HomeMy WebLinkAbout2014-641 EMS - NC Department of Public Safety State Applicant Disaster Assistance Agreement - Agenda Item 6i - 4-15-2014 —Please return this copy to the Clerk to the Board's -!
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North Carolina Department of Public Safety
Division of Emergency Management
APPLICANT: Q r c, a (' h `� DISASTER: Se—v e r e w iv\�V_Y- a�'v,-�
FEMA- y 162 -DR-NC
PUBLIC ASSISTANCE CFDA#97.036
STATE—APPLICANT DISASTER ASSISTANCE AGREEMENT
This Agreement made by and between the State of North Carolina,Dept. of Public Safety,
Division of Emergency Management("the State")and (D r a n a-e C o u n i-\j _
'`("the Applicant")shall be effective on the date signed by the State and the Applicant. It shall
apply to all disaster assistance funds provided by or through the State to the Applicant as a result
of the disaster called 5 e.vere Winter i rYr1 ;and pursuant to the Disaster Declaration
made by the President of the United States numbered FEMA- DR-NC.
The designated representative of the Applicant(Applicant's Agent)certifies that:
1. He/She has legal authority to apply for assistance on behalf of the Applicant pursuant to a
resolution duly adopted or passed by the Applicant's governing body.
2. The Applicant shall provide all necessary financial and managerial resources to meet the
terms and conditions of receiving Federal and State disaster grant assistance.
3. The applicant shall use disaster assistance funds solely for the purpose for which these funds
are provided and as approved by the Governor's Authorized Representative(GAR).
4. The Applicant is aware of and shall comply with cost-sharing requirements of Federal and
State disaster assistance: specifically that Federal assistance is limited to 75%of eligible
expenditures,and that State assistance is limited to 25%of the eligible costs. Alternate
projects selected by the Applicant may be eligible for only 75%of the approved Federal share
of estimated eligible costs.
5. The Applicant shall provide the following completed documentation to the State:
• Designation of Applicant's Agent;
• State-Applicant Disaster Assistance Agreement
• Private Non-Profit Organization Certification(if required);
• Summary of Documentation Form itemizing actual costs expended for large
project payment requests;.
• Monthly Progress Reports;
• Copies of Single Audit Reports as applicable. RECEIVED APR
2 4 2014
/ue C- P/4
Reviewed 10/2312012 Nee 1 of 7 Rev.06/02
If the Applicant fails to provide any of the above documentation,the State will be under
no obligation to reimburse the Applicant for eligible expenses.
6. The Applicant shall establish and maintain a proper accounting system to record expenditures
of disaster assistance funds in accordance with generally accepted accounting principals or as
directed by the Governor's Authorized Representative: If applicable,the Applicant shall
conduct audit(s)pursuant to the Single Audit Act of 1984,31 U.S.C.37501 et.M.,-44
C.F.R.Part 14,OMB Circular A-133,"Audits of States,Local Governments and Non-profit
Organizations,"and applicable North Carolina laws,rules and regulations.
7. The Applicant shall provide to the State monthly Progress Reports for all open large projects
funded by State and Federal disaster assistance grants. The first Progress Report will be due
on the 10th day of the first month following initiation of the project and subsequent Progress
Reports will be due on the 10th day of each and every month thereafter until project
completion. Forms and reporting requirements will be provided by the Governor's
Authorized Representative.
8. The Applicant,its employees and agents,including consultants,contractors and
subcontractors to be paid with funds provided under this Agreement,shall give State and
Federal agencies designated by the Governor's Authorized Representative,full access to and
the right to examine all records and documents related to the use of disaster assistance funds.
9. The Applicant shall return to the State,within thirty(30)days of a request by the Governor's
Authorized Representative,any funds advanced to the Applicant that are not supported by
audit or other Federal or State review of documentation maintained by the Applicant.
10.The Applicant shall comply with all applicable codes and standards in the completion of
eligible work to repair or replace damaged public facilities.
11.The Applicant shall comply with all applicable provisions of Federal and State statutes,rules
and regulations regarding the procurement of goods and services and regarding contracts for
the repair and restoration of public facilities.
12. The Applicant shall begin and complete all items of work within the time limits established
by the Governor's Authorized Representative and in accordance with applicable Federal and
State statues,rules and regulations.
13. The Applicant shall request a final inspection within ninety(90)days after completion of
each and every large project funded under this Agreement,or within ninety(90)days after
the expiration of the time limit established for each project under Paragraph 12 above,
whichever occurs first. Applicant shall present all supporting documentation to State and/or
Federal inspectors at the time of final inspection. The State,as Grantee,reserves the right
to conduct a final inspection of any large project after expiration of the ninety-(90)day
period and to reimburse Applicant only for costs documented at the time of final
inspection.
Rnvinwrd tn/?"019 Nan 7of7 Rev 06M
14. The Applicant shall comply with all applicable Federal and State statutes,rules and
regulations for publicly financed or assisted contracts including,but not limited to,non-
discrimination,labor standard,and access by the physically handicapped.
15.The Applicant's Designated Agent shall execute and comply with the Lobbying Prohibition
document incorporated herein as Attachment A.
16.The Applicant's Designated Agent shall execute and comply with the Statement of
Assurances(SF 424D)document incorporated herein as Attachment B.
17.The Applicant shall not enter into cost-plus-percentage-of-cost contracts for debris removal,
emergency protective measures,or completion of disaster restoration or repair work.
18.The Applicant shall not enter into contracts for which payment is contingent upon receipt of
State or Federal funds.
19.The Applicant shall not enter into any contract with any entity that is debarred or suspended
from participation in Federal Assistance. The State and/or FEMA will not be under any
obligation to reimburse Applicant for payments made to a debarred or suspended contractor.
Applicant may search for debarred or suspended contractors on the"Excluded Parties List
System"(EPLS)at the following website: www.sam.aov.
20.The Applicant shall comply with the provisions of 42 U.S.C. 35155 (Section 312 of the
Stafford Act)which prohibits duplication of benefits. Applicant shall notify State
immediately if any other source of funds is available to offset disaster assistance provided
pursuant to this Agreement. Applicant agrees that eligible costs under this Agreement will
be reduced by duplicate benefits received from any other source.
21.The Applicant shall comply with all uniform grant administration requirements required by
State and Federal statutes,rules and regulations,including but not limited to,the Robert T.
Stafford Disaster Relief and Emergency assistance Act,Public Law 93-288,as amended,
Title 44 of the Code of Federal Regulations,applicable OMB Circulars,and policy guidance
issued by the Federal Emergency Management Agency(FEMA).
22.If the Applicant pays contractors,subcontractors or consultants with fiends provided through
this Agreement then the Applicant shall include language in all contracts that binds the
contractor,subcontractor or consultant to the terms and conditions of this Agreement with the
State. Contractual arrangements with contractors,subcontractors or consultants shall in no
way relieve the Applicant of its responsibilities to ensure that all funds provided through this
Agreement are administered in accordance with all State and Federal requirements.
Reviewed 10/23/2012 Page 3 of 7 Rev.06/02
rtcvcwcn nHG.I/L\IIL Yaae4of7 Rev.06/02
FOR THE APPLICANT:
BY:
G
Date S'
A 4A,(A—,c Ali A,a
5l0 - (v00037-7
Applicant's Federal Tax I.D. Typed Name
Number(required)
Title
FOR THE STATE:
B
Date Signa e
Typed Name
Title
Reviewed 10/21P2012 Paoe 4 of 7 Rev.06102
ATTACHMENT A
LOBBYING PROHIBITION
The undersigned certifies,to the best of his or her knowledge and belief,that:
(a) No Federal appropriated funds have been paid or will be paid,by or on behalf of the
undersigned,to any person for influencing or attempting to influence either directly
or indirectly an officer or employee of any State or Federal agency,a member of the
N.C.Legislature,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.
(b) 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 undersigned shall complete and submit Standard Form-L.
"Disclosure Form to Report Lobbying,"in accordance with its instructions.
(c) The undersigned shall require that the language of this certification be included in the
award documents for all sub-awards at all tiers(including subcontracts,sub-grants,
and contracts under grants,loans,and cooperative agreements)and that all recipients
of funds under this Agreement shall certify and disclose accordingly.
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 failure.
Name of Applicant
BY:
Signature of Applicant's Designated Agent
Reviewed 10/2312012 , PaRe 5 of 7 Rev.06/02
ATTACHMENT B-1
OMB Approval No.0348.0042
ASSURANCES-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 15 minutes per response,Including time for reviewing Instructions,
searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send
comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the
Office of Management and Budget,Paperwork Reduction Project(0348-0042),Washington DC 20503
PLEASE AO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS
PROVIDED BY THE SPONSORING AGENCY
NOTE:Certain of these assurances may not be applicable to your project or program. If you have questions,please contact the
Awarding Agency. Further,certain Federal assistance awarding agencies may require applicants to certify to additional
assurances. If such is the case,you will be notified.
As the duly authorized representative of the applicant,I certify that the applicant:
1. Has the legal authority to apply for Federal assistance, 8. Will comply with the intergovernmental Personnel Act of
and the institutional, managerial and financial capability 1970 (42 U.S.G. 334728-2763) relating to prescribed
(including funds sufficient to pay the non-Federal share standards for merit systems for programs funded under
of the project costs) to ensure proper planning, one of the 19 statutes or regulations specified in
management and completion of the project described in Appendix A of OPM's Standards for a Merit System of
this application Personnel Administration(5 C.F.R.900,Subpart F).
2. Will give the awarding agency, the Comptroller General 9. Will comply with the Lead-Based Paint Poisoning
of the United States and, if appropriate, the State, Prevention Act(42 U.S.C.334801 at seq.)which prohibits
through any authorized representative,access to and the the use of lead-based paint in construction or
right to examine all records, books, papers, or rehabilitation of residence structures.
documents related to the assistance;and will establish a
proper accounting system in accordance with generally 10. Will comply with all Federal statures relating to non-
accepted accounting standards or agency directives. discrimination. These Include but are not limited to: (a)
Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
3. Will not dispose of, modify the use of, or change the which prohibits discrimination on the basis of race, color
terms of the real property title,or other interest in the site or national origin; (b) Title IX of the Education
and facilities without permission and instructions from the Amendments of 1972, as amended (20 U.S.C. 331681
awarding agency.Will record the Federal interest in the 1683,and 1685-1686),which prohibits discrimination on
title of real property in accordance with awarding agency the basis of sex;(c)Section 504 of the Rehabilitation Act
directives and will include a covenant In the title of real of 1973, as amended (29 U.S.C..3 794),which prohibits
property acquired in whole or in part with Federal discrimination on the basis of handicaps; (d) the Age .
assistance funds to assure non-discrimination during the Discrimination Act of 1975, as amended (42 U.S.C. 33
useful life of the project. 6101-6107), which prohibits discrimination on the basis
4. Will comply b the requirements of the assistance of age; (e) the Drug Abuse Office and Treatment Act of
pY Y q 1972 (P.L. 92-255), as amended, relating to
awarding agency with regard to the drafting, review and nondiscrimination on the basis of drug abuse; (f) the
approval of construction plans and specifications. Comprehensive Alcohol Abuse and Alcoholism
Prevention, Treatment and Rehabilitation Act of 1970
5. Will provide and maintain competent and adequate (P,L.91-616),as amended relating to nondiscrimination
engineering supervision at the construction site to ensure on the basis of alcohol abuse or alcoholism; (g) 33523
that the complete work conforms with the approved plans and 527 of the Public Health Service Act of 1912 (42
and specifications and will furnish progress reports and U.S.C.33290 dd-3 and 290 ee 3),as amended relating to
such other information as may be required by the confidentiality of alcohol and drug abuse patient records;
assistance awarding agency or State. (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C.
6. Will initiate and complete the work within the applicable 333601 at seq.), as amended relating to
time frame after receipt of approval of the awarding nondiscrimination in the sale, rental, or financing of
agency, housing;(1)any other nondiscrimination provisions in the
Specific statute(s) under which application for Federal
7. Will establish safeguards to prohibit employees from assistance is being made; and, (j) the requirements of
using their positions for a purpose that constitutes or any other nondiscrimination statute(s) which may apply
presents the appearance of personal or organizational to the application.
conflict of Interest,or personal gain.
Authorized for Local Reproduction Standard Form 424D(Rev.7-97)
Previous Edition Usable Page 6 of 7 Prescribed by OMB A-102
ATTACHMENT B-2
11. Will comply, or has already complied, with the floodplains in accordance with EO 11988; (e) assurance
requirements of Titles 11 and III of the Uniform Relocation of project consistency with the approved State
Assistance and Real Property Acquisition Policies Act of management program developed under the Coastal Zone
1970 (P.L. 91-646) which provide for fair and equitable Management Act of 1972 (16 U.S.C.331451 et seq,); (f)
treatment of persons displaced or whose property is conformity of Federal actions to State (Clean Air)
.acquired as a result of Federal and federally-assisted Implementation Plans under Section 176(c)of the Clean
programs. These requirements apply to all interests In Air Act of 1955,as amended(42 U.S.C.337401 at seq.);
real property acquired for.project purposes regardless of (g) protection of under ground sources of drinking water
Federal participation in purchases. under the Safe Drinking Water Act of 1974,as amended
(P.L. 93-523); and, (h) protection of endangered species
12. Will comply with the provisions of the Hatch Act(5 U.S.C. under the Endangered Species Act of 1973,as amended
331501-1508 and 7324-7328) which limit the political (P.L.93-206).
activities of employees whose principal employment
activities are funded in whole or in part with Federal funds. 16. Will comply with the Wild and Scenic Rivers Act of 1968
(16 U.S.C. 331271 et seq.) related to protecting
13. Will comply, as applicable, with the provisions of the components or potential components of the national wild
Davis-Bacon Act (40 U.S. C. 33276a to 276a-7), the and scenic rivers system.
Copeland Act(40 U.S.C.276c and 18 U.S.C. 3874),and
the Contract Work Hours and Safety Standards Act (40 17. Will assist the awarding agency in assuring compliance
U.S.C.33327-333)regarding labor standards for federally- with Section 106 of the National Historic Preservation Act
assisted construction subagreements. of 1966, as amended (16 U.S.C. 3470), EO 11593
(identification and protection of historic properties), and
,14. Will comply with flood insurance purchase requirements of the Archaeological and Historic Preservation Act of 1974.
Section 102(x) of the Flood Disaster Protection Act of (16 U.S,C.33469a-1 at seq.).
1973 (P.L.93-234)which requires recipients in a special
flood hazard area to participate In the program and to 18. Will cause to be performed the required financial and
purchase flood insurance if the total cost of insurable compliance audits in accordance with the Single Audit Act
construction and acquisition is$10,000 or more. Amendments of 1996 and OMB Circular No. A-133,
"Audits of States, Local Governments, and Non-Profit
15. Will comply with environmental standards which may be Organizations."
prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National 19. Will comply with all applicable requirements of all other
Environmental Policy Act of 1969 (P.L. 91-190) and Federal taws, executive orders, regulations, and policies
Executive Order (EO) 11514: (b) notification of violating governing this program.
facilities pursuant to EO 11738;(c)protection of wetlands
pursuant to EO 11990; (d)evaluation of flood hazards in
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
APPLICANT ORGANIZATION DATE SUBMITTED
Reviewed 218102 Page 7 of 7 SF-4240(Rev.7-27)Page 2