Loading...
Backup Documents 09/10/2013 Item #16E17 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLI? TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 4 t.1 THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#1.through#2 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#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s)(List in routing order) Office Initials Date 1. 2. 3. County Attorney Office County Attorney Office CJr I hi 4. BCC Office Board of County ' - \f J Commissioners 5. Minutes and Records Clerk of Court's Office PRIMARY CONTACT INFORMATION 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,may need to contact staff for additional or missing information. Name of Primary Staff Christine Boni tr uLxrc '-.v'c Phone Number 252-3617 Contact/ Department Agenda Date Item s 9/10/13 Agenda Item Numbe 16E17 Approved b A BC Y the � Type of Document State-Funded Subgrant Agreement Number of Original 3 -need all three Attached Documents Attached originals returned to PO number or account f ( send to the State /`I number if document is L" )U to be recorded S � �'[�v�� 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. Does the document require the chairman's original signature? 2. Does the document need to be sent to another agency for additional signatures? If yes, provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. -:,c� r/ 3. 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 C� by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's C(� Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the Cf:) document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's ,eD signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip should be provided to the County Attorney Office at the time the item is input into SIRE. 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! 8. The document was approved by the BCC on`t I to 13(enter date)and all changes made during the meeting have been incorporated in the attached document. The County _Ad Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready f• the • Chairman's signature. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12 MEMORANDUM Date: September 16, 2013 To: Christine Boni, Senior Admin. Assistant Bureau of Emergency Services From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: State Funded Sub-grant Agreement Contract # 14-CP-11-09-21-01-XXX CSFA: 31.067 Attached are three (3) original of the document referenced above, (Item #16E17) adopted by the Board of County Commissioners on Tuesday, September 10, 2013. Forward a fully executed original to the Minutes and Records Department to be kept as part of the Board's Official Records. If you have any questions, please call 252-7240. Thank you. Attachment T . 6E171 Contract Number: 14-CP-11-09-21-01-XXX CSFA:31.067 STATE-FUNDED SUBGRANT AGREEMENT THIS AGREEMENT is entered into by the State of Florida, Division of Emergency Management, with headquarters in Tallahassee, Florida(hereinafter referred to as the"Division"), and Collier County, (hereinafter referred to as the"Recipient"). THIS AGREEMENT IS ENTERED INTO BASED ON THE FOLLOWING REPRESENTATIONS: A. The Recipient represents that it is fully qualified and eligible to receive these grant funds to provide the services identified herein;and B. The Division has received these grant funds from the State of Florida, and has the authority to subgrant these funds to the Recipient upon the terms and conditions below; and C. The Division has statutory authority to disburse the funds under this Agreement. THEREFORE,the Division and the Recipient agree to the following: (1) SCOPE OF WORK. The Recipient shall perform the work in accordance with the Scope of Work and Schedule of Deliverables and Schedule of Payments(Attachments A and B)of this Agreement. (2) INCORPORATION OF LAWS, RULES, REGULATIONS AND POLICIES The Recipient and the Division shall be governed by applicable State and Federal laws, rules and regulations, including those identified in Attachment A. (3) PERIOD OF AGREEMENT. This Agreement shall begin upon execution by both parties,or July 1,2013,whichever is later, and shall end June 30, 2014, unless terminated earlier in accordance with the provisions of Paragraph(12)of this Agreement. (4) MODIFICATION OF CONTRACT Either party may request modification of the provisions of this Agreement. Changes which are agreed upon shall be valid only when in writing,signed by each of the parties, and attached to the original of this Agreement. (5) RECORDKEEPING (a) As applicable, Recipient's performance under this Agreement shall be subject to the federal OMB Circular No.A-102,"Common Rule: Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments"(53 Federal Register 8034)or OMB Circular No.A-110, "Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals, and Other Nonprofit Organizations,"and either OMB Circular No.A-87, "Cost Principles for State, Local and Indian Tribal Governments,"OMB Circular No.A-21, "Cost Principles for Educational Institutions,"or OMB Circular No.A-122,"Cost Principles for Non-profit Organizations." (b) The Recipient shall retain sufficient records to show its compliance with the terms of this Agreement,and the compliance of all subcontractors or consultants paid from funds under this Agreement,for a period of five years from the date the audit report is issued,and shall allow the Division or its designee, the State Chief Financial Officer or the State Auditor General access to the records upon request. The Recipient shall ensure that audit working papers are available to them upon request for a period of five years from the date the audit report is issued, unless extended in writing by the Division. The five year period may be extended for the following exceptions: 1. If any litigation,claim or audit is started before the five year period expires, and extends beyond the five year period,the records shall be retained until all litigation,claims or audit findings involving the records have been resolved. 16E1. 7 . 2. Records for the disposition of non-expendable personal property valued at $5,000 or more at the time it is acquired shall be retained for five years after final disposition. 3. Records relating to real property acquired shall be retained for five years after the closing on the transfer of title. (c) The Recipient shall maintain all records for the Recipient and for all subcontractors or consultants to be paid from funds provided under this Agreement, including documentation of all program costs,in a form sufficient to determine compliance with the requirements and objectives of the Scope of Work-Schedule of Deliverables-Schedule of Payments(Attachment A)and all other applicable laws and regulations. (d) The Recipient, its employees or agents, including all subcontractors or consultants to be paid from funds provided under this Agreement,shall allow access to its records at reasonable times to the Division, its employees,and agents. "Reasonable"shall ordinarily mean during normal business hours of 8:00 a.m.to 5:00 p.m., local time,on Monday through Friday. "Agents"shall include, but not be limited to,auditors retained by the Division. (6) AUDIT REQUIREMENTS (a) The Recipient agrees to maintain financial procedures and support documents,in accordance with generally accepted accounting principles,to account for the receipt and expenditure of funds under this Agreement. (b) These records shall be available at reasonable times for inspection, review, or audit by state personnel and other personnel authorized by the Division. "Reasonable"shall ordinarily mean normal business hours of 8:00 a.m.to 5:00 p.m., local time, Monday through Friday. (c) The Recipient shall provide the Division with the records, reports or financial statements upon request for the purposes of auditing and monitoring the funds awarded under this Agreement. (d) If the Recipient is a non-state entity as defined by Section 215.97, Fla.Stat., it shall comply with the following: If the Recipient expends a total amount of State financial assistance equal to or more than $500,000 in any fiscal year of such Recipient,the Recipient must have a State single or project-specific audit for such fiscal year in accordance with Section 215.97, Fla. Stat.; applicable rules of the Executive Office of the Governor and the Chief Financial Officer;and Chapters 10,550(local government entities)or 10.650(nonprofit and for-profit organizations),Rules of the Auditor General. EXHIBIT 1 to this Agreement shows the State financial assistance awarded by this Agreement. In determining the State financial assistance expended in its fiscal year,the Recipient shall include all sources of State financial assistance, including State funds received from the Division,other state agencies,and other non-state entities. State financial assistance does not include Federal direct or pass-through awards and resources received by a non-state entity for Federal program matching requirements. In connection with the audit requirements addressed in this Paragraph 6(d)above,the Recipient shall ensure that the audit complies with the requirements of Section 215.97(8), Fla. Stat. This includes submission of a reporting package as defined by Section 215.97(2)(e), Fla. Stat. and Chapters 10.550 (local governmental entities)or 10.650(nonprofit and for-profit organizations), Rules of the Auditor General. If the Recipient expends less than$500,000 in State financial assistance in its fiscal year,an audit conducted in accordance with the provisions of Section 215.97, Fla. Stat, is not required. In the event that the Recipient expends less than$500,000 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the provisions of Section 215.97, Fla. Stat,the cost of the audit must be paid from the non-state entity's resources(i.e.,the cost of such an audit must be paid from the Recipient's resources obtained from other than State entities). Additional information on the Florida Single Audit Act may be found at the following website: https://apos.fldfs.com/fsaa/sindleauditact.aspx. (e)Report Submission 1. The annual financial audit report shall include all management letters and the Recipient's response to all findings, including corrective actions to be taken. 2 16E17 2. The annual financial audit report shall include a schedule of financial assistance specifically identifying all Agreement and other revenue by sponsoring agency and Agreement number. 3. Copies of financial reporting packages required under this Paragraph 6 shall be submitted by or on behalf of the Recipient directly to each of the following: Division of Emergency Management Office of Inspector General 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 Auditor General's Office Room 401,Claude Pepper Building 111 West Madison Street Tallahassee,Florida 32399-1450 4. Any reports,management letter, or other information required to be submitted to the Division of Emergency Management pursuant to this Agreement shall be submitted on time as required under OMB Circular A-133, Florida Statutes,and Chapters 10.550(local governmental entities) or 10.650(nonprofit and for-profit organizations),Rules of the Auditor General,as applicable. 5. Recipients, when submitting financial reporting packages to the Division of Emergency Management for audits done in accordance with OMB Circular A-133 or Chapters 10.550 (local governmental entities)or 10.650(nonprofit and for-profit organizations), Rules of the Auditor General, should indicate the date that the reporting package was delivered to the Recipient in correspondence accompanying the reporting package. (f) If the audit shows that all or any portion of the funds disbursed hereunder were not spent in accordance with the conditions of this Agreement,the Recipient shall be held liable for reimbursement to the Division of all funds not spent in accordance with these applicable regulations and Agreement provisions within thirty days after the Division has notified the Recipient of such non- compliance. (g) The Recipient shall have all audits completed in accordance with Section 215.97, Fla. Stat. by an independent certified public accountant(IPA)who shall either be a certified public accountant or a public accountant licensed under Chapter 473, Fla.Stat. The IPA shall state that the audit complied with the applicable provisions noted above. The audit must be submitted to the Division no later than nine(9)months from the end of the Recipient's fiscal year. (7) REPORTS (a) If all required deliverables are not sent to the Division or are not completed in a manner acceptable to the Division,the Division may withhold further payments until they are completed or may take other action as stated in Paragraph(11)REMEDIES. "Acceptable to the Division"means that the work product was completed in accordance with the Scope of Work-Schedule of Deliverables- Schedule of Payments. (b) The Recipient shall provide additional program updates or information that may be required by the Division. (8) MONITORING. The Recipient shall monitor its performance under this Agreement,as well as that of its subcontractors and/or consultants who are paid from funds provided under this Agreement,to ensure that time schedules are being met,are being accomplished within the specified time periods, and other performance goals are being achieved. A review shall be done for each function or activity in Attachment A and B to this Agreement. In addition to reviews of audits conducted in accordance with paragraph(6)above,monitoring procedures may include, but not be limited to,on-site visits by Division staff, limited Scope of Work audits, and/or other procedures. The Recipient agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by the Division. In the event that the Division determines that 3 1 6E1 7 a limited audit of the Recipient is appropriate,the Recipient agrees to comply with any additional instructions provided by the Division to the Recipient regarding such audit. The Recipient further agrees to comply and cooperate with any inspections, reviews, investigations or audits deemed necessary by the Florida Chief Financial Officer or Auditor General. In addition,the Division will monitor the performance and financial management by the Recipient throughout the contract term to ensure timely completion of all tasks. (9) LIABILITY (a) Unless Recipient is a State agency or subdivision,as defined in Section 768.28, Fla. Stat.,the Recipient is solely responsible to parties it deals with in carrying out the terms of this Agreement,and shall hold the Division harmless against all claims of whatever nature by third parties arising from the work performance under this Agreement. For purposes of this Agreement, Recipient agrees that it is not an employee or agent of the Division, but is an independent contractor. (b) Any Recipient which is a state agency or subdivision, as defined in Section 768.28, Fla.Stat.,agrees to be fully responsible for its negligent or tortious acts or omissions which result in claims or suits against the Division,and agrees to be liable for any damages proximately caused by the acts or omissions to the extent set forth in Section 768.28, Fla. Stat. Nothing herein is intended to serve as a waiver of sovereign immunity by any Recipient to which sovereign immunity applies. Nothing herein shall be construed as consent by a state agency or subdivision of the State of Florida to be sued by third parties in any matter arising out of any contract. (10) DEFAULT. If any of the following events occur("Events of Default"), all obligations on the part of the Division to make further payment of funds shall, if the Division elects, terminate and the Division has the option to exercise any of its remedies set forth in Paragraph(11). However,the Division may make payments or partial payments after any Events of Default without waiving the right to exercise such remedies, and without becoming liable to make any further payment: (a) If any warranty or representation made by the Recipient in this Agreement or any previous agreement with the Division is or becomes false or misleading in any respect, or if the Recipient fails to keep or perform any of the obligations,terms or covenants in this Agreement or any previous agreement with the Division and has not cured them in timely fashion, or is unable or unwilling to meet its obligations under this Agreement; (b) If material adverse changes occur in the financial condition of the Recipient at any time during the term of this Agreement and the Recipient fails to cure this adverse change within thirty days from the date written notice is sent by the Division. (c) If any reports required by this Agreement have not been submitted to the Division or have been submitted with incorrect, incomplete or insufficient information; (d) If the Recipient has failed to perform and complete on time any of its obligations under this Agreement. (11) REMEDIES. If an Event of Default occurs,then the Division may, after thirty calendar days written notice to the Recipient and upon the Recipient's failure to cure within those thirty days, exercise any one or more of the following remedies,either concurrently or consecutively: (a) Terminate this Agreement, provided that the Recipient is given at least thirty days prior written notice of the termination. The notice shall be effective when placed in the United States,first class mail,postage prepaid, by registered or certified mail-return receipt requested,to the address in paragraph(13)herein; (b) Begin an appropriate legal or equitable action to enforce performance of this Agreement; (c) Withhold or suspend payment of all or any part of a request for payment; (d) Require that the Recipient refund to the Division any monies used for ineligible purposes under the laws, rules and regulations governing the use of these funds. (e) Exercise any corrective or remedial actions,to include but not be limited to: 4 0 1 E 7 1. request additional information from the Recipient to determine the reasons for or the extent of non-compliance or lack of performance, 2. issue a written warning to advise that more serious measures may be taken if the situation is not corrected, 3. advise the Recipient to suspend, discontinue or refrain from incurring costs for any activities in question or 4. require the Recipient to reimburse the Division for the amount of costs incurred for any items determined to be ineligible; (f) Exercise any other rights or remedies which may be available under law. (g) Pursuing any of the above remedies will not stop the Division from pursuing any other remedies in this Agreement or provided at law or in equity. If the Division waives any right or remedy in this Agreement or fails to insist on strict performance by the Recipient, it will not affect, extend or waive any other right or remedy of the Division, or affect the later exercise of the same right or remedy by the Division for any other default by the Recipient. (12) TERMINATION. (a) The Division may terminate this Agreement for cause after thirty days written notice. Cause can include misuse of funds, fraud, lack of compliance with applicable rules, laws and regulations, failure to perform on time,and refusal by the Recipient to permit public access to any document, paper, letter,or other material subject to disclosure under Chapter 119, Fla. Stat., as amended. (b)The Division may terminate this Agreement for convenience or when it determines, in its sole discretion,that continuing the Agreement would not produce beneficial results in line with the further expenditure of funds,by providing the Recipient with thirty calendar days prior written notice. (c) The parties may agree to terminate this Agreement for their mutual convenience through a written amendment of this Agreement. The amendment will state the effective date of the termination and the procedures for proper closeout of the Agreement. (d) In the event that this Agreement is terminated,the Recipient will not incur new obligations for the terminated portion of the Agreement after the Recipient has received the notification of termination. The Recipient will cancel as many outstanding obligations as possible. Costs incurred after receipt of the termination notice will be disallowed. The Recipient shall not be relieved of liability to the Division because of any breach of Agreement by the Recipient. The Division may, to the extent authorized by law, withhold payments to the Recipient for the purpose of set-off until the exact amount of damages due the Division from the Recipient is determined. (13) NOTICE AND CONTACT. (a) All notices provided under or pursuant to this Agreement shall be in writing, either by hand delivery, or first class, certified mail, return receipt requested, to the representative named below,at the address below,and this notification attached to the original of this Agreement. (b) The name,address, telephone number,fax number and email address of the Division contract manager for this Agreement is: Mr. Timothy Date 2555 Shumard Oak Boulevard Tallahassee, Florida 32399-2100 Telephone: (850)410-1272 Fax:(850)488-1739 Email: tim.date @em.myflorida.com 5 UEi7 • (c) The name and address of the Representative of the Recipient responsible for the administration of this Agreement is: Dan E. Summers 8075 Lely Cultural Pkwy, Suite 445 Naples, FL 34113 Telephone: 239-252-3600 Fax:239-252-3700 Email:dansummers@colliergov.net—also copy-christinebonicolliergov.net (d) In the event that different representatives are designated by either party after execution of this Agreement,notice of the name,address,telephone number,fax number and email address of the new representative will be provided as outlined in(13)(a)above. (14) SUBCONTRACTS If the Recipient subcontracts any of the work required under this Agreement,a copy of the unsigned subcontract must be forwarded to the Division for review and approval before it is executed by the Recipient. The Recipient agrees to include in the subcontract that(i)the subcontractor is bound by the terms of this Agreement,(ii)the subcontractor is bound by all applicable state and federal laws and regulations,and(iii)the subcontractor shall hold the Division and Recipient harmless against all claims of whatever nature arising out of the subcontractor's performance of work under this Agreement,to the extent allowed and required by law. The Recipient shall document the subcontractor's progress in performing its work under this Agreement. For each subcontract,the Recipient shall provide a written statement to the Division as to whether that subcontractor is a minority business enterprise,as defined in Section 288.703,Fla. Stat. (15) TERMS AND CONDITIONS This Agreement contains all the terms and conditions agreed upon by the parties. (16) ATTACHMENTS (a) All attachments to this Agreement are incorporated as if set out fully. (b) In the event of any inconsistencies or conflict between the language of this Agreement and the attachments,the language of the attachments shall control, but only to the extent of the conflict or inconsistency. (c) This Agreement has the following attachments: Exhibit 1 -Funding Sources Attachment A—Scope of Work Attachment B—Schedule of Deliverables-Schedule of Payments Attachment C—County Facilities Listing Attachment D—Financial Invoice Form Attachment E—Hazards Analysis Checklist and CAMEO Guide Attachment F—Hazards Analysis Site Visit Certification Form Attachment G—Warranties and Representations Attachment H—Certification Regarding Debarment, Attachment I—Statement of Determination (17) FUNDING/CONSIDERATION (a) This is a fixed fee agreement. The Recipient shall be reimbursed for costs incurred in the satisfactory performance of work hereunder in an amount not to exceed$7,129.00 subject to the availability of funds. (b) The sole intent of this Agreement is to provide financial assistance to the Recipient to support the conduct of site-specific hazards analyses and hazardous materials emergency management activities. It is therefore required that all expenditures paid from this fund be directly related to hazardous materials preparedness,response,recovery or mitigation activities. Contract funds are not required to be 6 Cq expended within the contract period; however,all work must be performed during the contract period. Any payments received after termination of the Agreement shall be considered payments for work performed pursuant to the Agreement. If the necessary funds are not available to fund this Agreement as a result of action by the United States Congress, the federal Office of Management and Budgeting,the State Chief Financial Officer or under subparagraph(19)(h)of this Agreement, all obligations on the part of the Division to make any further payment of funds shall terminate. This agreement may be renewed, at the Division's sole discretion,for a period that may not exceed three years or the term of the original Agreement,which ever period is longer,specifying the new price and subject to the availability of funds. Pursuant to Section 287.057(13), Florida Statues, exceptional purchase contracts pursuant to 287.057(3)(a)and(c), may not be renewed. (18) REPAYMENTS All refunds or repayments due to the Division under this Agreement are to be made payable to the order of"Division of Emergency Management"and mailed directly to the following address: Division of Emergency Management Cashier 2555 Shumard Oak Boulevard Tallahassee FL 32399-2100 In accordance with Section 215.34(2), Fla. Stat., if a check or other draft is returned to the Division for collection,Recipient shall pay the Division a service fee of$15.00 or 5%of the face amount of the returned check or draft,whichever is greater. (19) MANDATED CONDITIONS (a) The validity of this Agreement is subject to the truth and accuracy of all the information, representations,and materials submitted or provided by the Recipient in this Agreement, in any later submission or response to a Division request,or in any submission or response to fulfill the requirements of this Agreement. All of said information, representations,and materials are incorporated by reference. The inaccuracy of the submissions or any material changes shall,at the option of the Division and with thirty days written notice to the Recipient,cause the termination of this Agreement and the release of the Division from all its obligations to the Recipient. (b) This Agreement shall be construed under the laws of the State of Florida, and venue for any actions arising out of this Agreement shall be in the Circuit Court of Leon County. If any provision of this Agreement is in conflict with any applicable statute or rule,or is unenforceable, then the provision shall be null and void to the extent of the conflict,and shall be severable, but shall not invalidate any other provision of this Agreement. (c) Any power of approval or disapproval granted to the Division under the terms of this Agreement shall survive the term of this Agreement. (d) This Agreement may be executed in any number of counterparts, any one of which may be taken as an original. (e) The Recipient agrees to comply with the Americans With Disabilities Act(Public Law 101-336,42 U.S.C. Section 12101 et seq.),which prohibits discrimination by public and private entities on the basis of disability in employment, public accommodations,transportation, State and local government services,and telecommunications. (f) Those who have been placed on the convicted vendor list following a conviction for a public entity crime or on the discriminatory vendor list may not submit a bid on a contract to provide any goods or services to a public entity,may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to a public entity, may not be awarded or perform work as a contractor, supplier,subcontractor, or consultant under a contract with a public entity,and may not transact business with any public entity in excess of$25,000.00 for a period of 36 months from the date of being placed on the convicted vendor list or on the discriminatory vendor list. 7 16E17 (g) Any Recipient which is not a local government or state agency, and which receives funds under this Agreement from the federal government,certifies,to the best of its knowledge and belief, that it and its principals: 1. are not presently debarred, suspended, proposed for debarment,declared ineligible, or voluntarily excluded from covered transactions by a federal department or agency; 2. have not,within a five-year period preceding this proposal been convicted of or had a civil judgment rendered against them for fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(federal, state or local)transaction or contract under public transaction;violation of federal or state antitrust statutes or commission of embezzlement,theft,forgery, bribery, falsification or destruction of records, making false statements,or receiving stolen property; 3. are not presently indicted or otherwise criminally or civilly charged by a governmental entity(federal, state or local)with commission of any offenses enumerated in paragraph 19(g)2. of this certification;and 4. have not within a five-year period preceding this Agreement had one or more public transactions(federal, state or local)terminated for cause or default. If the Recipient is unable to certify to any of the statements in this certification,then the Recipient shall attach an explanation to this Agreement. In addition,the Recipient shall send to the Division(by email or by facsimile transmission)the completed "Certification Regarding Debarment, Suspension, Ineligibility And Voluntary Exclusion"(Attachment G)for each intended subcontractor which Recipient plans to fund under this Agreement. The form must be received by the Division before the Recipient enters into a contract with any subcontractor. (h) The State of Florida's performance and obligation to pay under this Agreement is contingent upon an annual appropriation by the Legislature,and subject to any modification in accordance with Chapter 216, Fla. Stat.or the Florida Constitution. (i) All bills for fees or other compensation for services or expenses shall be submitted in detail sufficient for a proper preaudit and postaudit thereof. (j) Any bills for travel expenses shall be submitted in accordance with Section 112.061, Fla. Stat. (k) The Division reserves the right to unilaterally cancel this Agreement if the Recipient refuses to allow public access to all documents, papers, letters or other material subject to the provisions of Chapter 119, Fla. Stat.,which the Recipient created or received under this Agreement. (I) If the Recipient is allowed to temporarily invest any advances of funds under this Agreement,any interest income shall either be returned to the Division or be applied against the Division's obligation to pay the contract amount. (m) The State of Florida will not intentionally award publicly-funded contracts to any contractor who knowingly employs unauthorized alien workers,constituting a violation of the employment provisions contained in 8 U.S.C. Section 1324a(e)(Section 274A(e)of the Immigration and Nationality Act ('INA")]. The Division shall consider the employment by any contractor of unauthorized aliens a violation of Section 274A(e)of the INA. Such violation by the Recipient of the employment provisions contained in Section 274A(e)of the INA shall be grounds for unilateral cancellation of this Agreement by the Division. (n) The Recipient is subject to Florida's Government in the Sunshine Law(Section 286.011, Fla. Stat.)with respect to the meetings of the Recipient's governing board or the meetings of any subcommittee making recommendations to the governing board. All of these meetings shall be publicly noticed, open to the public,and the minutes of all the meetings shall be public records,available to the public in accordance with Chapter 119, Fla. Stat. (o) All expenditures of state financial assistance shall be in compliance with the laws, rules and regulations applicable to expenditures of State funds, including but not limited to, the Reference Guide for State Expenditures. (p) The Agreement may be charged only with allowable costs resulting from obligations incurred during the term of the Agreement. (q) Any balances of unobligated cash that have been advanced or paid that are not authorized to be retained for direct program costs in a subsequent period must be refunded to the State. 8 cq 16Ei7 (r) The recipient is required to participate in Division of Emergency Management training specific to performance of the hazard analysis program. (20) LOBBYING PROHIBITION (a) No funds or other resources received from the Division under this Agreement may be used directly or indirectly to influence legislation or any other official action by the Florida Legislature or any state agency. (b) The Recipient certifies, by its signature to this Agreement,that to the best of his or her knowledge and belief: 1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the Recipient, to any person for influencing or attempting to influence an officer or employee of any agency,a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant,the making of any Federal loan, the entering into of any cooperative agreement, and the extension,continuation, renewal, amendment or modification of any Federal contract, grant, loan or cooperative agreement. 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this Federal contract,grant, loan or cooperative agreement,the Recipient shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities." 3. The Recipient shall require that this certification be included in the award documents for all subawards(including subcontracts, subgrants,and contracts under grants, loans, and cooperative agreements)and that all subrecipients shall certify and disclose. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. (21) COPYRIGHT, PATENT AND TRADEMARK ANY AND ALL PATENT RIGHTS ACCRUING UNDER OR IN CONNECTION WITH THE PERFORMANCE OF THIS AGREEMENT ARE HEREBY RESERVED TO THE STATE OF FLORIDA. ANY AND ALL COPYRIGHTS ACCRUING UNDER OR IN CONNECTION WITH THE PERFORMANCE OF THIS AGREEMENT ARE HEREBY TRANSFERRED BY THE RECIPIENT TO THE STATE OF FLORIDA. (a) If the Recipient has a pre-existing patent or copyright,the Recipient shall retain all rights and entitlements to that pre-existing patent or copyright unless the Agreement provides otherwise. (b) If any discovery or invention is developed in the course of or as a result of work or services performed under this Agreement,or in any way connected with it,the Recipient shall refer the discovery or invention to the Division for a determination whether the State of Florida will seek patent protection in its name. Any patent rights accruing under or in connection with the performance of this Agreement are reserved to the State of Florida. If any books,manuals,films, or other copyrightable material are produced,the Recipient shall notify the Division. Any copyrights accruing under or in connection with the performance under this Agreement are transferred by the Recipient to the State of Florida. (c) Within thirty days of execution of this Agreement, the Recipient shall disclose all intellectual properties relating to the performance of this Agreement which he or she knows or should know could give rise to a patent or copyright. The Recipient shall retain all rights and entitlements to any pre-existing intellectual property which is disclosed. Failure to disclose will indicate that no such property exists. The Division shall then, under Paragraph(b), have the right to all patents and copyrights which accrue during performance of the Agreement. (I)9 (22) LEGAL AUTHORIZATION The Recipient certifies that it has the legal authority to receive the funds under this Agreement and that its governing body has authorized the execution and acceptance of this Agreement. The Recipient also certifies that the undersigned person has the authority to legally execute and bind Recipient to the terms of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement. RECIPIENT: ATTEST: . p- BOARD OF COUNTY COMMISSIONERS DWIGHT`E.•BROCK,,PtERK OF COLICIE' COUNTY,FLORIDA E 7 °,` • z ' f By: Olt k rd / By: ,DE"ii LER G 'GIAA R LER, ESQ. Attest a tto*Chairtna''s C IRWOMAN signature only. C II C 11.3 Date: Fl D#59-6000558-156 Approved for form and legality: 22cd / 1 leen M Greene, Assistant County Attorney STATE OF FLORIDA DIVISION OF EMERGENCY MANAGEMENT By: Name and Title: Bryan W. Koon, Director Date: 10 6E1 EXHIBIT- 1 STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: SUBJECT TO SECTION 215.97,FLORIDA STATUTES: Division of Emergency Management, Florida Hazardous Materials Planning and Prevention Program, Catalog of State Financial Assistance Number 31.067 in the amount of$7,129.00. COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 1. Emergency Planning and Community Right-to-Know Act(EPCRA),Title III of the Superfund Amendments and Reauthorization Act of 1986,42 U.S.C.s. 11001, at seq. (SARA). 2. Florida Emergency Planning and Community Right-to-Know Act, Chapter 252, Part II, Florida Statutes 16E17 Attachment A SCOPE OF WORK Purpose To update the hazards analysis for all facilities listed in Attachment C, which have reported to the State Emergency Response Commission the presence of those specific Extremely Hazardous Substances designated by the U.S. Environmental Protection Agency in quantities above the Threshold Planning Quantity. The data collected under this Agreement will be used to comply with the planning requirements of the Superfund Amendments and Reauthorization Act of 1986, Title III,"Emergency Planning and Community Right-To-Know Act of 1986"and the Florida Emergency Planning and Community Right-To-Know Act,Florida Statutes,Chapter 252, Part H. Requirements A. The Recipient shall submit a list of facilities within the geographical boundaries of the County listed on Attachment C that are suspected of not reporting to the State Emergency Response Commission the presence of Extremely Hazardous Substances in quantities above the Threshold Planning Quantity,as designated by the U. S. Environmental Protection Agency. B. The completed hazards analysis shall comply with the site-specific hazards analysis criteria outlined in this Attachment for each facility listed in Attachment C.The primary guidance documents are Attachment E(Hazards Analysis Contract Checklist and CAMEO Guide)to this Agreement and the U.S.Environmental Protection Agency's "Technical Guidance for Hazards Analysis"at; htto://www.epa.gov/emergencies/docs/chem/tech.pdf. All hazards analyses shall be consistent with the provisions of these documents. Any variation from the procedures outlined in these documents must be requested in writing,submitted in advance and approved by the Division. C. Conduct an on-site visit at each Attachment C facility to ensure accuracy of the hazards analysis. Each applicable facility's hazards analysis information shall be entered into the U.S. Environmental Protection Agency's CAMEOfm version 2.4(download from): http://www.epa.gov/emergencies/content/cameo/index.htm. Each facility hazards analysis shall include, but is not limited to,the following items: 1. Facility Information (CAMEOfm Facility Page) (a) Enter the facility name(per Attachment C)in the Facility Name field. (b) Enter the facility physical address(no Post Office Box) in the Street Address fields of the Address tab. (c) Enter the geographic coordinates(in decimal degrees) in the latitude/longitude fields of the Map Data tab. j6Ei7 (d) Enter the maximum number of employees present at the facility at any given time in the Number of Employees on Site field of the ID Codes tab. (a minimum of one is required for unmanned facilities) (e) Enter the Facility phone number in the Facility Phones tab field. (f) Enter the name,title and 24-hour phone number of the designated facility emergency coordinator in the Contacts tab field. (g) Enter the main route(s) used to transport chemicals to the facility(from the County line to the facility) in the notes tab of the Facility Page. (h) Enter the route(s)used to exit the Vulnerable Zone(s)in the notes tab of the Facility Page. (i) Enter any past releases that have occurred in the last five years at the facility in the notes tab of the Facility Page. Include date,time,chemical name/quantity and number of persons injured or deaths(this information is available from the facility). If it is determined that a facility does not have a historical accident record, that shall be noted. 2. Hazard identification(CAMEOfm Chemical in Inventory Page) (a) For each Extremely Hazardous Substance present over the Threshold Planning Quantity(TPQ),create a Chemical in Inventory page(if a Chemical in Inventory page hasn't been created already)and enter the proper chemical name and Chemical Abstract Service(CAS) number. (b) On each Chemical in Inventory page created for each Extremely Hazardous Substance present over the TPQ,enter in pounds(not range codes)the maximum quantity of each Extremely Hazardous Substance in the Max Daily Amount field of the Physical State and Quantity tab. (c) Enter the amount(in pounds)of each Extremely Hazardous Substance stored in the largest container or interconnected containers in the Max amount in largest container field of the Physical State and Quantity tab(this is the release amount used to determine the Vulnerable Zone). (d) Choose the appropriate code from the drop down list for the Type of storage container(drum,cylinder,tank etc.),storage pressure(ambient,greater than ambient etc.)and storage temperature(ambient,greater than ambient etc.)of each Extremely Hazardous Substance in those fields on the Location tab. (e) For each Extremely Hazardous Substance over TPQ,On the Physical State& Quantity tab check the appropriate boxes in the Physical State, Hazards and Health Effects fields(information on the above may be found by clicking on the Datasheet button which opens the CAMEO Chemicals database. 3. Vulnerability Analysis(CAMEOjm Scenario Page) (a) For each Extremely Hazardous Substance present over the Threshold Planning Quantity(TPQ),create a New Scenario page(if a Scenario page hasn't been created already)and enter the maximum amount in the largest container or interconnected containers in the Amount Released field of the Scenario Description tab. (b) On the Scenario page(s)Scenario Description tab, enter the concentration percentage in the Concentration field. (c) On the Scenario page(s)Scenario Description tab, enter the release duration in the Release Duration field as follows: (1) Gases— 10 minutes (2) Powders or solids in solution— 10 minutes (3) Liquids—No value shall be entered (d) On the Scenario page(s)Scenario Description tab, use the weather default settings or,enter average wind speed(don't enter a value in the Wind From field)and Urban or Forest is recommended in the Ground Roughness field. (e) On the Scenario page(s)Scenario Description tab, rate the Risk, Consequences and Overall Risk of a release occurring at the facility on the bottom of the Scenario Page(the Risk Assessment should be based upon the Extremely Hazardous Substance, previous release history,maintenance conditions etc.). (f) After entering the information noted above on the Scenario Description tab and clicking on the Estimate Threat Zone Radius button,CAMEO will automatically estimate the extent of the vulnerable zone that may cause injury or death to human populations following an accidental release. (g) On the Scenario page(s)notes tab,enter an estimate of the total exposed population within the vulnerable zone(s). (h) On the Scenario page(s)notes tab, identify each critical facility by name and maximum expected occupancy within the vulnerable zone(s)(schools,day cares,public safety facilities,hospitals,etc.). If there are no critical facilities within the vulnerable zone(s),that shall be noted. D. Supporting documentation shall be submitted to the Division which lists the facilities for which a hazards analysis was not completed. In addition to the facility name and address, supporting documentation should indicate whether: I. Facility has closed or is no longer in business. 2. Facility is not physically located in the County(indicate appropriate County location, if known). 1fl7i 3. If the facility no longer has Extremely Hazardous Substances on-site or is below the Threshold Planning Quantity, notify the facility representative of the requirement to submit to the State Emergency Request Commission a; (a) Statement of Determination (Attachment I),or (b) Letter identifying the date and reason the Extremely Hazardous Substance is no longer present(closed, replaced with less hazardous substance,etc.)or below TPQ. E. On-Site Visits 1. Conduct a detailed on-site visit,within the period of this Agreement,of all the facilities listed in Attachment C,to confirm the accuracy and completeness of information in the hazards analysis. 2. Submit a completed Hazards Analysis Site Visit Certification Form (Attachment F) to the Division with the Facility Name included in the file naming convention (required format Facility NameSV). Add the site visit certification form to the Site Plan Tab of the Cameo Facilities Page for each facility visited or contacted. (a) On-Site visit exception for sulfuric acid (1) For facilities listed on Attachment C that report the presence of only sulfuric acid,an initial on-site visit is required and an on-site visit form (Attachment F)signed and dated by the facility representative and the Recipient shall be submitted to the Division. (2) In Agreements subsequent to the initial on-site visit,the Recipient shall contact the facility representative by email or telephone to verify the presence of all extremely hazardous substances.The on-site visit form shall be signed by the Recipient and identify the date the Recipient contacted the facility representative. Another on-site visit is not required in subsequent Agreements, unless,the facility reports the presence of another extremely hazardous substance. (3) If a facility representative reports the presence of an extremely hazardous substance other than sulfuric acid in Agreements subsequent to the period of Agreement in which the initial site visit was conducted,the Recipient shall conduct an on-site visit and submit a completed on-site visit form(Attachment F)to the Division. 3. For each facility that a hazard analysis is conducted, submit a site plan to the Division with the Facility Name included in the file naming convention(required format Facility NameSP). Add the site plan to the Site Plan Tab of the Cameo Facilities Page. The site plan shall contain sufficient information to provide situational awareness to provide,as a minimum: 16€ ! ? " (a) Location of major building(s) (b) Name and location of extremely hazardous substance(s). If multiple extremely hazardous substances are co-located,noting EHS is acceptable. (c) Name and location of street(s) (d) Identify pertinent access and egress point(s) (e) Note any additional features pertinent to hazmat and medical response F. Ensure that the Hazards Analysis information is reflected in the County Local Mitigation Strategy. 16E17 Attachment B Schedule of Deliverables—Schedule of Payments Schedule of Deliverables Deliverables 2, 3 and 4 shall be submitted to the Division by the required deadline to be considered eligible for payment.Work products submitted under Deliverables 2, 3 and 4 shall only be paid if they meet the criteria set forth in sections A through E of the Scope of Work (Attachment A). Late submissions will not be eligible for payment. Deliverable 1: Within 30 days after receipt of the executed contract, the recipient shall submit a sample hazard analysis to the Division for review to ensure the work being performed meets the requirements of the Scope of Work. Deliverable 2: On or before January 1, 2014, the Recipient shall submit fifty(50)percent of the completed hazards analyses for facilities listed on Attachment C to the Division for review and approval. Deliverable 3: On or before April 1, 2014,the Recipient shall submit the final fifty(50) percent of the completed hazards analyses for facilities listed on Attachment C to the Division for review and approval. Deliverable 4: A. On or before June 1, 2014, the Recipient shall submit a complete copy of each approved hazards analysis to the applicable Local Emergency Planning Committee and a copy of the transmittal document shall be submitted to the Division. B. On or before June 1, 2014, the Recipient shall notify all Attachment C facilities and applicable first responder agencies of the availability of the hazards analyses information, and make that information available upon request and submit proof of said notifications to the Division. Schedule of Payments Payment Deliverable#2-45%of the Agreement Amount $3.207.84 Deliverable#3-45% of the Agreement Amount $3,207.84 Deliverable#4- 10%of the Agreement Amount $712.85 Each payment shall be made upon satisfactory completion of the deliverable(s) above and upon receipt of an acceptable Financial Invoice(Attachment D). 1 .,. S et 0 N M I.1 O N C c c 0 U ac s ce oc cc s cc z W W W W W W W W J J J J J J J J 0 0 0 0 0 0 0 0 r N J eS1 co 0 0 M u z E E cc Q u> _ 2 G 0 0 W , A _y� E v V J N V o c N o o M > e. p 0 1NC ,0 E .^4 0 O A Cp c a rn Z M kJ m v '� M m a N L lNC CO 0 p O N 11 °: l•0 c d M .1 V d Al U U 0 U .� ^ c 03 O V N % CO ..I < p N .fir �' ? Q C LL a` < °'co C A m 03 c y E p M N @! .i m E N ac, -0 Al • ao Q aci 2 to �°q � ,°�`--E° mL ,°'na c@� M c � o`nod :1-, 4-1 o`+ �° oo+ a � on° Qd x° "' 01 rs o y W •C N - ,E N D O 0 N y m 7 N n Z 3 N j W fV 8A L Q Y E 8 N CU 3 U 5." 43 u C a y E c C 4; 2 c v o ^ c al 2 [ky Ol p c c ei (.% c $ Z `u QF c .-t u c C .0 D >. —, j C1 .0 — j V� C .0 < T= .c C > E L C n p c < >. Y L W d �- u .c a m F- 3 a I ►- w a = r- t .c o 0 f •y a r.. a = I- a c < I-,, aL J = a ria uY 2'i _La u e 3 • t A '3 tvto u3 5• E Qc '0 }o L E Qp m t E Qcp m -c E c ''a Y`' -c E Qcp ') -c E c 'A - E oco 10 co E c ' 0 O Z U W N Z U W N Z U W N Z V W 3 IV Z U W N Z 8 W , Z 8 W Z U W N U , z U I < z CW - C a _ U m `? tel Fif Q 0 N Al Q 0 O '7' N M E z z Z u W J u Q C _ y J V l J < r -I Z 0 d 3 , 0 U. , •L d 0 > U C W m 0, Q W J zJ ao m W < a � 4 U JDvo N z m 0 u v < W _J Q G s O 0 0 . 0 v Z d O H < q '^ " U Q OJ Z W •°'Cr < W = Aen al W r a j V J 0 .c 0 0 8 3 J Q Z 68 ° I ^; < t < — � ; LLa ` 3 o ° W oo ,± are � oho O ; N o � ., d ac ^ � Z c ° mE � ° EoA ° � co g a � Q oz g ga$ E � g a. 2 com M z V 0 u. ...t z 7 rn '% u, C 10 m N n m 2 e n .n C N as � 1. .+ a v, ai 00 10 o 00 m 0 01 M N o 2 M E 1 7 16E17 I . - - rr 0 N M rl O ■ N C c 3 LU z z LU rr z rt W w W W LU W W W W J J J J J J ? J 0 0 0 s 0 0 0 0 N N m M d E Z y o U o 2 OJ OJ G 0 ac c U YJ J d U M V > U w t u1 y u u1 W U -. 0 W C C «° Q o m m « u9 .A. u1 p v 1 ` d C U O O O ` V n ' ° eV v1 8 ° N H a C N N V01 ` —`e OO al 0 h T Q C O n O m T U > N T N U d N 'O } O .�i LL m e-1 W N ~ C U N C N C U C V tb a CO LJ O Al c N �• a Q d E v N W W CaJ N N C N n W c tD C Q1 Z a m w o m uZi m u Iii 0, 4 m th °� 400 cA ,,s o, ,_ cp ,i, c a �° E m M qQ u m !- u y {y/,1 v c m x u Z m E u `3 E u u 4, S E m S @! m Y E O N S E C M WW E H Ol N U E M Q1 W C W E C W ; N co E C N o W W U y W W O N G W d N a1 Z W N W t _ W = d O ;C c 2 W V L ,V i a o .Z` '�'� a? ou' a e�i u oS a z o u a a o 3 a a o 07 n C o u a o N Ii Q > a L 0 > U -C > > C L c� > Y t C Z > g L Z �. L C > A L ` > N L W r a3 � ca � uLa � zao> F a � f. � a U � ca � 3a J v ' r' •• 0/ ' Y' � a ' °C ti > > � _ u Q a• • Eo o - m � '° ti -° '° J a o`p E a `p E E �F ro `o E ° v ro o E g yy° re o E E e E o E E v b o Ti v m QQo E . O Z U W N Z V W W N Z U W N Z U W N S Z U W W N O W W N Z U W N Z V W N U f- z W J 2 LL x N Z it.) r^ 0 `' Q 2 Q Z 3 Q ` 0 U W a LL, G o E 19 8 °Q c 3a U t- Z g O Y m 1` Q U Z a 0 3 2 Z. m -J O z 0 $ ter OU Q a A J y p d O m W l7 w Z QQ d W W U 0 0 J O s 6 Q W Z f.. _Z O W E _y c> Q U LL W I- J LL H LL D uu Q W W W U tJL `) E 0 0 O J O a m u7 -J l7 O O it z g a Z W .� z W 4 O W a, O Q a J p ?7 � ° y g Q V1 v1 O �7i a Z 3 J V u. V -J 1.- lJ O O U 10 W f0 LA O O O Q O W W = h W VI VI O W W VI N W = O W A O 50Q dma Q $ a U ' d a0a aZa cc cL C `u ` O O t` Q Q �( ry Q Q O Q O p n �^ u1 O to Z 2 Z in z Z Z Z _ Z Z a0 Z C 03 00 00 03 0 U3 41 N a r M - m N CO N W m m rrn N N m M N o N 4 °a v $ 1 , 6E , ,7 v v_. 0 N M 0 N C C 3 3 • W W W W W W W J J J J J J J 0 0 0 0 0 0 0 0 I". _N N 0 M E z u E `Q o E o t. ti u u C VVV+ i app a n y •H in c c v U l u $ u a$ «. cr. M C Qp pC ° Ln I V y N 3 n y v 01 N N y� O• c031 N 8 W O N ° - 2 8 co Vl 0. Qi M a G �f1 a s �n .-, ao. 1r� O ^' �i 3 °p' rrr p O �J `^ p O @1 �^ o ao di r~n A n oho M w i:c C pp�� 7 to: U N N �„� U N N C U �p M Cu: 1 Q C p N al G N N d 01 d go' d C m N = L d CC 0.I W C n C N M m C a! 01 N m C E Q1 N > d O M u W M a■ 'D Q 2 3 2•-t W `4 a ry r —E •.. ao c .. 00 o f m o m E • ^! t E E c co cu U = Opp g W v yo °: GA El vo+ 1'- wa a) *c • a, � W yr as a c °>J c t n �' v c c 0 o° v t c c. ° = v u a o t- a 1 n o M W -1 h> Z O H H N O n tv F C n O us F> C n O o 1-- g 0. U � 3 0 I- s C a m t'i a to tt^ n Z 1 3a qr ti '° = a " t', 'C '5 wm t'ia 2 '^ t, '^ m 2 Q "to c a 'i0 L m a1 L 0 q o E „ Z S E ?. v g o E o 'S z u° w N ° E° o E v ° A pp E a q p o E E $ V Z U W N Z V W N Z U W N .0 2 t-) W N 2 U W W N V Z J J W x a O V N °s Q o n cc 0 Q Q LL to n O tu 7 Z $ O W d CO n -J a al cc D 4. W 0. 2 N - C _ 3 W > u u = N n E 0 co -J •4 co O W W 5. N H W C co J d U. E J LA. L9 C u cc ac r ac > C �° ” E m w Q a a LL Q W L O Q U LL n a/ L y N at CC 8 _ ai p 1" V1 O 2 w } w W N = C a w V J, cg d 7 -0 p 'O u O0Q � QU Nad N ,* gw A E v AS „ v ; / 0 2 3 w o N rr - y W O W W O W O N E Y �' o Y < to 2 W N Q U p < U < • < >45 $ E 3 to L o E a 01 n to Z to N 2 H Z .0 Z in N E .R a 2 1-. n C I t0 al 0• 1.0 N •-1 N a 0 T N rn W I T to �O O tO m m m 0 a, a, •gt Cr - 0 o o° 1 6€ I-I 0 N M II 0 N C c 0 0 v Ui G s or cc W W U W W W W J J J J O 0 0 0 0 0 r H J ON M Z t u �+ O W C y N " ° t' a E V1 0 c pEpvY c �, c m c Eoo c 0rn .y°o o V U O N U} R M N V? O V u R Q u ,; Q�t o� p,s M yL C 41 ^. U 1,E0 (Q U u N p� u> l i > ° Q N C !0 M C h h c C_ N pp [ O h U 00 M 0 E Z V O CO N 9 `0 ��E.. CO n v .-' M N E`�i0 L V1 al E. W N (p�m in Ea 'O N C C y N O °° j� vo > 4 m Ol G L y m N C .u.' h V. O i E _g ° v E11 mv, v E �j °+ N > E ! N � E �, N °' g' 3 Zol W N a = W c L m u W q N W N W 0 al & 4J en N W 0 w N V c ei r1 c - ° ui iO c c �>/ c ili a' c Y iy ° *Cr ?' � cLav 413- •= 0. C 1 > E o0. $ - A0. °0I- 000. 0t iv 0 0 W u 7 Q' 4. V a 7 4 Y u '.. it V .. 7 41 V 7 a U t'i L L. a iL m O0 A Q cp E v c° m o E v `c-,- 0 o f ° a m o E e m o E a �j° q o E ° Z U W N Z U W N 3 Z U W N Z U W N Z L W N } Z U W u I Z W 2 I N a v. -0 Q a H N Z E 00 c Z ° c W Z. W O A a ac ZoLL o �— LL d 2 s W Z p —°1 c E A a E c m u. g v o y j U E Z W mi LL 0 W i =0- E a F W F p 1- O y N t °' U F- J O Z c W � d c 3 V c v Q O O m y J a U C Q co m ' LL N H ›.-L O d J N W L '` in U Ip N A p F y Q C N N Z d g~ o > ry z .3 z 3 o z C gg ■er eo co et 07 IN CL h -' Co 1 oo N 003 N O N lD N m O ey 0 ui a - a v ., o 16Ei7 Attachment D FINANCIAL INVOICE FORM FOR HAZARDOUS MATERIALS HAZARDS ANALYSIS UPDATE RECIPIENT:Collier County AGREEMENT#14-CP-11-09-21-01-XXX AMOUNT AMOUNT APPROVED REQUESTED BY THE BY THE RECIPIENT DIVISION 1. First Payment(45%of contract amount) $ $ (50%Hazards Analyses completed/submitted) 2. Second Payment(45%of contract amount) $ $ (50%Hazards Analyses completed/submitted) 3, Final Payment(10%of contract amount) $ $ (approval,distribution&notification) TOTAL AMOUNT $ $ (To be completed by the Division) I certify that to the best of my knowledge and belief the billed costs are in accordance with the terms of the Agreement. Signature of Authorized OfficiaUTitle Date TOTAL AMOUNT TO BE PAID AS OF THIS INVOICE$ (To be completed by the Division) 161ETT" Attachment E Hazard Analysis Contract Checklist and CAMEOfm Guide Facility nformation(CAMEOfm:Facility Page) Facility Name(per Attachment C}(Facility Page) Facility Physical Address(Fadlity Page) Latitude and Longitude in Decimal Degrees(ex.30.197,-84.3621}(Map Data Tab on Facility Page) Facility 24-hour Emergency Phone Number (Facility Phones Tab on Facility Page) Facility Emergency Coordinator Name and Title Contact Tab on Facility Page) Transportation Route(s)(From County Line to the Facility)(Notes Tab on Facility Page) Evacuation Route(s)to exit the Vulnerable Zone(Notes Tab on Facility Page) Historical Accident Record ill none,please note)(Notes Tab on Facility Page) Facility Population(a minimum of one is required for unmanned facilities}(ID Codes Tab on facility Page) Hazard ld nt*ation(CAMEOfm Chewiest in Inventory Page):(for"ea'ditxt sme(y Hazirdons Substance'on site) ± °>.' Proper Chemical Name(s)(Chemical In Inventory Pages)) Chemical Abstract Service(CAS)Number(Chemical in Inventory Pages}) Physical State in Storage(ex.mixture,pure,liquid,gas}(Chemical in Inventory Page(s),Physical State and Quantity Tab) Maximum Quantity On-site in Pounds(Chemical in Inventory Page(s},Physical State and Quantity Tab) Amount in Largest Container or Interconnected Containers(Chemical in Inventory Page(s),Physical State and Quantity Tab) Type and Design of Storage Container(s) lex.cylinder,steel drum,carboy)(Chemical in Inventory Page(s),Physical State and Quantity Tab) Nature of the Hazard(ex.acute,chronic,fire,pressure,etc.)Chemical in Inventory Page(s),Physical State and Quantity Tab) VuhfenobllitY Analysis(CAMEOfm Scenario Page) (for each Extremely Hazardous Substance on?s . Enter maximum amount in largest container or interconnected containers in the Amount Released field(Scenario Description tab) Enter the concentration percentage in the Concentration field(Scenario Description tab) Enter Release Duration(10 minutes for gases,solids in solution or powders;no entry for liquids is required)(Scenario Description tab) Weather Information-Use the weather default settings or enter average wind speed(don't enter a value in the Wind From field)and Urban or Forest is recommended in the Ground Roughness field.(Scenario Description tab) Risk Assessment-Rate the Risk,Consequences and Overall Risk of a release occurring(based upon release history&maintenance etc.) (Scenario Description tab) Extent of Vulnerable Zone(CAMEO automatically calculates Threat Zone Radius when Edit button and Estimate Threat Zone Radius buttons are used}(Scenario Description tab) Enter estimate of Total Exposed Population(Notes Tab on Scenario Page(s)) Enter Critical Facilities(name of critical facility(s)and max occupancy for each;if none,state No Critical Facilities)(Notes Tab on Scenario Page(s)) 011 Site Visits;(for eadt facility firldtiiithin'fili Cont ict Period). . ' ; ;.; '_ I Site Visit Certification Form(Attached to Site Plan Tab on Facility Page)(file naming required format Facility NarneSV} Site Plan(Attached to Site Plan Tab on Fadlity Page)(file name required format Facility NameSP) Sufficient Detail to Identify: Location of Major Building(s) Name and Location of Extremely Hazardous Substance(s)(if extremely hazardous materials are co-located,noting EHS is acceptable) Name and Location of Street(s) identify Pertinent Access and Egress Points Note Additional Features Pertinent to Hazardous Materials and Medical Response AU data shall be submitted electronically via CAMEOfm version 2.4 in a.zip file format. 16E17 Attachment F "1,111111 FLORIDA STATE EMERGENCY RESPONSE CQMMISSION.FOR HAZARDOUS MAIESIALL • HAZARDS ANALYSIS'Si1'E VISIT CERTIF ICAiltoEO - Facility Name(Please print) Street Address, City&Zip Code(Please print) County(Please print) Name of Facility Representative (Please print) Facility Representative Signature Site Visit Date Site Visit Performed by (Please print) Signature Site Visit Date The individuals sianina above certify that a hazards analysis site visit was conducted on the above date. Notes: Li Check if facility representative was informed about using E-Plan(httositerplan,netieolan/login htm)for EPCRA on-line filing E 1 7 Attachment G Warranties and Representations Financial Management Recipient's financial management system must include the following: (1) Accurate,current and complete disclosure of the financial results of this project or program (2) Records that identify the source and use of funds for all activities.These records shall contain information pertaining to grant awards,authorizations,obligations, unobligated balances, assets,outlays, income and interest. (3) Effective control over and accountability for all funds, property and other assets. Recipient shall safeguard all assets and assure that they are used solely for authorized purposes. (4) Comparison of expenditures with budget amounts for each Request For Payment. Whenever appropriate,financial information should be related to performance and unit cost data. (5) Written procedures to determine whether costs are allowed and reasonable under the provisions of the applicable OMB cost principles and the terms and conditions of this Agreement. (6) Cost accounting records that are supported by backup documentation. Competition All procurement transactions shall be done in a manner to provide open and free competition. The Recipient shall be alert to conflicts of interest as well as noncompetitive practices among contractors that may restrict or eliminate competition or otherwise restrain trade. In order to ensure excellent contractor performance and eliminate unfair competitive advantage,contractors that develop or draft specifications, requirements,statements of work, invitations for bids and/or requests for proposals shall be excluded from competing for such procurements.Awards shall be made to the bidder or offeror whose bid or offer is responsive to the solicitation and is most 1 6E1 7 advantageous to the Recipient,considering the price,quality and other factors. Solicitations shall clearly set forth all requirements that the bidder or offeror must fulfill in order for the bid or offer to be evaluated by the Recipient.Any and all bids or offers may be rejected when it is in the Recipient's interest to do so. Codes of conduct. The Recipient shall maintain written standards of conduct governing the performance of its employees engaged in the award and administration of contracts. No employee,officer, or agent shall participate in the selection, award,or administration of a contract supported by public grant funds if a real or apparent conflict of interest would be involved. Such a conflict would arise when the employee,officer,or agent, any member of his or her immediate family, his or her partner,or an organization which employs or is about to employ any of the parties indicated, has a financial or other interest in the firm selected for an award.The officers,employees, and agents of the Recipient shall neither solicit nor accept gratuities,favors,or anything of monetary value from contractors or parties to subcontracts. The standards of conduct shall provide for disciplinary actions to be applied for violations of the standards by officers,employees, or agents of the Recipient. Business Hours The Recipient shall have its offices open for business,with the entrance door open to the public, and at least one employee on site,from 8:00 AM to 5:00 PM. Licensina and Permitting All subcontractors or employees hired by the Recipient shall have all current licenses and permits required for all of the particular work for which they are hired by the Recipient. 1_6E 7 Attachment H Certification Regarding Debarment,Suspension,Ineligibility And Voluntary Exclusion Subcontractor Covered Transactions (1) The prospective subcontractor of the Recipient, certifies, by submission of this document,that neither it nor its principals is presently debarred,suspended, proposed for debarment, declared ineligible,or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the Recipient's subcontractor is unable to certify to the above statement,the prospective subcontractor shall attach an explanation to this form. SUBCONTRACTOR: By: Collier County Signature Recipient's Name 14-CP-11-09-21-01-XXX Name and Title Agreement Number Street Address City, State, Zip Date l6Et7 Attachment I STATEMENT OF DETERMINATION Facility Name Physical Address (Street only) City County LEPC District I have determined that this facility is/is not subject to the following section(s)of EPCRA,Title III,for the reporting year(s)indicated (circle all applicable): SECTION 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 302/303 Y/N YIN Y/N YIN Y/N Y/N Y/N Y/N Y/N Y/N Y/N 311 /312 Y/N Y/N Y/N Y/N Y/N Y/N YIN Y/N Y/N Y/N Y/N 313 Y/N Y/N _ Y/N _ Y/N Y/N Y/N Y/N Y/N _ Y/N Y/N Y/N If"No"was indicated on any of the above, please check appropriate box(s)why: Sections Extremely Hazardous Substances (EHSs) are / were present only in amounts less than established 302/303 Threshold Planning Quantities(TPQs). No EHSs are Present. No EHSs were present on-site during the year. Sections Hazardous chemicalslEHSs are/were present only in amounts below established reporting thresholds. 311/312 No hazardous chemicals/EHSs are/were present. No hazardous chemicals were present on-site during the year. Section Not within covered SIC Codes. 313 Within covered SIC Codes,but less than ten(10)employees. Within covered SIC Codes.but no Section 313 chemicals were present or were below Section 313 reporting thresholds. Other Closed facility Chemicals removed Chemicals reduced below Date Effective: YES/NO YES I NO threshold/TPQ YES I NO New Facility. Date chemicals brought on site meeting/exceeding TPQ: Further explanation if necessary: CERTIFICATION: 1 understand the requirements of the law(s) circled above. I also understand that ultimate compliance responsibility lies with me and failure to comply, if required, can result in civil and criminal penalties under federal and state laws. Name of owner/operators authorized representative(printed): Official Title(printed): Signature: Date signed: