HomeMy WebLinkAboutWomen's History Month and 25th Anniversary of the Orange County Commission for Womenn .SUV[
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North Carolina Department of Crime_ Control and Public Safety
Division of Emergency Management
4713 Mail Service Center • Raleigh, NC 27699 -4713
Michael F. Easley - -- an E. Beatty
Governor `� M n/7 Secretary
-32001
GRANT AWARD
Grantee: Orange County
Amount of Award: $19,289.00
Date of Award: Account 1510 -512 -2001, 50% Federal Funds
This agreement is hereby made between North Carolina Department of Crime Control and Public Safety,
Division of Emergency Management, hereinafter referred to as Grantor, and the Orange County Emergency
Management Agency, PO Box 8181, Hillsborough, NC 27514 -8181, hereafter referred to as the Grantee.
Scope of Services to be rendered. The purpose of this Grant is to provide funds to assist the Grantee in cost of
developing and maintaining a comprehensive Emergency Management Program.- This Grant is subject to the
obligations as may be reasonably prescribed by the Division of Emergency Management and consistent with the
purpose of N.C.G.S. 166A, as amended below.
Compensation. The Grantor agrees that it will pay the Grantee as complete and total compensation for the
services to be rendered by the Grantee. Payment to the Grantee for expenditures under this Agreement will be
reimbursed after your cost report is submitted.
The Grantee will perform all tasks /objectives set forth in the Grant Award hereto:
• Provide payment(s) for any cost to maintain materials related to the completion of the scope work;
• If required, Grantee will solicit necessary bids under County Contract Bidding Procedures for
installation and/or maintenance of materials and equipment;
• Grantee will be responsible for all contracts required for accomplishing the scope of work;
• Grantee will notify the appropriate Branch Manager once the related scope of work is completed;
and
• Grantee will submit a cost report to the Division of Emergency Management, Accounts Payable
Branch to process for reimbursement of expenditures.
The Grantor will perform the following tasks hereto:
• Grantor will process the cost report/documentation submit to the Department of Crime Control
and Public Safety (DCC &PS), Fiscal Section for payment;
Location: 116 West Jones Street • Raleigh, NC 27603 -1135 • (919) 733 -3867
An Equal Opportunity/lAffirmative Action Employer
s-
The Grantor will perform the following tasks hereto:
• Grantor will process invoices and submit invoices /documentation to the Department of Crime
Control and Public Safety (DCC &PS), Fiscal Section for payment;
• Grantor will coordinate with the DCC &PS, Fiscal Officer to ensure that reimbursement of
expenditures are paid in a timely manner; and
Grantor (appropriate Branch Manager) will coordinate a visit to discuss the completed scope of
work.
Termination Date: The termination date of this Grant Award is September 30, 2001.
Compliance: Failure to comply with the specified conditions will result in the return of this Grant Award
to the North Carolina Division of Emergency Management.
Funding: All terms and conditions of this Agreement are dependent upon and subject to the allocation of
funds for the purpose set forth and the Agreement shall automatically terminate if funds cease to be
available.
Taxes: The Grantee shall be considered to be an independent Grantee and as such shall be responsible
for all taxes.
Warranty: As an independent Grantee, the Grantee will hold the Grantor harmless for any liability and
personal injury that may occur from or in connection with the performance of this Agreement.
State Property: The Grantee shall be responsible for the custody and care of any property furnished for
use in connection with the performance of this Agreement.
Situs: This Agreement shall be governed by the laws of North Carolina and any claim for breach or
enforcement shall be filed in State Court in Wake County, North Carolina.
Antitrust Laws: This Agreement is entered into in compliance with all State and Federal antitrust laws.
Entire Agreement: This Agreement and any exhibits and amendments annexed hereto and any
documents incorporated specifically be reference represents the entire agreement between the parties and
supersede ail prior oral and written statements or agreements. This Agreement may be amended only by
written amendments duly executed by the Grantor and the Grantee.
Effective Date: This Grant shall become effective as of the Date of Award on return to the Division of
Emergency Management the original of this award, properly executed on behalf of the Grantee.
for the Grand Accepted for the Grantor
i
e anaM. Link, Jr. he L. Tolbert
ger Director
Orange County North Carolina Division of Emergency Management
2
T i
NORTH CAROLINA LOCAL GOVERNMENT APPLICATION FOR FUNDING
1.1 Official Agency Name: Orange County Emergency Management
1.2 Address: PO Box 8181, Hillsborough, NC 27278
1914 New Hope Church Road, Chapel Hill, NC 27514
1.3 Population: Year -round 108,752
1.4 Population: Seasonal (if applicable):
LOCAL EMERGENCY MANAGEMENT STAFF BUDGET
2.1 Indicate actual percent of time devoted to Emergency Management activities.
Please do not include EMS, 9 -1 -1, Fire Marshal, Safety activities, etc.
5
2.2
Time
3.1
Salary
3.2
Benefits
EM Program Manager (Name)
Nick Waters
25
77,639
13,918
Other Staff (Name — Title)
a. Deputy Director / Fire Marshal Mike Tapp
20
51,272
7,421
b. Deputy Director / Communications Gwen Snowden
20
50,335
11,402
c. Deputy Director / EMS Kent McKenzie
20
47,666
11,059
d. Administrative Assistant II Tammy Comar
15
28,552
6,820
5
NORTH CAROLINA LOCAL GOVERNMENT APPLICATION FOR FUNDING
(Continued)
OPERATING EXPENSES
3.3 Tr,
Subsistence
& Transportation $2,000
3.4 All Other:
Rental
400
Postage
150
Office Supplies
200
Telephone
300
Utilities
150
Other (Specify)
Total 3.4*
1,200
*Does NOT include amount shown in 3.3 (Travel)
EM Form 66 (Rev. 01/01)
6
Verification of percent of times devoted to Emergency
Management Activities.
Signature of Area Coordinator
FEDERAL /STATE/LOCAL FY2001 EMGP AGREEMENT
AGENCY: Orange County Emergency Management
This is to certify that the above names agency agrees to successfully complete the activities below in full
partnership with the North Carolina Division of Emergency Management and the Federal Emergency
Management Agency. The appropriate Branch Manager and/or Area Coordinator will review the
progress of this agreement quarterly with the local Emergency Management Coordinator. This report will
also be the basis for continued funding during this fiscal year.
Please list in priority the Emergency Management activities you will work on or complete this fiscal year.
However, as outlined in the Department of Crime Control and Public Safety's Strategic Plan, you are
requested to complete the following activity:
2001.1 Formulate /Complete your County Capability Assessment of Readiness (CAR) tool.
Completion of this assessment toll will provide you more insight as to which local emergency programs
to implement that will enhance local capabilities for delivering pre and post disaster services.
Completed the OJP Assessment for domestic Preparedness Support
Facilitated and participated in the County Health Department's OJP Assessment
Attended the Emergency Management Workshops
Updated the County Multi - Hazard Emergency Plan
Provided I.C.S training to county departments
8
EM Form 66A (Rev. 01 /01)
Assistance for the Division of Emergency Management or the Federal Emergency Management Agency
to Complete this agreement will be made available to encourage each jurisdiction to participate in a
Comprehensive Emergency Management program.
Local Emergency Management
mance
EM FORM 66a (Rev. 01 /01) 9
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ORANGE COUNTY EMERGENCY MANAGEMENT
FUNCTIONAL STATEMENT
Duties:
EM Program Manager / Director of Emergency Management
Responsible for the administration of the emergency management program, emergency medical
services program, hazardous materials response, fire marshal program, the 9 -1 -1
communications center. Supervises 62 fill -time, 15 part-time and 90 contracted employees and
coordinates all disaster responses for the county and its municipalities, in addition to the UNC
Hospitals and the University of North Carolina.
Deputy Director / Fire Marshal
Administers the fire prevention, suppression, and arson investigation program for the county.
Also, facilitates the hazardous materials activities, SARA Title III program, and emergency
management mitigation through plans review and required plans development of nursing homes,
foster care homes, rest homes, group homes, etc.
Deputy Director / Communications
Administers the 9 -1 -1 consolidated communications center, providing access and dispatch to all
the citizens and for all the law enforcement, fire service, emergency medical services, rescue
services, and various support agencies for the county and all its municipalities. Position is also
responsible for the emergency operations center, its activations, staffing, operations, and
demobilization during times of emergencies and disasters.
Deputy Director / EMS
Administers the emergency medical services to the citizens of Orange County and all its
municipalities. The position also facilitates the emergency management mass casualty program
and provides medical staff in conjunction with the hospital and health department in supporting
shelter operations during times of emergencies and disasters.
Administrative Assistant II
Provides support to the director and deputy directors as required for administrative duties and
maintains the files, records, and updates of all emergency management documents and plans.
Serves as the office manager for the department and supervises clerical staff.
POSITION DESCRIPTION
ORANGE COUNTY EMERGENCY MANAGEMENT
CERTIFICATION
I DO HEREBY CERTIFY THAT THE POSITION DESCRIPTIONS ON
FILE IN THE FEMA REGIONAL AND STATE OFFICES ARE CURRENT
AND UP -TO -DATE AND MEET THE REQUIREMENTS AS OUTLINED
IN FEMA PUBLICATION CPG 1 -3.
NICK WATERS, EMERGENCY PROGRAM MANAGER
ORANGE COUNTY EMERGENCY MANAGEMENT
12
FOR CA FOR (Name of SWRI
2001_ _ ._ _- _North Carolina-,--
'j his atmmary shit includes ASSmlrances and Cernficadons that must be read, signed, and submitted as a part of the Application
for Federal Assistance.
An applicant must check each it:m that they se mrrifying to:
Part I ❑ FsMA Form 20-16A Assurances Nonconstruction Programs
Part IF F MA Form 20 -16B Assurances-Construction Programs
Part III ❑ Fx2AA Form 20-16C Certification Regarding Lobbying;
D:barment, Suspension, and Other Responsibility
Ma=rs; and Drug =Tree Worlmlace Requirements
P=T rV ❑ SF IS L Disclosure of Lobbying Activities (If applicable)
As the duly authorized representative of the applicant,
assuauccs and certifications.
Nick Waters
Typed Nan= of uthOezed R-presemative
Sigaszus of Autborasd Rep• -- -...•Live
I hereby certify that .the applicant will comply with the identified attached
Emergency Program Manager- EM Director
Tide .
February 22, 2001
Dam seed
NOTE• By signing th! certification regarding debarment, suspension, and other responsibility spatters for p:iwary covered
LMI- Saction, the applicant aU---s that, should the proposed covered transaction be entered into, it shall not imossingly cater into any
io�.r tier cov:r.d t-^ ctior_ nth a perscn who ;s dt barred, suspended, d_ -hacd ineiizible, or volunarily cxclud: d `-o*n
paricipadon in tE:iS cov.._d =Tlsaz:�on, tel: ss avr:'or'i ^d by Fr""MA ent:.rrg :nzo this transaction.
Tn: applicant further agre:._ by submitting this application that it will include the clause titled 'Certification
Re_arding D:barm:nt, SuTcrsion, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction,' provided by the
T MA Regional 05c: cn:zring into this covered transaction, without modification, in all lower tier covered r-AnG^tions and in all
soiicimtions for loarr ti:r covered transactions. (Refer to 4: Cr Part I7.)
Paperwork Burden Disclosure Notice
'Public repo-:ing burden for this form is estimated to average 1.7 hours per response. The burden estimate includes
1 the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing, reviewing, and maintaining the data needed, and completing and submitting the form. Send comments
1. retarding the accwacy of the burden estimate and any suggestions for reducing the burden to: Information
`Collections Management, f=ederal Emergency Management Agency, 500 C Stress, SW, Washington DC 20472.'
i
BMA Form 20.16. JUL 95
15
n
ADMINISTRATIVE ASSISTANT II
GENERAL DEFINITION OF WORK:
C1320 -7/911
Performs difficult skilled clerical and responsible administrative work requiring a
qualified typist providing office assistance to a County executive(s); does related
work as required.
Work is performed under general supervision. Supervision may be exercised over
subordinate clerical personnel.
TYPICAL, TASKS:
Handles citizen requests for service and complaints independently;
Performs follow -up tasks to ensure appropriate action on requests or complaints;
Coordinates department or County -wide projects and programs;
Provides information to other departments concerning programs that impact other
agencies;
Assists with the preparation of department budget and administration of
expenditures; _
Collects and processes data, conducts analysis and prepares statistical reports;
Screens visitors, telephone calls and mail directed to an executive;
Gives information to the public or directs requests to appropriate department;
Arranges meetings and conferences;
Transcribes correspondence and memoranda;
Composes and types letters and memoranda in conformance with County policies
independently from brief instructions;
Types reports and minutes of meetings;
Makes appointments for the department executive;
Sets up and maintains filing systems and office procedures;
Operates standard office, word processing and data entry equipment;
Maintains confidential personnel and related files;
Prepares or reviews the preparation of the staff payroll;
Collects information and prepares complex reports;
— Supervises and trains subordinate clerical personnel;
Performs related tasks as required.
KNOWLEDGES. SKILLS AND ABILITIES:
Comprehensive knowledge of standard office practices, procedures, equipment and
secretarial techniques; thorough knowledge of departmental functions, organization
and policies; comprehensive knowledge of business English and spelling; ability to
undertake and complete operational and administrative projects independently;
ability to work under pressure; ability to organize and perform work independently;
ability to lay out and type complex forms and tables; ability to make difficult
arithmetic calculations; ability to type and transcribe dictation at a reasonable rate
of speed; ability to establish and maintain effective working relationships with other
employees and the general public.
EDUCATION AND EXPERIENCE:
Any combination of education and experience equivalent to graduation from high
school and at least 6 years increasingly responsible experience in secretarial work
including at least one year of administrative experience.
C7030 -9/97
DEPUTY EMERGENCY MANAGEMENT DIRECTOR/COMMUNICATIONS
Gr�r�u e t nFEDEI'lON OF WORK_:
Performs difficult technical and .administrative work supervising the consolidated
communications center operation; does related work as required.
Work is performed under general supervision. Supervised is exercised over technical and
clerical staff.
TY'PIC_AT. TASKS:
Supervises the work of all employees in the Communications Center,
plans, directs and evaluates the operation of the Communications Center,
Assists Emergency Management Director in establishing goals and objectives for the
Communications Center,
Develops and implements policies and standard operating procedures;
Ensures compliance with Federal Communication Commission (FCC) regulations;
Prepares operating budget;
Determines training needs and oversees the training program,
Oversees the maintenance of the Computer Aided Dispatch (CAD) system;
Prepares and reviews all employee evaluations;
Evaluates, counsels and disciplines employees;
Plans organizes and schedules shift and work assignment of personnel;
Identifies and corrects safety hazards and enforces safety rules;
Oversees the operations and staffing of the Emergency Operations Center in the event of
an emergency;
Serves as liaison between communications center, agencies and the community in regard
to public relations;
Performs related tasks as required.
KNOWLEDGES SKIT IS AND ABMITM&'
Comprehensive knowledge of the methods and procedures of operating a 9 -1 -1
communication system; comprehensive knowledge Federal and State regulations
governing transmission by radio and teletype; thorough knowledge of the geography of
the County and surrounding area; ability to plan and supervise the work of others; ability
to operate all equipment utilized in a 9 -1 -1 center, ability to speak distinctly; ability to
deal courteously with the public under stressful conditions.
EDT J ATION AND EXPERMCL
Any combination of education and experience equivalent to graduation from high school
and at least 3 years experience as a Telecommunications Shift Supervisor.
SPECI Al, `RFO,X REU=S: Medical Di atch
Must possess Division of Criminal Informati on (DCI), Emergency sP
(EMD); Cardiopulmonary Resuscitation (CPR) and Incident Command System (ICS)
certifications; and have completed the Hazmat Awareness level training course. Must
-haye- completed the Domestic Violence and Administrative Office of the Courts (AOC)
4 C7120 -6/98 r'
DEPUTY EMERGENCY MANAGEMENT DIRECTOR/ADNMZSTRATION
- GENERAL DEFINITION OF WORK:
Performs difficult paraprofessional and administrative work supervising the emergency
management/medical program; does related work as required.
Work is performed under general supervision. Supervision is exercised over emergency
management staff.
TYPICAL TASKS:
Plans and directs the County's emergency medical program;
Supervises the work of all employees in the emergency medical program;
Trains, directs and evaluates staff in the provision of emergency medical services;
Assists Emergency Management Director in establishing goals and objectives for the emergency
management program;
Develops and implements policies, procedures and program rules and regulations to assure the
high quality of emergency services to County residents;
Compiles statistical data and generates reports showing results of statistical analysis;
Oversees and explains the process and procedures for ambulance billing which includes
interpreting medicaid and medicare requirements and the assignment of fees for services;
Determines training needs and evaluates training programs;
Promotes and maintains liaison with hospitals, agencies, organizations and the public;
Develops recommended budget;
Serves on emergency operations staff in the Emergency Operations Center in the event of an
emergency;
Performs related tasks as required.
KNOWLEDGES, SKILLS AND ABILITIES:
Thorough knowledge of emergency medical services and administration, practices and
procedures; thorough knowledge of emergency medical treatment and specialized cardiac
treatment; thorough knowledge of laws and regulations pertaining to emergency medical
services; general knowledge of medicaid and medicare billing requirements; ability to plan
effective in- service and staff development programs; general knowledge of personal computer
operating systems and applications; ability to research and compile statistical data; ability to
communicate orally and in writing; ability to establish and maintain effective working
relationships with officials, medical agencies, community organizations, volunteers and the
general public; ability to promote public awareness of program activities.
EDUCATION AND EXPERIENCE:
Any combination of education and experience equivalent to graduation from an accredited
college or university with major course work in emergency management, emergency medical
services, public administration or related field and at least 2 years experience in emergency
management, emergency medical services or related experience, including at least 2 years
supervisory experience.
SPECIAL REOUIREMENTS:
Possession of a valid North Carolina driver's license.
A
C 0 -7/9
DEPUTY EhzERGENCY MANAGEMENT DIRECTOR/FIRE MARSHAL
GENERAL DEFINITION OF WORT~::
Performs difficult paraprofessional and administrative work overseeing the County
fire protection program; does related work as required.
Work is performed under general supervision. Supervision is exercised over
subordinate staff.
TYPICAL TASKS,
Helps coordinate fire prevention activities including some inspections and works
with Planning Department, volunteer Fire Departments and civic groups;
Assists Fire Departments in developing long range plans and projections of
equipment needs including replacements and assists Fire Departments in obtaining
proper and adequate equipment;
Assists Fire Departments in determining causes of fires and provides classes in arson
detection for Fire Departments and works with Sheriffs Department;
Assists in the identification of local resources for use during emergency situations;
Assists in emergency planning and coordination for disasters;
Assists department in developing training program and coordination of classes;
Advises Emergency Management Director of status and needs of rural fire service;
Prepares reports of fire activities in the County and compiles an annual fire report for
commissioners;
Assists Fire Departments in assuring compliance with all codes, rules and
regulations;
Keeps County Manager and Board of Commissioners informed of any matters
pertaining to the present and future expansion of rural fire departments;
Serves as liaison between existing and potential volunteer fire departments and
other County agencies;
Works with hazardous materials response team in training of Fire Department
policies, SOPS and regulations;
Performs related tasks as required.
KNNOWLEDGES. SKILLS AND ABILITIES:
Thorough knowledge of f re suppression skills and administration, practices and
procedures; thorough knowledge of the laws pertaining to fire service equipment.
thorough knowledge of the methods and techniques used in fire sern•ice training, fire
prevention methods, fire cause determination and arson investigation; ability to
express ideas effectively, orally and in writing; ability to• establish and maintain
effective working relationships with officials, community organizations, volunteer
companies and the general public; ability to promote public awareness of program
activities.
EDUCATION AND EXPERIENCE:
Any combination of education and experience equivalent to graduation from an
accredited community college with major course work in fire science and at least least
b years experience in fire suppression including at least 2 years supervisory
experience.
SPECIAL REQUIREMENTS:
Possession of certification as firefighter, fire inspection and arson investigation.
7 C7130 -7/91
r)
DIRECTOR OF EINMRGENCY MANAGEMENT
GENERAL DEFINITION OF WORK:
Performs complex professional and difficult administrative work directing the
activities of the Emergency Management Department; does related work as required.
Work is performed under general supervision. Supervision is exercised over all
department personnel.
TYPICAL TASKS:
Plans, directs and coordinates a comprehensive emergency management program for
the County; prepares for the immediate use of all facilities, equipment, manpower
and other resources for the purpose of minimizing or preventing harm and damages
to persons and property during emergency situations;
Administers and directs the Emergency Medical Program for the County including
hiring, training and supervision of all personnel and setting goals and standards for
the program;
Supervises the Fire Marshal's activities and assigns work goals and objectives for
that office;
Assigns, instructs and supervises the work of the County emergency
telecommunicators;
Investigates complaints against Telecommunicators, Fire Marshal's Office, and
ambulance personnel from the general public, other emergency services law
enforcement personnel using the communications center;
Coordinates the recruitment of volunteer personnel and agencies to supplement
existing manpower and facilities for emergency management purposes;
Maintains liaison with State and Federal Emergency Management authorities and
officials of nearby political subdivisions to ensure the most effective operation of
- - emergency management plans;
Submits periodic written and verbal reports and recommendations to the County
Manager;
Directs County -wide response and recovery activities when natural or manmade
destructive forces threaten or cause injury and suffering to people, or destruction and
damage to property;
Determines and improves the ability to County to respond to all t,, pes of emergencies;
Performs related tasks as required.
KNOWLEDGES. SKILLS AND ABILITIES:
Comprehensive knowledge of emergency management administration, including
organization, staffing, financing, equipment management and maintenance, records
and reports; comprehensive knowledge of modern emergency medical techniques and
equipment; ability to plan, layout and review the activities of department personnel
and to maintain discipline; ability to exercise sound judgment in emergencies; ability
to analyze the effectiveness of an emergency management organization and to
institute improvements; ability to prepare and review reports; ability to establish
and maintain effective working relationships with subordinates, County officials and
the general public.
EDUCATION AND EXPERIENCE:
Any combination of education and experience equivalent to graduation from an
accredited college or university with major work in emergency management, public
administration or related field and at least 6 years professional and administrative
experience of a wide and progressively responsible nature in emergency
management.
I FEDERAL ENI RGENCY MANAGEi.IENT AGENCY
LOCAL..CIVIL RIGHTS COMPLIANCE CHECKLIST
Sre Reverse sicr for I O.M.E.IJO. 3067.017i
PapenvorkBurcenr :.:. ;Ce Expires Aug, 37.1ac3
I . POLITICAL SUBDIVISION
ORANGE COUNTY
:. LOCAL CONTACT OFFICIAL 4. TITLE
NICK :WATERS DIRECTOR OF EMERGENCY MANAGEMENT
Briefly explain all N/A answers on the reverse of this form.
GENERAL
6. What method_does the local recipient use to inform the public of its nondiscrimination policy
in FEMA: assisted programs?
7. How is the public informed about the right to file complaints all egino discrimination on the
basis of race, color, national origin, sex, and handicaps What is the procedure for handling
complaints? -
S. Does the local emergency management agency use a means to obtain advice f citizens
about civil rig m
hts Copliance issues? rom
?. Ir Such a means or method exists, briefly describe below.
WARNING AND COI INIUNiCATIONS
,v. Lava re_;nnable steps been planned to provide that emergency warning and erneroency
Public inforr,- ,ition and educational materials are issue: in -a language other than, English,
where c sUbS' :anilal portion of the Dopu!Etion understand$ such l. language or languages?
11. Have pians and agree.rnen,L WiLn local television si2iions or cable sys -t=ms addr ssc7 the
need TOr L'Sinc SoEcizl technicues to reach hearing Impaired Dersoris?
I Have plans a =d, essed the special information nE =ds of persons With visual impai- menns?
=• have Cgur:,., mneetings and Conferences funded in Whole or part with F =MA financial
assisTancE been publiClzed a,id m2naced so as . t t0 d15Crir'itnai= On the gfOURCS GT ; aC
COIOr, n2ti0 .al Orgln, sex or handicap, ano have Provisions for such events addressed speCiE!
riEeds of disabled persons?
2. STATE
NC
§1T4LE "'ONE
968 -2050
YES I NO I N,;
X
X
X
X
X
Ev;.CU:,T10H :.I:p S'r._ELTEn ^- _,•,
iL• ^2VE prOVlsiOnS been made tc iG=nti, }' ind(vi is 1 n :`� ;' =ti ^
' qua." who K'tl, rE_UI,'E asSlStanCc irOm place
G: residence to the Conoredat; Car -i-,r
Or F 1! - - E Sn" �- ' i" ;. =.rSo, - : :hc are viSJally Or mobs li'• pair c_
ihrou hout it
r' m rc ^C +G rJe� C�l� 2M: 1`IlJ � _. O t; it_' $c CaCrl, file Word �Silel terms m __n$ X
l ter,
I
15. Have cnc rESSe_ me inc the SDec:zl access? ,llliV rE^UI.'E:uc'1S of disabled --
at she- : z..-id during shelter says? p ='soy _I X I
ENIERGENCY OPER✓,TiNG CENT_ ?S _
I; the co.;,. ^,,;;iii ty has an Emergency C)Meratin0 CE7ier CORS:ruCiEd Or EQui*�Jped in wtlole or :
partthroua , T_:GrGI -lnCncIG? assistance, is that Center accessible to disableC' persons I
ECCOrmne to standards �h ' I
set 70. :n the UniTOrr„ Fec', ACC =sSaoil7ty Standards (1-1 C=,? 101.19-9) '
i
DEFICIENCIES NOTED t -
17, Where dEiiCienCies have been -ed
nG:__ in reSPOn$E iG any questions, please describe on the
—verse O, this form by question nurnbertOoetner with propos Corrective action.
Ai=_ OcTiciencies listed On the r= Sc. ve.r X
?
iE. _DDF.E:s W „ "VIEW W;S CON C-ED
DU i
I IS. DATE
1914 NEW HOPE CHURCH ROAD
CHAPEL HILL, NC 27514
20. SiCt.ATURE 0 =S -TE P.E� /1E W'
cn
13
Ix
02/22/2001
PAPERWORK BURDEN DISCLOSURE NOTICE
GENERAL -The following information is provided pursuant to Public Law 96 -511, The Paperwork Reduction Act of
19S0, as amended, dated December 11, 1950, to allow the public to participate more fully and meaningfully in the
Federal paperwork review process.
AUTHORITY - Public Law 96 -511, amended; 44U.S.C. 3507; and 5 CFR 1320
APPROVAL OF FORMS USED -The forms cited below have been approved by the Office of h•lanagement and
Budget and assigned OMIT approval number 3067 -0177, which expires August 31, 19Q3.
DISCLOSURE OF BURDEN - Public reporting burden for the collection of information entitled "Local Level
Civil Rights Compliance Checklist" is estimated to average 2 hours per response, which includes the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing
and reviewing the form. Send comments regarding the burden estimate or any aspect of the collection, including
suggestions for reducing the burden, to: Information Collections-Management, Federal Emergency Management
Agency, 500 C Street, S.W., Washington, D.C. 20472; and to the Office of Management and Budget, Paperwork
Reduction Pr oiect (3067 - 0177), Washing' Lon, D.C. 20503.
REMARKS (Lis, iten number for any explanations)
13. No FEMA funds used.
16. Emergency Operations Center is fully compliant with American Disabilities Act,
but not FEMA funded.
14
FEDERAL EMERGENCY MANAGEMENT AGENCY
ASSURANC =5- NON- CONSTRUnON PROGRAMS
gote: Certain of these assurances may not be applicable to your project or program. if you have any questions, pRease
;ontact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to
idditional assurances. if such is the case, you will be notified.
?,s the duly authorized representative of the applicant, I certify that the applicant:
1. Has the legal authority to apply for Federal assistance,
and the institutional, managerial and financial capability
(including funds sufficient to pay the non - Federal share of
project costs) to ensure proper planning, management and
completion of the project described in this application.
2. Will give the awarding agency, the comptroller
general of the United States, and if appropriate, the State,
hrough any authorized representative, access to and the
-ight to examine all records, books, papers, or documents
-elated to the award; and will establish a proper accounting
;vstem in accordance with generally accepted accounting
;.andards or agency directives.
3. Will establish safeguards to prohibit employees from
using their positions for a purpose that constitutes or
presents tl?- appearance of personal gain.
A. Will i. -ii:: zta and compiete the wort: within the
applicable time frame after receipt of approval of the
awarding agency.
5: Will comply with the Intergovernmental Personnel
Act of 1970 (42 U.S.C.Section 4727 -476:) relating to
prescribed standards for merit systems for programs funded
iunder one of the nineteen statues or regulations specified in
4 4ppend:x A of OPM's Standards for a Merit System of
I Pe sonnel Admin;s-ation) 5 C.F.R 900, Subpar 7).
as amended, relating to nondiscrimination in the sale,
rental or financing of housing; (1) any other
nondiscrimination provision in the specific statute(s)
under which application for Federal assistance is being
made; and (j) the requirements of any other
nondiscrimination statute(s) which may apply to the
application.
6. Will comply with all Federal statutes relating to
nonciscrimiratio^.These include but are not limited to : (a)
Title VI of the Civil Rig
'nts Act of 1964 (P.L. 98 - :EZ) whir i
prohibits discrimination on the basis of race, cowr, or
national or�_�.;.- �; (b) Title IV of the Edu;atic::; Amendments
of 1972, as amended (20-C.S.C. Scctiors 1681 -1683, and
!! 16c5- 16S6), which prohibits dise-*ninartion on the basis of
sex.; (c) Sec ion 504 of the Re_�sabil.itation Act of 1973, as
amended (29 U.S.C. Section 79-4), which prohibits
discrimination on the basis of handicaps; (d) the Age
Discrimination Act of 1975, as amended (42 U.S.C.
Sections 6101 - 6107), which prohibits discrimination on the
• basis o: age; (e) the Drug Abuse Office and Treatment Act of
!972 (pal.. 92 -255), as amended, relating to
nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention,
Treatment and Rehabilitation Act of 1970 (P.L. °: -616), as
amended, relating to nondiscrimination on the basis of
J alcohol abuse or alcoholism; (g) Sections 623 and 627 of the
?ublic Health Service Act of 1912 (42 U.S.C. 290 -66.3 and
290 ee -3), as amended, relating to confidentiality of alcohol
and drug abuse patient records; (h) TiLle V1I1 of the Civil
e,.c Ar1c,R tt2 t7_S_C. Section 3601 et sec.).
7. Will comply, or has already complied, with the
requirements of Title 11 and III of the Uniform
Relocation Assistance and Real Property Acquisition
Policies Act of 1970 (P.L. 91 -646) which provide for fair
and equitable treatment of persons displaced or whose
property is acquired as a result of Federal or Federally
assisted programs. These requirements apply to all
interest in real property acquired fnr project purposes
regardless of Federal partic:patioz, In purchase.
8. Will comply with provisions e: the Hatch A ct (5
U.S.C. Sections 1501 -1308 and 732:7328) which limit
the political activities of employees whose principal
employment activities are funded in whole or in pus
with Federal funds.
9. Will comply, as applicable, with the provisiors of
the Davis -Bacon Act (40 U.S.C. Sections 276a to 276a-
7), the Copeland Act (40 U.S.C. Section 276c and 18
U.S.C. Sections 874), and t-he Contract Work Hours
and Safety Standards Act (40 U.S.C. Sections 327 -3w3),
regarding labor standards for federally assisted
construction subagreem mts.
10. Will comply, u applicable with flood :su. azn_e
purchase requirements of Sectinn 102a of the Flood
Disaster- Protection Act of 1973 %P.L•. °3 -234) whica
requires recipients in a special flood ha: and area to
p2 1cpate in the program and to purchase flood
irsi:rante if the total cost of insurable construction and
acousition is $10,000 or more.
FEMA Form 2G- 16A.JJN 51 16
11. Will comply with environmental standards which
may be prescribed pursuant to the following: (a)
institution of environmental quality control measures
under the National Environmental Policy Act of 1969
(P.L. 91 -190) and Executive Order (EO) 11514; (b)
notification of violating facilities pursuant to EO 11738;
(c) protection of wetlands pursuant to EO 11990; (d)
evaluation of flood hazards in floodplains in accordance
with EO 11988; (e) assurance of project consistency with
the approved State management program— developed
under the Coastal Zone Management Act of 1972 (16
U.S.C. Sections 1451 et seq.); (f) conformity of Federal
actions to State (Clear Air) implementation Plans under
Section 176 (c) of the Clear Air Act of 1955, as amended
(42 U.S.C. Section et seq.); (g) protection underground
sources of drinking water under the Safe Drinking Water
Act of 1974, as amended, (PI, 93 -523); and (h) protection
of endangered species under the Endangered Species Act
of 1973, as amended, (P.L. 93 -2M.
12.- Will comply with the Wild and Scenic Rivers Act of
1968 (16 U.S.C. Sections 1271 et seq.) related to
protecting components of the national wild and scenic
rivers systems.
13. Will assib. the awarding agency in assuring
compliance with Section 106 of the National Historic
- Preservation Art of 1966, as amended (16 U.S.C. 470), EO
11393 (identification and protection of historic
properties), and the Archaeological and Historic
Preservation Act of 1974 (16 U.S.C. 469a et seq.).
14. Will comply with P.L. 93-348 regarding the
protection of human subjects involved in research,
development, and related activities supported by this
award of assistant
15. Will comply with the Laboratory Animal Welfare
Act of 1966 (P.L. 89 -544, as amended, 7 U.S.C. 2131 et
seq.) pertaining to the care, handling, and treatment of
warm blooded animals held for research, teaching, or
other activities supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning
Prevention Act (42 U.S.C. Sections 4801 et seq.) which
prohibits the use of lead based paint in construction-or
rehabilitation of residence structures:
17. Will cause to be performed the required financial
and compliance audits in accordance with the Single
Audit Act of 1984.
18. Will comply with all applicable requirements of all
other Federal laws, executive orders, regulations and
policies governing this program.
19. It will comply with the minimum wage and
maximum hours provisions of the Federal Fair Labor
Standards Act (29 U.S.C. 201), as they apply to employees
of institutions of higher education, hospitals, and other
non -profit organizations.
17
c L'EMERGENCY MANAUCMENT AGENCY
CERTIF1CA1ONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND
OTHER RESPONSIBILITY MATT cRS; AND DRUG -FREE WORKPLACE REQUIREMENTS
Applicants should refer to the regulations cited below to determine the certification to which tkey are required to attest.
Applicants should also review the instructions for certification included in the regulations before completing this form.
Signature of this form provides for compliance with certification requirements under 44 CFR Part 18, "New Restrictions
on Lobb, irg' and 28 CFR Part I7, "Government -wide Debarment and Suspension (Nonprocurement) and Government.
wide Requirements for Drug -Free Workplace (Grants)." The certifications shall be.treated as a material representation
of fact upon which reliance will be placed when the Federal Emergency Management Agency (F&MA) determines to
award the covered transaction, grant, or cooperative agreement.
1. LOBBYING
As required by section 1352. Title 31 of the U.S. Code, and
implemented at 44 CFR Part 18, for persons entering into a
grant or cooperative agreement over S 100.000, as defined at
44 CFR Par, 18, the applicant certifies :hat:
(a) No Federal appropriated funds have been paid or will be paid, by or
on behalf of the undersigned, to any person for influencing or
attempting- to mftuence an officer or employee of any agency, a
Member of Conoress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with the makino of
jany Federal grant. the entering into of any cooperative agreement, and
the extension, continuation, renewal, amendment, or modification of
any Federal grant or cooperative agreement;
(b) If any other funds than Federal appropriated funds have been paid or
will be paid to any.person tor- influencing or a- empting to influence an
officer or employee of any agency, a Member of Congress, an officer or
an employee of Congress, or employee of a member of Congress in
tonne_ ion with this Federal grant or cooperative agreement, :he
undersigned shall complete and submit Standard Form- LLL.'Disclosure
of Lobbying Activities.' in accordance with its instructions;
(c) The undersioned shall require that the language of this certification
be included in the award documents for all subawards at all tiers
(including subgranu, contracts under grants and cooperative
agreements, andsubcontrac -s) and that all subrecipients shall certify and
disclose accordinoly.
I Standard Form- -Disclosure of Lobbying Activities- arached.
T his form must be a-aciied to certification if nonapproariarec f.n;s
are to be used to infiverce actwitie_)
2. DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MA j i ERS
(DIREiT RECIPIENT)
As repuired by Executive Order 12549. Debarment and Suspension, and
molemented a: 4t C-rR Par, 67, for prospe =ive participants in primary
covered transactions, as defined at = CFR Part 17, Section 17 S 10-A.
Tne appiicar.. certifies trat it and its principaLr:
(a) Are not presently debarred. suspended. proposed for debarment.
declared ineligible, sentenced to a denial of Federal benefits by a Save
or Federal tour,, or volurtarfiy excluded from covered transactions by
any Federai department or agency;
(b) Have no: within a three -year period preceding this application been
convicted of or had a civilian judgment rendered against them for
commission of fraud or a criminal offense in connection with
FEM_ Form 20.16C JUN 94
obtaining, attempting to obtain, or performm, a public (Federal. State,
or locan transaction or contract under a public transaction; violation
of Federal or State antn:rust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of
records, making false statements, or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or civilly
charged by a governmental entity (Federal, -Stare, orlocal) with
commission of any of the offenses enumerated in paragraph (1)(b)
of this certification; and
(d) Have not within a three -year period preceding this application
had one or more public transactions (Federal, State, or local)
terminated for cause or default; and -
E. where the applicant is unable to certify to any of the statements
in this certification, he or she shall attach an explanation to tnis
application.
3. DRUG-FREE WORKPLACE
(GRANTEES OTHER THAN INDIVIDUALS)
As required by the Druc -Free workplace Act of 19BB, and
implemented at r_c C-R Par, 17, Subpar, F. for grantees. as aefined
a-, Ac CFR Par, 17 Sections 17.615 and 17.620-
A. The applicant certifies that it will continue to provide a druc -
free workplace by;
(a) Publishing a statement notifying employees that the unlawful
manufacture, distriout.cn, dispensing, possession, or use of a
controlled subsarce is prohibited in the orantee's workplace a-..;'
specifying the actions sat will be taken against. empio••ec-s for
violation of sup prurimr- -ion;
(b) Establishing an on -going drug free awarenc:s prcoram to
inform employees about-
(1) The dancers of druc abuse in the workplace;
(2) The grantee's policy of mainainine a drug-free workplace;
(3) Any available druc counseling, rehabilitation, and
employee assirance programs; and
(4) The penalties tna; may be imposed upon employees for
druc abuse vio!a;ions occurring in the workplace;
(c) Makinc a a reouiremem—rhat each employee to be engaged in
the performance of the gran: to be oiven a ccpy of the ratement
required by paracr aph (a);
(d) Notifying the employee in the statement required by
paragraph (a)tnat, as a condition of emplovment under the orart,
the employee will-
18
vii
(1) Abide by the terms of the statement; and
(2) Notify the employee in writing of his or her conviction for a
>Iation of a criminal drug statute occurring in the workplace no later
an five calendar days after such convection;
e) Notifying the agency, in writing, within 10 calendar days after
ceiving notice under subparagraph (d)(2) from an !mployee or
:herwise receiving actual notice of such convicgon. Employers of
)nvicted employees must provide notice. including position ri-Je. to the
Dplicable FEMA awarding office, i.e„ regional office or FEMA office.
(f) Taking one of the following actions, wit►+ir 30 calendar days of
:ceiving notice under subparagraph (d)(2), with respect to any employee
rho is so convicted-
(1) Taking appropriate personnel action against such an employee.
ip to and including termination, consistent with the requirements of the
tehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a drug
abuse assistance or rehabilitation program approved for such purposes by
a Federal. State, or local health, law enforcement, or other appropriate
agency;
(g) Makiny a good faith effort :r continue to maintain a druc free
workC•are through impiemen ation of paragraphs (a),(b). (c),(c7.(e).
and(f). -
S. The grantee may insert in the space provided below the sites; for the
performance of work done in connection wi*h the specific gran
Place of Performance (Street address, City, County, Stare, Zip code) I
ChEck ❑ if there are workplaces on file that are not identified here. -
Section 17.630 of the regulations provide that a grantee that is a State
may elect :o make one certification in each Federal fiscal year. A copy of
which should be included with each application for FEMA funding.
States and State agencies may elect to use a state wide certification
19
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MVAM
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pepoRing Registrant Page of
AM o$zrrd for Lam! PApoducbm
Standard Form - L':-A
21