HomeMy WebLinkAboutFD Get Ready 5th Grade Grant 2nd AmendmentAGREEMENT BETWEEN THE CITY AND COUNTY OF
SAN FRANCISCO AND THE CITY OF SAN RAFAEL
FOR THE DISTRIBUTION OF FY 2010 REGIONAL CATASTROPHIC PREPAREDNESS
GRANT PROGRAM FUNDS
SECOND AMENDMENT
THIS AMENDMENT (this "Amendment") is made as of JANUARY 1, 2013, in San Francisco,
California, by and between the CITY OF SAN RAFAEL ("SAN RAFAEL") and the City and County of
San Francisco, a municipal corporation ("City"), in its capacity as fiscal agent for the UASI Approval
Authority, acting by and through the San Francisco Department of Emergency Management.
RECITALS
WHEREAS, City and SAN RAFAEL have entered into the Agreement (as defined below); and
WHEREAS, City and SAN RAFAEL desire to modify the Agreement on the teens and conditions set
forth herein;
NOW, THEREFORE, SAN RAFAEL and the City agree as follows:
1. Definitions. The following definitions shall apply to this Amendment:
a. Agreement. The term "Agreement" shall mean the "Agreement between the City and
County of San Francisco and SAN RAFAEL for the Distribution of FY 2010 Regional Catastrophic
Preparedness Grant Program Funds" dated November 1, 2011, between SAN RAFAEL and City, and as
amended by the:
• First Amendment, dated September 1, 2012.
b. Other Terms. Terms used and not defined in this Amendment shall have the meanings
assigned to such tertns in the Agreement.
2. Modifications to the Agreement. The Agreement is hereby modified as follows:
a. Section 3.2, Grant Allocation; Grant Match. Section 3.2 of the Agreement currently
reads as follows:
The total allocation of Grant Funds to SAN RAFAEL is TWO HUNDRED SIXTY-FOUR
THOUSAND, SIX HUNDRED SIXTY-SEVEN DOLLARS ($264,667). The total allocation includes
a mandatory 25% local Grant Match requirement of SIXTY-SIX THOUSAND, ONE HUNDRED
SIXTY-SEVEN DOLLARS ($66,167). SAN RAFAEL shall provide the required Grant Match through
in-kind services or appropriation of non -Federal funds, as defined in 44 C.F.R. § 13.24. Pursuant to its
approved Grant Match plan due under Appendix A, SAN RAFAEL shall provide a Grant Match of in-
kind services or non -Federal fiords each time it submits a Reimbursement Request under Section 3.11, in
an amount equal to 25% of the Reimbursement Request.
Such section is hereby amended in its entirety to read as follows:
FY 10 RCPGP - SAN RAFAEL 2nd Amendment Page I of 3 January 1, 2013
The total allocation of Grant Funds to SAN RAFAEL is ONE HUNDRED SIXTY-SEVEN
THOUSAND, THREE HUNDRED THIRTY-THREE DOLLARS ($167,333). The total allocation
includes a mandatory 25% local Grant Match requirement of FORTY-ONE THOUSAND, EIGHT
HUNDRED THIRTY-THREE DOLLARS ($41,833). SAN RAFAEL shall provide the required Grant
Match through in-kind services or appropriation of non -Federal funds, as defined in 44 C.F.R. § 13.24.
Pursuant to its approved Grant Match plan due under Appendix A, SAN RAFAEL shall provide a Grant
Match of in-kind services or non -Federal funds each time it submits a Reimbursement Request under
Section 3.11, in an amount equal to 25% of the total allocation of Grant Funds.
b. Section 3.3, Maximum Amount of Funds. Section 3.3 of the Agreement currently
reads as follows:
In no event shall the amount of Grant Funds disbursed hereunder exceed ONE HUNDRED NINETY-
EIGHT THOUSAND, FIVE HUNDRED DOLLARS ($198,500).
Such section is hereby amended in its entirety to read as follows:
In no event shall the amount of Grant Funds disbursed hereunder exceed ONE HUNDRED TWENTY-
FIVE THOUSAND, FIVE HUNDRED DOLLARS ($125,500).
C. Appendix A, Authorized Expenditures and Timelines. Appendix A includes project
descriptions, deliverables, not to exceed ("NTE") amounts, and deadlines for deliverables and
invoices/Reimbursement Requests.
Such Appendix is hereby amended to reflect the following:
i) Decrease planning finds, in the amount of $73,000, Community Prep Planning for
Project C.
d. Appendix B, Grant Assurances. Appendix B contains the applicable grant assurances.
Appendix B is not amended but SAN RAFAEL is re-signing Appendix B in executing this Amendment,
to certify its current compliance with all applicable grant assurances.
e. Appendix C, Form of Reimbursement Request dated January 1, 2013. A revised
Appendix C is attached to this Amendment and incorporated by reference as though frilly set forth herein.
The attached Appendix C supersedes all prior versions of Appendix C.
3. Effective Date. Each of the modifications set forth in Section 2 shall be effective on and after the
date of this Amendment.
4. Legal Effect. Except as expressly modified by this Amendment, all of the terms and conditions
of the Agreement shall remain unchanged and in frill force and effect.
FY 10 RCPGP - SAN RAFAEL 2nd Amendment Page 2 of 3 January 1, 2013
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be duly executed as of the
date first specified herein.
CITY AND COUNTY OF SAN FRANCISCO
SAN FRANCISCO DEPARTMENT OF
EMERGENCY MANAGEMENT
By:
ANNE KRONEN ERG
EXECUTIVE DIRECTOR
Approved as to Form:
Dennis J. Herrera
City Attorney
By:�/Ilttomey
Thomas Ow
Deputy City
CITY OF SAN RAFAEL:
By:
-/�4vit'g4 )1lU"J�-b
NANCY MACkLE
CITY MANAGER
Federal Tax ID #: 94-6000424
Appendices:
Amended Appendix A, Authorized Expenditures and Timelines, dated January 1, 2013
Appendix B, Grant Assurances, dated January 1, 2013
Amended Appendix C, Fonn of Reimbursement Request, dated January 1, 2013
FY 10 RCPGP - SAN RAFAEL 2"d Amendment Page 3 of 3 January 1, 2013
Appendix A — Authorized Expenditures and Timelines
ENTITY: SAN RAFAEL
Total allocation to be spent on the following solution areas:
UASI Project Solution
Title Area
GRANT MATCH Grant Match
Project C
Regional Public
Outreach and
Community
Preparedness
Project Plan
Planning
Program Description
THE REQUIRED GRANT MATCH IS
SET IN SECTION 3.2 OF THIS
AGREEMENT. By not later than
06/29/2012, SAN RAFAEL shall submit
a plan for its required local Grant Match
in the amount of $41,833 (including
budget allocation information for any
cash match and in-kind services), which
plan is subject to approval by UASI
Management Team.
Funds for Get Ready 5`" Grade (GR5)
Disaster Preparedness and Readiness
Program.
Project duties include:
• Establish a GR5 working group
(GR5WG) comprised of agency
representatives from throughout the
Bay Area to revise the current SAN
RAFAEL County GR5 manual into a
Bay Area GR5 manual.
• Develop an outreach and marketing
plan describing regional roll out and
implementation targeting the
2012/2013 school year.
• Conduct four GR5 orientation
sessions, one for each of the four
established major regions of the Bay
Area UASI (north, south, west, and
east regions).
• Print 113,000 GR5 manuals for local
agency use and implementation of
the GR5 program for an initial two
years.
• The GR5 student manual will be
translated into Spanish. Additional
language translations may be
considered pending budget and as
determined by the GR5WG.
• Conduct four Train -the -Trainer (T3)
sessions, one for each of the four
Deliverable
Dates Amount
06/29/2012
Not to
11/01/2011 - Exceed:
11/30/2012 $125,500
FY 10 RCPGP - SAN RAFAEL 2nd Amendment A-1 January 1, 2013
established major regions of the Bay
Area UASI (north, south, west, and
east regions).
• Develop a website for GR5 materials
and resources to be available for all
agencies to access.
• Develop a Bay Area GR5
Sustainability Plan to address issues
and concerns regarding long term
implementation of the program.
• Personnel — Prior to any
reimbursement for expenditures for
personnel SAN RAFAEL must
submit the following: all functional
time sheets, payroll documentation
showing payment of salaries and
benefits, or cancelled checks.
• Expenditures for this item cannot be
released until UASI General
Manager and SAN RAFAEL OES
specifically identify the
representative and mutually agree
on the work plan, including the
assignment, critical task and job
functions and the expected
deliverables.
• Project contact: Steven E. Hancock
• Contracts — All contracts must be
pre -approved by the UASI prior to
execution. In addition, SAN RAFAEL
must satisfy the following guidelines:
Procurement of contractual
services must follow local policies
and procedures for competitive
purchasing (provided they are not
in conflict with Federal
regulations which supersede
them). If sole source approval is
needed, SAN RAFAEL must
transmit the sole source request
to the UASI for submission to the
State.
r The contract must have a clearly
stated scope of work and
deliverables, deadlines for
completion of work, and a
schedule of contract payments.
All services must be performed
and paid within the grant
performance period.
• Travel - travel for planning activities
must be pre -approved by the UASI
Director of Strategy and Compliance
FY 10 RCPGP - SAN RAFAEL 2nd Amendment A-2 January 1, 2013
or designee prior to scheduling.
Invoices for all travel expenses must
be submitted by no later than
12/31/2012. Invoices must include
all backup documentation, including
conference agendas, programs,
brochures, lodging receipts, per
diem calculations, airfare
receipts/boarding passes, mileage
calculations, other transportation
receipts, and proof of payment
Final deadline to submit a
Reimbursement Request is
12/31/2012.
TOTAL ALLOCATION
NOT TO
EXCEED:
$125,500
• All requests for reimbursements must be submitted by December 31, 2012, unless an
earlier deadline is set in this Appendix.
• Descriptions of authorized expenditures are in the following documents:
FY 2010 Regional Catastrophic Preparedness Grant Program, Guidance and Application
Kit dated December, 2009:
http://w3. calema. ca. aov/WebPaae%eswebsite. nsf/ClientOESFileLibrandHomeland % 20S
ecurity % 20Files/$fileIFY2010RCPGPFederaIGuidance. pdf
California Supplement to Federal Program Guidance and Application Kit:
http://w3. calema. ca. aov/WebPaae%eswebsite. nsf/ClientOESFileLibrary/Homeland %20S
ecuritv % 20Files/$file/FY201ORCPGPCAStateSupplement. pdf
Office of Justice Programs Financial and Administrative Guide for Grants:
http://www. oin. usdoi. goWfinancialauide/
• No Management and Administration expenses are allowed, unless expressly
identified and authorized in this Appendix.
FY 10 RCPGP - SAN RAFAEL 2nd Amendment A-3 January 1, 2013
Appendix B-- Grant Assurances
Name of Jurisdiction: CITY OF SAN RAFAEL
Name of Authorized Agent: Nancv Mackie. Citv Manaoer
Address: 1400 Fifth Avenue
City: San Rafael State: CA Zip Code: 94901
Telephone Number: (415) 485-3070
Fax Number: (415) 459-2242
E -Mail Address: Nancv.Mackle(a)citvofsanrafael.oro
As the duly authorized representative of SAN RAFAEL, I certify that SAN RAFAEL:
Will assure that grant funds will support efforts related to providing an integrated
mechanism to enhance the coordination of national priority efforts to prevent, respond to,
and recover from terrorist attacks, major disasters and other emergencies.
2. Has the legal authority to apply for Federal assistance and has the institutional, managerial
and financial capability to ensure proper planning, management and completion of the grant
provided by the U.S. Department of Homeland Security (DHS)/Federal Emergency
Management Agency (FEMA) and sub -granted through the State of California, California
Emergency Management Agency (Cal EMA).
3. Will assure that grant funds are used for allowable, fair, and reasonable costs only and will
not be transferred between grant programs (for example: State Homeland Security Program,
Urban Area Security Initiative, Citizen Corps Program, and Metropolitan Medical Response
System) or fiscal years.
4. Will comply with any cost sharing commitments included in the FY2010 Investment
Justifications submitted to DHS/FEMA/Cal EMA, where applicable.
5. Will give the Federal government, the General Accounting Office, the Comptroller General of
the United States, the State of California, the Office of Inspector General, through any
authorized representative, access to, and the right to examine, all paper or electronic
records, books, or documents related to the award; and will establish a proper accounting
system in accordance with generally accepted accounting standards and/or awarding
agency directives.
6. Agrees that funds utilized to establish or enhance State and Local fusion centers must
support the development of a statewide fusion process that corresponds with the Global
Justice/Homeland Security Advisory Council (HSAC) Fusion Center Guidelines, follow the
Federal and State approved privacy policies, and achieve (at a minimum) baseline level of
capability as defined by the Fusion Capability Planning Tool.
FY 10 RCPGP - SAN RAFAEL 2ND Amendment B-1 January 1, 2013
Initials V
7. Will provide progress reports, and other such information as may be required by the
awarding agency, including the Initial Strategy Implementation Plan (ISIP) within 45 (forty-
five) days of the award, and update via the Grant Reporting Tool (GRT) twice each year.
8. Will initiate and complete the work within the applicable time frame after receipt of
approval from Cal EMA.
9. Will maintain procedures to minimize the time elapsing between the award of funds and
the disbursement of funds.
10. Will comply with all provisions of DHS/FEMA's codified regulation 44, Part 13, Uniform
Administrative Requirements for Grants and Cooperative Agreements to State and Local
Governments, including the payment of interest earned on advances.
11. 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 gain for themselves or others, particularly those with whom they have family,
business, or other ties.
12. Understands and agrees that Federal funds will not be used, directly or indirectly, to support
the enactment, repeal, modification or adoption of any law, regulation, or policy, at any level
of government, without the express prior written approval from DHS/FEMA/Cal EMA.
13. Agrees that, to the extent contractors or subcontractors are utilized, will use small, minority-
owned, women -owned, or disadvantaged business concerns and contractors or
subcontractors to the extent practicable.
14. Will notify Cal EMA of any developments that have a significant impact on award -supported
activities, including changes to key program staff.
15. Will comply, if applicable, 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
structures.
16. Will comply with all Federal and State Statues relating to Civil Rights and Nondiscrimination.
These include, but are not limited to:
a. Title VI of the Civil Rights Act of 1964 (P.L. 88-352), as amended, 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 gender.
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.
FY 10 RCPGP - SAN RAFAEL 2ND Amendment B-2 January 1, 2013
Initials:
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. Title 44 Code of Federal Regulations (CFR) Parts 7, 16, and 19 relating to
nondiscrimination.
j. The requirements on any other nondiscrimination provisions in the specific
statute(s) under which the application for Federal assistance is being made.
k. Will, in the event that a Federal or State court or Federal or State administrative
agency makes a finding of discrimination after a due process hearing on the grounds
or race, color, religion, national origin, gender, or disability against a recipient of
funds, the recipient will forward a copy of the finding to the Office of Civil Rights,
Office of Justice Programs.
I. Will provide an Equal Employment Opportunity Plan, if applicable, to the Department
of Justice Office of Civil Rights within 60 days of grant award.
m. Will comply, and assure the compliance of all its subgrantees and contractors,
with the nondiscrimination requirements and all other provisions of the current
edition of the Office of Justice Programs Financial and Administrative Guide for
Grants, M7100.1.
17. Will comply with the requirements of Titles II and III of the Uniform Relocation Assistance and
Real Property Acquisition Policies Act of 1970 (42 U.S.C. § 4601 et seq. [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. Will also comply with Title 44 CFR, Part 25, Uniform Relocation Assistance and
Real Property Acquisition for Federal and Federally -assisted programs.
18. 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 ten thousand dollars ($10,000) or more.
19. Will comply with all applicable Federal, State, and Local environmental and historical
preservation (EHP) requirements. Failure to meet Federal, State, and Local EHP
requirements and obtain applicable permits may jeopardize Federal funding. Will comply with
all conditions placed on any project as the result of the EHP review; any change to the scope
of work of a project will require reevaluation of compliance with these EHP requirements.
20. Agrees not to undertake any project having the potential to impact the EHP resources without
the prior written approval of DHS/FEMA/Cal EMA, including, but not limited to, ground
disturbance, construction, modification to any structure, physical security enhancements,
communications towers, and purchase and/or use of any sonar equipment. The subgrantee
FY 10 RCPGP - SAN RAFAEL 2ND Amendment B-3 January 1, 2013
Initials:
must comply with all conditions placed on the project as a result of the EHP review. Any
construction- related activities initiated without the necessary EHP review and approval will
result in a noncompliance finding, and may not be eligible for reimbursement with
DHS/FEMA/Cal EMA funding. Any change to the scope of work will require re-evaluation of
compliance with the EHP. If ground -disturbing activities occur during the project
implementation, the subgrantee must ensure monitoring of the disturbance. If any potential
archeological resources are discovered, the subgrantee will immediately cease activity in that
area and notify DHS/FEMA/Cal EMA and the appropriate State Historic Preservation Office.
21. Will ensure that the facilities under its ownership, lease or supervision, which shall be
utilized in the accomplishment of this project, are not on the Environmental Protection
Agency's (EPAs) List of Violating Facilities, and will notify Cal EMA and the Federal Grantor
agency of the receipt of any communication from the Director of the EPA Office of Federal
Activities indicating if a facility to be used in the project is under consideration for listing by
the EPA.
22. Will provide any information requested by DHS/FEMA/Cal EMA to ensure compliance with
applicable laws, including the following:
a. Institution of environmental quality control measures under the National Environmental
Policy Act, National Historical Preservation Act, Archaeological and Historic
Preservation Act, Endangered Species Act, and Executive Orders on Floodplains
(11988), Wetlands (11990) and Environmental Justice (EO12898) and Environmental
Quality (EO11514).
b. Notification of violating facilities pursuant to EO 11738.
c. 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.).
d. 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.).
e. Protection of underground sources of drinking water under the Safe Drinking Water Act
of 1974, as amended, (P.L. 93-523).
f. California Environmental Quality Act (CEQA). California Public Resources Code
Sections 21080-21098. California Code of Regulations, Title 14, Chapter 3 Section
15000-15007.
g. 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.
h. Applicable provisions of the Coastal Barrier Resources Act (P.L. 97-348) dated October
19, 1982 (16 USC 3501 et seq.) which prohibits the expenditure of most new Federal
funds within the units of the Coastal Barrier Resources System.
23. Will comply with Standardized Emergency Management System (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.
24. Agrees that all publications created or published with funding under this grant shall
prominently contain the following statement: "This document was prepared under grant
from FEMA's Grant Programs Directorate, U.S. Department of Homeland Security. Points of
view or opinions expressed in this document are those of the authors and do not necessarily
FY 10 RCPGP - SAN RAFAEL 2ND Amendment B-4 January 1, 2013
Initials:
represent the official position or policies of FEMA's Grant Programs Directorate or the U. S.
Department of Homeland Security. " The recipient also agrees that, when practicable, any
equipment purchased with grant funding shall be prominently marked as follows: "Purchased
with funds provided by the U.S. Department of Homeland Security."
25. Acknowledges that DHS/FEMA reserves a royalty -free, nonexclusive, and irrevocable license
to reproduce, publish, or otherwise use, and authorize others to use, for Federal government
purposes: a) the copyright in any work developed under an award or sub -award; and b) any
rights of copyright to which a recipient or sub -recipient purchases ownership with Federal
support.
26. The recipient agrees to consult with DHS/FEMA/Cal EMA regarding the allocation of any
patent rights that arise from, or are purchased with, this funding.
27. Has requested through the State of California, Federal financial assistance to be used to
perform eligible work approved in the submitted application for Federal assistance and after
the receipt of Federal financial assistance, through the State of California, agrees to the
following:
a. 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.
b. 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.
c. Separately account for interest earned on grant funds, and will return all interest
earned, in excess of $100 per Federal Fiscal Year.
28. 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).
29. 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.
30. Will comply, if applicable, with P.L. 93-348 regarding the protection of human subjects
involved in research, development, and related activities supported by this award of
assistance.
31. Will comply, if applicable, 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.
32. 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.
FY 10 RCPGP - SAN RAFAEL 2N° Amendment B-5 January 1, 2013
Initials
33. 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 sub -agreements.
34. Agrees that:
a. No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with the making of any
Federal grant, the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any Federal grant or cooperative
agreement.
b. If any other funds than Federal appropriated funds have been paid or will be paid to any
person for 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.
c. 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.
d. 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.
35. Agrees that equipment acquired or obtained with grant funds:
a. Will be made available pursuant to applicable terms of the California Disaster and Civil
Defense Master Mutual Aid Agreement in consultation with representatives of the
various fire, emergency medical, hazardous materials response services, and law
enforcement agencies within the jurisdiction of the applicant, and deployed with
personnel trained in the use of such equipment in a manner consistent with the
California Law Enforcement Mutual Aid Plan or the California Fire Services and
Rescue Mutual Aid Plan.
b. Is consistent with needs as identified in the State Homeland Security Strategy and will
be deployed in conformance with that Strategy.
36. 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.
37. Will comply with all applicable Federal statutes, regulations, policies, guidelines and
requirements, including OMB Circulars A102 and A-133, E.O. 12372 and the current
Administrative Requirements, Cost Principles, and Audit Requirements.
FY 10 RCPGP - SAN RAFAEL 2ND Amendment B-6 January 1, 2013
Initials
38. Will comply with all provisions of 2 CFR, including: Part 215 Uniform Administrative
Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals,
and Other Non -Profit Organizations (OMB Circular A-110); Part 225 Cost Principles for State,
Local and Indian Tribal Governments (OMB Circular A-87); Part 220 Cost Principles for
Educational Institutions (OMB Circular A-21); Part 230 Cost Principles for Non -Profit
Organizations (OMB Circular A-122).
39. Will comply with Subtitle A, Title II of the Americans with Disabilities Act (ADA) 1990.
40. Agrees to cooperate with any assessments, national evaluation efforts, or information or data
collection requests, including, but not limited to, the provision of any information required for
the assessment or evaluation of any activities within this agreement.
41. Will comply with Federal Acquisition Regulations (FAR), part 31.2 Contract Cost Principles
and Procedures, Contracts with Commercial Organizations.
42. Will comply with the financial and administrative requirements set forth in the current edition
of the DHS Financial Management Guide.
43. Agrees that all allocations and use of funds under this grant will be in accordance with the
FY 2010 Homeland Security Grant Program Guidance and Application Kit, and the
California Supplement to the FY 2010 Homeland Security Grant Program Guidance and
Application Kit. All allocations and use of funds under this grant will be in accordance with
the Allocations, and use of grant funding must support the goals and objectives included in
the State and/or Urban Area Homeland Security Strategies as well as the investments
identified in the Investment Justifications which were submitted as part of the California
FY2010 Homeland Security Grant Program application. Further, use of FY10 funds is
limited to those investments included in the California FY10 Investment Justifications
submitted to DHS/FEMA/Cal EMA and evaluated through the peer review process.
44. Will not make any award or permit any award (subgrant 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".
45. As required by Executive Order 12549, Debarment and Suspension, and implemented at
44 CFR Part 17, for prospective participants in primary covered transactions,
a. The applicant certifies that it and its principals:
i. Are not presently debarred, suspended, proposed for debarment, declared
ineligible, sentenced to a denial of Federal benefits by a State or Federal court, or
voluntarily excluded from covered transactions by any Federal department or
agency.
Have not within a three-year period preceding this application been convicted of
or had a civil judgment rendered against them for commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or performing a
public (Federal, State, or local) transaction or contract under a public transaction;
violation of Federal or State antitrust statutes or commission of embezzlement,
FY 10 RCPGP - SAN RAFAEL 2N° Amendment B-7 January 1, 2013
Initials:
theft, forgery, bribery, falsification or destruction of records, making false
statements, or receiving stolen property.
iii. Are not presently indicted for or otherwise criminally or civilly charged by a
governmental entity (Federal, State, or local) with commission of any of the
offenses enumerated in paragraph (1)(b) of this certification; and have not within a
three-year period preceding this application had one or more public transactions
(Federal, State, or local) terminated for cause or default; and
Where the applicant is unable to certify to any of the statements in this certification, he
or she shall attach an explanation to this application.
46. Agrees to comply with the Drug -Free Workplace Act of 1988, and certifies that it will or
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:
i. The dangers of drug abuse in the workplace;
ii. The grantee's policy of maintaining a drug-free workplace;
iii. Any available drug counseling, rehabilitation, and employee assistance programs;
and
iv. 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 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
i. Abide by the terms of the statement; and
ii. Notify the employer 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:
Department of Justice, Office of Justice Programs
ATTN: Control Desk
633 Indiana Avenue, N.W.
Washington, D.C. 20531
Notice shall include the identification number(s) of each affected grant.
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.
FY 10 RCPGP - SAN RAFAEL 2ND Amendment B-8 January 1, 2013
Initials:
i. 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
ii. 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).
47. Will comply with all applicable requirements of all other Federal and State laws, executive
orders, regulations, program and administrative requirements, policies and any other
requirements governing this program.
48. Understands that failure to comply with any of the above assurances may result in
suspension, termination, or reduction of grant funds.
The undersigned represents that he/she is authorized by SAN RAFAEL to execute these Grant
Assurances for and on behalf of SAN RAFAEL.
Signature of Authorized Agent:
Printed Name of Authorized Agent:
Title: Citv Manager
Nancv Mackle
FY 10 RCPGP - SAN RAFAEL 2ND Amendment
i
Date:
B-9 January 1, 2013
Initials:
Appendix C -- Form of Reimbursement Request
REIMBURSEMENT REQUEST
, 2012
UASI Management Team
711 Van Ness Avenue, Suite 420
San Francisco, CA 94102
Re: FY 10 RCPGP Grant Reimbursement Request
Pursuant to Section 3.11 of the "Agreement between the City and County of San Francisco and
the City of San Rafael for the Distribution of FY 2010 Regional Catastrophic Preparedness
Grant Program Funds" (the "Agreement"), dated NOVEMBER 1, 2011, and as amended by the
Second Amendment dated JANUARY 1, 2013, between the City of San Rafael ("SAN
RAFAEL") and the City and County of San Francisco, SAN RAFAEL hereby requests
reimbursement as follows:
Total Amount of
Reimbursement
Requested in this $
Request:
Maximum Amount of
Funds Specified in
Section 3.3 of the
Agreement: $
Total of All Funds
Disbursed Prior to this
Request: $
Total Amount of Grant
Match in this Request: $
Total Grant Match
provided prior to this $
Request.
Total Required Grant
Match under Section 3.2 $
of the Agreement:
FY 10 RCPGP - SAN RAFAEL 2ND Amendment C-1 January 1, 2013
SAN RAFAEL certifies that:
(a) The total amount of funds requested pursuant to this Funding Request will be used
to reimburse SAN RAFAEL for Authorized Expenditures, which expenditures are
set forth on the attached Schedule 1, to which are attached true and correct copies
of all required documentation of such expenditures.
(b) The total amount of Grant Match specified in this Reimbursement Request will be used to
satisfy some or all of SAN RAFAEL's required Grant Match. The Grant Match is set forth
in the attached Schedule 2, to which are attached true and correct copies of supporting
and verifying documentation. For a cash Grant Match, SAN RAFAEL shall attach a true
and correct copy of an expenditure report. For a Grant Match of in-kind services, SAN
RAFAEL shall provide true and correct copies of all documentation demonstrating the
value of the in-kind services.
(c) After giving effect to the disbursement requested pursuant to this Reimbursement
Request, the Funds disbursed as of the date of this disbursement will not exceed the
maximum amount set forth in Section 3.3 of the Agreement, or the not to exceed amounts
specified in Appendix A for specific projects and programs.
(d) The representations, warranties and certifications made in the Agreement are true
and correct in all material respects as if made on the date hereof, and SAN
RAFAEL is in compliance with all Grant Assurances in Appendix B of the
Agreement;
(e) No Event of Default has occurred and is continuing; and
(f) The undersigned is an officer of SAN RAFAEL authorized to execute this
Reimbursement Request on behalf of SAN RAFAEL.
Signature of Authorized Agent:
Printed Name of Authorized Agent:
Title:
Date:
FY 10 RCPGP - SAN RAFAEL 2N° Amendment C-2 January 1, 2013
SCHEDULE 1 TO REQUEST FOR REIMBURSEMENT
The following is an itemized list of Authorized Expenditures for which reimbursement is
requested:
Project Payee
Amount Description
The following are attached as part of this Schedule 1:
(i) An invoice for each item of expenditure for which reimbursement is requested;
(ii) The front and the back of canceled checks or other written evidence documenting the
payment of each invoice;
(iii) For expenditures which are wages or salaries, payroll registers containing a detailed
breakdown of earnings and withholdings, together with both sides of canceled payroll
checks evidencing payment thereof (unless payment has been made electronically).
FY 10 RCPGP - SAN RAFAEL 2ND Amendment C-3 January 1, 2013
SCHEDULE 2 TO REQUEST FOR REIMBURSEMENT
The following is an itemized list of SAN RAFAEL's Grant Match associated with this
Reimbursement Request:
Specify Cash or In Kind Amount Description
The following are attached as part of this Schedule 2:
(i) An expenditure report supporting cash Grant Match; and
(ii) Appropriate and complete documentation supporting the in-kind Grant Match.
FY 10 RCPGP - SAN RAFAEL 2ND Amendment C-4 January 1, 2013