HomeMy WebLinkAboutResolution - 2001-R0144 - Application To Federal Emergency Management Administration For Supplies - 04/26/2001Resolution No. 2001-RO144
April 26, 2001
Item No. 23
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock BE and is hereby authorized and
directed to execute for and on behalf of the City of Lubbock an Application to the
Federal Emergency Management Administration to procure Training Equipment and
Two departmental vehicles to be used by the Lubbock Fire Department and authorizing
the City to allocate $181,185 in matching funds for said Grant, and all related
documents. Said Application 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 26th
day of April , 2001.
DKE, MAYOR PRO TEM
ATTEST:
Rebecca Garza, City Secretary'
APPROVED AS TO CONTENT:
Fire Chief
APPROVED AS TO FORM:
City Attorney
ALS:cp L:1CityattlAmy/FedEmergMngtAdmin-GrantApp.res & ccdocs
April 17, 2001
APPLICATION FOR
Resolution No. 2001-RO144
April 26, 2001
Item No. 2.3
OMB Approval No. 0348.0043
FEDERAL ASSISTANLL 2.
DATE SUBMITTED
Appicant Iderdier
1. TYPE OF SUBMISSION: 3.
DATE RECEIVED BY STATE
State Appicalicn ICentft)er
APPS Preapplicatipn
@Co�� BCon�4.
DATE RECEIVED BY FEDERAL AGENCY
Federal Identifier
Non-Constntation Non-C4xistruction
S. APPLICANT INFORMATION
Legal
OrgWizabonal Unit:
Lubbock -Fire
Address (give any, ="Y. State. and JW -de):
Name and telephone number of person to be contacted 0n matters involving
1515 E. U r s u l i n e
this application (grwe area code)
Lubbock, TX 79408
6. EMPLOYER IDENTIFICATION NUMBER (EIN):
7. TYPE OF APPLICANT: (enter appropWe leder in box)
❑N
A. State H.Independert Sct+ool Dist
B. Carty 1. State Controlled Institution of Higher Learning
S. TYPE OF APPLICATION:
MX New []Continuedon
E]Revision
C. Mtrlicipal J. Private University
D. Township K. Indian Tube
it Revision, enter appropriate Ietter(s) in box(es) M M
E. Interstate L Individual
F. Interm nkipal M. Pro& Organization
A. Increase Award 8. Decrease Award C. Increase Duration
G. Special District N. Other (Specify) fire dept,
D. Decrease Duration Other (specify):
-{}
9. NAME OF FEDERAL AGENCY:
Federal Emergency Management Agency
10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER:
11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT:
TITLE: Firefighters Assistance Grants
12 AREAS AFFECTED BY PROJECT (CXies. Canities, States, etc.):
City of Lubbock
13. PROPOSED PROJECT:
CONGRESSIONAL DISTRICTS OF:
rAqpk-*r*
Start Date
Ending Date
I Prt>ject
15. ESTIMATED FUNDING:
IC IS APPLICiTION SUBJECT TO REVIEW BY STATE EXECUTIVE
ORDER 12372 PROCESS?
a. Federal
S pp
422.765
a. YES. THIS PREAPPUCATIONAPPUCATION WAS MADE AVAILABLE
TO THE STATE EXECUTIVE ORDER 12372 PROCESS FOR
b• Applicant
$ .00
181 85
REVIEW ON:
c. State
$ .00
DATE:
d. Local
f .00
b. No. X PROGRAM IS NOT COVERED BY E.O. 12372
OR PROGRAM HAS NOT BEEN SELECTED BY STATE
e• Other
S .00
FOR REVIEW
L Program k=me
$ .00
17. IS THE APPLICANT DEUW)UENT ON ANY FEDERAL. DEBT?
aYes It 'Y4*,' attach an explanation
9. TOTAL
$ .00
18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPUCATIONIPREAPPLICATION ARE TRUE AND CORRECT, THE
DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE
ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED.
a. Type Name of Authorized Representative
b. Title
. Telephone Number
S11M LEY
FIRE CHIEF
806-775-2630
c.a..... ,...�
e. Date Signed
oto...:.,... __.
Sfrdard Form 424 (Rev. 7-97)
Prescribed by OMB Circular A•102
I . TABLE OF CONTENTS
I. FEMA Form -20, Budget Information ............................................ Pg. 3
Program Narrative and Responses to FEMA ................................... Pg. 4
FEMA Form 20-16 (Summary Sheet for Assurances& Certifications) Pg. 15
IV. FEMA Form 20-16A .............................................................. Pg. 16
VI. FEMA Form 29-16C .............................................................. Pg. 18
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Suggested Format for the
Assistance to Firefighters Grants Program's
Project Narrative
Instructions: Please be sure that your narrative addresses each of the following areas
to the best of your ability. Your narrative should be concise, but brief. If you need more
room than has been allotted for your answer, please use the back of the suggested form
or fee/ free to attach more sheets. Your narrative may ncZt exceed a maximum of r_rvg
pages including this form. The ro'ect narrative must be double spaced.
Applicant Name: C�TRM�NiING
LUBBOCK FIRE DEPARTMENT / VEHICLE
Please describe in full the project that you are requesting to be funded.
SEE BACK OF PAGE
Please provide a detailed description of your planned uses of the grant funds for
each major budget category as listed on the budget form (SF 20-20).
SEE BACK OF PAGE
Please explain why this program would be beneficial to your community and/or to
your department.
SEE BACK OF PAGE
Please explain why this project cannot be
SEE BACK OF PAGE
rnded solely through local fundina.
Please provide any additional relevant information
consider when evaluating your application.
SEE BACK OF PAGE
4
YOU would like us to
PROJECT NARRATIVE
PROJECT DESCRIPTION:
The Lubbock Fire Department is formally requesting funds in the amount of $422,765 to initiate and complete two
deserving projects. Project I is eligible under the FEMA Category of Training which seeks to emend the existing methods
of instruction for the purpose of maximizing training efficiency and the learning experience. Project II is eligible under the
FEMA Category of Vehicles which seeks to replace two (2) departmental units necessitating retirement.
PLANNED USE OF AWARDED FUNDS:
To successfully accomplish our intent, Project I will require the acquisition of items arranged under the following headers:
Streaming Video to 14 Fire Stations
(14) Computers & (14) monitors
$37,800
(1) DVD Writer
$1,250
(1) Media 5 cleaner
$600
Training Academy Props
A two story prefabricated burn house
$200,000
A Pickup and fire extinguisher prop
$7,500
Materials for smoke house maze
$3,000
Technology Update
(3) License fire ground simulation softeware
$3,300
(2) Digital cameras
$1,000
(1) Digital video camera
$1,700
(1) Multimedia projector
$4,000
(1) Laptop computer
$3,700
(5) Computer workstations
$15,000
Essentials for fire fighting CD Rom instructors package
$600
Project 11 will require the acquisition of:
(1) Four door cab Pumper
$280,000
(1) 28,OOOIb GVWR crew cab and chassis $44,500
DEPARTMENT J COMMUNITY BENEFITS:
Afforded critical video streaming equipment, Project I will exhibit the following benefits:
A.) Video transmission will permit equipment & personnel to remain in service as they receive broadcast training at the
Firehouse that shall be interactive between instructor and students.
B.) Curtail prolonged response times caused by neighboring Firehouses having to cover and relieve an average of one
Engine and three Truck companies at a time pulled from service to receive instruction at the academy.
C.) Permit instruction to Firehouse 11 personnel at the Lubbock International Airport who are restricted from leaving the
premises / station mandated by FAA regulations.
D.) Compress a four hour training course administered over a nine day period to three half -days and an eight hour course
administered over a period of eighteen days to six half -days.
E.) Permit currently subscribed Fire and Emergency Television Network (FETN) to be broadcast at all firehouses in the
absence of normally scheduled training. Please be advised that FETN training is used to comply with firefighter and
medical CE requirements mandated by the Texas Commission on Fire Protection (TCFP) and the Texas Department
of Health (TDH) in order to retain certification.
F.) Aid the City of Lubbock's coordinated efforts as a Federally designated "Project Impact" community.
G.) Secure quality fire protection to residents provided new applications that offer necessary fire instruction to enhance
fire fighter skills.
Afforded essential Prop equipment, Project I will exhibit the following benefits:
A.) Permit fire fighting in basement and second floor structures for certification training required from TCFP. (This state
curriculum proves troublesome for the department in training and certifying new fire fighters with no such provisions
available.)
B.) Permit fire fighting instruction in the extinguishment of vehicle fires and fire extinguisher operations required from
TCFP. (This state curriculum proves troublesome for the department in training and certifying new fire fighters with no
such provisions available.)
C.) Permit acquisition of materials consisting of plywood and 2x4's producing an interior maze for our 40'x40' metal
smokehouse. Construction of maze will permit SCBA training and the development of a mask confident course
5
available for instruction to fire personnel and 1000+ volunteer fire fighters from rural communities in the immediate
area during the course of the year and or for those attending our annual fire conference.
D.) Aid the City of Lubbock's coordinated efforts as a Federally designated "Project Impact" community.
E.) Secure quality fire protection to residents provided new applications that offer necessary fire instruction to enhance
fire fighter skills.
Afforded technology update equipment, Project I will exhibit the following benefits:
A.) Permit effective presentations by Senior Officers in the training of personnel at the firehouse. (Fire scene simulation
software and a digital video camera will be used to snap pictures of structures and target hazards in their respective
territories for the development of strategies and tactics in responding to such environments.)
B.) Permit effective classroom instruction at the training academy. (Computer workstations will be installed at instructor
podiums at the academy granting access to the department's server for PowerPoint presentations and access to the
Internet when teaching regional classes at the academy.)
C.) Aid the City of Lubbock's coordinated efforts as a Federally designated "Project Impact" community.
D.) Secure quality fire protection to residents provided new applications that offer necessary fire instruction to enhance
fire fighter skills.
In summation, the Training division maintains the capacity to produce and transmit training materials but lacks the critical
equipage to receive transmission at the firehouse. Afforded the described equipment, project I will generate four
formidable outcomes. They are: 1). Significantly increase fire fighter safety through continual study applying modem
technological applications, 2.) Secure better fire protection to the citizens of our community with personnel remaining at the
firehouse while acquiring skilled fire instruction, 3.) Bring the Lubbock Fire Department into compliance with the Texas
Commission on Fire Protection, the Texas Department of Health, CE requirements for fire fighters in receiving and or
renewing certifications, and 4.) aid the city's public safety efforts as a "Project Impact Community'. Afforded today's
technology, it is no longer admissible to remove equipment and personnel out of service when other more effective options
exist.
Afforded vehicle replacements, Project II will exhibit the following benefits:
A.) Replacement Pumper will permit removal of existing aged unit and bring department into compliance with NFPA
Standard 1901 requiring all fire personnel to be seated in an enclosed cab vehicle.
B.) Secure community / department confidence in the daily operation of a public safety vehicle that is increasingly
responding to a greater volume of 911 calls with the recent implementation of a First Responder Program activated
February 2001. (Calls for the first three months of this calendar year at the future home of new Pumper have
surpassed 125 and are projected to exceed 500.)
C.) Permit a reduction in maintenance costs associated with current vehicle when compared with a new replacement.
6
D.) GVWR Crew Cab will permit the removal of an aged unit that is employed to pull a specially fabricated Fire Safety
house to all public / private primary schools in the community including selected public events for educational
applications. (Refurbished unit has been subjected to relentless usage that over time has required substantial
maintenance including engine overhau! thereby limiting the volume of presentations our educational team may initiate
attributed to unscheduled maintenance down time.)
A.) Permit a reduction in maintenance costs associated with current vehicle when compared to a new replacement.
B.) Permit educational team to travel all together in a single vehicle thereby maximizing efficiency and costs savings.
C.) Aid the City of Lubbock's coordinated efforts as a Federally designated "Project Impact" community.
D.) Permit improved availability for community fire safety presentations with the transport of the department's mobile fire
safety house.
In summation, the Lubbock Fire Department maintains a life safety operation that necessitates reliable equipment . To
maximize the dollars of tax paying citizens, acquisition of new vehicles will: 1.) upgrade necessary equipment to NFPA
1901 compliancy, and .2) relieve maintenance downtime and associated expenses to department and taxpaying citizens
allowing more educational opportunities for the Fire Safety House, and 3.) aid the city's public safety efforts as a "Project
Impact Community".
CONTENTION FOR FEDERAL FUNDING
The purpose for applying for this grant is to see that these projects become a realization benefiting local residents, fire
personnel and volunteer fire departments. In recent years, the West Texas Region has experienced a decline in
population growth with the City of Lubbock experiencing a dismal 2% growth over ten years according to the US Census
2000. With such stagnate growth, opportunities for successfully acquiring federal funding has become extremely difficult
especially for rural communities within Lubbock County that must demonstrate substantial burdens dictated by social
ailments. Despite diminishing growth, fire protection remains a necessity.
In addition and perhaps most evident, the city's budget is experiencing cutbacks in the approval of funding such projects
attributed to lessening revenues generated from sales and property taxes and from Lubbock's homed owned utility
company, visibly reflected in national rising fuel costs that have shrunken profits. Earnestly speaking, the city cannot
afford to solely fund these credible projects at this time nor can it be projected to see these realized in the near future as a
precautionary budget measure. In an effort to supplement notable financial setbacks, city departments have been urged to
pursue alternative sources of funding that shall support deserving projects.
7
General (questions for All Aunlicants
For FEMA Use
Questions, page 1 of 2
pay
1. Are you a Fire Department or the authorized
representative of a fire department? (circle one)
Yes.
b) No.
2. Are you a Federal Fire Department or contracted
by the Federal government and solely responsible
for suppression of fires on Federal property?
a) Yes.
C) No.
3. Is your active firefighting staff (circle one) :
g all paid/career?
b) all volunteer or combination volunteer
and career?
4. Is your department located in (circle one) :
a) an urban community
(population over 250,000)?
Q a suburban community
(population between 20,000 and 250,000)?
c) a rural community
(population under 20,000)?
5. How many active firefighters are in the operations/ -
EMS divisions of you department?
S = Number of active firefighters.
General Ouestions for All Annlirantc
Questions, page 2 of 2
°T Only
6. What is the permanent resident population of your
primary/first-response area or jurisdiction served?
199.562= population of response area.
7. What category (or categories) of assistance are you
applying for with this application and how much is
the total Federal share of the cost of the project that
you are seeking in each category?
Category#1: Training- $
Category #2: V a h i r 1 e $
8. If the population you protect is 50,000 or less, you
are required to provide a non -Federal cost -share
equal to 10 percent of the total project cost. If the
population you protect is over 50,000, you are
required to provide a non -Federal cost -share equal
to 30 percent of the total project cost. Are you willing
to comply with this requirement? (circle one)
® Yes.
b) No.
9. It is also a requirement that departments receiving
funding under this grant program agree to provide
information to the national fire incident reporting
system (NFIRS). If you receive an award, do you agree
to provide information to this national system? (circle one)
0 Yes.
b) No.
Questions for Training Program Category
10
For FEMA Use
Questions
Only
1. List the training activities you plan to conduct with
this grant:
Basic Fire Fischting. Hazmat. Heavy Rescue,
Dive Team traini ¢ fi arc a Re c Me Fi re
Fi ghti ne
2. Generally, the training activities outlined above are
(cirlce one):
Q Direct -delivery training.
b) Off-site training.
3. Generally, the training you will conduct under this grant
can best be catagorized as (circle one):
a) Basic training for firefighters (i.e., training in
basic firefighting duties or vehicle operations).
b) Officer training (either supervisory or
safety officer training).
c) Specialized training.
Other, specify = Ai an -r. of
4. Generally, the training provided under this grant
(circle one):
® Will fulfill a statutory requirement.
b) Will achieve voluntary compliance with a
national standard.
c) Does not have any statutory basis.
5. What is the percentage of applicable staff within your
department that this program will train?
loo = Percent of trained personnel.
10
Questions for Vehicle C'ateQnry
11
For FEMA Use
Questions, page 1 of 2
Only
1. What type of vehicle will you use the grant funds
to purchase (circle one):
® Engine (includes Pumpers)
b) Tanker
c) Heavy Rescue Vehicle
d) Brush Truck
e) Ambulance
fl Aerial Apparatus (includes Ladders)
g) Other, specify =
2. The purpose for this grant is to (circle one):
a) Obtain an additional vehicle for firefighting fleet.
® Replace/retire an old firefighting vehicle.
c) Refurbish an old firefighting vehicle.
d) Purchase a new vehicle to fulfill a
new mission.
3. How many vehicles of the type or class you are
planning to purchase, does your department own?
13 = Number of vehicles.
4. What is the age of your newest first -response
vehicle in this class that you currently own?
L- == Age of newest vehicle.
11
Questions for Vehicle Category
12
For FEMA Use
Questions, page 2 of 2
Only
5. What is the age of the oldest first -response vehicle
in this class that you currently own?
21 = Age of oldest vehicle.
6. What is the mileage on the first -response
vehicle you are replacing/refurbishing?
68 _ 395 = Mileage of vehicle.
7. What is the average number of annual responses
for the first -response vehicle you are
replacing/refurbishing?
504 = Average annual responses.
12
Questions for Vehicle Category
For FEMA Use
Questions, page 1 of 2 Only
I. What type of vehicle will you use the grant funds
to purchase (circle one):
a) Engine (includes Pumpers)
b) Tanker
c) Heavy Rescue Vehicle
d) Brush Truck
e) Ambulance
f) Aerial Apparatus (includes Ladders)
g Other, specify =
2. The purpose for this grant is to (circle one):
a) Obtain an additional vehicle for firefighting fleet.
® Replace/retire an old firefighting vehicle.
c) Refurbish an old firefighting vehicle.
d) Purchase a new vehicle to fulfill a
new mission.
3. How many vehicles of the type or class you are
planning to purchase, does your department own?
1 = Number of vehicles.
4. What is the age of your newest first -response
vehicle in this class that you currently own?
17 Age of newest vehicle.
13
.t•a..v�avu.7 aqua V CUa%:1C %. Utt!
I
Questions, page 2 of 2 For FEMA Use
nrIw
5. What is the age of the oldest first -response vehicle
in this class that you currently own?
17 = Age of oldest vehicle.
o. What is the mileage on the first -response
vehicle you are replacing/refurbishing?
87_ 7,000 = Mileage of vehicle.
7. What is the average number of annual responses
for the first -response vehicle you are
replacing/refurbishing?
75 = Average annual responses.
14.
FEDERAL EMERGENCY MANAGEMENT AGENCY' O.M.B. No. 3067-0206
SUMMARY SHEET FOR ASSURANCES AND CERTIFICATIONS Expires February 29, 2004
FFOR of CA FOR (Name Apolicano
FY 2001 Lubbock Fire Dept.
summary sheet includes Assurances and Certifications that must be read, signed, and submitted as a part of the
]cation for Federal Assistance.
o applicant must check each item that they are certifying to:
Part I ® FEMA Form 20-16A9 Assurances-Nonconstruction Programs
Part II [:] FEMA Form 20.16B, Assurances -Construction Programs
Partin a FEMA Form 20-16C, Certifications Regarding Lobbying;
Debarment, Suspension, and Other Responsibility
Matters; and Drug -Free Workplace Requirements
Part IV (] SF LLL, Disclosure of Lobbying Activities (If applicable)
the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the identified
ached assurances and certifications.
of Authorized Representative
Signature of Autb
Title
011111a�
Date Signed
r'E: By signing the certification regarding debarment, suspension, and other responsibility matters for primary covered
sact]on, the applicant agrees that, should the proposed covered transaction be entered into, It shall not knowingly enter
any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded
i 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
prding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," provided by
FEMA Regional Office entering into this covered transaction, without modification, in all lower tier covered transactions
In all solicitations for lower tier covered transactions. (Refer to 44 CFR Part 17.)
Paperwork Burden Disclosure Notice
"Public reporting burden for this forth Is estimated to average 1.7 hours per response. Burden means the time, effort and
nancial resources expended by persons to generate, maintain, retain, disclose, or to provide information to us. You may
nd comments regarding the burden estimate or any aspect of the form, including suggestions for reducing the burden
o: 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 comer of this form. Please do not send your completed form to the above
liaddress.
FEMA Form 20-16. FEB 01
15
FEDERAL EMERGENCY MANAGEMENT AGENCY
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,
alcohol abuse or alcoholism; (g) Sections 523 and 527 of
and the institutional, managerial and financial capability
the Public Health Service Act of 1912 (42 U.S.C. 290-dd-3
(including funds sufficient to pay the non -Federal share of
and 290-ee-3), as amended, relating to confidentiality of
project costs) to ensure proper planning, management and
alcohol and drug abuse patient records; (h) Title VIII of the
completion of the project described in this application.
Civil Rights Acts of 1%8 (42 U.S.C. Section 3601 et seq.),
as amended, relating to nondiscrimination in the sale,
2. Will give the awarding agency, the Comptroller
rental or financing of housing; (i) any other
General of the United States, and if appropriate, the State,
nondiscrimination provisions in the specific statute(s)
through any authorized representative, access to and the
under which application for Federal assistance is being
right to examine all records, books, papers, or documents
made; and (J) the requirements of any other
related to the award; and will establish a proper accounting
nondiscrimination statute(s) which may apply to the
system in accordance with generally accepted accounting
application.
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
1685-1680, 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
CCUA E-- '.A 4!A ..to A•
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 AM (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.
16
11. Will comply with environmental standards which may
be prescribed pursuant to the following: (a) institution
of environmental quality control measures under the
National Environmental Policy Act of 1%9 (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 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. 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.).
17
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.
FEDERAL EMERGENCY MANAGEMENT AGENCY
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 (b) Have not within a three-year period prem this
A. As required by section 1352, Tide 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 infkrencing 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;
(c) The undersigned shall require that the language of this certification
be included in the award documents for all subawards at all tiers
Buffing subgrants, contracts under grants and cooperative
agreements, and subcontracts) and that all subrecipients shall
certify and disclose accordingly.
QStandard Fort LLL, 'Disclosure of Lobbying Activities' attached.
(This form must be attached to certibcation d nonSAoroodated funds
are to be used to influence activies.)
2. DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS
(DIRECT RECIPIENT)
As requitired by Executive Order 12549, Debarment and Suspension,
aril 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 deoartrnent or aaencv:
FEMA Form 20.160. JUN 94
appMcatp I 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, W perform a public (Fedeftte,
Or kocap transaction or contract under a public transaction: vW8
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 licitly,
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 a three-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 exptanatiori to
application.
3. DRUG-FREE WORKPLACE
(GRANTEES OTHER THAN INDIVIDUALS)
As required by the Drug -Free Workplace Act of 1988da
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 a drug-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 time workplace;
18
u, v
(c) Makin it a requirement that each employee to be engaged in
V* 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
V= five calendar days atter 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
FEMA Fonm 20-16c (BACK)
19
(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), (a),
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, City, 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.