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HomeMy WebLinkAboutAgenda - 05-03-2007-4fORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: May 3, 2007 Action Agenda Item No. ~{- ~~ SUBJECT: Application for Emergency Management Performance Grant (EMPG) DEPARTMENT: Emergency PUBLIC HEARING: (Y/N) No Services/Management ATTACHMENT(S): INFORMATION CONTACT: Cover Letter from NCEM Director Hoell Kent McKenzie, 968-2050 2007 EMPG Application Packet DHS Assurances & Certifications PURPOSE: To apply for a grant from the State Emergency Management Agency to help support the County emergency management program. BACKGROUND: The State provides grants to local governments to help support local emergency management programs. The grant is based on the county population and a share of the program cost. Counties with over 200,000 population are eligible fora 100 percent matching cost grant based on certain emergency management functions. Counties with less than 200,000 population are eligible fora 50 percent match. The grants are awarded each year and may vary depending on the federal funding available. This grant has been awarded to Orange County for multiple years to offset the personnel costs of the Emergency Management Specialist position, and a portion of the Health Department position coordinating the Community Emergency Response Team program, as well as other operating costs. Associated revenues have been included in each year's budget. Staff was notified that the County can again apply for funding under this program for the period from October 1, 2006 -September 30, 2007 with the. application due no later than Wednesday May 16th. The following chart displays the amounts of Emergency Management Performance Grant funds awarded the County over the last several years. ~Y Grant Award 2003-04 $39,694 2004-05 $40,356 2005-06 $32,354 2006-07 $29,887 2 FINANCIAL, IMPACT: The grant requires a 50 percent local match of funds. The currently approved Emergency Management budget includes the required matching funds. No additional funds will be required. RECOMMENDATION(S): The Manager recommends that the Board authorize the application for this grant funding. '~ srii~'4'' ,~:~., •'V Nnv iii ~yS "~, r ~ .. ~- ~. ~-,J. ~„ .~ ~' a.,l 4,~~',_ _'~ Cpc ~~,~' ^~u.nn+, ~r ''S'.`oy M/n'w vat `~. ,y «r:>-~ North Carolina Department of•Crime Control and Public Safety Division of Emergency Management Michael F. Easley, Governor H. Douglas Hoell, Jr., Director Bryan E. Beatty, Secretary MEMORANJDUM TO: Local Emergency Management Coordinator FROM: H. Douglas Hoeil, Jr., Director DATE: Apri14, 2007 SUBJECT: Emergency Management Performance Grant (EMPG) FFY 2007 Funding This year, North Carolina along with other states was successful in getting additional funding for Emergency Management Performance Grants (EMPG) program. You are invited to submit your application for EMPG funding for FFY 2007 (October 1, 2006-September 30, 2007). The enclosed application package contains State and Federal Guidance and the necessary forms to complete your application. Please review this material and gather the information needed. Your Area Coordinator or Branch Manager will be available to assist you in completing the application package. Additionally, your Area Coordinator will work with you to determine the actual percent of time you devote to emergency management, preparedness, mitigation, response and recovery activities (excluding Fire Marshal, EMS, 911, safety activities, etc.). To receive EMPG funds, you must complete, sign and submit to your Branch Office the completed documents below by the following deadlines: 1. EM Form 66 -North Carolina Local Government Application for FFY 2007 Funding; must be completed and submitted to your Branch Office no later than May 16, 2007; 2. EM Form 66A -Federal/State/Local FY 2007 EMPG Agreement; must be completed and submitted to your Branch Office no later than June 1, 2007; 3. A signed Position Description Certification form stating that the EM Program Director position is not vacant or is currently being filled by an acting county employee and that job description(s) you submit or previously submitted are still current and remain unchanged; must be completed and attached to your EM Form 66A and submitted to your Branch Office no later than June 1, 2007; MAILING ADDRESS: 4713 Mail Service Center Raleigh, NC 27699-4713 Telephone: 919-733-3 867 _=~,_ wtivw. NCCrin7eCond•ol. w•g An Equal Opportunity/Affirmative Action Employer LOCATION: I I6 W. Jones Street Raleigh, NC 27603-1135 Fax:919-733-5406 4 4. FEMA Fonns: must be completed and attached to your EM Form 66A and submitted to your Branch Office no later than June 1, 2007; ^ 20-16 -Summary Sheet for Assurances and Certifications; ^ 20-16A -Assurances-Non-Construction Programs; ^ 20-16C -Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirements. 5. Standard Form LLL -Disclosure of Lobbying Activities; must be completed and attached to your EM Form 66A and submitted to your Branch Office no later than June 1, 2007; 6. Separate job description or functional statement for EM DIRECTOR POSITION identified on EM Form 66; must be completed and attached to your EM Form 66A and submitted to your Branch Office no later than June 1, 2007; 7. Current Organizational Chart; must be attached to your EM Form 66A and submitted to your Branch Office no later than June 1, 2007; Funding Eligibility Criteria Federal funds administrated through the State are available to local governments to assist in the cost of developing and maintaining a "Comprehensive Emergency Management" program. Continued EMPG funding is contingent upon completion of all EMPG funding requirements. The following eligibility criteria must be adhered to during FFY 2007 for EMPG funds: 1. Every participant must be established as an Emergency Management agency by appropriate or county resolution/ordinance; 2. The County must have afull-time or part-time (at least 50%) Emergency Management Program Director; 3. Employees must be covered by an approved Pay Plan. However, the Director may be exempt from this requirement; 4. The political subdivision must have an acceptable local travel regulation plan or accept the state travel regulations. I recommend you develop and complete your Emergency Management Performance Grant (EMPG) Application for Funding package in consultation with your key county officials. I encourage you to use this opportunity to discuss your program with your county officials. Please remember that since EMPG Awards are based upon your jurisdiction's commitment to complete certain activities as scheduled, failure to do so may result in a delay of your reimbursement, reduction in your grant award, or even cancellation of the grant. If you have questions about this package, please contact your Area Coordinator or Branch Manager. Thank you. HDH/jaa Enclosures NORTH CAROLINA LOCAL GOVERNMENT APPLICATION FOR FFY 2007 FUNDING INSTRUCTIONS FOR COMPLETING EM FORM 66 1.1 EM Agency Name -Type or print the official legal title of the Emergency Management (EM) agency. 1.2 Address, City, Zip Code -Type or print the address, city, and zip code. 1.3 Date Completed -Type or print the date form was completed. 2.1 EM Program Director -Type or print the name of the local EM Program Director and other EM staff by name and title. NOTE: Must be the same title on the Position Description and Organizational Chart. 2.2 Time % - EM Program Director will type or print the percent of time they devote to Emergency Management program activities (e.g. 50%, 75%, 100%). 2.3 Current Salary -Type or print the current annual salary for each EM program staff person. (Round to the nearest dollar). 2.4 Benefits -Type or print the annual benefits for the EM Program Director to include social security, retirement, insurance and unemployment. (Round to the nearest dollar). 2.5 Date Hired As. EM Program Director -Type or print the starting date that the EM Program Director began work in this position. Type or print the Other EM Staff by name and job title, their % time with EM activities and current salary in the appropriate blocks. 2.6 Travel -Type or print the annual expenses for Transportation and Subsistence (Meals and Hotels) as it pertains to the Emergency Management personnel. (Round to the nearest dollar). 2.7 All Other -Type or print all other allowable annual operating expenses which are required for day-to-day operations of the emergency management office. (Round to the nearest dollar). Rental - To include: (Building or Space) -Rent of building or space occupied by emergency management personnel. 5 6 (Motor Vehicles) -Rent for temporary possession or use of motor vehicles utilized SOLELY on the Administration of Emergency Management Program. Vehicles must be rented from an established firm regularly engaged in the business of renting. Payments must be in accordance with the terms of a written contract. Day-To-Day Operating Expenses Postage Office Supplies Telephone Utilities Note: Janitorial/custodial services are allowable, however, limited to pro rata share of the cost if shared. Others (Specify) - i.e. Special Cases Administrative Office Equipment Purchase and repair of administrative office equipment and furniture (limited to cost of office machines, equipment and furniture required) for administration and operations of the Emergency Management Office. • Automated Data Processing (ADP) Equipment and Software Contribution for ADP equipment and software are limited to the pro rata share of the ADP equipment which supports emergency management activities. Mobile and Portable Communications Equipment Federal contributions for mobile and portable communications equipment are limited to costs of equipment for day-to-day emergency management business for emergency management personnel (personnel must occupy positions listed on EM Form 66). • Liability Insurance costs for Emergency Management administrative facilities, vehicles, or equipment. 7 UNALLOWABLE EXPENSES Rent for buildings or space which was constructed, in part or wholly, with federal funds. Rent for space occupied by employees assigned from other state or local governments (full-time or part-time). EXPENDITURES FOR THE PURCHASE OF VEHICLES. ~ L ~ ~_ V CV _ ~` i ~ ~ ~ ~ W Z ~ t ~ _ ~ ~ i ESE ~ Z '~' a> ~ ° ~ N ~ ~ _ ~ d m N - c ~ C ~ "' ~ O W N ~ O = C ~+ ~ N m M L tQ ® M ILLl.. N N V ~ Q ~ Q ~ ~ H ~ ~ o ~ ~ ~' ` 0 o J d ~ ' ~ N N q~ o ~ ~ N a. t9 Z ~, ~~ ,o ~~ W N ~ "'' '+°' ~ ~ ~ L ~. c° F - r• W O W ° ~ ~ c~ ~ ~ ~ cfr ~ ~ cfr G ~ m N ~~ ~ ~ o . z ~ ., ~u °' ~ U w a~,R °' ~ ~ E°- ~' ,J .~ ~ ~ i W J V V ~.. ~ ~ ~ Z ~( N Z ~- (~ J p :~+ ~ ate C ~ Z tU _ J • , . v v ~L ~-- ~ ~ ~ ~ ~ a~ c.C~ °. ~_ ( ~ a ~ ~ ~ (~ q -~ U •.. as ~ cu ~ ` ~ p .~ ~ ~ - Q. Z c~ ~ E N S ~=W ~ ~ s ~ ~ ~ O Z ~ ~ ~ ~ ~ ~ ~ ~ F - ~ a~ ~ j o c z ~ . v a , ''a~~~, o ~ ~ ~, ~ ~ ~ ~ ~ ~ ~ ~' °' °' =' ~ W ~ ~ ~ Q N U N ' ~ ~ ~ tV W ~ I- fA ~ ~ O I-- ~ O i ~ ~ ` '- ~ ~ ' L O ~ V V T ~ cp h• W Q D U. W •~ Rs N 0 ca .Q CU '~ N v~ N N T N M + T T T N U cts C N N ca C U C m W ~ O a 0 vas a~ E a U i N Q N 4..,„' E 0 c `a O V ttf Q rn L L 0 v d L Q 4~ V ++ ti O M O d 10 INSTRUCTIONS FOR COMPLETING EM FORM 66A (FEDERAL/STATE/LOCAL FFY 2007 EMPG AGREEMENT) It is important that the Finance Officer and the local Chief Executive Officer have. information and knowledge of the local EM program and the financial status of the local EM Agency. By coordinating the program emphasis with your county officials, the State's "Comprehensive Emergency Management Criteria" and the state and federal required activities, your partnership agreement should serve as a master plan for the year's activities. The Federal/State/Local FFY 2007 EMPG Agreement requires the signature of the Local Emergency Management Coordinator, the Local Finance Officer, and the Local Chief Executive Officer (the last may be the same individual). Your Area Coordinator will monitor your EMPG for FFY 2007 quarterly. REPORTING EMPG reports are required. These reports serve a vital role in the evaluation of your agency's performance in the completion of scheduled activities and in the preparation of reports the State must provide to FEMA. Your reports will be made b rLyour Area Coordinator after quarterly consultations no later than ten (10) days following the end of each quarter. Each report (after the initial report) will incorporate and supercede the prior report. The Division does recognize that circumstances may prevent the accomplishment of a scheduled activity. However, for Federal funding in FY07, all National Incident Management System (NIMS) requirements must be completed by September 30, 2007. All requests for revisions (rescheduling_or substitution of an equivalent activity) must be justified in writinc~to the Director of NC Division of Emergency Management through the appropriate Branch Manager. 10 11 EM FORM 66A (Rev. 03/07) FEDERAL/STATE/LOGAL FY 2007 EMPG AGREEMENT AGENCY: This is to certify that the above named agency agrees to successfully complete the activities below in full partnership with the North Carolina Division of Emergency Management and the Department of Homeland Security..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 complete or have completed this federal fiscal year ending September 30, 2007. You are required to certify completion of the following activities: 2007.1 Update the NIMCAST baseline conducted in 2005 online by September 30, 2007; 2007.2 EM personnel complete the NIMS Awareness Course: National Incident Management System (NIMS), An Introduction (IS-700) by September 30, 2007; 2007.3 EM personnel complete the (IS-800) The National Response Plan (NRP) Course by September 30, 2007; 2007.4 EM personnel complete the (ICS-100) An Introduction to ICS (online) and (ICS-200) Basic ICS Course (classroom), ICS-300 for everyone and ICS-400 for those in senior management positions by September 30, 2007; 2007.5 Each county by September 30, 2007 should complete the following: ^ Adopt NIMS at the community level for all government departments and agencies; as well as promote and encourage NIMS adoption by associations, utilities, non- , governmental organizations (NGOs), and private sector incident management and response organizations; ^ Update and incorporate NIMS into Emergency Operations Plans (EOPs) and provided an electronic CD copy of your county EOP to the NCEM I&P Planning Support Branch Manager and your Branch offices; ^ Revise and update plans and SOPs to incorporate NIMS components, principles and policies, to include planning, training, response, exercises, equipment, evaluation, and, corrective actions; ^ Provide letter from county manager certifying that tasks identified in the NIMS 2007 Local Matrix have been completed. Matrix to be provided by separate correspondence. Local Matrix provided as FY2007 NIMS Compliance Matrix Local/Tribal at http://www.fema.gov/pdf/emergency/nims/comp .met local.pdf. ^ Incorporate NIMS into existing training programs and exercises; ^ Manage all emergency incidents and preplanned (recurring/special) events in accordance with ICS organizational structures, doctrine, and procedures, as defined in NIMS; ^ Incorporate corrective actions from after action reviews infio preparedness and response plans and procedures; ^ Inventory community response assets to conform to homeland security resource typing standards; 11 12 EM FORM 66A (Rev. 03/07) ^ Review, promote, and facilitate mutual aid agreements; • Attend training on utilizing Homeland Security Exercise and Evaluation Program (HSEEP) and conduct exercises in compliance with HSEEP standards; ^ Report all training and exercises conducted utilizing federal preparedness funds to the Division Training & Exercise Branch 2007.6 Identify from available resources a dedicated WebEOC operator; training to be provided by NCEM. Recommendation would be from 24 hour Communication Center. 2007.7 Update your County Mutual Aid Agreement to include signed additional local governments or as necessary updated your current County Mutual Aid Agreement and send in the new or updated agreement by September 30, 2007; 2007.8 At a minimum verify at least one person from each funded jurisdiction attend the Spring All Hazards Conference. Attendance of all local EM staff at both the Spring and Fall conferences is encouraged, but not required; 2007.9 Each funded jurisdiction conduct an annual Training Exercise Planning Workshop (TEPW) sponsored by NCEM to determine the types of training needed to further develop and maintain a quality Emergency Management Program in that jurisdiction by September 30, 2007; 2007.10 Each funded jurisdiction plan for and participate in a minimum of two all hazards exercises. Exercises should include multiple local and/or state agencies, and may take the form of a table-top, functional or full scale activity. Exercise activity should be coordinated with your appropriate Branch Office; and the Division's Training and Exercise Branch, including dates, number personnel trained, scenario utilized, and planning meetings conducted. This information is required by the DHS National Exercise Scheduler (NEXS) system; 2007.11 During this fiscal year each funded jurisdiction test the satellite telephone by contacting your appropriate NC Division of Emergency Management's Branch Office the first and last Fridays of each month; 2007.12 During this fiscal year funded jurisdictions should continue the formation and support of a t_ocal Emergency Planning Committee (~EPC). The LEPC should be County or Regional; 2007.13 Each funded jurisdiction sends in EM-43 Emergency Event Forms to advise the Division's Communication Officer of events such as, Hazardous Material Spills, Property Damage, Injuries and / or Deaths, Relocation of a minimum of 10 Residents, Opening of Shelter(s), and Terrorism related activities; (Reporting will be done on WebEOC by June 1St); 2007.14 Each funded jurisdiction develops a written plan for the implementation and operation of a county receiving and distribution point (CRDP) and develops written plan for distribution of resources from the CRDP to the county. County must provide copy of plans to the NCEM Logistics Chief; 2007.15 Each funded jurisdiction develops a written summary of shelter plans to include housing general populations of evacuatees, and special populations of evacuees, (special populations would include residents of hospitals, nursing homes, assisted living facilities, and home health patients) and pet sheltering. 12 13 EM FORM 66A (Rev. 03/07) NOTE: In order to receive FY08 preparedness funding, the FY07 NIMS compliance requirements described above must be met. Applicants will be required to certify as part of their FY08 grant applications that they have met the FY07 NIMS requirements. NIMCAST is the primary tool for measuring NIMS compliance. Requirements that must be completed, updated or maintained to continue NIMS Compliance in FY 2008 and Beyond FY 2008 ^ Amend or re-authorize, as necessary the executive order, proclamation, resolution, or legislation of NIMS as the official all-hazards, incident response system; ^ Ensure that NIMS training is part of the program for all new employees, recruits and first responders who have direct role in emergency preparedness, incident management, or response; ^ Complete all NIMS local matrix requirements for FY 2008 as defined by the DHS National Integration Center (NIC); ^ Complete training that may be required to satisfy credentialing standards; ^ Manage incidents and events using ICS. ^ . Update .plans and SOPs, incorporating lessons learned and best practices from exercises and response operations; ^ Expand mutual aid agreements beyond support services and equipment to include information sharing; ^ Support and adopt the ongoing efforts of the NIMS Integration Center (NIC) to develop a national credentialing system; ^ Work towards developing procedures to credential first responders in conformance with national standards; ^ Continue to incorporate NIMS into all local training and HSEEP compliant exercises, to include drills, tabletop exercises, functional exercises, and full-scale exercises; ^ Continue to participate in NIMS -oriented exercises, to include drills, tabletop exercises, functional exercises, and full-scale exercises; ^ Develop and implement a county resource inventory, ordering and tracking system ^ Report all training conducted using federal preparedness funds to the NCEM Training and Exercise Branch; ^ Continue featuring common terminology and plain English commands for all response activities. 13 14 EM FORM 66A (Rev. 03/07) This Agreement will become effective upon execution of all parties to the Agreement. The date of execution shall be the date of the last signature. EXECUTED THIS THE DAY OF , 2007 Signature of Local Emergency Management Coordinator Date Signature of Local Finance Officer Date Signature of Local Chief Executive Officer Date County of 14 15 POSITION DESCRIPTION CERTIFICATION CAROLINA COUNTY EMERGENCY MANAGEMENT AGENCY 1 DO HEREBY CERTIFY THAT THE EM PROGRAM DIRECTOR POSITION IS NOT VACANT OR IS CURRENTLY BEING FILLED BY AN ACTING COUNTY EMPLOYEE AND THE DESCRIPTION(S) ON FILE IN THE STATE OFFICES IS/ARE CURRENT AND UP-TO-DATE AND MEET DEPARTMENT OF HOMELAND SECURITY PROGRAM AND STATE REQUIREMENTS. Si nature: ~=~ C- 9 LAWRENCE B. JONES, EMERGENCY P CAROLINA COUNTY EMERGENCY MAC 15 16 POSITION DESCRIPTION CERTIFICATION COUNTY EMERGENCY MANAGEMENT AGENCY I DO HEREBY CERTIFY THAT THE EM PROGRAM DIRECTOR POSITION IS NOT VACANT OR IS CURRENTLY BEING FILLED BY AN ACTING COUNTY EMPLOYEE AND THE DESCRIPTION(S) ON FILE IN THE STATE OFFICES IS/ARE CURRENT AND UP-TO-DATE AND MEET DEPARTMENT OF HOMELAND SECURITY PROGRAM AND STATE REQUIREMENTS. Signature: EM PROGRAM DIRECTOR COUNTY EMERGENCY MANAGEMENT AGENCY 16 ~7 U.S. Department of Homeland Security O.M.B. No. 3067-0206 SUMMARY SHEET FOR ASSURANCES AND CERTIFICATIONS Expires February 28, 2007 FOR CA FOR (Name of Applicant) FY This summary sheet includes Assurances and Certifications that must be read, signed, and submitted as a part of the Application for Federal Assistance. An applicant must check each item that they are certifying to: Part I ^X FEMA Form 20-16A, Assurances-Nonconstruction Programs Part II ~ FEMA Form 20-16B, Assurances-Construction Programs Part III ~X FEMA Form 20-16C, Certifications Regarding Lobbying; Debarment, Suspension, and Other Responsibility Matters; and Drug-Free Workplace Requirements Part IV ^X SF LLL, Disclosure of Lobbying Activities (If applicable) As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the identified attached assurances and certifications. Typed Name of Authorized Representative Title Signature of Authorized Representative Date Signed NOTE: By signing the certification regarding debarment, suspension, and other responsibility matters for primary covered transaction, the applicant agrees that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by FEMA entering into this transaction. The applicant further agrees by submitting this application that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction," provided by the FEMA Regional Office entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. (Refer to 44 CFR Part 17.) Paperwork Burden Disclosure Notice "Public reporting burden for this form is estimated to average 1.7 hours per response. Burden means the time, effort and financial resources expended by persons to generate, maintain, retain, disclose, or to provide information to us. You may send comments regarding the burden estimate or any aspect of the form, including suggestions for reducing the burden to: Information Collections Management, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472, Paperwork Reduction Project (3067-0206). You are not required to respond to this collection of information unless a valid OMB control number appears in the upper right corner of this form. Please do not send your completed form to the above address. Form 20-16, FEB 01 i8 U.S. DEPARTMENT OF HOMELAND SECURITY ASSURANCES-NON-CONSTRUCTION PROGRAMS Note: Certain of these assurances may not be applicable to your project or program. If you have any questions, please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. As the duly authorized representative of the applicant, I certify that the applicant: 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non-Federal share of project costs) to ensure proper planning, management and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. Section 4728-4763) relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration) 5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. Sections 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. Section 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. Sections 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Sections 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290-dd-3 and 290-ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VHI of the Civil Rights Acts of 1968 (42 U.S.C. Section 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and (j) the requirements of. any other nondiscrimination statute(s) which may apply to the application. 7. Will comply, or has already complied, with the requirements of Title II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or Federally assisted programs. These requirements apply to all interest in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply with provisions of the Hatch Act (5 U.S.C. Sections 1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 9. Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. Sections 276a to 276a- 7), the Copeland Act (40 U.S.C. Section 276c and 18 U.S.C. Sections 874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. Sections 327-333), regarding labor standards for federally assisted construction subagreements. 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more. Form 20-76A, JUN 94 l~ 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. Section 1451 et seg.); (f) conformity of Federal actions to State (Clean Air) Implementation Plans under Section 176(c) of the Clean Air Act of 1955, as amended (42 U.S.C. Section 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205). 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. Section 1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.). 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. Section 4801 et seq.) which prohibits the use of lead based paint in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act 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. Form 20-16A (BACK) a~ U.S. DEPARTMENT OF HOMELAND SECURITY CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS Applicants should refer to the regulations cited below to determine the certification to which they are required to attest. Applicants should also review the instructions for certification included in the regulations before completing this form. Signature on this form provides for compliance with certification requirements under 44 CFR Part 18, "New Restrictions on Lobbying; and 28 CFR Part 17, "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 (FEMA) determines to award the covered transaction, grant, or cooperative agreement. 1. LOBBYING A. 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 $100,000, as defined at 44 CFR Part 18, the applicant certifies that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of congress, or an employee of a Member of Congress in connection with the making of any Federal grant, the entering into of any cooperative agreement, and 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 for influencing or attempting 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 connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form LLL, "Disclosure of Lobbying Activities," in accordance with its instructions; (b) Have not within athree-year period preceding this application been convicted of ar had a civilian judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or perform a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust 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, State, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and (d) Have not within athree-year period preceding this application had one or more public t ransactions (Federal, State, or local) terminated for cause or default; and B. Where the applicant is unable to certify to any of the statements in this certification, he or shall shall attached an explanation to this application. 3. DRUG-FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS) (c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants, contracts under grants and cooperative agreements, and subcontract(s) and that all subrecipients shall certify and disclose accordingly. Standard Form LLL, "Disclosure of Lobbying Activities" attached. (This form must be attached to certification if nonappropriated funds are to be used to influence activities.) 2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS (DIREGT RECIPIENT) As required by Executive Order 12549, Debarment and Suspension, and implemented at 44 CFR Part 67, for prospective participants in primary covered transactions, as defined at 44 CFR Part 17, Section 17.510-A. The applicant certifies that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, sentenced to a denial of Federal benefits by a State or Federal court, or voluntarily excluded from covered transactions by any Federal department or agency; As required by the Drug-Free Workplace Act of 1988, and implemented at 44 CFR Part 17, Subpart F, for grantees, as defined at 44 CFR Part 17, Sections 17.615 and 17.620: A. The applicant certifies that it will continue to privide a drug- free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions tht will be taken against employees for violation of such prohibition; (b) Establishing an on-going drug free awareness program to inform empoyees about: (1) The dangers of drug abuse in the workplace; (2) The grantee's policy of maintaining adrug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and (4) the penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; Form 20-16C, JUN 94 ai (c) Making it a requirement that each employee to be engaged in the performance of the grant to be given a copy of the statement required by paragraph (a); (d) Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant, the employee will: (1) Abide by the terms of the statement; and (2) Notify the employee in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction. (e) Notifying the agency, in writing, within 10 calendar days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to the applicable FEMA awarding office, i.e., regional office or FEMA office. (f) Taking one of the following actions, within 30 calendar days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted: (1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency. (g) Making a good faith effort to continue to maintain a drug free, workplace through implementation of paragraphs (a), (b), (c), (d), (e), and (f). 8. the grantee may insert in the space provided below the site(s) for the performance of work done in connection with the specific grant: Place of Performance (Street address, Gity, County, State, Zip code) 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 to 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 Statewide certification. Form 20-16C (BACK) as DISCLOSURE OF LOBBYING ACTIVITIES. ApprovedbvoMB Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046 (Spa rpvarse fnr rmhlic hurdpn disclosure) 1. Type of Federal Action: ~a. contract 2. Status of Federal Action: ~a. bid/offer/application 3. Report Type: ~a. initial filing b. grant b. initial award b. material change c. cooperative agreement c. post-award For Material Change Only: d. loan year quarter e. loan guarantee date of last report f. loan insurance 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee, Enter Name Prime Subawardee and Address of Prime: Tier ,if known: Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable 8. Federal Action Number, if known: 9. Award Amount, if known: 10. a. Name and Address of Lobbying Registrant b. Individuals Performing Services (including address if (if individual, last name, first name, MI): different from No. 10a) (last name, first name, MI): 11. Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material Signature: representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This Print Name: disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be Title: available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less Telephone No.: Date: than $10,000 and not more than $100,000 for each such failure. Federal Use Only: Authorized for Local Reproduction Standard Form LLL (Rev. 7-97)