HomeMy WebLinkAboutResolution - 2012-R0076 - Agreement - TX DPS/TX HSSAA - 02/23/2012 (2)Resolution No. 2012-R0076
February 23, 2012
Item No. 5.1.1
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the City Council of the City of Lubbock does hereby ratify the actions of
the Mayor in signing for and on behalf of the City of Lubbock a 2011 Sub -Recipient
Agreement, Federal Grant Award Number EMW-2011-SS-00019, by and between the
City of Lubbock and the Texas Department of Public Safety/Texas Home and Security
State Administration Agency, and all related documents. Said Agreement is attached
hereto and incorporated in this Resolution as if fully set forth herein and shall be included
in the minutes of the Council.
Passed by the City Council this February 23 , 2012.
TOM MA TIN, MAYOR
I ATTEST:
Reber, u Garza, City Secretary
APPROVED AS TO CONTENT:
,4^-LZ
-
Nike Kemp, Fire h1of
IAPPROVED AS TO FORM:
f
RES.Agreement-Texas Dept Public Safety-& Homeland Sec
2.13.12
Resolution No. 2012-R0076
OF
Texas Department of Public Safety
E x
2011 Sub -Recipient Award
T is A
for
*W-
City of Lubbock
1. General Awned Infonnatlon
Reference/Encumbrance No:
Date of Award: November 17, 2011
Prepared By: Wilson, Kenneth
3. SAA Award Number: 11-SR 45000-01
4. Sub -Recipient Name and Addrera
S. Federal Grant Information
Federal Grant Title: Homeland Security Grant Program (HSGP)
Metropolitan Medical Response System (MMRS)
Federal Grant Award Number: EMW-2011-SS-00019
Mayor Tom Martin
City of Lubbock
Federal Granting Agency: Department of Homeland Security FEMA
P.O. Box 2000
Grant Programs Directorate
Lubbock, TX 79457-0001
Date Federal Grant Awarded to TxDPS: October 7, 2011
CFDA: 97.067
6. Award Amount and Grant Breakdown
Grant Period:
MMRS
from: To:
Sep 1, 2011 Aug 31, 2013
$267, 608.35
(The SAA must receive all invoices by the end of grant period)
7. Statutory Authority for Grant: The Department of Defense and Full -Year Continuing Appropriations Act 2011 (Public Law 112-10),
and Section 2003 of the Homeland Security Act of 2002, as amended by section 101 of the Implementing Recommendations of the 9/11
Commission Act, 6 U.S.C. 604.
8. Method of Payment: Primary method is reimbursement.
9. Debarment/Suspension Certification: The Sub -Recipient certifies that the sub -recipient and its contractors/vendors are not
debarred,suspended, proposed for debarment, declared ineligible or voluntarily excluded by any federal department or agency and do
not appear in the Excluded Parties Gist System at http://www.epls.gov/epls/search.do
10. Agency Approvals
Approving TxDPS Official:
Signature of TxDPS Official:
Machelle Pharr
Deputy Assistant Director
Texas Homeland Security
State Administrative Agency
Texas Department of Public Safety
11. Sub -Recipient Acceptance
I have read, understood and agree to this Sub -Recipient Agreement and the attached Terms and Conditions.
Print name and title of Authorized Sub -Recipient official:
Signature of Sub -Recipient Official:
Mayor Tom Martin
City of Lubbock
Entai Employer IdentiflRcation Number (EIN) or
DUNS Number.
Date Signed.
Federal Tax Ida. tifka an Number.
7 5- 1.00059 0
S .. Z.l - 3,69 3
DUE DATE: January 5, 2012 Signed award and Direct Deposit Form must be returned to TxDPS on or before the due date.
2011 TERMS AND CONDITIONS
The Sul-rpient must.
1. Fill in the intbrmation and sign the Sub -Recipient Award,
2. Certify fhey have read and understand the Tents and Conditions by initiating the bottom of each page.
3. Fiii in the information located on Page 4,
4. Certify to the statements provided in Exhibits A, B, C and D located at the back ofthis document by filft in contact information
and signing all exhibits.
5. Retum eN documents to the DPSITHSSAA on or before the date provided in the transmittal letter and+br in the agreement
riles to ,Sub-tecinient Agreement
This Sub -recipient Agreement (includes the Sub -recipient Award and the Terms and Conditions) is made and entered into by and between
the Department of Public Safety / Texas Homeland Security State Administrative Agency, an agency of the State of Texas, hereinafter
referred to as "DPS/THSSAA," and the funds recipient, hereinafter referred to as the "Sub-recipienL Furthermore, DPS/THSSAA and the
Sub recipient are cGlectivety hereinafter referred to as the "Parties.' The Sub -recipient Agreement is only an offer until the Sub -recipient
returns the signed copy of the 2011 Sub -recipient Agreement on or before the date provided in the transmittal letter and/or in the
Sub -recipient Agreement Award.
Sub -recipient may not assign or transfer any interest in this Sub -recipient Agreement without the express, prior written consent of the
DPS/THSSAA.
All allocations and use of funds under this grant must be In accordance with the FY 2011 Grant Program Guidance for the Federal
Grant Title specified on the Sub-reclplent Agreement Award. All award Sub -recipients are required to have read, understood and
accepted the FY 2011 Grant Program Guidance as binding.
Standard of Performance. The Sub -recipient shall ppeerform all activities and projects entered into the DPS/THSSAA web -based rants
management system which were approved by the THSSAA The Sub -recipient shall perform all activities in accordance with all terms,
provisions and requirements set forthin this Sub -recipient agreement, Terms and Conditions and the following Exhibits located at the end of
this document:
1. Assurance — Non -Construction Programs, hereinafter referred to as 'Exhibit A'
2. Assurance — Construction Programs, hereinafter referred to as 'Exhibit B"
3. Certification, hereinafter referred to as `Exhibit C'
4. Assurance — From UGMS §_.14 hereinafter referred to as "Exhibit D'
Failure to Perform. In the event the Sub -recipient fails to implement the project(s) entered into the DPSITHSSAA web -based grants
management system, or comply with any of this Sub -recipient agreement's provisions, in addition to the remedies specified in this
Sub -recipient agreement, the Sub -recipient is liable to DPSITHSSAA for an amount not to exceed the award amount of this Sub -recipient
agreement and may be barred from applying for or receiving additional DHS/FEMA grant program funds or any other federal program funds
administered by DPS/THSSAA until repayment to DPS/THSSAA is made and any other conPh�nce or audit finding is satisfactorily
resolved. Failure to timely implement projects may reduce fixture funding in additional DHS/FEMA grant programs administered by the
DPS/THSSAA.
MeasWre of Liability. DPSITHSSAA shall not be liable to the Sub -recipient for any costs incurred by the Sub -recipient that are not allowable
costs.
Sub-irtrjpient Agreement Fund§ Defined and Limit of Liability, The term "Sub -recipient agreement funds" as used in this Sub -recipient
agreement means funds provided by DPS/THSSAA under the DHSIFEMA grant programs. The term "Sub -recipient's funds" or match funds
as used in this Sub-redpient agreement means funds provided by the Sub -recipient.
Notwithstanding any other provision of this Sub -recipient agreement, the total of all payments and other obligations incurred by
DPS/THSSAA under this Sub -recipient agreement shall not exceed the Total Award Amount listed on the Sub -recipient Award.
Sub -recipient shall contribute the match funds listed on the Sub -recipient Award.
Excess Pavmgnts. The Sub -recipient shall refund to DPSITHSSAA any sum of Sub -recipient agreement funds that has been paid to the
Sub -recipient by DPS/THSSAA or that DPSlTHSSAA determines has resulted in overpayment to the Sub -recipient or that DPSITHSSAA
determines has not been spent by the Sub -recipient in accordance with this Sub -recipient agreement No refund payment(s may be made
from local, state or federal grant funds unless repayyment with grant funds is specifically permitted by statute or regulation. he
Sub -recipient shall make such refund to DPS/THSSAA within thirty (30) days after DPS/THSSAA requests such refund.
Initial Date J, �
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suspensi n
In the event the Sub -recipient fails to comply with any of this Sub -recipient Agreement's terms, DPSITHSSAA may, upon written notification
to the Sub -recipient, suspend this Sub -recipient agreement in whole or in part, withhold payments to the Sub -recipient and prohibit the
Sub -recipient from incurring additional obligations of Sub -recipient agreement funds.
Termination
DPSITHSSMs Right to Ea3a ate, DPS/THSSAA shall have the right to terminate this Sub -recipient agreement, in whole or in part, at any
time before the end of the Performance Period, whenever DPS/THSSAA determines that the Sub -recipient has failed to comply with any of
this Sub -recipient Agreement's terns. DPS/THSSAA shall notify the Sub -recipient in writing prior to the thirtieth (30th) day preceding the
termination of such determination and include:
1. the reasons for such termination;
2. the effective date of such termination; and
1 in the case of partial termination, the portion of the Sub -recipient agreement to be terminated.
Appeal may be made to the Deputy Director of Homeland Security, Department of Public Safety
In taking an enforcement action, the awarding agency will provide the sub -recipient an opportunity for such hearing, appeal, or other
administrative proceeding to which the sub -recipient is entsUed under any statute or regulation applicable to the aeon involved.
Conflict Of In ,
No employee, officer or agent of the sub -recipient shall participate in selection, or in the award or administration of a contract supported by
Federal funds if a conflict of interest, real or apparent, would be involved.
Monitalrfng
Sub -recipients will be monitored periodically by federal, state or local entities, both programmatically and finandally, to ensure that project
goals, objectives, performance requirement, timelines, milestone completion, budget, and other related program criteria are being met
DPS/THSSAA or its authorized representative reserves the right to perform periodic desk/office-based and/or on -site monitoring of the
Sub -recipient's compliance with this Sub -recipient agreements terms and conditions and of the adequacy and timeliness of the
Sub -recipient's performance pursuant to this Sub -recipient agreement After each monitoring visit, DPSITHSSAA shall provide the
Sub -recipient with a written report of the monitor's findings. If the monitoring report notes deficiencies in the Sub -recipients performance
under this Sub -recipient agreement's terms, the monitoring report shall include requirements for the timely correction of such deficiencies by
the Sub -recipient. Failure by the Sub -recipient to take action specified in the monitoring report may be cause for this Sub -recipient
agreement's suspension or termination pursuant to the Suspension and/or Termination Section.
Audit of Federal and cjW% Funds The Sub -recipient shall arrange for the performance of an annual financial and compliance audit of
Sub -recipient agreement funds received and performances rendered under this Sub -recipient agreement as n uired by the Single Audit
Act {OMB Circular A-133; 44 C.F.R. 13.26). The Sub —recipient will also comp as applicable, with Texas Govemment Code, Chapter
783, 1 TAC 5.141_et seq_ and the Uniform Grant Management Standards (UGMS)„ State Uniform Administrative Requirements for Grants
and Cooperative Agreements.
Right to Audit The Sub—redpient shall give the United States Department of Homeland Security (DHS), the Comptroller General of the
Unfte�, the Texas State Auditor, DPS/THSSAA, or any of their duly authorized representatives, access to and the right to conduct a
financial or compliance audit of Sub -recipient agreement funds received and performances rendered under this Sub -recipient agreement
The Sub -recipient agrees to permit DPS/THSSAA or its authorized representative to audit the Sub -recipient's records. The sub -recipient
shall provide any documents, materials or information necessary to facilitate such audit
9�tftent's Liability for Disallowed Costs, The Sub -recipient understands and agrees that it shall be liable to DPS/THSSAA for any
costs disallowed pursuant to financial and compliance audit(s) of Sub -recipient agreement funds. The Sub -recipient further understands
and agrees that reimbursement to DPS/THSSAA of such disallowed costs shall be paid by the Sub -recipient from funds that were not
provided or otherwise made available to the Sub -recipient pursuant to this Sub -recipient agreement or any other federal contract.
SuIi-recipient's Facilitation of Aud t The Sub -recipient shall take such action to facilitate the performance of such audit(s) conducted
pursuant to this Section as DPS/THSSAA may require of the Sub -recipient The Sub —recipient shall ensure that this clause concerning the
authority to audit funds received indirectly by subcontractors through the Sub -recipient and the requirement to cooperate is included in any
subcontract it awards.
Qthe�uirements
A. During the performance period of this grant, Sub-reaplent government jurisdictions must maintain an Emergency Management Plan
at the Intermediate Level of planning preparedness or higher, as prescribed by the Texas Division of Emergency Management (TDEM).
This may be accomplished by ajurisdiction maintaining its own emergency management plan or participating in an inter -jurisdictional
ds. emergency management program that meets the required standar!f TDEM identifies deficiencies in the Sub -recipient government
jurisdiction's plan, Sub -recipient will correct deficiencies within 60 days of receiving notice of such deficiencies from TDEM.
Initial Datee= l/
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B. Projects identified in the DPS/THSSAA web -based grant management system must identify and relate to the goals and objectives
indicated by the applicable approved project investments for the period of performance of the grant. Sub -recipient will submit its project
plans, narrative and budget to DPS/THSSAA and FEMA (if required) for approval prior to expending or requesting advances of any funds
for this award. During the performance period of this grant, Sub -recipient agrees that it will participate in a legally -adopted county and/or
regional mutual aid agreement
C. During the performance period, the Sub -recipient must be a registered user of the Texas Regional Response Network (TRRN) (or other
response asset inventory management system specified by DPS/THSSAA) and must identify all major resources such as vehicles and
trailers, equipment costing $5,000 or more, and specialized teams/response units equipped and/or trained using grant funds (i.e. hazardous
material, decontamination, search and rescue, etc_). This registration is to ensure jurisdictions or organizations are prepared to make grant
funded resources available to other jurisdictions through mutual aid.
D. Sub -recipients must submit Fiscal Year 2010 Indirect Cost Allocation Plan signed by Cognizant Agency. 'Cognizant agency' means the
Federal agency responsible for reviewing, negotiating, and approving cost allocation plans or indirect cost proposals developed under 2
CFR Part 225 on behalf of all Federal agencies. OMB publishes a lining of cognizant agencies. Plan should be forwarded to the
DPS/THSSAA.
E. Regional Planning Commissions/Council of Governments (COGS) will follow guidelines listed in the DPS/THSSAA FY2011 COG
Statement of Work.
F. Sub -recipient acknowledges that FEMA National Preparedness Directorate reserves a royalty -free, non-exclusive, and irrevocable
license to reproduce, publish, or otherwise use, and authorize others to use, for government purposes: (1) the copyright in any work
developed under an award or sub -award; and (2) any rights of copyright to which a recipient or Sub -recipient purchases ownership with
Federal support The sub -recipient agrees to eonsuft with DPS/THSSAA regarding the allocation of any patent rights that arise from, or are
purchased with, this funding.
A. The Sub -recipient must have expended all grant funds and submitted expenditure reimbursement requests and any invoices by the end
of the performance period listed on the sub -recipient agreement.
B. DPS/THSSAA will dose a sub -award after receiving Sub -recipient's final performance report indicating that all approved work has been
completed and all funds have been disbursed, completing a review to confirm the accuracy of the reported information, and reconciling
actual costs to award modifications and payments. If the dose out review and reconciliation indicates that the Sub -recipient is owed
additional funds, DPS/THSSAA will send the final payment automatically to the Sub -recipient. If the Sub-redpient did not use all the funds
received, DPS/THSSAA will issue a Grant Adjustment Notice (GAN) to recover the unused funds. Sub -recipient will return the funds to the
DPS/THSSAA within 30 days of receiving the GAN.
C. At the completion of the sub -recipient's performance period, DPS/THSSAA will de -obligate all uncommitted / unexpended funds.
A In cases where local funding is established by a COG or UASI governing board, the release of funds by DPS1THSSAA is contingent
upon funding allocation approval by the governing board.
B. Notwithstanding any other agreement provisions, the parties hereto understand and agree that DPS1THSSAA's obligations under this
agreement are contingent upon the receipt of adequate funds to meet DPS/THSSAA's liabilities hereunder, except as required by HSGP
ggrant DPS/THSSAA shall not be liable to the Sub -recipient for costs under this Agreement which exceed the amount specified in the
Sub -recipient Award.
C. All notices or communication required or permitted to be given by either party hereunder shall be deemed sufficiently given if mailed by
registered mail or certified mail, return receipt requested, or sent by overnight courier, such as Federal Express or Loan Star, to the other
party at its respective address set forth below or to a Point of Contact listed for the sub -recipient in the DPS/THSSAA Grants Management
System.
DPSITHSSAA Contact Information
Sub -Recipient Contact Infonnation
(Please F1114n Cordact InfonneNon below)
Deputy Assistant Director,
Name: Tom Martin
Texas Homeland Security State Admin. Agency
Title: Mayor— City of Lubbock
Texas Department of Public Safety
Agency: City of Lubbock, Texas
P.O. Box 4087
Address: P.O. Box 2000
Lubbock, Texas 79457-0001
Austin, TX 78773-0220
Except as specifically modified by law or this Sub -recipient agreement's provisions, the Sub -recipient shall administer the award through
compliance with the most recent version of all applicable Laws and Regulations. A non-exclusive list is provided below.
A. Administrative Requirements
1. 44 C.F.R. Part 13, Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments;
2. 2 C.F.R. Part 215, Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals and
Other Non -Profit Organizations (OMB Circular A-110).
3. 44 CFR Part 10, Environmental Considerations
Initial Date J
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B. Cost Principles
1. 2 C.F.R. Part 225, Cost Principles for State, Local and Indian Tribal Governments (OMB Circular A-87)
2. 2 C.F.R. Part 220, Cost Principles for Education Institutions (OMB Circular A-21)
3. 2 C.F.R. Part 230, Cost Principles for Non -Profit Organizations (OMB Circular A-122)
4. 48 CFR 31.2. Federal Acquisition Regulations (FAR), Contracts with Commercial Organizations
C. Audit Requirements --0IAB Circular A-133, Audits of States, Local Governments and Non -Profit Organizations.
D. Grant Guidance
The sub -recipient agrees that all allocations and use of funds under this grant will be in accordance with the applicable FY2011 Grant
Program Guidance and application kit and supplemental resources, e.g., for Homeland Security Grant Program currently available at
http:/twww.fema_govr xttgovemmenVgrantt2Ol1/fvl 1_hsgp kit.bd; for Regional Catastrophic Preparedness Grant Program,
http:ltwww.fema.gov/bd/govemmenVgranV2011/fy11_rcpgp�kittxt; for Emergency Operations Center Grant Program
http:/twww.fema.govtbd/govemmentigrant/2011/fy11_eoc kr.txt; and Nonprofit Security Grant Program,
h ttp: /hvww.fema. govhWg ovemm enttgrant/2011 /ty 11 _nsg p_kit. txt.
Lobbong< Prohibited
Sub -Recipient understands and agrees that it cannot use any federal funds, either directly or indirectly in support of the enactment, repeal,
modification or adoption of any law, regulation, or policy, at any level of government, without the express prior written approval of FEMA
Environmental Review
The Sub -recipient, as soon as possible upon receiving their grant award, must provide information to DPSIrHSSAA to assist with the
legally -required environmental planning and historic preservation (EHP) review and to ensure compliance with applicable EHP laws and
Executive Orders (EO) currently using the FEMA EHP Screening Form OMB Number 1660-0115/FEMA Form 024-0-01 and submitting it,
with all supporting documentation, to DPSITHSSAA for review. These EHP requirements include but are not limited to National
Environmental Policy Act, National Historic Preservation Act, Endangered Species Ad, EO 11988 — Floodplain Management, EO 11990 —
Protection of Wetlands, and EO 12898 — Environmental Justice. The recipient must comply with all Federal, State, and local EHP
requirements and obtain applicable permits and clearances. See FEMA Information Bulletin 329.
Recipient shall not undertake any written activity from the project that would result in ground disturbance, facility modification, or purchase
and use of sonar equipment without the prior approval of FEMA These include but are not limited to communications towers, physical
security enhancements involving ground disturbance, new construction, and modifications to buildings that are 50 years old or older.
Recipient must comply with all mitigation or treatment measures required for the ppr 'eas the result of FEMA's EHP review. Any changes
to an approved project description will require re-evaluation for compliance with EHPd requirements before the project can proceed. tf
ground disturbing activities occur dudno project implementation, the recipient must ensure monitoring of ground disturbance and if any
potential archeological resources are discovered, the recipient will immediately cease construction in that area and notify FEMA and the
appropriate State Historical Preservation Office. Initiation of these activities prior to completion of FEMA's EHP review will result in a
non-compliance finding and may not be eligible for grant funding.
Retention gl Records. The Sub -recipient shall maintain fiscal records and supporting documentation for all expenditures of Sub -recipient
agreement funds pursuant to the applicable OMB Circular, 44 CFR Section 13.42, UGMS 42, and this Sub-recipiertt agreement The
Sub -recipient shall retain these records and any supporting documentation for a minimum o three (3) years from the later of the completion
of this projects public objective, submission of the nal expenditure report, any litigation, dispute, or audit Records shall be retained for 3
years after any real estate or equipment final disposition. The DHS or DPS/THSMaA may direct the sub -recipient to retain documents or to
transfer certain records to DHS custody when DHS determines that the records possess long term retention value.
The Sub -recipient shall give the United States Department of Homeland Security (DHS), the Comptroller General of the
United States, the Texas State Auditor, DPS/THSSAA, or any of their duty authorized representatives, access to and the right to examine all
books, accounts, records, reports, files, other papers, things or proper belonging to or in use by the Sub -recipient pertaining to this
Sub -recipient agreement including records concerning the past use of HSIFEMA funds. Such rights to access shall continue as long as the
records are retained by the Sub -recipient The Sub -recipient agrees to maintain such records in an accessible location and to provide
citizens reasonable access to such records consistent with the Texas Public information Act, Texas Government Code Chapter 552.
Inclusion in Subcontract. The Sub -recipient shall include the substance of the Retention of Records and Access to Records sections in all
subcontracts.
After Action Renortina The Sub -recipient shall complete, deliver to the appropriate source, and retain copies of all after -action and
certificates of completion for all training and exercises paid for by this grant
Signatory Authority. The Sub -recipient assures and guarantees that the Sub -recipient possesses the legal authority to enter into this
Sub -recipient agreement, receive Sub -recipient agreement funds and to perform the services the Sub -recipient has obligated itself to
perform pursuant to this Sub -recipient agreement.
Authorized Rearesentative. The person or persons signing and executing this Sub -recipient agreement on the Sub -recipient's behalf do
warrant and guarantee that he, she or they have been duly authorized by the Sub -recipient to execute this Sub -recipient agreement on the
Sub -recipient's behalf and to validly and legally bind the Sub -recipient to all contractual terms, performances and provisions.
Initial Date J/ 40,12
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Conflicts in Reouirements. If conflict exists between federal, state, or local requirements, the sub -recipient shall comply with the strictest
requirement
ftdce of Litigation apd Claims
The Sub -recipient shall give DPS/THSSAA immediate notice in writing of any action, including any proceeding before an administrative
agency, filed against the Sub -recipient arising out of the performance under this Sub -recipient agreement
Except as otherwise directed by DPS/THSSAA, the Sub -recipient shall furnish immediately to DPS/THSSAA copies of all documentation or
pleadings received by the Sub -recipient with respect to such action or claim.
Non -Waiver of Defaults
ANY FAILURE OF DPSITHSSAA, AT ANY TIME, TO ENFORCE OR REQUIRE THE STRICT KEEPING AND PERFORMANCE OF ANY
PROVISION OF THIS AGREEMENT WILL NOT CONSTITUTE A WAIVER OF SUCH PROVISION, AND WILL NOT AFFECT OR IMPAIR
SAME OR THE RIGHT OF DPS/THSSAA AT ANY TIME TO AVAIL ITSELF OF SAME. A WAIVER DOES NOT BECOME EFFECTIVE
UNLESS DPS/THSSAA EXPRESSLY AGREES TO SUCH WAIVER IN WRITING. ANY PAYMENT BY DPS/THSSAA SHALL NOT
CONSTITUTE A WAIVER OR OTHERWISE IMPAIR OR PREJUDICE ANY RIGHT, POWER, PRIVILEGE, OR REMEDY AVAILABLE TO
DPS/THSSAA TO ENFORCE ITS RIGHTS, AS SUCH RIGHTS, POWERS, PRMLEGES, AND REMEDIES ARE SPECIFICALLY
PRESERVED.
AS PERMITTED BY LAW, SUB -RECIPIENT SHALL INDEMNIFY, DEFEND AND HOLD DPS/THSSAA AND THE STATE OF TEXAS
ROM AND AIGAINST ANY OF THE FOLLOWING THAT ARSEEMPLOYEEOUT OF OR RESULT FROM SUB- ECIIPfAGENTS AND THEIR SUCCESSORS)ENT'S NEGLIGEINDEMNITEES-NCE (ANY SS
AND ALL), FAULT, ACT, FAILURE TO ACT, OMISSION, BREACH OF THIS AGREEMENT OR VIOLATION OF ANY STATE OR
FEDERAL LAW AND/OR REGULATION, AS WELL AS ANY VIOLATION OF ANY MATTER MADE THE BASIS OF A TREATY AND/OR
CONVENTION AND/OR AGREEMENT BETWEEN THE UNITED STATES AND ANOTHER NATION: CLAIMS; LAWSUITS; DAMAGES;
LIABILITIES; PENALTIES; TAXES; FINES; INTEREST; EXPENSES (INCLUDING, WITHOUT LIMITATION, ATTORNEYS' FEES, COURT
COSTS, INVESTIGATION COSTS AND ALL DIRECT OR INDIRECT COSTS OR EXPENSES INCURRED IN DEFENDING AGAINST ANY
CLAIM, LAWSUIT, OR OTHER PROCEEDING, INCLUDING THOSE EXPENSES INCURRED IN ANY NEGOTIATION, SETTLEMENT, OR
ALTERNATIVE DISPUTE RESOLUTION? ANY AND ALL DAMAGES, HOWEVER CHARACTERIZED, SUCH AS DIRECT, GENERAL,
INCIDENTAL, INDIRECT, CONSEQUENTIAL, PUNITIVE, OR SPECIAL DAMAGES OF ANY KIND (INCLUDING LOST REVENUES OR
PROFITS, LOSS OF BUSINESS, LOSS OF USE, OR LOSS OF DATA) ARISING OUT OF OR IN CONNECTION WITH OR RELATED TO
THIS AGREEMENT OR THE RIGHTS PROVIDED THEREIN.
IN ANY AND ALL CLAIMS AGAINST ANY OF THE INDEMNITEES BY ANY EMPLOYEE OF THE SUB -RECIPIENT OR ANY EMPLOYEE
OF ITS SUBCONTRACTOR(S , THE INDEMNIFICATION OBLIGATION UNDER THIS AGREEMENT WILL NOT BE LIMITED IN ANY WAY
BY THE AMOUNT OR TYPE 8F DAMAGES, COMPENSATION, OR BENEFITS PAYABLE BY OR FOR THE SUB -RECIPIENT OR ANY
OF ITS SUBCONTRACTOR(S) UNDER WORKER'S DISABILITY COMPENSATION ACTS, DISABILITY BENEFITS ACTS, OR OTHER
EMPLOYEE BENEFITS ACTS.
SUB -RECIPIENT SHALL COORDINATE ITS DEFENSE AND ANY SETTLEMENT WITH THE ATTORNEY GENERAL FOR THE STATE
OF TEXAS AS REQUESTED BY THE DPS/THSSAA. IN ANY SETTLEMENT, SUB -RECIPIENT MUST NOT MAKE ANY ADMISSION OF
LIABILITY ON THE PART OF ANY OF THE INDEMNITEES.
THIS SECTION SHALL NOT BE CONSTRUED TO ELIMINATE OR REDUCE ANY OTHER INDEMNIFICATION, CONTRIBUTION OR
RIGHT WHICH ANY OF THE INDEMNITEES HAVE BY LAW OR EQUITY.
THIS SECTION SHALL SURVIVE THE TERMINATION OR EXPIRATION OF THIS AGREEMENT.
Changes and Amendments
Modification. FEMA or the DPS/THSSAA may change the award document after an award has been made. Once notification has been
made in writing, any subsequent request for funds indicates sub -recipient's acceptance of the changes to the award.
Written Amendment. Aterations, additions or deletions to this Sub -recipient agreement's terms, such as changes to period of performance
and award amounts, will be made through Grant Adjustment Notices generated by the DPSfTHSSAA web -based grants management
system and executed by the Parties.
Authg2ty to Amend. During the period of this Sub -recipient agreement's performance DPSfTHSSAA and/or FEMA may issue policy
directives that serve to establish, interpret or clarify this Sub -recipient agreement's performance requirements. Such policy directives shall
be promulgated by DPS/THSSAA or FEMA in the form of Information Bulletins and Sub -recipient Manuals and shall have the effect of
qualifying this Sub -recipient agreement's terms and shall be binding upon the Sub-redpient as if written in the Sub -recipient agreement.
Effect of Chances in Federal and State Laws. Any alterations, additions, or deletions to the Sub -recipient agreement's terms that are
required by the changes in federal and state laws or regulations are automatically incorporated into this Sub -recipient agreement without
written amendment to this Sub -recipient agreement and shall become effective on the date designated by such law or regulation. In the
event FEMA or DPS/THSSAA determines that changes are necessary to the award document after an award has been made, including
changes to period of performance or terns and conditions, recipients will be notified of the changes in writing. Once notification has been
made, any subsequent request for funds will indicate sub -recipient acceptance of the changes to the award.
Initial Date A 2 ' .l Z
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HAM=
Headings and captions of this Sub -recipient agreement's sections and paragraphs are only for convenience and reference. These headings
and captions shall not affect or modify this Sub -recipient agreement's terms or be used to interpret or assist in the construction of this
Sub -recipient agreement.
V ue
For purposes of litigation pursuant to this Sub -recipient agreement, venue shall lie in Travis County, Texas, and be governed by Texas Law.
DUNS Number. Sub -recipient confirms its Data Universal Numbering Systems Number (DUNS) is the number listed on the Sub -recipient
agreement award. Data Universal Numbering System (DUNS) number means the nine digit number established and assigned by Dun and
Bradstreet, Inc., at 866/705-5711 or http://fedgov.dnb.00m/webform.
Central Contractor Rggistration ang Universal Identifier Requirements, Sub -recipient maintains that it has registered on www.ocr.gov, and
entered DPS/THSSAA-required information. See SAA Information Bulletin. Sub -recipient will keep current, and then review and update the
CCR information at least annually, at the beginning of September of each year. Sub -recipient will keep information current in Central
Contractor Registration database until the later of when it submits this grants final financial report or receives final grant award payment.
Sub -recipient agrees that it will not make any subaward agreement or contract related to this award without first obtaining the
vendor/subawardee's mandatory DUNS number. See section .210 of OMB Circular A-133, Audits of States, Local Governments, and
Non-profit Organizations.
Reporting Total Compensation of Sub -recipient Executives_ 2 CFR 170.320; see FEMA Information Bulletin 350; SAA Information Bulletin.
1. Applicability and what to report: Sub -recipient must report whether Sub -recipient received $25 million or more in Federal procurement
contracts or financial assistance subject to the Transparency Act per 2 CFR 170.320. Sub -recipient must report whether 80% or more of
Sub -recipient's annual gross revenues were from Federal procurement contracts or Federal financial assistance. If Sub -recipient answers
yes" to both questions, Sub -recipient must report, along with Sub -recipient's DUNS number, the names and total compensation (see 17
CFR 229.402(c)(2)) for each of the Sub -recipient's five most highly compensated executives for the preceding completed fiscal year.
2. Where and when to report. Sub -recipient must report executive total compensation at By signing this agreement
Sub -recipient is certifying that, if required, Sub -recipient's jurisdiction has already registered, entered required information, and agrees to
keep information in the Central Contractor Registration database current, and update the information at least annually at the beginning of
September for each year until the later of when the jurisdiction submits its final financial report or receives final payment Sub -recipient
agrees that it will not make any subaward agreement or contract without first obtaining the subawardee's mandatory DUNS number.
Contract Provisions_ All contracts executed under this award will contain the contrail provisions listed under 44 CFR 13.37(b), Uniform
Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments.
No Contracts with Debarred or Suspended Parties. Prior to contracting with any vendor or subawardee, the Sub -recipient will determine
whether the vendor/subawardee is debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded by any federal
department and agency and will confirm the vendor/subawardee does not appear in the Excluded Parties List System, currently at
www.epis.gov./search-do.
Direct Deposit. Since September 1, 2011, Sub —recipient has either forwarded or is currently forwarding to DPS an updated direct deposit
form currently available at http:Nwww.window.state.tx.us/taxinfo/taxformsl74-176.pdf. Sub -recipient may simultaneously sign up for the
Advance Payment Notification email feature which provides state of Texas payees with a one -business -day advance notice that a direct
deposit payment has been sent to their financial institution. After receiving an APN, payees may securely access their payment details online.
Points of Contacts. Within 30 days of any change, Sub -recipient will enter, confirm, and/or correct the chief elected official, program,
and/or financial points of contact in the DPS1THSSAA grant management system.
Publications. All publications produced as a result of this funding, which are submitted for publication in any magazine, journal, or trade
paper shall carry the following: 'This material is based upon work supported by the U.S. Department of Homeland Security. The views and
conclusions contained in this document are those of the authors and should not be interpreted as necessarily representing the official
policies, either expressed or implied, of the U.S. Department of Homeland Security."
Quartedy Performance Reports The sub -recipient will submit performance reports and progress reviews per DPSITHSSAA andlor FEMA's
direction. Currently most reports are entered into the grants management system. For Homeland Security Grant Program, Emergency
Operations Center Grant Program, Regional Catastrophic Preparedness Grant Program and Non-profit awards performance reports are
currently due on each January 20, April 20, July 20 and October 20. The final report is to be filed the quarter after the end of Sub -recipients
performance period. Failure to timely complete performance reports will result in the Sub -recipient being unable to request additional
reimbursements/advances.
Controlled Unclassified Information. Some information and materials provided pursuant to or resulting from this Award may be export
controlled, sensitive, for official use only or otherwise protected by law, executive order or regulation. The sub -recipient is responsible for
compliance with at applicable laws and regulations.
Initial 4122 Date
Page 7 OF 19
Sub -recipients of this award shall use their own security procedures and protections to protect Sensitive Information
received or distributed under this Award. The sub -recipient shall also establish procedures to provide reasonable assurance that no
Sensitive information will be developed or generated under this award. Such security procedures should indude procedures (e.g., security
check forms, type of background chedcfinvestigabons performed (if necessary) and requirements for successful adjudication of the type of
background checkrinvestigations performed) to determine the suitability of sub -recipients' personnel requiring recurring access to
goverment facilities or access to Sensitive Information provided under this award. A copy of the security procedures and any proposed
Non -Disclosure Agreement for the sub -recipients' personnel shall be submitted to the DPS/THSSAA within two (2) weeks after signing this
agreement_ The sub -recipient will be notified of any concerns that may be identified once the security procedures are forwarded and
reviewed by OHS.
Sensitive Information. Work under this award may involve access to Sensitive Information from the Federal Goverment Therefore, the
sub -recipient shall not disclose, orally or in writing, any Sensitive Information to any person unless authorized in writing by the DHS Grants
Officer. Further, the sub -recipient shall ensure that Sensitive Information is protected in such a manner that it is safeguarded from public
disclosure in compliance with local, state or Federal laws and with sub-redpienTs security procedures. For those sub -recipient personnel
authorized access to Sensitive Information, the sub -recipient must ensure that these persons receive training concerning the protection and
disclosure of Sensitive Information both during and after the period of performance.
Public Dissemination of Sensitive Information. The sub -recipient will notify the DPS/THSSAA of any workshops, conferences, seminars or
other public venues at least 100 days before presenting any potentially sensitive information regarding this pro ed. No Sensitive
Information may be presented by the sub -recipients' personnel without DPS/THSSAA and DHS Grants Officers review and prior written
approval.
Securitv Concerns/Violations, The sub -recipient shall inform the THSSAA's Deputy Assistant Director in writing within two (2) days of the
sub-redpient being made aware of any security concerns with individuals having access to govemment facilities or Sensitive Information. In
the event that Sensitive Information is divulged in violation of sub -recipient's security procedures, the sub -recipient will immediately notify
the DPS/THSSAA Deputy Assistant Director and take appropriate law enforcement and legal action.
Site'Osits. The DHS and/or DPS/THSSAA, through authorized representatives, has the right, at all reasonable times to make site visits to
review project accomplishments and management control systems and to provide such technical assistance as may be required. If any site
visit is made by the DHS on the premises of the sub -recipient, or a contractor under this Award, the sub -recipient shall provide and shall
require its contractors to provide all reasonable facilities and assistance for the safety and convenience of the Goverment representatives
in the performance of their duties. All site visits and evaluations shall be performed in such a manner that will not unduly delay the work -
Use of DHS. DP - and PPSrTHSSAA Seals and Non -Endorsement. The sub -recipient shall obtain the respective agency's prior written
approval before using either agencies' seal. Funding of this Award does not equate to endorsement of use of funding agencies' seals.
Initial Date
Va"s OF is
1) Trafficking In Person and Commercial Sex Act Prohibition
a) Provisions applicable to a sub -recipient that is a private entity.
i) A sub -recipient and/or the sub -recipient's employees, may not:
(1 Engage in severe forms of trafficking in persons during the period of time that the award is in effect;
(2 Procure a commercial sex act during the period of time that the award is in effect; or
(3) Use forced labor in the performance of the award or sub -award under this award_
ii) DPSITHSSAA or FEMA may unilaterally terminate this award, without penalty, if the sub -recipient that is a private entity:
(1) is determined to have violated a prohibition in paragraph 1a of this award term; or
(2) Has an employee who is determined by an agency official authorized to terminate the award to have violated a prohibition of this
award term through conduct that is either.
(a) Associated with performance under this award; or
(b) Imputed to the sub -recipient using the standards and due pprocess for imputing the conduct of an individual to an organization that
are provided in 2 CFR Part 180, 'OMB Guidelines to Agencies on Govemment Debarment and Suspension (Non -procurement),' as
implemented at 2 CFR Part 3000.
b) Provisions applicable to a sub -recipient that is not a private entity.
i) THSSAA may unilaterally terminate this award, without penslry, if the sub -recipient:
ii) Is determined to have violated a prohibition in paragraph 1a of this award term; or
iii) Has an employee who is determined by the agency official authorized to terminate the award to have violated an applicable
prohibition in paragraph a1 of this award term through conduct that is either:
�1 Assocatec wdh performance under this award: or
2� Imputed to the sub -recipient using the standards and due process for imputing the conduct of an individual to an organization that
are provided in 2 CFR Part 180, 'OMB Guidelines to Agencies on Government Debarment and Suspension (Non -procurement),' as
im lemernted at 2 CFR Part 3000.
c Provisions applicable to any recipient:
i) A Sub -recipient must inform the DPS/THSSAA immediately of any information it received from any source alleging a violation of a
prohibition in pparaaggraph a1 of this award term.
ii) DPSITHSSAA's right to terminate unilaterally is described in I or 2 of this section:
�1) Implements section 106(g) of the Trafficking Victims Protection Act of 2000 (fVPA), as amended (22 U.S.C. 7104 (g)), and
2) Is in addition to all other remedies for noncompliance that are available to DpPS/THSAA under this award.
iii) Sub -recipient must include the requirements of 1a of this award term in any sub -award the sub -recipient makes to a private entity.
d) Definitions, For purposes of this award term.
i) "Employee' means either.
#1 An individual employed by a sub -recipient who is engaged in the performance of the projector program under this award: or
2� Another person engaged in the performance of the project or program under this award and not compensated by Sub -recipient
including, but not limited to, a volunteer or individual whose services are contributed by a third party as an in -kind contribution toward cost
sharing or matching requirements.
ii) Forced labor' means labor obtained by any of the following methods: the recruitment, harboring, transportation, provision, or
obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude,
peonage, debt, bondage, or slavery.
iii 'Private entity means:
1) Any entity other than a State, local government, Indian Tribe, or foreign public entities, as those terms are defined in 2 CFR 176.25.
2jj Includes:
(a) A non-profit'organization, including any nonprofit institution of higher education, hospital, or tribal organization other than one
inducted in the definition of Indian Tribe at 2 CFR 175.25(b).
(b) A for -profit organization
iv) "Severe forms of trafficking in persons,' "commercial sex act,' and "coercion' have the meaning given at section 103 of the TVPA, as
amended (22 U.S.C. 7102).
2)
a) 'Classified national security information' as defined in Executive Order (EO) 12958, as amended, means information that has been
determined pursuant to EO 12958 or any predecessor order to require protection against unauthorized disclosure and is marked to indicate
its classified status when in documentary form.
b) No funding under this award shall be used to support a contract, sub -award, or other agreement for goods or services that will include
access to dassifred national security information if the award recipient has not been approved for that access to such information
c) Where an award recipient has been approved for and has access to classified national security information, no funding under this
award shall be used to support a contract, sub -award, or other agreement for goods or services that will include access to classified national
security information by the contractor, sub-awardee, or other entity without prior written approval from the OHS Office of Security, Industrial
Security Branch Program (ISBP), or an appropriate official within the Federal department or agency with whom the classified effort will be
performed.
d) Such contracts, sub -awards, or other agreements shall be processed and administered in accordance with the DHS ' Standard
Operation Procedures, Classified Contracting by States and Local Entities,' dated July 7, 2008: EO's 12829, 12959, 12968, as amended;
the National Industrial Security Program Operating Manual (NISPOM); and for other applicable implementing directives or instruction. All
security requirement documents are currently located at http;/Mrww.dhs/gov/xopnbiz/grantsrindex_shtm.
e) Immediately upon determination by the award recipient that funding under this award will be used to support such a contract,
sub -award, or other agreement, and prior to execution of any action to facilitate the acquisition of such a contract sub -award, or other
agreement, the award recipient shall contact ISPB, or the appropriate Federal department or agency, for approval and processing
instructions. DHS Office of Security ISPB contact information: Telephone: 202-447-5346, Email: D254AdministrabveSecubidhs.gov, Mail:
Department of Homeland Security, Office of the Chief Security Officer, ATTN: ASDAndustrial Security Program Branch, Washington, DC. 20528
Initial Date /I L-
Page 9 OF Is
Operation Stonegarden (QPSG) Snecific Condition
The OPSG Sub -recipient is prohibited from obligating or expending Operation Stonegarden (OPSG) funds provided through this award until
each unique, specific, or modified county level or equivalent Operational Order/Fra Operation Order with embedded estimated operational
budget has been reviewed and approved through an official email notice issued by FEMA removing this special programmatic condition.
The Operations Order approval processlstructure is as follows: Operations Orders are submitted to (1) THE APPROPRIATE Customs and
Border Productions JCBP) Border Patrol (BP) Sector Headquarters (HQ) upon approval by the Sector HQ, forwarded through the Border
Patrol Enforcement ransfer System (BPets) system to (2) the OPSG Coordinator, CBP/BP Washington, DC and upon approval forwarded
to (3) Federal Emergency Management Agency (FEMA), Grant Program Directorate (GPD), Grant Development and Administrative Division
(GD&A). Notification of release of programmatic hold will be sent by FEMA via email to the Texas Homeland Security State Administrative
Agency (THSSAA) with a copy to OPSG Coordinator at CBP/BP HQ, Washington DC.
meMancft Qjwradens Center Grant Program (EQCGP) Specific Condition
The Sub -recipient is prohibited from obligating, expending or drawing down EOCGP funds provided through this award until the required
budget and budget narrative are reviewed and approved by FEMA and an official notice has been issued from FEMA removing this special
condition.
Regional Catast=hk t par, dness G nra t Progiam (RCPGP Sgecfc Condition
The Sub -recipient is prohibited from obligating or expending RCPGP funds provided through this award until the required budget and budget
narrative are approved by FEMA and this condition is rescinded. In addition, the Sub -recipient is prohibited from obligating or expending
RCPGP funds provided through this award until ❑HS/FEMA has provided signed approval of the project narrative and project plans to the
Sub-reopient
State Requirements for Grants
Sub -recipient shall also comply with all other federal, state, and local laws and regulations applicable to this Sub -recipient agreement's
activities and performances rendered by the Sub -recipient including but not limited to the laws and the regulations promulgated in Texas
Government Code Chapter 783, Uniform Grant and Contract Management Code: State Administrative Agency Information Bulletins,
currently available at http://www..Lxdps,state.tx.ustdirector staff/saalinformation bullstins.htm. Texas Uniform Grants Management
Standards (UGMS) currently at governor.state.tx.uslfileststate-grants!?UGMS062004.doc; and the State Administrative Agency
Sub -recipient Manual, currently available at r ientManualildt
Sub -recipients) must, in addition to the assurances and certifications, comply and require each of its subcontractors employed in the
completion of the project to comply with all applicable statutes, regulations, executive orders, OMB circulars, terms and conditions of the
award, and the approved application.
The Sub -recipient will follow Texas General Appropriations Act, Art_ IX, section 4.05 which requires conforming with:
a) Texas General Appropriations Ad, Art IX, Parts 2 and 3 of the General Appropriations Act, except there is no requirement for
increased salaries for local government employees;
b) Texas Government Code section 556.004, 556.005, and 556.006 including not using any money or vehicle to support the candidacy of
any person for office; not influencing positively or negatively the payment, loan, or gift to a person or political organization for a political
purpose; and not using grant funds to influence the passage or defeat of a legislative including not assisting with the funding of a Lobbyist,
or using grant funds to pay dues to an organization with a registered Lobbyist;
c Texas Government Code section 2113.012 and 2113.101 including not using grant funds to compensate any employee who uses
akoholic beverages on active duty plus Sub-redpient may not use grant funds to purchase an alcoholic beverage and may not pay or
reimburse any travel expense for an alcoholic beverage;
d) Texas General Appropriations Act, Art IX, section 6.13 requiring Sub -recipients to make every effort to attain key performance target
levels associated with this grant award, including performance milestones, milestone time frames, and related performance reporting
requirements; and
e) General Appropriations Ad, Art. IX, section 7.01, 7.02, and 7.03 and Texas Government Code § 2102.0091, including grants funds
may only be expended if the Sub-redpient timely completes and files its reports.
Please fill In the appropriate information and sign.
Print Name of Authorized Official Tom Martin
Title Mayor- The City of Lubbock
Sub-redpient Organization The City of -Lubbock. -Texas %%��j
4?,P7 00� 1/Z,-I)L—
Signature of Authorized Official Date
Initial Date .
Page 10 OF 10
Resolution No. 2012—R0076
EXHIBIT A
ASSURANCES - NON -CONSTRUCTION PROGRAMS See Standard Form 4248
As the duly authorized representative of the sub -recipient, I certify that the sub -recipient:
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 cost) to ensure proper planning, management and completion of the project described in this
agreement.
2. Will give the Department of Homeland Security, the Department of Public Safetythe 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 or organizational conflict of interest, or 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. §§4728-4763) relating to prescribed standards for merit
systems for programs funded under one of the 19 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) Trtie 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) Tile IX of the Education Amendments
of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1685which prohibits discrimination on the basis of sex; (c) Section 504 of the
Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps (d) the Age
Discrimination Act of 1975, as amended (42 U.S.C. §§6101-610T), 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) §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C.
§§290dd-3 and 290ee- 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights
Act of 1968 (42 U.S.C. §§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 agreement for Federal assistance is being made; and, 0) 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 Titles 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 interests in real property acquired for project
purposes regardless of Federal participation in purchases.
8. Will comply, as applicable, with provisions of the Hatch Act (5 U.S.C. §§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. §§276a to 276a-7), the Copeland Act (40 U.S.C.
9276c and 18 U.S.C. §874), and the Contract Work Hours and Safety Standards Act (46 U.S.C. §§327-333), regarding labor standards for
federally -assisted construction sub -agreements.
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.
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) 11614; (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; assuranceof protect consistency with the approved State management program developedunder the
Coastal Zone Management Z of 1972 (16 U.S.C. §§1451 et seq.); (1) 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. §§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. §§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. §§4801 et seq.) which prohibits the use of lead -based paint
in construction or rehabilitation of residence structures.
17, Wiil cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996
and OMB Circular No. Ar133, "Audits of States, Local Governments, and Non -Profit Organizations."
Initial Date r 2 /7•/ 2-
Page I OF IS
18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations, grant guidance, and policies
goveming this program.
Please fill in the appropriate information and sign.
Print Name of Authorized Official Tom Martin
Title Mayor — The City of Lubbock
Sub -recipient Organization The City of Lubbock, Texas
Sign re of Authonz Official Date
Initial Date 1 w i- 1i'j 1'
Page 12 Of 18
Resolution No. 2012—R0076
EXHIBIT B
ASSURANCES - CONSTRUCTION PROGRAMS
As the duly authorized representative of the sub -recipient, I certify that the sub -recipient:
1. Has the legal author to apply for Federal assistance, and the institutional, managerial and financial capability (including funds
ffi sucient to pay the non -Federal share of project costs) to ensure proper planning, management and completion of project described in this
agreement
2. Will give the Department of Homeland Security, the Department of Public Safety, the Comptroller General of the United States and, if
appropriate, the State, the right to examine all records, books, papers, or documents related to the assistance; and will establish a proper
accounting system in accordance with generally accepted accounting standards or agency directives.
3. Will not dispose of, modify the use of, or change the terms of the real Property title or other interest in the site and facilities without
permission and instructions from the awarding agen . Will record the Federal awarding agency directives and will include a covenant in the
Ube of real property acquired in whole or in part with7ederal assistance funds to assure nondiscrimination during the useful life of the project.
4. Will comply with the requirements of the assistance awarding agency with regard to the drafting, review and approval of construction
plans and specifications.
5. Will provide and maintain competent and adequate engineering supervision at the construction site to ensure that the complete work
conforms with the approved plans and specifications and will famish progressive reports and such other information as may be required by
the assistance awarding agency or State.
6. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
7. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of
personal or organizational conflict of interest, or personal gain_
8. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§4728-4763) relating to prescribed standards of merit
systems for programs funded under one of the 19 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).
9. WiN comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §§4801 et seq.) which prohibits the use of lead -based pain
in construction or rehabilitation of residence structures.
10. 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. §§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. 794), which prohibits discrimination on the basis of handicaps; (d) the Age
Discrimination Act of 1975, as amended (42 U.S.C. W101-6107), 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) §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C.
6§290dd-3 and 290ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Tide Vill of the Civil Rights
Act of 1968 (42 U.S.C_ §§3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other
nondisuimination provisions in the specific statue(s) under which agreement for Federal assistance is being made; and 0) the requirements
of any other nondiscrimination statue(s) which may apply to the agreement.
11. Will comply, or has already complied, with the requirements of Titles 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 and federally -assisted programs. These requirements apply to all interests in real property acquired for
project purposes regardless of Federal participation in purchases.
12. Will comp)y with the provisions of the Hatch Act (5 U.S.C. §§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.
13. Will comply, as applicable, with the provisions of the Mavis -Bacon Act (40 U.S.C. §S276a to 276a-7), the Copeland Act (40 U.S.C.
§276c and 18 U.S.C. §874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§327- 333) regarding labor standards for
federally -assisted construction sub -agreements_
14. Will comply 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.
15. 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. §§1451 et seq.); (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. § 7401 et seq.); (g) protection of underground sources of
drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-52 ); and, (h) protection of endangered species under the
Endangered Species Act of 1973, as amended (P.L. 93-205).
16. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§1271 et seq.) related to protecting components or potential
components of the national Mid and scenic rivers system.
17, 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 1159 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of
1974 (16 U.S.C. §§469a-1 et seq).
Initial Date�—
Page 13 or is
18. Wil1 cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996
and OMB Circular No. A-133, "Audits of States, Local Governments, and Non -Profit Organizations."
19. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations, grant guidance and policies
governing this program.
Please fill in the appropriate information and sign.
Print Name of Autfiorized Official Tom Martin
Title Mayor— The City of Lubbock
Sub -recipient Organization The City of Lubbock. Texas
Signature of Authorized Official Date
Initial Date
Page 14 If 19
Exhibit C
Resolution No. 2012—R0076
Certifications
The undersigned, Tom Martin (print), as the authorized official of The City of Lubbock, 'E14rtifies the following
to the best of his/her n ge an a ie .
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 an agency, a Member of Congress, an officer or employee of Congress, or an employee
or 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, of 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 or a Member
of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard Form-LLL Disclosure of Lobbying Activities, in accordance with its instructions.
C. The undersigned shall require that the language of this certification prohibiting lobbying be included in the award documents for all
sub -awards at ail tiers (including subcontract, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all
sub -recipients shall certify and disclose accordingly. This certification is a material representation of fad upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction
imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not
less than $10,000 and not more than $100,000 for each such failure.
D. As required by Executive Order 12549, Debarment and Suspension, and implemented at 28 C.F.R. Part 67, for prospective participants
in primary covered transactions, as defined at 28 C.F.R. Part 67, Section 67.510. (Federal Certification). The Sub -recipient certifies that it
and its principals and vendors:
1. Are not 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; Sub -recipients can access
debarment information by going to wv mepls.00v and the State Debarred Vendor List
4vww.window.state. .uslorocurementtnroo/yendor performance/debarred.
2. Have not within a three-year period preceding this agreement been convicted of or had a civil judgment rendered against them for
commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing 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;
3. Are not presently indicted for or otherwise criminally or civilly charged by a govemmental entity (Federal, State, or local) with
commission of any of the offenses enumerated in paragraph (D)(2) of this certification; and
4. Have not within a three-year period preceding this agreement had one or more public transactions (Federal, State, or local)
terminated for muse or default; or
5. Where the sub-reaplent is unable to certify to any of the statements in this certification, he or she shall attach an explanation to this
agreement (Federal Certification)
E. The Sub -recipient certifies federal funds will be used to supplement existing funds, and will not replace (supplant) funds that have been
appropriated for the same purpose. Sub -recipient may be required to supply documentation certifying that a reduction in non-federal
resources occurred for reasons other than the receipt or expected receipt- of federal funds.
F. Sub -recipient must comply with 2 CFR Part 180 Subpart C as a condition of receiving grant funds, and sub -recipient must require such
compliance in any sub -grants or contract at the next tier.
G. Drug -free Workplace Act, as amended, 41 U.S.C. §701 et seq. — Requires the recipient to publish a statement about its drug -free
workplace program and give a copy of the statement to each employee (mduding consultants and temporary personnel) who will be
involved in award -supported activities at any site where these activities will be carried out. Also, place(s) where work is being performed
under the award (i.e., street address, City, state, and zip code) must be maintained on file. The recipient must notify the Grants Officer of
any employee convicted of a violation of a criminal drug statute that occurs in the workplace. For additional information, see 44 CFR Part 17.
H. Sub -recipient agrees that it is not delinquent on any Federal debt
I. Sub -recipient will comply with all applicable requirements of all other federal laws, executive orders, regulations, program and
administrative requirements, policies and any other requirements goveming this program.
Initial Date
Page 15 OF 18
J. Sub -recipient understands that failure to comply with any of the above assurances may result in suspension, termination or reduction of
grant funds.
Please fill in the appropriate information and sign.
Print Name of Authorized Official Tom Martin
Title Mayor - The City of Lubbock
Sub -recipient Organization The CIty of Lubbock, Texas
T -�
Date
Initial Date - .1 Z
Pepe 16 OF 18
EXHIBIT D Resolution No. 2012—R0076
State of Texas Assurances
As the duly authorized representative of the sub -recipient, I certify that the sub -recipient
1. Nil comply with Texas Government Code, Chapter 573, by ensuring that no officer, employee, or member of the applicants governing
body or of the applicant's contractor shall vote or confirm the employment of any person related within the second degree of affinity or the
third degree of consanguinity to any member of the governing body or to any other officer or employee authorized to employ or supervise
such person. This prohibition shall not prohibit the employment of a person who shall have been continuously employed for a period of two
years, or such other period stipulated by local law, prior to the election or appointment of the officer, employee, or governing body member
related to such person in the prohibited degree.
2. Must insure that all information collected, assembled, or maintained by the applicant relative to a project will be available to the public
during normal business hours in compliance with Texas Government Code, Chapter 552, unless otherwise expressly prohibited by law.
3. Must comply with Texas Government Code, Chapter 551, which requires all regular, special, or called meetings of governmental bodies to
be open to the public, except as otherwise provided by law or specifically permitted in the Texas Constitution.
4. Must comply with Section 231.006, Texas Family Code, which prohibits payments to a person who is in arrears on child support payments
5. Will not contract with or issue a license, certificate, or permit to the owner, operator, or administrator of a facility if the subgrantee is a
health, human services, public safety, or law enforcement agency and the license, permit, or certificate has been revoked by another health
and human services agency or public safety or law enforcement agency.
6. Must comply with all rules adopted by the Texas Commission on Law Enforcement Officer Standards and Education pursuant to Chapter
1701, Texas Occupations Code or must provide the grantor agency with a certification from the Texas Commission on Law Enforcement
Officer Standards and Education that the agency is in the process of achieving compliance with such rules if the subgrantee is a law
enforcement agency regulated by Texas Occupations Code, Chapter 1701,
7. Will follow all assurances. When incorporated into a grant award or contract, standard assurances contained in the application package
become terms or conditions for receipt of grant funds. Administering state aggencies and local subrecipients shall maintain an appropriate
contract administration system to insure that all terms, conditions, and specifications are met. (See UGMS Section ___.36 for additional
guidance on contract provisions).
B. Must comply with the Texas Family Code, Section 261.101, which requires reporting of all suspected cases of child abuse to local law
enforcement authorities and to the Texas Department of Child Protective and Regulatory Services. Subgrantees shall also ensure that ali
program personnel are properly trained and aware of this requirement.
9. 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_ 86-352), 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. §§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. §794). which prohibits discrimination on the basis of handicaps and the Americans with
Disabilities Act of 1990; (d) the Age Discrimination Act of 1974, as amended (42 U.S.C. §§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, relatinto nondiscrimination on the basis of
drug abuse; ( the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabi itation Act of 1970 (P.L. 91-616), as
amended, relating to the nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§523 and 527 of the Public Health Service Act
of 1912 (42 U.S.C.§§§290dd-3 and 290ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title All
of the Civil Rights Act of 1968 (42 U.S.C. §§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 0) the requirements of any other nondiscrimination statute(s) which may apply to the application.
10. Will corn as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C_ G276a to 276a-7), the Copeland Act (40 U.S.C. §276c
and 18 U.S, §874), and the Contract Work Hours and Safety Standards Act (40 U.S. . §§327-333), regarding labor standards for
federally assisted construction subagreements.
11. Will comply with requirements of the provisions of the Uniform Relocation Assistance and Real Property Acquisitions 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 interests in real property acquired for project purposes regardless of Federal
participation in purchases.
12. Nil comply with the provisions of the Hatch Political Activity Act (5 U.S.C. §§7321-29), which limit the political activity of employees
whose principal employment activities are funded in whole or in part with Federal funds.
13, Will oomply with the minimum wage and maximum hours provisions of the Federal Fair Labor Standards Act and the Intergovernmental
Personnel Act of 1970, as applicable.
14. Will insure that the facilities under its ownership, lease, or supervision which shall be utilized in the accomplishment of the project are
not listed on the Environmental Protections Agency's (EPA) list of Violating Facilities and that it will notify the Federal grantor agency of the
receipt of any communication from the Director of the EPA Office of Federal Activities indicating that a facility to be used in the project is
under consideration for listing by the EPA (EO 11738).
Initial Date ar
rage i? of is
15. Will comply with the flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973, Public Law
93-234. Section 102(a) requires the purchase of flood insurance in communities where such insurance is available as a condition for the
receipt of any Federal financial assistance for construction or acquisition proposed for use in any area that has been identified by the
Secretary of the Department of Housing and Urban Development as an area having special flood hazards.
16. 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 opproject consistency with the approved state management program developed under the
Coastal Zone Management Act of 1972 (16 U.S.C. §§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. §§7401 et sect.); (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).
17. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U_S.C. §§1271 et seq.) related to protecting components or potential
components of the national wild and scenic rivers system.
18. 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.).
19. 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.
20. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U_S.C. §§4801 et seq.) which prohibits the use of lead -based paint
in construction or rehabilitation of residential structures.
21. Will comply with Public Law 103-277, also known as the Pro -Children Act of 1994 (Act), which prohibits smoking within any portion of
any indoor facility used for the provision of services for children as defined by the Act
22. Will comply with all federal tax laws and are solely responsible for filing all required state and federal tax forms.
23. Will comply with all applicable requirements of all other federal and state laws, executive orders, regulations, and policies governing this
program.
24. Certifies that is and its principals are eligible to participate and have not been subjected to suspension, debarment, or similar ineligibility
determined by any federal, state, or local governmental entity and it is not listed on a state or federal government's terrorism watch list as
described in Executive Order 13224. Entities ineligible for federal procurement are listed at httnalwww.ec)ls.aov,
25. Must adopt and impplement applicable provisions of the model HIV/AIDS work place guidelines of the Texas Department of Health as
required by the Texas Health and Safety Code, Ann., Sec. 85.001, et seq.
Please fill in the appropriate information and sign.
Print Name of Authorized Official Tom Martin
Title Mayor — The City of Lubbock
Sub -recipient Organization The City of Lubbock. Texas
! � 7 =-*� - -
Signa re of Authorized Official I— ate
Initial Date Z—
Page Id 6F 15
74-176
""" lRev5-7Vtt1
Vendor Direct Deposit 1 Advance Payment
Notification Authorization
This form may be used by vendors or individual recipients
- to receive payments from the state of Texas by direct deposit
- to change or cancel existing direct deposit information
Transaction Type
Resolution No, 2012-R0076
For ComproAers Use Only
Fa State Agency Use
❑ Advance Payment Notification
❑ International Payments Verification
❑ Interagency Transfer
O❑ New setup (Sections 2, 3, 4 and 5 - Section 6 is optional) ❑ Change account type (Sections 2, 3. 4 and 5 - Section 6 is optional)
r ❑ Change financial institution (Sections 2, 3. 4 and 5 - Section 6 is opt)onal) ❑ Cancellation (Sections 2 and 4 • Sections 7 and 9 for state agency use)
rw ❑ Change account number (Sections 2, 3, 4 and 5 - Section 6 is optional)
Payee Identification
Social Security Number (SSN) or
n Employer Identification Number (EIN)
Z
0 Payee name (Business4ridvlduai)
City of Lubbock
Meiling address
P.O. Box 2000
7,5,6,0,0,0,5,9,0
City
Lubbock
Financial Institution (Completion by financial institution is recommended.)
Mail code
(if not known, leave blank.) I I I I
Phone number
{ 806 } 775-3000 ext.
State I ZIP Code
TX 1 79457
Financial mstituh0n name
ity
Slate
Wells Fargo Bank N.A.
TLubbock
I TX
(n
Routing transit number (9 digits)
Customer edount number (maximum r7 chareders)
Type of account
p0,-
t 0 1 0, 2 14 I- u
14 1 0 1 0 t 0, 01 4 t 7 19 1 5, 1 1 I 1 1 , I I I
Checking ❑ Savings
Financial representative name (optionat)
Title (optional)
UJI
Rains Young
Business RelationshipManor er
Financial representative signature (optional)
Phone number (gxional)
Date (optional)
806 } 767-7473 ext.
Authorization for Setup, Changes or Cancellation (required)
I authorize the Texas Comptroller of Public Accounts to deposit my payments from the state of Texas to my financial institution electronically.
I understand that the Texas Comptroller of Public Accounts will reverse any payments made to my account in error.
zv
0
1 further understand that the Texas Comptroller of Public Accounts will comply at all times with the National Automated Clearing House Association's
0
w
rules. (For further information on these rules, please contact your financial institution.)
to
sign Au1h sig lured,, Primed name
here d Andy eurcham
Date
27 • i�
International Payments Verification (required)
Will these payments be forwarded to a financial institution outside the United StatesT..................................................... ❑ YES VNO
Autnorizauon Tor Aavance Payment NotrTrcation ,etup
I authorize the Texas Comptroller of Public Accounts to send an email notification one business day prior to the payment posting to my account.
0 Contael name (Please pnno Contact phone number
Zane Graham ( 806 } 775-2160 ext-
uj
Email DoorsillIzIgIrIaIhlalmt@ImlyIIIuIblb101c I k 1-I VISI
Cancellation by Agency (forstate agency use)
r` Reason
U
W
to
Authorized Signature (for state aunty use)
Signature
Date
sign
here
aD
Phone number
Agercy nt lber
0
{ } ext.
0
Agency name —
W
to
Comments
Please return your completed form to:
ATTEST:
Rebecca rza, City Secretary
APPROVED AS TO CONTENT:
Mike Kemp, Fire C ief
APPROVED AS TO FORM:
Amy L. Sims, Assistant City Manager
Report:
Region:
Subgrantee:
Grant:
Grant Number:
Report Execution:
Subgrantee Expenditure List
South Plains Association of Governments
City of Lubbock
2011 MMRS
1MMRS006
02/06/2012 09:53 AM CST
Project I
Develop/Enhance interoperable
Communications Systems
(04.MD.03.DISP) Display, Video
(06.0.0I.1)ORT) Radio, Portable
(140.HF.0I.SPSA) Specialist
(120.TP.0I,TRPL) Travel/per diem related to
training activities
Enhance Capabilities to Respond to CBRNE
Events
(09.PH.03.CPR0) Ciprofloxacin
(120.00.01.OTHE) Expenses directly related
to the conduct or attendance of training
(09.MS.0I.TTAG) Tags and Supplies, Triage
Establish/Enhance Mass Care Shelter and
(120.00.0I.OTHE) Expenses directly related
Alternative Medical Facilities Operations
to the conduct or attendance of training
(09.ME.0I.SHEL) Shelter, Medical
Establish/Enhance Regional Response
Teams
(21.GN.00.CCEQ) Equipment, Citizen Corps
(1.40.MP.0I.OFSP) Office supplies expenses
required to directly support planning
activities
(120.TP.0I.TRPL) Travel/per diem related to
training activities
Establish/Enhance a Public Health
(04.AP.03.GISS) System, Geospatial
Surveillance System
, Information (GIS)
FOR OFFICIAL USE ONLY
FOR
Notes Quantity Unit Cost Total Cost AG
Display, Video 1 $5,858.00 $5,858.00 0
OFFICIAL
LE
0
US
EMS-NF
0
Radio, Portable
1
$10,000.00
$10,000.00
0
0
0
Specialist
1
$75,000.00
$75,000.00
0
0
0
Travel/per diem related to training activities
1
$5,000.00
$5,000.00
0
0
0
Ciprofloxacin
1
$21,000.00
$21,000.00
0
0
0
Expenses directly related to the conduct or
attendance of training
1
$67,500.00
$67,500.00
0
0
0
Tags and Supplies, Triage
1
$13,000.00
$13,000.00
0
0
1
Expenses directly related to the conduct or
attendance of training
1
$9,250.00
$9,250.00
0
0
0
Shelter, Medical
1
$15,750.00
$15,750.00
0
0
0
Equipment, Citizen Corps
1
$5,000.00
$5,000.00
0
0
0
Office supplies expenses required to directly
support planning activities
1
$5,000.00
$5,000,00
0
0
0
Travel/per diem related to training activities
1
$10,250.35
$10,250.35
0
0
0
System, Geospatial Information (GIS)
1 1
$25,000.001
$25,000.00
0
0
0
List Total:
$Z67,6O8.35
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