HomeMy WebLinkAboutFD Project Assurances for Federal Assistance Hazard Mitigation GrantsPROJECT ASSURANCES FOR FEDERAL ASSISTANCE
HAZARD MITIGATION GRANTS
Note: Certain of these assurances may not be applicable to your project or program. If you have
questions, please contact California Governor's Office of Emergency Services (Cal OES).
Further, certain federal assistance awarding agencies may require applicants to certify to
additional assurances. If such is the case, you will be notified.
As the duly authorized representative of the applicant, I certify that
the applicant:
Has the legal authority to apply for federal assistance, and the institutional, managerial
and financial capability (including funds sufficient to pay the non-federal share of project
costs) to ensure proper planning, management and completion of the project described in
this application.
2. Will give the awarding agency, the Comptroller General of the United States, Federal
Office of Inspector General 2 CFR 200.336, and if appropriate, the state, through any
authorized representative, access to and the right to examine all records, books, papers, or
documents related to the assistance; and will establish a proper accounting system in
accordance with generally accepted accounting standards or agency directives.
Will not dispose of, modify the use of, or change the terms of the real property title, or
other interest in the site and facilities without permission and instructions from the
awarding agency. Will record the federal interest in the title of real property in
accordance with awarding agency directives and will include a covenant in the title of
real property acquired in whole or in part with federal assistance funds to assure
nondiscrimination during the useful life of the project.
Will comply with the requirements of the assistance -awarding agency with regard to the
drafting, review and approval of construction plans and specifications.
5. Will provide and maintain competent and adequate engineering supervision at the
construction site to ensure that the complete work conforms with the approved plans and
specifications and will furnish progress reports and such other information as may be
required by the assistance awarding agency or state.
Will initiate and complete the work within the applicable time frame after receipt of
approval of the awarding agency.
7. Will establish safeguards to prohibit employees from using their positions for a purpose
that constitutes or presents the appearance of personal or organizational conflict of
interest, or personal gains.
Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §§ 4801 et
seq.), which prohibits the use of lead based paint in construction or rehabilitation of
residence structures.
Cal OES 89 (Rev. 04/25/17)) 1
9. Will comply with all federal statues relating to nondiscrimination. These include but are
not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits
discrimination on the basis of race, color or national origin; (b) Title IX of the Education
Amendments of 1972, as amended (20 U.S.C. §§ 1681-1683 and 1685-1686) which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of
1973, as amended (29 U.S.C. § 794) which prohibit discrimination on the basis of
handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §§ 6101-
6107) which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 93-255) as amended, relating to nondiscrimination on the
basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention,
Treatment and Rehabilitation Act of 1970 (P.L. 91-616) as amended, relating to
nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§ 523 and 527 of the
Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as amended,
relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the
Civil Rights Act of 1968 (42 U.S.C. § 3601 et seq.), as amended, relating to
nondiscrimination in the sale rental or financing of housing; (i) any other
nondiscrimination provisions in the specific statute(s) under which application for federal
assistance is being made, and 0) the requirements on any other nondiscrimination
statute(s) which may apply to the application.
10. Will comply, or has already complied, with the requirements of Titles II and III of the
Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L.
91-646) which provides for fair and equitable treatment of persons displaced or whose
property is acquired as a result of federal and federally assisted programs. These
requirements apply to all interests in real property acquired for project purposes
regardless of federal participation in purchases.
11. Will comply with the flood insurance purchase requirements of Section 102(a) of the
Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special
flood hazard area to participate in the program and to purchase flood insurance if the total
cost of insurable construction and acquisition is $5,000 or more.
12. Will comply with environmental standards which may be prescribed pursuant to the
following: (a) institution of environmental quality control measures under the National
Environmental Policy Act of 1969 (P.O. 91-190) and Executive Order (EO) 11514; (b)
notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with
EO 11988; (e) assurance of project consistency with the approved state management
program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §§ 1451
et seq.); (f) conformity of federal actions to State (Clean Air) Implementation Plans under
Section 176(c) of the Clean Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.); (g)
protection of underground sources of drinking water under the Safe Drinking Water Act
of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the
Endangered Species Act of 1973, as amended, (P.O. 93-205).
13. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§ 1271 et seq.)
related to protecting components or potential components of the national wild and scenic
rivers system.
Cal OES 89 (Rev. 04/25/17)) 2
14. Will assist the awarding agency in assuring compliance with Section 106 of the National
Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593
(identification and preservation of historic properties), and the Archaeological and
Historic Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.).
15. Will comply with Standardized Emergency Management (SEMS) requirements as stated
in the California Emergency Services Act, Government Code, Chapter 7 of Division 1 of
Title 2, Section 8607.1(e) and CCR Title 19, Sections 2445, 2446, 2447 and 2448.
16. Subrecipients expending $750,000 or more in federal grant funds annually are
required to secure an audit pursuant to OMB Uniform Guidance 2 CFR Part 200,
Subpart F. Will cause to be performed the required financial and compliance audits
in accordance with the Single Audit Act of 1984 and the Single Audit Act
Amendments of 1996.
17. Will disclose in writing any potential conflict of interest to the Federal awarding
agency or pass -through entity in accordance with §200.112.
18. Will comply with all applicable requirements of all other federal laws, Executive
Orders, regulations and policies governing this program.
19. Has requested through the State of California, federal financial assistance to be used
to perform eligible work approved in the subrecipient application for federal
assistance. Will, after the receipt of federal financial assistance, through the State of
California, agree to the following:
a. The state warrant covering federal financial assistance will be deposited in a
special and separate account, and will be used to pay only eligible costs for
projects described above;
b. To return to the State of California such part of the funds so reimbursed pursuant
to the above numbered application, which are excess to the approved actual
expenditures as accepted by final audit of the federal or state government.
c. In the event the approved amount of the above numbered project application is
reduced, the reimbursement applicable to the amount of the reduction will be
promptly refunded to the State of California.
20. The non -Federal entity for a Federal award must disclose, in a timely manner, in
writing to the Federal awarding agency or pass -through entity all violations of
Federal criminal law involving fraud, bribery, or gratuity violations potentially
affecting the Federal award §200.113. Failure to make required disclosures can result
in any of the remedies described in §200.338 Remedies for noncompliance, including
suspension or debarment.
21. Will not make any award or permit any award (subaward or contract) to any party
which is debarred or suspended or is otherwise excluded from or ineligible for
participation in Federal assistance programs under Executive Order 12549 and
12689, "Debarment and Suspension.
Cal OES 89 (Rev. 04/25/17)) 3
"I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly
authorized by City of San Rafael , CA
(Name of Organization)
to enter into this agreement for and on behalf of said subrecipient, and by my signature do bind
the subrecipient to the terms thereof .
Jim Schutz
Printed Name of Authorized Applicant's Agent
r
Ne-
Sigrt f Auth ized pplicant's Agent
City Manager
Title
4-1)-?Z-
Date
Authorization
1, Jim Schutz , do hereby certify as the authorized representative or
Printed Name
officer of City of San Rafael , CA , that the information contained in this
Name of Organization
application is true and correct.
City Manager �4�I -
Title Si ature Date
Cal OES 89 (Rev. 04/25/17)) 4
CONTRACT ROUTING FORM
INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below.
TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER:
Contracting Department: Fire
Project Manager: Kate Anderson Extension: 3327
Contractor Name: FEMA
Contractor's Contact: N/A Contact's Email: N/A
❑ FPPC: Check if Contractor/Consultant must file Form 700
Step
RESPONSIBLE
DESCRIPTION
COMPLETED
REVIEWER
DEPARTMENT
DATE
Check/Initial
Project Manager
N/A
1
a. Email PINS Introductory Notice to Contractor
N/A
b. Email contract (in Word) and attachments to City
Attorney c/o Laraine.Gittens@cityofsanrafael.org
2
City Attorney
a. Review, revise, and comment on draft agreement
N/A
and return to Project Manager
N/A
❑
b. Confirm insurance requirements, create Job on
PINS, send PINS insurance notice to contractor
❑
3
Department Director
Approval of final agreement form to send to
Click or tap
❑
contractor
to enter a
date.
4
Project Manager
Forward three (3) originals of final agreement to
Click her. to
❑
contractor for their signature
enter a date
5
Project Manager When necessary, contractor -signed agreement
❑ N/A
agendized for City Council approval *
*City Council approval required for Professional Services
❑
Agreements and purchases of goods and services that exceed
Or
$75,000; and for Public Works Contracts that exceed $175,000
Click'nere to
Date of City Council approval
enter a date
PRINT
Project Manager
CONTINUE ROUTING PROCESS WITH HARD COPY
6
Forward signed original agreements to City
Attorney with printed copy of this routing form
7
City Attorney
Review and approve hard copy of signed
yl�5'� ZOZ
agreement
8
City Attorney
Review and approve insurance in PINS , and bonds
4)15
(for Public Works Contracts)
9
City Manager / Mayor
Agreement executed by City Council authorized
official
Attest signatures, retains original agreement and
10 City Clerk
/ h
forwards copies to Project Manager
A Lt