HomeMy WebLinkAboutGEORGIA EMERGENCY MANAGEMENT AGENCY (AUGUSTA FIRE DEPT GEORGIA EMERGENCY MANAGEMENT AGENCY
GEORGIA OFFICE AF HOMELAND SECURITY
NATHAN DEAL CHARLEY ENGLISH
GOVERNOR DIRECTOR
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July 27, 2012
RE: FIPS #245-04196-03
GAN #EMW-2011-SS-000$1-S01
Budget Worksheet #2764
City of Augusta Fire Department
Honorable Deke Copenhaver
Mayor
City of Augusta
3117 Deans Bridge Road
Augusta, Georgia 30906
Dear Mayor Copenhaver:
On behaif of Governor Nathan Deal, it is my pleasure to provide you a copy of your
executed Grantee-Subgrantee Agreement for the 2011 Homeland Security Grant Program,
Please adhere to all requirements included in the agreement. In addition, mail request for
reimbursement to our office, Attention: Public Assistance, Post Office Box 18055, Atlanta,
Georgia 30316. Documentation should include copies of invoices, cancelled checks or other
type of justification and an executed Exhibit E.
Quarterly progress reports are due at the end of each calendar quarter. The initial
progress report will cover the period through June 30, 2012 and should be submittad no later
than July 15, 2012.
If you require further information as to the grantee package, please contact Tara Diaz,
Grants Manager, at 404-635-7066. Thank you for your work on behalf of the citizens of �
Georgia
S'
Angi . ley
Public Assist nce Division Director
aw/Id
Enclosures
cc: Byron Taylor, Special Op�rations Chief
City of Augusta Fire Department
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Post Office Box 18055 • Atlanta, Georgia • 30316- 055
(404) 635-7000 • Toll-free in Georgia 1-800-TRY GEMA • w .gema.ga.gov
GEORGIA EMERGENCY MANAGEMENT AGENCY
GEORGIA OFFICE OF HOMEI..AND SEGURITY
NATHAN DEAL CHARLEY ENGLISH
GpVERNOR DIRECTOR
June 12, 2012
RE: FIP #245-04196-03
GAN #EMW-2011-SS-00081-S01
Budget Worksheet #2764
City of Augusta Fire Department
Honorable Deke Copenhaver
Mayor
City of Augusta
3117 Deans Bridge Road
Augusta, Georgia 30906
Dear Mayor Copenhaver.
On behalf of Governor Nathan Deal, it is our pleasure to award your agency with a Fiscal
Year 2011 Hometand Security Grant Program/State Homeland Security Grant Progr�m from the
Department of Homeland Security (DHS). Enclosed is the Grantee-Subgrantee Agreement for
funding awarded to you agency by the Georgia Emergency Management Agency (GEMA), This
agreement governs the use of funding provided by DHS to help your agency to build and
enhance capabilities to prevent, protect against, respond to, and recover from terrorist attacks,
major disasters and other emergencies in accordance with the goals and objectives of the State
Strategic Plan.
The amount of this agreement is $20,000.00. You may not exceed in either quantity nor
total dollar amount the items expressly approved for you to purchase, as shown on the
accompanying detailed budget worksheet(s).
Attached to the Grantee-Subgrantee Agreement are Exhibits A- I. Please review and
return signed originals of the Grantee-Subgrantee Agreement, Exhibit C, F, and Exhibit G to the
attention of your grants manager within 14 days of receipt of this letter. A copy of the fully
executed agreement will be returned to you for your files.
If you require further information as to the grantee package, please contact Tara Diaz,
Grants Manager, at 404-635-7066. Thank you for your work an behalf of the citizens of
Georgia.
Sincerely,
ngi a e
Publi ssis ance Division Director
aw/kr
Enclosures
cc: Byron Taylor, Chief
Augusta Fire Department
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Post Office Box 18055 • Atlanta, Georgia • 30316-0055
(404) 635-7000 • Toll-free in Georgia 1-800-TRY GEMA • www.gema.ga.gov
FISCAL YEAR 2011 HOMELAND SECURITY GRANT PROGRAM
,GRANTEE-SUBGRANTEE AGREEMENT
STATE HOMELAND SECURTY GRANT PROGRAM
The United States Department of Homeland Security (DHS), Federal Emergency Management Agency
(FEMA), Grant Programs Directarate (GPD), approved the application and awarded grant funding from the
Fiscal Year 2011 Homeland Security Grant Program to the Georgia Emergency Management Agency (GEMA)
on behalf of the State of Georgia, in accordance with authorizing federal GEMA will maintain overall
responsibility and accountability to the federal government for the duration of the program. GEMA, as Grantee,
has awarded the amount of $20,000.00 to Augusta Fire Department, as Subgrantee, in accordance with the
Fiscal Year 2011 Homeland Security Grant Program (HSGP), State Homeland Security Grant Program.
Under this Agreement, GEMA will execute the interests and responsibilities of the Grantee. The individual
designated to represent the State is Charley English, Authorized Grantee Official. The State has designated
Ralph Reichert as the Program Manager of this program. The Subgrantee's Authorized Official has
authority to legally bind the Subgrantee and will execute the interests and responsibilities of the Subgrantee.
The Subgrantee's Authorized Official is the person whose name appears on page eleven (11) of this agreement
and whose signature appears on page eleven (11) of this agreement.
Purpose: The Subgrantee agrees to use allocated funds only as approved, to comply with the terms, conditions
and guidelines as stated within tl�is agreement and to request reimbursement only for expenditures made in
accordance with the Approved Detailed Budget Worksheet (Exhibit D). Any change to the budget worksheet
must be requested in writing by the Subgrantee and must be approved by the Program Manager prior to the
execution of that change. After all approved items on the approved budget worksheet have been reimbursed to
the Subgrantee, this Subgrantee Agreement shall terminate, and any remaining funds will be thereby forfeited by
the Subgrantee and such funds shall be deobligated and reallocated by GEMA. If a detailed Budget Worksheet
has not been approved or attached to this agreement, a Budget Worksheet for all funding awarded in this
subgrant must be approved by the Program Manager and this agreement must be amended to add the approved
Budget Worksheet as Exhibit D before any expenditures may be made by or on behalf of the Subgrantee.
Effective Date: September 1, 2011 to Apri130, 2014
The Subgrantee agrees that all purchases and expenditures authorized under this program must be completed by
the effective end date.
Exhibits: Exhibits are attached or attainable via the internet and made a part of this agreement:
Exhibit A United States Department of Homeland Security (DHS), Preparedness Directorate, Office
of Grants and Training (G&T), Office of Grant Operations (OGO) Financial Management
Guide (Financial Guide), available on the DHS Web site at:
http://www.dhs.gov/xlibrary/assets/Grants_FinancialManagementGuide.pdf
Exhibit B United States Department of Homeland Security (DHS) Fiscal Year 2011 Homeland
Security Grant Program Guidance and Application Kit (DHS Guide), located on the
Federal Emergency Management Agencyweb site at
http://www.fema.gov/pdf/governmendgrant/2011/fyll hsgp_kit.pdf
Exhibit C NIMS Compliance Form
Exhibit D Approved Detailed Budget Worksheet(s)
E�chibit D Approved Detailed Budget Worksheet(s)
Exhibit E� Payment Request Form •
Exhibit F Standard Assurances — Standard Form 424B (Non-Construction) or Standard Form 424 D
(Construction), as applicable
Exhibit G Certification Regarding Lobbying; Debarment, Suspension, and Other Responsibility
" Matters; and Drug-Free Workplace Requirements, OJP Form 4061l6
Exhibit H Financial Status Report (FSR) Reporting Form
Exhibit I Acknowledgment Porm of Receipt of Goods or Services Paid for by the State on Behalf
of Subgrantee
Exhibit J Grant Programs Directorate Information Bulletin No. 371
Exhibit K Environmental and Historic Preservation Screening Memo (EHPSM)
Reimbursement and Reporting Reguiremeqts
1. Payment Request Forms: Payments to the Subgrantees will be made only upon presentation of the
approved Payment Request Fozm (Exhibit E). Reimbursements from invoices and applicable canceled
checks (or other justifying documentation) will only be made for eligible equipment, materials,
expenses and costs upon approval of the Program Manager. Omission of pertinent documentation will
constitute justification for non-payment of any amounts submitted on the Payment Request Forms.
2. State Pur�hases on behalf of Subgraate�e: GEMA may, with the Written Consent of the Subgrantee,
retain and expend grant funding on behalf of the Subgrantee. Before the State will make purchases on
behalf of locals the Subgrantee must provide justification, receive approval from GEMA and provide .
GEMA with the Written Consent for GBMA to expend these funds. If GEMA does agree to retain and
expend grant funding on behalf af the Subgrantee, the Subgrantee is required to submit documentation
to verify receipt and acceptance of the goods or services on the Acknowledgment Form (Exhibit I) and
pro�ide any other documentation or information requested by GEMA. Tf the Acknowledgement Form is
not returned to GEMA in a timely manner, the Subgantee will be held accountable for payment to the
vendor. The Subgra.ntee will also be accountable for submitting Financial Status Reports (FSR) on a
timely basis according to the guidelines in following paragraph.
3 Financial Status Report (FSR): The disposition of grant funds, including all obligarions and
expenditures, must be reported to GEMA on a quarterly basis through the FSR, which is due within 30
days of the end of each calendar quarter (i.e. for the quarter ending March 31, FSR is due no later than
April 30). A copy of this form is attached as Exhibit H to this agreement.
2. Biannual Strategy Implementation Reports (BSIR): The Subgrantee shall complete and submit any
other reports as requested by GEMA and cooperate and assist GEMA in complying with the DHS
tracking and reporting requirements. Specifically, without Iirriitation, Subgrantee shall submit
information at GEMA's request and direction to assist GEMA in submitting $iannual Straxegy
Implementation Repores, Categorical Assistance Program Reports and any other necessary reports.
3. Grant CToseout Report: Within 60 days after the ending effective date of the subgrant, the Sub�rantee
shall submit a final FSR and final program report detailing all accomplishments throughout the project.
After both of these reports have been reviewed and approved by GEMA; a Closeout Repor� will be
generated indicating the project as being closed and listing any remaining funds that will be deobligated.
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Audits, Financial Regulations and Guides
1. Audits and Monitoring: The Subgrantee agrees that federaT'or state officials and auditors or theii duly
authorized representatives may conduct programmatic, financial and administrative monitoring, audits
and examinations. The Subgrantee further agrees that such o�cials, auditors or representatives shall
have access to any books, documents, papers, property and records of any recipients of this funding and
of any persons or entities which perf�rm any activity which is reimbursed to any extent with federal or
state funds distributed under the authority federal or state law, including the Department of Homeland
Security Appropriations Act, 2011, and this Agreement.
2. Laws, Regulations and Program Guidance: The Subgrantee shall comply with all applicable laws,
regulations, and administrative requirements. A non-exclusive list of regulations is listed below.
Referenced Code of Federal Regulations (CFR) sections may be accessed online at
www.gpoaccess.gov/ecfr/.
A. Administrative Requirements �
1) 44 CFR Part 13, Uniform Administrative Requirements for Grants and Cooperative Agreements
to State and Local Governments (OMB Circular A-102) .
2) 2 CFR Part 215, Uniform" Administrative Requirements for Grants and Agreements with
Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations (OMB Circular
� A-I10)
B. Cost Principles
1) 2 CFR Part 225, Cost Principles for State, Local and Indian Tribal Govemments (OMB Gircular
A-87)
2) 2 CFR Part 220, Cost Principles for Educational Institutions (OMB Circular A-21)
3) 2 CFR Part.230, Cost Principles for Non-Profit Organizations (OMB Circular A-122)
4) 48 CFR 31.2, Feder�l Acquisition Regulations (FAR) Contract Cost Principles with
Commercial Orgsnizations .
C. Office of Management and Budget (OMB) Circular A-133, Audits of States, Local
Governments, and Non-Profit Organizations
The Subgrantee agrees to comply with the organizational audit requirements of OMB Circular
A-133, Audits of States, Local Governments, and Non-Profit Organizations,. as further described in
the current edition of the.Financial Guide (Exhibit A).
1) Subgrantees that expend $500,000 or more of federal funds during their fiscal year are required
to submit an organization-wide financial and compliance audit report. The audit mu5t be
performed in accordance with the Grant Accountability Office's (GAQ's) Government Auditing
Standards, which may be accessed online at hrip://www.gao.gov/govaud/ybkOl.htm, and with
the OMB Circulaz A-133, Audits of States, Local Governments, and Non-Profit Organizations,
located at http://ww�v.whitehouse.gov/omb/circulars/a133/a133.htm1. Audit reports .are
currently due to the Federal Audit Clearinghouse no later than.nine months after the end of�the
recipient's f scal year.
2) In addition; Subgrantees must submit the audit report to the State of Georgia, by sending a copy
to the Georgia Depariment of Audits and Accounts, Nonprofit and Local Gavernments Audits
270 Washington Street, SW, Room I-1.56, Atlanta, Georgia 30334=8400.
3) If required to submit an audit report under the requirements of OMB Circular A-133,
Subgrantee shall provide GEMA with wriiten documentation showing that it has complied with
the single audit requirements. Such documentation shall be returned to GEMA with this signed
Agreement. Subgrantee shall immediately notify GEMA in writing directed to the Granfs
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Manager at any future time that it is required to conduct a single audit and provide
c�ncumentatinn within a re�sonable time period showing compliance with the� single audit
requirement.
D. Office of Maaagement and Budget (OMB) Circular A-87 Inventory Requirements:
The Subgrantee agrees to comply with the requirements of OMB Circular.A-87 and specifically,
without limitation, agrees to eomply with the requirement to take physical 'inventories of any
equipment received through this subgrant at least once every two years.
E. Data Universal Numbering System (DTJNS) Number Requirement:
No entity may receive a subgrant under this award unless GEMA has received the DUNS number
for the prospective subgrantee.
P. Federal Funding Accountability and Transparency Act (FFATA):
(a) A11 new subawazds under this grant of $25,000 or more are su�ject to FFATA reporting
requirements. Subgrantee is responsible fox providing any information requested by
GEMA to complete the required report.
(b) Unless exempt, Subgrantee shall report the names and total compensation of its five
most highly compensated executives for its preceding completed fiscal yeax. This
report is only required if:
(1) In Subgrantee's preceding fiscal year, Subgrantee received
(A) 80 percent or more of its annual gross revenues from federal procurement contracts and
subcontracts and federal financial assistance subject to the Transparency Act, as defined
at 2 CFR 170.320 (and subawards); and �
(B) T'he public does not have access to information about the compensation of the
� executives through periodic reports filed under section 13(a) or 15(d) of the Securities
" Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 61104 of the Intemal
Revenue Code of 1986.
(c) Additional information regaxding the FFATA requirements can be found at
www.whitehouse.govlomb/open, www.USAspending.gov, and www.fsrs.gov
4. OGO Financial Management. Guide: The Subgrantee agrees to compiy with the financial and
administrative requirements set forth in the current edition of the United States Department of
Homeland Security, Preparedness Directorate, Office of Grants and Training, Office of Grant
Operations, Financial Management Guide (Exhibit A).
5. Accounting System: The Subgrantee agees to maintain an accountin� system integrated with adequate
internal fiscal and management controls to capture and, report gant data with accuracy, providing full
accountability for revenues, expendiivres, assets and liabilities. This system shall provide rea'sonable
assurance that the subgrantee is managing federal and state financial assistance programs in compliance
with the current edition of the Financial Guide (Exhibit A) and all applicable laws and regulations.
6. Retentio`n and Maintenance of Records; Subgrantee shall comply with the ONiB administrative
requirements circulars and the current edition of the Financial Guide (Exhibit A) in retaining and
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maintaining records pertinent to the subgrant award. All such records shall be retained by the
subgrantee for at least three years from the date of the final expenditure report by GEMA to DHS to
close out the State of Geo'rgia's 2011 HSGP grant. Refer to the Financial Guide (Exhibit A) for
exceptions which would require a longer record retention period.
7. Withholding and Repayment of Funds: In addition to any other remedies provided by law or the
terms of this agreement, if the Subgrantee fails to compiy with any of the terms or conditions of this
Agreement; including all exhibits hereto, or with any applicable federal or state law or regulation,
GEMA may withhold or require repayment of grant funds in connection with which the violation
occurred. In addition, GEMA may withhold or require repayment of aIl or any portion of the financial
award which has been or is to be made available to the Subgrantee for other projects under this program,
or under this or other agreements.
S. Payment of Funds to GEMA: In addition to any other remedies available; the parties agree that
GEMA will be entitled to payment from the Subgrantee for any funds paid by the state or for which the
state is responsible to pay an behalf of the Subgrantee for which GEMA is unable to receive payment
from or will be required to repay the grant funds due to the Subgantee's failure to cooperate in
praviding the required documentation showing receipt of the goods or services or other failure on the
part of the Subgrantee, including without limitation timely completing and returning to GEMA the
Acknowledgment Form attached as Exhibit I.
National Initiatives .
1. Subgrantee agrees to comply with all applicable terms and conditions of the Fiscal Year 2011 Homeland
Security Grant Program Guidance (Exhibit B), including without limitation meeting the minimum
National Incident Management System (NIMS) Fiscal Yeaz 2011 compliance requirements in the MMS
Compliance section of the DHS Guide and the NIIvIS Integration Center (MC). State, territory, tribat
and local governments are considered to be in full NIMS compliance if they have adopted and/or
implemented the current compliance activities, as determined by the National Incident Management
System Compliance Assistance Support Tool (NIMSCAST) to be reported by September 30, 2011 or
other accepted means. Additional information on achieving compliance is available through the FEMA
NIC at http://www.fema.gov/emergency/nims/. In order to assure compliance with NiMS
reguirements, all terms and conditions of thes agreement are predicated and conditional upon .the
Subgrantee's, assurance by completing and signing the NTMS Compliance Forni (Exhibit C) and
retuming the �ompleted and signed form to GEMA along with the signed original Grrantee-Subgrantee
Agreement. For the next grant period, NIMSCAST will be the required means to report NIlVIS
compliance.
2. Subgrantee agrees to comply with all terms and conditions of,the Fiscal Year 2011 Homeland �ecurity �
Grant Program Guidance (Exhibit B), including without limitaxion meeting the Nationa[ Incident
Management System (TtIMS) compliance requirements in the N1MS Compliance section of the DHS
Guide and the requirements of the NIIvIS Integration Cenfer (NIC). For Fiscal Year 2011 HSGP
� preparedness grant award eligibility, all Subgrantees must have met the requirement to show compliance
by submitting the required compliance assessment via the Ir1IMSCAST by September 3U, 2011 and/or
the Conective Action Plan by October 31, 20.11. Additional information on achieving compliance is
available through the FEMA 1VIC at http://www.fema.gov/nirns/. In addition, in order to assure
compliance with MMS requirements, all terms and conditions of this agreement are predicated and
conditional upon the Subgrantee's assurance by completing and signing the NINIS Compliance Fortn
(E�chibit C) and returning the completed and signed form to GEMA along with the signed original
Grantee-Subgrantee Agreement.
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3. Subgrantce tzgrces to institutionalize the use of the Incident Command System (ICS) as required by
Georgialaw and the NIMS minimum complian.ce requirements: .
_ 4. Subgrantee agrees that any exercises conducted with grant funds will be managed anc� executed in
compliance with the Homeland Security Exercise and Evaluation Program (HSEEP}. All exercises will
be planned, conducted, and evaluated with implementation of improvement in accordance with the
guidance in the HSEEP manuals, volumes I through IV, available at http://hseep.dhs.gov.
(a) Any exercises implemented with grant funds must be threat- and performance-based and should
evaluate performance of critical tasks required to respond to the exercise scenario.
(b) All funded exercises must be included in the Multiyear Exercise Plan calendar, added to the
National Exercise Schedule through the National Exeroise Schedule (NEXS) Application, located at
https://www.hseep.dhs.gov/ and must be preapproved by the GEMA Exercise Program Manager.
(c) Subgrantee must report to the GBMA Exercise Program Ivlanager prior to conducring scheduled
exercises and provide the Program Manager with an After Action Report (AAR) and Improvement
Plan for each exercise conduetezi within 45 days following completion of the exercise in accordance
with the DHS Guide (Exhibit B):
(d) Exercises conducted using HSGP funding must be NIMS compliant, as defined by the cwrent
NIMS coznpliance matrices. Further information is available on the NIMS Integration Center Web
site at www.fema.gov/emergency/nims/. '
Special Conditions
1. The Subgrantee agrees to use all grant funding awarded from the Fiscal Year 2011 Homeland Security
Grant Program (HSGF) for costs related to preparedness activities associated with implementing the
2006 State Strategic .Plan for Terrorism and All-Hazards Preparedness, iancluding goals and objectives,
and any respective Urban Area Security SUrategies.
2. The Subgrantee agrees that all allocations and use of funds under this grant will be in accordance with
the Fiscal Year 2011 Homeland Security Grant Program (HSGP) Guidance and Application Kit (Exhibit
B), and to comply with all DHSIFEMA requirements and cooperate wifh GEMA to comply with federal
and state requirements related to the grant funding.
3. The Subgrantee understands and agrees that any allocations and use of grant funding must support and
may only be used to fund the investments identified in the Fiscal Year 2011 HSGP applicarion grant
application submitted by GEMA to DH$/FEMA and to use grant funding only for projects pre-approved
by GEMA.
4. The Subgrantee agrees to sign and comply with the terms and conditions of G.EMA.'s Statewide Mutual
Aid and Assistance Agreement and to render mutual aid for a suspected or real attack or in the case of
weapons of mass destruction or other event, as GEMA determines needed. Subgrantee shall sign any
other Mutual Aid Agreements GEMA or DHS/FEMA shall deem necessary in order to assure the
Subgrantee will fulfill its obligations to render mutual aid.
5. Any Subgrantee receiving funding for purposes of explosive ordnance disposal (EOD) agrees to compl.y
with the following:
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(a) Each EOD and EOD K-9 team shall report responscs via the Georgia Bureau of Investigation (GBI)
Response Reporting automated program. This condition shall take effect as soon as the program,
currently under development,.is available for use: .
(b) Each local EOD and EOD K-9 team shall contact the GBI by telephone immediately whenever
responding outside of its jurisdiction.
(c) Each EOD and EOD K-9 team shall participate in the Georgia Explosives Response and Reporting
Network (GERRN) as requested and to the extent requested by GEMA, Georgia Bureau of
Tnvestigation (GBI) and/or other agency(ies) designated by GBMA. Once activated, use of the
GERRN may supersede conditions (a) and (b):
6. Subgrantee will continuously maintain up-to-date data for its current resources in the Resource Database
which can be accessed on the Web at https://rdb.gema.ga.gov.
7. Non-Supplanting. Requirement: The Subgrantee agrees that federal grant funds received under this
' award will not replace (supplant) funds that have been budgeted for the same purpose through
non-federal saurces. Applicants or grantees may be required to demonstrate and document that a
reduction in non-federal resources occurred for reasons other than the. receipt or expected receipt of
federal funds will be used to supplement, but not supplant, sfate or local funds for the same purposes.
8. The Subgrantee agrees to cooperate with any assessments, national evaluation efforts, or requests for
information or data collection, including, but not limited to, the provision of any information required
far the assessment or evaluation of any activities within this agreement.
9. Federal funds provided under this grant program are for 100% reimbursement of all eligible
expenditures. Subgrantee will follow procurement standards as stated in the current edition of the
Financial Guide (Exhibit A). .
10. Subgrantee understands and agrees that compensation for individual consultant services is to be
reasonable and consistent with the amount paid for similar services in the marketplace. Time and effort
reports for consulfant services are required, and competitive bidding is encouraged, as explained in the
current edition of tbe Financial Guide (Exhibit A).
11. Subgrantee 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, regalation or policy, at any tevel
of government, without the express prior written approvai of GEMA and DHS GPA
12. No elected or appointed official or employee of the Subgrantee shall be admitted to any share or part of
any benefit, directly or indirectly, from this agreement or. from the grant award. This provision shall not
be construed to exten� to any contract made with a corporation for its general benefit.
13. If the Subgrantee violates any of tlie conditions of this agreement, including any exhibits hereto, or of
applicable federal and state law or regulation, in addition to any other recourse available, GEMA shall
notify the Subgrautee that additional funds for the grant in connection with wliich the violation occurred
will be withheld until such violation has been conected to the satisfaction of GEMA. In addition, .
GEMA may also withhold or require repayment of all or any portion of the financial award which has
been or is to be made available to the Subgrantee or retained and expended or obligated on behalf of
Subgrantee for other projects under this program, this or other agreements, and applicable federal. and
state regulations until adequate corrective action is taken.
14. Copyright: The Subgrantee understands and agxees that for any copyrightable work based on or
containing data first produced under grant funding, the Subgrantee grants the government a royalty-frce,
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nonexclusive and irrevocable license to reproduce, display, distribute copies, perform, disserninate, or
prepare derivative works, and to authorize others to do so, for government purposes in all such
cnpyri�hted wnrks. Subgrantee shall affix the applicable copyri.ght notices of 17 U.S.C. §401 or 402 .
and an acknowledgement of government sponsorship (including grant award number) to any work �rst .
produced under this grant award:
1 S. (a) Subgrantee shall comply with all applicable federal state, and local environmental and historic
preservation (EHP) requirements and shall provide any information requested by FEMA andlor
GEMA to ensure compliance with applicable laws, including: National Environmental Policy Act,
National Historic Preservation Act, Endangered Species Act, and Executive Orders on Floodplains
(11988), Wetlands (11990) and EnvSronmental Justice (12898). Failure of the Subgrantee to meet
federal, state, and� local EHI' requirements and obtain applicable permits may jeopardize federal
funding. Subgrantee shall not undertake any project having the potetttial to impact EHP resources
without the prior approval of FEMA, through GEMA, including but not limited to communicarions
towers, physical security enhancements, new construction, and modifica#ions to buildings that are
50 yeazs old or greater and shall coordinate with PEMA, through GEMA, regarding any activities
using grant funding that require specific documentation of compl'iance with federal laws and/or
regulations. �
(b) Among othex requirements, Subgrantee must complete and rettirn to GEMA witl� the signed
Subgrantee Agreement the Environmental and Historic Preservation Screeriing Memo (EHPSivn,
attached as Exhibit K to this ageement. Subgrantee must comply with all conditions p[aced on the
project as the result of the EHP review.
(c) The subgrantee shall provide any information requested by GEMA or by FEMA to ensure
compliance with applicable federal EHP requuements. Any change to the approved pioject scope
of work will require re-evaluation for compliance with these EHP requirements. If ground
disturbing activities may occur during project implementation, the Subgrantee must ensure
monitoring of ground disturbarrce, and, if any potential archeological resources are discovered, the '
recipient will immediately cease construction in that area and notify FEMA through G.EMA and the
, Georgia Deparqnent of Natural Resources, Georgia State Historic Preservation Division.
(d) Subgrantee shall not. undertake any project to which the National Environmental Poticy Act (NEPA)
requirements are applicable wit6out obtaining written approval by FEMA, through GEMA, prior to
use of any HSGP funds for. constxuction or renovation, including without limitation, security
equipment and certain non-construction projects, Subgrantee shall coordinate with GEMA
regarding any activities using grant funding that require specific documentation of, NEPA
compliance. Any construction activities that have been initiated prior to the full environmental and
historic preservation review and evaluation will result in a non-compliance finding and will not be
eligible for HSGP funding.
(e) For more inforniation on FEMA's fiHP requirements, Subgrantee should refer the FY 2011 Hometand .
Security Grant Program (HSGP) Program Guidance and Application Kit. (Exhibit B) and to the
FEM.4's Information $ulletins 329, 345, 356, and 371, available on the intemet at:
http://www.fema.gov/pdflgovernmendgrant/bulletins/info329
http://www.fema.govlpdflgovemmentlgrant/bulletins/info345
http://www
http://www.fema.go.v/pd�/government/granf/builetins/info3 71
Additiona3 infoi�mation and resources can be found at http:J/www.fema:gov/plan/ehp/
18. Subgrantee agrees to cooperate with GEMA in assuring that any training funded through HSGP funding
is reported through the training Information Reporting System ("Web-Forms"), as rr►ore fully explained
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22. In accordance with the Department of Homeland Security Appropriations Act, 20l 1(Public, Law '
l 11-083), grant funds must comply with the following two reguirements:
(a) None of the funds made availa6le shafl be used in contravention of the Federal buildings
. performance and reporting requirements of Executive prder 13123,.part 3 of title V of the National
Energy Conservation Policy Act (42 USC 8251 et. Seq:), or subtitle A of title I of the Energy Policy
Act of 2005 (including the amendments made thereby).
(b) None of the funds made available shall be used in contravention of Section 303 of the Energy Policy
Act af 1992 (42 USC13212).
23. In addition to other noncompliance remedies, GEMA/HS or DHS-FEMA may unilaterally tertninate this
grant award, without penalty, if the Subgrantee, any employee or any person or entity otherwise imputed
to the Subgrantee is determined to have violated or failed to report allegations of a violation of certain
provisions of the Traffickit�g Victims Protection Act of 2000, as amended, engaged in severe forms of �
� tra�cking in persons, procured a commercial sex act, or use forced labor:
24. When implementing DHS/FEMA GPD-funded activities, the Subgrantee understands and agrees that it
must comply with all federal civil rights laws, to include Title VI of the Civil Rights Act, as amended:
25. If using subcantractors or contractors, Subgrantee shall use small; minority, women-owned or
disadvantaged business concerns and �ontractors or subcontractors to the extent practicable.
26. The Subgrantee understands that beginning on July 1, 2007, any public contracts and subcontracts that
are funded by the HSGP must comply with the requirements of O.C.G.A. §13-10-90, et seq., and
Georgia Department of Labor Rules 300-10-1, et seq., to verify the contractor's or subcontractor's new
employees' work eligibility through a federal work authorization program.
Changes to Agreement: There shall be no changes to this Agreement unless mutually agreed upon by all
parties to the Agreement.
Termination
This agreement may be terminated for any.or all of the following reasons:
1. Cause/Default: This agreement may be terminated for cause, in rvhole or in part, at any time by the
State for failure of the Subgrantee to perform any of the provisions ar to comply with any terms and
conditions fierein. If the State exercises its right to terminate this agreement under the provisions of this
paragraph, the termination shall be accomplished in writing and specify the reason and termination date.
The Subgrantee will be required to submit the final invoice not later than 30 days after the effective date
of written notice of termination. Upon termination of this agreement; the $tate shall not incur any new
obligations after the effective date of the termination and shall cancel as many outstanding obligations
as possible. The above remedies are in addition to any other remedies provided by law or the terms of
' this agreement.
2. Convenience: This agreement may be cancelled or terminated by either of the parties without cause;
however, the party seeking to terminate or cancet this agreement must give written notice of its intention
to do so to the other pariy at least 30 days prior to the effective date af canceIlation or termination.
3. Non-Availability of Funding: Notwithstanding any other provision of this agreement, in the event that
either of the sources of funding for reimbursernent under this agreement (appropriatioris from the
General Assembly of the State of Georgia or the Congress of the United States_of America) no longer
. .10-
exist or in the event the sum �of all obligations of GEMA incurred under this and all other ageements ,
entered into for this program exceeds tl�e balance of such fundinp, then this agreement shall
immediately ferminate without further obligation of GEMA as of tfiat moment. The certification by the
Director of GEMA of the occurrence of either of the events stated above shall be conclusive.
AGREED by all parties:
By: g �
Aut rized Gra ee antee's Authorized Officia
'� � � �vE !S 20/ 2-
Signature e Signature Date .
��¢�a-u�ck L. �.u,rs6u-
. Printed or Typed Name of
Subgrantee's Authorized Official
/
..i w
� -11- . . �
: . ��ch i b it � � .
.
NIMS Compliance Form
This NIl1�IS Compliance Form MUST be completed by each agency
requesting or benefitting from funding.
In federal Fiscal Year 2011; state agencies, tribes, and local governments are considered to be in full NIMS compliarice if
they have adopted and/or implemented the FY 2011 compliance activities as determined by the National Incident
Management System Capability Assessment Support Tool .(NIMSCAST�. This document describes the actions that
jurisdictions must have taken by September 30, 2011 to be compliant with I�1IMS. Homeland Security Presidential Directive
5(HSpD-5), Management of Domestic Incidents, requires all federal departments and agencies to adopt and implement the
NIMS, and requires state and local jurisdictions to implement the NIIvIS to xeceive federal preparedness funding. Please
check the box next to each action that your organization has completed. For those actions not completed please provide a
one-page summary of the plan to complete these actions and fully implement NIMS. Additional I�IMS guidance can be
found at www.fema.gov/nims
�Communiry Adoption: Adopt NIMS at the community �Implementation plan exists at agency level that identifies
level for all government departments and/or agencies; as the appropriate personnel to complete the tielow listed
well as promote and encourage NIMS adoption by NTMS training requirements.
associations, utilities, non-governmental organizations �Complete IS-700 NTMS: An Introduction
(NGOs), and private sector incident management and �Camplete IS-800 NRP: An Introduction
response organizations. �Complete ICS 100 and ICS 200 Training
�Incident Command System (ICS): Manage all emergency �Implement TCS-304 Intermediate ICS
incidents and preplanned (recurring/special) events in []Implement ICS-400 Advanced ICS
accordance with ICS organizational structures, doctrine, ,%(�Implementation plans exists at agency level that identifies
and procedures, as defined in NIMS. ICS implementation the appropriate personnel to complete the below listed
must include the consistent application of Incident Action NIlvIS �training requirements
Planning and Common Communications Plans. �Implement IS-701: NIlviS . Mutliagency Coordination
�Public Information System: Implement processes, Systems (MACS)
procedures, and/or plans to communicate timely, accurate [jImplement IS-702: NIMS Public Information
information to the public during an incident through a �Implement IS-703: N1MS Resource Management
Joint Information System and Joint Information Center. �Implement IS-704: NIlvIS Communications &
�Preparedness/Planning: Establish the community's NIMS Information Management
baseline against the FY2008 and FY2009 implementation QIncorporatb NI1v1S/ICS into all tribal, local, and regional
requirements. (NIMSCAST and/or Implementation Plan) training and exercises.
�Develop and implement a system to coordinate all federal �Participate in an all-hazard exercise program based on
preparedness funding to implement the NIMS across the � NIMS that involves responders from multiple disciplines
community. and multiple jurisdictions.
[��evise and update plans and SOPs. to incorporate NIMS �Incorporate corrective actions into preparedness and
components, principles and policies, to include planning, response plans and procedures.
training, response, exercises, equipment, evaluation, and �Inventory community respanse assets to conform to
corrective actions. homeland security resource typing standards.
�To the extent permissible by law, ensure that relevant
national standards and guidance to achieve equipment,
� communication, and data interoperability are incorporated
into tribal and local acquisition programs.
�Apply standardized and consis#ent terminology, including
fhe establishment of plain English communications
standards across ublic safe sector.
Authorized y � --
Signature: " C.-.� Date: �� 0���— Agency: A��STA F p: D� R�t�rr
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i.r
. Ex�it�it_'� �
►
EXHIBIT E � �
Date: .
Georgia Emergency. Management Agency
OJP FY04 Stat� Domestic Preparedness Equipment Program
Payment Reques� Form
Instructions: All requests for payments must be supported by documentation supporting actuat expenditures. Itemize each
expenditure below to the fullest detail possible. Attach documentation that supports this payment request, such as copies of bills of
sale, invoices, receipts, and canceled checks evidencing payment. Do not send originals. Attach a continuation sheet if necessary.
" Please refer to Budget Warksheet for information needed in the following section *_
Budget Worksheet Number: GAN Number: FIPs Number: �
Applicant: Area:
(from Continuation sheet attached)
SUBTOTA'L
TOTAL .
NET AMOUNT RE UESTED
Under penalty of perjury, I certify that to the best of my knowledge and belief the data above are cc�rrect and that all outlays were made
in accordance with the grant conditions or ather agreements, comply with procurement regulatians contained within the Financial
Guide, and that payment is due and has not been previously requested. I understand that any part of this pay�nent request that is not
supported by cost documents and/or expended within the scope of the approved project will be refunded to the State of Georgia within
30 days of receiving the deobligation notice.
Signature of Subgrantee's Authorized Representative Printed Name Contact Phone Number
�
� . h�b��
�X
,
. _ . �
. public�reporiing burden for thib:coilectbn oi &�formaU� ic eatimatetl to averepe 1b minutes per response, includinp Bme tor revlewing '
inctructicns, ceerchinp existln� idata souress, pather(ng and malnt�iining �the dsts needed, and compleUnp end �eviewinp the aolleeti0n ot �.
Inlormation: Send 4ommenfa•FepardJr�p the burden sstimnte or any other Bsped o1 thls collection oflnformation, indudinp auppcsUons tor
reducinp thfs burden, to the Office of Manapement and BudQet, Papenvork Reduction ProJett (�948•0042), Washlnptan, DC 20GQ9.
' • ' . ,:
PLEASE DO NOT'RETURN YOUR COMPLETEQ FORM TO 7HE OFFICE OF.MANAGEMENT �ND .
BUDGET.'. SEND fT TO THf ADDRESS PROVIDED,BY THE SPOi�$ORlNG AGEN�Y.
NOTE Certafn of tlie6e acsurences. may not be appticeble to your proJect or p�o8rem. If you haVe qt+esUons, plesse contsct the
Awerding Apency. FurtAer, certein Eede�faesiaffinCe awardin8 agencies may requlre applicantc to certtfylo edditionsl
asaurances, if auch fs the, case, you vv�U be nottffed. . �
As the duly authorized repreeentetiye oi ihe spplicant:, I certNy that ttie applicsnt:
1. Hec the legal euthorlty to eppiy for F,ederal esslatance, 8. WIII �mply with ihe Intergovemmentet Pe�aonnel Acf
snd the instttuUonal, menaper(al and flnenclel,capabilky oi 1�7b (42 U.S.Cs §§4738-476.3) rela�ing to proscrlbed �
(including funda sufficlenl to:pay the nori-Fedeia! share • stsndarda Qf.merH systems for p�opreme funded . .
� ot�rojed.coats) to enoure proper planninp, � �under:one of th9 18 �tatufes o[ repuls�ions.specHied in
menepeinent and compleUon oL projec4 deacribed 1n Appef�dix A of OPM'a Standards ior a Merit•Syalem of . .
���pD���4�r ' ' Pertonnel AdministraUon (5 C.F.R. 9�0, &ubparl F).
' 2, VJill glve the awa.rdtnp epency, the Comptroller �6, WIIT cortiplywith the Lead-6esed Palnt.i?olEOninp .
of ttfe Unfted Sfetes and; K appKtpriaie, tho Stste,, PrevenUon,Act.(42 U.S.C'. §§4801 el seq.) which .
the tlpht to examine ell records, tiooka, papers, or proMibkc.the uae of bad-besed paln In conafiuction•or
tlocuments related (o the assistance; and wUl esiabltah rehabilltatlon ei rosidence 6hvcturea.
s proper accounttng eyc�em in eceordarce with � `
genersllyaccepfedaccourtQnp�atendardsorepency �0. Wtit.corimpywith'a1lFedeteFsfnlutesfielatinp.tpnon ,
directives. tli�C�Imirqtbn.,Thes��includ�.but s�e not UrnNed to: (a) . �
• . � Tftle Vl.tif the f;iVlt Riphts Act o!'19G4.(F.L. 88-862)
8. WJII aot disppte;of,. madHy the use of,�or ehappe the rVh�p� distxifikiatlqn Qn 1Me-bhsls o! race,
tertna �of tbe.rea! Propertytitte. cr+tlther�inteteatin'Me 'kf�lbr�1 oripin; (b) 7fNe IX ot the Edu�aticn
: arie:�nd ^fee�Iitiee withp�rt.periilieeion and inetr�ctiona ',p,'�1$i!�id�t�s� of �1992, ss ame„ded (20 iJ.S.C. §§1687 •
front the awerdinp epency. WI!l�record tf►e, Federel 1B83.. and 1s85-1686). wF�ich prohibiffi dtec�iminatlen
; awerdinp.�8enc,y:dlrectives and wtll k►clude a eoveriant on tl�e basis o7 sex; (c) SectioYi 504 ot Nie
.Jn 1he.tMle.ot.ceal' property acquked In wMle or tri part � ttadiabN�atio� Aci M.'187�, is;rt�ended (29).U.$.C.
with�Federsi assictsnce fundk to pesufe ►1on-• rah[bits disct3inineUonon the•basi� ot
��r'�� , .
diacdmi�aUon durinp'the usetul.11Te •oi fhe pro�ect. M�tstl3craps;qtf�.�the�A�e .DleirimlA�loe Ac1 of � 976, as
amended�•(42�U.S.C. §�6l01-6107), v�d11�1i pro�ib�ta
4_ •�II�COmply. wlth the tequlremehta oi the ascisiance diaC[imination •o� the basfa ot.aQe; (ej the Dn�p Abuae
ewariiin8 apency with repard to �he.dreitinp,,review and plTic$: and T�qatmenY Aet oi��1872•(P:L. 93•�65), as
aRproyal of plena.and cyssctQca.tjons. amendsd rela�np to.nondiscriminafion,on the basis ot
' drup.�buse;. (� fhe Cotnp(eh�rnive: Ak;olml MuEe.• and
S. V17II.provide and mefiteM cpmpeta�t and edequatB q�ohoUsm P.revetaUoA, T►setmeM and Reheblll�e,tion
engineierinp aup.eM6lqn.et tbe conttruction.a.he;to qct of:1870 (?.L: 91-�18j;�as ame�ded, roleUnp ta
erw�►,re thaf �the comple.le woNc•eoMortno wtth t11e nendieeHmirmUonron the b�sis •oi abohol abuse or
�appr4ved.planc and speclflcaSone ai►d wAI turriish • aloohoqsm;.(p) ¢�629 and 62� ottbe 1'ublie, Heafth •
pro8�ssive reports and euch othbr inforrrttUomse may be SeMee Aat of 1914 {4� U.S.C. �§290 dd-8,and 290. ee •
roqu(retl by, the�aeefsiance awardinp agency or Stete. 3j, aa $mendep; relatl� to. i�n8detitialily of slcohol
. . ' and drup dbuse�pa'tiqnYtscordr,•(h)Twe V111.Mthe ,
6. 1Mii Inttlaie and caraPlete the�wqrk.within the npplfcabte Cfvil R(phta'Act•ot 1�68"(42'US,C: §§9�01 et sbq.), as
time trame'stter 'reeelpt oi appr�vsrof the sws�d)np aBency. amended, relagnp tq hontliscMnManon in the sale,
• rentatorfinan�lnp of.h�usin�r(Il eny'other
7, �JIIIest�bllshasfepuardatt+prohlBlt�mpltfyaesiroin nondlcciiminalinqprovislqn��inllie�spedTic.etatue(s)
uslnp thelr posftions for e puijwee Khat cor�ttttutea or under whtch appllcatlon Tor Fedeiel;ae�lite�,� ��►8
presents the eppearanee ot petson,sl or orQanlsstianel � made; end (()'fhe requiretnenta oi 8ny other
confltct of Interost, or pe�sonst gsini ' , nondlocrlrnlnaticn atatue(a)whict�'inoy epply�to tbe appllcetlon.
Pnevloua Edttton Usable �. AutFiorized tor I:oeel Reptody�tlon � SfsndeM Formm �t0 (Rev:.7� .
. , j, ' • Pr�sertbed bj�.ON�B Clleultr /4102 —
. .. ....- ---� � - • - -
requfrements of'iiUe6 IFend 111 ot the .Unliorm Relocation 190) and.Executive Ordet (EO).1'1514; (b) notNicsUon .
Asai�tanCe end Reel Property AcquisNlon. Policiea Act o! o! violetinp tedUUas pursuant lo EO 117.88; (c)'
4970 (R.L. 91-645) which provide for loir and 'equNabk' proteclion ot wetlands purauant fo E011990; (d)
trepii»ent of persona displeced or whae properly.ta � evaluaHon o1 tlood hezerda in floodplains In acc4rdance �.
� acquired as a reauH of Federsi end tederally-ascisted with E011988; �e).asaurance oi p'roject .
propr,ams. Theab�requiremenfs epplyto ell Inte►ests in rea! wlfh the approved 8tste meneQement ptoB►am
propertyacquirod !or proJect puryso�es repmrdiesa oi. developed under the Cosctal Zone ManapsmehTAet of
Federal parUcipetion in pprctiasea. 1872 (16 U:S.C. §�1461 et'seq.); (� corKormity ot
. ' • Federel aetfons to 8tate (Clean Air) ImplementaUon .
12: VJlll comply wfth the provicions M the Hatch Act (b U.S.C. Plsns under Sectfon 176(c) oi the Cle�n�Nr Aci o1 •
§§1501•9608 and 792�{-7828)whkh 11mHthe poitlicBJ 1855; as emended (42.U.S.G. §¢.7401 etseq.); (p) .
activities of empleyees whoae p►incipal employment .protectlon of underground eourcea of drinkinq�wator
aetivitles are iund�d in wbole or in pert wlth Federal tunds. under the Safe Drinkinp Water Act oi 1874, aa
� amended (�.L: 89�523); and, (h)pro�ction oi
13. Wi11 compty, as appUeable,'wfth ffie provlsions of the Dav(s• endanpered species under the Ei►danpered Spetles Act
Becon Act (40 U:S.C. §§276a to 276e-7), the Copeland Act of � 878, ad amended (P.L. 98=208).
• (40 U.S.C. §Y76c�end 18 U.S.C. §874), snd the Contract
Work Nours �nd Ssfety Standardc.Act (40 U.S:C. §§327• 16. � Will comPly with the Wfld and ScenCc Rivera Acf of
�. SSS)'cepa►dinp labor sisndards forfederally.ess)sied , � 19B8 (16 U.S.C. §§7277 etseq.) telated.to prbiscfing
construction sutiapreements. • � componerris or potential.componenfs pi the naUonsl . '
� ' � ' wild and eceNc rivers tyetem. �
14: �II comply wlth flood Inoutance•purcbase tequlrements, of � �
Sectton 102(s) of the Flood Disaafe� Protection.Acf of l973 • � 17. Wilt�assist th� awnrdinp egehcy In a:curinp eompUpnce
(P.L: 93-2$4) requlr�c ►ecipients in 8 speciel'fbod� with Section �.06.otttje J�atlonalHfetoric ProseivaUen,
hazeid area to perticipats in the prbpiam and 2o purchese Act ot 1966,, as amentled (76 U.S:C.�§470), EO 'f 1699
flood in'suranae H fhe tot�l cost oi inaurable coriaVuction• . .pdentNicalion and ptotecllon of hfstodc p.ropetUea), and
snd acquisWQn�is 510,000 or more.• , the Arcfieeolopical and HisloNcPnaer�aUori Aet of
. �1874 (!6 U.S:C. §§489a-1 et.�eq).
45. VJpI comply with enWronmentai standarda whioh rr�ey be ' � '
preacribed pursuant�to the followinp: (e) fnctibition oi 18. Will•eeuse to be perfotmed the�tequired firrencisl 8nd
anvlroAmental quadty control meaenres under the . eomplia,n.ce.audit6 lri eacotdance•wilh 1he Sfnple Audlt
�. . Aet Amendments at 1986and OMB �ircular No. A-133,
• •Aurlits•�oiSta�ea. l:ocal ¢O�mmantc. and Non-Pro1N
Dr�ani�stk�� ` � '
18. YYillr�piywfth atl appllcaDle, roquiremeMa of aD other
Federe►iswa, executive.orders, regulsUons, and poUcles
. povern(tiD twis proDram: �
• SIGNATURE OF AUTHORIZ�D CER FY�NG OFFlC ' TRLE � � �
Completed on suDmission 1p Grantapov � . � • �
• APFUCANT OR6lkiJ�Z�4T10N � � ' ' • DATE SUB1J117TED ,
Complelee q� submission to GrnMs.pov
. � . . bF424D (Rev 7-971 Bak
. ' . . • .Ezplra9on De1s 04180�OD8 '
' - AS$tlRANCEB -�htQN-CONS.?RUCTION PRO'l3RAMS : • • . • ,
Pubtic reportlnp burdeh tor fhk colkatfon lnfonn�Uon.is eatimnted to �verapE �6 minutes per recponse, including;Ume ior rsvlev,�inp �
• inst►uctfo�s, sesrchinp exia8np dats apprces, pathetinp and m�tnteininp !he tlate nesded, 6nd cotn'pletlng snd,revte,wfnp ihe cotlection bf ., .
trNormation. Sand eomments teparating the burden eaUmate or eny other bspect of thia collection of lniormstion, lricluding tuppeciiona for
reducinp this burden, 4o tbe:Of(ice of Menagemenl snd'Budpet, Paper.woric I�etluciion Prejeci (.0348-0040),�WeehMpton, QC 20503.
PLEASE DO NOT RffTI�ItN YOUR COMPLEj�D FORM TQ THE OFfICE.OF WiANACeEMENT AND SUDGET. SEND
IT TO .T.HE ADDRE$S PROViDED RY 7NE S.PpN$QRING AGENCY. � ' '
N07E: �ertein.of theae asaursnCea m�y riot be appliaable !o you► ptojeci or proptarii. If you have,questlons, please contacf tNe .
, awerdfng agency. Furiher, certsin Federal awardln� e8encies may requlre applicsnta to ce�fHq to adtliUonal essurences. li
sucA !s the cese, y0u. wiil be notiffed. '
As ihe duly auth�rized teproaentaUve qf tbe applicant, I certify thet the appifcant: ,
• . �. Hsa 1he lepel,authoritylo apply for Federel sasiatence Act of �978, sa emended (28 U.S.C. §794), Whlch
and t�e,inatltudonal, mahag8rial;sndfinendal cepability prohtbks on the bae[s'of hsndloaps; �d) .
{includin� funda'auHicientto pay the non-F�deral,sh$re the Age Discrimination Att of l�15, as amended (42
ot'proJect cdst) to`ensute proper p�lannl�8, mgnapemant U.S.C. §§6901-61D7); whfch piohlbltadls�Minsiion
and compieUon o!!he proJect:described in ffifs on .the baais �of ape;.(ej the D'rup Abute 081ae and
eppace8o�. • �� Tnatment Act of 197�.(p:l; 92�2bb), as emended,
relaU�p to.nondiscrimMetlon on tFie: beti� a1•drug
2• Wflt Bjve the awardlhp apenry, tAs ComptroNer General abuse; �(� tMe Compceheruh!e Alcohal �Abuse end
. of the .United antl, if ap.proprieie, the State, Alcoholism Prevenilon, Treatnient�and RehablUtstion
tfirouBA ahy euifiorized tepresentsiive, aocess to and Act of 1970 (P.L. 81-B16j,:sa amerided relptinp tp •
' 'the dgfif to,eze,mine all recorda, books, pepibrs, or nondiscrlin�nstfon.on tne qado oi alcohot abuse or
docqmatne relat�d to the awatd; a�nd will sstablish s.' a�cotwlfsm; (gj �¢b29 antl'b27 oiZl�e Pubitctleelth
properaecou�inp•syaLem in accordance vvi�•perilrapy Setvrae A� of i8i2 (42 U,S,C §�2eo �a-a an� seo e�.
accept�d iccounBnB standarQa br aQera�y direCtfves. ' 9), aa amer�ded, ►elaHnp' fo con}3dentlsl�ty ot ok;phol .
� ' aad �lwg abu6e petien!'recotds; (h) Ykle Vtll oi the
� 9. 'Witl:�estebtish satepuanfa, to.prohibit.employses fr+cm CIv11�Rights'ACt of 1�G8 (?(2 U:S.C: �§9601 et seg.], as
�uatnp•thefr po'sNtont,tor a purpase�tAaf coMfltutes or ameriiiad. reletfnp tc�nondiscrlmhq�tJon !n the s�elE, •
presnnis appe.rsaoe of.�argpr�l�pr organ�;lOra41 tentel or fltoan�ing housing;.(i) any other
eoMUct oi interast,� er�perscael,galn. � ,r�oadiscrimli�sUon provial4i� in the specti�c st�wle(s)
.na►�r�pVMtch,appdcetioo for Federat assisterice k being
-• 4. Wttl ]nitiatp and�complate.ihe work vvltt►ir� the appliceble mede; and,.Qj.tt�e requfremer�i {af anp other{. �
Ume fram� aftec reeeipi�pf approyal�oi thZ �swerdinp nondiscNmirlstibn etstuto(aj.whtoh�may s'pply'tq the
� apenc�y.. ' • .
. BPPUcatfon. ,
� 6: Will comply with thc In4ergovem'meMal Personpel:Acl of . 7. Wiil con�ply, or hhc: already.coiriptfled. +�flth the•
i970�(42 U.S.C..§§4728,-4763) tsi�Unp lo�pr�eacribed �qui[ett�eMs. of TfEles 11 ebd:Jli ofil►e 41nMam
stand erda ior medt eystemr for�yroprams: funded under �
one of the 19 ttetetee oc repule�iona epealtfed In �e�atlon Aae�afance and Rsai PMp4rty'Acquiaitibn
APP6ndlx A of nP,M'e Stpbdards: ior a M4Nt System of Pcliciea Act isi 1870 (P.L. 91�&f6}.whicliptov)de ior
Persnpnel AdminEo.tretlon {5 C.F.R, 900, Subp�rl F), ��r.and.�qufts6le troattnei�t M persono dfspieced or
, . , whoae prope[ty !e acqi!Ind ss a rasulf oi Fsderal or •.
6.. . VVlll;cpmplywtfh.a7t �eder�l:aletytes reJettnQ to' • iederaliy-asslaUe�F ProBrems.'�e.requirements.aPP�Y
�ondfscriminaUOn, 7hec,e ir�clude b W�e►e noi IimHod to: to ell irrteresis M.teal. P►cP�er�Y aWWcid dor Dt'olect .
• (s) 71tle Vl b! the.�iWl:Rights •A�t. of 1966 (P.L, 88-8�2) Purp6se6 repardlsas•M Federal parfid�eNqn ln
'> which.prohlDfts.dfacrlml�aUon or�, the.beaic M nce, color Purchasea. '
or nationpl oripin� (b) TIl►e IX oi fhe Education g, W(!t eompfy� 6b 8ppllCeble� with proviabns oi ths
Amendmnn�s'of.1672, sc.amended'j2D,U.S.C. ��1.681- �
1683, snd 1866�1686); which prohibtts dfscrlminaiion'pn �Natch Act (5 U..S.C. §§1b01=150$ and 7�24-.7a28)
the baets oi snx; (c) Seetlon 604 of the RehabtlftaUon ��h pmlt the polkbel eeUvhles o! employeee whose
prfncippt amploytnent activltks aro funded M wt�oie or
� ' • ' in part with Federal fund;. �
Prn7ous EdHten.uuble • - .
• 8tandu0 Fonn tII1B (Rw.1�fT)
Authortzsd for Loeel Reproductlon I�r�salb�d by o1R6 Ckeui.r A.tos •
- ' �
9: tN)II comply; at eppllceble, with the provisiona oi,lhe Davia- 92 Witf comply wMhYhe WIW and 9aenic.Rivera Ad oi.
Bacon Act (40, U.S.C, §�276a �tio 276e-7j, ttie Copeland Act t968 (16 U:S.C. §�1271 8t seq.) teleted }o proieeting
(40. U.S.C. §2I6c and 18 U.S.C. §874), and the CoMreet components or potenUel components oi the tistional'
Work Houf� a�d S81ety Stendards Act (40 U.S.C. �§927- wUd and scenle f(vera ayctem. �• � .
S93), tegaMtnp Jabor atendard6 for fede►elly-assfckd . ' .
constniction autiepreements. ��, YJtll asafstlHe ewardinp epency in eQaurinp cbmplierice .
� ' wkh SeCiion 1 D6 of ihe Natbnal Hiatoric Pre�eryeUon
10. Wifl aompty, Bapp�icable, with itood insurance, purchase Act oi 1.966, es ameoded (16 U.S.C. f470j, �0 19593 �
. � iequiremente oi SecUon 102(aj o! th,e Elood Disa6ter • (iden.tHiCaUoq end proteeUon'oi historic propeRka), and �
P►otection Act ot 1823 (P,L, 88•294) whl�h requires the fvchaeolopical and Historic AFt oi
reciptents in a.cpeciel ilood,h8zard ores to participate in tne� 1874 (16 U:S:C. §§468e-1 etseq.).. •
. propram and �o.purcFiase,ilood ins�rance H the totel cost of �
InsuraAle cohatruGion and.ecquisitlon Is $1D,000 or more, 14. WIII comply wYth P.l. 83-948 repetdinp the protection o!.
� �� ' . fiuman subJecta �nvolvod in reseatsh, developmeM, and
'�?• Wiil comply with enVirbnmeniel Stendards which msy be �I�ted act�vlties supported by thir awerd oi a8fietar�e.
p�eacribed pursu'entYo the fallowing:' ir�slltuUon of � fi, . •• ' '� '
environmantei, uai con�oi measure.€,underthe Natlonei W�►� comply wtth tl►e Leboratory Anfrr�sl Wet(ere Act o!
� �. 1866.(P.L..89-644. 7 U'.5.�. �§2191 ei .
Environmentel POlicy Act o71969 (FS.L. 9�-190) and. �
F�cecutiVe Otdar (EOj 1y6T4; rb) no2lfication of vlolaUng 8�4•) P��inlnp to tfie: cere;.hendlinp,.snd ireatment pf
• fecilities ur�uent to EO il788� c warm blooded anfmqls held 1ar'reseprcfi, teaehinp, or
P ,(_ j protection M weUandb other activtlteE suppaKed bytfila,aweM of a�slatance.
purauant fo �011880� (dJ evalu8tion of flood hez�►ds. ln . . .
floedplalns in accordanc� v�th EO 11988; (e) sesurance of � .yy�p �mpy with the Lead-Based Ps1M Pofsonlny
project conaistency�wiih the approved �Siste manapement p��nUon Act (42 U.S.C. $$4601 et 6eq.) wtiich � �
propram develope,d�under the.Coas�e! Zotie Menapement ' prohibFts the use,oi lend•tiasad palM in conatrucUon or
Act of '1972 (i6 U.S.C, §§145'I et seq:); (!) coMormlfy of ���b(lifallon M�ealdence aVueturos.
Federpl aCUons foStsle (Clean Air) Itnp(ementat�on Pleas • .
, under.Section 176�cj oT.Uie Clepn�Air Act oi 1�56, es 19, WIII cause.d9 be perfom�ad ifie tequired ifnancisl and. •
, amended•(42 U.S.C.��§�401.et seq,); (gj protectlo� of compllance audltg In accordsnce wfih the Slnple Audit
•unde�round sourees of drinklnp waYer upd�r the Safe Act Arii�fiBfients oi 1986 eod OMB Circular No. A-183,
, DrtnkinD YVstet.Act of 1974, aa emei►ded (P.L. 93-629); •q�dlt6 of 8tates, Locel Goverriments, anid lJOn-P�ntti
. � and, (fi) protectlon of endangered species under the Orpaniz�tions '
Endanper.ed Speclea Act of l979, �a arpen�ed (P.L. 99-
2�5). ' .. . ��8• ,�dIAI �aup.l� w1tN.eU appllcable requ}rements oi all other
• �1#�ww8; executWWe orders, tepulations, end pollclea
� �oa�tg�is prog[am.
' SIONATURE OF AUTHORIZED CERTIFYING OFFICIAL • TITLE• •
. Carop�eted on submftaion to GtaMs.gw
' APPUCANT'ORGANIZATIAN: ' " DATf �UBMITTED � . /_ / ! g /�O � Z � '
�7 � l
. ` Canpleled•on aubmtsslon to Grontapov
. ' Sbndnd Fenm.4ZtB�Rw:7�o7) �sdc
� � �
. � �; X�� �
�
�
U:8: D�PARRT'MEKT �F dWST10E � • .
' OFFICf'.OFJUSTIC�.PROGRAMB . , '
' � ;►� - . .?F3FFI,�:E �F YHE' COMPTROLi:ER : � � ' .
. , ' CERT(�fCATlO�i6 Ft�GA�DING� LO� �SUSPLNSiOH �htQ
� OTHER RESpONSIBiLITY MA7T�R�; At�ID I3F��1C-�EVt±Q.R�'t�A��:R�r�UIR,�M�NTS �
Applicsa'!s should rete� lo the�re8uiatlons cilted below to determine the celtlflcat�on to •whtoh ihe� are r�qufred lo,
attest. Ap�►1laeNs ahoutd slao �ev,lew• the 9natfvcilona for oertifioation lncladed.ln the �egulatlotss b�fose oompi6tlnp ttiis
fortn.'Slgttature of (his fonn providos fo� dotr�Ptisnoe with oerttAa�atlo.n requlremeots, under.28 C�fit Part 68; `Ne�c � '
Restrictlons: bn �cbbying' and 28 GFR Pst� 67y'l3q�rernmiat-wlde:0ebsrmenf �nd 8uapertiloh (No:n��crotiretnepQ and
Go'vat/itit�at wide Req�lte.lneafs for Di'ug-1�e,Workplaoe ((3tienis): The oe.R(1tloef(qns shsll be �r�atod•aa .� +nateNei
• rep�esentatl'o'n o1 fsCt Upon wtiioh i�llsnce• wllfbe; pteoed• whe�+ tbe Dapattmenr of`Juat(ce�detettnlAea to aWi►rd tFie
oaveretl trenaeistion; �rant,or oo�para�ve:atirsamsnt� . , .
. !. LQ881'IN(� ' . . • . . . •
, . . . publ}o,(F4dasl:
�.r�ciui�i::by.�ouon �ssz.,nae. st a:a� u.�, ca�, a�a � �u«►.�r F:ao� a s+� 8� smaa� .
• implemenled ;at;28 �FY Pan•8�, fioc porr4fls etrtetii,�p Nit�► a or ootarnti�lon'�f � ta�ery'� .. . '.
� gta�11-o��ooeE!e� �tQ+►a�`tlOOA�..�'d�tie�l�s btfbery i�ekin�iake�
28•�C'�{t,:P�►1:69;.'Ifie�ap�lkiant oa�tfies tfitti ` '�� r�osMnq �..eioloif Propetty:
. cal�+o:���:+�r�ari.�d w�rs �� �beeo p.ta a«na ae. �ol are.�wi�x �aia�i � o�.oia.� o� •: •
. • paldi;�yer9l+�bs'hp'ff',pfNie'upderb�pned;fo�ny,��esotl�tor'!n- �TNUgsel�by,
lfue�l�.Yir'a 1q,l�iuq�b�.aii o�6oet.e►� eit�pl Pf any �y� ��E•�y�alftNe�i s�rtlsd ln,
apl�xlojr�� ��, atf cl'Ao11ro[•e�pid� df. �y�riip�t�b'�* �:��
�; +cr'a�i d�oyos;of a 1ot�ber:ot Co.r�p[Vess � oa�- . • � ' '
r�e�ar►.'�h�•!!��P.��tb'Fede�t��r�nt,•.thid'.eC@er�krio•' (d�Ftsvel�ctwlihtasth�ssryaarPetiOd.P��±�O��PP�-
te
' Of � �BfIB�Ih601:�Afltl 1h! :�I0�4 OOfWH1�I011. �10f1'I11� bDe OI IpOro.���`. ���'����� �8 a
�ei�rwet:�ri�dmsrtt, o�mo�oatten'ot eny gedRisl pnc�t or ' tooaq t�+n�!it�! tcr•ou�e �r,�laiut:.sr►d: •
�a!!'.te.'°�eie!� , .. � � ' . a.�ntl� �i�'�o#�os��Lo,�yao��e .
• �6) Fsdersl aPPr'o1'���,tunda. tiava s1e� �•��'�'�' � '
b �+��,��'
ts�Ve'.��-�flm�'n.�('or•!mP.�oyee of�atlY�°Y. g , • , „ �. •' � ' � � �
Metab�`!Pf��4K�+1� oitios� �r�n�loy,e�� GtinDfs�e. or •
aa� bf d b�r:of Cb�rese 1n q�rReo�lar:w�lt �1�� 3. DF�Uf3-F�Y�fQRl�'1.AGE . .
+ � r � . ti ., d f ?4 � I�ilt � ►d•'F�rii:- �`21�i�l�a�lr�id�l+1� �� (QF�#1�Y�€B ,
Spoi4 �9
."�s..., � �`
,. 'Ls 1�����l�i ht �boor'dilloe+�lth �s Nis�or�: As t�qqt�Ir�ed:4Y �"�''W Ipon•AOte�I•Aii88i.snd
�a�:il�:�jocsj�rwdahqp{�quh+�:thtiShs.J�u�e,qflk�ls,oec� ' �d2�•.CiFRl�tt�8l�.�'��'as
�'pdu8md;�lrifM�awiM�ociaiiaAs:��easc�qw�nds; dd���:����� .�ib�IYdd:�:6�6-r',
st� ���$�� �!D'��+ �4'iM�� �.and' A.'i.'I� �PP�!��`ibatJi wlll or.w�l,�onUriUs kk>.�f�qvide
�pe�pgy�e� � , ��„�.�,�� �tl si�b- a �lnes'�rari�e�e trP�'� .
redp�ehk; . . . . ' ' � . .
: . unt�x7u1:'inalla�t�; disWlW+lia,ti:. ' s � � °t .
2 D6 . . .: • usa oi�'o�'�� Js' , , . .� g�A •
AUM1E�NIFhtTi SCI.r[�Bt�tSIC��I; 7�Wp' {�THH�i` pe•aAd �p�ottyk�pi the: �'�1'w1� be t�ikeh aDbinst .
�P{�I�StQI�:f'�Y�$`, T . . �ibr���asi�t+prc►h • .
(p1�G7` 1��'11�J�7'}� . • ' (p �ab"Ilpti4tig:sn bo�i�oT!�p !lrog�troe`swa^""ess p'°p'�'m 1° .
� • Ddtiani�et�t �nd � � °� #boul-- , •
' ps iequl�d�by E�qeoitU,iro OMer 12649; ... ' •.
. 8uspon�lon, and Ir�QlerAetited at 28 C�R PaK'6't;'�or. ProsPeo- '(1).The dan�s of drup abvse Irt the wotlqAaoe: • .
qVe pb�idPan�cltl ptltt�ary�ooverod trupseat#Dna, ss'�st�ried dt •�:� ��� �� matntalatnp a dNp�hee wotkplace� • .
' 2g GFR Parl:67. 8eci4�n 8�.5i 0-: t 9 ) . � �� d� oovi�saUnp� rehabltUeUon. and: employee.
A. The appiteenl e�rilifes thsi f4 and iis,pNndpalsi . �a p��; and . , �
. (e) fue.not P�senqY debatr�� susD,eed4d. P�sed tot debar- (4) The ix�j th�i mey be : impo�ad upon emDk�° �. .
menL dedand ineliplble. senienoed to •a� denta! of fedasl ' �� �Se NoleUons 000uMn9 tn the vaorkplaoe� , • .
Z1Q[16��E �ly 8�l�6 Of F8d8[B� OOVf�. Of YO�W1�j' �lCO�qd6d •'.
lrorn covered t�oUoria !�y atg� Federal �Rpartrnsnt � ��, k.a roquk �n� t� � e,P�� of dhe s�9- � .
or�+s9oa�l: meM rsQotrod •bY PeraD.�Ph (�): . .
(�) yave nat �rtthio a•three-y�earpeNod proosQtng l�ib applios- � N fhe employee in fho statemer� requirod by pars- ,
Uon bee�cotn9�ted of'or dad�a dvl!)udgment ronderod eDalnst � �� � a oondHion of employraent u�det the 9raat,
� ih�n for oommi��ion cf ttau6• or s�oriminat off�n�e Ia ocnneo- ��� � . . . •
tlori wllfi o�sfnlnQ. stlemptlny to obtaln, or pbrtorinlnp, a . �
o7P FotWt Io6i1B 1�)��S.oJP POtWS.lo6111.4oCih Mto 1oeUt 1vWOH NiE OBaOIETE. . . `
. , �
I .
. • . . : , � �• � .
, j , . . , .
' (1) Ablde by the termc oftfie statement; and . . . . �
'. (2) Noilfy the emplayer ia wrfUnp of h1a or her oom�lotton fo� a . � . , .
• vfolaHon of s. a9tninat drup.s�ab�te 000urttc�$ in the woii�lace ." --�-'
� no l�ter lhsri tive o�lendar ilsyc aHer svoh' oorwiotfon; ' � CMdc Q' t� there sre w�orkplsoss on tile that are not Uiderdlt�tf .
;(e) Notifyln$ ltse. aDenq', � wd8pg� w!!h(� •tb olatendar daYa hece.. ; ' ,
after reoetvin8 notbe undei sutipAt$gn4�Ph d�C1�.tro�n en. 8eatltti 61; 63�.of the teputaibns prr�ddea thal s; grsntes tha! .
( rorn
� 6mPbyee or o�tiwise reaeh�i��aotuel•notioe �of suctt oonvlodla�. � e'Stele rtiay�eleat•to mske one. oerttfioaHo� in lseoh Federal
�mployera 'of �oorivb�ed employ�eea rri�cl`provkk, rio�oe� lndudinp f�sosl y.ear. A ocpy o� v'vhtoh shovld' be.lnduded +Mih eaoti aDr .� , .
po�titon �tle;,losDepartrtient otJus�ois. Ot�oa ef ' � •plibatlontor Daaanr6nent ofJuaUoe,iundinp.8tetes and 5tafe •
JusNoe ProOr�ms. ATTtQ: Cotthpl Dsz{t,�'BS9 iRtlFaria Averwe� �p�noies msy �leot !o tae OJF Fom� 406if�. `
N..V1« washt�lon, fl.C..2059i. Nolioe slwH Molude fhe ideh- ' .. ,
U1"ioatio0 number(s) o( e�ah �e�•gr�nL � • . C�enk I3 R the Stete tyes elected �,00mplete� OJP f�m '.
(�;taWnqong.of the follpwln9 whh1A 90 oelendeP 406x/7. . ,
daysofr�eoe�hdn8,�iotloetMd+�r�utiPaca�iqPh'(�(Yj..Wltlt:' ��— • � " • •
. respac( b ai�y:entP���a#s oo coiwlt�fs�-- '•' ' DRU . YYQRKPtACE. .. .
: : .. , , . . . : , (Cipps��i1�1 AFfE
,. . ,
<1� 7�ild.�v. �pA�prfate �e�t�o�on. s8�tnsi •auoh an , . . . . ... . .
.maoy�e�up.iaarw���saaar�}g�.ter�i�I�iai�n,±oor�:eM�w�n►a�e nsreqt!uietsiri;�g:��►8�ewo�pt.oe.Aator�9as�ana
ceqiitiiR�:i��ttie.iieh'dbbltAtbn;A�•of=(8�:�s�eiidail;.or. h�hetNed.nt,28��R"Part�6T,8�t��'torptai►�Aes...ae . ,
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E�ck�ibit J
U.S. Depat�tment of Homefand Security
Washington, DC 20472
. ��"�"�y�
� � FEMA
� � � . �F��ND SE�� . . .
Grant Programs Directorate Information Bulletin
No. 371
August 31, 2011
MEMORANDUM FOR: All State Adminisirative Agency Heads
All State Administrative Agency Points of Contact
All Sta.ta Emergency Management Agency Directors
All State Homeland Securiry Directors
All Tribal Nation Points of Conta.ct
All Urban Areas Security Initiative Points of Contact
Port and Transit Points ofContact
FROM: Elizabeth M. Harman .
Assistant Administrator �
� Grant Programs Directorate
SUBJECT: Streamlined submissian of Environmental and Historic
Preservarion (EHI') Review Packets and Narrowbanding EHP
Requirements
The purpose of this Information Bulletin is to advise grantees of four streamlining imp�vements
to the EHP review process for the Grant Programs Directorate (GPD).
1. New Contact Informationi.
Effective immediately all EHP materials should be submitted to: GPDE infona,fema.gov.
The GPD-EHP inbox cari receive files up to 15 MB in size. (Note: After September 30, 2011
EHP maferial sent to askCSIDC�a dhs.gov will no longer be processed).
2. Redised EHP Screening Form:
In aai attempt to fiuttier streamline tha EHP review process, tlie CrPD-EHP team has
simplified and shortened the EHP Scieening Forin. A copy of the revised EHP Screening
Form can be downloaded frorn:
btta://www.fema.eov/doc/ og ve_znmenbg�ant/bulletins/info329 final screenin� memo docx.
This form must be completed for a11 of the following GPD funded activities:
• Physical security enhancemerits
• Renovations%upgrades/modifications to structures
www�ema.gov
�
• Any projects with the potential to cause adverse impacts to natural, biological or
cultural resources (including historic .properties)
Upon receipt of an EHP review packet, each project will be issued a Case ID number. Grantees
will be sent an e-mail with this Gase ID number within five business days. To facilitate
communications, the Case ID number shauld be used in all futuz'e EHP-related correspondence
for this project. Although the EHP Screening Form is comprehensive, further information and
documentation may be required in order to complete the EHP review.
The following activities do not require submission of an EHP Screening Forin:
• Management and Administration (M&A)
• Planning
• Classroom•based Training
• Tabletop Exercises and Functional Exercises
� Training and Operatianal Facercises in Existing Facilities
• Purchase of Mobile and Portable Equipment (without installation)
3. Ne,ed for timely response to requests for more information on EHP reviews:
The first step of the EHP review is to ensure that the grantee's xeview packet is complete, as
an EHP review cannot proceed if the packet is missing information/documentation. If an
EHP packet is found to be incomplete, the grantee will be informed of tlus finding within 10
— 1 S business days and given specific instructions on the information that is required before
the EHP review can start.
To ensure that an EHP detezmination can be made without delay we ask that �rantees comply
with anq requests for additional information from GPD as soon as possible. To encourage
that response, the GPD-EHP Team and your Program Analyst will send grantees reininders
and notific�tions until the information is received. However, if a grantee remains
unresponsive for 12 weeks, the case will become inacrive. Once a case has become inactive,
the project will not be funded unril the grant�e has resubmitted a new and complete EHP
review packet.
4. Envfronmental and historic preseryation (EHP) requirements for grant-funded projects
rel�ted to narrowbandin� migration:
In December 2004, the Fede�al Communications. Comsnission (FCC) annQUnced that all non-
Federal radio licensees operating 25 kHz systems in the 15U-174 MHz and 421=�IZ MHz
bands (VHF and UHF) must migrate to more efficient 12.5 kHz (narrowband) channels by
January l, 2013. T}us will require a wide range of, activities, ranging from replacing and
retuning mobile and portable equipment to the replacing or upgrading fixed equipment.
GPD has defined several categories of naixowbanding projects and their associated EHP
documentation requirements:
• Category 1- Software.upgrades and retuning/reprogramming of egistitng .
equiptnent; These projects involve na physical replacement of equipmenf and
will not require the subrnission of an EHP Screening Form.
• Gategory 2— Purchase of mobile and portable or plug-in equipmentc These
projects only include the purchase or replacement of mobile and portable or plug-
in equipment, though no equipment that requires permanent installation on or in
existing buildings or structures. These projects will not 7equire the submission of
an EHP Screening Form.
• Category 3— Replacement of components within e�sting consoles, sirens or
radios: These projects involve. the replacement of plug-in equipment or
components within existing boxES, consoles, sirens, or radios. These projects w�l
not require the submission of an EHP Screening Form. .
• Category 4- Installation of sirens, radios or other equipment: These pro1ects
involve replacement or permaneni installation of equipment on or in e�cisting
buildings or shuctures, not including the component replacement activities
specified in Category 3. These projects will require the submission of an EHP
Screening Form.
All other narrowbanding projects not described above will require the completion of an EHP
Screening Form, _
The GPD-EHP Team appreciates your understanding and cooperation. If you have any questions
about submitting materials for an EHP review, please contact: gpdehpinfol�a,fema.�o_v.
.
b� � �
EXh� �
. � . ._---,
' ;
Grant Programs Directorate
� �B � Horr�.eland
� ��� Security
�GHD S�+
OMB Control#: 1660-0115
Expira6on Date: 10/31/2013
FEMA Form: 024-0-1
DEPA.RTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY
ENVIRONMENTAL AND HISTORIC PRESERVATI�N SCREENING FORM
Paperwork Bnrden Disclosure Notice
Public reporting burden for this form is estimated to average 8 hours per response. The burden estimate
includes the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and submitting the form. Yau are not required to respond to this
collection of information unless it displays a valid OMB control number. Send comments regarding the
accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections
Management, Department of Homeland Security, Federal Emergency Managemettt Agency, S00 C Street,
SW, Washington, DC 20472, Paperwork Reduction Project (1660- O11S) NOTE: Do not send your
completed form to this address.
Completing the Screening Form:
This form must be attached to all project information sent to the Grant Programs Directorate (GPD) to
initiate environmental and historic preservation (EHP) compliance review, per the National
Environmental Policy Act (NEPA) and other EHP laws and executive orders. There is no need to
complete and submit this form if the grant scope is limited to planning, management and administration,
classroom-based Iraining, table-top exercises and functional exercrses, or purchase of mobile and
portable equipment where no installation needed. Information Bulletin 345 (September 1, 2010) provides
details on these activities. The form must be completed by someone with in-depth understanding of
project details and location. Completion of t�is form does not conclude the EHP review process and
FEMA may need to contact you for further information. Not providing requested information may result
in funding release delays. This form is intended to be completed electronically. The following website
provides a version of this form that is suitable for printing and completing by hand as well as additional
guidance such as on how to make an aerial map: http://www.fema.gov/plan/ehp/ehp-applicant-
help.shtm#5.
a �
To check (X) a box (for example, ❑ Yes ❑ No), left double- ,��" Y�y? �;;; �
click using your mouse and a Check Box Form Field Options x � �� � '"
box will appear, then under the Default Value, select Checked �� r
and press OK (see figure, right). To write in a text field (_),
setect the te�ct field with your mouse and 6egin typing. s'
� _ �
� ;� �-, .
,�� ;� �� .+M r 3��� � ' � :� �. , ,
Submit completed form with necessary attachments to �
GPDEHPInfo@dhs.gov with the fallowing information in the e- '�
mail subject line: EHP Submission: Project Title, Subgrantee "
Name; Grant Award Number (Example, EHP Submusian: � � Y � ��
h�i+r. i:' r�`I.nkR� �+. OA 8 .!�lM4V 4.
Courthouse Camera Installation, Any Town, State,12345).
1
Environmental Planning and Historic Preservation (EHP)
Program
The following project types have been determined to have no environmental impacts; the
Programmatic Environmental Assessment (PEA) setves as the required EHP documentation
for the following projects, and no further EHP documentation for these project types will be
required.
❑Management and Administration (M&A)
❑Planning
❑Classroom-based Training
❑Tabletop Exercises and Functional Exercises
❑Training and Operational Exercises in Existing Facilities
� Purchase of Mobile and Portable Equipment (without installation) �
Fiscal Yeax: 2011 Ptoject Tide: GSAR
Grant amount: 20 000 Sub grantee: Augusta Fite De�axtment
Budget Worksheet # 2764
This project does not require submission of an EHP Screening Form
i�� ���-.,, �?. `
Reviewer signature; �
Date: 07-23-2012
Grant Programs Directorate
1 .
Environmental and Historic Preservation Screening Form
Complete all of Section A, Section B, all of each portion(s) of Section C corresponding
to checked blocks in Section B, and all of section D that apply to the project.
A. PROJECT INFORMATION (complete all)
DHS Grant Award Number: EMW-2011-53-00081-SO1 Grant Program:.......... HSGP
Fiscal Year : ............... 2011
Project Title :.............. GSAR
Grantee (SAA): ......... GEMA Sub grantee:...Augusta Fire Department
Grantee POC : ............ Ronnie Register Subgrantee POC: ....... Byron Taylor
Mailing Address:....... P. O. Box 18055 Mailing Address:....... 3117 Deans Bridge Road.
Atlanta. GA 30316 Augusta. GA 30906
E-mail......ronnie.register�a,uema,ea.eov E-mail :............btaylor@augustaga.gov
Dollar value of grant (if known): 20 000.00
B. PROJECT TYPE
Please check ALL the block(s) that best fit the scope of the project.
❑ 1. Training and Exercises. Go to page 2. Complete all of Section C.1,
� 2. Purchase of Equipment. Go to page 3. Complete all of Section C.2.
❑ 3. Physical security enhancements. Go to page 3. Complete all of Section C.3.
❑ 4. Renovations/upgrades/modifications to existing structures. Go to page 3. Complete all of
Section C.4.
❑ 5. New construction/addition. Go to page 4. Complete all of Section C.S.
❑ 6. Communication towers, related equipment, and equipment shelters. Go to page 5.
Complete all of Section C.6.
❑ 7. Other. If your project does not match any of these categories, go to page 6. Complete
Section C.7
The following informarion is reguired to initiate EHP review of the project. Based on the project's scope of
work, determine which project type applies below and complete dhat section. For multi-component projects or
those that may fit into multiple project types, complete the section that best applies and provide a complete
project description. The project descriptron should contain a brief summary of what specific action is proposed,
where it is proposed, a»d how it will be implemented. If the project imolves multiple locations, information for
each must be provided. Attach additional pages, if needed.
Provide a complete project description: GSAR equipment and maintenance
C. PROJECT DETAILS
1. ❑ Training and Exercises (check each that appl�es): ❑Classroom-based ❑ Field-based
If the lraining is classroom and d3scuss�on-based only, and ls not field-based, this form
does not need to be completed and submitted All other training must pravide the
following:
a. Describe the scope of the proposed training or exercise (purpose, frequency, materials,
and equipment needed, number of participants, and type of activities required)
2
Environmental and Historic Preservation Screening Form
(Attach additional pages, if needed) : .......................................................................................
b, Wil1 the field-based training take place at an existing facility having established
procedures for that particular proposed training and exercise, and that conforms with
existing land use designations (refer to Information Bulletin #329
(h�t p•//fema dps mo eov/empe/IB%20329 20090902 pdfl for further information)? ............ ❑ Yes [� No
• If yes, please provide the name and location of the facility (physical training site
address or latitude-longitude) : ...................... .................................,................
• If no, provide the location (physical project address or latitude-longitude) and a full
description of the area where training will occur : .........................................................
c. Does the field-based training/exercise differ in any way (including, but not limited to
frequency, amount of facilities/land used, materials or equipment used, number of
participants, type of activities) from previously permitted training exercises and training
practices? .................................................................. .............................................................. ❑ Yes Q No
• If yes, explain any differences between the proposed activity and those that were
approved in the past, and the reason(s) for the change in scope :.................
d. Will any equipment or structures need to be instailed to facilitate training7 ........................... ❑ Yes [� No
• If yes, explain how and where this is proposed to be done (include site-specific color
photographs: .......................................................................................................................
2. � Purchase of equipment (If the entireproJect is limited to purchase of mobile/portable
equipment and there �S no installatlon needed, you do not need to complete and submit
thls form.)
a. Specify what equipment, and the quantity: .......... ............
b. Provide AEL number(s) (if known) :.......................... .........................................................
c. Will this equipment be installed? ............................................................................................. � Yes � No
• If Yes, go to page 6. Complete Section D.
3. ❑ Physical security enhancements and or installations (for example: installation of back-
up generators, fencing, cameras, building/room access control, bollards, motion
detection systems, x-ray machines, and lighting).
a. Describe what, how, and where improvement(s)/installation(s) will occur in/on the
facility/building/structure : ...............................................................................................:......
b. Provide project location (physical project address and latitude-longitude) : ............................
c. Wili the new equipmenbimprovements use the existing pawer supply systems? .................... � Yes Q No
• If no, describe new power source and installation (such as utility trenching) : ...................
d. If generator installation, please state the capacity (KW) : ........................................................
• If a separate fuel tank is also inciuded, describe if it is to be installed above or below
ground, and its capaciry �gallons) :......................................................................................
e. Go to Page 6. Provide addirivnal project details in Section D.
4. ❑ Renovatio�cs/upgrades/modifications to existing structures.
3
Environmental and Historic Preservation Screening Form
a. Providc dctailcd dcscription of modifications : .....................................................................
b. Provide project location (physical project address and latitude-longitude) : ...........................
c. Will any equipment need Eo be installed? ..................................... .:....... Q Yes Q No
..................................
• If yes, please note in Section 2, (purchase of equipment).
f. Go to Page 6. Provida additional project details in Section D.
5. ❑ New construction/addition (for example: emergency operations centers, docks, piers,
security guardhouse).
a. Provide detailed scope of work (site acreage, new facility square footage/number of stories,
utilities, parking, stormwater features, etc) : ..:..........
b. Provide project location (physical project address or latitude-longitude) :...............................
c. Will any equipment need to be installed? :.. ❑ Yes [Q No
.............................................................................
• If yes, please note in Section 2(purchase of equipment).
d. Will the new building/facility/renovations use existing utilities7 .........................
...................❑Yes�No
• If no, describe installation of new utilities in (a) above (including trenching) :..................
e. Go to Page 6. Provide additional project details in Section D.
6. ❑ Communication towers, related equipment, and equipment shelters
a. Provide a detailed description of the project ................................................:...........................
b. Provide project location (physical project address or latitude-longitude :................................
c. Provide the elevation above mean sea level of the project location :........................................
d. For projects involving antenna(s) installations on existing towers:
• Provide the height of the existing tower : ........................................................................
• The height of the tower following the installarion of the new antenna(s) :........................
e. For new tower projects, state the total height (in feet) of the communication tower or
structure including any antennae to be mounted :.......................................................:.............
• If the proposed tower height is greater than l 99 feet above ground level, state why
this is needed to meet the requirements of the project : .............................
• Will the tower be free-standing or require guy wires? .........................❑ Free standing ❑ Guy wires
• If guy wires are required, state number of bands and how many : ....................................
• State why a guyed tower is needed to meet the requirements ofthis project : ..................
• What kind of lighting will be installed, if any (for example: white strobe, red sirobe,
or steady burning?) : ........................................................................................................
f. A general description of terrain (For example: mountainous, rotling hills, flat to
undulating) : .....................................................
g. Describe the frequency and seasonality of fog/low cloud cover :.............................................
4
i
Environmental and Historic Preservation Screening Form
h. Provide a list of habitat types and land use on and adjacent to the tower site (within %s mile),
by acreaga and percentage of total (e.g., woodland conifer forest, grassland, agriculture)
waterbody marsh) : .................................................................................................................
i. Is there evidence of bird roosts or rookeries present within Yz-mile of the proposed site? ...... � Yes Q No
a . If yes, describe :...................................................................................................................
• Distance to nearest wetland area (for example: forested swatnp, marsh, riparian, marine)
andcoastline if applicable : .................................................................................................
i. Distance to nearest telecommunication tower : ........................................................................
j. Have measures been incorporated for minimizing impacts to migratory birds7 ...................... � Yes � No
• If yes, describe :...................................................................................................................
k. Has an FCC registration been obtained for this tower? ........................................................... � Yes Q No
• If yes, provide Registration # : ...........................................................................................
l. Has the FCC E106 process been completed7 ........................................................................... � Yes [] No
m. Has the FCC Tower Construction Notification System (TCNS) process been completed7..... Q Yes � No
• If yes, attach all relevant environmental documentation submitted as part of the
registration process including use of the Tower Construction Notification System
(TCNS), if applicable. FRN# ............................................................................................
n. Will any equipment or structures need to be installed? ........................................................... � Yes (] No
•]f yes, explain what type how and where this is proposed to be done (attach additional
PaBeS, fPages needed) : ............................................... ..........................
o. Will equipment be co-located on existing FCC licensed tower or other structure7 ................. [] Yes � No
• If yes, identify the type of structure :...................................................................................
p. Go to Page 6. Provide additional project details in Section D.
7. ❑ Other. For any project that does not fit a category listed above, please provide a thorough
summary of the proposed action and location. Include as much detail as necessary to
ensure someone not personally familiar with the project is able to conduct an EHP review.
a. Project Summary:
b. Provide additional project details in Section D.
D. OTHER PROJECT RELATED INFORMATION (complete alt that apply)
The follawing website may provide some additional EHP related guidance and resources to help
complete this section http;//www.fema.gov/plan/ehp/ehp-anvlicant-help.shtm#5.
1. If work is proposed on/in an existing building(s) or structure(s) provide the year built : ................
• If the building or structure involved is over 45 years old and significant renovation,
rehabilitation, or modification has occurred, please provide the year(s) and briefly
describe the nature of remodeling : ............................................................................................
2. If the project affects the exterior of the building, are there any known buildings and/or structures
that aze 45 yoars or otder in the immediate project area? ................................................................ [] Yes � No/NA
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Environmental and Historic Preservation Screening Form
• If yes, please provide the location, ground-level color photos of these, and identify thelr
location(s) on the aerial map.
3. Is the building or structure on which work is proposed a historic property or in a historic district,
or are there any adjacent historic properties? .............................. ................................. ... ❑ Yes [] No
• Information about historic properties may be found on the National Register of Historic
Places at http://nrhp.focus.nps.gov/�►atreehome.do?searchtype=natre ome or the respective
State Historic Preservation Office may have information on their website.
4. Will ground disturbance be required to complete the project7 ........................................................ � Yes Q No
• If yes, provide total extent (depth, length and width) of each unique ground disturbing
activity. Light poles, bollards and fencing are eacH unique ground disturbing activities
(For example, six light poles, 24" dia. x 4' deep; trenching 12" x 500' x 18" deep) :................
5. Has the ground been previousiy disturbed? .................................................................................... [� Yes � No
• If yes, please describe the current disturbed condition of the area (for example, parking
lot, roadway right-of-way, commerciai development) : .............................................................
6. Are there technical drawings or site plans available, if yes please attach . ....................................: ❑ Yes � No
7. Attach color site photographs:
• Ground-level color site photos that provide context and show where site work/physical
installations are proposed (label photos),
• Ground-level color photographs of each side of the building involved.
• Aerial color photograph with project limits outlined and with the location of any
proposed instailations identified.
• Aerial color photograph(s) showing all ground disturbing activities (if applicable).
8. Is the project part of an approved plan such as a Master Plan or an Implementation Plan or any
targer action/project? ........... ...................................................................................................... 0 Yes [] No
• If yes, provide the plan/project name and brief description :......................................................
9. Is there any previously completed environmental documentation for this project (for example:
Environmental Impact Statement, Environmental Assessment, wetland delineation,
archaeological study)? ..................................... .......... .... � Yes ❑ No
............................. .....................................
• If yes, please attach documentation. If a NEPA document, what was the decision? (Check
one, and please attach):
❑ Finding ofNo Significant Impact (FONSI) or
❑ Record of Decision (ROD)
Name of preparing agency :...............
Date approved :..................................
10. Is there any previously completed agency coordination for this project (for example
correspondence w�th the U.S. Fish and Wildlife Service, State Historic Preservation Office
(SHPO), Tribal Historic Preservation Office (TI�PO), or permitting agencies? ............................. � Yes Q No
• If yes, please attach documentation unless included in NEPA documentation identified
above.
11. Provide FEMA Flood Insurance Rate Map (FIRM), with project limits outlined. FIRM maps can
be created from: http://www:fema.eov/hazard/map/firm.shtm
12. Provide U.S. Fish and Wildlife Service, National Wetlands Inventory (NWI) Map created from:
http•//www fws gov/wetiands/Data/Ma� en r html
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