HomeMy WebLinkAbout040918_ca06Consent Agenda
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Lynn Sterbenz, Director, Department of Emergency Management
DATE: April 9, 2018
RE: FFY17 HOMELAND SECURITY GRANT PROGRAM AGREEMENT
E18-151
STATEMENT OF ISSUE:
Jefferson County Department of Emergency Management relies upon federal and state grants to
support staffing of the Department and Emergency Operations Center.
ANALYSIS:
The US Department of Homeland Security annually award funds, through the State of WA Emergency
Management Division, to local jurisdictions with emergency management programs to assist in
preparing for all hazards through sustainment and enhancement of those programs as described in the
grant agreement work plan.
FISCAL IMPACT:
Currently, no General Funds have been allotted by the County for staffing of the Emergency
Management Department except for the Director's position. This grant, in the amount of $51,542,
provides $38,000 for staffing each year. Additionally, this grant provides for the annual cost ($7,300)
for the County -wide Nixle Alert and Warning contract, and $6,242 for Community Resilience projects
such as public education materials, workshops, trainings, outreach, multimedia, and All -County Picnic.
RECOMMENDATION:
Approval. ASAP (I must meet a 45 day timeline to return it).
Signatures required from the following County Employees:
• Philip Morley (Signature Authorization Form)
• Philip Hunsucker (Page 1)
• David Sullivan (Page 1 and the Signature Authorization Form)
• Rose Ann Carroll (2 CFR Part 200 Subpart F Audit Certification Form and IRS W-9 Form)
DEPARTMENT CONTACT:
Lynn Sterbenz (360) 316-6008
REVIEWED BY:
Philip Morley, County'` min' trator Date
Washington State Military Department
HOMELAND SECURITY GRANT PROGRAM AGREEMENT FACE SHEET
1. Subrecipient Name and Address:
2.Grant Agreement Amount:
3. Grant Agreement Number:
Jefferson County
Department of Emergency Management (DEM)
$51,542
E18-151
81 Elkins Road
Port Hadlock, WA 98339-9700
4. Subrecipient Contact, phonetemail:
5. Grant Agreement Start Date:
6. Grant Agreement End Date:
Lynn Sterbenz, 360-344-9729
08/31/2019
lsterbenz@co.jefferson.wa.us
09/01/2017
7. Department Contact, phone/email:
8. Data Universal Numbering System
9. UBI # (state revenue):
Gary Stumph, 253-512-7483
(DUNS): 179278197
601-098-110
gary.stumph@mil.wa.gov
10. Funding Authority:
Washington State Military Department (the "Department") and the U.S. Department of Homeland Security (DHS)
11. Federal Funding Identification #:
12. Federal Award Date:
13. Catalog of Federal Domestic Assistance (CFDA) # & Title:
EMW-2017-SS-00101-S01
08/31/2017 1
97.067 - HSGP 17SHSP
14. Total Federal Award Amount:
15. Program Index # & OBJ/SUB-OBJ:
16. TIN:
$13,204,851
773SZ, 773SH, 773SB, 773SL, 773SC, 773SQ / NZ
I N/A
17. Service Districts:
18. Service Area by County(ies):
19. Women/Minority-Owned, State
BY LEGISLATIVE DISTRICTS: 24
Jefferson
Certified? X N/A ❑ NO
BY CONGRESSIONAL DISTRICTS: 6
❑ YES, OMWBE #
20. Agreement Classification
21. Contract Type (check all that apply):
❑ Personal Services ❑ Client Services X Public/Local Gov't
❑ Contract X Grant X Agreement
❑ Research/Development ❑ A/E ❑ Other
❑ Intergovernmental RCW 39.34 ❑ Interagency
22. Subrecipient Selection Process:
23. Subrecipient Type (check all that apply)
X "To all who apply & qualify' ❑ Competitive Bidding
❑ Private Organization/Individual ❑ For -Profit
❑ Sole Source ❑ A/E RCW ❑ N/A
X Public Organization/Jurisdiction X Non -Profit
❑ Filed w/OFM? ❑ Advertised? ❑ YES ONO
❑CONTRACTOR X SUBRECIPIENT ❑ OTHER
24. PURPOSE & DESCRIPTION:
The purpose of the Federal Fiscal Year (FFY) 2017 Homeland Security Grant Program (17HSGP) is to support state and local efforts to prevent terrorism
and other catastrophic events and to prepare the Nation for threats and hazards that pose the greatest risk to the security of the United States. 17HSGP
provides funding to implement investments that build, sustain, and deliver the core capabilities essential to achieving the National Preparedness Goal (the
Goal) of a secure and resilient Nation. 17HSGP supports core capabilities across the five mission areas of Prevention, Protection, Mitigation, Response, and
Recovery based on allowable costs. HSGP is comprised of three interconnected grant programs: State Homeland Security Program (SHSP), Urban Areas
Security Initiative (UASI), and Operation Stonegarden (OPSG). Together, these grant programs fund a range of preparedness activities, including planning,
organization, equipment purchase, training, exercises, and management and administration.
The Department is the Recipient and Pass-through Entity of the 17HSGP Award EMW-2017-SS-00101-S01, which is incorporated in and attached hereto
as Attachment 1, and is making a subaward of funds to the Subrecipient pursuant to this Agreement. The Subrecipient is accountable to the Department for
use of Federal award funds provided under this Agreement. The Subrecipient's Scope, Schedule, and Budget for the subaward are detailed in Attachment
2.
IN WITNESS WHEREOF, the Department and Subrecipient acknowledge and accept the terms of this Agreement, including all referenced Exhibits and
Attachments which are hereby incorporated in and made a part hereof, and have executed this Agreement as of the date below. This Agreement Face Sheet;
Special Terms & Conditions (Exhibit A); General Terms and Conditions (Exhibit B); Attachments 1 and 2; and all other documents, exhibits and attachments
expressly referenced and incorporated herein contain all the terms and conditions agreed upon by the parties and govern the rights and obligations of the
parties to this Agreement. No other understandings, oral or otherwise, regarding the subject matter of this Agreement shall be deemed to exist or to bind any
of the parties hereto.
In the event of an inconsistency in this Agreement, unless otherwise provided herein, the inconsistency shall be resolved by giving
precedence in the following order:
1. Applicable Federal and State Statutes and Regulations 4. Special Terms and Conditions
2. DHS/FEMA Award and program documents 5. General Terms and Conditions, and,
3. Scope, Schedule, and Budget 6. Other provisions of the Agreement incorporated by
reference.
WHEREAS, the parties hereto have executed this Agreement on the day and year last specified below.
FOR THE DEPARTMENT: FOR THE SUBRECIPIENT:
Signature Date Signature Date
Regan Anne Hesse, Chief Financial Officer David Sullivan, Chair
Washington State Military Department Jefferson County Board of Commissioners
BOILERPLATE APPROVED TO FORM:
Signature on File (10/26/2017) A R VE A� T� AFORM (if a licable :
Brian E. Buchholz, Assistant Attorney General �, g, pp
/_16
-
Applicant's Legal Review Date
Philip C. Hunsucker, Chief Civil Deputy Prosecuting Attorney
Form 09/09/2015 mll
DHS-FEMA-HSGP-SHSP-FFY17 Page 1 of 35 Jefferson County DEM, E18-151
Exhibit A
SPECIAL TERMS AND CONDITIONS
ARTICLE I -- KEY PERSONNEL
The individuals listed below shall be considered key personnel for point of contact under this Agreement. Any
substitution of key personnel by either party shall be made by written notification to the current key personnel.
SUBRECIPIENT MILITARY DEPARTMENT
Name
Lynn Sterbenz
Name
Gary Stumph
Title
Director
Title
Program Coordinator
E -Mail
Isterbenz@co.jefferson.wa.us
E -Mail
gary.stumph@mil.wa.gov
Phone
360-344-9729
Phone
253-512-7483
Name
Name
Sierra Wardell
Title
Title
Section Supervisor
E -Mail
E -Mail
sierra.wardell@mil.wa.gov
Phone
Phone
253-512-7121
Name
Name
Dalton Gamboa
Title
Title
Program Assistant
E -Mail
E -Mail
dalton.gamboa@mil.wa.gov
Phone
Phone
253-512-7044
ARTICLE II -- ADMINISTRATIVE AND/OR FINANCIAL REQUIREMENTS
The Subrecipient shall comply with all applicable state and federal laws, rules, regulations, requirements and
program guidance identified or referenced in this Agreement and the informational documents published by
DHS/FEMA applicable to the 17HSGP Program, including, but not limited to, all criteria, restrictions, and
requirements of the "Department of Homeland Security Notice of Funding Opportunity Fiscal Year 2017
Homeland Security Grant Program" document, the DHS Award Letter for Grant Number EMW-2017-SS-00101-
S01, and the federal regulations commonly applicable to DHS/FEMA grants, all of which are incorporated herein
by reference. The DHS Award Letter is incorporated in this Agreement as Attachment 1.
The Subrecipient acknowledges that since this Agreement involves federal award funding, the period of
performance described herein may begin prior to the availability of appropriated federal funds. The Subrecipient
agrees that it will not hold the Department, the State of Washington, or the United States liable for any damages,
claim for reimbursement, or any type of payment whatsoever for services performed under this Agreement prior
to distribution of appropriated federal funds, or if federal funds are not appropriated or in a particular amount.
A. STATE AND FEDERAL REQUIREMENTS FOR DHS/FEMA PREPAREDNESS GRANTS:
The following requirements apply to all DHS/FEMA Preparedness Grants administered by the Department.
1. SUBAWARDS & CONTRACTS BY SUBRECIPIENTS
a. The Subrecipient must make a case-by-case determination whether each agreement it makes for
the disbursement of 17HSGP funds received under this Agreement casts the party receiving the
funds in the role of a subrecipient or contractor in accordance with 2 CFR 200.330.
b. If the Subrecipient becomes a pass-through entity by making a subaward to a non-federal entity
as its subrecipient:
The Subrecipient must comply with all federal laws and regulations applicable to pass-
through entities of 17HSGP funds, including, but not limited to, those contained in 2 CFR
200.
The Subrecipient shall require its subrecipient to comply with all applicable state and federal
laws, rules, regulations, requirements and program guidance identified or referenced in this
Agreement and the informational documents published by DHS/FEMA applicable to the
17HSGP Program, including, but not limited to, all criteria, restrictions, and requirements of
the "Department of Homeland Security Notice of Funding Opportunity Fiscal Year 2017
Homeland Security Grant Program" document, the DHS Award Letter for Grant No. EMW-
2017-SS-00101-S01 in Attachment 1, and the federal regulations commonly applicable to
DHS/FEMA grants
DHS-FEMA-HSGP-SHSP-FFY17 Page 2 of 35 Jefferson County DEM, E18-151
iii. The Subrecipient shall be responsible to the Department for ensuring that all 17HSGP
federal award funds provided to its subrecipient are used in accordance with applicable
federal and state statutes and regulations, and the terms and conditions of the federal award
set forth in Attachment 1 of this Agreement.
2. BUDGET, REIMBURSEMENT, AND TIMELINE
a. Within the total Grant Agreement Amount, travel, sub -contracts, salaries, benefits, printing,
equipment, and other goods and services or other budget categories will be reimbursed on an
actual cost basis unless otherwise provided in this Agreement.
b. The maximum amount of all reimbursement requests permitted to be submitted under this
Agreement, including the final reimbursement request, is limited to and shall not exceed the total
Grant Agreement Amount.
c. If the Subrecipient chooses to include indirect costs within the Budget (Attachment 2), an indirect
cost rate agreement negotiated between the federal cognizant agency for indirect costs and the
Subrecipient establishing approved indirect cost rate(s) as described in 2 CFR 200.414 and
Appendix VII to 2 CFR 200 must be submitted to the Department. However, under 2 CFR
200.414(f), if the Subrecipient has never received a negotiated indirect cost rate agreement
establishing federally negotiated rate(s), the Subrecipient may negotiate a rate with the
Department or charge a de minimis rate of 10% of modified total direct costs. The Subrecipient's
actual indirect cost rate may vary from the approved rate, but must not exceed the approved
negotiated indirect cost rate percentage for the time period of the expenditures. If a Subrecipient
chooses to charge the 10% de minimis rate, but did not charge indirect costs to previous
subawards, a request for approval to charge indirect costs must be submitted to the Department's
Key Personnel for approval with an explanation for the change.
d. For travel costs, the Subrecipient shall comply with 2 CFR 200.474 and should consult their
internal policies, state rates set pursuant to RCW 43.03.050 and RCW 43.03.060 as now existing
or amended, and federal maximum rates set forth at http://www.gsa.gov, and follow the most
restrictive. If travel costs exceed set state or federal limits, travel costs shall not be reimbursed
without prior written approval by Department Key Personnel.
e. Receipts and/or backup documentation for any approved items that are authorized under this
Agreement must be maintained by the Subrecipient consistent with record retention requirements
of this Agreement, and be made available upon request by the Department, and federal, state, or
local auditors.
f. The Subrecipient will submit reimbursement requests to the Department by submitting a properly
completed State A-19 Invoice Form and Reimbursement Spreadsheet (in the format provided by
the Department) detailing the expenditures for which reimbursement is sought. Reimbursement
requests must be submitted to Reimbursements(cDmil.wa.gov no later than the due dates listed
within the Timeline (Attachment 2), but not more frequently than monthly.
Reimbursement request totals should be commensurate to the time spent processing by the
Subrecipient and the Department. If the reimbursement request isn't substantial enough, the
Subrecipient should request prior written approval from Department Key Personnel to waive the
due date in the Timeline (Attachment 2) and instead submit those costs on the next scheduled
reimbursement due date contained in the Timeline.
g. Any request for extension of a due date in the Timeline (Attachment 2) will be treated as a request
for Amendment of the Agreement and must be submitted to the Department's Key Personnel
sufficiently in advance of the due date to provide adequate time for Department review and
consideration, and can be granted or denied within the Department's sole discretion.
h. All work under this Agreement must end on or before the Grant Agreement End Date, and the
final reimbursement request must be submitted to the Department within 45 -days after the Grant
Agreement End Date, except as otherwise authorized by written amendment of this Agreement
and issued by the Department.
DHS-FEMA-HSGP-SHSP-FFY17 Page 3 of 35 Jefferson County DEM, E18-151
i. No costs for purchases of equipment/supplies will be reimbursed until the related
equipment/supplies have been received by the Subrecipient, its contractor, or any non-federal
entity to which the Subrecipient makes a subaward, and is invoiced by the vendor.
j. Failure to timely submit complete reports as required by this Agreement (including, but not limited
to, those reports in the Timeline) will prohibit the Subrecipient from being reimbursed until such
complete reports are submitted and the Department has had reasonable time to conduct its
review. Final reimbursement requests will not be approved for payment until the Subrecipient is
current with all reporting requirements contained in this Agreement.
k. A written amendment will be required if the Subrecipient expects cumulative transfers among
project budgets, as identified in the Scope and Budget (Attachment 2), to exceed 10% of the
Grant Agreement Amount. Any adjustments to project totals other than in compliance with this
paragraph will not be reimbursed.
I. Subrecipients shall only use federal award funds under this Agreement to supplement existing
funds, and will not use them to replace (supplant) non-federal funds that have been budgeted for
the same purpose. The Subrecipient may be required to demonstrate and document that the
reduction in non-federal resources occurred for reasons other than the receipt or expected receipt
of federal funds.
3. REPORTING
a. The Subrecipient shall submit with each reimbursement request a report indicating the status of
activities (Attachment 2) for which reimbursement is sought in the format provided by the
Department.
b. The Subrecipient shall comply with the Federal Funding Accountability and Transparency Act
(FFATA) and related OMB Guidance consistent with Public Law 109-282 as amended by section
6202(a) of Public Law 110-252 (see 31 U.S.C. 6101 note) and complete and return to the
Department the FFATA Form located at http://mil.wa.gov/emergency-management-
division/grants/reguiredgrantforms; which is incorporated by reference and made a part of this
Agreement.
c. SHSP & UASI Subrecipients shall participate in the State's annual capabilities assessment for
the State Preparedness Report.
4. EQUIPMENT AND SUPPLY MANAGEMENT
a. The Subrecipient and any non-federal entity to which the Subrecipient makes a subaward shall
comply with 2 CFR 200.318 — 200.326 when procuring any equipment or supplies under this
Agreement, 2 CFR 200.313 for management of equipment, and 2 CFR 200.314 for management
of supplies, to include, but not limited to:
i. Upon successful completion of the terms of this Agreement, all equipment and supplies
purchased through this Agreement will be owned by the Subrecipient, or a recognized non-
federal entity to which the Subrecipient has made a subaward, for which a contract,
subrecipient grant agreement, or other means of legal transfer of ownership is in place.
ii. All equipment, and supplies as applicable, purchased under this Agreement will be recorded
and maintained in the Subrecipient's inventory system.
iii. Inventory system records shall include:
A. description of the property
B. manufacturer's serial number, model number, or other identification number;
C. the source of funding for the equipment, including the Federal Award Identification
Number (FAIN)
D. Catalog of Federal Domestic Assistance (CFDA) number
E. who holds the title
F. acquisition date
G. cost of the equipment and the percentage of federal participation in the cost
H. location, use and condition of the equipment at the date the information was reported,
and
I. disposition data including the date of disposal and sale price of the property.
DHS-FEMA-HSGP-SHSP-FFY17 Page 4 of 35 Jefferson County DEM, E18-151
iv. The Subrecipient shall take a physical inventory of the equipment and reconcile the results
with the property records at least once every two years. Any differences between quantities
determined by the physical inspection and those shown in the records shall be investigated
by the Subrecipient to determine the cause of the difference. The Subrecipient shall, in
connection with the inventory, verify the existence, current utilization, and continued need
for the equipment.
V. The Subrecipient shall be responsible for any and all operational and maintenance
expenses and for the safe operation of their equipment and supplies including all questions
of liability. The Subrecipient shall develop appropriate maintenance schedules and
procedures to ensure the equipment, and supplies as applicable, are well-maintained and
kept in good operating condition.
vi. The Subrecipient shall develop a control system to ensure adequate safeguards to prevent
loss, damage, and theft of the property. Any loss, damage, or theft shall be investigated and
a report generated and sent to the Department.
vii. The Subrecipient must obtain and maintain all necessary certifications and licenses for the
equipment.
viii. If the Subrecipient is authorized or required to sell the property, proper sales procedures
must be established and followed to ensure the highest possible return.
A. For disposition, if upon termination or at the Grant Agreement End Date, when original
or replacement supplies or equipment acquired under a federal award are no longer
needed for the original project or program or for other activities currently or previously
supported by a federal awarding agency, the Subrecipient must comply with the
following procedures:
B. For Supplies: If there is a residual inventory of unused supplies exceeding $5,000 in
total aggregate value upon termination or completion of the project or program and the
supplies are not needed for any other federal award, the Subrecipient must retain the
supplies for use on other activities or sell them, but must, in either case, compensate
the federal government for its share. The amount of compensation must be computed
in the same manner as for equipment.
C. For Equipment:
1) Items with a current per-unit fair -market value of $5,000 or less may be retained,
sold, or otherwise disposed of with no further obligation to the federal awarding
agency.
2) Items with a current per-unit fair -market value in excess of $5,000 may be retained
or sold. The Subrecipient shall compensate the federal awarding agency in
accordance with the requirements of 2 CFR 200.313 (e) (2).
ix. Records for equipment shall be retained by the Subrecipient for a period of six years from
the date of the disposition, replacement, or transfer. If any litigation, claim, or audit is started
before the expiration of the six-year period, the records shall be retained by the Subrecipient
until all litigation, claims, or audit findings involving the records have been resolved.
b. The Subrecipient shall comply with the Department's Purchase Review Process, which is
incorporated by reference and made part of this Agreement. No reimbursement will be provided
unless the appropriate approval has been received.
c. Allowable equipment and supply categories for 17HSGP are listed on the Authorized Equipment
List (AEL) located on the FEMA website at http://www.fema.clov/authorized-equipment-list. The
AEL consists of 21 categories which are divided into sub -categories. It is important the
Subrecipient and any non-federal entity to which the Subrecipient makes a subaward regard the
AEL as an authorized purchasing list identifying items allowed under the specific grant program,
and includes items that may not be categorized as equipment according to the federal, state,
local, and tribal definitions of equipment. The Subrecipient is solely responsible for ensuring
DHS-FEMA-HSGP-SHSP-FFY17 Page 5 of 35 Jefferson County DEM, E18-151
purchased items under this Agreement are authorized as allowed items by the AEL at time of
purchase.
If the item is not identified on the AEL as allowable under HSGP, the Subrecipient must contact
the Department Key Personnel for assistance in seeking FEMA approval prior to acquisition.
d. Unless expressly provided otherwise, all equipment must meet all mandatory regulatory and/or
DHS/FEMA adopted standards to be eligible for purchase using federal award funds.
e. For OPSG Subrecipients, equipment purchased with DHS federal award funds is to be marked
with "Purchased with funds provided by the U.S. Department of Homeland Security" when
practicable.
Prior to procuring pharmaceuticals, Subrecipients must have in place an inventory management
plan to avoid large periodic variations in supplies due to coinciding purchase and expiration dates.
Subrecipients are encouraged to enter into rotational procurement agreements with vendors and
distributors. Purchases of pharmaceuticals must include a budget for the disposal of expired drugs
within each fiscal year's period of performance for 17HSGP. The cost of disposal cannot be
carried over to another DHS/FEMA grant or grant period.
The Subrecipient must pass on equipment and supply management requirements that meet or
exceed the requirements outlined above to any non-federal entity to which the Subrecipient
makes a subaward of federal award funds under this Agreement.
5. ENVIRONMENTAL AND HISTORICAL PRESERVATION
The Subrecipient shall ensure full compliance with the DHS/FEMA Environmental Planning and
Historic Preservation (EHP) Program. EHP program information can be found at
https://www.fema.gov/office-environmental-planning-and-historic-preservation, all of which are
incorporated in and made a part of this Agreement.
a. The Subrecipient proposing projects that have the potential to impact the environment, including,
but not limited to, construction of communication towers; modification or renovation of existing
buildings, structures and facilities; or new construction, including replacement of facilities, must
participate in the DHS/FEMA EHP review process prior to project initiation. Modification of existing
buildings, including minimally invasive improvements such as attaching monitors to interior walls,
and training or exercises occurring outside in areas not considered previously disturbed also
require a DHS/FEMA EHP review before project initiation.
b. The EHP review process involves the submission of a detailed project description that includes
the entire scope of work, including any alternatives that may be under consideration, along with
supporting documentation so FEMA may determine whether the proposed project has the
potential to impact environmental resources and/or historic properties.
c. The Subrecipient agrees that to receive any federal preparedness funding, all EHP compliance
requirements outlined in applicable guidance must be met. The EHP review process must be
completed and approval received before any work, for which reimbursement will be later
requested, is started. Expenditures for projects started before the EHP review approval is
received will not be reimbursed.
6. PROCUREMENT
a. The Subrecipient shall comply with all procurement requirements of 2 CFR Part 200.318 through
200.326 and as specified in the General Terms and Conditions, Exhibit B, A.11.
b. For all sole source contracts expected to exceed $150,000, the Subrecipient must submit to the
Department for pre -procurement review and approval the procurement documents, such as
requests for proposals, invitations for bids and independent cost estimates. This requirement must
be passed on to any non-federal entity to which the Subrecipient makes a subaward, at which
point the Subrecipient will be responsible for reviewing and approving sole source justifications of
any non-federal entity to which the Subrecipient makes a subaward.
7. SUBRECIPIENT MONITORING
a. The Department will monitor the activities of the Subrecipient from award to closeout. The goal of
the Department's monitoring activities will be to ensure that agencies receiving federal pass-
DHS-FEMA-HSGP-SHSP-FFY17 Page 6 of 35 Jefferson County DEM, E18-151
through funds are in compliance with this Agreement, federal and state audit requirements,
federal grant guidance, and applicable federal and state financial regulations, as well as 2 CFR
Part 200 Subpart F.
b. To document compliance with 2 CFR Part 200 Subpart F requirements, the Subrecipient shall
complete and return to the Department the 2 CFR Part 200 Subpart F Audit Certification Form"
located at hftp://mil.wa.gov/emergency-management-division/grants/requiredgrantforms with the
signed Agreement and each fiscal year thereafter until the Agreement is closed, which is
incorporated by reference and made a part of this Agreement.
c. Monitoring activities may include, but are not limited to:
i. review of financial and performance reports
ii. monitoring and documenting the completion of Agreement deliverables
iii. documentation of phone calls, meetings, e-mails, and correspondence
iv. review of reimbursement requests and supporting documentation to ensure allowability and
consistency with Attachment 2, and federal requirements
v. observation and documentation of Agreement -related activities, such as exercises, training,
funded events, and equipment demonstrations
vi. on-site visits to review equipment records and inventories, to verify source documentation for
reimbursement requests and performance reports, and to verify completion of deliverables.
d. The Subrecipient is required to meet or exceed the monitoring activities, as outlined above and in
2 CFR Part 200, for any non-federal entity to which the Subrecipient makes a subaward as a
pass-through entity under this Agreement.
e. Compliance will be monitored throughout the performance period to assess risk. Concerns will be
addressed through a Corrective Action Plan.
8. LIMITED ENGLISH PROFICIENCY (CIVIL RIGHTS ACT OF 1964 TITLE VI)
The Subrecipient must comply with the Title VI of the Civil Rights Act of 1964 (Title VI) prohibition
against discrimination on the basis of national origin, which requires that subrecipients of federal
financial assistance take reasonable steps to provide meaningful access to persons with limited
English proficiency (LEP) to their programs and services. Providing meaningful access for persons
with LEP may entail providing language assistance services, including oral interpretation and written
translation. Executive Order 13166, Improving Access to Services for Persons with Limited English
Proficiency (August 11, 2000), requires federal agencies to issue guidance to recipients, assisting
such organizations and entities in understanding their language access obligations. DHS published
the required recipient guidance in April 2011, DHS Guidance to Federal Financial Assistance
Recipients Regarding Title VI Prohibition against National Origin Discrimination Affecting Limited
English Proficient Persons, 76 Fed. Reg. 21755-21768, (April 18, 2011). The Guidance provides
helpful information such as how a recipient can determine the extent of its obligation to provide
language services; selecting language services; and elements of an effective plan on language
assistance for LEP persons. For additional assistance and information regarding language access
obligations, please refer to the DHS Recipient Guidance at https://www.dhs.gov/quidance-published-
_help-department-supported-organizations-provide-meaningful-access-people-limited and additional
resources on hftp://www.lep.gov.
9. NIMS COMPLIANCE
a. The National Incident Management System (NIMS) identifies concepts and principles that answer
how to manage emergencies from preparedness to recovery regardless of their cause, size,
location, or complexity. NIMS provides a consistent, nationwide approach and vocabulary for
multiple agencies or jurisdictions to work together to build, sustain, and deliver the core
capabilities needed to achieve a secure and resilient nation.
b. Consistent implementation of NIMS provides a solid foundation across jurisdictions and
disciplines to ensure effective and integrated preparedness, planning, and response. NIMS
empowers the components of the National Preparedness System, a requirement of Presidential
DHS-FEMA-HSGP-SHSP-FFY17 Page 7 of 35 Jefferson County DEM, E18-151
Policy Directive 8, to guide activities within the public and private sector and describes the
planning, organizational activities, equipping, training and exercising needed to build and sustain
the core capabilities in support of the National Preparedness Goal.
c. In order to receive IFFY 2017 federal preparedness funding, to include HSGP, the Subrecipient
will ensure all NIMS objectives have been initiated and/or are in progress toward completion.
NIMS Implementation Objectives are located at hftps://www.fema.gov/media-
library/assets/documetns/1 30743 .
B. HSGP SPECIFIC REQUIREMENTS
1. 17HSGP stipulates the following for overall grant funding; specific caps or thresholds for this
Agreement may differ:
a. Up to 5% percent of the HSGP award received by the Department may be used for management
and administrative (M&A) purposes directly related to administration of the HSGP grant. The
maximum percentage of the Grant Agreement Amount that may be used by the Subrecipient for
M&A costs under this Agreement is identified in the Budget (Attachment 2), and may be less than,
but will not exceed, the maximum 5%.
b. At least 25% of the combined HSGP award allocated under SHSP and UASI are to be dedicated
towards law enforcement terrorism prevention activities (LETPA). The LETPA percentage of the
Grant Agreement Amount that must be met as a minimum requirement of this Agreement by the
Subrecipient is identified in the Budget (Attachment 2) and may differ from the combined 25%
requirement. If the Subrecipient anticipates spending less than the indicated amount on LETPA
activities as indicated in the Budget (Attachment 2), a budget amendment is required.
c. The combined total of personnel expenses may not exceed 50% percent of the HSGP award
received by the Department unless a Personnel Cap Waiver has been received from DHS. The
maximum percentage of the Grant Agreement Amount that may be used by the Subrecipient for
personnel expenses under this Agreement is identified in the Budget (Attachment 2) and may
differ from the 50% HSGP limit. If the Subrecipient anticipates spending an amount different than
what's in the Budget (Attachment 2), a budget amendment is required.
2. SHSP-funded projects must address high-priority preparedness gaps across all core capabilities
where a nexus to terrorism exists. All supported investments are based on capability targets and
gaps identified during the assessment process.
3. UASI-funded projects must build and sustain the capabilities necessary for high -threat, high-density
Urban Areas to prevent, protect against, mitigate, respond to, and recover from acts of terrorism.
4. OPSG-funded projects must enhance cooperation and coordination among Customs and Border
Protection, United States Border Patrol, and local, tribal, territorial, state, and federal law enforcement
agencies in a joint mission to secure the United States' borders along routes of ingress from
international borders to include travel corridors in states bordering Mexico and Canada, as well as
states and territories with international water borders.
5. The Subrecipient shall use HSGP funds only to perform tasks as described in the Scope (Attachment
2), as approved by the Department, and in compliance with this Agreement.
6. Subrecipients are required to develop a multi-year Training and Exercise Plan (TEP) that identifies
training and exercise priorities and activities. Inclusion in the State's TEP meets the intent of this
requirement. Subrecipients that choose to develop their own TEP shall submit it to
hseep(ab_fema.dhs.gov and emd.training(c _mil.wa.gov no later than June 1st annually.
a. Subrecipients are encouraged to participate in the State's annual Training and Exercise Planning
Workshop (TEPW) or may conduct their own local/regional TEPW.
7. Subrecipients will develop and maintain a progressive exercise program consistent with the
Homeland Security Exercise and Evaluation Program (HSEEP) and support the National Exercise
Program (NEP). Upon completion of an exercise, an After Action Report and an Improvement Plan
must be prepared and submitted to hseep(cD_fema.dhs.gov and emd.training(D_mil.wa.gov. Further
information regarding the use of HSEEP can be found at https:Hhseep.preptoolkit.org/.
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8. Subrecipients will provide reports and/or assist with completion of reports required by the HSGP
federal award, including, but not limited to, the State Preparedness Report (SPR), Threat and Hazard
Identification and Risk Assessment (THIRA), core capabilities assessment, and data calls.
C. DHS FFY17 HSGP TERMS AND CONDITIONS
As a subrecipient of 17HSGP program funding, the Subrecipient shall comply with all applicable DHS
terms and conditions of the 17HSGP Award Letter and its incorporated documents for DHS Grant No.
EMW-2017-SS-00101-S01, which are incorporated in and made a part of this Agreement as Attachment
1.
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Exhibit B
Washington State Military Department
GENERAL TERMS AND CONDITIONS
Department of Homeland Security (DHS)/
Federal Emergency Management Agency (FEMA)
Grants
A.1 DEFINITIONS
As used throughout this Agreement, the terms will have the same meaning as defined in 2 CFR 200
Subpart A (which is incorporated herein by reference), except as otherwise set forth below:
a. "Agreement" means this Grant Agreement.
b. "Department" means the Washington State Military Department, as a state agency, any division,
section, office, unit or other entity of the Department, or any of the officers or other officials lawfully
representing that Department. The Department is a recipient of a federal award directly from a
federal awarding agency and is the pass-through entity making a subaward to a subrecipient
under this Agreement.
C. "Subrecipient" when capitalized is primarily used throughout this Agreement in reference to the
non-federal entity identified on the Face Sheet of this Agreement that has received a subaward
from the Department. However, the definition of "subrecipient" is the same as in 2 CFR 200.93
for all other purposes.
d. "Monitoring Activities" means all administrative, financial, or other review activities that are
conducted to ensure compliance with all state and federal laws, rules, regulations, authorities and
policies.
e. "Investment" means the grant application submitted by the Subrecipient describing the project(s)
for which federal funding is sought and provided under this this Agreement. Such grant
application is hereby incorporated into this Agreement by reference.
A.2 ADVANCE PAYMENTS PROHIBITED
The Department shall make no payments in advance or in anticipation of goods or services to be provided
under this Agreement. Subrecipient shall not invoice the Department in advance of delivery and invoicing
of such goods or services.
A.3 AMENDMENTS AND MODIFICATIONS
The Subrecipient or the Department may request, in writing, an amendment or modification of this
Agreement. However, such amendment or modification shall not be binding, take effect or be
incorporated herein until made in writing and signed by the authorized representatives of the Department
and the Subrecipient. No other understandings or agreements, written or oral, shall be binding on the
parties.
A.4 AMERICANS WITH DISABILITIES ACT (ADA) OF 1990, PUBLIC LAW 101-336 42 U.S.C. 12101 ET
SEQ. AND ITS IMPLEMENTING REGULATIONS ALSO REFERRED TO AS THE "ADA" 28 CFR Part
35.
The Subrecipient must comply with the ADA, which provides comprehensive civil rights protection to
individuals with disabilities in the areas of employment, public accommodations, state and local
government services, and telecommunication.
A.5 ASSURANCES
The Department and Subrecipient agree that all activity pursuant to this Agreement will be in accordance
with all the applicable current federal, state and local laws, rules and regulations.
A.6 CERTIFICATION REGARDING DEBARMENT, SUSPENSION OR INELIGIBILITY
As federal funds are a basis for this Agreement, the Subrecipient certifies that the Subrecipient is not
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participating in this Agreement by any federal department or agency.
The Subrecipient shall complete, sign, and return a Certification Regarding Debarment, Suspension,
Ineligibility, and Voluntary Exclusion form located at http://mil.wa.gov/emergency-management-
division/grants/requiredgrantforms. Any such form completed by the Subrecipient for this Agreement
shall be incorporated into this Agreement by reference.
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Further, the Subrecipient agrees to comply with all applicable federal regulations concerning the federal
debarment and suspension system, including 2 CFR Part 180. The Subrecipient certifies that it will
ensure that potential contractors or subrecipients or any of their principals are not debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from participation in "covered
transactions" by any federal department or agency. "Covered transactions" include procurement
contracts for goods or services awarded under a non -procurement transaction (e.g. grant or cooperative
agreement) that are expected to equal or exceed $25,000, and subawards to subrecipients for any
amount. With respect to covered transactions, the Subrecipient may comply with this provision by
obtaining a certification statement from the potential contractor or subrecipient or by checking the System
for Award Management (http://www.sam.gov) maintained by the federal government. The Subrecipient
also agrees not to enter into any arrangements or contracts with any party on the Washington State
Department of Labor and Industries' "Debarred Contractor List"
(htt s:Hsecure.Ini.wa.gov/debarandstrike/ContractorDebarList.aspx). The Subrecipient also agrees not
to enter into any agreements or contracts for the purchase of goods and services with any party on the
Department of Enterprise Services' Debarred Vendor List
(http://www.des.wa qov/services/ContractingPurchasing/Business/PagesNendor-Debarment aspx).
A.7 CERTIFICATION REGARDING RESTRICTIONS ON LOBBYING
As required by 44 CFR Part 18, the Subrecipient hereby certifies that to the best of its knowledge and
belief: (1) no federally appropriated funds have been paid or will be paid by or on behalf of the
Subrecipient to any person for influencing or attempting to influence an officer or employee of an agency,
a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress
in connection with the awarding of any federal contract, the making of any federal grant, the making of
any federal loan, the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement; (2)
that if any funds other 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 employee of Congress, or an employee of a Member of Congress in connection with this
Agreement, grant, loan, or cooperative agreement, the Subrecipient will complete and submit Standard
Form -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions; (3) and that, as
applicable, the Subrecipient will require that the language of this certification be included in the award
documents for all subawards at all tiers (including sub -contracts, sub -grants, and contracts under grants,
loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This
certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into, and is a prerequisite for making or entering into this transaction imposed by section
1352, title 31, U.S. Code.
A.8 CONFLICT OF INTEREST
No officer or employee of the Department; no member, officer, or employee of the Subrecipient or its
designees or agents; no member of the governing body of the jurisdiction in which the project is
undertaken or located; and no other official of the Subrecipient who exercises any functions or
responsibilities with respect to the project during his or her tenure, shall have any personal or pecuniary
gain or interest, direct or indirect, in any contract, subcontract, or the proceeds thereof, for work to be
performed in connection with the project assisted under this Agreement.
The Subrecipient shall incorporate, or cause to incorporate, in all such contracts or subawards, a
provision prohibiting such interest pursuant to this provision.
A.9 COMPLIANCE WITH APPLICABLE STATUTES, RULES AND DEPARTMENT POLICIES
The Subrecipient and all its contractors and subrecipients shall comply with, and the Department is not
responsible for determining compliance with, any and all applicable federal, state, and local laws,
regulations, executive orders, OMB Circulars, and/or policies. This obligation includes, but is not limited
to: nondiscrimination laws and/or policies, Energy Policy and Conservation Act (PL 94-163, as amended),
the Americans with Disabilities Act (ADA), Age Discrimination Act of 1975, Title VI of the Civil Rights Act
of 1964, Civil Rights Act of 1968, the Robert T. Stafford Disaster Relief and Emergency Assistance Act,
(PL 93-288, as amended), Ethics in Public Service (RCW 42.52), Covenant Against Contingent Fees (48
CFR Section 52.203-5), Public Records Act (RCW 42.56), Prevailing Wages on Public Works (RCW
39.12), State Environmental Policy Act (RCW 43.21 C), Shoreline Management Act of 1971 (RCW 90.58),
DHS-FEMA-HSGP-SHSP-FFY17 Page 11 of 35 Jefferson County DEM, E18-151
State Building Code (RCW 19.27), Energy Related Building Standards (RCW 19.27A), Provisions in
Buildings for Aged and Handicapped Persons (RCW 70.92), and safety and health regulations.
In the event of noncompliance or refusal to comply with any applicable law, regulation, executive order,
OMB Circular or policy by the Subrecipient, its contractors or subrecipients, the Department may rescind,
cancel, or terminate the Agreement in whole or in part in its sole discretion. The Subrecipient is
responsible for all costs or liability arising from its failure, and that of its contractors and subrecipients, to
comply with applicable laws, regulations, executive orders, OMB Circulars or policies.
A.10 CONTRACTING & PROCUREMENT
a. The Subrecipient shall use a competitive procurement process in the procurement and award of
any contracts with contractors or sub -contractors that are entered into under the original contract
award. The procurement process followed shall be in accordance with 2 CFR Part 200.318
General procurement standards through 200.326 Contract Provisions.
As required by Appendix 11 to 2 CFR Part 200, all contracts entered into by the Subrecipient under
this Agreement must include the following provisions, as applicable:
1) Contracts for more than the simplified acquisition threshold currently set at $150,000, which
is the inflation adjusted amount determined by the Civilian Agency Acquisition Council and
the Defense Acquisition Regulations Council (Councils) as authorized by 41 U.S.C. 1908,
must address administrative, contractual, or legal remedies in instances where contractors
violate or breach contract terms, and provide for such sanctions and penalties as appropriate.
2) All contracts in excess of $10,000 must address termination for cause and for convenience
by the non-federal entity including the manner by which it will be effected and the basis for
settlement.
3) Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all
contracts that meet the definition of "federally assisted construction contract" in 41 CFR Part
60-1.3 must include the equal opportunity clause provided under 41 CFR 60-1.4(b), in
accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319,
12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375,
"Amending Executive Order 11246 Relating to Equal Employment Opportunity," and
implementing regulations at 41 CFR part 60, "Office of Federal Contract Compliance
Programs, Equal Employment Opportunity, Department of Labor."
4) Davis -Bacon Act, as amended (40 U.S.C. 3141-3148). When required by Federal program
legislation, all prime construction contracts in excess of $2,000 awarded by non-federal
entities must include a provision for compliance with the Davis -Bacon Act (40 U.S.C. 3141-
3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Part
5, "Labor Standards Provisions Applicable to Contracts Covering Federally Financed and
Assisted Construction"). In accordance with the statute, contractors must be required to pay
wages to laborers and mechanics at a rate not less than the prevailing wages specified in a
wage determination made by the Secretary of Labor. In addition, contractors must be
required to pay wages not less than once a week. The non-federal entity must place a copy
of the current prevailing wage determination issued by the Department of Labor in each
solicitation. The decision to award a contract or subcontract must be conditioned upon the
acceptance of the wage determination. The non-federal entity must report all suspected or
reported violations to the federal awarding agency. The contracts must also include a
provision for compliance with the Copeland "Anti -Kickback" Act (40 U.S.C. 3145), as
supplemented by Department of Labor regulations (29 CFR Part 3, "Contractors and
Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or
Grants from the United States"). The Act provides that each contractor or subrecipient must
be prohibited from inducing, by any means, any person employed in the construction,
completion, or repair of public work, to give up any part of the compensation to which he or
she is otherwise entitled. The non-federal entity must report all suspected or reported
violations to the federal awarding agency.
5) Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). Where applicable,
all contracts awarded by the non-federal entity in excess of $100,000 that involve the
employment of mechanics or laborers must include a provision for compliance with 40 U.S.C.
3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under
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40 U.S.C. 3702 of the Act, each contractor must be required to compute the wages of every
mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of
the standard work week is permissible provided that the worker is compensated at a rate of
not less than one and a half times the basic rate of pay for all hours worked in excess of 40
hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to construction
work and provide that no laborer or mechanic must be required to work in surroundings or
under working conditions which are unsanitary, hazardous or dangerous. These
requirements do not apply to the purchases of supplies or materials or articles ordinarily
available on the open market, or contracts for transportation or transmission of intelligence.
6) Rights to Inventions Made Under a Contract or Agreement. If the federal award meets the
definition of "funding agreement' under 37 CFR §401.2 (a) and the recipient or subrecipient
wishes to enter into a contract with a small business firm or nonprofit organization regarding
the substitution of parties, assignment or performance of experimental, developmental, or
research work under that "funding agreement," the recipient or subrecipient must comply with
the requirements of 37 CFR Part 401, "Rights to Inventions Made by Nonprofit Organizations
and Small Business Firms Under Government Grants, Contracts and Cooperative
Agreements," and any implementing regulations issued by the awarding agency.
7) Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33
U.S.C. 1251-1387), as amended—Contracts and subgrants of amounts in excess of
$150,000 must contain a provision that requires the non-federal award to agree to comply
with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42
U.S.C. 7401-7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C.
1251-1387). Violations must be reported to the federal awarding agency and the Regional
Office of the Environmental Protection Agency (EPA).
8) Debarment and Suspension (Executive Orders 12549 and 12689)—A contract award (see 2
CFR 180.220) must not be made to parties listed on the government -wide exclusions in the
System for Award Management (SAM), in accordance with the OMB guidelines at 2 CFR 180
that implement Executive Orders 12549 (3 CFR part 1986 Comp., p. 189) and 12689 (3 CFR
part 1989 Comp., p. 235), "Debarment and Suspension." SAM Exclusions contains the
names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties
declared ineligible under statutory or regulatory authority other than Executive Order 12549.
9) Byrd Anti -Lobbying Amendment (31 U.S.C. 1352)—Contractors that apply or bid for an award
exceeding $100,000 must file the required certification. Each tier certifies to the tier above
that it will not and has not used federal appropriated funds to pay any person or organization
for influencing or attempting to influence an officer or employee of any agency, a member of
Congress, officer or employee of Congress, or an employee of a member of Congress in
connection with obtaining any federal contract, grant or any other award covered by 31
U.S.C. 1352. Each tier must also disclose any lobbying with non-federal funds that takes
place in connection with obtaining any federal award. Such disclosures are forwarded from
tier to tier up to the non-federal award.
10) Procurement of recovered materials -- As required by 2 CFR 200.322, a non-federal entity
that is a state agency or agency of a political subdivision of a state and its contractors must
comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource
Conservation and Recovery Act. The requirements of Section 6002 include procuring only
items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part
247 that contain the highest percentage of recovered materials practicable, consistent with
maintaining a satisfactory level of competition, where the purchase price of the item exceeds
$10,000 or the value of the quantity acquired during the preceding fiscal year exceeded
$10,000; procuring solid waste management services in a manner that maximizes energy
and resource recovery; and establishing an affirmative procurement program for
procurement of recovered materials identified in the EPA guidelines.
11) Notice of awarding agency requirements and regulations pertaining to reporting.
12) Federal awarding agency requirements and regulations pertaining to copyrights and rights in
data.
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13) Access by the Department, the Subrecipient, the federal awarding agency, the Comptroller
General of the United States, or any of their duly authorized representatives to any books,
documents, papers, and records of the contractor which are directly pertinent to that specific
contract for the purpose of making audit, examination, excerpts, and transcriptions.
14) Retention of all required records for six years after the Subrecipient has made final payments
and all other pending matters are closed.
15) Mandatory standards and policies relating to energy efficiency which are contained in the
state energy conservation plan issued in compliance with the Energy Policy and
Conservation Act (Pub. L. 94-163, 89 Stat. 871).
b. The Department reserves the right to review the Subrecipient procurement plans and documents,
and require the Subrecipient to make changes to bring its plans and documents into compliance
with the requirements of 2 CFR Part 200.318 through 200.326. The Subrecipient must ensure
that its procurement process requires contractors and subcontractors to provide adequate
documentation with sufficient detail to support the costs of the project and to allow both the
Subrecipient and Department to make a determination on eligibility of project costs.
C. All contracting agreements entered into pursuant to this Agreement shall incorporate this
Agreement by reference
A.11 DISCLOSURE
The use or disclosure by any party of any information concerning the Department for any purpose not
directly connected with the administration of the Department's or the Subrecipient's responsibilities with
respect to services provided under this Agreement is prohibited except by prior written consent of the
Department or as required to comply with the state Public Records Act, other law or court order.
A.12 DISPUTES
Except as otherwise provided in this Agreement, when a bona fide dispute arises between the parties
and it cannot be resolved through discussion and negotiation, either party may request a dispute
resolution panel to resolve the dispute. A request for a dispute resolution board shall be in writing, state
the disputed issues, state the relative positions of the parties, and be sent to all parties. The panel shall
consist of a representative appointed by the Department, a representative appointed by the Subrecipient
and a third party mutually agreed upon by both parties. The panel shall, by majority vote, resolve the
dispute. Each party shall bear the cost for its panel member and its attorney fees and costs, and share
equally the cost of the third panel member.
A.13 LEGAL RELATIONS
It is understood and agreed that this Agreement is solely for the benefit of the parties to the Agreement
and gives no right to any other party. No joint venture or partnership is formed as a result of this
Agreement.
To the extent allowed by law, the Subrecipient, its successors or assigns, will protect, save and hold
harmless the Department, the State of Washington, and the United States Government and their
authorized agents and employees, from all claims, actions, costs, damages or expenses of any nature
whatsoever by reason of the acts or omissions of the Subrecipient, its sub -contractors, subrecipients,
assigns, agents, contractors, consultants, licensees, invitees, employees or any person whomsoever
arising out of or in connection with any acts or activities authorized by this Agreement.
To the extent allowed by law, the Subrecipient further agrees to defend the Department and the State of
Washington and their authorized agents and employees in any litigation; including payment of any costs
or attorneys' fees for any claims or action commenced thereon arising out of or in connection with acts
or activities authorized by this Agreement.
This obligation shall not include such claims, costs, damages or expenses which may be caused by the
sole negligence of the Department; provided, that if the claims or damages are caused by or result from
the concurrent negligence of (1) the Department, and (2) the Subrecipient, its agents, or employees, this
indemnity provision shall be valid and enforceable only to the extent of the negligence of the Subrecipient,
or Subrecipient's agents or employees.
Insofar as the funding source, the Department of Homeland Security (DHS)/Federal Emergency
Management Agency (FEMA), is an agency of the Federal government, the following shall apply:
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44 CFR 206.9 Non -liability. The Federal government shall not be liable for any claim based upon the
exercise or performance of, or the failure to exercise or perform a discretionary function or duty on the
part of a federal agency or an employee of the Federal government in carrying out the provisions of the
Stafford Act.
A.14 LIMITATION OF AUTHORITY — AUTHORIZED SIGNATURE
The signatories to this Agreement represent that they have the authority to bind their respective
organizations to this Agreement. Only the Department's Authorized Signature representative and the
Authorized Signature representative of the Subrecipient or Alternate for the Subrecipient, formally
designated in writing, shall have the express, implied, or apparent authority to alter, amend, modify, or
waive any clause or condition of this Agreement. Any alteration, amendment, modification, or waiver of
any clause or condition of this Agreement is not effective or binding unless made in writing and signed
by both parties' Authorized Signature representatives.
Further, only the Authorized Signature representative or Alternate for the Subrecipient shall have
signature authority to sign reimbursement requests, time extension requests, amendment and
modification requests, requests for changes to projects or work plans, and other requests, certifications
and documents authorized by or required under this Agreement.
A.15 LOSS OR REDUCTION OF FUNDING
In the event funding from state, federal, or other sources is withdrawn, reduced, or limited in any way
after the effective date of this Agreement and prior to normal completion or end date, the Department
may unilaterally reduce the scope of work and budget or unilaterally terminate all or part of the Agreement
as a "Termination for Cause" without providing the Subrecipient an opportunity to cure. Alternatively, the
parties may renegotiate the terms of this Agreement under "Amendments and Modifications" to comply
with new funding limitations and conditions, although the Department has no obligation to do so.
A.16 NONASSIGNABILITY
Neither this Agreement, nor any claim arising under this Agreement, shall be transferred or assigned by
the Subrecipient.
A.17 NONDISCRIMINATION
The Subrecipient shall comply with all applicable federal and state non-discrimination laws, regulations,
and policies. No person shall, on the grounds of age, race, creed, color, sex, sexual orientation, religion,
national origin, marital status, honorably discharged veteran or military status, or disability (physical,
mental, or sensory) be denied the benefits of, or otherwise be subjected to discrimination under any
project, program, or activity, funded, in whole or in part, under this Agreement.
A.18 NOTICES
The Subrecipient shall comply with all public notices or notices to individuals required by applicable local,
state and federal laws and regulations and shall maintain a record of this compliance.
A.19 OCCUPATIONAL SAFETY/HEALTH ACT and WASHINGTON INDUSTRIAL SAFETY/ HEALTH ACT
(OSHA/WISHA)
The Subrecipient represents and warrants that its work place does now or will meet all applicable federal
and state safety and health regulations that are in effect during the Subrecipient's performance under this
Agreement. To the extent allowed by law, the Subrecipient further agrees to indemnify and hold harmless
the Department and its employees and agents from all liability, damages and costs of any nature,
including, but not limited to, costs of suits and attorneys' fees assessed against the Department, as a
result of the failure of the Subrecipient to so comply.
A.20 OWNERSHIP OF PROJECT/CAPITAL FACILITIES
The Department makes no claim to any capital facilities or real property improved or constructed with
funds under this Agreement, and by this subaward of funds does not and will not acquire any ownership
interest or title to such property of the Subrecipient. The Subrecipient shall assume all liabilities and
responsibilities arising from the ownership and operation of the project and agrees to indemnify and hold
the Department, the state of Washington and the United States government harmless from any and all
causes of action arising from the ownership and operation of the project.
A.21 POLITICAL ACTIVITY
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No portion of the funds provided herein shall be used for any partisan political activity or to further the
election or defeat of any candidate for public office or influence the approval or defeat of any ballot issue.
A.22 PROHIBITION AGAINST PAYMENT OF BONUS OR COMMISSION
The assistance provided under this Agreement shall not be used in payment of any bonus or commission
for the purpose of obtaining approval of the application for such assistance or any other approval or
concurrence under this Agreement provided, however, that reasonable fees or bona fide technical
consultant, managerial, or other such services, other than actual solicitation, are not hereby prohibited if
otherwise eligible as project costs.
A.23 PUBLICITY
The Subrecipient agrees to submit to the Department prior to issuance all advertising and publicity
matters relating to this Agreement wherein the Department's name is mentioned or language used from
which the connection of the Department's name may, in the Department's judgment, be inferred or
implied. The Subrecipient agrees not to publish or use such advertising and publicity matters without the
prior written consent of the Department. The Subrecipient may copyright original work it develops in the
course of or under this Agreement; however, pursuant to 2 CFR Part 200.315, FEMA reserves a royalty -
free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize
others to use the work for government purposes.
Publication resulting from work performed under this Agreement shall include an acknowledgement of
FEMA's financial support, by CFDA number, and a statement that the publication does not constitute an
endorsement by FEMA or reflect FEMA's views.
A.24 RECAPTURE PROVISION
In the event the Subrecipient fails to expend funds under this Agreement in accordance with applicable
federal, state, and local laws, regulations, and/or the provisions of the Agreement, the Department
reserves the right to recapture funds in an amount equivalent to the extent of noncompliance. Such right
of recapture shall exist for the life of the project following Agreement termination. Repayment by the
Subrecipient of funds under this recapture provision shall occur within 30 days of demand. In the event
the Department is required to institute legal proceedings to enforce the recapture provision, the
Department shall be entitled to its costs and expenses thereof, including attorney fees from the
Subrecipient.
A.25 RECORDS
a. The Subrecipient agrees to maintain all books, records, documents, receipts, invoices and all
other electronic or written records necessary to sufficiently and properly reflect the Subrecipient's
contracts, subawards, grant administration, and payments, including all direct and indirect
charges, and expenditures in the performance of this Agreement (the "records").
b. The Subrecipient's records related to this Agreement and the projects funded may be inspected
and audited by the Department or its designee, by the Office of the State Auditor, DHS, FEMA or
their designees, by the Comptroller General of the United States or its designees, or by other
state or federal officials authorized by law, for the purposes of determining compliance by the
Subrecipient with the terms of this Agreement and to determine the appropriate level of funding
to be paid under the Agreement.
C. The records shall be made available by the Subrecipient for such inspection and audit, together
with suitable space for such purpose, at any and all times during the Subrecipient's normal
working day.
d. The Subrecipient shall retain and allow access to all records related to this Agreement and the
funded project(s) for a period of at least six (6) years following final payment and closure of the
grant under this Agreement. Despite the minimum federal retention requirement of three (3)
years, the more stringent State requirement of six (6) years must be followed.
A.26 RESPONSIBILITY FOR PROJECT/STATEMENT OF WORK/WORK PLAN
While the Department undertakes to assist the Subrecipient with the project/statement of work/work plan
(project) by providing federal award funds pursuant to this Agreement, the project itself remains the sole
responsibility of the Subrecipient. The Department undertakes no responsibility to the Subrecipient, or
to any third party, other than as is expressly set out in this Agreement.
DHS-FEMA-HSGP-SHSP-FFY17 Page 16 of 35 Jefferson County DEM, E18-151
The responsibility for the design, development, construction, implementation, operation and maintenance
of the project, as these phrases are applicable to this project, is solely that of the Subrecipient, as is
responsibility for any claim or suit of any nature by any third party related in any way to the project.
Prior to the start of any construction activity, the Subrecipient shall ensure that all applicable federal,
state, and local permits and clearances are obtained, including, but not limited to, FEMA compliance with
the National Environmental Policy Act, the National Historic Preservation Act, the Endangered Species
Act, and all other environmental laws, regulations, and executive orders.
The Subrecipient shall defend, at its own cost, any and all claims or suits at law or in equity, which may
be brought against the Subrecipient in connection with the project. The Subrecipient shall not look to the
Department, or to any state or federal agency, or to any of their employees or agents, for any
performance, assistance, or any payment or indemnity, including, but not limited to, cost of defense
and/or attorneys' fees, in connection with any claim or lawsuit brought by any third party related to any
design, development, construction, implementation, operation and/or maintenance of a project.
A.27 SEVERABILITY
If any court of rightful jurisdiction holds any provision or condition under this Agreement or its application
to any person or circumstances invalid, this invalidity does not affect other provisions, terms or conditions
of the Agreement, which can be given effect without the invalid provision. To this end, the terms and
conditions of this Agreement are declared severable.
A.28 SINGLE AUDIT ACT REQUIREMENTS (including all AMENDMENTS)
Non-federal entities, as subrecipients of a federal award, that expend $750,000 or more in one fiscal year
of federal funds from all sources, direct and indirect, are required to have a single or a program -specific
audit conducted in accordance with 2 CFR Part 200 Subpart F. Non-federal entities that spend less than
$750,000 a year in federal awards are exempt from federal audit requirements for that year, except as
noted in 2 CFR Part 200 Subpart F. As defined in 2 CFR Part 200, the term "non-federal entity" means
a State, local government, Indian tribe, institution of higher education, or non-profit organization that
carries out a federal award as a recipient or subrecipient.
Subrecipients that are required to have an audit must ensure the audit is performed in accordance with
Generally Accepted Government Auditing Standards (GAGAS) as found in the Government Auditing
Standards (the Revised Yellow Book) developed by the United States Comptroller General and the OMB
Compliance Supplement. The Subrecipient has the responsibility of notifying its auditor and requesting
an audit in compliance with 2 CFR Part 200 Subpart F, to include the Washington State Auditor's Office,
a federal auditor, or a public accountant performing work using GAGAS, as appropriate. Costs of the
audit may be an allowable grant expenditure as authorized by 2 CFR Part 200.425.
The Subrecipient shall maintain auditable records and accounts so as to facilitate the audit requirement
and shall ensure that any sub -contractors also maintain auditable records. The Subrecipient is
responsible for any audit exceptions incurred by its own organization or that of its sub-
contractors. Responses to any unresolved management findings and disallowed or questioned costs
shall be included with the audit report. The Subrecipient must respond to Department requests for
information or corrective action concerning audit issues or findings within 30 days of the date of
request. The Department reserves the right to recover from the Subrecipient all disallowed costs
resulting from the audit.
After the single audit has been completed, and if it includes any audit findings, the Subrecipient must
send a full copy of the audit and its corrective action plan to the Department at the following address no
later than nine (9) months after the end of the Subrecipient's fiscal year(s):
Contracts Office
Washington Military Department
Finance Division, Building #1 TA -20
Camp Murray, WA 98430-5032
If the Subrecipient claims it is exempt from the audit requirements of 2 CFR Part 200 Subpart F, the
Subrecipient must send a completed "2 CFR Part 200 Subpart F Audit Certification Form"
(https://www.mil.wa.gov/emer-encu-management-division/grants/reauiredgrantforms) to the Department
at the address listed above identifying this Agreement and explaining the criteria for exemption no later
than nine (9) months after the end of the Subrecipient's fiscal year(s).
DHS-FEMA-HSGP-SHSP-FFY17 Page 17 of 35 Jefferson County DEM, E18-151
The Department retains the sole discretion to determine whether a valid claim for an exemption from the
audit requirements of this provision has been established.
The Subrecipient shall include the above audit requirements in any subawards.
Conducting a single or program -specific audit in compliance with 2 CFR Part 200 Subpart F is a material
requirement of this Agreement. In the absence of a valid claim of exemption from the audit requirements
of 2 CFR Part 200 Subpart F, the Subrecipient's failure to comply with said audit requirements may result
in one or more of the following actions in the Department's sole discretion: a percentage of federal awards
being withheld until the audit is completed in accordance with 2 CFR Part 200 Subpart F; the withholding
or disallowing of overhead costs; the suspension of federal awards until the audit is conducted and
submitted; or termination of the federal award.
A.29 SUBRECIPIENT NOT EMPLOYEE
The parties intend that an independent contractor relationship will be created by this Agreement. The
Subrecipient, and/or employees or agents performing under this Agreement are not employees or agents
of the Department in any manner whatsoever. The Subrecipient will not be presented as, nor claim to
be, an officer or employee of the Department by reason of this Agreement, nor will the Subrecipient make
any claim, demand, or application to or for any right or privilege applicable to an officer or employee of
the Department or of the State of Washington by reason of this Agreement, including, but not limited to,
Workmen's Compensation coverage, unemployment insurance benefits, social security benefits,
retirement membership or credit, or privilege or benefit which would accrue to a civil service employee
under Chapter 41.06 RCW.
It is understood that if the Subrecipient is another state department, state agency, state university, state
college, state community college, state board, or state commission, that the officers and employees are
employed by the state of Washington in their own right and not by reason of this Agreement.
A.30 TAXES, FEES AND LICENSES
Unless otherwise provided in this Agreement, the Subrecipient shall be responsible for, pay and maintain
in current status all taxes, unemployment contributions, fees, licenses, assessments, permit charges and
expenses of any other kind for the Subrecipient or its staff required by statute or regulation that are
applicable to Agreement performance.
A.31 TERMINATION FOR CONVENIENCE
Notwithstanding any provisions of this Agreement, the Subrecipient may terminate this Agreement by
providing written notice of such termination to the Department Key Personnel identified in the Agreement,
specifying the effective date thereof, at least thirty (30) days prior to such date.
Except as otherwise provided in this Agreement, the Department, in its sole discretion and in the best
interests of the State of Washington, may terminate this Agreement in whole or in part by providing ten
(10) calendar days written notice, beginning on the second day after mailing to the Subrecipient. Upon
notice of termination for convenience, the Department reserves the right to suspend all or part of the
Agreement, withhold further payments, or prohibit the Subrecipient from incurring additional obligations
of funds. In the event of termination, the Subrecipient shall be liable for all damages as authorized by
law. The rights and remedies of the Department provided for in this section shall not be exclusive and
are in addition to any other rights and remedies provided by law.
A.32 TERMINATION OR SUSPENSION FOR CAUSE
In the event the Department, in its sole discretion, determines the Subrecipient has failed to fulfill in a
timely and proper manner its obligations under this Agreement, is in an unsound financial condition so
as to endanger performance hereunder, is in violation of any laws or regulations that render the
Subrecipient unable to perform any aspect of the Agreement, or has violated any of the covenants,
agreements or stipulations of this Agreement, the Department has the right to immediately suspend or
terminate this Agreement in whole or in part.
The Department may notify the Subrecipient in writing of the need to take corrective action and provide
a period of time in which to cure. The Department is not required to allow the Subrecipient an opportunity
to cure if it is not feasible as determined solely within the Department's discretion. Any time allowed for
cure shall not diminish or eliminate the Subrecipient's liability for damages or otherwise affect any other
remedies available to the Department. If the Department allows the Subrecipient an opportunity to cure,
the Department shall notify the Subrecipient in writing of the need to take corrective action. If the
DHS-FEMA-HSGP-SHSP-FFY17 Page 18 of 35 Jefferson County DEM, E18-151
corrective action is not taken within ten (10) calendar days or as otherwise specified by the Department,
or if such corrective action is deemed by the Department to be insufficient, the Agreement may be
terminated in whole or in part.
The Department reserves the right to suspend all or part of the Agreement, withhold further payments,
or prohibit the Subrecipient from incurring additional obligations of funds during investigation of the
alleged compliance breach, pending corrective action by the Subrecipient, if allowed, or pending a
decision by the Department to terminate the Agreement in whole or in part.
In the event of termination, the Subrecipient shall be liable for all damages as authorized by law, including,
but not limited to, any cost difference between the original Agreement and the replacement or cover
Agreement and all administrative costs directly related to the replacement Agreement, e.g., cost of
administering the competitive solicitation process, mailing, advertising and other associated staff time.
The rights and remedies of the Department provided for in this section shall not be exclusive and are in
addition to any other rights and remedies provided by law.
If it is determined that the Subrecipient: (1) was not in default or material breach, or (2) failure to perform
was outside of the Subrecipient's control, fault or negligence, the termination shall be deemed to be a
"Termination for Convenience".
A.33 TERMINATION PROCEDURES
In addition to the procedures set forth below, if the Department terminates this Agreement, the
Subrecipient shall follow any procedures specified in the termination notice. Upon termination of this
Agreement and in addition to any other rights provided in this Agreement, the Department may require
the Subrecipient to deliver to the Department any property specifically produced or acquired for the
performance of such part of this Agreement as has been terminated.
If the termination is for convenience, the Department shall pay to the Subrecipient as an agreed upon
price, if separately stated, for properly authorized and completed work and services rendered or goods
delivered to and accepted by the Department prior to the effective date of Agreement termination, the
amount agreed upon by the Subrecipient and the Department for (i) completed work and services and/or
equipment or supplies provided for which no separate price is stated, (ii) partially completed work and
services and/or equipment or supplies provided which are accepted by the Department, (iii) other work,
services and/or equipment or supplies which are accepted by the Department, and (iv) the protection and
preservation of property.
Failure to agree with such amounts shall be a dispute within the meaning of the "Disputes" clause of this
Agreement. If the termination is for cause, the Department shall determine the extent of the liability of
the Department. The Department shall have no other obligation to the Subrecipient for termination. The
Department may withhold from any amounts due the Subrecipient such sum as the Department
determines to be necessary to protect the Department against potential loss or liability.
The rights and remedies of the Department provided in this Agreement shall not be exclusive and are in
addition to any other rights and remedies provided by law.
After receipt of a notice of termination, and except as otherwise directed by the Department in writing,
the Subrecipient shall:
a. Stop work under the Agreement on the date, and to the extent specified, in the notice;
b. Place no further orders or contracts for materials, services, supplies, equipment and/or facilities
in relation to this Agreement except as may be necessary for completion of such portion of the
work under the Agreement as is not terminated;
C. Assign to the Department, in the manner, at the times, and to the extent directed by the
Department, all of the rights, title, and interest of the Subrecipient under the orders and contracts
so terminated, in which case the Department has the right, at its discretion, to settle or pay any
or all claims arising out of the termination of such orders and contracts;
d. Settle all outstanding liabilities and all claims arising out of such termination of orders and
contracts, with the approval or ratification of the Department to the extent the Department may
require, which approval or ratification shall be final for all the purposes of this clause;
e. Transfer title to the Department and deliver in the manner, at the times, and to the extent directed
by the Department any property which, if the Agreement had been completed, would have been
required to be furnished to the Department;
DHS-FEMA-HSGP-SHSP-FFY17 Page 19 of 35 Jefferson County DEM, E18-151
f. Complete performance of such part of the work as shall not have been terminated by the
Department in compliance with all contractual requirements; and
g. Take such action as may be necessary, or as the Department may require, for the protection and
preservation of the property related to this Agreement which is in the possession of the
Subrecipient and in which the Department has or may acquire an interest.
A.34 UTILIZATION OF MINORITY AND WOMEN BUSINESS ENTERPRISES (MWBE)
The Subrecipient is encouraged to utilize business firms that are certified as minority-owned and/or
women -owned in carrying out the purposes of this Agreement. The Subrecipient may set utilization
standards, based upon local conditions or may utilize the state of Washington MWBE goals, as identified
in WAC 326-30-041.
A.35 VENUE
This Agreement shall be construed and enforced in accordance with, and the validity and performance
shall be governed by, the laws of the state of Washington. Venue of any suit between the parties arising
out of this Agreement shall be the Superior Court of Thurston County, Washington. The Subrecipient,
by execution of this Agreement acknowledges the jurisdiction of the courts of the State of Washington.
A.36 WAIVERS
No conditions or provisions of this Agreement can be waived unless approved in advance by the
Department in writing. The Department's failure to insist upon strict performance of any provision of the
Agreement or to exercise any right based upon a breach thereof, or the acceptance of any performance
during such breach, shall not constitute a waiver of any right under this Agreement.
DHS-FEMA-HSGP-SHSP-FFY17 Page 20 of 35 Jefferson County DEM, E18-151
Award Letter
Bret Daugherty
Washington Military Department
Building 20
Camp Murray, WA98430 - 5122
Re: Grant No.EMW-2017-SS-00101
Dear Bret Daugherty:
ATTACHMENT 1
FFY17 HSGP Award Documents
E M W -2017-S S -00101-S 01
U.S. Department of Homeland Security
Washington, D.C. 20472
Congratulations, on behalf of the Department of Homeland Security, your application for financial assistance submitted under
the Fiscal Year (FY) 2017 Homeland Security Grant Program has been approved in the amount of $13,204,851.00. You are
not required to match this award with any amount of non -Federal funds.
Before you request and receive any of the Federal funds awarded to you, you must establish acceptance of the award. By
accepting this award, you acknowledge that the terms of the following documents are incorporated into the terms of your
award:
• Agreement Articles (attached to this Award Letter)
• Obligating Document (attached to this Award Letter)
• FY 2017 Homeland Security Grant Program Notice of Funding Opportunity.
Please make sure you read, understand, and maintain a copy of these documents in your official file for this award.
In order to establish acceptance of the award and its terms, please follow these instructions:
Step 1 : Please log in to the ND Grants system at https:Hportal.fema.gov.
Step 2: After logging in, you will see the Home page with a Pending Tasks menu. Click on the Pending Tasks menu, select the
Application sub -menu, and then click the link for "Award Offer Review" tasks. This link wig navigate you to Award Packages
that are pending review.
Step 3: Click the Review Award Package icon (wrench) to review the Award Package and accept or decline the award. Please
save or print the Award Package for your records.
System for Award Management (SAM): Grant recipients are to keep all of their information up to date in SAM, in particular,
your organization's name, address, DUNS number, EIN and banking information. Please ensure that the DUNS number used
in SAM isthe same one used to apply for all FEMA awards. Future payments will be contingent on the information provided
in the SAM, therefore, it is imperative thatthe information is correct. The System for Award Management is located at http://
www. sa m. a ov. .
If you have any questions or have updated your information in SAM, please let your Grants Management Specialist (GMS)
know as soon as possible. This will help use to make the necessary updates and avoid any interruptions in the payment
process.
DHS-FEMA-HSGP-SHSP-FFY17 Page 21 of 35 Jefferson County DEM, E18-151
Agreement Articles
Fri Sep 01 00:00:00 GMT 2017
GRANTEE:
PROGRAM:
AGREEMENT NUMBER
Article I
Article II
Article III
Article IV
Article V
Article VI
Article VII
Article VIII
Article IX
Article X
Article XI
Article X II
Article XIII
U.S. Department of Homeland Security
Washington, D.C. 20472
AGREEMENT ARTICLES
Homeland Security Grant Program
Washington Military Department
Homeland Security Grant Program
EMW-2017- S 5-00101- S01
TABLE OF CONTENTS
Summary Description of Award
Assurances, Administrative Requirements, Cost Principles,
and Audit Requirements
DHS Spe cific Acknowled go ments and Assurances
Acknowledgment of Federal Funding from DHS
Acceptance of Post Award Changes
Disposition of Equipment Acquired Under the Federal Award
Prior Approval for Modification of Approved Budget
Procurement of Recovered Materials
Whistleblower Protection Act
Use of DHS Seal, Logo and Flags
USA Patriot Act of 2001
Universal Identifier and System of Award Management
(SAM)
Reporting of Matters Related to Recipient Integrity and
Performance
DHS-FEMA-HSGP-SHSP-FFY17 Page 22 of 35 Jefferson County DEM, E18-151
Article XIV
Rehabilitation Act of 1973
Article XV
Trafficking Victims Protection Act of 2000
Article XVI
Terrorist Financing
Article XVII
SAFECOM
Article XVIII
Reporting Subawards and Executive Compensation
Article XIX
Debarment and Suspension
Article XX
Copyright
Article XXI
Civil Rights Act of 1964 - Title VI
Article XXII
Best Practices for Collection and Use of Personally
Identifiable Information (PII)
Article XXIII
Americans with Disabilities Act of 1990
Article XXIV
Age Discrimination Act of 1975
Article XXV
Activities Conducted Abroad
Article XXVI
Patents and Intellectual Property Rights
Article XXVII
Notice of Funding Opportunity Requirements
Article XXVIII
Non -supplanting Requirement
Article XXIX
Nondiscrimination in Matters Pertaining to Faith -Based
Organizations
Article XXX
National Environmental Policy Act
Article XXXI
Lobbying Prohibitions
Article XXXII
Limited English Proficiency (Civil Rights Act of 1964, Title VI)
Article XXXIII
Hotel and Motel Fire Safety Act of 1990
Article XXXIV
Fly America Act of 1974
Article XXXV
Federal Leadership on Reducing Text Messaging while
Driving
Article XXXVI Federal Debt Status
DHS-FEMA-HSGP-SHSP-FFY17 Page 23 of 35 Jefferson County DEM, E18-151
Article XXXVII
Article XXXVIII
Article XXXIX
Article XL
Article XLI
Article XLII
Article XLIII
Article XLIV
Article XLV
Article I - Summary Description of Award
False Claims Act and Program Fraud Civil Remedies
Energy Policy and Conservation Act
Education Amendments of 1972 (Equal Opportunity in
Education Act) - Title IX
Duplication of Benefits
Drug -Free Workplace Regulations
Civil Rights Act of 1968
Operation Stonegarden Program Hold
Fusion Center Investment Hold - SHSP
Fusion Center Investment Hold - UASI
The purpose of the FY 2017 HSGP is to support state and local efforts to prevent terrorism and other catastrophic events
and to prepare the Nation for the threats and hazards that pose the greatest risk to the security of the United States.
The HSGP provides funding to implement investments that build, sustain, and deliver the 32 core capabilities essential to
achieving the National Preparedness Goal of a secure and resilient Nation. Among the five basic homeland security missions
noted in the DHS Quadrennial Homeland Security Review, HSGP supports the goal to Strengthen National Preparedness
and Resilience. The building, sustainment, and delivery of these core capabilities are not exclusive to any single level of
government, organization, or community, but rather, require the combined effort of the whole community. This HSGP award
consists of State Homeland Security Program (SHSP) funding in the amount of $6,476,000, Urban Area Security Initiative
(UASI) funding in the amount of $5,180,000, and Operation Stonegarden (OPSG) funding in the amount of $1,548,851. The
following counties shall receive Operation Stonegarden subawards for the following amounts: Clallam, $300,000; Colville
Tribe, $65,000, Ferry, $100,000, Island, $140,000, Jefferson, $74,000, Okanogan, $136,680; Pend Oreille, $75,000; San
Juan, $130,000, Skagit, $50,218, Stevens, $80,000, Swinomish Tribe, $52,953, Whatcom, $345,000. These grant programs
fund a range of activities, including planning, organization, equipment purchase, training, exercises, and management and
administration across all core capabilities and mission areas.
Article 11 -Assurances, Administrative Requirements, Cost Principles, and Audit Requirements
DHS financial assistance recipients must complete either the OMB Standard Form 424B Assurances - Non -Construction
Proarams or OMB Standard Form 424D Assurances - Construction Programs as applicable. Certain assurances in these
documents may not be applicable to your program, and the DHS financial assistance office may require applicants to certify
additional assurances. Applicants are required to fill out the assurances applicable to their program as instructed by the
awarding agency. Please contact the financial assistance office if you have any questions.
DHS financial assistance recipients are required to follow the applicable provisions of the Uniform Administrative
Requirements, Cost Principles, and Audit Requirements for Federal Awards located at 2 CFR Part 200, and adopted by
DHS at 2 C. F. R. Part 3002.
Article III - DHS Specific Acknowledgements and Assurances
All recipients, subrecipients, successors, transferees, and assignees must acknowledge and agree to comply with applicable
provisions governing DHS access to records, accounts, documents, information, facilities, and staff.
1. Recipients must cooperate with any compliance reviews or compliance investigations conducted by DHS.
2. Recipients must give DHS access to, and the right to examine and copy, records, accounts, and other documents and
sources of information related to the federal financial assistance award and permit access to facilities, personnel, and other
DHS-FEMA-HSGP-SHSP-FFY17 Page 24 of 35 Jefferson County DEM, E18-151
individuals and information as may be necessary, as required by DHS regulations and other applicable laws or program
guidance.
3. Recipients must submit timely, complete, and accurate reports to the appropriate DHS officials and maintain appropriate
backup documentation to support the reports.
4. Recipients must comply with all other special reporting, data collection, and evaluation requirements, as prescribed by law
or detailed in program guidance.
5. If, during the past three years, recipients have been accused of discrimination on the grounds of race, color, national origin
(including limited English proficiency (LEP)), sex, age, disability, religion, or familial status, recipients must provide a list of all
such proceedings, pending or completed, including outcome and copies of settlement agreements to the DHS FAO and the
DHS Office of Civil Riahts and Civil Liberties (CRCL) by e-mail at crcIahq.dhs.gov or by mail at U.S. Department of Homeland
Security Office for Civil Rights and Civil Liberties Building 410, Mail Stop #0190 Washington, D.C. 20528.
6. In the event courts or administrative agencies make a finding of discrimination on grounds of race, color, national origin
(including LEP), sex, age, disability, religion, or familial status against the recipient, or recipients settle a case or matter
alleging such discrimination, recipients must forward a copy of the complaint and findings to the DHS FAO and the CRCL
office by e-mail or mail at the addresses listed above.
The United States has the right to seek judicial enforcement of these obligations.
Article IV - Acknowledgment of Federal Funding from DHS
All recipients must acknowledge their use of federal funding when issuing statements, press releases, requests for proposals,
bid invitations, and other documents describing projects or programs funded in whole or in part with federal funds.
Article V - Acceptance of Post Award Changes
In the event FEMA determines that changes are necessary to the award document after an award has been made, including
changes to period of performance or terms and conditions, recipients will be notified of the changes in writing. Once
notification has been made, any subsequent request for funds will indicate recipient acceptance of the changes to the award.
Please call the FEMA/GMD Call Center at (866) 927-5646 or via e-mail to ASK-GMDO-dhs.aov if you have any questions.
Article VI - Disposition of Equipment Acquired Under the Federal Award
When original or replacement equipment acquired under this award by the recipient or its sub -recipients is no longer needed
for the original project or program or for other activities currently or previously supported by DHS/FEMA, you must request
instructions from DHS/FEMA to make proper disposition of the equipment pursuant to 2 C.F.R. Section 200.313.
Article VII - Prior Approval for Modification of Approved Budget
Before making any change to the DHS/FEMA approved budget for this award, you must request prior written approval from
DHS/FEMA where required by 2 C.F.R. Section 200.308. For awards with an approved budget greater than $150,000, you
may not transfer funds among direct cost categories, programs, functions, or activities without prior written approval from
DHS/FEMA where the cumulative amount of such transfers exceeds or is expected to exceed ten percent (10%) of the total
budget DHS/FEMA last approved. You must report any deviations from your DHS/FEMA approved budget in the first Federal
Financial Report (SF -425) you submit following any budget deviation, regardless of whether the budget deviation requires
prior written approval.
Article Vlll - Procurement of Recovered Materials
All recipients must comply with Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and
Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental
Protection Agency (EPA) at 40 C. F.R. Part 247 that contain the highest percentage of recovered materials practicable,
consistent with maintaining a satisfactory level of competition.
Article IX - Whistleblower Protection Act
All recipients must comply with the statutory requirements for whistleblower protections (if applicable) at 10 U.S.C.
Section 2409, U.S.C. Section 4712, 10 U.S.C. Section 2324, 41 U.S.C. Sections 4304 and 4310.
Article X - Use of DHS Seal, Logo and Flags
DHS-FEMA-HSGP-SHSP-FFY17 Page 25 of 35 Jefferson County DEM, E18-151
All recipients must obtain permission from their DHS FAO, prior to using the DHS seal(s), logos, crests or reproductions of
flags or likenesses of DHS agency officials, including use of the United States Coast Guard seal, logo, crests or reproductions
of flags or likenesses of Coast Guard officials.
Article XI - USA Patriot Act of 2001
All recipients must comply with requirements of the Uniting and Strengthening America by Providing Appropriate Tools
Required to Intercept and Obstruct Terrorism Act (USA PATRIOT Act, which amends 18 U.S.C. sections 175-175c.
Article XII - Universal Identifier and System of Award Management (SAM)
All recipients are required to comply with the requirements set forth in the government -wide financial assistance award term
regarding the System for Award Management and Universal Identifier Requirements located at 2 C.F.R Part 25 Appendix A
the full text of which is incorporated here by reference in the terms and conditions.
Article XIII - Reporting of Matters Related to Recipient Integrity and Performance
If the total value of the recipients currently active grants, cooperative agreements, and procurement contracts from all federal
assistance offices exceeds $10,000,000 for any period of time during the period of performance of this federal financial
assistance award, you must comply with the requirements set forth in the government -wide Award Term and Condition for
Recipient Integrity and Performance Matters located at 2 C.F.R. Part 200 Appendix XII, the full text of which is incorporated
here by reference in the award terms and conditions.
Article XIV - Rehabilitation Act of 1973
All recipients must comply with the requirements of Section 504 of the Rehabilitation Act of 1973, 29 U S C. section_ 794, as
amended, which provides that no otherwise qualified handicapped individuals in the United States will, solely by reason of the
handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or
activity receiving federal financial assistance.
Article XV - Trafficking Victims Protection Act of 2000
All recipients must comply with the requirements of the government -wide award term which implements Section 106(8) of the
Trafficking Victims Protection Act of 2000, (TVPA) as amended by 22 U.S.C. section 7104. The award term is located at 2
C.F.R. section 175 15, the full text of which is incorporated here by reference in the award terms and conditions.
Article XVI - Terrorist Financing
All recipients must comply with E.O. 13224 and U.S. law that prohibit transactions with, and the provisions of resources and
support to, individuals and organizations associated with terrorism. Recipients are legally responsible to ensure compliance
with the Order and laws.
Article XVII - SAFECOM
All recipients receiving federal financial assistance awards made under programs that provide emergency communication
equipment and its related activities must comply with the SAFECOM Guidance for Emergency Communication Grants,
including provisions on technical standards that ensure and enhance interoperable communications.
Article XVIII - Reporting Subawards and Executive Compensation
All recipients are required to comply with the requirements set forth in the government -wide Award Term on Reporting
Subawards and Executive Compensation located at 2 C.F.R. Part 170 Appendix A, the full text of which is incorporated here
by reference in the award terms and conditions.
Article XIX - Debarment and Suspension
All recipients are subject to the non -procurement debarment and suspension regulations implementing Executive Orders
(E.O.) 12549 and 12689, and 2 C.F.R. Part 180. These regulations restrict federal financial assistance awards, subawards,
and contracts with certain parties that are debarred, suspended, or otherwise excluded from or ineligible for participation in
federal assistance programs or activities.
Article XX - Copyright
DHS-FEMA-HSGP-SHSP-FFY17 Page 26 of 35 Jefferson County DEM, E18-151
All recipients must affix the applicable copyright notices of 17 U.S.C. sections 401 or 402 and an acknowledgement of U.S.
Government sponsorship (including the award number) to any work first produced under federal financial assistance awards.
Article XXI - Civil Rights Act of 1964 - Title VI
All recipients must comply with the requirements of Title VI of the Civil Rights Act of 1964 (42 U.S.C. section 2000d et sea ),
which provides that no person in the United States will, on the grounds of race, color, or national origin, be excluded from
participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal
financial assistance. DHS implementing regulations for the Act are found at 6 C.F.R. Part 21 and 44 C.F.R. Part 7.
Article XXII - Best Practices for Collection and Use of Personally Identifiable Information (PII)
DHS defines personally identifiable information (PII) as any information that permits the identity of an individual to be directly
or indirectly inferred, including any information that is linked or linkable to that individual. All recipients who collect PII are
required to have a publically-available privacy policy that describes standards on the usage and maintenance of PII they
collect. Recipients may also find the DHS Privacy Impact Assessments: Privacy Guidance and Privacy template as useful
resources respectively.
Article XXIII - Americans with Disabilities Act of 1990
All recipients must comply with the requirements of Titles I, 11, and I I I of the Americans with Disabilities Act, which prohibits
recipients from discriminating on the basis of disability in the operation of public entities, public and private transportation
systems, places of public accommodation, and certain testing entities. (42 U.S.C. sections 12101-12213).
Article XXIV -Age Discrimination Act of 1975
All recipients must comply with the requirements of the Age Discrimination Act of 1975 (Title 42 U.S. Code section 6101 et
seq. ), which prohibits discrimination on the basis of age in any program or activity receiving federal financial assistance.
Article XXV - Activities Conducted Abroad
All recipients must ensure that project activities carried on outside the United States are coordinated as necessary with
appropriate government authorities and that appropriate licenses, permits, or approvals are obtained.
Article XXVI - Patents and Intellectual Property Rights
Unless otherwise provided by law, recipients are subject to the Bayh-Dole Act Pub L No 96-517, as amended, and codified
in 35 U.S.C. section 200 et seq. All recipients are subject to the specific requirements governing the development, reporting,
and disposition of rights to inventions and patents resulting from financial assistance awards located at 37 C.F.R. Part 401 and
the standard patent rights clause located at 37 C.F.R. section 401.14.
Article XXVII - Notice of Funding Opportunity Requirements
All of the instructions, guidance, limitations, and other conditions set forth in the Notice of Funding Opportunity (NOFO) for
this program are incorporated here by reference in the award terms and conditions. All recipients must comply with any such
requirements set forth in the program NOFO.
Article XXVIII - Non -supplanting Requirement
All recipients receiving federal financial assistance awards made under programs that prohibit supplanting by law must
ensure that federal funds do not replace (supplant) funds that have been budgeted for the same purpose through non-federal
sources.
Article XXIX - Nondiscrimination in Matters Pertaining to Faith -Based Organizations
It is DHS policy to ensure the equal treatment of faith -based organizations in social service programs administered or
supported by DHS or its component agencies, enabling those organizations to participate in providing important social
services to beneficiaries. All recipients must comply with the equal treatment policies and requirements contained in 6 C.F.R
Part 19 and other applicable statues, regulations, and guidance governing the participations of faith -based organizations in
individual DHS programs.
Article XXX - National Environmental Policy Act
DHS-FEMA-HSGP-SHSP-FFY17 Page 27 of 35 Jefferson County DEM, E18-151
All recipients must comply with the requirements of the National Environmental Policy Act (NEPA) and the Council on
Environmental Quality (CEQ) Regulations for Implementing the Procedural Provisions of NEPA, which requires recipients to
use all practicable means within their authority, and consistent with other essential considerations of national policy, to create
and maintain conditions under which people and nature can exist in productive harmony and fulfill the social, economic, and
other needs of present and future generations of Americans.
Article XXXI - Lobbying Prohibitions
All recipients must comply with 31 U.S.C. section 1352, which provides that none of the funds provided under an federal
financial assistance award may be expended by the recipient to pay any person to influence, or attempt 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 any federal action concerning the award or renewal.
Article XXXII - Limited English Proficiency (Civil Rights Act of 1964, Title VI)
All recipients must comply with the Title VI of the Civil Rights Act of 1964 (Title VI) prohibition against discrimination on
the basis of national origin, which requires that recipients of federal financial assistance take reasonable steps to provide
meaningful access to persons with limited English proficiency (LEP) to their programs and services. For additional assistance
and information regarding language access obligations, please refer to the DHS Recipient Guidance https //w_ww.dhs.gov/
guidance -published -help -department -supported -organizations -provide -meaningful -access -people limited and additional
resources on http://www.lep.ciov.
Article XXXIII - Hotel and Motel Fire Safety Act of 1990
In accordance with Section 6 of the Hotel and Motel Fire Safety Act of 1990, 15 U.S.C. section 2225a, all recipients must
ensure that all conference, meeting, convention, or training space funded in whole or in part with federal funds complies
with the fire prevention and control guidelines of the Federal Fire Prevention and Control Act of 1974, as amended, 15
U.S.C. section 2225.
Article XXXIV - Fly America Act of 1974
All recipients must comply with Preference for U.S. Flag Air Carriers (air carriers holding certificates under 49 U.S.C. section
41102) for international air transportation of people and property to the extent that such service is available, in accordance
with the International Air Transportation Fair Competitive Practices Act of 1974 (49 U.S.C. section 40118) and the
interpretative guidelines issued by the Comptroller General of the United States in the March 31, 1981 amendment to
Comptroller General Decision B-138942.
Article XXXV - Federal Leadership on Reducing Text Messaging while Driving
All recipients are encouraged to adopt and enforce policies that ban text messaging while driving as described in EO
1_3513, including conducting initiatives described in Section 3(a) of the Order when on official government business or when
performing any work for or on behalf of the federal government.
Article XXXVI - Federal Debt Status
All recipients are required to be non -delinquent in their repayment of any federal debt. Examples of relevant debt include
delinquent payroll and other taxes, audit disallowances, and benefit overpayments. (See OMB Circular A-129.)
Article XXXVII - False Claims Act and Program Fraud Civil Remedies
All recipients must comply with the requirements of 31_U.S_C. section 3729 - 3733 which prohibits the submission of false or
fraudulent claims for payment to the federal government. (See 31 U.S.C. section 3801-3812 which details the administrative
remedies for false claims and statements made.)
Article XXXVIII - Energy Policy and Conservation Act
All recipients must comply with the requirements of 42. U.S C, section 6201 which contain policies relating to energy efficiency
that are defined in the state energy conservation plan issued in compliance with this Act.
Article XXXIX - Education Amendments of 1972 (Equal Opportunity in Education Act) - Title IX
All recipients must comply with the requirements of Title IX of the Education Amendments of 1972 (20 U.S.C. section 1681
et seg.), which provide that no person in the United States will, on the basis of sex, be excluded from participation in, be
DHS-FEMA-HSGP-SHSP-FFY17 Page 28 of 35 Jefferson County DEM, E18-151
denied the benefits of, or be subjected to discrimination under any educational program or activity receiving federal financial
assistance. DHS implementing regulations are codified at 6 C.F.R. Part 17 and 44 G.F.R Part 19
Article XL - Duplication of Benefits
Any cost allocable to a particular federal financial assistance award provided for in 2 C.F. R. Part 200. Subpart E may not
be charged to other federal financial assistance awards to overcome fund deficiencies, to avoid restrictions imposed by
federal statutes, regulations, or federal financial assistance award terms and conditions, or for other reasons. However, these
prohibitions would not preclude recipients from shifting costs that are allowable under two or more awards in accordance with
existing federal statutes, regulations, or the federal financial assistance award terms and conditions.
Article XLI - Drug -Free Workplace Regulations
All recipients must comply with the Drug -Free Workplace Act of 1988 (41 U.S.C. section 8101 et seq.), which requires all
organizations receiving grants from any federal agency agree to maintain a drug-free workplace. You as the recipient must
comply with drug-free workplace requirements in Subpart B (or Subpart C, if the recipient is an individual) of 2 CFR part 3001,
which adopts the Government -wide implementation (2 CFR part 182) of sec. 5152-5158 of the Drug -Free Workplace Act of
1988 (Pub. L. 100-690, Title V, Subtitle D; 41 U.S.C. 8101-8107).
Article XLII - Civil Rights Act of 1968
All recipients must comply with Title VIII of the Civil Rights Act of 1968, which prohibits recipients from discriminating in the
sale, rental, financing, and advertising of dwellings, or in the provision of services in connection therewith, on the basis of
race, color, national origin, religion, disability, familial status, and sex (42 U.S.C. section 3601 et seq.), as implemented by the
Department of Housing and Urban Development at 24 C.F.R. Part 100. The prohibition on disability discrimination includes the
requirement that new multifamily housing with four or more dwelling units-i.e., the public and common use areas and individual
apartment units (all units in buildings with elevators and ground -floor units in buildings without elevators) -be designed and
constructed with certain accessible features. (See 24 C.F.R. section 100.201.)
Article XLIII - Operation Stonegarden Program Hold
The recipient is prohibited from drawing down or reimbursing sub -recipients of Operation Stonegarden (OPSG) funding
provided through this award until each unique, specific or modified county level, tribal or equivalent Operations Order and
or Fragmentary Order (Frago) has been reviewed by FEMA/GPD and Customs and Border Protection/United States Border
Patrol (CBP/USBP). The recipient will receive the official notification of approval from FEMA/GPD.
Article XLIV - Fusion Center Investment Hold - SHSP
A program hold is placed on SHSP Investment #1 and the recipient is prohibited from obligating, expending, or drawing
down SHSP funds in the amount of $628,515 in support of its State and/or Major Urban Area Fusion Center. In order to
release this hold, the recipient is required to submit the Fusion Center Addendum, which captures requirements for all Fusion
Center investments, per page 42 of the FY 2017 HSGP Notice of Funding Opportunity. Please contact your DHS/FEMA GPD
Headquarters Program Analyst to receive a copy of the Addendum, and to receive further guidance on the steps required to
release this hold.
Article XLV - Fusion Center Investment Hold - UASI
A program hold is placed on UASI Investment #1 and the recipient is prohibited from obligating, expending, or drawing
down UASI funds in the amount of $929,587 in support of its State and/or Major Urban Area Fusion Center. In order to
release this hold, the recipient is required to submit the Fusion Center Addendum, which captures requirements for all Fusion
Center investments, per page 42 of the FY 2017 HSGP Notice of Funding Opportunity. Please contact your DHS/FEMA GPD
Headquarters Program Analyst to receive a copy of the Addendum, and to receive further guidance on the steps required to
release this hold.
BUDGET COST CATEGORIES
Personnel $0.00
DHS-FEMA-HSGP-SHSP-FFY17 Page 29 of 35 Jefferson County DEM, E18-151
Fringe Benefits
Travel
Equipment
Supplies
Contractual
Construction
Indirect Charges
Other
$0.00
$0.00
$0.00
$0.00
$13,056,331.00
$0.00
$148,52000
$000
DHS-FEMA-HSGP-SHSP-FFY17 Page 30 of 35 Jefferson County DEM, E18-151
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DHS-FEMA-HSGP-SHSP-FFY1 7 Page 31 of 35 Jefferson County DEM, E18-151
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DHS-FEMA-HSGP-SHSP-FFY1 7 Page 31 of 35 Jefferson County DEM, E18-151
Homeland Security Region 2 - Jefferson County
17SHSP
State Overview
As the Pass-through Entity (PTE), the Washington State Military Department (WMD) Emergency Management Division's (EMD(
Preparedness Grants Section (PGS), referenced as the Department, is responsible for ensuring federal funding is expended and
pr.grams implemented In full accordance with governing law and ragulabans Eighty -percent of the state's award Is allocated to
local and tribal units of government in accordance with Federal guidelines Washington Steta.a di—de,! Int. nine Homeland Security
Regions. Funding Is allocated to Regons accordmgto a county base, population, and pop 1 t d ity funding formula The
meg twenty percent Is allocated to snte.gendes usjng a sostainment funding mod I Each H eland Security Repo, and
participating State Agency submitted projects that were Included In the State's In—m— JusUfic.ti The pr.Jects were further
detailed in subprojects, which are the focus.1 the work pian
ant 25;.512-X
Regi-nl Zaie tlnMe z -ie Choate@ I. agw a )46ta6l
RegionlGary Staph guy-rtulph@ L ew 7483
Region3 Zoie (Irate choaze@ t. 6 1—
RM .4
461Rep.n4 Zoic Choate - hcaae@ 1. g v 7461
Region s —A Alston 'chxl aklon@mil ora 8or 7083
Reglan6 Gary Rinnph gory..rnph@md.wa a. 7463
Region 7 Michael Akron Iwchael aklon@mil ora gov 7063
Regan 8 Michael Ahton michael akt @ '1 g v )0113
Zgon9 Deborah Heide. dehorah. heed @ Iwo gee 74.
lbvue, ceyd Gary Stumph gary.stvmph@ I g 7x63
Senile City of Gary 5—ph p,y.—mph@ 'I. g 74113
Serve WA Deborah Henderson deborah henderson@mil.wa.gw 7470
WSOA Deborah Henderson deb.rah.henderson@mil.wa.gw 74H1
WSP Deborah NeMerson debarahhenderson@mil ora gov 74H1
Governance
Region 2 is locatad in the Northwest comer of the stn. and consists of three c -unties and sewn tribes with a population of 370,000
people. The Region's three counties are Kltsap, Clallam, and Jefferson. KRsap County serves as the lead county for Region 2.
Gowmance and funding are outlined in an Interlocal Agreement (pending) between the three c -unties.
Washington Homeland Security Regions
�,�y wtatan
R ' ion
y101 2 pure r f iggi Y IBJ
fK-6 _
Region
4 `4n 4 Regiorx s Y W -
Threats & Hazards
Terrorist targats include: Primary all -hazard risks include:
• Military instillations •Earthquakes •Bio -epidemics
•Tsunamis •Radiological
• Seiches • Tenorism
• Flo.ds • Severe storm
• Wildfires • Cyber incidents
• Landslides • School violence
Me i—nn percentage of the Grant Agreement Amount that may be used by the Subracipmrn for management and I • The maximum percentage of the Grant Agreement Am— that may be used by the Subrecipient for pars -noel expenaes under
nlstration oats under this Agreement is identifled in the Budget, and may be less than, but will not exceed, the meeimum 5%. this Agreement is identified in the Budget and may differ from the SMHSGP limit.
At .,at 25% of the -well award amounts for SHSP and UASI must be dedicated toward. law enforcement termism prawnd-n • Any budget change to LETPA and/or Pe—noel must be made in writing and wil be reviewed for an amendment.
tivitiea (LETPA). The LETPA percentage of the Grant Agreement Amount that must be met as a minimum requirement of this
merit by the Subrecipient is identified in the Budget.
Overall Investment JusUflcaUo.
$6.476,808
a" A kra.slmant
JustM"tlon
$5,10"w
M&A SAA
$323,800
M&A SAA
$259,000
Investment rl
1 Washington State Fusion 4rltar
$621,515
Investment KI
1 Washington State Fusion Center
SM.547
Project 8l WSPSupportof Fusion Center
$528,515
Project el WSP Support of Fusion Curter
$479,587
Project 82 Region 6 Support of Fusion Center
$100,000
Project r2 Seattle Support of Fusion Center
$450,000
Investment R2Washington
State Agenclas Homeland S.curt y Projects
$442ASS
Investment 82
Seattle UA51
$3,6.,000
Project 81 State Planning, Exercise, and Train ing
$275,923
P.el.at 8l Seattle Urban Area Sustainment and Enhancement
$3,6911AM
Project 82 Agriculture Emergency Planning
$74,804
Investment 113
lWaahbguan Sbte Agencies Projeete
$37,433
Pro 113 Citizen Corps Program
$92,158
Peojad81Stab"idePlanning, Training, and Exerclse Program
$259,253
Investment K3
Washington Regional Homeland Securlly Projeen
$5,080,800
Peeled 62 Citizen Corps Expo and Leadership Summit
$38,160
r1 Region 1- Homeland Security
$595,199
ZProject
hopct r2 Region 2 - Homeland Security
$296,903
Project r3 Region3-Homeland Security
$379,032
Project. Region 4 -Homeland Security
$440,572
Project 85 Region 5 - Homeland Security
$759,385
Project. Region 6- Haneland5ecurity
$1,359,714
Project K7 Region 7 -Homeland Security
$289,602
Project 411 Region 8 -Homeland Security
$371,301
Project 09 Region 9 - Homeland Security
$589,092
DHS-FEMA-HSGP-SHSP-FFY17
Page 32 of 35
Jefferson County DEM, E18-151
Homeland Security Region 2 -Jefferson County
17SHSP
This work plan supports the 2017 Washington State HSGP (SHSP) Investment Justification,
Investment a3- Washington Regional Homeland Security Projects, Project P2—Region
2 Homeland Security (WAI7SHSP>INV-3>PROJ-2).
PROJECT DESCRIPTION
Award Amount
$51,542
Funding will be directed towards the follovdng identified capability gaps:
AMOUNT
PERSONNEL LETPA
SUBPROJECT SCOPE
1) Planning -ongoing gap in plan compliance to Support all areas of emergency management;
Salaries & Benefits
$0
2) Community Resilience -continuo outreach to Public and improve disaster preparedness by 20%m the region
winhowhism
Budgeted Amount
through CERT teams, Map Your Neighborhood program, and enhancing volunteer skills and service;
Management g administration IN")
SYdAgreennnt Amount
$o
3) On Scene Security and Protection -enhance the capability of SWAT with medical triage capabikry to minimize
parsoond
SOJA W overall Award
$0
Ions of,esponcle, and victim lives; ongoing program to align law and EMS as one coordinated response unit during
Casts
$38,000
domestic or terrorism incidents and sustain and enhance the ability of law agencies to handle potential terrorism
IEfPA
25YdlAWi5H5P Awards
$7,30p
IED capabilities incidents;
Total
$0
$0
4) Mass CarnimProve mass care Support by adding or maintaining community poim, of distribution systems and
Subproject 81
provide the service to accommodate 20% of the public; Build ESF-6 capabilities to Support disaster response and
$0
$o $0
The goal is to increase the number of existing text messaging system (TMS) users (subscribers) through
esdiemy,
Organization
$7,300
5) Operational Coordination -improve EOC response to emergencies through ongoing training and exercise
public education, outreach, and incentive programs, augmenting the alert and warning system. The link to
the approved 17SHSP Investment Justification is-- 6) Public Information and Warning -enhance outreach
Vet courses of action with stakeholder groups
programs and equipment and technology upgrades; and
and waming for potential dangers in the community and reach out to 2WA of the papulation. Gaol: There
6) Public Information and W—mgronhance outreach and warning for potential dangers in the community and
Equipment
so
reach out to 10°.6 of the Population.
is limited AM/FM broadcast capabilities and the TMS makes use of tertiary technology (text messaging and
Alert and Warping
Training
DHS-FEMA-HSGP-SHSP-FFY17 Page 33 of 35 Jefferson County DEM, E18-151
SOLUTION AREA/
BUOG'ETCATEGORY
AMOUNT
PERSONNEL LETPA
SUBPROJECT SCOPE
MILESTONES
Salaries & Benefits
$0
$0
Overtime/Backfill
M&A
Goods &Services
$0
Travel &Per Diem
$0
Total
$0
$0
Subproject 81
Planning
$0
$o $0
The goal is to increase the number of existing text messaging system (TMS) users (subscribers) through
Develop courses of action
Organization
$7,300
--'"
$0 $7,300
public education, outreach, and incentive programs, augmenting the alert and warning system. The link to
the approved 17SHSP Investment Justification is-- 6) Public Information and Warning -enhance outreach
Vet courses of action with stakeholder groups
and waming for potential dangers in the community and reach out to 2WA of the papulation. Gaol: There
Implement approved courses of action
Equipment
so
'.. $0
is limited AM/FM broadcast capabilities and the TMS makes use of tertiary technology (text messaging and
Alert and Warping
Training
$o
$0 $0
emads) to reach a large portion of the population at risk. TMS currently reaches about 14% of the
population. The focus area for this funding cycle is to Support wstainment of the current notification and
Vakdate d actmns achieved desired outcome
Exercises
$o
" i
�� $0
warning system and increase participation. Fundine will maintain service contracts with the current
warning system provider. The desired outcome is continued operation of the alert and warning system
and mcreased citizen participation.
Evaluate success o desired outcome and determine
next she ps
Total
$7,300
$0 $7,300
Subproject P2
Plammng
$38,000
$39,000 $0
The goal is to continue improvement m the core capability of Operational Caordinatmn for the County. The
Deuelop courses of action
-
-- ----
link to the approved 17SHSP Investment Justification is-- 5) Operational Coordination -Improve ECIC
Vet<ourses of action with rtakeholdtt groups
Organization
$0
$0 $O
response to emergencies through ongoing training and exercise programs and equipment and technology
upgrades. Gans: continuing action items from the 2016 Cassadia Rising Exercise (CRX) After Action Report
(AAR), 1) Continue to recruit and train Incident Management Team (MITI to establish team depth by
Equipment
$o
$0
having a "reserve" team; 2) Reconfigure or re -align the primary EOC team space to enhance EOC
Implement approved courses of actoin
oordination allowing for increased scalability from small incident to catastrophic disaster; and 3)
Planning
Training
$0
E
$O1 $0
Reconfigure the alternate EOC to align with the primary EOC layout for efficiency, installing additional
phones and computer terminals. Focus arca will be development of the EOC IMT and the City Coordination
Vakdate if actions achieved desired outcome
Center Team Activities will include IMT training to correct issues identified in the CRX AAR and
$0 $0
$38 , 000 $O
Evaluate success of desired outcome and determine
nett steps
Exercises
Total
$0
$38,000unty
improvements in EOC set-up to supportoperational coordination. Funding will be used for staffsupport of
trammg and coordination and for planning and execution of EOC upgrades. Desired outcome is that
co is better prepared to respond to a terrorism or all -hazard event.
DHS-FEMA-HSGP-SHSP-FFY17 Page 33 of 35 Jefferson County DEM, E18-151
PERSONNEL AMOUNT $38,000 74%
LETPA AMOUNT $7,300 14%
Given Personnel Costs and LETPA are Calculated on a statewide basis, it is acceptable for local
percentages to deviate from the grant requirement. However, any budget changes to LETPA
and/or Personnel expenses will require an amendment.
DHS -FEMA -HSG P-SHSP-FFY17 Page 34 Of 35 Jefferson County DEM, E18-151
SOLUTION AREA/
BUDGETCATEGORY
AMOUNT
PERSONNEL LETPA
SUBPROJECT SCOPE
MILESTONES
Subproject R3
Planning
$o
$0 $0
The Boal is to build on Previous efforts to ensure resiliency of the whole community. The link to the
Develop courses of action
-------"-
approved 175HSP Investment Justification is -2) Community Resilience -continue outreach to public and
yet courses of action with stakeholder groups
Organization
$6,242
..
j0. $0
-.-
improve disaster preparedness by 20% in the region through CERT and Map Your Neighborhood program
and enhance volunteer skills and service. Gaol exist in the number and level of training for citizen response
Equipment
$n
SU
groups Foos areas for this funding cycle are further development of the Neighborhood Preparedness
Workgmup (N PREP), increasing the level of training for citizen response teams through formal exercises,
Implement approved courses of action
Community Resilience
Training
Training
'"""-"
$O
'-' -` "-----
$0. $B
o
and recruiting response ng additional team members. Fundi will evel
wi be used for doiling, printing, and
distributing emergency preparedness training and educational materials and for community outreach and
recruiting. Funding will also support hands on training for citizen responders and establishing community
Validate ifactions achieved desired outcome
Exercises
$o
$0.. $0
points of distribution (CPDD) systems. The desired outcome is that citizens and communities are better
prepared to respond to and recover from terrorist or all -hazard events. Assessments have shown budding
community resilience is a primary cornerstone for emergency preparedness.
Evaluate success of desired outcome and determine
next steps
Toro,
$r,242
$0 $0
SUBTOTAL
$51.542
53g.00n C7 am
PERSONNEL AMOUNT $38,000 74%
LETPA AMOUNT $7,300 14%
Given Personnel Costs and LETPA are Calculated on a statewide basis, it is acceptable for local
percentages to deviate from the grant requirement. However, any budget changes to LETPA
and/or Personnel expenses will require an amendment.
DHS -FEMA -HSG P-SHSP-FFY17 Page 34 Of 35 Jefferson County DEM, E18-151
Homeland Security Region 2 - Jefferson County
17SHSP
Date
Task
September 1, 2017
Grant Agreement Start Date
July 1, 2018
Estimated date work will begin
July 31, 2018
Submit Spend Plan
NLT October 30, 2018
Submit Reimbursement Request and Progress Report
NLT January 31, 2019
Submit Reimbursement Request and Progress Report
NLT April 30, 2019
Submit Reimbursement Request and Progress Report
NLT July 31, 2019
Submit Reimbursement Request and Progress Report
August 31, 2019
Grant Agreement End Date. All work ceases.
November 15, 2019
Submit Final Reimbursement Request and Closeout Report.
* Reports are due before final invoice will be reimbursed.
HSGP Grant Performance Period: September 1, 2017 - August 31, 2020
DHS-FEMA-HSGPSHSP-FFV17 Page 35 of 35 Jefferson County DEM, E1&151
Form
WM9
Request for Taxpayer
Give Form to the
(Rev.December 20
Identification Number and Certification
on
requester. not
Department of the Treasury
Internal Revenue Service
Iury send to the RS.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
Jefferson County
N
2 Business name/disregarded entity name, if different from above
a
rn
m
CL
3 Check appropriate box for federal tax classification; check only, one of the following seven boxes:
4 Exemptions (codes apply only to
C
Elcertain
IndividuaVsole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑Trust/estate
entities, not individuals; see
U)
o. CO
LLC
instructions on page 3):
� •�
Limited
❑Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ►
Exempt payee code (if any)
o L
Note. For a single -member LLC that is disregarded, do not check LLC; check the
9 9 appropriate box in the line above for
Exemption from FATCA reporting
the tax classification of the single -member owner.
code (if any)
•i C
IL o
Q Other (see instructions) ► Government
(Applies to accounts maintained outside the U S)
v
5 Address (number, street, and apt. or suite no.)
Requester's name and address (optional)
c
P.O. Box 1220/1820 Jefferson Street
y
6 City, state, and ZIP code
Port Townsend, WA 98368
7 List account number(s) here (optional)
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding. For individuals, this is generally your social security number (SSN). However, fora _ m _
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN on page 3. or
Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for I Employer identification number
guidelines on whose number to enter. F --F-7
ilIiI01iI0iilDiilDiil0lilDM"W
lj� Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage
interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and
generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the
instructions on page 3.
Sign Signature of
Here U.S. person ► Date Do -
General
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments. Information about developments affecting Form W-9 (such
as legislation enacted after we release it) is at www.irs.gov/fw9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an information
return with the IRS must obtain your correct taxpayer identification number (TIN)
which may be your social security number (SSN), individual taxpayer identification
number (ITIN), adoption taxpayer identification number (ATIN), or employer
identification number (EIN), to report on an information return the amount paid to
you, or other amount reportable on an information return. Examples of information
returns include, but are not limited to, the following:
• Form 1099 -INT (interest earned or paid)
• Form 1099 -DIV (dividends, including those from stocks or mutual funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)
• Form 1099-B (stock or mutual fund sales and certain other transactions by
brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T
(tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident alien), to
provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might be subject
to backup withholding. See What is backup withholding? on page 2.
By signing the filled -out form, you:
1. Certify that the TIN you are giving is correct (or you are waiting for a number
to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S. exempt payee. If
applicable, you are also certifying that as a U.S. person, your allocable share of
any partnership income from a U.S. trade or business is not subject to the
withholding tax on foreign partners' share of effectively connected income, and
4. Certify that FATCA code(s) entered on this form (if any) indicating that you are
exempt from the FATCA reporting, is correct. See What is FATCA reporting? on
page 2 for further information.
Cat. No. 10231X Form W-9 (Rev. 12-2014)
Form W-9 (Rev. 12-2014)
Page 2
Note. If you are a U.S. person and a requester gives you a form other than Form
W-9 to request your TIN, you must use the requester's form if it is substantially
similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are considered a U.S.
person if you are:
• An individual who is a U.S. citizen or U.S. resident alien;
• A partnership, corporation, company, or association created or organized in the
United States or under the laws of the United States;
• An estate (other than a foreign estate); or
• A domestic trust (as defined in Regulations section 301.7701-7).
Special rules for partnerships. Partnerships that conduct a trade or business in
the United States are generally required to pay a withholding tax under section
1446 on any foreign partners' share of effectively connected taxable income from
such business. Further, in certain cases where a Form W-9 has not been received,
the rules under section 1446 require a partnership to presume that a partner is a
foreign person, and pay the section 1446 withholding tax. Therefore, if you are a
U.S. person that is a partner in a partnership conducting a trade or business in the
United States, provide Form W-9 to the partnership to establish your U.S. status
and avoid section 1446 withholding on your share of partnership income.
In the cases below, the following person must give Form W-9 to the partnership
for purposes of establishing its U.S. status and avoiding withholding on its
allocable share of net income from the partnership conducting a trade or business
in the United States:
• In the case of a disregarded entity with a U.S. owner, the U.S. owner of the
disregarded entity and not the entity;
• In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally,
the U.S. grantor or other U.S. owner of the grantor trust and not the trust; and
• In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a
grantor trust) and not the beneficiaries of the trust.
Foreign person. If you are a foreign person or the U.S. branch of a foreign bank
that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use
the appropriate Form W-8 or Form 8233 (see Publication 515, Withholding of Tax
on Nonresident Aliens and Foreign Entities).
Nonresident alien who becomes a resident alien. Generally, only a nonresident
alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on
certain types of income. However, most tax treaties contain a provision known as
a "saving clause." Exceptions specified in the saving clause may permit an
exemption from tax to continue for certain types of income even after the payee
has otherwise become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an exception contained in the
saving clause of a tax treaty to claim an exemption from U.S. tax on certain types
of income, you must attach a statement to Form W-9 that specifies the following
five items:
1. The treaty country. Generally, this must be the same treaty under which you
claimed exemption from tax as a nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that contains the saving
clause and its exceptions.
4. The type and amount of income that qualifies for the exemption from tax.
5. Sufficient facts to justify the exemption from tax under the terns of the treaty
article.
Example. Article 20 of the U.S.-China income tax treaty allows an exemption
from tax for scholarship income received by a Chinese student temporarily present
in the United States. Under U.S. law, this student will become a resident alien for
tax purposes if his or her stay in the United States exceeds 5 calendar years.
However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30,
1984) allows the provisions of Article 20 to continue to apply even after the
Chinese student becomes a resident alien of the United States. A Chinese student
who qualifies for this exception (under paragraph 2 of the first protocol) and is
relying on this exception to claim an exemption from tax on his or her scholarship
or fellowship income would attach to Form W-9 a statement that includes the
information described above to support that exemption.
If you are a nonresident alien or a foreign entity, give the requester the
appropriate completed Form W-8 or Form 8233.
Backup Withholding
What is backup withholding? Persons making certain payments to you must
under certain conditions withhold and pay to the IRS 28% of such payments. This
is called "backup withholding." Payments that may be subject to backup
withholding include interest, tax-exempt interest, dividends, broker and barter
exchange transactions, rents, royalties, nonemployee pay, payments made in
settlement of payment card and third party network transactions, and certain
payments from fishing boat operators. Real estate transactions are not subject to
backup withholding.
You will not be subject to backup withholding on payments you receive if you
give the requester your correct TIN, make the proper certifications, and report all
your taxable interest and dividends on your tax return.
Payments you receive will be subject to backup withholding if:
You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the Part II instructions on page
3 for details),
3. The IRS tells the requester that you furnished an incorrect TIN,
4. The IRS tells you that you are subject to backup withholding because you did
not report all your interest and dividends on your tax return (for reportable interest
and dividends only), or
5. You do not certify to the requester that you are not subject to backup
withholding under 4 above (far reportable interest and dividend accounts opened
after 1983 only).
Certain payees and payments are exempt from backup withholding. See Exempt
payee code on page 3 and the separate Instructions for the Requester of Form
W-9 for more information.
Also see Special rules for partnerships above.
What is FATCA reporting?
The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign
financial institution to repot all United States account holders that are specified
United States persons. Certain payees are exempt from FATCA reporting. See
Exemption from FATCA reporting code on page 3 and the Instructions for the
Requester of Form W-9 for more information.
Updating Your Information
You must provide updated information to any person to whom you claimed to be
an exempt payee if you are no longer an exempt payee and anticipate receiving
reportable payments in the future from this person. For example, you may need to
provide updated information if you are a C corporation that elects to be an S
corporation, or if you no longer are tax exempt. In addition, you must furnish a new
Form W-9 if the name or TIN changes for the account; for example, if the grantor
of a grantor trust dies.
Penalties
Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are
subject to a penalty of $50 for each such failure unless your failure is due to
reasonable cause and not to willful neglect.
Civil penalty for false information with respect to withholding. If you make a
false statement with no reasonable basis that results in no backup withholding,
you are subject to a $500 penalty.
Criminal penatty for falsifying information. Willfully falsifying certifications or
affirmations may subject you to criminal penalties including fines and/or
imprisonment.
Misuse of TINs. If the requester discloses or uses TINs in violation of federal law,
the requester may be subject to civil and criminal penalties.
Specific Instructions
Line 1
You must enter one of the following on this line; do not leave this line blank. The
name should match the name on your tax return.
If this Form W-9 is for a joint account, list first, and then circle, the name of the
person or entity whose number you entered in Part I of Form W-9.
a. Individual. Generally, enter the name shown on your tax return. If you have
changed your last name without informing the Social Security Administration (SSA)
of the name change, enter your first name, the last name as shown on your social
security card, and your new last name.
Note. ITIN applicant: Enter your individual name as it was entered on your Form
W-7 application, line 1 a. This should also be the same as the name you entered on
the Forth 1040/1040A/1040EZ you filed with your application.
b. Sok proprietor or single -member LLC. Enter your individual name as
shown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade,
or "doing business as" (DBA) name on line 2.
c. Partnership, LLC that is not a single -member LLC, C Corporation, or S
Corporation. Enter the entity's name as shown on the entity's tax return on line 1
and any business, trade, or DBA name on line 2.
d. Other entities. Enter your name as shown on required U.S. federal tax
documents on line 1. This name should match the name shown on the charter or
other legal document creating the entity. You may enter any business, trade, or
DBA name on line 2.
e. Disregarded entity. For U.S. federal tax purposes, an entity that is
disregarded as an entity separate from its owner is treated as a "disregarded
entity." See Regulations section 301.7701-2(c)(2)(iii). Enter the owner's name on
line 1. The name of the entity entered on line 1 should never be a disregarded
entity. The name on line 1 should be the name shown on the income tax return on
which the income should be reported. For example, if a foreign LLC that is treated
as a disregarded entity for U.S. federal tax purposes has a single owner that is a
U.S. person, the U.S. owner's name is required to be provided on line 1. If the
direct owner of the entity is also a disregarded entity, enter the first owner that is
not disregarded for federal tax purposes. Enter the disregarded entity's name on
line 2, "Business name/disregarded entity name." If the owner of the disregarded
entity is a foreign person, the owner must complete an appropriate Form W-8
instead of a Form W-9. This is the case even if the foreign person has a U.S. TIN.
Form W-9 (Rev. 12-2014)
Line 2
If you have a business name, trade name, DBA name, or disregarded entity name,
you may enter it on line 2.
Line 3
Check the appropriate box in line 3 for the U.S. federal tax classification of the
person whose name is entered on line 1. Check only one box in line 3.
Limited Liability Company (LLC). If the name on line 1 is an LLC treated as a
partnership for U.S. federal tax purposes, check the "Limited Liability Company"
box and enter "P" in the space provided. If the LLC has filed Form 8832 or 2553 to
be taxed as a corporation, check the "Limited Liability Company" box and in the
space provided enter "C" for C corporation or "S" for S corporation. If it is a
single -member LLC that is a disregarded entity, do not check the "Limited Liability
Company" box; instead check the first box in line 3 "Individual/sole proprietor or
single -member LLC."
Line 4, Exemptions
If you are exempt from backup withholding and/or FATCA reporting, enter in the
appropriate space in line 4 any code(s) that may apply to you.
Exempt payee code.
• Generally, individuals (including sole proprietors) are not exempt from backup
withholding.
• Except as provided below, corporations are exempt from backup withholding
for certain payments, including interest and dividends.
• Corporations are not exempt from backup withholding for payments made in
settlement of payment card or third party network transactions.
• Corporations are not exempt from backup withholding with respect to attorneys'
fees or gross proceeds paid to attorneys, and corporations that provide medical or
health care services are not exempt with respect to payments reportable on Form
1099-MISC.
The following codes identify payees that are exempt from backup withholding.
Enter the appropriate code in the space in line 4.
1—An organization exempt from tax under section 501(a), any IRA, or a
custodial account under section 403(b)(7) if the account satisfies the requirements
of section 401(f)(2)
2—The United States or any of its agencies or instrumentalities
3—A state, the District of Columbia, a U.S. commonwealth or possession, or
any of their political subdivisions or instrumentalities
4—A foreign government or any of its political subdivisions, agencies, or
instrumentalities
5—A corporation
6—A dealer in securities or commodities required to register in the United
States, the District of Columbia, or a U.S. commonwealth or possession
7—A futures commission merchant registered with the Commodity Futures
Trading Commission
8—A real estate investment trust
9—An entity registered at all times during the tax year under the Investment
Company Act of 1940
10—A common trust fund operated by a bank under section 584(a)
11—A financial institution
12—A middleman known in the investment community as a nominee or
custodian
13—A trust exempt from tax under section 664 or described in section 4947
The following chart shows types of payments that may be exempt from backup
withholding. The chart applies to the exempt payees listed above, 1 through 13.
IF the payment is for ...
THEN the payment is exempt for ...
Interest and dividend payments
All exempt payees except
for 7
Broker transactions
Exempt payees 1 through 4 and 6
through 11 and all C corporations. S
corporations must not enter an exempt
payee code because they are exempt
only for sales of noncovered securities
acquired prior to 2012.
Barter exchange transactions and
Exempt payees 1 through 4
patronage dividends
Payments over $600 required to be
Generally, exempt payees
reported and direct sales over $5,000'
1 through 5Z
Payments made in settlement of
Exempt payees 1 through 4
payment card or third party network
transactions
I See Form 1099-MISC, Miscellaneous Income, and its instructions.
Page 3
'However, the following payments made to a corporation and reportable on Form
1099-MISC are not exempt from backup withholding: medical and health care
payments, attorneys' fees, gross proceeds paid to an attorney reportable under
section 6045(f), and payments for services paid by a federal executive agency.
Exemption from FATCA reporting code. The following codes identity payees
that are exempt from reporting under FATCA. These codes apply to persons
submitting this form for accounts maintained outside of the United States by
certain foreign financial institutions. Therefore, 0 you are only submitting this form
for an account you hold in the United States, you may leave this field blank.
Consult with the person requesting this form if you are uncertain if the financial
institution is subject to these requirements. A requester may indicate that a code is
not required by providing you with a Form W-9 with "Not Applicable" (or any
similar indication) written or printed on the line for a FATCA exemption code.
A—An organization exempt from tax under section 501(a) or any individual
retirement plan as defined in section 7701(ax37)
B—The United States or any of its agencies or instrumentalities
C—A state, the District of Columbia, a U.S. commonwealth or possession, or
any of their political subdivisions or instrumentalities
D—A corporation the stock of which is regularly traded on one or more
established securities markets, as described in Regulations section
1.1472-1(c)(1)()
E—A corporation that is a member of the same expanded affiliated group as a
corporation described in Regulations section 1.1472-1(c)(1)()
F—A dealer in securities, commodities, or derivative financial instruments
(including notional principal contracts, futures, forwards, and options) that is
registered as such under the laws of the United States or any state
G—A real estate investment trust
H—A regulated investment company as defined in section 851 or an entity
registered at all times during the tax year under the Investment Company Act of
1940
I—A common trust fund as defined in section 584(a)
J—A bank as defined in section 581
K—A broker
L—A trust exempt from tax under section 664 or described in section 4947(a)(1)
M—A tax exempt trust under a section 403(b) plan or section 457(g) plan
Note. You may wish to consult with the financial institution requesting this form to
determine whether the FATCA code and/or exempt payee code should be
completed.
Line 5
Enter your address (number, street, and apartment or suite number). This is where
the requester of this Form W-9 will mail your information returns.
Line 6
Enter your city, state, and ZIP code.
Part 1. Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. If you are a resident alien and you do not
have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer
identification number (ITIN). Enter it in the social security number box. If you do not
have an ITIN, see How to get a TIN below.
If you are a sole proprietor and you have an EIN, you may enter either your SSN
or EIN. However, the IRS prefers that you use your SSN.
If you are a single -member LLC that is disregarded as an entity separate from its
owner (see Limited Liability Company (LLC) on this page), enter the owner's SSN
(or EIN, if the owner has one). Do not enter the disregarded entity's EIN. If the LLC
is classified as a corporation or partnership, enter the entity's EIN.
Note. See the chart on page 4 for further clarification of name and TIN
combinations.
How to get a TIN. If you do not have a TIN, apply for one immediately. To apply
for an SSN, get Form SS -5, Application for a Social Security Card, from your local
SSA office or get this form online at www.ssa.gov. You may also get this form by
calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer
Identification Number, to apply for an ITIN, or Form SS -4, Application for Employer
Identification Number, to apply for an EIN. You can apply for an EIN online by
accessing the IRS website at www.irs.gov/businesses and clicking on Employer
Identification Number (EIN) under Starting a Business. You can get Forms W-7 and
SS -4 from the IRS by visiting IRS.gov or by calling 1 -800 -TAX -FORM
(1-800-829-3676).
If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN
and write "Applied For" in the space for the TIN, sign and date the form, and give it
to the requester. For interest and dividend payments, and certain payments made
with respect to readily tradable instruments, generally you will have 60 days to get
a TIN and give it to the requester before you are subject to backup withholding on
payments. The 60 -day rule does not apply to other types of payments. You will be
subject to backup withholding on all such payments until you provide your TIN to
the requester.
Note. Entering "Applied For" means that you have already applied for a TIN or that
you intend to apply for one soon.
Caution: A disregarded U.S. entity that has a foreign owner must use the
appropriate Form W-8.
Form W-9 (Rev. 12-2014)
Part II. Certification
To establish to the withholding agent that you are a U.S. person, or resident alien,
sign Form W-9. You may be requested to sign by the withholding agent even if
items 1, 4, or 5 below indicate otherwise.
For a joint account, only the person whose TIN is shown in Part I should sign
(when required). In the case of a disregarded entity, the person identified on line 1
must sign. Exempt payees, see Exempt payee code earlier.
Signature requirements. Complete the certification as indicated in items 1
through 5 below.
1. Interest, dividend, and barter exchange accounts opened before 1984
and broker accounts considered active during 1983. You must give your
correct TIN, but you do not have to sign the certification.
2. Interest, dividend, broker, and barter exchange accounts opened after
1983 and broker accounts considered inactive during 1983. You must sign the
certification or backup withholding will apply. If you are subject to backup
withholding and you are merely providing your correct TIN to the requester, you
must cross out item 2 in the certification before signing the form.
3. Real estate transactions. You must sign the certification. You may cross out
item 2 of the certification.
4. other payments. You must give your correct TIN, but you do not have to sign
the certification unless you have been notified that you have previously given an
incorrect TIN. "Other payments" include payments made in the course of the
requester's trade or business for rents, royalties, goods (other than bills for
merchandise), medical and health care services (including payments to
corporations), payments to a nonemployee for services, payments made in
settlement of payment card and third party network transactions, payments to
certain fishing boat crew members and fishermen, and gross proceeds paid to
attorneys (including payments to corporations).
5. Mortgage interest paid by you, acquisition or abandonment of secured
property, cancellation of debt, qualified tuition program payments (under
section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or
distributions, and pension distributions. You must give your correct TIN, but you
do not have to sign the certification.
What Name and Number To Give the Requester
For this type of account:
Give name and SSN of:
1. Individual
The individual
2. Two or more individuals (joint
The actual owner of the account or,
account)
if combined funds, the first
individual on the account'
3. Custodian account of a minor
The minor'
(Uniform Gift to Minors Act)
4. a. The usual revocable savings
The grantor -trustee'
trust (grantor is also trustee)
b. So-called trust account that is
The actual owner
not a legal or valid trust under
state law
5. Sole proprietorship or disregarded
The owner'
entity owned by an individual
6. Grantor trust filing under Optional
The grantor'
Form 1099 Filing Method 1 (see
Regulations section 1.671-4(b)(2)(i)
(A))
For this type of account:
Give name and EIN of:
7. Disregarded entity not owned by an
The owner
individual
8. A valid trust, estate, or pension trust
Legal entity
9. Corporation or LLC electing
The corporation
corporate status on Form 8832 or
Form 2553
10. Association, club, religious,
The organization
charitable, educational, or other tax-
exempt organization
11. Partnership or multi -member LLC
The partnership
12. A broker or registered nominee
The broker or nominee
13. Account with the Department of
The public entity
Agriculture in the name of a public
entity (such as a state or local
government, school district, or
prison) that receives agricultural
program payments
14. Grantor trust filing under the Form
The trust
1041 Filing Method or the Optional
Form 1099 Filing Method 2 (see
Regulations section 1.6714(b)(2)(i)
(B))
' List first and circle the name of the person whose number you fumish. If only one person on a
joint account has an SSN, that person's number must be furnished.
' Circle the minis name and furnish the minor's SSN.
Page 4
' You must show your individual name and you may also enter your business or DBA name on
the "Business nameldisregarded entity" name line. You may use either your SSN or EIN (if you
have one), but the IRS encourages you to use your SSN.
4 List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the
personal representative or trustee unless the legal entity itself is not designated in the account
title.) Also see Special rules for partnerships on page 2.
'Note. Grantor also must provide a Form W-9 to trustee of trust.
Note. If no name is circled when more than one name is listed, the number will be
considered to be that of the first name listed.
Secure Your Tax Records from Identity Theft
Identity theft occurs when someone uses your personal information such as your
name, SSN, or other identifying information, without your permission, to commit
fraud or other crimes. An identity thief may use your SSN to get a job or may file a
tax return using your SSN to receive a refund.
To reduce your risk:
• Protect your SSN,
• Ensure your employer is protecting your SSN, and
• Be careful when choosing a tax preparer.
if your tax records are affected by identity theft and you receive a notice from
the IRS, respond right away to the name and phone number printed on the IRS
notice or letter.
If your tax records are not currently affected by identity theft but you think you
are at risk due to a lost or stolen purse or wallet, questionable credit card activity
or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit
Form 14039.
For more information, see Publication 4535, Identity Theft Prevention and Victim
Assistance.
Victims of identity theft who are experiencing economic harm or a system
problem, or are seeking help in resolving tax problems that have not been resolved
through normal channels, may be eligible for Taxpayer Advocate Service TAS)
assistance. You can reach TAS by calling the TAS tall -free case intake line at
1-877-777-4778 or TTY/TDD 1-800-829-4059.
Protect yourself from suspicious emails or phishing schemes. Phishing is the
creation and use of email and websites designed to mimic legitimate business
emails and websites. The most common act is sending an email to a user falsely
claiming to be an established legitimate enterprise in an attempt to scam the user
into surrendering private information that will be used for identity theft.
The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does
not request personal detailed information through email or ask taxpayers for the
PIN numbers, passwords, or similar secret access information for their credit card,
bank, or other financial accounts.
If you receive an unsolicited email claiming to be from the IRS, forward this
message to phishing0irs.gov. You may also report misuse of the IRS name, logo,
or other IRS property to the Treasury Inspector General for Tax Administration
(TIGTA) at 1-800-366-4484. You can forward suspicious emails to the Federal
Trade Commission at: spamOuce.gov or contact them at www.ftc.gov/i (theft or
1-877-IDTHEFT (1-877-438-4338).
Visit IRS.gov to learn more about identity theft and how to reduce your risk.
Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to provide your correct
TIN to persons (including federal agencies) who are required to file information
returns with the IRS to report interest, dividends, or certain other income paid to
you; mortgage interest you paid; the acquisition or abandonment of secured
property; the cancellation of debt; or contributions you made to an IRA, Archer
MSA, or HSA. The person collecting this form uses the information on the form to
file information returns with the IRS, reporting the above information. Routine uses
of this information include giving it to the Department of Justice for civil and
criminal litigation and to cities, states, the District of Columbia, and U.S.
commonwealths and possessions for use in administering their laws. The
information also may be disclosed to other countries under a treaty, to federal and
state agencies to enforce civil and criminal laws, or to federal law enforcement and
intelligence agencies to combat terrorism. You must provide your TIN whether or
not you are required to file a tax return. Under section 3406, payers must generally
withhold a percentage of taxable interest, dividend, and certain other payments to
a payee who does not give a TIN to the payer. Certain penalties may also apply for
providing false or fraudulent information.
2 CFR Part 200 Subpart F Audit Certification Form
Audits of States, Local Governments, Indian Tribes, and Non -Profit Organizations
Contact Information
Subrecipient Name (Agency, Local Government, or organization): Jefferson County Department of Emergency Management
Authorized Chief Financial Officer (central accounting office): Rose Ann Carroll
Address: P.O. Box 563 Port Townsend, WA 98368
Email: carrollra@co.jefferson.wa.us Phone #: 360-385-9231
Purpose: As a pass-through entity of federal grant funds, the Washington Military Department/Emergency Management Division (Department)
is required by 2 CFR Part 200 Subpart F to monitor activities of subrecipients to ensure federal awards are used for authorized purposes and
verify that subrecipients expending $750,000 or more in federal awards during their fiscal year have met the 2 CFR Part 200 Subpart F Audit
Requirements. Your entity is a subrecipient subject to such monitoring by MIL/EMD because it is a non-federal entity that expends federal grant
funds received from the Department as a pass-through entity to carry out a federal program. 2 CFR Part 200 Subpart F should be consulted
when completing this form.
Directions: As required by 2 CFR Part 200 Subpart F, non-federal entities that expend $750,000 in federal awards in a fiscal year shall have
a single or program -specific audit conducted for that year. If your entity k.!191 subject to these requirements, you must complete Section A of
this Form. If your entity is subject to these requirements, you must complete Section B of this form. When completed, you must sign, date,
and return this form with your grant agreement and every fiscal year thereafter until the grant agreement is closed. Failure to return this
completed Audit Certification Form may result in delay of grant agreement processing, withholding of federal awards or disallowance of costs,
and suspension or termination of federal awards.
SECTION A: Entities NOT subject to the audit requirements of 2 CFR Part 200 Subpart F
Our entity is not subject to the requirements of 2 CFR Part 200 Subpart F because (check all that apply):
IN We did not expend $750,000 or more of total federal awards during the fiscal year.
❑ We are a for-profit agency.
❑ We are exempt for other reasons (describe):
However, by signing below, I agree that we are still subject to the audit requirements, laws and regulations governing the program(s) in
which we participate, that we are required to maintain records of federal funding and to provide access to such records by federal and state
agencies and their designees, and that WMD/EMD may request and be provided access to additional information and/or documentation to
ensure proper stewardship of federal funds.
SECTION B: Entities that ARE subiect to the audit requirements of 2 CFR Part 200 Subpart F
(Complete the information below and check the appropriate box
❑ We completed our last 2 CFR Part 200 Subpart F Audit on [enter date] for Fiscal Year ending [enter date] There
were no findings related to federal awards from WMD/EMD. No follow-up action is required by WMD/EMD as the pass-through entity.
A complete copy of the audit report, which includes exceptions, corrective action plan and management response, is
either provided electronically to contracts.officeRmil.wa.gov or provide the state auditor report number:
❑ We completed our last 2 CFR Part 200 Subpart F Audit on [enter date] for Fiscal Year ending [enter date] There
were findings related to federal awards.
A complete copy of the audit report, which includes exceptions, corrective action plan and management response, is either
provided electronically to contracts.office(dmil.wa.gov or provide the state auditor report number:
❑ Our completed 2 CFR Part 200 Subpart F Audit will be available on [enter date] for Fiscal Year ending
[enter date]. We will provide electronic copy of the audit report to contracts. officeg4miLwa.gov at that time or
provide the state auditor report number:
I hereby certify that I am an individual authorized by the above identified entity to complete this form. Further, I certify that the
above information is true and correct and all relevant material findings contained in audit report/statement have been disclosed.
Additionally, I understand this Form is to be submitted every fiscal year for which this entity is a subrecipient of federal award
funds from the Department until the grant agreement is closed.
Signature of Authorized Chief Financial Officer:
Date:
Print Name 8t Title: Rose Ann Carroll, County Auditor
WMD Form 1009-13, 8119/2013, Updated 9/92015
Washington Military Department Contract Number: E18-151
Debarment, Suspension, Ineligibility or Voluntary Exclusion Certification Form
NAME
Doing business as (DBA)
Jefferson County Department of Emergency Management
JCDEM
ADDRESS
Applicable Procurement
WA Uniform Business
Federal Employer Tax
81 Elkins Road
or Solicitation #, if any:
Identifier (UBI)
Identification #
Port Hadlock, WA 98339
601-098-110
91-6001322
This certification is submitted as part of a request to contract.
Instructions For Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion --Lower
Tier Covered Transactions
READ CAREFULLY BEFORE SIGNING THE CERTIFICATION. Federal regulations require contractors and bidders to sign and
abide by the terms of this certification, without modification, in order to participate in certain transactions directly or
indirectly involving federal funds.
1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out
below.
2. The certification in this clause is a material representation of fact upon which reliance was placed when this
transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an
erroneous certification, in addition to other remedies available to the Federal Government the department or agency
with which this transaction originated may pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant shall provide immediate written notice to the department, institution or office to
which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was
erroneous when submitted or had become erroneous by reason of changed circumstances.
4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person,
primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meaning
set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the
person to which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered
transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is
proposed for debarment under the applicable CFR, debarred, suspended, declared ineligible, or voluntarily excluded
from participation in this covered transaction, unless authorized by the department or agency with which this
transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled
"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered
Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered
transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered
transaction that it is not proposed for debarment under applicable CFR, debarred, suspended, ineligible, or voluntarily
excluded from covered transactions, unless it knows that the certification is erroneous. A participant may decide the
method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required
to, check the List of Parties Excluded from Federal Procurement and Non -procurement Programs.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to
render in good faith the certification required by this clause. The knowledge and information of a participant is not
required to exceed that which is normally possessed by a prudent person in the ordinary course of business activity.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction
knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under applicable
CFR, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other
remedies available to the Federal Government, the department or agency with which this transaction originated may
pursue available remedies, including suspension and/or debarment.
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion --Lower Tier
Covered Transactions
The prospective lower tier participant certifies, by submission of this proposal or contract, that neither it nor its
principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded
from participation in this transaction by any Federal department or agency. Where the prospective lower tier
participant is unable to certify to any of the statements in this certification, such prospective participant shall
attach an explanation to this form.
Bidder or Contractor Signature: Date: 3 —d3 > fU
Print Name and Title: Lynn Sterbenz, Director, JCDEM
FFATA FORM
Subrecipient Agency: Jefferson County Department of Emergency Management
Grant and Year: FFY2017 HSGP
I
Agreement Number: E18-151
Completed Lynn Sterbenz
by:
Director, JCDEM
360-316-6008
Name
Title
Telephone
Date Completed: March 23, 2018
STEP 1
Is your grant agreement less than $25,000?1:1analysis
YES
STOP, no further
needed,
GO to Step 6
NO
GO to Step 2
STEP 2
In your preceding fiscal year, did your
organization receive 80% or more of its annual
gross revenues from federal funding?
YES
1:1GO
to STEP 3
NO
STOP, no further
analysis needed, GO to
Step 6
STEP 3
In your preceding fiscal year, did your
organization receive $25,000,000 or more in
federal funding?
YES
1:11:1Step
GO to STEP 4
NO
STOP, no further
analysis needed, GO to
6
STEP 4
Does the public have access to information about
the total compensation' of senior executives in1:1analysis
your organization?
YES
STOP, no further
needed,
GO to step 6
NO
GO to STEP 5
STEP 5
Name:
Executive #1
Total Compensation amount: $
Name:
Executive #2
Total Compensation amount: $
Name:
Executive #3
Total Compensation amount: $
Name:
Executive #4
Total Compensation amount: $
Name:
Executive #5
Total Compensation amount: $
STEP 6
If your organization does not meet these criteria, specifically identify below each criteria that is not met for your
organization: For Example: "Our organization received less than $25,000."
Our organization received more than $25,000 from this grant agreement.
Signature: /," e;C��
z-�
Date: March 23, 2018
" Total compensation refers to:
• Salary and bonuses
• Awards of stock, stock options, and stock appreciation rights
• Other compensation including, but not limited to, severance and termination payments
• Life insurance value paid on behalf of the employee
Additional Resources:
http://www.whitehouse.gov/omb/open
hftp://www.hrsa.gov/qrants/ffata.htmi
httD://www.opo.00v/fdsys/pkq/FR-2010-09-14/pdf/2010-22705.pdf
http://www.grants.gov/
Page 1 of 3
FFATA PROVISIONS AND INSTRUCTIONS
For Compliance With The
Federal Funding Accountability and Transparency Act of 2006 (P.L. 109-282) (FFATA)
The Federal Funding Accountability and Transparency Act (FFATA) was signed on September
26, 2006. The FFATA legislation requires information on federal awards (federal financial
assistance and expenditures) be made available to the public via a single, searchable website.
Federal awards include grants, subgrants, loans, awards, cooperative agreements and other forms
of financial assistance as well as contracts, subcontracts, purchase orders, task orders, and
delivery orders. The legislation does not require inclusion of individual transactions below
$25,000 or credit card transactions before October 1, 2008. However, if an award is initially
below this amount yet later increased, the act is triggered. Due to this variability in compliance
Subrecipients are required by the Military Department to be familiar with the FFATA
requirements and complete this Worksheet for each contract for the State's submission in to the
FFATA portal.
ADDITIONAL PROVISIONS
A. This contract (subaward) is supported by federal funds, requiring compliance with the
Federal Funding Accountability and Transparency Act (FFATA or the Transparency Act)
and Office of Management and Budget Guidance (OMB). Public Law 109-282 as amended
by section 6202(a) of Public Law 110-252 (see 31 U.S.C. 6101 note). By entering into this
contract, contractor agrees to provide all applicable reporting information to the Washington
Military Department (WMD) required by FFATA and OMB Guidance.
B. The FFATA requires the OMB to establish a publicly available online database
(USASpending.gov) containing information about entities that are awarded Federal grants,
loans, and contracts. As required by FFATA and OMB Guidance, certain information on the
first-tier subawards related to Federal contracts and grants, and the executive compensation
of awardees, must be made publicly available.
C. For new Federal grants beginning October 1, 2010, if the initial subaward is equal to or
greater than $25,000, reporting of the subaward and executive compensation information is
required. If the initial subaward is below $25,000 but subsequent grant modifications result
in a total subaward equal to or over $25,000, the subaward will be subject to the reporting
requirements as of the date the subaward exceeds $25,000. If the initial subaward equals or
exceeds $25,000 but funding is subsequently de -obligated such that the total award amount
falls below $25,000, the subaward continues to be subject to the reporting requirements of
the Transparency Act and OMB Guidance.
D. As a Federal grant subawardee under this contract, your organization is required by FFATA,
OMB Guidance and this contract to provide the WMD, as the prime grant awardee, all
information required for FFATA compliant reporting by WMD. This includes all applicable
subawardee entity information required by FFATA and OMB Guidance, subawardee DUNS
number, and relevant executive compensation data, as applicable.
1. Data about your organization will be provided to USASpending.gov by the WMD.
System for Award Management (SAM) is a government wide registration system for
organizations that do business with the Federal Government. SAM stores information
about awardees including financial account information for payment purposes and a link
to D&B for maintaining current DUNS information, www.sam.gov. WMD requires SAM
registration and annual renewal by your organization to minimize unnecessary data entry
Page 1 of 2
and re-entry required by both WMD and your organization. It will also reduce the
potential of inconsistent or inaccurate data entry.
2. Your organization must have a Data Universal Numbering System (DUNS) number
obtained from the firm Dun and Bradstreet (D&B) (www.dnb.com). A DUNS number
provides a method to verify data about your organization. D&B is responsible for
maintaining unique identifiers and organizational linkages on behalf of the Federal
Government for organizations receiving Federal assistance.
E. The WMD, as the prime awardee, is required by FFATA to report names and total
compensation of the five (5) most highly compensated officers of your organization (as the
subawardee) if -
1.
i
1. Your organization (the subawardee), in the preceding fiscal year, received 80 percent or
more of its annual gross revenues from Federal awards and $25,000,000 or more in
annual gross revenues from Federal awards; and
2. The public does not have access to this information about the compensation of the senior
executives of your organization through periodic reports filed under section 13(a) or
15(d) of the Securities and Exchange Act of 1934 (15 U.S.C. §§ 78m(a), 78o(d) or
section 6104 of the Internal Revenue Code of 1986.
"Total compensation" for purposes of this requirement generally means the cash and non-
cash value earned by the executive during the past fiscal year and includes salary and bonus;
awards of stock, stock options and stock appreciation rights; and other compensation such as
severance and termination payments, and value of life insurance paid on behalf of the
employee, and as otherwise provided by FFATA and applicable OMB guidance.
F. If (1) in the preceding fiscal year your organization received 80 percent or more of its annual
gross revenues from Federal awards and $25,000,000 or more in annual gross revenues from
Federal awards, and (2) the public does not have access to this information about the
compensation of the senior executives of your organization through periodic reports filed
under section 13(a) or 15(d) of the Securities and Exchange Act of 1934 (15 U.S.C. §§
78m(a), 78o(d) or section 6104 of the Internal Revenue Code of 1986, insert the names and
total compensation for the five most highly compensated officers of your organization as
identified in Step 5 of the FFATA Form.
Page 2 of 2
SIGNATURE AUTHORIZATION FORM
WASHINGTON STATE MILITARY DEPARTMENT
Camp Murray, Washington 98430-5122
Please read instructions on reverse side before completing this form.
NAME OF ORGANIZATION
DATE SUBMITTED
Jefferson County Department of Emergency Management
March 23, 2018
PROJECT DESCRIPTION
CONTRACT NUMBER
FFY17 Homeland Security Grant Program
E18-151
1. AUTHORIZING AUTHORITY
SIGNATURE
PRINT OR TYPE NAME
TITLE/TERM OF OFFICE
David Sullivan
Chair, BOCC
Philip Morley
County Administrator
2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE
PRINT OR TYPE NAME
TITLE
David Sullivan
Chair, BOCC
Philip Morley
County Administrator
3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT
SIGNATURE
PRINT OR TYPE NAME
TITLE
Lynn Sterbenz
Director, JCDEM
Philip Morley
County Administrator
\\NAC-1\VOL1\HOME\KARENB\.... \WP\SIGNAUTH Revised 3/03
INSTRUCTIONS FOR SIGNATURE AUTHORIZATION FORM
This form identifies the persons who have the authority to sign contracts, amendments,
and requests for reimbursement. It is required for the management of your contract with
the Military Department (MD). Please complete all sections. One copy with original
signatures is to be sent to MD with the signed contract, and the other should be kept with
your copy of the contract.
When a request for reimbursement is received, the signature is checked to verify that it
matches the signature on file. The payment can be delayed if the request is
presented without the proper signature. It is important that the signatures in MD's files
are current. Changes in staffing or responsibilities will require a new signature
authorization form.
1. Authorizing Authority. Generally, the person(s) signing in this box heads
the governing body of the organization, such as the board chair or mayor. In
some cases, the chief executive officer may have been delegated this
authority.
2. Authorized to Sign Contracts/Contract Amendments. The person(s) with
this authority should sign in this space. Usually, it is the county
commissioner, mayor, executive director, city clerk, etc.
3. Authorized to Sign Requests for Reimbursement. Often the executive
director, city clerk, treasurer, or administrative assistant have this authority.
It is advisable to have more than one person authorized to sign
reimbursement requests. This will help prevent delays in processing a
request if one person is temporarily unavailable.
If you have any questions regarding this form or to request new forms, please call your
MD Program Manager.