces localized flooding Attach any continuations or additional bans to this page Form No.HMGP 001,Eft 062012 DRAFT ❑Other(please explain) 16C1 3. List the total number of persons that will be protected by the proposed project: 113 4. Fill in the level of protection and the magnitude of event the proposed project will mitigate. (e.g.23 structures protected against the 100-year[1%] flood) structure(s)protected against the -year Flood(10,25,50,100,or 500 year) 2 structure(s)protected against 135 mile per hour(mph)winds 5. Engineered projects only(e.g.Drainage Improvements,Erosion Control or other special project types. [Other special project types include drainage and other engineered projects. These projects are unlike acquisition, elevation or wind retrofits/shutters.]) Attach to this page ALL engineering calculations and design plans used to determine the above level of protection. 6. Project will provide protection against the hazard(s)above for 15 years.(i.e.,what is the useful life of the project?) B. Project Description,Scope of Work,and Protection Provided(Must be Completed in Detail) I. Describe,in detail,the existing problem,the proposed project,and the scope of work. Explain how the proposed project will solve the problem(s)and provide the level(s)of protection described in Part A. Also,if available,attach a vendor's estimate and/or a contractor's bid for the scope of work. Please ensure that each proposed project is mitigation and not maintenance. 2. Description of the existing problems:Currently the two buildings located at 4370 Mercantile have 33 overhead doors that do not meet current hurricane wind standards. 3. Describe the type(s)of protection that the proposed project will provide:The project,when completed,will provide increased protection for the overhead bay and warehouse doors against hurricane strength winds up to 130 mph. The doors are Wind Resistant Windlock 652 Series Doors that are designed to lock the door edges into the 16 gauge steel guides. 4. Scope of Work(describe in detail what you are planning to do): Replace 33 outdated overhead doors with hurricane rated doors that are designed to last 15 years or more. The doors will be installed by a certified installer hired by Action Automatic Door and Gate. 5. Describe any other on-going or proposed projects in the area that may impact,positively or negatively,the proposed HMGP or FMA project:None Section IL Project Location(Fully describe the location of the proposed project.) A. Site 1. Describe the physical location of this project,including street numbers(or neighborhoods)and zip codes. If available,please provide precise longitude and latitude coordinates for the site utilizing a hand-held global positioning system(GPS)unit or the equivalent: : Two buildings located at 4370 Mercantile Ave,Naples FL, 34104. LATITUDE=26°09'550047"N, LONGITUDE=81°45'21.344"W. 2. Title Holder: Collier County Water-Sewer District 3. Is the project site seaward of the Coastal Construction Control Line(CCCL)? DYES ONO 4. Provide the number of each structure type(listed below)in the project area that will be affected by the project. That is,all structures in project area. Attach any continuations or additional items to this page Form No.HMGP 001,Eff.06/2012 DRAFT 1 6 C ❑Residential property: ❑Businesses/commercial property: Public buildings:2 ❑ Schools/hospitals/houses of worship: ❑Other: B. Flood Insurance Rate Map(FIRM)showing Project Site Attach two(2)copies of the FIRM map,a copy of the panel information from the FIRM,and,if available,the Floodway Map. FIRM maps are required for this application(if published for your area). Also,all attached maps must have the project site and structures clearly marked on the map. FIRMs are typically available from your local floodplain administrator who may be located in a planning,zoning,or engineering office. Maps can also be ordered from the Map Service Center at 1-800-358-9616. For more information about FIRMS,contact your local agencies or visit the FIRM site on the FEMA Web-page at https://msc.fema.gov/webapp/wcs/stores/servlet/FemaWelcomeView?storeld=10001&catalogld=10001&langld=-I Using the FIRM,determine the flood zone(s)of the project site(Check all zones in the project area). (See FIRM legend for flood zone explanations)(A Zone must be identified) ❑ VE or V 1-30 ❑AE or A 1-30 ❑AO or AH ❑A(no base flood elevation given) ®B or X(shaded) ❑C or X(unshaded) ❑Floodway ❑Coastal Barrier Resource Act(CBRA)Zone(Federal regulations strictly limit Federal funding for projects in this zone. Please coordinate with your state agency before submitting an application for a CBRA Zone project). ❑If the FIRM Map for your area is not published, please attach a copy of the Flood Hazard Boundary Map(FHBM) for your area,with the project site and structures clearly marked on the map. ZAttach a copy of a Special Flood Hazard Area Flood Insurance Assurance(s). C. City or County Map with Project Site and Photographs Attach a copy of a city or county scale map(large enough to show the entire project area)with the project site and structures marked on the map. Attach a USGS TOPO map with project site clearly marked on the map. ❑For acquisition or elevation projects,include copy of Parcel Map(Tax Map,Property Identification Map,etc.) showing each property to be acquired. The map should include the Tax ID numbers for each parcel,if possible. Attach photographs(a minimum of 2 photographs)for each project site per application. The photographs should be representative of the project area,including any relevant streams,creeks,rivers,etc.,and drainage areas,which affect the project site or will be affected by the project. For each structure,please include the following angles: front,back and both sides. Attach any continuations or additional items to this page Form No.HMGP 001,Eff.06/2012 DRAFT 16C1 4 Section III. Budget/Costs In this section,provide details of all the estimated costs of the project. As this information is used for the Benefit-Cost Analysis, reasonable cost estimates are essential. Do not include contingency costs in the budget. Avoid the use of lump sum costs. Note:To be eligible for HMA funding,pre-award costs must be identified as separate line items in the cost estimate of the application. This must be done in addition to filling out the HMGP Pre-Award Cost Request Form.Please mark each pre-award cost with an asterisk A. Materials Item Dimension Quantity Cost per Unit Cost Roll-Up Door W/Chain Hoist 10'x 12' 16 891.00 14,256.00 Roll-Up Door W/O Chain Hoist 10'x 12' 16 871.00 13,936.00 Roll-Up Door W/Chain Hoist 12 x 12 1 951.00 951.00 B. Labor(Include equipment costs.Please indicate all"soft"or in-kind matches.All in-kind match must be identified in the Section III.Budget/Costs of this application.) Description Hours Rate Cost 2-Man Installation Labor 99 89.00 8,811.00 C. Fees Paid (Include any other costs associated with the project.) Description of Task Hours Rate Cost N/A Total Estimated Project Cost$37.954.00 Attach any continuations or additional items to this page Form No.HMGP 001,Eff.06/2012 DRAFT 1601 D. Funding Sources(Round figures to the nearest dollar.) The maximum FEMA share for HMGP projects is 75%. The other 25%can be made up of State and Local funds as well as in-kind services. The FMA program requires that the maximum in-kind match be no more than 12.5%of the total project costs. HMGP/FMA funds may be packaged with other Federal funds,but other Federal funds(except for Federal funds that lose their Federal identity at the State level such as CDBG and certain tribal funds)may not be used for the non-Federal share of the costs. Estimated FEMA Share $28,465.50 75%of Total(maximum of 75%) Non-Federal Share Estimated Local Share $9,488.50 25%of Total(Cash) $ %of Total(In-kind*) $ %of Total(Project Global Match**) Global Match Project Title: Other Agency Share $ %of Total (Identify Other Non-Federal Agency and availability date: Total Funding sources from above $37,954.00 100 Total%(should equal 100%) *Identify proposed eligible activities directly related to project to be considered for In-kind services.(Note on Section B) **Separate project application must be submitted for each project(Global)Match project. E. Project Milestones/Schedule of Work List the major milestones in this project by providing an estimated time-line for the critical activities not to exceed a period of 3 years for performance,e.g.Designing,Engineering,Permitting,etc. These milestones should correspond with the scope of work and budget. Milestone Number of Days to Complete [Example: Demolition of 6 structures and removal of debris 14 days] Obtain quotes from vendors to install 33 wind resistant doors 21 Days Review quotes and select the one that best meets the requirements 5 Days Approve contract and schedule a start date 21 Days Removal and installation of 33 doors 14 Days Inspection of work done 2 Days Payment and close out of project 45 Days Attach any continuations or additional items to this page Form No. HMGP 001,Eft:06/2012 DRAFT 16C1 4 Section IV. Environmental Review and Historic Preservation Compliance (NOTE: This application cannot be processed if this section is not completed) Because HMGP/FMA are federally funded programs,all projects are required to undergo an environmental and historic preservation review as part of the grant application process. Moreover,all projects must comply with the National Environmental Policy Act(NEPA) and associated Federal,State,Tribal,and Local statutes to obtain funding. NO WORK can be done prior to the NEPA review process. If work is done on your proposed project before the NEPA review is completed,it will NOT be eligible for Federal funding. A. The following information is required for the Environmental and Historic Preservation review: All projects must have adequate documentation to determine if the proposed project complies with NEPA and associated statutes. The State Environmental Staff provide comprehensive NEPA technical assistance for applicants, with their consent, to complete the NEPA review. The type and quantity of NEPA documents required to make this determination varies depending upon the project's size, location, and complexity. However, at a minimum, please provide the applicable documentation from this section to facilitate the NEPA compliance process. ®Detailed project description,scope of work,and budget/costs(Section I and Section III of this application). ®Project area maps with project site and staging area marked(Section II,part B&C of this application). ®Project area/structure photographs(Section II,part C of this application). ®Preliminary project plans. ®Project alternatives description and impacts(Section IV of this application). ®Please complete the applicable project worksheets. Dates of construction are required for all structures. ®Environmental Justice—Attach documents regarding evaluation(required)and satisfactory resolution(if necessary)of Environmental Justice issues(Highly Disproportionate,Adverse Impacts[effects]on Minority or Low Income Populations.) Documents can include public meeting records,media reports,letters from interested persons and groups,studies on population,ethnic groups,quality of life,housing,economics,transportation,public services,schools,public health, recreation,voting,etc. ®Provide any applicable information or documentation referenced on the Information and Documentation Requirements by Project Type(p. 10 of this application). B. Executive Order 12898,Environmental Justice for Low Income and Minority Population Are there low income or minority populations in the project area or adjacent to the project area?If yes,please describe any disproportionate and adverse effects to these populations. No To help evaluate the impact of the project,please indicate below any other information you are providing: ❑Description of the population affected and the portion of the population that would be disproportionately and adversely affected.Please include specific efforts to address the adverse impacts in your proposal narrative and budget. Attached materials or additional comments. Attach any continuations or additional items to this page Form No.HMGP 001,Eff.06/2012 DRAFT 16C1 C. Information required for Tribal Consultations Section 106 of the National Historic Preservation Act(NHPA)requires federal agencies to take into account the effect of their undertakings on historic properties. The NHPA requires that agencies must complete this process prior to the expenditure of any Federal funds on the undertaking. A Tribal Consultation is required for any project disturbing ground or moving soil, including but not limited to:drainage projects; demolition;construction;elevation; communication towers; tree removal; utility improvements. 1. Describe the current and future use of the project location.A land use map may be provided in lieu of a written description. 2. Provide information on any known site work or historic uses for project location. ❑ Attach a copy of a city or county scale map(large enough to show the entire project area)with the horizontal limits(ft) and vertical depths(sq ft)of all anticipated ground disturbance. D. Alternative Actions The NEPA process requires that at least two alternative actions be considered that address the same problem/issue as the proposed project. In this section, list two feasible alternative projects to mitigate the hazards faced in the project area. One alternative is the"No Action Alternative." 1. No Action Alternative Discuss the impacts on the project area if no action is taken. If no action is taken and Collier County is impacted by a major hurricane, it is possible that the buildings and its contents will sustain extensive wind and structural damage. 2. Other Feasible Alternative Discuss a feasible alternative to the proposed project. This could be an entirely different mitigation method or a significant modification to the design of the current proposed project. Complete all of parts a-e(below)and include engineering details (if applicable). a. Project Description for the Alternative Describe,in detail,the alternative project.Also,explain how the alternative project will solve the problem(s)and/or provide protection from the hazard(s). The project,when completed,will provide increased protection for the overhead bay and warehouse doors against hurricane strength winds up to 130 mph. The doors are Wind Resistant Windlock 652 Series Doors that are designed to lock the door edges into the 16 gauge steel guides. b. Project Location of the Alternative(describe briefly) ['Attach a map or diagram showing the alternative site in relation to the proposed project site ['Photographs(2 copies)of alternative site Attach any continuations or additional items to this page Form No. HMGP 001,Eff.06/2012 DRAFT 16 �. C. Scope of Work for Alternative Project Replace 33 outdated overhead doors with hurricane rated doors that are designed to last 15 years or more. The doors will be installed by a certified installer hired by Action Automatic Door and Gate. d. Impacts of Alternative Project Below,discuss the impact of this alternative on the project area. Include comments on these issues as appropriate:Environmental Justice,Endangered Species,Wetlands,Hydrology(upstream and downstream surface water impacts),Floodplain/Floodway,Historic Preservation and Hazardous Materials. None e. Estimated Budget/Costs for Alternative Project In this section,provide details of all the estimated costs of the alternative project(round figures to the nearest dollar).A lump sum budget is acceptable. 1. Materials Item Dimension Quantity Cost per Unit Cost Rolling Steil Door with Chain Hoist 10'x 12' 32 $1,915.00 $6,1280.00 Rolling Steel Door with Chain Hoist 12'x 12' 1 $2,282.00 $2,282.00 2. Labor (Include equipment costs.Please indicate all"soft"or in-kind matches.) Description of Task Hours Rate Cost 2-Man Installation Labor 133 $89.00/hr $11,837.00 Attach any continuations or additional items to this page Form No.HMGP 001,Eff.06/2012 DRAFT 16 C 1 3. Fees Paid (Include any other costs associated with the project.) Description of Task Hours Rate Cost N/A Total Estimated Project Cost$$75,399.00 Attach any continuations or additional items to this page Form No.HMGP 001,Eff.06/2012 DRAFT 16 C1 # HMGP ENVIRONMENTAL REVIEW Information and Documentation Requirements by Project Type Retrofits to Existing Facilities/Structures Elevations Acquisitions with Demolition ✓ Dates of Construction ✓ Concurrence from State Historic Preservation Officer if structure is 50 years or older, if work to be done is outside the existing footprint or if there is six(6) inches or more of ground disturbance. • Drainage Improvements ✓ Engineering plans/drawings ✓ Permit or Exemption letter to address any modifications to water bodies and wetlands o Department of Environmental Protection o Water Management District o U.S.Army Corps of Engineers ✓ Concurrence letter from State Historic Preservation Office addressing archeological impacts.Required if there is six(6)inches or more of ground disturbance. ✓ Concurrence from U.S. Fish and Wildlife addressing any impacts to wildlife, particularly endangered and threatened species and their habitats. ✓ If the project is in coastal area,attach a letter from the National Marine Fisheries Service addressing impacts to marine resources. ✓ Concurrence from Natural Resource Conservation Service if project is located outside city limits and may impact prime or unique farmland. Note: This is a general guideline for most projects. However,there will be exceptions. Consult with environmental staff on project types not listed Attach any continuations or additional items to this page Form No.HMGP 001,Eff.06/2012 1601 Section V. Maintenance Agreement .111 applicants whose proposed project involves the retrofit or modification of existing public property or whose proposed project would result in the public ownership or management of property,structures, or facilities,must first sign the following agreement prior to.submitting the application to FEMA. (NOTE: Those applicants whose project only involves the retrofitting, elevation, or other modification to private property where the ownership will remain private after project completion DO NOT have to complete this form.) The Board of County Commissioners of Collier County, State of Florida, hereby agrees that if it receives any Federal aid as a result of the attached project application. it will accept responsibility, at its own expense if necessary, for the routine maintenance of any real property, structures, or facilities acquired or constructed as a result of such Federal aid. Routine maintenance shall include. but not be limited to, such responsibilities as keeping vacant land clear of debris, garbage, and vermin; keeping stream channels, culverts, and storm drains clear of obstructions and debris; and keeping detention ponds free of debris, trees, and woody growth. The purpose of this agreement is to make clear the Subgrantee's maintenance responsibilities following project award and to show the Subgrantee's acceptance of these responsibilities. It does not replace. supercede, or add to any other maintenance responsibilities imposed by Federal law or regulation and which are in force on the date of project award. Signed by Georgia A. Hiller. Chairwoman,the duly authorized representative of the Collier County Board of County Commissioners,on this 12°'day of February. 2013. ATTEST: OWNER: DWIGHT-E,BROCK, Clerk BOA 0 COI 'I'Y COMMISSIONERS COL I 'R UntL ►TY, FLORIDA .All. A. �� fight E, $4)isarit, By : 2 - WIMP k G f7fr A. Hiller Chairwoman $1 . Approved'as`to form and Legal sufficiency: (4-5 124) Scott R. Teach -' Deputy County Attorney 16C1 - - _fit ) U U u L J 1 1 1 THIS WORKSHEET APPLIES FOR THE FOLLOWING MITIGATION ACTIVITIES: -Non-structural Retrofitting of Existing Buildings and Facilities(Ex:Shutters,Roof Hurricane Straps,etc.) -Structural Retrofitting of Existing Buildings(Ex:Code Plus,Load Path,etc.) -Acquisition -Mitigation Reconstruction Note:Please make sure you review the eligible activities,depending on the program you are applying for. IMPORTANT:PLEASE FILL OUT THIS WORKSHEET COMPLETELY. A SEPARATE WORKSHEET IS REQUIRED FOR EACH STRUCTURE TO BE WIND RETROFITTED. PROJECT GENERAL INFORMATION 1 PROJECT NAME Public Utilities Operations Center Hurricane Door Hardening 2 OWNER/APPLICANT Collier County Water-Sewer District 3 CONTACT PERSON Name:James Price Address(Please include City,State,and Zip Code): 4370 Mercantile Ave, Naples, FL,34104 Phone number:239-252-6246 Email:jamesprice @colliergov.net 4 PROGRAM APPLICATION(FMA,SRL,RFC,HMGP,PA,PDM) HMGP STRUCTURE GENERAL INFORMATION 5 STRUCTURE TYPE (Please select) BUILDING X OTHER UTILITY 6 ADDRESS 4370 Mercantile Ave 7 CITY,STATE AND ZIP Naples, FL,34104 8 COUNTY Collier 9 IS THIS A HISTORIC BUILDING? IYES NO X MITIGATION 10 MITIGATION TYPE (Please select below) SHUTTERS X LOAD PATH ( ) ROOF [ CODE PLUS f J ACQUISITION r (Only residential) l COST ESTIMATION INFO 11 PROJECT USEFUL LIFE 15 years 12 MITIGATION PROJECT COST $22,960.00 13 ANNUAL MAINTENANCE COST OF THE PROJECT $700.00 Page 1 of3 16C STRUCTURE INFORMATION 14 ZIP CODE OR LATITUDE AND LONGITUDE OF THE PROPERTY ZIP CODE 34104 LATITUDE 26°09'550047"N LONGITUDE 81°45'21.344"W 15 WHAT IS THE TOTAL SIZE OF THE BUILDING? (SF) 42,792 Note:For non-residential buildings,please provide the square footage for first floor only. For residential buildings,the total size consists of the enclosed area within the building,including finished and unfinished basements,and the entire living space;however,it does not include porches, garages,or other outside areas. 16 BUILDING REPLACEMENT VALUE ($/SF) $3,931,200.00 17 IS THIS A RESIDENTIAL BUILDING? YES i INO 18 IF NOT,PLEASE ANSWER ONE OF THE FOLLOWING RETROFIT PROJECT ((l x t� NEW BUILDING l 1 19 IS THIS A CODE PLUS PROJECT? (Not allowed for wood buildings) IVES 0 NO 20 IF SO,PLEASE ANSWER THE FOLLOWING DESIGN WIND SPEED(MPH) CODE PLUS WIND SPEED(MPH) 21 NUMBER OF STORIES ABOVE GRADE 2 22 LOSS OF RENT 23 TYPE OF CONSTRUCTION (Please select one below) WOOD Comments: MASONRY Comments: STEEL x 1 Comments: MANUFACTURED HOME J Comments: LOSS OF SERVICE - NON RESIDENTIAL BUILDING 24 VALUE OF BUILDING CONTENTS $668,000.00 25 DISPLACEMENT COST($/MONTH) $1/SF/Month 26 ANNUAL OPERATING BUDGET OF ORGANIZATION $116,700.00 If building is a Fire Station,the following information is required: 27 HOW MANY PEOPLE ARE SERVED BY THIS FIRE STATION? N/A 28 INDICATE THE TYPE OF AREA SERVED BY THIS FIRE STATION URBAN SUBURBAN RURAL WILDERNESS Page 2 of 3 1601 oi WHAT IS THE DISTANCE IN MILES BETWEEN THIS FIRE STATION AND THE FIRE 29 STATION THAT WOULD PROVIDE FIRE PROTECTION FOR THE GEOGRAPHIC AREA NORMALLY SERVED BY THIS FIRE STATION? 30 DOES THE FIRE STATION PROVIDE EMERGENCY MEDICAL SERVICE(EMS)? YES NO IF YES,WHAT IS THE DISTANCE IN MILES BETWEEN THIS FIRE STATION AND THE FIRE 31 STATION THAT WOULD PROVIDE FIRE PROTECTION FOR THE GEOGRAPHIC AREA NORMALLY SERVED BY THIS FIRE STATION? If building is a Hospital,the following information is required: 32 HOW MANY PEOPLE ARE SERVED BY THIS HOSPITAL? N/A 33 WHAT IS THE DISTANCE IN MILES BETWEEN THIS HOSPITAL AND THE HOSPITAL THAT WOULD TREAT THESE PEOPLE IN THE EVENT THIS HOSPITAL WAS INOPERATIVE? 34 HOW MANY PEOPLE ARE NORMALLY SERVED BY THE ALTERNATIVE HOSPITAL? If building is a Police Station,the following information is required: 35 INDICATE THE TYPE OF AREA SERVED BY THIS POLICE STATION METROPOLITAN N/A CITY [ ) RURAL 36 HOW MANY PEOPLE ARE REGULARLY SERVED BY THIS POLICE STATION? 37 HOW MANY POUCE OFFICERS WORK AT THIS POLICE STATION? 38 HOW MANY POUCE OFFICERS WOULD SERVE THE SAME AREA IF THE POLICE STATION WAS SHUT DOWN DUE TO DISASTER? Page 3 of 3 1601 ' ' , !r. :) 11, /; IEU � u " L J I j THIS WORKSHEET APPLIES FOR THE FOLLOWING MITIGATION ACTIVITIES: -Non-structural Retrofitting of Existing Buildings and Facilities(Ex:Shutters,Roof Hurricane Straps,etc.) -Structural Retrofitting of Existing Buildings(Ex:Code Plus,Load Path,etc.) -Acquisition -Mitigation Reconstruction Note:Please make sure you review the eligible activities,depending on the program you are applying for. IMPORTANT:PLEASE FILL OUT THIS WORKSHEET COMPLETELY. A SEPARATE WORKSHEET IS REQUIRED FOR EACH STRUCTURE TO BE WIND RETROFITTED. PROJECT GENERAL INFORMATION 1 PROJECT NAME Public Utilities Operations Center Hurricane Door Hardening 2 OWNER/APPLICANT Collier County Water-Sewer District 3 CONTACT PERSON Name:James Price Address(Please include City,State,and Zip Code): 4370 Mercantile Ave, Naples, FL,34104 Phone number:239-252-6246 Email:jamesprice @colliergov.net I4 PROGRAM APPLICATION(FMA,SRL,RFC,HMGP,PA,PDM) HMGP STRUCTURE GENERAL INFORMATION 5 'STRUCTURE TYPE (Please select) BUILDING ( X OTHER UTILITY 6 ADDRESS 4420 Mercantile Ave 7 CITY,STATE AND ZIP Naples, FL,34104 8 COUNTY Collier 9 IS THIS A HISTORIC BUILDING? IVES ( NO [ x j MITIGATION 10 MITIGATION TYPE (Please select below) SHUTTERS ( X J LOAD PATH ( ROOF CODE PLUS ACQUISITION (Only residential) COST ESTIMATION INFO 11 PROJECT USEFUL LIFE 15 years 12 MITIGATION PROJECT COST $ 14,994.00 13 ANNUAL MAINTENANCE COST OF THE PROJECT $455.00 Page 1 of 3 16C1 STRUCTURE INFORMATION 14 ZIP CODE OR LATITUDE AND LONGITUDE OF THE PROPERTY ZIP CODE 34104 LATITUDE 26°09'550047"N LONGITUDE 81°45'21.344"W 15 WHAT IS THE TOTAL SIZE OF THE BUILDING? (SF) 42,792 Note:For non-residential buildings,please provide the square footage for first floor only. For residential buildings,the total size consists of the enclosed area within the building,including finished and unfinished basements,and the entire living space;however,it does not include porches, garages,or other outside areas. 16 BUILDING REPLACEMENT VALUE (5/SF) $3,888,000.00 17 IS THIS A RESIDENTIAL BUILDING? YES E INO 18 IF NOT,PLEASE ANSWER ONE OF THE FOLLOWING RETROFIT PROJECT f NEW BUILDING 19 IS THIS A CODE PLUS PROJECT? (Not allowed for wood buildings) YES INO 0 20 IF SO,PLEASE ANSWER THE FOLLOWING DESIGN WIND SPEED(MPH) CODE PLUS WIND SPEED(MPH) 21 NUMBER OF STORIES ABOVE GRADE 2 22 LOSS OF RENT 23 TYPE OF CONSTRUCTION (Please select one below) WOOD ( ) Comments: MASONRY (- 1� Comments: ( STEEL x Comments: MANUFACTURED HOME ( Comments: LOSS OF SERVICE - NON RESIDENTIAL BUILDING 24 VALUE OF BUILDING CONTENTS $668,000.00 25 DISPLACEMENT COST($/MONTH) $1/SF/Month 26 ANNUAL OPERATING BUDGET OF ORGANIZATION $116,700.00 If building is a Fire Station,the following information is required: 27 HOW MANY PEOPLE ARE SERVED BY THIS FIRE STATION? N/A 28 INDICATE THE TYPE OF AREA SERVED BY THIS FIRE STATION URBAN f SUBURBAN RURAL WILDERNESS Page 2 of 3 16 C 1 WHAT IS THE DISTANCE IN MILES BETWEEN THIS FIRE STATION AND THE FIRE 29 STATION THAT WOULD PROVIDE FIRE PROTECTION FOR THE GEOGRAPHIC AREA NORMALLY SERVED BY THIS FIRE STATION? 30 DOES THE FIRE STATION PROVIDE EMERGENCY MEDICAL SERVICE(EMS)? YES NO IF YES,WHAT IS THE DISTANCE IN MILES BETWEEN THIS FIRE STATION AND THE FIRE 31 STATION THAT WOULD PROVIDE FIRE PROTECTION FOR THE GEOGRAPHIC AREA NORMALLY SERVED BY THIS FIRE STATION? If building is a Hospital,the following information is required: 32 HOW MANY PEOPLE ARE SERVED BY THIS HOSPITAL? N/A 33 WHAT IS THE DISTANCE IN MILES BETWEEN THIS HOSPITAL AND THE HOSPITAL THAT WOULD TREAT THESE PEOPLE IN THE EVENT THIS HOSPITAL WAS INOPERATIVE? 34 HOW MANY PEOPLE ARE NORMALLY SERVED BY THE ALTERNATIVE HOSPITAL? If building is a Police Station,the following information is required: 35 INDICATE THE TYPE OF AREA SERVED BY THIS POLICE STATION METROPOLITAN N/A CITY RURAL 36 HOW MANY PEOPLE ARE REGULARLY SERVED BY THIS POLICE STATION? 37 HOW MANY POUCE OFFICERS WORK AT THIS POLICE STATION? 38 HOW MANY POUCE OFFICERS WOULD SERVE THE SAME AREA IF THE POLICE STATION WAS SHUT DOWN DUE TO DISASTER? Page 3 of 3 16C1 .�� I,. Memorandum .\ TO: Harry Huber Senior Project Manager Public Utilities Engineering Department FROM: Hans Russell Property Acquisition Specialist Real Estate Services DATE: July 29, 2003 RE: Public Utilities Operations Center--Structural Inspection Report On July 23, 2003, an inspection of the structures and systems existing at the property on Mercantile and Progress Avenues proposed for the above facility was conducted by representatives of the Facilities Management Department. This inspection was conducted in accordance with Section 6.015 of the Agreement for Sale and Purchase pertaining to the facility as approved by the Board of County Commissioners on June 24, 2003. The inspection team consisted of the following individuals: Mark Callis, Maintenance Supervisor Ben Bryan, Tradesworker Carpenter Bernard Cleary, Master Fire Technician David Holmes, Senior Electrician Kurt Jokela, Senior HVAC Craftsman Glen Miles, Senior Plumber The team was conducted through the facility by Mike Vance, full time maintenance person for the current owner of the facility, and myself. The team was given ample time and opportunity to conduct their inspections and to question various aspects of the facility. They were then asked to make note of their concerns on Facility Inspection Forms and return them to me. Copies of the Forms submitted are attached for reference, and the areas of concern are summarized as follows: Structural: -No elevator in Phase I [2-story office section of east building]. -Noticed several areas-roof leaks. Office of Real Estate Services 16 C1 -Severe floor crack in front section Phase III [2-story office section of west building]. -Also soft spot in parking lot northeast front area of Phase III that might have caused severe crack in floor of that area. -Windows don't appear to be hurricane proof. -Missing screens top floor Phase III. -Phase I doors don't fit properly. -Floor tile sounds hollow underneath. -Most overhead doors open spaces at tops. -Not enough bathrooms. -Light fixtures in way of door opening. -Front walks in need of railings. Fire/Safety: -No fire sprinkler system. -No central fire alarm system. -Dead batteries in many emergency lights. -Several holes in fire and smoke barrier walls. -Elevator needs to be inspected before occupancy. Electrical: -Poor in most areas except main finished offices. -No outlets in some bathrooms. -Some uncovered electrical boxes. -Some K.O. seals missing on boxes and panelboards. -Light fixtures in poor repair in some warehouse areas. -Emergency and exit signs need new batteries. -Some conduit is loose in some warehouse areas. -Note: unable to check electrical service(s) because power is off by F.P.L. in some areas. HVAC: -Add return ductwork and vents to all rooms and hallways. -Units new and appear to work OK [some not yet connected]. Plumbing: -Water leak by west building front. -Overall condition of building, property and parking area good. -Lawn sprinkling system and landscaping OK. -Room for future use. The representative of the current owner has agreed to address the roof leaks and water leak issues discovered, and I have asked that I be provided with acceptable proof that these items have been appropriately repaired. In addition, the owner has agreed to have the two underground propane gas tanks that are not currently in use removed by the gas company. I also noticed a rectangular hole cut by one of the tenants in the west side of the west building for ventilation purposes, which I will request be closed up once that tenant has vacated. Pending your review of this report, I have not specifically Office of Real Estate Services 16C1 addressed any of the other areas of concern, many of which may or could be handled during the renovation process. Your attention is directed to Section 6.02 of the Agreement for Sale and Purchase, which outlines our remedies if we are not satisfied with the results of the inspections. Although the current owner has agreed to make some repairs, and may agree to others, he is under no obligation to do so. Our remedy is to withdraw from the deal if we are not satisfied, and if this is the case we must do so within the next two weeks. Would you please give me a call once you have digested this information so that we can discuss your questions and comments and determine where we go from here. I will look forward to hearing from you. My direct extension is 2623. Attachments as stated cc: T. A. Mott Office of Real Estate Services 16 C1 6 December 2012 Mr. Miles Anderson,State Hazard Mitigation Officer Florida Division of Emergency Management 2555 Shumard Oaks Blvd. Tallahassee, FL 32399-2100 Re: Hazard Mitigation Grant Program (HMGP)Applications for FEMA 4068-DR-FL"Tropical Storm Debby" Dear Mr.Anderson, The Collier County Local Mitigation Strategy(LMS)working group has approved by vote and prioritized the following projects for HMGP funding from this disaster. These projects align with our goals and objectives as noted and with the State's mitigation goals and objectives (in accordance with the Code of Federal Regulations 44 201.6) The Collier County LMS group therefore presents the projects below in the order in which they are to be considered for funding. Funding Project Name or Description Applicant Goal/Objective Estimated Priority Implemented Federal Share 1 Public Utilities Ops Ctr Collier County Public Goal 3: Obj 3.1.&3.3 overhead door replacement Utilities Division $28,500 for wind hazard 2 Portable Generator Cable Collier County School Goal 1,Obj:1.1, 1.2 Goal 3, pass-through hole and District Obj 3.1 generator pad with $75,000 anchoring point for General Population Risk-Shelters 3 Naples City Hall Window City of Naples Goal 3,objs 3.1,3.3 replacement for wind $487,500 protection 4 Marco Substation Relay Lee County Electric Goal 1,objs. 1.1, 1.2, 1.2.1, Vault Replacement& Cooperative Goal 2,objs. 2.2,2.3,2.4, and $337,500 Elevation Goal 3,objs.3.1,3.2,3.3 5 Wood pole replacement Lee County Electric Goal 1,objs. 1.1, 1.2, 1.2.1, with concrete ones Cooperative Goal 2,objs. 2.2,2.3,2.4, and $750,000 Goal 3,objs.3.1,3.2,3.3 6 Wind retrofit residential Retrofit Southwest Goal 1, Obj 1.1, 1.2, & Goal homes Florida 5, obj 5.2 $987'000 For further information or inquiry, please contact Richard Zyvoloski,239-252-3603, RichardZyvoloskiPCollierGov.net. Sincerely, Victor Hill, LMS Chair Collier County Local Mitigation Strategy Working Group 16 C 1 1 Collier County Map 7 c .a f r *_ fir.4.1 k air i:J, _ -J':: 2?:,,,,, ._ `t--x ',,— tJ, r y tr-- :2,--, rT-,4,-,. " ge,• y ,,,i .,.. .. 4 .-1_ . ._ .. ...:, : .. ,_ , ' 4370 Mercantile Ave I F y. ya - - I', 1 •..fit:. . _.-- MyTopo Map Print Page 1 of 1 16 C1 4 ', ... '"t,„ 1 ". ''ti,..if -4"- "'lr,..-,-: ,,, ,..„ ,, , ,, t... A,,,„ ... . II 'MIL- El ...... »_ [ •.: T3; 44 — r....v.— 1! III i 4. un '�� t v iwiw,.Tr I a � • �i1:1 y Iu --■ *s:iG I _.. ■ � 1 i _ . .r • $ .' 111UIIII _ . r IIIIII LT- w �. f e" r '�� IIi ®: I 1 i� fill ::INN III . I 14 PI - ,„„,.. me im i,,e) itt;:al VIM..../.."' 1111rallgutraill 1... ,"r• .._....._i , ,■,j■„, 0 4 MIS MIMI 11 It VIM os ... (0.4,.- 1., " � f" ` ,M ...ems 1 ■ Avow SUM f} MEN NMI \\: 4:-.. 7 �.:+ '4.,.5..`°-"'.a .i "�` ,ate NM w;Urn MM.MI • ' f c ` ` [ fi, ' , . - d j'. I, . u ""ill C G 4 0 6 MI Map provided by MyTopo.com oi 130000 Ft Vt http://map-pas s.mytopo.com/maps/print_mytopo.asp?print=20&scale=60&layer=DRG&1... 12/18/2012 , 1 6 C 1 141 2 •_ .,• STATE OF FLORIDA DIVISION OF EMERGENCY MANAGEMENT RICK SCOTT BRYAN W.KOON Governor Director MEMORANDUM To: Local Governments, State and Regional Agencies, Indian Tribal Governments, Local Mitigation Strategy Working Groups, Private Non- Profit Organizations Submitting Hazard Mitigation Grant Program Applications for the Tropical Storm Debby. From: Bryan W. Koon, State Coordinating Officer ul-p' Subject: Hazard Mitigation Grant Program Funding Summary Date: October 18, 2012 Program Summary The Florida Division of Emergency Management (the Division) is pleased to announce the availability of Hazard Mitigation Grant Program (HMGP) funds as a result of the recent Presidential Disaster Declaration for Tropical Storm Debby(FEMA 4068-DR-FL). HMGP funding is authorized by Section 404 of the Robert T. Stafford Disaster Relief Act. This funding helps communities implement measures to reduce or eliminate long- term risk to people and property from natural hazards and their effects. The Division encourages all potential applicants to submit applications for projects that address eligible mitigation activities. The amount of HMGP funding available to the state is based on the total federal disaster assistance for the Presidential Disaster Declaration. Application Timeline Applications are currently being accepted. The application period will close February 15, 2013. Applications mailed to the Division must be postmarked on or before February 15, 2013. Hand-delivered applications must be stamped in at the Division no later than 5:00 p.m. EST on February 15, 2013. The Division encourages potential applicants to submit complete applications before the close of the application period. Applications will only be accepted from eligible applicants as defined in the Minimum Program Eligibility section of this notice. FLORIDA RECOVERY OFFICE • DIVISION HEADQUARTERS • STATE LOGISTICS RESPONSE CENTER 5900 Lake Elienor Drive 2555 Shumard Oak Boulevard 2702 Directors Row Orlando, FL 32809 Tallahassee. FL 32399-2100 Orlando. FL 32809.5631 Tel: 850-413-9989 • Fax: 850-488-1018 www.FloridaDisaster.ore. MEMORANDUM 1 6 C 1 October 18, 2012 Page 2 Please provide four completed copies of the State of Florida Hazard Mitigation Grant Program Application and all appropriate attachments. The application and all other pertinent forms may be obtained at the Division's website located at http://www.floridadisaster.org/Mitigation/Hazard/forms.htm. You may also contact the Division directly at(850) 922-4182. Completed applications must be sent to the following address: ATTN: Kathleen Marshall, Hazard Mitigation Grant Program Florida Division of Emergency Management Mitigation Section 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 Minimum Program Eligibility Eligible Applicants: According to the Code of Federal Regulations (CFR)44 §206.434(a), the following parties are eligible to apply for Hazard Mitigation Grant Program funds: • State and local governments who have an approved Local Mitigation Strategy (LMS) in accordance with 44 CFR 201.6, prior to receipt of HMGP subgrant funding for projects; • Private non-profit organizations or institutions that own or operate a private non- profit facility as defined in §206.221(e); and • Indian tribes or authorized tribal organizations. Eligible Activities:Activities include mitigation projects that will result in protection of public or private property from natural hazards. Activities for which implementation has already been initiated or completed are not eligible for funding. Eligible projects include, but are not limited to, the following: • Acquisition or relocation of hazard prone structures • Retrofitting of existing buildings and facilities that will result in increased protection from hazards • Elevation of flood prone structures • Infrastructure protection measures • Stormwater management improvements • Minor structure flood control projects • Residential and community safe room construction MEMORANDUM 16 C October 18, 2012 Page 3 Ineligible Activities: The state will not consider funding requests for: • Generators (unless they are an integral part of a larger eligible project); • Construction of new facilities (Nevertheless, the cost associated with above code upgrades to new facilities may be considered); • Equipment such as emergency pumps, vehicles, and communication devices; • Tree removal, debris removal and other forms of maintenance; or • Projects already in progress (Construction may not begin until the contract between the State and subgrantee is executed and the project has met requirements of the National Environmental Policy Act). Eligibility Criteria: All projects submitted must meet minimum criteria to be considered for funding. An eligible project must: • Conform to the Florida State Hazard Mitigation Plan and the respective community's LMS; • Conform to the funding priorities for the disaster, as established in the appropriate LMS; • Demonstrate cost-effectiveness; • Be technically feasible; • Benefit the designated disaster area; • Conform to all applicable environmental laws and regulations, as well as Executive Orders; • Solve a problem independently or constitute a functional part of a solution; • Benefit a National Flood Insurance Program (NFIP) participating community that is not on probation or is suspended from the NFIP; and • Meet all applicable State and local codes and standards. Cost-Share Requirements Under the HMGP, FEMA will contribute up to 75-percent of the total amount approved under the grant award to implement eligible, cost-effective mitigation measures. The applicant must provide the remaining 25-percent non-federal share. Contributions, cash, and in-kind services are acceptable as part of the non-federal share. Requirements for in-kind contributions can be found in 44 CFR §13.24. In-kind contributions must be directly related to the eligible project cost and are those personnel, materials, equipment and supplies owned, controlled, and operated by the applicant or a third party contributor. Applicants may use the Global Match concept as part of the 25-percent non-federal share. Global Match permits a potential applicant to meet the non-federal share match by receiving credit for state and/or local government funds that were committed to similar type project(s). These similar, non-federally funded projects must meet all of the , 6C1 MEMORANDUM October 18, 2012 Page 4 HMGP eligibility requirements. This means that if Global Match is approved, the applicant may receive up to 100-percent federal share. Pre-Award Costs Prior to receiving a grant award, pre-award costs may be requested. Pre-award costs include items such as engineering, environmental study, permitting, and other "soft" costs associated with a construction project. Construction activities are not considered pre-award costs. Pre-award costs must be requested in writing. Guidelines for pre- award costs are included in Attachment A. County Funding Allocation To ensure funds are distributed equitably, designated counties have been assigned a portion of the total HMGP grant. The amount is based on a calculation of the proportional share of the total federal assistance under the Public Assistance (PA), Individual Assistance (IA), and Small Business Administration (SBA) programs as of October 2012. Commitment of project funds by the Division is contingent upon receipt of appropriate Legislative Budget Authority. These figures are shown in Attachment B and represent the estimated amount of HMGP funds currently available. HMGP funding is available only to those counties that have a current FEMA-approved LMS. Project applications will be considered only if: (1) The application is accompanied by an endorsement by the LMS Chairperson or Vice-Chairperson stating that the project is included in the current LMS; and, (2) If more than one project is submitted, the endorsement indicates the prioritization. A sample project submission letter is shown in Attachment C. The Division will attempt to fund each submitted project in priority order until the county's allocation has been exhausted. In accordance with Florida Administrative Code (F.A.C.) 27P-22.006, the Division uses the following tiered allocation system up until the State application deadline with FEMA: Tier I The available HMGP funds are allocated to counties included in the relevant Presidential Disaster Declaration in proportion to each county's share of federal disaster funding from the Public Assistance (PA), Individual Assistance (IA), and Small Business Administration (SBA) Disaster Loan Program as of the date of receipt of the FEMA funding notice described above. Eligible projects submitted by each county included in the relevant Presidential Disaster Declaration will be funded in order of priority as outlined in the LMS until the allocated funds (through the 12-Month Lock-in) are exhausted or all eligible projects are funded. MEMORANDUM Cl 16 October 18, 2012 Page 5 Tier 2 Any allocation remaining after all eligible projects in any declared county are funded, shall be re-allocated to those counties included in the relevant Presidential Disaster Declaration whose allocation was not sufficient to fund all submitted eligible projects. The order of priority for re-allocating funds is detailed in Attachment D. Tier 3 In the event funds remain after the Tier 1 and Tier 2 process, any remaining funds will be offered on a statewide basis as described in Attachment D. Please see Attachment D for a detailed explanation of funding tiers. Funding Availability and Notification FEMA notifies the State of HMGP funding availability at several milestones: 1. Initial Estimate This represents an early estimate only and is not an actual commitment of funding by FEMA. Funding may increase or decrease based on actual disaster claims during the declaration period. These estimates are provided for planning purposes and to jump-start the HMGP application process. 2. 180 Days from the Date of Declaration This represents the State's Lock-in Amount. It is the minimum the State can expect to receive from FEMA. County allocations listed in Attachment B are based on this estimate. After this disclosure, HMGP funds to the State cannot be decreased. It is important for potential applicants to recognize that HMGP funds are contingent upon FEMA's reexamination of the disaster figures at the given time intervals. A county's funding allocation can increase or decrease after it has submitted an application. Technical Assistance The Division is in the process of scheduling HMGP application development workshops. Please check the Division's website httD://www.floridadisaster.orq/Mitioation/Hazard for date, time, location and a short overview of the workshops. The Division will provide technical assistance throughout the application process. This includes assistance with the application process, Benefit Cost Analysis, Engineering Feasibility and Environmental/Historical Preservation Compliance. If there are any questions regarding the allocation of funds or the project review and selection criteria, please call Bureau staff at one of the following numbers: (850) 922-5944 (Program Eligibility) 16C1 MEMORANDUM October 18, 2012 Page 6 (407) 888-3720 (Program Eligibility) (407) 856-5040 (Environmental) (407) 856-5010 (Engineering and Technical Feasibility) For additional information and technical assistance, please refer to FEMA's Hazard Mitigation Assistance Unified Guidance document available at http://www.fema.gov/library/viewRecord.do?id=4225 . To assist you in submitting qualified project applications, the following attachments are located on the Division website http://www.floridadisaster.org/Mitigation/Hazard including the Hazard Mitigation Grant Program Assistance Application: Attachment A: HMGP Program Policy on Pre-award Cost and Form Attachment B: Initial Estimate of Available HMGP Funding Attachment C: Sample Project Submission Letter Attachment D: Florida Administrative Code 27P-22 BWK/km Attachments 16C1 Attachment A 16C1 Guidance on Pre-award Cost Associated with HMGP Projects Pre-award costs are costs incurred by a sub-grantee before the grant was awarded. Any and all pre-award costs associated with an HMGP project must be incurred after the date of declaration of a disaster under which the project is proposed for funding (GAO 10-129). All construction associated with an HMGP project must be incurred after approval by FEMA and after the State of Florida and the sub-grantee has executed a project contract. According to Webster's II New Riverside Dictionary Revised Edition, the word construction means "the act, process, or work of building." Breaking ground, installing a shutter, taking out a window to replace with impact glass, are all examples of "construction." FEMA may approve pre-award costs. These costs include study or research required to plan a construction project. Such activities may include engineering, modeling, permitting, environmental study, benefit-cost analysis, etc. These are soft costs and not to be confused with hard construction costs. Construction costs may not be included as pre-award costs. Pre-award costs must be factored into total project costs and included in the benefit-cost analysis calculations. The applicant may request pre-award costs any time after the disaster declaration. The request must be in writing and include the type of activity or activities proposed and estimated cost. All pre-award activity must clearly be associated with the applicant's proposed project. The State and FEMA will do a preliminary review of the request and may concur that the activities are necessary for the type of project envisioned or may consult with the applicant on an identified activity that the State or FEMA does not feel is necessary for a proposed project. Conversely, the State or FEMA may suggest additional study or research the applicant has not identified for a particular project. Review by the State and FEMA of pre-award activities may save money and time for the State, FEMA, and the applicant. Letters and documentation of all pre-award activities will need to be submitted to the State with the project application. Preliminary review by the State or FEMA of pre-award activities is no guarantee of eligibility or approval of the activities or the proposed project. FEMA will provide a written final determination on the pre-award request. An alternative is for the applicant to request approval of pre-award cost by letter attached to the project application. The request must include the type of activity or activities and costs incurred by the applicant. There is greater risk to the applicant with this alternative that incurred costs may not be considered eligible. If the proposed project meets all eligibility criteria and is approved by FEMA, then pre- award costs identified by the applicant prior to project submittal, or identified by the applicant in documentation attached to the application, will be considered project costs eligible for 75/25 re-imbursement (same as other project costs). 1601 All pre-award costs are subject to an approved grant award and available funding. If funding is not available, even if pre-award costs are approved in writing, they will not be reimbursed and will be solely the responsibility of the applicant. REFERENCES General Accounting Office, Principles of Federal Appropriations Law, Volume II, January 2004 Excerpts from OMB Cost Principle Circulars: OMB Circular A-87 and A-122 (2 CFR 225 and 2 CFR 230, respectively) - Pre-award costs are those incurred prior to the effective date of the award directly pursuant to the negotiation and in anticipation of the award where such costs are necessary to comply with the proposed delivery schedule or period of performance. Such costs are allowable only to the extent that they would have been allowable if incurred after the date of the award and only with the written approval of the awarding agency. OMB Circular A-21 (2 CFR 220) - Pre-agreement costs incurred prior to the effective date of the sponsored agreement, whether or not they would have been allowable thereunder if incurred after such date, are unallowable unless approved by the sponsoring agency. 44 CFR Part 206.439(c) further explains the pre-award cost regulations as allowable costs under HMGP. 44 CFR Part 13.22(b) lists the circulars above as the applicable cost principles for HMGP applicants; governments (A-87), private non-profits (A-122), & educational institutions (A-21). !.,. 16C1 -, STATE OF FLORIDA DIVISION OF EMERGENCY MANAGEMENT RICK SCOTT BRYAN W.KOON Governor Director HAZARD MITIGATION ASSISTANCE PROGRAM PRE-AWARD COST REQUEST FORM To request Pre-Award Costs, please complete this form and submit with your project application. All ELIGIBLE pre-award costs are subject to an approved grant award and availability of funding. If funding is not available or the project is not approved, pre-award costs will NOT be reimbursed and will be the sole responsibility of the applicant. If your project is approved and pre-award costs are eligible, the costs share for the reimbursement of these activities is up to a 75/25 split. Program: Name of Applicant: Project Title: Start Date for Pre-Award Activities: Pre-award costs associated with this request incurred prior to the date of declaration are NOT eligible. These costs include: study or research to plan project, engineering, modeling, permitting or environmental study. These costs must be reflected as a line Item in the project budget. Construction costs should NOT be included. Construction activities may NOT begin until after a contract has been fully executed with the State for this project. Activity Estimated Cost Estimated Start Date Point of Contact Information: Name: Title: Agency: Address: Phone: Email: Authorized Applicant Agent: Name: Title: Signature: Date: FLORIDA RECOVERY OFFICE • DIVISION HEADQUARTERS • STATE LOGISTICS RESPONSE CENTER 5900 Lake Ellenor Drive 2555 Shumard Oak Boulevard 2702 Directors Row Orlando, FL 32809 Tallahassee, FL 32399-2100 Orlando. FL 32809-5631 Tel: 850-413-9969 • Fax: 850-488-1016 www.FlorldaDisaster.or0 16C1 Attachment B 16c1 FEMA-4068-DR-FL Tropical Storm Debby Initial 90-Day Estimate �� Federal 25%Non- Allocation Federal Match Baker County $284,505.24 $94,835.08 Bradford County $239,507.58 $79,835.86 Charlotte County $310,019.08 $103,339.69 Citrus County $195,941.03 $65,313.68 Clay County $414,405.12 $138,135.04 Collier County $1,098,575.09 $366,191.70 Columbia County $1,901,297.48 $633,765.83 *Note: The amounts shown are Dixie County $88,480.48 $29,493.49 initial 90-day estimates and Duval County $896,234.39 $232,078.13 should be used for planning Franklin County $409,744.97 $136,581.66 purposes only. These figures Gilchrist County $2,530.13 $843.38 are based upon best available Gulf County $767,733.02 $255,911.01 data as of October 2012 and Hamilton County $112,630.00 $37,543.33 are subject to change. Hemando County $478,688.85 $159,629.62 The State anticipates that Highlands County $18,978.45 $6,325.48 FEMA will provide the 6-month Hillsborough County $81,157.23 $27,052.41 Lock-in estimate for the Hazard Jefferson County $818,166.42 $272,722.14 Lafayette County $70,052.96 $23,350.99 Mitigation Grant Program in Lee County $306,497.39 $102,165.80 January 2013. This future Levy County $79,310.84 $26,436.95 estimate will be used to re- Liberty County $106,618.88 $35,539.63 evaluate the initial 90-day Madison County $124,624.57 $41,541.52 estimate and establish a lock-in Manatee County $962,322.11 $320,774.04 ceiling. At this time the lock-in Nassau County $203,526.92 $67,842.31 ceiling will reflect any increase Pasco County $1,527,290.16 $509,096.72 or decrease in the amount of Pinellas County $757,755.33 $252,585.11 available HMGP funding. Polk County $39,354.06 $13,118.02 Putnam County $95,662.76 $31,887.59 Santa Rosa County $256,552.90 $85,517.63 Sarasota County $873,387.65 $291,129.22 Suwannee County $2,343,665.41 $781,221.80 Taylor County $77,401.05 $25,800.35 Union County $167,870.39 $55,956.80 Wakulla County $689,444.40 $229,814.80 $16,600,130.31 55,533,376.77 16 C1 Attachment C 16C1 Date Mr. Miles Anderson, State Hazard Mitigation Officer Florida Division of Emergency Management 2555 Shumard Oaks Boulevard Tallahassee, Florida 32399-2100 Re: Hazard Mitigation Grant Program (HMGP) applications for FEMA 4068-DR- FL "Tropical Storm Debby" Dear Mr. Anderson, The County Local Mitigation Strategy (LMS) working group has approved by vote and prioritized the following projects for HMGP funding from this disaster. These projects align with our LMS goals and objectives as noted, and with the State's mitigation goals and objectives (in accordance with the Code of Federal Regulations 44§ 201.6.) The County LMS group therefore presents the projects below (or in the attachment) in the order in which they are to be considered for funding. FEMA 4068-DR-FL "Tropical Storm Debby" Funding Project name Applicant Goal/ Estimated priority or objective federal share description implemented 1. Project name Applicant 3. B. (2) $000,000 2. Project name Applicant 1. A. (4) $000,000 3. Project name Applicant 2. B. (4) $000,000 Etcetera For further information or inquiry, please contact me at phone number and email. Sincerely, , LMS Chair County LMS cc: 16 C1 Attachment D 16C1 CHAPTER 27P-22 HAZARD MITIGATION GRANT PROGRAM 27P-22.001 Purpose 27P-22.002 Definitions 27P-22.003 Eligibility 27P-22.004 LMS Working Groups 27P-22.005 Local Mitigation Strategy 27P-22.006 County Allocations and Project Funding 27P-22.007 Application 27P-22.001 Purpose. This chapter describes the processes for application, project selection and distribution of funds under the Hazard Mitigation Grant Program. Rulemaking Authority 252.35(2)(x) FS. Law Implemented 252.311, 252.32, 252.35 FS. History—New 2-24-02, Formerly 9G-22.001. 27P-22.002 Definitions. (1) "Adoption" means a resolution, ordinance or other formal action taken by the governing body of a county or municipality indicating agreement with and acceptance of the relevant Local Mitigation Strategy. (2) "Application" means the request for hazard mitigation funding as submitted to the Division by an Applicant. (3) "Applicant" means a state agency, local government, Native American tribe or authorized tribal organization or private non-profit organization requesting hazard mitigation funding. (4) "FEMA" means the Federal Emergency Management Agency. (5) "Florida Hazard Mitigation Strategy" means Florida's version of the Hazard Mitigation Plan referred to in 44 C.F.R., Part 206, Subpart M. The Florida Hazard Mitigation Strategy (Rev. September 11, 1997) is hereby incorporated into this rule by reference. A copy may be obtained by contacting the Division of Emergency Management. (6) "Hazard" means a condition that exposes human life or property to harm from a man-made or natural disaster. (7) "Hazard Mitigation" means any action taken to reduce or eliminate the exposure of human life or property to harm from a man-made or natural disaster. (8) "Hazard Mitigation Grant Program", herein referred to as HMGP, means the program authorized under Section 404 of the Stafford Act and implemented by 44 C.F.R., Part 206, Subpart N, hereby incorporated by reference, a copy of which may be obtained by contacting the Division, which provides funding for mitigation projects as identified in the State Hazard Mitigation Strategy. (9) "Local Mitigation Strategy" or "LMS" means a plan to reduce the identified hazards within a county. (10) "Project" means a hazard mitigation measure as identified in an LMS. (11) "Repetitive loss structures" means structures that have suffered two or more 16 C 1 t occurrences of damage due to flooding and which have received payouts from the National Flood Insurance Program as a result of those occurrences. (12) "Working Group" is the group responsible for the development and implementation of the Local Mitigation Strategy. Rulemaking Authority 252.35(2)(x) FS. Law Implemented 252.311, 252.32, 252.35 FS. History—New 2-24-02, Formerly 9G-22.002. 27P-22.003 Eligibility. (1) Eligible types of projects shall include, but not be limited to, the following: (a) New construction activities that will result in protection from hazards; (b) Retrofitting of existing facilities that will result in increased protection from hazards; (c) Elevation of flood prone structures; (d) Vegetative management/soil stabilization; (e) Infrastructure protection measures; (f) Stormwater management/flood control projects; (g) Property acquisition or relocation; and (h) Plans that identify and analyze mitigation problems and include funded, scheduled programs for implementing solutions. (2) In order to be eligible for funding, projects shall meet the following requirements: (a) Conform to the Florida Hazard Mitigation Strategy; (b) Conform to the funding priorities for the disaster as established in the LMS governing the project; (c) Conform to 44 C.F.R., Part 9, Floodplain Management and Protection of Wetlands, and 44 C.F.R., Part 10, Environmental Considerations, both hereby incorporated by reference, copies of which may be obtained by contacting the Division; (d) Eliminate a hazard independently or substantially contribute to the elimination of a hazard where there is reasonable assurance that the project as a whole will be completed; and (e) Be cost-effective and substantially reduce the risk of future damage, hardship, loss, or suffering resulting from a disaster. Rulemaking Authority 252.35(2)(x) FS. Law Implemented 252.311, 252.32, 252.35 FS. History—New 2-24-02, Formerly 9G-22.003. 27P-22.004 LMS Working Groups. Each county electing to participate in the HMGP must have a formal LMS Working Group and a current LMS. (1) Not later than the last working weekday of January of each year the Chairperson of the Board of County Commissioners shall submit to the Division a list of the members of the Working Group and its designated Chairperson and Vice- Chairperson. (2) The Working Group shall include, at a minimum: (a) Representation from various agencies of county government which may 16C1 include, but not be limited to, planning and zoning, roads, public works and emergency management; (b) Representation from all interested municipalities within the county; and (c) Representation from interested private organizations, civic organizations, trade and commercial support groups, property owners associations, Native American Tribes or authorized tribal organizations, water management districts, regional planning councils, independent special districts and non- profit organizations. (3) The county shall submit documentation to show that within the preceding year it has issued a written invitation to each municipality, private organization, civic organization, Native American Tribe or authorized tribal organization, water management district, independent special district and non-profit organization, as applicable, to participate in the LMS working group. This documentation shall accompany the membership list submitted to the Division. (4) The Working Group shall have the following responsibilities: (a) To designate a Chairperson and Vice-Chairperson; (b) To develop and revise an LMS as necessary; (c) To coordinate all mitigation activities within the County; (d) To set an order of priority for local mitigation projects; and (e) To submit annual LMS updates to the Division by the last working weekday of each January. Updates shall address, at a minimum: 1. Changes to the hazard assessment; 2. Changes to the project priority list; 3. Changes to the critical facilities list; 4. Changes to the repetitive loss list; and 5. Revisions to any maps. Rulemaking Authority 252.35(2)(x) FS. Law Implemented 252.311, 252.32, 252.35 FS. History—New 2-24-02, Formerly 9G-22.004. 27P-22.005 Local Mitigation Strategy. Each LMS shall have the following components: (1) A description of the activities of local government and private organizations that promote hazard mitigation; a description of the policies, ordinances or programs that guide those activities; and any deficiencies in the policies, ordinances, and programs with recommendations to correct those deficiencies; (2) A description of the methods used to engage private sector participation; (3) A statement of general mitigation goals, with Working Group recommendations for implementing these goals, and estimated dates for implementation; (4) A description of the procedures used by the Working Group to review the LMS at regular intervals to ensure that it reflects current conditions within the County; (5) A hazard assessment to include, at the minimum, an evaluation of the vulnerability of structures, infrastructure, special risk populations, environmental resources and the economy to storm surge, high winds, flooding, wildfires and any other hazard to which the community is susceptible; 16C1 (6) A statement of procedures used to set the order of priority for projects based on project variables which shall include technical and financial feasibility; (7) A list of approved projects in order of priority with estimated costs and associated funding sources; (8) A list of critical facilities that must remain operational during and after a disaster; (9) A list of repetitive loss structures; and (10) Maps, in Geographical Information System (GIS) format, depicting hazard areas, project locations, critical facilities and repetitive loss structures. Rulemaking Authority 252.35(2)(x) FS. Law Implemented 252.311, 252.32, 252.35 FS. History—New 2-24-02, Formerly 9G-22.005. 27P-22.006 County Allocations and Project Funding. (1) The available HMGP funds shall be allocated to the counties included in the relevant presidential disaster declaration, as defined in Section 252.34(1), F.S., in proportion to each county's share of the federal disaster funding from the Public Assistance, Individual Assistance and Small Business Administration programs as of 90 days after the disaster declaration as reported by FEMA. (a) Eligible and submitted projects for each county included in the relevant presidential disaster declaration will be funded in order of priority as outlined in the LMS until the allocated funds are exhausted, or all eligible projects are funded, whichever occurs first. (b) Any allocation remaining after all eligible projects in any declared county are funded shall be reallocated to those counties included in the relevant presidential disaster declaration whose allocation was not sufficient to fund all submitted eligible projects in proportion to each county's share of unfunded projects. (2) If funds remain after all eligible projects under subsection (1) above have been funded, then they shall be applied to fund eligible projects submitted from counties not included in the relevant presidential disaster declaration on a first-come-first- served basis until all available funds are obligated. (3) Once a project has been selected for funding, the agreement between the applicant and the Division regarding the terms and conditions of the grant shall be formalized by contract. Rulemaking Authority 252.35(2)(x) FS. Law Implemented 252.311, 252.32, 252.35 FS. History—New 2-24-02, Formerly 9G-22.006. 27P-22.007 Application. (1) The following entities may apply for funding under the program: (a) State agencies and local governments; (b) Private non-profit organizations or institutions that own or operate a private non-profit facility as defined in 44 C.F.R., §206.221(e), hereby incorporated by reference, a copy of which may be obtained by contacting the Division; and (c) Indian tribes or authorized tribal organizations. 16c1 (2) The Division shall notify potential applicants of the availability of HMGP funds by publishing a Notice of Funding Availability in the Florida Administrative Weekly. (3) Applicants will have not less than ninety (90) days from the date of notification to submit project applications. The opening and closing dates will be specified in the Notice of Funding Availability, and applications must be postmarked or stamped in at the Division no later than 5:00 p.m. on the final due date. (4) A letter shall accompany each application from the Chairperson or Vice- Chairperson of the LMS Working Group endorsing the project. The endorsement shall verify that the proposed project does appear in the current LMS and state its priority in relation to other submitted projects. Applications without this letter of endorsement will not be considered. (5) Applications must be submitted using Form No. HMGP/FMA-001, State of Florida Joint Hazard Mitigation Grant Program & Flood Mitigation Assistance Application (Effective Date September 30, 2001), which is incorporated into this rule by reference, a copy of which may be obtained by contacting the Division. (6) If the Division receives an incomplete application, the applicant will be notified in writing of the deficiencies. The applicant will have thirty (30) calendar days from the date of the letter to resolve the deficiencies. If the deficiencies are not corrected by the deadline the application will not be considered for funding. (7) Applications are to be delivered or sent to: Division of Emergency Management Bureau of Mitigation 2555 Shumard Oak Boulevard Tallahassee, Florida 32399 ATTENTION: Hazard Mitigation Grant Program Rulemaking Authority 252.35(2)(x) FS. Law Implemented 252.311, 252.32, 252.35 FS. History-New 2-24-02, Formerly 9G-22.007. 16C1 From: Balmer.Adele To: Pricelamea Subject: Poverty/Minority Date: Thursday,December 20,2012 2:12:55 PM Hello Mr. Price, I looked up poverty status and minority status in zip code 34104. I found 13.9% minorities 11.2% below poverty level This information was obtained through the US Census Bureau American FactFinder 2007- 2011 American Community Survey 5-Year Estimates on Dec 20, 2012. The information provide is enough for the application. Please feel free to contact me if you have any additional questions. Sincerely, Adele Balmer Environmental Specialist, Mitigation Florida Division of Emergency Management 2702 Directors Row Orlando, Florida 32809-5631 Office: (407) 856-5019 www.floridadisaster.org A * ' : o ssionat R 1 t1Q*.: �±�;°� ;�' �llr��.��.;c• ...r-,+t' .-s W•.a > �-�`, 3.sK .:5 ,. ..:_ z: }.:,$� .=':... D6N[HONE- MOOT DBM DOM DIVIIIHONS CAW!Peva -!G c2 crjrtmer,+;( BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats B.Facts Publications FBC Staff BCIS Site Map Links Search Busines Professional Product Approval Unit:Public User Regulation Product Approval Menu>Product or Application Search>Application List>Application oetai ql!; FL#I FL12230-R1 Application Type Revision Code Version 2010 Application Status Approved Comments Arc hived Product Manufacturer USDoor And Building Components Address/Phone/EmaI 134 Janus International Blvd. Tensile,GA 30179 (770)562-2850 Ext 360 curtsojanusintl.com Authorized Signature Curtis Schroeder curts®janusinticom Technical Representative Curtis Schroeder Address/Phone/Ernal 134 Janus Intematonal Blvd. Temple,GA 30179 (770)562-2850 Ext 360 curts@janusintl.com Quality Assurance Representative Jake Lyons Address/Phone/Ertel 134 Janus Intematbnal Blvd. Temple,GA 30179 (770)562-2850 Ext 304 jakelCJanuslntLc om Category Exterior Doors Subcategory Roll-Up Exterior Door Assemblies Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report- Hardcopy Received Florida Engineer or Architect Name who developed the JOSEPH H. DIXON Evaluation Report Florida License PE-7768 Quality Assurance Entity National Accreditation&Management Institute, Quality Assurance Contract Expiration Date 12/31/2015 Validated By Gordon Thomas, P.E. Validation Checklist- Hardcopy Received Certificate of Independence FL12230 R1 COI Financial Indeo 030209.odf Referenced Standard and Year(of Standard) Standard Year ANSI/DASMA 108-02 2002 ASTM E330-02 2002 Equivalence of Product Standards Certified By Sections from the Code Product Approval Method Method 1 Option D Date Subnitted 02/23/2012 16 C 1 1 Date Validated 02/23/2012 Date Pending FBC Approval 02/29/2012 Date Approved 04/03/2012 Summary of Products FL* Model,Number or Name Description 12230.1 501_502-30 ROLL UP SHEET DOOR WITH NYLON WINDLOCKS. MAXIMUM WIDTH — — 8.-8". Limits of Use ;Installation Instructions Approved for use In HVHZ:No FL12230 R1 II 32003 Install 501-502.odf Approved for use outside HVHZ:Yes 1L12230 R1 II 501 502- 30-104.odf Impact Resistant:No , Verified By:JOSEPH H. DIXON JR. PE-7768 Design Pressure:+28.0/-30.0 Created by Independent Third Party: No Other:NOT FOR USE IN HIGH VELOCITY HURRICANE ZONE. Evaluation Reports , 1112230 R1 AE ER-09-0003-R.odf Created by Independent Third Party:Yes 12230.2 501_502-42.2 ROLL UP SHEET DOOR WITH NYLON WINDLOCKS. MAXIMUM WIDTH 10'-0" . Limits of Use - ------------------ Approved for use In HVHZ:No Installation 1220 II Instructions 1112230 RI II 32003 Insta11501-502.odf Approved for use outside HVHZ:Yes FL12230 RI II 501 502- 42- 120.odf Impact Resistant:No I Verified By:JOSEPH H DIXON JR.PE-7768 Design Pressure:+39.6/-42.2 Created by Independent Third Party: No Other:NOT FOR USE IN HIGH VELOCITY HURRICANE ZONE. Evaluation Reports FL12230 RI AE ER-09-0003-R.odf Created by Independent Third Party: Yes — 12230.3 '651-28 ROLL UP SHEET DOOR WITH STEEL WINDLOCKS. MAXIUMUM DOOR WIDTH 20'-0'. ■ Limits of Use Installation Instructions Approved for use In HVHZ:No FL12230 R1 II 32003 Install 651.odf Approved for use outside HVHZ:Yes FL12230 R1 II 651- 28- 240.odf Impact Resistant:No ; Verified By:JOSEPH H.DIXON JR. PE-7768 Design Pressure:+26.0/-28.0 ' Created by Independent Third Party: No j Other:NOT FOR USE IN HIGH VELOCITY HURRICANE ZONES. Evaluation Reports ■ 1112230 R1 AE ER-09-0003-R.odf Created by Independent Third Party: Yes 12230.4 '651-37 ,ROLL UP SHEET DOOR WITH STEEL WINDLOCKS. MAXIMUM DOOR ■ WIDTH 16'-0". Omits of Use Installation Instructions Approved for use In HVHZ:No ! FL12230 R1 II 32003 Install 651.odf I Approved for use outside HVHZ:Yes ; FL12230 RI II 651- 37- 192.odf Impact Resistant:No Verified By:JOSEPH H. DIXON JR. PE-7768 Design Pressure:+37.0/-37.0 , Created by Independent Third Party: No Other:NOT FOR USE IN HIGH VELOCITY HURRICANE ZONE. SEE ,Evaluation Reports DRAWING FOR VARIOUS PRESSURES VERSUS WIDTH. Ft 32230 R1 AE ER-09-0003-R.odf Created by Independent Third Party: Yes 12230.5 652-30 ROLL UP SHEET DOOR WITH NYLON WINDLOCKS. MAXIMUM WIDTH ' 18'-0". T Omits of Use Installation Instructions Approved for use In HVHZ:No FL12230 R1 II 32003 Install 652.odf Approved for use outside HVHZ:Yes FL12230 R1 II 652- 30- 144.od( ' Impact Resistant:No I Verified By:JOSEPH H DIXON JR. PE-7768 Design Pressure:+28.0/-30.0 Created by Independent Third Party: No Other:NOT FOR USE IN HIGH VELOCITY HURRICANE ZONE. SEE Evaluation Reports DRAWING FOR VARIOUS PRESSURES VERSUS WIDTH. FL12230 RI AE ER-09-0003-R.odf ; i Created by Independent Third Party:Yes Lontact U=::1940 North Monroe Street.Tallahassee FL 32399 Phone:850-487-1a21 The State of Florida Is an AA/ff0 employer.f oovrinht 2007-201.0 State of Florida,::privacy Statement::arzsugMbte term nt::gerund Statement Under Florida law,email addresses are public records.If you do not sent your e-mail address released In response to a public-records request,do not send elecronk mall to this entity.Instead,contact the once by phone or by traditional mall.If you hive any questions,please contact 850.487.1395."Pursuant to Section 455.275(1),Florida Statutes,effective October 1,2012,licensees licensed under Chapter 455,F.S.must provide the Department MO an email address If they have one.The emalis provided may be used for official communication with the licensee.However email addresses are public record.If you do not wish to supply a personal address,please provide the Department with an email address which can be made available to the public To determine If you are a licensee under Chapter 455,F.S.,please dick tier_. 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Z C..V p ' z� \ 1• i EN' O $ 5' n oOv• n o Q 2 m5-•0\o r C p p b' O m < _ m.. Q y ° tg m o S Revised 1-31-17 C.S �:�:� 16 c 1 1. tt' tu. Door DOOR INSTALLATION INSTRUCTIONS & adurna Components ' RIGHT BRACKET 0 WARNING DRUM SPRING �, oI i� . SPIRAL TUBE o ���lll��lll�lll�ll�� ,. rI C I. SPRING BRACKET 1 U BOLT 1: AXLE 0• j� /• GUIDE �''0 "LEAD IN" SADDLE 17 ` j .. LEFT DOOR BRACKET 18 O �l»l���llll»----�..... i �� I ' � ROLLER CHAIN 19 4 I .1 ,�'•O % a o SPROCKET©0 Ij �. i����� -��, %a 14 ' i'l .r► a = HEAD STOP •. till: .. � .�!�, , a AXLE ii n �✓� �% 4 CENTERLINE ;; ;! ‹-_ ��%� - .0000000000.1.01 CHAIN HOIST ! j/�-% '•"/ RIGHT DOOR GUIDE BRACKET � , I �i / fi , (UNIVERSAL) I /�i��' � i "� , 0:01 :00"..:.--�/� NYLON OPTIONAL /i:°ie!� '�� WIND CHAIN HOIST LOCKS HEAD STOP 23 /���� �" - ii%i��/i='-/ WEAR 1O � yi %�i�- ` /l" a STRIP •- ���iS� �' i �` , LEFT DOOR O2 A�/� 'i- %_ % GUIDE I ' // 0 SPACER CHAIN 3 LOCK / 11 LOCK SLIDE 0 20"DOOR SHEETS 0 BOTTOM BAR ANGLE o /, --�_-,-� _ ®VINYL WEATHER STRIP PREPARED \, 0 LIFT CLIP AMBS BY JOTHERS --,...• O5 BOTTOM BAR `�` IMPORTANT REMARKS t; • - 16C1 2. U DOOR INSTALLATION INSTRUCTIONS & i Components DOOR SUPPORT BRACKET LOCATION TABLE STEP 1 CHECK DOOR OPENING . CHECK THE WIDTH AND HEIGHT OF THE DOOR MINIMUM MINIMUM OPENSIZES ING ONHTHEEDOOR PACKING SLIP. CLEARANCES SIDE ROOM HEADROOM Al A2 B C D CHECK BOTH DOOR JAMBS FOR PLUMB. DOOR HEIGHT HAND OPERATED-PULL ROPE CHECK HEADER AND FLOOR FOR LEVEL. CHECK TO BE SURE THAT THERE IS SUFFICIENT UP TO 10'-0" HIGH 5" 5" 19.5" 9.5" 10" CLEARANCE AT THE JAMBS AND AT THE HEAD Al A2 B C D (SEE TABLE AT RIGHT). DOOR HEIGHT CHAIN OPERATOR-REDUCTION GEAR UP TO 10'-0" HIGH 6" 5" 19.5" 9.5" 10" STEP 2 INSTALL SUPPORT BRACKETS 10.-1" TO 14'-0" HIGH 6" 5" 21.5" 10.5" 11" FROM DIMENSION ON TABLE AT RIGHT, MARK THE 14'-1" TO 16'-0" HIGH 6" 5" 23" 11" 12" LOCATION FOR DOOR SUPPORT BRACKET, IF THE DOOR WAS SUPPLIED WITH A CHAIN HOIST USE THE DIMENSIONS SHOWN FOR Al ON THE SIDE HOIST IS TO BE INSTALLED. ��CEILING,`e1,I, IF OPENING IS GREATER OR LESS THAN SHOWN ON f THE PACKING SLIP, ADJUST THE Al AND A2 DIMENSIONS - D Ol� �� TO COMPENSATE FOR THE DIFFERENCE. IF OPENING B Elms Nletl'•. IS MORE THAN 3/4" WIDER THAN SHOWN ON PACKING I V SLIP GU DES yyI D00R TEND NOT T�E KDOOR OPENINOF THE _� C ,l ?%` • f `,�GENS�•.•. , MARK FOR HEIGHT LOCATION OF DOOR SUPPORT BRACKETS DOOR m w L NTE I� •t - SUPPORT • BY USING DIMENSION "C". VERIFY THAT THERE IS AMPLE CLEARANCE ABOVE THE BRACKET, DIMENSION "D'. BRACKET m®1 Awe* • IF CLEARANCE IS NOT AVAILABLE, YOU CAN LOWER r THE BRACKET TO OBTAIN THE REQUIRED SPACE. THE Al 1M®. •••fr(ORIDP �2 ; DOOR WILL HANG IN THE HEAD WHATEVER DISTANCE YOU 911 a• r • .•LOWER THE BRACKETS. IT WILL BE NECESSARY TO CUT SIDE VIEW .+i" : •.!a: CS C'THE SAME AMOUNT OFF THE BOTTOM OF BOTH GUIDES / •NAL � %s" AND RE—NOTCH FOR SLIDE BOLT LOCK CLEARANCE. NOTE: `7-113 fn.-- /f/t,[i % REDUCED DRIVE CHAIN HOIST MAY BE ON tITPI LLtt R�SIDE. FASTEN DOOR SUPPORT BRACKETS TO BUILDING WITH VERIFY WITH DOOR ASSEMBLY. FASTENERS SUPPLIED. USE A FASTENER IN ALL HOLES OF THE SUPPORT BRACKETS. OPTIONAL CHAIN HOIST STEEL JAMBS USE: 3/8"x 1 1/2" HEX HEAD BOLTS. IF DOOR IS TO BE CHAIN HOIST OPERATION, INSTALL MASONRY JAMBS USE: concrete screws 1/4" x 1.75" SPROCKET ON APPROPRIATE END OF DOOR BEFORE LIFTING NOTE: 3/8" DIAMETER THROUGH BOLTS (NOT SUPPLIED) DOOR INTO POSITION ON BRACKETS (SEE FIGURE 2). ARE REQUIRED WHEN MOUNTING TO SOFT BRICK OR ACCESS TUBE BLOCK. IF STEEL MOUNTING PLATES (OPTIONAL) ARE TO HOLE SHAFT BE USED, ATTACH MOUNTING PLATE TO BUILDING AS SHOWN IN FIGURE 1. ∎'' 1/2" LONG SPACERS (3) ( 0V �1 7 OPTIONAL REQUIRED �� ®•t,� �J1 0 STEEL BUILDING 7"x 12"x 3/16" + i , 1 •• c j JAMB STEEL PLATE ON 4r. .'• ®%I J✓I NUT WELDS NON HOIST SIDE. 3 8"x 2 1 2" y • 'f'• ® i�/ LOCK 7"x 24"x 3/16" / f: ' ∎1• it WASHER DOOR ' STEEL PLATE ON BOLTS ' OPENING 0 CHAIN HOIST SIDE. 11"'' DRUM CHAIN OIST gice m g,:/��A HP ROCKET NOTE: WIND LOCKS NOT SHOWN � 1_M� I FIGURE 2 2 i" t 13/4" 1 5/16" I I IF BOLTING USE WILL CUT TTOLD�ATVACLATERLTIM OOXACTLY WHEN (3)-3/8"BOLTS TO CUT THEM (STEP 6). NO GUARANTEE WILL BE GIVEN NOT SUPPLIED OR RESPONSIBILITY ACCEPTED BY MANUFACTURER IF DOOR IS NOT ERECTED AS INSTRUCTED. FOR PERFECT FIGURE 1 OPERATION FOLLOW INSTRUCTIONS GIVEN. PLEASE REVIEW ALL INSTRUCTIONS BEFORE STARTING ACTUAL WORK. K '' 3. ièDoor DOOR INSTALLA IN CTIONS & i Components STEP 5 PRETENSION THE DOOR SPRINGS STEP 3 LIFTING THE DOOR ASSEMBLY s.otaitit 1,4:iiiiIit, `N ,,(? .r. ...Ng," G E S ` •. •: ) =1 1IMPCD F?MA.NT w ••• . STATE OF c; .. • 941.'441 0''.•.. 1 e/ii:IONAL,f;ittyvVie 4�- FIGURE 5 ■ .� Z/Z01- STEP 6 REMOVING TAPE& PLASTIC WRAP !� •. CAUTION: SPRINGS ARE UNDER TENSION AND DOOR COULD UNWIND IF LET GO. ', I MAINTAIN COMPLETE CONTROL OF DOOR. FIGURE 3 STEP 4 ' .1.S.4) .P- ---1 SECURE AXLE SADDLES AND CHAIN HOIST(if supplied) Ic ti10 1 r I-- 7 ,- -- .,,.;%<i 001 \ 0 1 as IL - FIGURE 4 FIGURE 6 16 Cl 4. WOoor DOOR INSTALLATION INSTRUCTIONS 6 = i , Components STEP 9 cont. /� /'4$16 STEP 7 INSTALLING GUIDES / ` �� ts/� 10. me 's r S • cr ��• ;2OR1O�'.0 w FIGUIs+r` �•••..•.•••' G�2•,"` ' T •rt �NAt. FIGURE 7A STEEL JAMBS STEP 10 INSTALL SLIDE BOLT LOCKS FIGURE 10 STEP 11 INSTALL LIFT CLIP(Manual Operation Only) FIGURE 7B MASONRY JAMBS STEP 8 INSTALLING HEAD STOPS �� FIGURE 11 STEP 12 CHECK OPERATION OF DOOR �IIII FIGURE 8 STEP 9 CHECK AND ADJUST BALANCE emu- 16c1 f_ • coiNrMOrawmom _sea nd, _s_ 27-7033 - V _ Pant Tav 811 i Change of Address Prop.rty Sannury Property Detod Aerral Sketches Trim Notices hard Nor 0e2742000S3 SNr Ak.442$PROGRESS AVE Nre o Addrr.0O•RD Of courmr comassiONats COUNTY WATER SEWER DISTRICT 2301 TAMING TRL E CNp NAPLES SIN.FL Zip 34112-4101 Map No. Strap Nor Section Township Nry. Atm 4434 402031104.0014A36 30 N 25 4.77 34 40 25 f1/2 Of N 656.606 Of S 2005.0NT OF W1/2 Of El/2 Of Of W1/2 Of NE1/4,LESS S SOFT&W1/2 Of N Naafi Of 52415.11 FT Of E1/2 Of EY2 Of La9al W1/2 OF NE1/4 LESS 5 SOFT LESS 0 OF T DESC IN OR 1WO PIS 1923 bgamatAtsall 1.40 INNOLNOILO ccI0de14Oc Sob./Cord.la0-AQEAOE HEADER Sdr.al Odour Total UN C.d.•01-COUNTIES INCLU0ING NON-MUNICIPAL GOY. 5.576 6-0722 12.242 Latest Saks History 2012 Certified Tax Roll cs.aiat a O...44 Dab 0ooe-P.M Amount Land Wm 5 1.102.500 00/30/01 3401.14411 $5.500•660 (.)improstwi Value S 0.0 0,010 10/16/07 113 k1Et1 10 (_)Morita VaeN S 4,277.520 01/1741 1111314 S MAN O1/01/114 1061-:401 S 54.000 (-)sow a.thr Exempt SO (_)A.aaN.d Value S 4,277,520 (-)Hesn..6.ed a other Ena.pt S 4,277,520 (_)Taxable VON S (=t School Taaa01.Value 10 ,1 Yalu.Awn a n•wr..r.a r,er an.w.w fax z.. 1d.•-sane W hon.-owner raw aw o uc on mauve..ean.ra _ # Ntrn0 I 0■066Ltard Med.On •A• 4.103% • ro 1 iS & 0 .. aae• ACTION 11360 Metro Pkwy Nay esport 4 N 1 6 C 1 • Ft Myers, FL 33966 Naples, FL 34104 Customer Proposal iAUTOMATIC Phone:239-768-3667 Fax: -643- 3-3667 .DO�OR�GATE Fax:239-768-3740 Fax:239-643-4467 www ActionDoor corn Proposal Date ti."74e 1,elegee°6 Pk 7xfE6.9 1r"met'' 3667 375 800- - a.,ss lime.ei s..•�.E....aa..e 11/15/12 Customer: CEMZEMEMID BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY WATER DIST.DEPT 3299 TAMIAMI TRAIL E STE 700 4370 MERCANTILE AVE NAPLES FL 34112 NAPLES FL 34104 JAMES PRICE Salesperson: Paul Couto 239-707-4723 16 10x12 652-30 WHITE, CHAIN HOIST 16 10x12 652-30 WHITE, RE-CONNECT EXISTING OPERATOR 1 12x12 652-30 WHITE 33 STEEL MOUNTING PLATES 16 SPROCKET FOR EXISTING OPERATOR 33 REMOVE OLD DOOR US Door 851 roll-up steel door designed to meet 130 MPH windload by using windlocks on curtain and heavy duty guides with windlock bar; hot-dipped galvanized steel curtain with baked-on polyester primer paint. Minor scratches are not considered to be a defect. Choice of 20 standard factory colors. INCLUDES: INSTALLATION AND ONE YEAR GUARANTEE ON PARTS & LABOR. TAX EXEMPT - NO SALES TAX INCLUDED ""* PRICES VALID FOR 30 DAYS FROM DATE OF QUOTE *** Material : $ 29143.00 99 HRS e $89/HR Labor: $ 8811 .00 Total : $ 37954.00 Thank you for your business! Behind our work is more than just our great name—there's me,George Ebel.if at any time you feel you did not receive a fair value call me at 1-800-375-3667. ...11, 1,_E CIEWGE F t .=a ndl:e 7.7:e:10,t pail n+thtn.I £j,s--11tH)-L•'ERC ENT4',E R- E'if 19`s:t∎,e asora'.ae ∎tenon Ewe AS't JO plus 311 c lie!tton costs 3n0 ahame..ee5 alt•.e[3.11:outs to!'.:gnt '_�te".E1.:'ECN..R',E .F5,-,v..11':e 3^O..._to ELI 3_i.a-U. 3met ,.)oJ_1r-::t p3io,.mnoJ:3,S-7,11F11•:E:FLLit:.E:if 1 :?s xr11:e vie-Ito�, ,,,tS J",-;,,"t0.t_,.r ,A Cart.Thin',:1.5 -r./,til;AL r ERCE(IT.7.,E 4t.TE C.F'3% re3s, ._._i�s._tt�n`ee>f S 1 J0;:i■s sal .,,,t .15 1r 1:ea3'.a.ae;Roma.!ees.,dl e C'A 1 o,_re-24of 7 HE TERMS A74O CON011 KIN S PRrNTE 0 ON 1 HE SACK•tE RE Of ARE NE RE SY E SPRE S SNEY MADE A PART OI THIS C ON 1 RAC T. ACCEPTED BY SELLER: ACCEPTED BY BUYER: BY: _ BY: ...E -.,,E r.. -.E. DATE ACCEPTED: 4E a _ Ø6C1 .. , , , 1!t E r ' E�s IAN Ali . 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I t s \ l r \ J . \ J t 1 \ J ! r 1 y \ I 1 C. 1 I \ J 1 3 J ! .1 [ d1,: . \ l Ff:•u 4,,. _._i® o PUBLIC UTILITIES WEST a 1 �_"- gyre .rcra ��,,,�� i �xn OF COUNTY'Corrrssronsns "' a�-a m A ""`• rp COU R:en COUNTY;1WRIOa ______ _ 1ST FLOOR PLAN ' lawTas Mg C NJUIT IRPARI WNT .�- 0 J �af�r a,r rr•wafl a..r Pr PM'S rr s ae.r A .._ Ia-., I 16C1 Q. Co 4.. O C Q. (n 1 1 ■ J I a ,•I O O N P m C w N r w QI"D- �•1 C N N I en rmfi''' N p ''VIN I I 4\i\1 J N V - a I t .s y1 Ewe wR° W°g °CI,° 0N° c - y J CA) 0 N N 0)X N O 0.) O W p O i- N CO IQ 0) o PUBLIC UTILITIES WEST 44.1*► `:,"°` N° "TO °1R0A y BOARS Ol aooM7 COYMISSIO vERS d ,,.-0,b. A . ht I.,,, COLLIER counn ftottmu c2ND FLOOR PLAN `` � � MOW Mm czwsxr aEpaM ZN? 1..1- 0 " �j��t a I.N.N.laawll.+.0 pnnae .. UM".r ••••••_ — — mu 16C1 Collier County Water Distribution-Cornell Rolling Service Doors A. Materials Item Dimension Quantity CostperUnit Cost Rolling Steel Dr w/Ch Hoist 10'0 x 12'0 32 1915.00 61280.00 Rolling Steel Dr w/Ch Hoist 12'0 x 12'0 1 22112 00 2282.00 B.Labor (Include equipment costs—please indicate all "soft"or in-kind matches) Description Hours Rate_ Cost 2-Man Installation Labor 133 89.00/hr 11837.00 C. Fees Paid Include any other costs associated with the project. Description of Task Hours Rate C ost N/A Total Estimated Project Cost$_75399.00 1000 16C1 4 4 ..,c) eir COLLIER COUNTY WATER DEPARTMENT 4370 Mercantile Avenue Naples, FL 34104 December 18, 2012 To Whom It May Concern, The Collier County Utilities Operations Center located at 4370 Mercantile Avenue is funded from user fees from the customer's of the Collier County Water Sewer District. The current budget for FY13 is $116,700. The FY13 budget cycle Is from October 1, 2012 to September 30, 2013. I have attached a copy of the budget as approved by the Board of County Commissioners. If you have any additional questions, please contact me at (239) 252-6245 or via email at Pamelalibby @colliergov.net. Sincerely, i , i Pamela Libby Water Operations .na. -r 16C1 • EIEEIE2E3Eio21 § 008881188 § § -“ gin orc -213Z * -4i0 Z -CI i' 0 E m n r � r T O C mmzDoz m x m v 3m iiy Glo “ 5o ° mo ; Zm v v � m4 .-uf _4zm cliT( m Eircz1 70 70 • N x c CD c a $ g _ J J 5J N J J A Y. � g25o 'cSo � $ $ I • 88888888888885 0 2 m rn s � a "< � w c CC W J 8 § $ 8 § $ S ^' 8 go25 ,o° 5 88888888888888 16 C1 A. Item Roll-Up Door W/Chain Hoist Roll-Up Door W/O Chain Hoist Roll-Up Door W/Chain Hoist B. Description 2-Man Installation Labor 16C1 Materials Dimension 10' a 12' 16 $891.00 10'a 12' 16 $871.00 12'a 12' 1 $951.00 Labor (Include equipment costs—please indicate all "soft"or in-kind matches) 99 $89.00 $8,811.00 Total: 1601 Quantity Cost per Unit Cost $14,256.00 $13,936.00 $951.00 Hours Rate Cost $37,954.00 1 6 C 1 ,„,, •. Cl' . Ito. .. 4 �o IJ f L !�R o ! Y if I J {-: . c J ! , ...., .., _ • ,..,4 .. X�rr J l 1 J 1 , r l , I ,t 0' r.; o L PUBLIC UTIUTIES EAST I *MI j� 18 OM RP ■■ BOARD a comer?CwavaRIawtRS �..,,,,t —� �- �.,r, I 9 mum COON!!:MOBIL 1ST FLOOR PLAN 7I'A�RULORRZ►rRRNIRTYRNr —. — �— r r.r.wtia.e pq swr LY'.1' 0 16C1 ..4., , .., • _ ___ ___ _ _ _ _ m N we °C CO 'vo a, Ni L---n--------L II J 1 r - . ,. C ,.., .„....,,„,,, Ay C N N(I A 8 1 . _ J ADO . NN q,' W N N O O g-N wX C Cr N ..) -7 N W W C C Z C N W N N Q) o PUBUC UTIUTIES EAST .p I— p •..� j -- 41% ,, 0 saw op coverr carnas:a tm ,=. .,...,.�. 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If yes to Question 1,answer Question 2:Yes[ NOD If you answered"Yes"to Question 2,move to signature If "No"to Question 2,please fill out the following information TOTAL COMPENSATION CHART FOR MOST RECENTLY COMPLETED FISCAL YEAR Date of Fiscal Year Completion:Chcl< here to enter a date. Rank (Highest Total Compensation for to Name Most Recently Lowest) (Last,First,MI) Title Completed Fiscal Year 1 2 3 4 5 THE UNDERSIGNED CERTIFIES THAT ON THE DATE WRITTEN BELOW, THE INFORMATION PROVIDED HEREIN IS ACCURATE. SIGNATURE: NAME AND TITLE: DATE: C.. ., r . ,-- . , iydripc.- '.. D1 . .. ,.. *rw._. N - - � m N rn f •�. W INDUSTRIAL BOULEVARD 1 CD N D m : m me alb # z �' m ii cD .t„,„.!\\* cl z ,. ., m _ w. ma z ,.< _ , c ,,m N Qi)1.---- 4 D O , c � r 2 Z rn k � N o 7111111 .. M ow a , c>; z ,1` m '1' m :P,OWER':•STREET,• �°�, N S �� D Z ~ (r.l. cn ,. 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