HomeMy WebLinkAboutGEORGIA EMERGENCY MANAGEMENT AGENCY EMPG FFY 2012 Georqia Emergency Maaage�ment Agency
STATS�TT OF SIIBG�tA�T A�iARD
�.,. EMPG FFY 2 412
�E�E71I, t�71�! ; Emergency Managentent Performance Grant
p=p�L �p� �p��: EMW-2012-�P-00051-SOI �� �: 97.042
E�]Ni'p'1"O�LT �ISY FO�t C�71ti't :
This praject is supported under DR5 Appropriations Act of 2012 (P.L. I11-83t
�7�iT� D�T,�p�=IAQ, �CZ; pRp.7=CS ID: OEM12-I23
Augusta-Ric2uaond Countiy
530 Greene Street g=� p� 07/U1/2012
Augusta, GA 309Q�
� ��; 06/30/2013
!EI �: 58-22204274 A1O1i�tD Dl►TE: 07/09/2012
S�B�711�' P�lQ�II�: l�DER71L Al0lRD bOC�►L 1A?CH '1�0'1'ILL Pi00JlCT
pp]► gas� 1�a=d 60,165. 00 60,165. 00 120, 330. 00
SP�CIAI. C�NDITZQ�S :
�ii� !i 2012 �rtoaa�c� L+srta�rship ]lward is tv�d by tha D�Srta�nt o! Horlaad
�aari.tr �ss�a�t' Kaea4e*at Pesfox�an+a� �rant t�6) lward and iaalncLs a
sinia�a� 50 perc�at (caah andJar inl�incU aatch requira�r�at. ]►7.I espeaaes a�st be ia
ssaaozdanc� ritb tbo► Offiar o� Manaq�a��t ax�d Ht�c1ylt Ciraul.ars b-67, �-102 aad ]1-133
fbttp: //nw�►. whit.baQSS. grw/arb/r.�xcula,rs/iad�x-slg. aapu�) .?itl.e 44 of tha Cod� og
ladsrzl Rr�ulations Cbaptsr 13 Part 24 iMatch acoquir�itsj
ll�ttp: //'ww�r- 9Poaccsas • y�av/cfr/ind�s. btml� . and tha pi 2012 lC�tsq�ncq
Meaag�at P+�rfas�a�acae tiraut R�ndin�q Opportumu.ty Laaounoe�ant
lhttP� //vw�r. firoa. gav/Pdf/qnvsz'�dorat/9raat/2QZ2/fY1Z wQg �Eos.gdfl . aad rrithin
tbe period af perfor�sr�ce. Fed�aral fuads casinot bo vsod to aatch thi.s arard.
'to receive !X 2012 ft�ndi�q Grante.:
• snst 2iav�e �wt the ter�a of tha 2012 Perfcra�a�ace Par�rship ]lqreaesnt (PP]►I
• a�siat hsva shona satisfactosy proqrass on tbe 2011 PP]!. rorkplaa as
d,�toYSit�ed by th�ir 1'ield Ccwrdinstor i3+C)
.�rast Lasv�e sutimitted all required 2011 � ac3oriaistarat��e docmteats to b'��l
.'aat have c�o�leted �IIYSG3T Roll-u� for 2011
Pap�tt �rfll not brr aada �atil t� YY12 PPA R�wq�st for Pay�etnt Fo� is
ravod tb� GD�! Dir�ctor of ti��I.d ratsons.
l►uthazisrd �raist�ea Official /
'"�;. A✓�' S. Cvf�V�il'4� r�►t.t �C.. 7 3� f[ L..--
Please Brint Name Title Signature Date of Acceptance
�l ty -
� �j � Zdj�
y � ��� Date
{ PPAA--20 )
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�!• Georgia Emergency Management Agency
��
Ernergency ManagemeM Performance Grarft CDFA 97.042
2012 PerfoRnartce Partnership Agreement {PPA}
Base Award Paymertt Request Form
Request:
Under penalty af pe�jury, I certiiy that to the best af my 3cnowtedge and beiief that all
requiremerrts af the 2012 Performance Partnership Agreement with the Geor�Bia
Emergency Management Agency-Home#and Security have been sa�tisfied. i hereby
request paymer�t of the Base Award to cover expenses for the period of July 1, 2012
through June 30, 2013.
Award Number: OEM12 -
Payee Addrass:
4r Eme�er�cy ManaQernerrt Agency
Atm. l ey.r 1i1�._.� �SC� � �,�. /�.R��'
q�� �c'�'� ;5�.
�I,�s� e�, c�eor�ia .3l�90 /
.�-�" ������.
� � �
��ar�J �au.s�a4a.. Aa� �.��-,�ss'
En,al � T- Pnone N�rr�r
Recommend Approval:
�
Si�rteti.rre of Area C.00rdmator
Approval:
5' /?�-t.Z
pf Date
a�MA-Fie+d operatbns '
BAPRF-Z012
EXHIBIT A
CERTIFICATION REGARllING LUBBYIlVG;
DEBARMENT, SUSPENSION, AND DRUG FREE WORKPLACE
Lob�a�
As required by section 1352, Title 31 of the U.S. Cocie, and implemented at 44 CFR Part 18, for persoas
entering into a grant or cooperaCing agreement over $ 100,00(?, as dcfined at 44 CFR Part i S, the applicarn
certifies that:
1. No Federal apprapriate� fur�ds have i�een paid or will be paid, by or on behalf of the
undoc�signed, to any person for influencing or attempting to influence an officer or exnployee of any
agency, a Member oP Congc�ess, an officer or employee of Congr�ess, or an euiploye� of a Member of
Congress in connection with the r�aking of any Federal gant, tbe en�bering into of any cooperative
agreeme� and the extension, coutinc�ation, renewal, amendment, or modification of any FederaI grant nr
cooperative agreement,
2. If any other fimds than Federal appropriated funds have t�een paid or will be paid to arry ather
person for inIluencing ar attempting to influencc an officer or emptoyee of anY aB�Y, a member of
Congress, an vf�icer or an emQloyee af Congress, or employee of a member of Congress in connection
with this Federal Grarrt or cooperative agreernent, the undersigned slaa3l cornplete and submit Stand Form-
LLL, "Disclosure of Lobbying Activities," in accordance with its instructions.
3. The undersigned shall require t6at ffic langusge of this certification be inclvded 'ut the award
documen#s for all subawards at ail tiers (including subgrants, contracts under grants and caoperat�ve
agreements, and subconhacts) and that all subre�ipien#s shall certify and disclose accordingly.
Debarcnent. Susnension. and Other Rg�poasibilicv Mgtter3.;, D}'�¢-Free Workula¢e
This ce�rtification is required by the regulations implemevting Executive Order 12549, Debarnnent aad
Suspensioh, 44 GFR Part l7 and cnaintenance of a Drug Fnee Worlcplace (44CFR, Subpatf F). The
applicairt certif es that it and its principais:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, sentenced
to a deniai of Federal bc�ct"ats by a State or Federal court, or voluntarily excluded frocn covered
transactions by any Pederal dcparane,at ar agency;
2. Have not within a three-ycar period prcceding this applic,stion beeu convicted of or had a
civilian judgment rendered against them for cominission of fraud or a crimina! offense ia cannection with
obtaining, attempting to obtain, or perforrn a public (Federal, State, or local} Vavsaction or coutract under
a public transaction; viulatian of Federa( or State antitrust statutes or commission of embezzlemern, theft,
forgery, tnibery, falsification or destruction af records, maldng false statements, ar recciving sto�en
property;
3. Are not presently indicted for or otherwise criminaUy or civilly charged try a govertmetrtal
entity (Federal, State, or locally) with commission of any ofthe offenses enumetated in paragaph (lxb)
of this certification; and
> . �
4. Have not with�in a three year period preceding this application had pne or more public
transactions (Fedetal, State, or Iocal) tertninated for cause or default; and
5. As required iry the Drug-Free Workptace Act of 1988, aad impleinented at 44 CFR Part 1 �.
Sections 17.615 and l'7.620, the applicant cer�fies it will coMinue to provide a drug-free workplace per
referenced regulations.
As the duly aut�orized represezrtativc of the applicant, I herelry certify that the appiicant will comply with
the above certifications.
1. Grantee Name and Addtess: �� /� ��'�f
� � r T /
t/ ���''�
��.r,�.S��.��R • �0�90 /
��"if�t /,�� /.23 S� a�2o5� 2 ?�
2. Application Number and/or Project Name 3. Graatce IRS/Vendor Number
'3�JS� �- Ca�a� 4f�4��-
4. TyQed or P`rinfe,d Name and Title of Authorized Representative
�.��.C� �l �� I ►�
5. Si�re d. Date
,
CER77F7CAT10N RP6ARDfN� LOHBYII'!G, DE6ARMEM', 9ifSPENS[ON N7D DRU6 FREE W 0&KYI,.�CF Psge Z of3