HomeMy WebLinkAboutCC Resolution 11435 (CERT Funding)RESOLUTION NO. 11435
RESOLUTION OF THE SAN RAFAEL CITY COUNCIL AUTHORIZING STAFF TO
EXECUTE CONTRACT WITH GOVERNOR'S OFFICE ON SERVICE AND
VOLUNTEERISM FUNDS FOR COMMUNITY EMERGENCY RESPONSE TEAMS
(CERT) (TEN YEAR AGREEMENT FROM DECEMBER 2003 THROUGH DECEMBER
2013)
Whereas, the Governor's Office on Service and Volunteerism and FEMA have made
available $10,796 to the City of San Rafael in Federal "First Responder" funds; and,
Whereas, this money is designed to be spent to pay costs associated with
Community Emergency Response Team training; and,
Whereas, the State requires the City of San Rafael to designate individuals to apply for
these funds and execute subsequent contracts for a three year period from December
2003 through December 2013; and,
Whereas, the City Manager and the Assistant City Manager are the individuals who are
authorized by City of San Rafael Municipal Code to enter into contract and authorize
expenditures; and,
Whereas, the Fire Chief and Division Chief are the most knowledgeable of
programmatic requirements and costs of program expense,
NOW, THEREFORE BE IT RESOLVED, that the City Council authorizes the Mayor, the
City Manager, the Assistant City Manager, the Fire Chief and Division Chief to execute
for and on behalf of the City any actions necessary for the purpose of obtaining federal
financial assistance under P.L. 107-206.
I, Jeanne M. Leoncini, Clerk of the City of San Rafael, hereby certify that the foregoing
resolution was duly and regularly introduced and adopted at a regular meeting of the
San Rafael City Council meeting held on the 3rd day of November, 2003 by the
following vote, to wit:
AYES: COUNCILMEMBERS: Cohen, Heller, Miller, Phillips and Mayor Boro
NOES: COUNCILMEMBERS: None
ABSENT: COUNCILMEMBERS: None
JEA N-�M. LEONCINI, City Clerk
k
Bit 61 N AL ��
State of California
GOVERNOR'S OFFICE ON
SERVICE AND VOLUNTEERISM
GOVERNING BODY RESOLUTION
BE IT RESOLVED BY THE City Council OF THE
(Governing Body)
_City of San Rafael THAT
(Name of Applicant)
Albert J. Boro, Mayor OR
(Name or Title of Authorized Agent)
Rod Gould, City Manager OR
(Name or Title of Authorized Agent)
Kenneth A. Nordhoff, Assistant City Manager.
(Name or Title of Authorized Agent)
is hereby authorized to execute for and on behalf of the named applicant, a public entity established under
the laws of the State of California, any actions necessary for the purpose of obtaining federal financial
assistance under P.L. 107-206. This resolution is in effect from this date until December 2013.
Passed and approved this 3`d day of November , 20 03
I, Jeanne M. Leoncini
(Name)
City Clerk
(Title)
CERTIFICATION
, duly appointed and
of the City of San Rafael
(Governing Body)
do hereby certify that the above is a true and correct copy of a resolution passed and approved
by the City Council of the City of San Rafael on the
(Governing body) (Name of Applicant)
Third day of November
Date:
120 03 .
Jeanne H. Leoncini,
City Clerk
(Official Position)
(Signature)
WA
Mayor
Albert J. Boro
0 'sir i.."
.r.*a
Council Members
Paul M. Cohen
Barbara Heller
Cyr N. Miller
Gary O. Phillips
Fire Chief
Robert E. Marcucci
The Governing Body Resolution allows for the appointment of the following
individuals or positions to execute for and on behalf of the City any actions necessary
for the purpose of obtaining federal financial assistance under P.L. 107-206.
#1
#2
❑ Jurisdiction: City of San Rafael Fire Department
❑ Telephone: 415-485-3304
❑ Grant Program Citizen Corps & Community Emergency Response
Team Grant Program
❑ Fax #: 415-459-2242
❑ Name Al Boro
❑ Cell Phone # n/a
❑ Title Mayor, City of San Rafael
❑ E -Mail Address al.boro@ci.san-rafael.ca.us
❑ Address
❑ City
❑ Zip Code
❑ Jurisdiction:
❑ Telephone:
1400 Fifth Avenue
San Rafael
94901
City of San Rafael Fire Department
415-485-3304
❑ Grant Program Citizen Corps & Community Emergency Response
Team Grant Program
❑ Fax #: 415-459-2242
❑ Name Rod Gould
❑ Cell Phone # n/a
❑ Title City Manager
❑ E -Mail Address rod.gould@ci.san-rafael.ca.us
❑ Address 1400 Fifth Avenue
❑ City San Rafael
❑ Zip Code 94901
Fire Department Offices: 1039 C Street, San Rafael, CA 94901
Administration: (415) 485-3304 Fire Prevention: (415) 485-3308
#3
❑ Jurisdiction: City of San Rafael Fire Department
❑ Telephone: 415-485-3304
❑ Grant ProgramCitizen Corps & Community Emergency Response Team
Grant Program
❑ Fax #: 415-459-2242
❑ Name Ken Nordhoff
❑ Cell Phone # n/a
❑ Title Assistant City Manager
❑ E -Mail Address ken.nordhoff@ci.san-rafael.ca.us
❑ Address 1400 Fifth Avenue
❑ City San Rafael
❑ Zip Code 94901
#4
o Jurisdiction: City of San Rafael Fire Department
❑ Telephone: 415-485-3304
❑ Grant ProgramCitizen Corps & Community Emergency Response Team
Grant Program
❑ Fax #: 415-453-1627
❑ Name: Robert E. Marcucci
❑ Cell Phone #: 415-519-0399
❑ Title: Fire Chief
❑ E -Mail Address: bob.marcucci@ci.san-rafael.ca.us
❑ Address: 1039 C St.
o City: San Rafael, Ca.
❑ Zip Code: 94901
#5
❑ Jurisdiction: City of San Rafael Fire Department
❑ Telephone: 415-485-3304
❑ Grant ProgramCitizen Corps & Community Emergency Response Team
Grant Program
❑ Fax #:
415-453-1627
❑ Name:
Brian Waterbury
❑ Cell Phone #:
415-297-5154
❑ Title:
Division Chief
❑ E -Mail Address:
brian.waterbury@ci.san-rafael.ca.us
❑ Address: 1039 C St.
❑ City: San Rafael, Ca.
❑ Zip Code: 94901
ARNOLD SCHWARZENEGGER
Govemor
ALEX REID
Chair
MEMORANDUM
DAVID MURAKI
Executive Director
TO: Rod Gould, City Manager
City of San Rafael Fire Department
FROM: Mimi Morris, Director of Fiscal Affairs
DATE: 2/6/2004
RE: CERT Grant Award Contract, Program Year 2003-2004
Enclosed is your copy of the fully executed Citizen Corps/CERT Grant Award Contract for Program
Year 2003-2004.
You may now invoice for allowable expenses dating back to December 5, 2003, the start date of
the contract term. Final Invoices are due 60 days after the expiration of your contract, which is
February 2, 2005. Programs must use the approved GO SERV invoice form and expenditure
report, which can be found in Grantee Central on our website (www.goserv.ca.gov).
Thank you for your assistance in this regard. If you have questions or need assistance, please
contact me at (916) 324-4786 or my assistants. They are Jared Amalong at (916) 650-6671 and
Terry Daldry at (916) 323-3226.
GOVERNOR'S OFFICE ON SERVICE AND VOLUNTEERISM
1110 K Street, Suite 210 - Sacramento, CA 95814
Tel: 916.323.7646 - Fax: 916.323.3227 - www.goserv.ca.gov
S"ATE OF CA-IFORNIA AGREEMENT NUMBER
STAND AGREEMENT Y2CCOA21
STD NEW 98)
Federal EIN
94-6000424
1. This A reement is entered into between the State Agency and the Contractor named below
STATE AGENCY'S NAME
OPR/Governor's Office of Service and Volunteerism
CONTRACTOR'S NAME
City of San Rafael Fire Department
2. The term of this
Agreement is: December 5, 2003 - December 4, 2004
3. The maximum amount $10,796.00
of this Agreement is:
L The parties agree to comply with the terms and conditions of the following exhibits which are by this reference made
a part of the Agreement:
Exhibit A, entitled "Terms and Conditions"
Exhibit B, entitled "Scope of Work"
Exhibit C, entitled "Budget FomVBudget Narrative"
Exhibit D, entitled "Grant Assurances and Certifications"
Exhibit E, entitled "Reimbursement Rates/ Conditions"
V WITNESS WHEREOF, this Agreement has been executed by the parties hereto.
CONTRACTOR
DNTRACTOR'S NAME (If other than an individual, state whether a corporation, partnership, etc.)
;ity of San Rafael Fire Department
CALIFORNIA
Department of General Services use only
Y (Authorized Signature) DATE SIGNED
- 12/9/03_ _
UNTED NAME AND TITLE OF PERSON SIGNING AT FEST : yy,
ROD GOULD. Citv Manaaer 9'MIE M. LEK CI I, City Clerk'
)CRESS 1400 FIFTH AVENUE, ROOM 203 P.O. BOX 151560
SAN RAFAEL, CA 94901 SAN RAFAEL, CA 94915=1560
STATE OF CALIFORNIA
'ENCY NAME
IPR/Governor's Off ice Service and Volunteerism
(Authorized Sig azure I DATE SIGNED
I ZZO
TINTED NAME AND TITLE OF P RSON SIGNING
avid Muraki, Interim Executive Director, GO SERV
CRESS
110 K Street, Suite 210, Sacramento, CA 95814 ®Exempt per AG Opinion No. 80-111
EXHIBIT A
Governor's Office on Service and Volunteerism - 2003 CERT Grant Award
EXHIBIT A
TERMS AND CONDITIONS
1. Approval
This Agreement is of no force or effect until signed by both parties and approved
by the Department of General Services, if required. Contractor may not commence
performance until such approval has been obtained.
2. Amendment
No alteration or variation of the terms of This Agreement shall be valid unless
made in writing and signed by the parties hereto, and no oral understanding or
agreement not incorporated herein, shall be binding on any of the parties hereto.
3. Assignment
Without the written consent of the State, This Agreement is not assignable by
Contractor either in whole or in part.
4. Right to Monitor, Audit, and Investigate
Contractor agrees that the awarding department, the Department of General
Services, the Bureau of State Audits, the Federal Government, or their designated
representative shall have the right to review and to copy any records and
supporting documentation pertaining to the performance of This Agreement.
Contractor agrees to maintain such records for possible audit for a minimum of
three (3) years after final payment, unless a longer period of records retention is
stipulated. Contractor agrees to allow the auditor(s) access to such records during
normal business hours and to allow interviews of any employees who might
reasonably have information related to such records. Further, Contractor agrees to
include a similar right of the State to audit records and interview staff in any
subcontract related to performance of This Agreement. (GC 8546.7, PCC 10115 et
seq., CCR Title 2, Section 1896).
The Federal Government, State, or a duly authorized representative of the State
government shall have the right to undertake investigations in accordance with
Section (42 U.S.C. §9908 et seq.), as amended.
All agreements entered into by Contractor with audit firms for purposes of
conducting independent audits under This Agreement shall contain a clause
permitting the State or a duly authorized representative of the State or Federal
government access to the working papers of said audit firm(s).
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Governor's Office on Service and Volunteerism - 2003 CERT Grant Award
9. Non -Discrimination Clause
During the performance of This Agreement, Contractor and its subcontractors
shall not unlawfully discriminate, harass, or allow harassment against any
person, including a service recipient, program staff, or applicant for these
positions because of sex, sexual orientation, race, color, ancestry, religious
creed, national origin, disability (including HIV and AIDS), mental disability,
medical condition (cancer), age, marital status, and denial of family care leave.
Contractor and subcontractors shall insure that the evaluation and treatment of
their employees and applicants for employment are free from such
discrimination and harassment. Contractor and subcontractors shall comply
with the provisions of the Fair Employment and Housing Act (Government
Code Section 12990 (a -f) et seq.) and the applicable regulations promulgated
thereunder (California Code of Regulations, Title 2, Section 7285 et seq.). The
applicable regulations of the Fair Employment and Housing Commission
implementing Government Code Section 12990 (a -f), set forth in Chapter 5 of
Division 4 of Title 2 of the California Code of Regulations are incorporated into
This Agreement by reference and made a part hereof as if set forth in full.
Contractor and its subcontractors shall give written notice of their obligations
under this clause to labor organizations with which they have a collective
bargaining or other Agreement.
10. Time
Time is of the essence in This Agreement.
11. Compensation
The consideration to be paid Contractor, as provided herein, shall be in
compensation for all of Contractor's expenses incurred in the performance
hereof, including travel, per diem, and taxes, unless otherwise expressly so
provided.
12. Governing Law
This contract is governed by and shall be interpreted in accordance with the
laws of the State of California.
Page 3 of 13
Revised 9/8/2003
Governor's Office on Service and Volunteerism - 2003 CERT Grant Award
A non-profit organization must provide the State with a copy of a resolution,
order, motion, or ordinance of the governing body which by law has authority
to enter into an agreement, authorizing execution of the agreement.
18. Payee Data Record Form (Std. 204)
The data requested on Form 204 has been integrated into the CERT Invoice
Form and must be completed by all contractors.
19. Payments
In consideration of the services specified in the "Scope of Work" (Exhibit B,
"Scope of Work"), Contractor shall invoice the State monthly, quarterly, or at
the end of the performance period, according to the budget categories in
Exhibit C, 'Budget". Invoices must be submitted in triplicate to the address
given for the State in Item 27. Payment is contingent upon approval of the
invoice by the State. Budget revisions must be approved in advance by the
State. In no event shall the maximum amount payable under This Agreement
exceed the amount specified in item number three (3) on page 1 of This
Agreement. The final invoice is due by February 4, 2005.
In accordance with GC Section 16645.2:
a) The recipient of a grant of state funds, including state funds disbursed as a
grant by a public agency, shall not use the funds to assist, promote, or deter
union organizing.
b) For purposes of this section, each recipient of a grant of state funds shall
account for those funds as follows:
(1) State funds designated by the grantor for use for a specific
expenditure of the recipient shall be accounted for as allocated to
that expenditure.
(2) State funds that are not designated as described in paragraph
(1) shall be allocated on a pro rata basis to all expenditures by the
recipient that support the program for which the grant is made.
c) The grant recipient (Contractor) shall include on every invoice a
certification to the state that none of the state funds will be used to assist,
promote, or deter union organizing during the life of the contract,
including any extensions or renewals thereof. Any recipient that makes
expenditures to assist, promote, or deter union organizing shall maintain
records sufficient to show that state funds have not been used for those
expenditures. The grant recipient shall provide those records to the
Attorney General upon request.
Page 5 of 13
Revised 91811003
Governor's Office on Service and Volunteerism - 2003 CERT Grant Award
H. Request of each subcontractor the certification required regarding
Debarment and Suspension as stated in the Grant Assurances and
Certifications, contained in Exhibit D.
21. Compliance with Rules, Regulations, and Procedures
Activities of Contractor with respect to This Agreement shall be conducted in
accordance with pertinent Federal and State rules and regulations, including
relevant Office of Management and Budget (OMB) circulars, and amendments
thereto.
22. Provisions for Federally Funded Contracts
It is mutually understood between the parties that This Agreement may have
been written before ascertaining the availability of Congressional appropriation
of funds, for the mutual benefit of both parties, in order to avoid program and
fiscal delays which would occur if This Agreement were executed after that
determination was made.
This Agreement is valid and enforceable only if the United States Government
makes sufficient funds available to the State for the purposes of this program.
In addition, This Agreement is subject to any additional restrictions,
limitations, or conditions enacted by the Congress or any statute enacted by the
Congress which may affect the provisions, terms, or funding of This
Agreement in any manner.
It is mutually agreed that if the Congress does not appropriate sufficient funds
for this Program This Agreement shall be amended to reflect such reduction in
funds.
The State has the option to void This Agreement under the thirty -day (30)
cancellation clause or to amend This Agreement to reflect any reduction of
funds.
23. National Labor Relations Board Certification
Contractor hereby certifies under penalty of perjury that no more than one final
unappealable finding of contempt of court, by a Federal Court, has been issued
against Contractor within the immediately -preceding two-year period because
of Contractor's failure to comply with an order of a Federal Court which orders
compliance with an order of the National Labor Relations Board.
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Governor's Office on Service and Volunteerism - 2003 CERT Grant Award
26. Conflict of Interest
Contractor certifies that its employees and the officers of its governing body
shall avoid any actual or potential conflicts of interest, and that no officer or
employee who exercises any functions or responsibilities in connection with
This Agreement shall have any personal financial interest or benefit which
either directly or indirectly arise from This Agreement.
Contractor shall establish safeguards to prohibit employees or officers from
using their positions for a purpose which could result in private gain, or gives
the appearance of being motivated for private gain for themselves or others,
particularly those with whom they have family, business, or other ties.
Contractor needs to be aware of the following provisions regarding current or
former state employees. If Contractor has any questions on the status of any
person rendering services or involved with This Agreement, the awarding
agency must be contacted immediately for clarification.
Current State Employees (PCC 10410):
a) No officer or employee shall engage in any employment, activity, or
enterprise from which the officer or employee receives compensation
or has a financial interest and which is sponsored or funded by any
state agency, unless the employment, activity, or enterprise is required
as a condition of regular state employment.
b) No officer or employee shall contract on his or her own behalf as an
independent contractor with any state agency to provide goods or
services.
Former State Employees (PCC 10411):
a) For the two-year period from the date he or she left state employment,
no former state officer or employee may enter into a contract in which
he or she engaged in any of the negotiations, transactions, planning,
arrangements or any part of the decision-making process relevant to the
contract while employed in any capacity by any state agency.
b) For the twelve-month period from the date he or she left state
employment, no former state officer or employee may enter into a
contract with any state agency if he or she was employed by that state
agency in a policy-making position in the same general subject area as
the proposed contract within the 12 -month period prior to his or her
leaving state service.
Page 9 of 13
Revised 9/8%2003
Governor's Office on Service and Volunteerism - 2003 CERT Grant Award
Local governmental agencies shall submit the required number of copies
of the audit report in accordance with the guidelines set by the Division of
Audits of the State Controller's Office. Said reports are to be submitted to
the following address:
State Controller
Division of Audits
300 Capitol Mall, Fifth Floor
Sacramento, CA 95814
Where services or funds under This Agreement are provided to, for, or by,
a wholly owned, or wholly -controlled, subsidiary of Contractor,
Contractor hereby provides assurance that an audit shall be performed of
this subsidiary organization in accordance with this paragraph. Said
required audit report shall be made available to the State.
29. Rights on Data
The State and the Corporation reserve the right to use and reproduce all
reports, data produced and delivered and any other copyrightable material
produced pursuant to This Agreement and reserves the right to authorize
others to use or reproduce such materials.
30. Reporting Requirement
a. Progress Reports
Operational Areas and the Intertribal Council of California are required to
submit quarterly programmatic and financial status reports that describe their
grant funded activities, accomplishments, and federal expenditures.
Performance reports must include a summary of all local Citizen Corps Council
and CERT program activities, such as: public education and outreach; training;
and volunteer activities relating to community and family safety. Additional
activities such as integration with SEMS and stakeholder involvement should
also be described in the report.
Quarterly progress reports must be submitted directly to the GO SERV
Program Coordinator during the duration of the grant period or until all
activities are completed and the grant is formally closed. Each report must
include a brief status on all activities.
Reports are due to GO SERV as follows*:
Page 11 of 13
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Governor's Office on Service and Volunteerism - 2003 CERT Grant Award
of the term in all documents. For example, on the introduction of the term
write: "the Governor's Office on Service and Volunteerism (GO SERV)."
The acronym alone should then be used throughout the rest of the text.
d) Provide to the GO SERV's Communications Director two copies of all
media communications materials supported by the grant.
e) Include the following acknowledgment and disclaimer in any external
report or publication of material based upon work supported by this
Grant:
"This material is based upon work supported by the Federal
Emergency Management Agency and the Governor's Office on Service
and Volunteerism under CERT Grant No. . Opinions or points of
view expressed in this document are those of the authors and do not
necessarily reflect the official position of, or a position that is endorsed
by, FEMA or GO SERV.
32. DEFINITIONS
Citizen Corps: means the federal programs funded under 42 U.S.C. 5121-5206,
Public Law 93-288; 38 USC 301, Public Law 106-74; 42 USC -250 et seq., Public
Law 104-208.
Contractor/Grantee/Subgrantee: for the purposes of This Agreement means
the direct recipient of Federal Funds granted by the State through this grant
award. The terms and conditions of this grant award legally bind the
Contractor.
Federal Government: means the Federal Emergency Management Agency or
any other entity authorized by the Federal Government to administer the
Federal Governments' national service grant program and to perform such
other duties prescribed by law.
- State: means the Governor's Office on Service and Volunteerism or any other
entity authorized by the State of California to administer the State's national
service plan and national service grant program and to perform such other
duties prescribed by law.
Page 13 of 13
Revised 9/81,'2003
EXHIBIT B
TITLE PAGE FOR 2003 CERT PROGRAM APPLICANTS
CERT Application for Grant Funding
Please type or print in black ink.
Date of Submission:
1. Total budget amount requested (cannot exceed Award Amount - See Appendix A):
2. Legal Applicant Agency/Organization Name: City of San Rafael Fire De ap rtment
Legal Applicant Point of Contact: Rod Gould
Address (please do not use a P. 0. Box): 1400 Fifth Avenue
City: San Rafael State: California
Telephone Number: (415) 458-3075 Fax Number: (415) 459-2242
3. Employer Identification Number (EIN) of the Legal Applicant Agency/Organization:
4. This application is for the following county (ies): Marin
5. If this application is for a regional collaborative, please list other partner counties:
Contact Person's Name: NIA
Agency/Organization:
Telephone Number: ( ) Fax Number: ( )
Contact Person's Name:
Agency/Organization:
Telephone Number: ( ) Fax Number: ( )
6. Program Contact
CFDA #
Please leave blank for GO SERV use.
$ —U.796
Title: Citv Manaoer
83.564
Zip Code: 94901
E -Mail Address: rod.gould@ci.san-rafael.ca.us
94-6000424
Title:
County:
E -Mail Address:
Title:
County:
E -Mail Address:
Contact Person's Name: Brian Waterbury Title: Division Chief
Agency/Organization: San Rafael Fire Department County: Marin
Telephone Number: ( 415) 485-3306 Fax Number: ( 415 ) 453-1627 E -Mail Address: brian.Waterbury anci.san-rafael.ca.us
7. FEMA CERT Online Directory
FEMA requires jurisdictions accepting CERT grants to list its program in FEMA's national CERT directory
htto://trainina.fema.aov/emiweb/CERT/dir.asr)
GO SERV staff will submit this information on your behalf using the contact information of your Program Contact (#6 above) and the information
provided below.
CERT Program Name: Disaster Area Resoonse Team (DART)
CERT Program Website: www.srfddart.orq
CERT Program Description:
The el
Page 1 of 4
CFDA 4 83.564
9. Certification:
The applicant certifies to the best of his/her knowledge and belief that the data in this application are true and correct and that filing of the
application has been duly authorized by the governing body of the applicant and that applicant will comply with the assurances required of
applicants if the assistance is approved.
I hereby certify that the attached application represents the consensus of a diverse group of Operational Area stakeholders, which includes many
of the organizations and agencies recommended by FEMA and GO SERV.
Name: Rod Gould Signature:
Title: City Manaqer Telephone Number:( 415 ) 458-3075 Date:
Please complete the Program Narrative on page 3.
Page 2 of 4
A.
C.
I�
F.
CFDA 4 83.564
2003 CERT Program Narrative
How will 2003 CERT funds be used to further the goals outlined in your 2002 application?
In the 2002 application, we noted that the San Rafael Fire Department had graduated 450 citizens from the six-
week course DART training since 1989. The 2002 funding added 100 additional graduates to the course that
was enhanced to include dual Disaster Medicine Sessions. The special four-hour FEMA terrorism module is
offered throughout 2003 to DART graduates as an Advanced Course and incorporated into the 21 hour DART
training for new attendees. Those graduates are encouraged to form neighborhood teams. With the new grant
funding, this author anticipates enough CERT trained citizens to form two to three effective teams this grant
year, 2003 through 2004. The 2003 CERT funds will also be used to increase the number of trainers trained to
train the trainers as San Rafael certified trainers will be trained as part of the "74" program goal.
Please note: While other Emergency Response Team training is geographic specific (you have to work or live
within specific geographical boundaries), the City of San Rafael's DART program is open to all Citizens.
While 90% of the DART trainees come from the greater San Rafael area, a good 10% come from other parts
of Marin County and the greater Bay area.
How will your CERT program be coordinated with local Citizen Corps Councils?
(Check all that apply)
❑ CERT program is already a part of most councils
❑ Councils will be invited to help develop and implement the CERT program
® Councils will be offered CERT training
❑ CERT members will help councils with special initiatives and projects
❑ CERT members will assist with ongoing council membership development
❑ CERT members will aid in new council expansion
❑ Other
How will CERT teams be utilized in non -emergency situations?
(Check all that apply)
® Staffing booths are community events
® Training community members and/or recruiting others to complete CERT training
® Making preparedness and safety presentations at schools, senior centers, etc.
® Participating in exercises and drills
® Helping with special initiatives and projects
® First responder administrative support
❑ Other
How night CERT teams be utilized in emergency situations?
(Check all that apply)
® Managing volunteers and/or donations
® Staffing shelters and/or hotlines
® Non-technical search and rescue
® First aid
® Damage and hazard assessment
® Working with community- and faith -based organizations
® Other: Help staff Emeraencv Ooerations Center
Provide estimates for the following four items to be completed during the performance period:
Page 3 of 4
CFDA # 83.564
4 # of CERT courses that will be offered
100 # of individuals that will complete CERT training
I # of CERT T -T -T courses that will be offered
—� # of individuals that will complete CERT T -T -T courses (through the Operational Area, GO SERV
regional training, or FEMA EMI)
Page 4 of 4
EXHIBIT C
CERT 2003 Budget Form
E
p
V
FULL LEGAL APPLICANT AGENCY/
ORGANIZATION NAME:
Please attach Budget Narrative to this page.
City of San Rafael Fire Department
TOTAL DIRECT COSTS I 10,283.00 II $10,283
Indirect Costs (NTE 5% of Total Direct Costs) 513 $513
TOTAL I $10,796 I I $10,796
Exhibit B.1, Page 1 of 1�
CERT I
TOTAL
Personnel
4,110.00
$4,110.00
Fringe Benefits
0.00
$0.00
Travel
0.00
$0.00
Equipment I
750.00
$750.00
Supplies I
4,423.00
$4,423.00
Contracts I
0.00 I
$0.00
(Please Specify in Budget Narrative) Other I
1,000.00 I
$1,000.00
TOTAL DIRECT COSTS I 10,283.00 II $10,283
Indirect Costs (NTE 5% of Total Direct Costs) 513 $513
TOTAL I $10,796 I I $10,796
Exhibit B.1, Page 1 of 1�
CERT 2003 Budget Narrative
Full Legal Applicant
Agency/Organization Name: City of San Rafael Fire Department
CERT
PERSONNEL
Overtime for Course Instructors (10 classes @)$411 /class) $4,110
SUBTOTAL PERSONNEL $4,110.00
FRINGE BENEFITS
Included in Overtime above
SUBTOTAL FRINGE BENEFITS $0.001
TRAVEL
SUBTOTAL TRAVELI $0.00
EOUIPMENT
Training materials (props and recharge fire extinguisher) 750
SUBTOTAL EQUIPMENTI $750.00
SUPPLIES
Instruction manual ($10/manual @ 108 participants) 1080
Consumable supplies ($50/classs @10 classes) 500
EMERGENCY RESPONSE PACK ($95/pack 1d; 27 participants)
(details below) 2565
Charts, maps and resource material 278
CONTRACTS
SUBTOTAL SUPPLIES $4,423.00
Total
$0.00
$0.00
$750
$750.00
$1,080
$500
$2,565
$278
$4,423.00
CONTRACTS $0.001 $0.00
OTHER
Classroom space (10 classes @ $100 classes) $1,000 $1,000
SUBTOTAL OTHER $1,000.001 $0.00
1 1
TOTAL DIRECT COSTS 1 $10,283.001 $10,283.00
INDIRECT COSTS
Maximum 5% of Direct Program Costs $513 $513
SUBTOTAL INDIRECT COSTS $5131 $513
I
TOTAL BUDGETS $10,7961 $10,796
Exhibit 13.1, Page-
'P—of
CERT 2003 Budget Narrative
Full Legal Applicant
Agency/Organization Name: City of San Rafael Fire Department
EMERGENCY PACK CONTENTS
Hard hats (27 @ $7/each)
Identification Vests (27 @ $20/each)
Safety Gloves (27 @ $7/each)
Eye Protection (goggles) (27 @ $5/each)
Flashlight w/batteries (27 @ $7/each)
Backpack (27 @ $20/each)
Medical Supplies (27 @ $10/each)
Natural Gas Shutoff Wrench (27 @ $8/each)
Glo Sticks (3 pack) (27 @ $6/pack)
Water Bottle (27 @ $5/each)
CERT I Total
Exhibit B.1, Page A of 2,
EXHIBIT D
State of California
GOVERNOR'S OFFICE ON
SERVICE AND VOLUNTEERISM
(GO SERV)
GRANT ASSURANCES AND CERTIFICATIONS
Full Legal Applicant
Agency/Organization Name: City of San Rafael Fire Department
Address: 1400 Fifth Avenue
City: San Rafael
Telephone: 415-485-3070
Authorized Agent: Rod Gould
Title: City Manager
State: California Zip Code: 94901
Fax Number: 415-459-2242
Exhibit D
Page 1 of 5
ASSURANCES - CONSTRUCTION PROGRAMS and NON -CONSTRUCTION
PROGRAMS
Note: Certain of these assurance may not be applicable to all of your grants. If you have questions, please contact
the Governor's Office on Service and Volunteerism.
As the duly authorized representative of the applicant, I certify that the applicant named above:
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial
capability (including funds sufficient to pay the non-federal share of grant costs) to ensure proper planning,
management and completion of the grant described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state,
through any authorized representative, access to and the right to examine all records, books, papers, or
documents related to the award; and will establish a proper accounting system in accordance with generally
accepted accounting standards or agency directives.
3. Will 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.
4. Will comply with the requirements of the assistance awarding agency with regard to the drafting, review and
approval of construction plans and specifications.
5. Will provide and maintain competent and adequate engineering supervision at the construction site to ensure
that the complete work conforms with the approved plans and specifications and will famish progress reports
and such other information as may be required by the assistance awarding agency or state.
6. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding
agency.
7. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or
Exhibit D
Page 2 of 5
presents the appearance of personal or organizational conflict of interest, or personal gains.
8. 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.
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 prohibits 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. 92-255) as
amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§ 523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. 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 or federally
assisted programs. These requirements apply to all interested in real property acquired for project purposes
regardless of federal participation in purchases.
11. Will comply, if applicable, 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 $10,000 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.L. 91-
190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c)
protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance
with EO 11988; (e) assurance of project consistency with the approved state management program developed
under the Coastal Zone Management Act of 1972 (16 U.S.C. §§ 1451 et seq.); (f) conformity of federal
actions to State (Clean Air) Implementation Plans under Section 176(c) of the Clean Air Act of 1955, as
amended (42 U.S.C. § 7401 et seq.); (g) protection of underground sources of drinking water under the Safe
Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the
Endangered Species Act of 1973, as amended, (P.L. 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.
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. 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. Has requested through the State of California, federal financial assistance to be used to perform eligible work
approved in the applicant's 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
Exhibit D
Page 3 of 5
account, and will be used to pay only eligible costs;
b. To promptly return to the State of California all the funds received which exceed the approved,
actual expenditures as accepted by the federal or state government.
C. In the event the approved amount of the grant is reduced, the reimbursement applicable to the
amount of the reduction will be promptly refunded to the State of California.
18. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S C. Sections 4728-4763) relating to
prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations
specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900,
Subpart F).
19. Will comply with provisions of the Hatch Act (5 U.S.C. Sections 1501-1508 and 7324-7328) which limit the
political activities of employees whose principal employment activities are funded in whole or in part with
federal funds.
20. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development,
and related activities supported by this award of assistance.
21. Will comply with the Laboratory Animal Welfare Act of 1966 (P. L. 89-544, as amended, 7 U.S.C. 2131 et
seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or
other activities supported by this award of assistance.
22. It will comply with the minimum wage and maximum hour provisions of the Federal Fair Labor Standards
Act (29 U.S.C. 201), as they apply to employees of institutions of higher education, hospitals, and other non-
profit organizations.
23. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. Section 276a to 276a-7),
the Copeland Act (40 U.S.C. Section 276c and 18 U.S.C. Sections 874), and the Contract Work Hours and
Safety Standards Act (40 U.S.C. Sections 327-333), regarding labor standards for federally assisted
construction subagreements.
24. Will obtain approval by the appropriate federal agency of the final working drawings and specifications
before the project is advertised or placed on the market for bidding; that it will construct the project, or cause
it to be constructed, to final completion in accordance with the application and approved plans and
specifications; that it will submit to the appropriate federal agency for prior approval changes that alter the
cost of the project, use of space, or functional layout, that it will not enter into a construction contract(s) for
the project or undertake other activities until the conditions of the construction grant program(s) have been
met.
25. Will operate and maintain the facility in accordance with the minimum standards as may be required or
prescribed by the applicable federal, state, and local agencies for the maintenance and operation of such
facilities.
26. Will require the facility to be designed to comply with the "American Standard Specifications for Making
Buildings and Facilities Accessible to, and Usable by, the Physically Handicapped," Number A117.-1961, as
modified (41 CFR 101-17.703). The applicant will be responsible for conducting inspections to ensure
compliance with these specifications by the contractor.
27. Does agree that if any real property or structure thereon is provided or improved with the aid of federal
financial assistance extended to the applicant, this assurance shall obligate the applicant, or in the case of any
transfer of such property, any transfer, for the period during which the real property or structure is used for a
purpose for which the federal financial assistance is extended or for another purpose involving the provision
of similar services or benefits.
28. Will not make any award or permit any award (subgrant or contract) at any tier 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."
29. Does agree that:
1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to
any person for influencing or attempting to influence an officer or employee of any agency, a Member of
Exhibit D
Page 4 of 5
Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection
with the making of any federal grant, the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any federal grant or cooperative agreement;
2) If any other funds than federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an
officer or an employee of Congress, or employee of a Member of Congress in connection with the federal
grant or cooperative agreement, the undersigned shall complete and submit Standard Form LLL,
"Disclosure of Lobbying Activities," in accordance with its instructions;
3) The undersigned shall require that the language of this certification be included in the award
documents for all sub awards at all tiers including subgrants, contracts under grants and cooperative
agreements, and subcontract(s) and that all sub recipients shall certify and disclose accordingly.
4) This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making or
entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file
the required certification shall be subject to a civil penalty of not less than $10,000 and not more than
$100,000 for each such failure.
30. Agrees that funds awarded under this grant will be used to supplement existing funds for program activities,
and will not supplant (replace) non-federal funds.
31. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and
policies governing this program.
32. As required by the Drug -Free Workplace Act of 1988, and implemented at 44 CFR Part 17, Subpart F, for
grantees, as defined at 44 CFR Part 17, Sections 17.615 and 17.620:
A. The applicant certifies that it will continue to provide a drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful
manufacture, distribution, dispensing, possession, or use of a controlled
substance is prohibited in the grantee's workplace and specifying the
actions that will be taken against employees for violation of such
prohibition;
(b) Establishing an on-going drug free awareness program to inform
employees about:
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and
employee assistance programs; and
(4) The penalties that may be imposed upon employees for
drug abuse violations occurring in the workplace;
(c) Making it a requirement that each employee to be engaged in the
performance of the grant to be given a copy of the statement required
by paragraph (a);
(d) Notifying the employee in the statement required by paragraph (a)
that, as a condition of employment under the grant, the employee
will:
(1) Abide by the terms of the statement; and
(2) Notify the employee in writing of his or her conviction for a
violation of a criminal drug statute occurring in the workplace no
later than five calendar days after such conviction.
(e) Notifying the agency, in writing, within 10 calendar days after
receiving notice under subparagraph (d) (2) from an employee or
otherwise receiving actual notice of such conviction. Employers of
convicted employees must provide notice, including position title, to
the applicable FEMA awarding office, i.e., regional office or FEMA
office.
Exhibit D
Page 5 of 5
(f) Taking one of the following actions, within 30 calendar days of
receiving notice under subparagraph (d)(2), with respect to any
employee who is so convicted:
(1) Taking appropriate personnel action against such an
employee, up to and including termination, consistent with the
requirements of the Rehabilitation Act of 1973, as amended;
or
(2) Requiring such employee to participate satisfactorily in a
drug abuse assistance or rehabilitation program approved
for such purposes by a Federal, State, or local health, law
enforcement, or other appropriate agency.
(g) Making a good faith effort to continue to maintain a drug free
workplace through implementation of paragraphs (a), (b), (c), (d), (e),
and (f).
B. The grantee may insert in the space provided below the site(s) for the performance of
work done in connection with the specific grant:
Place of Performance (Street address, City, County, State, Zip code)
1009 C Street
San Rafael Marin County
California 94901
Check ❑ if there are workplaces on file that are not identified here.
Section 17.630 of the regulations provides that a grantee that is a State may elect to make one certification in each
Federal fiscal year. A copy of which should be included with each application for FEMA funding States and State
agencies may elect to use a Statewide certification.
The undersigned represents that he/she is authorized by the above named applicant to enter into this agreement for and
on behalf of the said applicant.
SIGNATURE OF AUTHORIZED AGENT
Rod Gould
PRINTED NAME
Citv Manaeer
TITLE
DATE
EXHIBIT E
Exhibit E, Page 1 of 2
REE14BURSEMENT RATES/ CONDITIONS
REQUIREMENTS/ RESOURCES
Reimbursement shall not be made for expenses incurred within 50 miles of home or
headquarters.
MEALS/ INCIDENTALS- IN-STATE/ OUT OF STATE TRAVEL
FOR EACH FULL 24 HOUR PERIOD OF TRAVEL
Breakfast — actual expense up to $ 6.00
Lunch — actual expense up to $10.00
Dinner — actual expense up to $18.00
Incidentals — actual expense up to $ 6.00
TIME FRAME REOUIREMENTS FOR CLAIMING MEALS WHILE ON TRAVEL
STATUS
FIRST DAY OF TRAVEL, TRIP OF 24 HOURS OR MORE:
Trip begins at or before 6am:
Trip begins at or before 11 am:
Trip begins at or before 5pm:
CONTINUING AFTER A TRIP OF 24 HOURS
Trip ends at or after 8am:
Trip ends at or after 2pm:
Trip ends at or after 7pm:
breakfast may be claimed
lunch may be claimed
dinner may be claimed
breakfast may be claimed
lunch may be claimed
dinner may be claimed
FRACTIONAL DAYS OF TRAVEL — TRIP OF LESS THAN 24 HOURS*
Trip begins at or before 6am AND ends at or after 9am: breakfast may be claimed
Trip begins at or before 4pm AND ends at or after 7pm: dinner may be claimed
*No lunch or incidentals on one day trips. Meals claimed on trips of less than 24 hours when
there is no overnight stay are taxable.
Meals provided by the State or included in hotel expenses or conference fees, or in transportation
costs such as airline tickets, or otherwise provided shall not be claimed for reimbursement.
Snacks and continental breakfasts, such as rolls, juice and coffee, are not considered to be meals.
No meal expense may be claimed or reimbursed more than once in any given 24-hour period.
Page 1 of 2
Exhibit E, Page 2 of 2
LODGING REIMBURSEMENT
SHORT TERM TRAVEL- When overnight lodging expenses are incurred at a commercial
lodging establishment catering to the short term traveler, such as hotel, motel, bed and breakfast,
public campground etc. The following short term travel lodging rates are effective March 17,
2003.
ALL EMPLOYEES Actual lodging expense, supported by a receipt, to a maximum of
$84 per night plus tax, EXCEPT AS NOTED BELOW. Receipts
include those for public campgrounds. (no receipt- no lodging
reimbursement.)
In Los Angeles (Central and Western Los Angeles only*) and San
Diego counties, actual lodging supported by a receipt, to a
maximum of $110 plus tax.
In Alameda, San Francisco, Santa Clara and San Mateo Counties,
actual lodging supeorted bv_ a receipt, to a maximum of $140 plus
tax.
*Central and Western Los Angeles is a designated geographical
area within the boundaries of Sunset Boulevard on the North, the
Pacific Ocean on the West, Imperial Blvd./Freeway 105 on the
South, and Freeways 110, 10, and 101 on the East. This area
includes downtown L.A., Inglewood, L.A. International Airport,
Playa del Rey, Venice, Santa Monica, Brentwood, West L.A.,
Westwood Village, Culver City, Beverly Hills, Century City,
West Hollywood and Hollywood.
STATE SPONSORED CONFERENCE, ETC.: Receipted lodging up to $110 when
attending a state sponsored conference when the lodging is contracted by the State sponsor for
the event, and the State has granted prior approval for attendance and lodging at the contracted
rate and establishment.
NON -STATE SPONSORED CONFERENCE, ETC.: Receipted at the lodging while
attending a non -state sponsored conference when the lodging is contracted by the sponsor for
the event, and the State has granted prior approval for attendance and lodging at the contracted
rate and establishment.
Page 2 of 2