HomeMy WebLinkAboutMason Conservation District - Interlocal Agreementroc, c.o wacA 23 -09-9
INTERAGENCY AGREEMENT
Between
MASON CONSERVATION DISTRICT
And
MASON COUNTY ENVIRONMENTAL HEALTH
This agreement is made by and between Mason Conservation District, hereinafter referred to as the
District, and Mason County Environmental Health, hereinafter referred to as Contractor pursuant to
authority granted by Chapter 39.34 RCW.
Purpose: The purpose of this agreement is to implement an education and outreach campaigns through
education outreach events workshops, and public meetings.
Therefore, it is mutually agreed that:
Statement of Work and Budget: The Contractor shall furnish the necessary personnel, equipment,
materials and/or services and otherwise do all things necessary for or incidental to the performance of
the work set forth in Exhibit A, attached hereto and incorporated herein.
Period of Performance: Subject to its other provisions, the period of performance of this Agreement
should commence on Date of Execution and be completed on June 30, 2026, unless terminated sooner
as provided herein. Any work done outside of the period of performance shall be provided at no cost to
the District.
Federal Funding Accountability and Transparency Act (FFATA): This Agreement is supported by federal
funds that require compliance with the Federal Funding Accountability and Transparency Act. The
purpose of the Transparency Act is to make information available online so the public can see how
federal funds are spent.
To comply with the act and be eligible to enter into this contract, your organization must have a Unique
Entity Identifier (UEI) number. A UEI number provides a method to verify data about your organization.
If you do not already have one, you may receive a UEI number free of charge by contacting System for
Award Management (SAM) at SAM.GOV.
Information about your organization and this Agreement will be made available by the pass through
entity (State of Washington Department of Health hereinafter referred to as DOH) on
www.USASpending.gov as required by P.L. 109-282.
Payment: Compensation for the work provided in accordance with this Agreement has been established
under the terms of RCW 39.34.130. The parties have estimated that the cost of accomplishing the work
herein will not exceed $57,480 in accordance with Exhibit A, attached hereto and incorporated herein.
Consideration includes but is not limited to all taxes, fees, surcharges, etc. Payment will not exceed the
amount without a prior written amendment. The District will authorize payment only upon satisfactory
completion and acceptance of the deliverables and for allowable costs as outlined in the statement of
work and/or budget.
Billing Procedure; Payment to the Contractor approved and completed work will be made by warrant by
the District within 30 clays of receipt of the invoice. Upon expiration of the Agreement, any claim for
payment not already made shall be submitted per the Statement of Work, Exhibit A (if applicable) or
within 30 days after the contract expiration date, whichever is earlier.
Agreement Alterations and Amendments: This Agreement may be amended by mutual agreement of
the parties subject to approval by the pass through entity (DOH). Such amendments shall not be binding
unless they are in writing and signed by personnel authorized to bind each of the parties.
Allowable Costs: Shall mean an expenditure which meets the test of the Uniform Guidance (2CFR 200)
(see "I. Federal Compliance"). The most significant factors affecting allowability of cost are: 1) they must
be necessary and reasonable, 2) they must be allocable, 3) they must be authorized or not prohibited
under State or local laws and regulations, and 4) they must be adequately documented. For more
specifics see Selected Items of Cost 2 CFR 200.420.
Assignment: The work to be provided under this Agreement, and any claim arising thereunder, is not
assignable or delegable by either part in whole or in part, with the express written consent of the other
party, which consent shall not be unreasonably withheld.
Confidentiality/Safeguarding of Information:: The use or disclosure by any party of any information
concerning a client obtained in provided service under this Agreement shall be subject to Chapter 42.56
RCW and Chapter 70.02 RCW, as well as any other applicable Federal and State statutes and regulations.
Any unauthorized access or use of confidential information must be reported to the District's Executive
Director at ebauder@masoncd.org . The notification must be made in the most expedient time possible
(usually within one business day of discovery) and without unreasonable delay, consistent with the
legitimate needs of law enforcement, or any measures necessary to determine the scope of the breach
and restore the reasonable integrity of the data system.
Contract: Shall mean the purpose of obtaining goods and services for the non -Federal entity's own use
and creates a procurement relationship with the Contractor. See §200.22 Contract. Characteristics
indicative of a procurement relationship between the non -Federal entity and a Contractor are when the
non -Federal entity receiving the Federal funds:
A. Provides the goods and services within normal business operations;
B. Provides similar goods or services to many different purchasers;
C. Normally operates in a competitive environment;
D. Provides goods or services that are ancillary to the operation of the Federal program; and
E. is not subject to compliance requirements of the Federal program as a result of the agreement,
though similar requirements may apply for other reasons.
Contractor: Shall mean that agency, firm, provider, organization, individual or other entity performing
services under this contract. It shall include any subcontractor retained by the prime contractor as
permitted under the terms of this contract,
Disputes: In the event that a dispute arises under this Agreement, it shall be determined by a Dispute
Board in the following manner: Each party to this agreement shall appoint one member to the Dispute
Board. The members so appointed shall jointly appoint an additional member to the Dispute Board. The
Dispute Board shall review the facts, Agreement terms and applicable statutes and rules and make a
determination of the dispute. The determination of the Dispute Board shall be final and binding on the
parties hereto. As an alternative to this process, either of the parties may request intervention by the
Governor, as provided by RCW 43.17.330, in which event the Governor's process will control.
Governance: This Agreement is entered into pursuant to and under the authority granted by the laws of
the State of Washington and any applicable federal laws. The provisions of this Agreement shall be
construed to conform to those laws. In the event of an inconsistency in the terms of this Agreement, or
between its terms and any applicable statute or rule, the inconsistency shall be resolved by giving
precedence in the following order:
A. Federal statutes and regulations
B. State statutes and regulations
C. Agreement amendments
D. The Agreement (in this order)
1. Federal compliance and Standard Federal Certifications and Assurances (Attachment 1)
2. primary document (document that includes the signature page)
3. Statement of Work (Exhibit A)
Independent Capacity: The employees or agents of each party who are engaged in the performance of
this Agreement shall continue to be employees or agents of that party and shall not be considered for
any purpose to be employees or agents of the other party.
Noncompliance Shall mean if a non -Federal entity fails to comply with Federal statutes, regulations or
the terms and conditions of a Federal award, the Federal awarding agency or pass -through entity may
impose additional conditions, as described In §200.207 Specific conditions. If the Federal awarding
agency or pass -through entity determines that noncompliance cannot be remedied by imposing
additional conditions, the Federal awarding agency or pass -through entity may take one or more of the
following actions, as appropriate in the circumstances:
A. Temporarily withhold cash payments pending correction of the deficiency by the non -Federal entity or
more severe enforcement action by the Federal awarding agency or pass -through entity.
B. Disallow (that is, deny both use of funds and any applicable matching credit for) all or part of the cost
of the activity or action not in compliance.
C. Wholly or partly suspend or terminate the Federal award.
D. Initiate suspension or debarment proceedings as authorized under 2 CFR part 180 and Federal
awarding agency regulations (or in the case of a pass -through entity, recommend such a proceeding be
Initiated by a Federal awarding agency).
E. Withhold further Federal awards for the project or program.
F. Take other remedies that may be legally available,
Privacy: Personal information collected, used or acquired in connection with this Agreement shall be
used solely for the purposes of this Agreement. Contractor and its subcontractors agree not to release,
divulge, publish, transfer, sell or otherwise make known to unauthorized persons personal Information
without the express written consent of the agency or as provided by law. Contractor agrees to
implement physical, electronic and managerial safeguards to prevent unauthorized access to personal
information.
The District reserves the right to monitor, audit or investigate the use of personal information collected,
used or acquired by the Contractor through this Agreement. The monitoring, auditing, or investigating
may include but is not limited to "salting" by The District. Contractor shall certify the return or
destruction of all personal information upon expiration of this Agreement. Salting is the act of placing a
record containing unique but false information in a database that can be used later to identify
inappropriate disclosure of data contained in the database.
Any breach of this provision may result in termination of the Agreement and the demand for return of all
personal information. The contractor agrees to indemnify and hold harmless the District for any
damages related to the Contractor's unauthorized use of personal information.
Records Maintenance: The parties to this Agreement shall each maintain books, records, documents and
other evidence which sufficiently and properly reflect all direct and indirect costs expended by either
party in the performance of the services described herein. These records shall be subject to inspection,
review or audit by personnel of both parties, other personnel duly authorized by either party, the Office
of the State Auditor, and federal officials so authorized by law. All books, records, documents, and other
material relevant to this Agreement will be retained for six years after expiration and the Office of the
State Auditor, federal auditors, and any persons duly authorized by the parties shall have full access and
the right to examine any of these materials during this period. Records and other documents, in any
medium, furnished by one party to this Agreement to the other party, will remain the property of the
furnishing party, unless otherwise agreed. The receiving party will not disclose or make available this
material to any third parties without first giving notice to the furnishing party and giving it a reasonable
opportunity to respond. Each party will utilize reasonable security procedures and protections to assure
that records and documents provided by the other party are not erroneously disclosed to third parties.
Rights in Data: Unless otherwise provided, data, which originates from this Agreement shall be "works
for hire" as defined by the U.S. Copyright Act of 1976 and shall be owned by the District. Data shall
include, but not be limited to, reports, documents, pamphlets, advertisements, books magazines,
surveys, studies, computer programs, films, tapes, and/or sound reproductions. Ownership includes the
right to copyright, patent, register, and the ability to transfer these rights.
Risk Assessment: Shall mean (2 CFR 200.331(b)) The District is required to evaluate each subrecipient's
risk of noncompliance with Federal statutes, regulations, and the terms and conditions of the subaward
for purposes of determining the appropriate subrecipient monitoring described in paragraphs (d) and (e)
of this section, which may include consideration of such factors as:
A. The subrecipient's prior experience with the same or similar subawards;
B. The results of previous audits including whether or not the subrecipient receives a Single Audit in
accordance with Subpart F—Audit Requirements of this part, and the extent to which the same or
similar subaward has been audited as a major program;
C. Whether the subrecipient has new personnel or new or substantially changed systems; and
D. The extent and results of Federal awarding agency monitoring (e.g., if the subrecipient also receives
Federal awards directly from a Federal awarding agency).
Severability: If any provision of this Agreement or any provision of any document incorporated by
reference shall be held invalid, such invalidity shall not affect the other provisions of this Agreement
which can be given effect without the invalid provision, if such remainder conforms to the requirements
of applicable law and the fundamental purpose of this Agreement, and to this end the provisions of this
Agreement are declared to be severable.
Specific Conditions:
A. The Federal awarding agency or pass -through entity may impose additional specific award conditions
as needed, in accordance with (2 CFR 200.207) paragraphs (b) and (c) of this section, under the following
circumstances;
1. Based on the criteria set forth in §200.205 Federal awarding agency review of risk posed by
applicants;
2. When an applicant or recipient has a history of failure to comply with the general or specific
terms and conditions of a Federal award;
3. When an applicant or recipient fails to meet expected performance goals as described in
§200.210 Information contained in a Federal award; or
4. When an applicant or recipient is not otherwise responsible.
B. These additional Federal award conditions may include items such as the following:
1. Requiring payments as reimbursements rather than advance payments;
2. Withholding authority to proceed to the next phase until receipt of evidence of acceptable
performance within a given period of performance;
3. Requiring additional, more detailed financial reports;
4, Requiring additional project monitoring;
5. Requiring the non -Federal entity to obtain technical or management assistance; or
6. Establishing additional prior approvals.
C. The Federal awarding agency or pass -through entity must notify the applicant or non -Federal entity as
to:
1. The nature of the additional requirements;
2. The reason why the additional requirements are being imposed;
3. The nature of the action needed to remove the additional requirement, if applicable;
4. The time allowed for completing the actions if applicable, and
5. The method for requesting reconsideration of the additional requirements imposed.
D. Any specific conditions must be promptly removed once the conditions that prompted them have
been corrected
Subcontracting: Neither the Contractor, nor any subcontractors, shall enter into subcontracts for any of
the work contemplated under this agreement without prior written approval of the District and DOH. In
no event shall the existence of the sub operate to release or reduce the liability of the Contractor to the
District for any breach in the performance of the contractor's duties. This clause does not include
contracts of employment between the contractor and personnel assigned to work under this Agreement.
Additionally, the Contractor Is responsible for ensuring that all terms, conditions, assurances and
certifications set forth in this Agreement are carried forward to any subcontracts. Contractor and its
subcontractors agree not to release, divulge, publish, transfer, sell or otherwise make known to
unauthorized persons personal information without the express written consent of the District or as
provided by law.
If, at any time during the progress of the work, the District determines in its sole judgment that any
subcontractor is incompetent, the District shall notify the Contractor, and the Contractor shall take
immediate steps to terminate the subcontractor's involvement in the work. The rejection or approval by
the District of any subcontractor or the termination of a subcontractor shall not relieve the Contractor of
any of Its responsibilities under the Agreement, nor be the basis for additional charges to the District.
Subrecipient: Shall mean a non -Federal entity that received a subaward from a pass -through entity to
carry out part of a Federal program; but does not include an individual that is a beneficiary of such
program. A subrecipient may also be a recipient of other Federal awards directly from a Federal
awarding agency. (2 CFR 200.93)
Characteristics which support the classification of the non -Federal entity as a subrecipient include when
the non -Federal entity:
A. Determines who is eligible to receive what Federal assistance;
B. Has its performance measured in relation to whether objectives of a Federal program were met;
C. Has responsibility for programmatic decision making;
D. Is responsible for adherence to applicable Federal program requirements specified in the Federal
award; and
E. In accordance with its contract, uses the Federal funds to carry out a program for a public purpose
specified in authorizing statute, as opposed to providing goods or services for the benefit of a
passthrough entity.
Suspension of Performance and Resumption of Performance: In the event contract 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, the District may give notice to Contractor to suspend
performance as an alternative to termination. The District may elect to give written notice to Contractor
to suspend performance when the District determines that there is a reasonable likelihood that the
funding insufficiency may be resolved in a timeframe that would allow performance to be resumed prior
to the end date of this Agreement. Notice may include notice by facsimile or email to Contractor's
representative. Contractor shall suspend performance on the date stated In the written notice to
suspend. During the period of suspension of performance each party may inform the other of any
conditions that may reasonably affect the potential for resumption of performance.
When the District determines that the funding insufficiency is resolved, the District may give Contractor
written notice to resume performance and a proposed date to resume performance. Upon receipt of
written notice to resume performance, Contractor will give written notice to the District as to whether it
can resume performance, and, if so, the date upon which it agrees to resume performance. If Contractor
gives notice to the District that it cannot resume performance, the parties agree that the Agreement will
be terminated retroactive to the original date of termination. If the date Contractor gives notice it can
resume performance is not acceptable to the District, the parties agree to discuss an alternative
acceptable date. If an alternative date is not acceptable to the District, the parties agree that the
Agreement will be terminated retroactive to the original date of termination.
Termination: Either party may terminate this Agreement upon 30 days prior written notification to the.
other party. If this Agreement is so terminated, the parties shall be liable only for performance rendered
or costs incurred in accordance with the terms of this Agreement prior to the effective date of
termination.
Termination for Cause: If for any cause, either party does not fulfill in a timely and proper manner its
obligations under this Agreement, or if either party violates any of these terms and conditions, the
aggrieved party will give the other party written notice of such failure or violation. The responsible party
will be given the opportunity to correct the violation or failure within 15 working days. If the failure or
violation is not corrected, this Agreement may be terminated immediately by written notice of the
aggrieved party to the other.
Waiver: A failure by either party to exercise its rights under this Agreement shall not preclude that party
from subsequent exercise of such rights and shall not constitute a waiver of any other rights under this
Agreement unless stated to be such in a writing signed by an authorized representative of the party and
attached to the original Agreement.
All Writing Contained Herein: This Agreement contains all the terms and conditions agreed upon by the
parties. 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 Witness Whereof, the parties have executed this Agreement.
Tim Whiteh , hte'f'rTepuiy Prosecutor
Mason County Environmental Health, AS /+ fz�
Sharon Trask, Chair, Board of County Commissioners
Mason County Environmental Health
Date
\DJ kOI 2023
Date
JasjlRagan, Chair, Board ofpervisors Date
Mason Conservation District
EXHIBIT A
STATEMENT OF WORK
MCD Contract #
Mason County Environmental Health
Mason County Environmental Health Community Engagement
Mason County Environmental Health will conduct two community meetings annually for the three year
lifespan of the grant targeting North Bay, Site #10 (Mason County North) and Oakland Bay, Site #8
(Oakland Bays) —for a target of 6 total. MCEH will distribute educational mailings and public meeting
notifications for each public meeting.
North and Oakland Bays are part of a listed threatened Shellfish Growing Area and potentially face a
downgrade in status. The purpose of the engagement Is to educate and create awareness of actions
residents can take to mitigate pollution sources in North and Oakland Bays.
Budget not to exceed $57,480.
EXHIBIT A
STATEMENT OF WORK
MCD Contract #
Mason County Environmental Health
Terms and Conditions
A. Recognition of EPA Funding;
Reports, documents, signage, videos, or other media, developed as part of projects funded by this
assistance agreement shall contain the following statement:
"This project has been funded wholly or in part by the United States Environmental Protection Agency
under assistance agreement PC-01J89801 to the Washington State Department of Health. The contents
of this document do not necessarily reflect the views and policies of the Environmental Protection
Agency, nor does mention of trade names or commercial products constitute endorsement or
recommendation for use."
B. Lobbying
The chief executive officer of this subrecipient agency shall ensure that no grant funds awarded under
this assistance agreement are used to engage in lobbying of the Federal Government or in litigation
against the U.S. unless authorized under existing law. The subrecipient shall abide by the Cost Principles
available at 2 CFR 200 which generally prohibits the use of federal grant funds for litigation against the
U.S. or for lobbying or other political activities.
C. Copyrighted Materials:
In accordance with 2 CFR 200.315, EPA has the right to reproduce, publish, use and authorize others to
reproduce, publish and use copyrighted works or other data developed under this assistance agreement
for Federal purposes. Examples of a Federal purpose include but are not limited to: (1) Use by EPA and
other Federal employees for official Government purposes; (2) Use by Federal contractors performing
specific tasks for the Government; (3) Publication in EPA documents provided the document does not
disclose trade secrets (e.g, software codes) and the work is properly attributed to the subrecipient
through citation or otherwise; (4) Reproduction of documents for inclusion in Federal depositories; (5)
Use by State, tribal and local governments that carry out delegated Federal environmental programs as
"co -regulators" or act as official partners with EPA to carry out a national environmental program within
their jurisdiction and; (6) Limited use by other grantees to carry out Federal grants provided the use is
consistent with the terms of EPA's authorization to the other grantee to use the copyrighted works or
other data.
D. Light Refreshments and/or Meals
Unless the event(s) and all of its components are described in the approved workplan, the subrecipient
agrees to obtain prior approval from EPA for the use of grant funds for light refreshments and/or meals
served at meetings, conferences, training workshops and outreach activities (events). The subrecipient
must send requests for approval to the NEP Contract Manager and include:
1. An estimated budget and description for the Tight refreshments, meals, and/or beverages to
be served at the event(s);
2. A description of the purpose, agenda, location, length and timing for the event; and,
3. An estimated number of participants in the event and a description of their roles.
Costs for light refreshments and meals for subrecipient staff meetings and similar day-to-day activities
are not allowable under EPA assistance agreements. Subrecipients may address questions about whether
costs for light refreshments, and meals for events may be allowable to the subrecipient's NEP Contract
Manager; however, the Agency Award Official or Grant Management Officer will make final
determinations on allowability.
Agency policy prohibits the use of EPA funds for receptions, banquets and similar activities that take
place after normal business hours unless the subrecipient has provided a justification that has been
expressly approved by EPA's Award Official or Grants Management Officer.
EPA funding for meals, light refreshments, and space rental may not be used for any portion of an event
where alcohol is served, purchased, or otherwise available as part of the event or meeting, even if EPA
funds are not used to purchase the alcohol.
Note: U.S. General Services Administration regulations define light refreshments for morning, afternoon
or evening breaks to include, but not be limited to, coffee, tea, milk, juice, soft drinks, donuts, bagels,
fruit, pretzels, cookies, chips, or muffins. (41 CFR 301-74.7)
General information
Subrecipient Name: Mason County Environmental Health
Subrecipient Unique Identifier:
Federal Award Identification Number: PC-01J89801-1
Pass -Through Entity Subaward Number: C8028192-0
Federal Award Date: 5/31/22
Subaward Period of Performance: July 24, 2023 to June 30, 2026
Name of Federal Awarding Agency: United State Environmental Protection Agency
Name of First Pass -Through Entity: Washington State Department of Health
Name of Second Pass -Through Entity: Mason Conservation District
CFDA Number: 66.123
CFDA Program Title: Puget Sound Action Agenda: Technical Investigations and Implementation
Assistance Program
Amount of Federal Funds Obligated by this Action: $57,480
ATTACHMENT 1
FEDERAL COMPLIANCE
AND STANDARD FEDERAL CERTIFICATIONS AND ASSURANCES
I. FEDERAL COMPLIANCE - The use of federal funds requires additional compliance and control
mechanisms to be in place. The following represents the majority of compliance elements that may
apply to any federal funds provided under this contract. (Refer to Catalog of Domestic Assistance
number(s) cited in the "Payment" section of this contract for requirements specific to that fund
source,) For clarification regarding any of these elements or details specific to the federal funds in
this contract, contact:
Compliance and Internal Control Officer
Office of Financial Services
Department of Health
Post Office Box 47901
Olympia, Washington 98504-7901
1, UNIFORM ADMINISTRATIVE GUIDANCE — The Uniform Administrative Guidance (Supercircular)
became effective December 26, 2014 and combines numerous OMB Circulars into one document.
This document established requirements which govern expenditure of federal funds. These
requirements apply to the. Department of Health, as the primary recipient of federal funds, and then
follow the funds to the subrecipient. The Uniform Administrative Guidance provides the applicable
administrative requirements, cost principles, and audit requirements are identified by subrecipient
organization type,
Compliance Matrix
OMB Circular
Entity Type
Administrative
Requirements
Cost
Principles
Audit
Requirements
State, Local and Indian Tribal
Governments & Governmental
Hospitals
2 CFR 200
Subpart D
2 CFR 200
Subpart E
2 CFR 200
Subpart F
Non -Profit Organizations
2 CFR 200
Subpart D
2 CFR 200
Subpart E
2 CFR 200
Subpart F
Hospitals
2 CFR 200
Subpart D
2 CFR 200
Appendix E
2 CFR 200
Subpart F
Colleges or Universities &
Affiliated Hospitals
2 CFR 200
Subpart D
2 CFR 200
Subpart E
2 CFR 200
Subpart F
2, CITIZENSHIP/ALIEN VERIFICATION/DETERMINATION - The Personal Responsibility and Work
Opportunity Reconciliation Act (PRWORA) of 1996 (PL 104-193) states that federal public benefits
should be made available only to U.S. citizens and qualified aliens. Entities that offer a service
defined as a "federal public benefit" must make a citizenship/qualified alien determination/
verification of applicants at the time of application as part of the eligibility criteria. Non -US citizens
and unqualified aliens are not eligible to receive the services. PL 104-193 also includes specific
reporting requirements. Exemptions from the determination/verification requirement is afforded the
following programs offered by the Department of Health: Family Planning, Breast, Cervical and Colon
Health Program (BCCHP), Special Supplemental Nutrition Program for Women, Infants, and Children
(WIC), WIC Farmers Market Program, Immunization Programs, and Ryan White CARE Act programs
and other communicable disease treatment and diagnostic programs.
3, CIVIL RIGHTS AND NONDISCRIMINATION - During the performance of this agreement, the
Contractor shall comply with all current and future federal statutes relating to nondiscrimination.
These include but are not limited to: Title VI of the Civil Rights Act of 1964 (PL 88-352), Title IX of the
Education Amendments of 1972 (20 U.S.C. §§ 1681-1683 and 1685- 1686), section 504 of the
Rehabilitation Act of 1973 (29 U.S.C. § 794), the Age Discrimination Act of 1975 (42 U.S.C. §§ 6101-
6107), the Drug Abuse Office and Treatment Act of 1972 (PL 92-255), the Comprehensive Alcohol
Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), §§523 and
527 of the Public Health Service Act of 1912 (42 U.S.C. §§290dd3 and 290ee-3), Title VIII of the Civil
Rights Act of 1968 (42 U.S.C. §§3601 et seq.), and the Americans with Disability Act (42 U,S.C.,
Section 12101 et seq.).
4. SINGLE AUDIT ACT - A subrecipient (including private, for -profit hospitals and non-profit
institutions) shall adhere to the federal Uniform Administrative Guidance (subpart F) as well as all
applicable. Federal and State statutes and regulations. A subrecipient who expends $750,000 or more
in federal awards during a given fiscal year shall have a single or program -specific audit for that year
in accordance with the provisions of 2 CFR 200 Subpart F.
II. STANDARD FEDERAL CERTIFICATIONS AND ASSURANCES - Following are the Assurances,
Certifications, and Special Conditions that apply to all federally funded (in whole or in part)
agreements administered by the Washington State Department of Health.
CERTIFICATIONS
1. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
The undersigned (authorized official signing for the contracting organization) certifies to the best of
his or her knowledge and belief, that the contractor, defined as the primary participant in
accordance with 45 CFR Part 76, and its principals:
A. are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any Federal Department or agency;
B. have not within a 3-year period preceding this contract been convicted of or had a civil judgment
rendered against them for commission of fraud or a criminal offense in connection with obtaining,
attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a
public transaction; violation of Federal or State antitrust statutes or commission of embezzlement,
theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving
stolen property;
C. are not presently indicted or otherwise criminally or civilly charged by a governmental entity
(Federal, State, or local) with commission of any of the offenses enumerated in paragraph (b) of this
certification; and
D. have not within a 3-year period preceding this contract had one or more public transactions
(Federal, State, or local) terminated for cause or default.
Should the contractor not be able to provide this certification, an explanation as to why should be
placed after the assurances page in the contract.
The contractor agrees by signing this contract that it will include, without modification, the clause
titled Certification Regarding Debarment, Suspension, In eligibility, and Voluntary Exclusion-- Lower
Tier Covered Transactions in all lower tier covered transactions (i.e., transactions with subgrantees
and/or contractors) and in all solicitations for lower tier covered transactions in accordance with 45
CFR Part 76.
2. CERTIFICATION REGARDING DRUG -FREE WORKPLACE REQUIREMENTS
The undersigned (authorized official signing for the contracting organization) certifies that the
contractor will, or will continue to, provide a drug -free workplace in accordance with 45 CFR Part 76
by:
A. Publishing a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession or use of a controlled substance is prohibited in the grantee's workplace and
specifying the actions that will be taken against employees for violation of such prohibition;
B. Establishing an ongoing drug -free awareness program to inform employees about:
1) The Dangers of drug abuse in the workplace;
2) The contractor's policy of maintaining a drug -free workplace;
3) Any available drug counseling, rehabilitation, and employee assistance programs; and
4) The penalties that may be Imposed upon employees for drug abuse violations occurring in the
workplace;
C. Making it a requirement that each employee to be engaged in the performance of the contract be
given a copy of the statement required by paragraph 1) above;
D. Notifying the employee in the statement required by paragraph 1), above, that, as a condition of
employment under the contract, the employee will:
1) Abide by the terms of the statement; and
2) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute
occurring in the workplace no later than five calendar days after such conviction;
E. Notifying the agency in writing within ten calendar days after receiving notice under paragraph D.
2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted
employees must provide notice, including position title, to every contract officer or other designee
on whose contract activity the convicted employee was working, unless the Federal agency has
designated a central point for the receipt of such notices. Notice shall include the identification
number(s) of each affected grant;
F. Taking one ofthe following actions, within 30 calendar days of receiving notice under paragraph D.
2) with respect to any employee who is so convicted;
1) Taking appropriate personnel action against such an employee, up to and including termination,
consistent with the requirements of the Rehabilitation Act of 1973, as amended; or
2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation
program approved for such purposes by a Federal, State, or local health, law enforcement, or other
appropriate agency;
G. Making a good faith effort to continue to maintain a drug -free workplace through implementation
of paragraphs (A), (B), (C), (D), (E), and (F).
For purposes of paragraph (E) regarding agency notification of criminal drug convictions, the District
has designated the following central point for receipt of such notices;
Finance & Administration Manager
Mason Conservation District
450 W Business Park Rd
Shelton, WA 98584
3. CERTIFICATION REGARDING LOBBYING
Title 31, United States Code, Section 1352, entitled "Limitation on use of appropriated funds to
influence certain Federal contracting and financial transactions," generally prohibits recipients of
Federal grants and cooperative agreements from using Federal (appropriated) funds for lobbying the
Executive or Legislative Branches ofthe Federal Government in connection with a SPECIFIC grant or
cooperative agreement. Section 1352 also requires that each person who requests or receives a
Federal grant or cooperative agreement must disclose lobbying undertaken with nonFederal (non -
appropriated) funds. These requirements apply to grants and cooperative agreements EXCEEDING
$100,000 in total costs (45 CFR Part 93).
The undersigned (authorized official signing for the contracting organization) certifies, to the best of
his or her knowledge and belief, that;
A. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned,
to any person for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress
in connection with the 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.
B. If any funds other than Federally 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 Federal contract, grant, loan, or cooperative agreement, the undersigned shall
complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its
instructions. (If needed, Standard Form-LLL, "Disclosure of Lobbying Activities," its instructions, and
continuation sheet are included at the end of this application form.)
C. The undersigned shall require that the language of this certification be included in the award
documents for all subcontracts at all tiers (including subcontracts, subcontracts, 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. Submission of this certification is a prerequisite for making or
entering into this transaction imposed by Section 1352, U.S. Code. Any person who fails to file the
required certification shall be subject to a civil penalty of not Tess than $10,000 and not more than
$100,000 for each such failure.
4. CERTIFICATION REGARDING PROGRAM FRAUD CIVIL REMEDIES ACT (PFCRA)
The undersigned (authorized official signing for the contracting organization) certifies that the
statements herein are true, complete, and accurate to the best of his or her knowledge, and that he
or she is aware that any false, fictitious, or fraudulent statements or claims may subject him or her to
criminal, civil, or administrative penalties. The undersigned agrees that the contracting organization
will comply with the Public Health Service terms and conditions of award if a contract is awarded..
5. CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE
Public Law 103-227, also known as the Pro -Children Act of 1994 (Act), requires that smoking not be
permitted in any portion of any indoor facility owned or leased or contracted for by an entity and
used routinely or regularly for the provision of health, day care, early childhood development
services, education or library services to children under the age of 18, if the services are funded by
Federal programs either directly or through State or local governments, by Federal grant, contract,
loan, or loan guarantee. The law also applies to children's services that are provided in indoor
facilities that are constructed, operated, or maintained with such Federal funds. The law does not
apply to children's services provided in private residence, portions of facilities used for inpatient drug
or alcohol treatment, service providers whose sole source of applicable Federal funds is Medicare or
Medicaid, or facilities where WIC coupons are redeemed.
Failure to comply with the provisions of the law may result in the imposition of a civil monetary
penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance
order on the responsible entity.
By signing the certification, the undersigned certifies that the contracting organization will comply
with the requirements of the Act and will not allow smoking within any portion of any indoor facility
used for the provision of services for children as defined by the Act.
The contracting organization agrees that it will require that the language of this certification be
included In any subcontracts which contain provisions for children's services and that all
subreclpients shall certify accordingly.
The Public Health Services strongly encourages all recipients to provide a smoke -free workplace and
promote the non-use of tobacco products. This is consistent with the PHS mission to protect and
advance the physical and mental health of the American people.
6, CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS
INSTRUCTIONS FOR CERTIFICATION
By signing and submitting this proposal, the prospective contractor is providing the certification set
out below.
A. The inability of a person to provide the certification required below will not necessarily result in
denial of participation in this covered transaction. The prospective contractor shall submit an
explanation of why it cannot provide the certification set out below. The certification or explanation
will be considered in connection with the department or agency's determination whether to enter
into this transaction. However, failure of the prospective contractor to furnish a certification or an
explanation shall disqualify such person from participation in this transaction.
B. The certification in this clause is a material representation of fact upon which reliance was placed
when the department or agency determined to enter into this transaction. If it is later determined
that the prospective contractor knowingly rendered an erroneous certification, in addition to other
remedies available to the Federal Government, the department or agency may terminate this
transaction for cause of default.
C. The prospective contractor shall provide immediate written notice to the department or agency to
whom this contract is submitted if at any time the prospective contractor learns that its certification
was erroneous when submitted or has become erroneous by reason of changed circumstances.
D. 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 meanings set out in the Definitions and Coverage sections of the rules
implementing Executive Order 12549. You may contact the person to whom this contract is
submitted for assistance in obtaining a copy of those regulations.
E. The prospective contractor agrees by submitting this contract 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 debarred, suspended, declared ineligible, or voluntarily excluded from participation
in this covered transaction, unless authorized by the District.
F. The prospective contractor further agrees by submitting this contract that it will include the clause
titled Certification Regarding Debarment, Suspension, ineligibility and Voluntary Exclusion -- Lower
Tier Covered Transaction, provided by HHS, without modification, in all lower tier covered
transactions and in all solicitations for lower tier covered transactions.
G. 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 debarred, suspended, ineligible, or voluntarily excluded
from the covered transaction, 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 Non -procurement List (of excluded parties).
H. 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 dealings.
I, Except for transactions authorized under paragraph 6 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the District may terminate this
transaction for cause or default.
7. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS -
PRIMARY COVERED TRANSACTIONS
A. The prospective contractor certifies to the best of its knowledge and belief, that it and its
principals:
1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any Federal department or agency;
2) Have not within a three-year period preceding this contract been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection
with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction
or contract under a public transaction; violation of Federal or State antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
3) Are not presently indicted for or otherwise criminally or civilly charged by a governmental •
entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph
1. B. of this certification; and
4) Have not within a three-year period preceding this contract had one or more public
transactions (Federal, State or local) terminated for cause or default.
B. Where the prospective contractor is unable to certify to any of the statements in this certification,
such prospective contractor shall attach an explanation to this contract.
FEDERAL ASSURANCES - NON -CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 15 minutes per
response, including time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. Send
comments regarding the burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction
Project (0348-0040), Washington, DC 20503
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET.
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have
questions, please contact the awarding agency. Further, certain Federal awarding agencies may require
applicants to certify to additional assurances. If such is the case, you will be notified,
As the duly authorized representative of the contractor, I certify that the contractor:
1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial
capability (including funds sufficient to pay the non -Federal share of project cost) to ensure proper
planning, management, and completion of the project described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the
State, through any authorized representative, access to and the right to examine all records, books,
papers, or documents related to the award; and will establish a proper accounting system in accordance
with generally accepted accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that
constitutes or presents the appearance of personal or organizational conflict of interest, or personal
gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the
awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§4728-4763) relating to
prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations
specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900,
Subpart F).
6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited
to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of
race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C.
§§1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the
Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of
handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §§ 6101-6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse Ofiice and Treatment Act of 1972 (P.L. 92-255), as
amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse
and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating
to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§ 523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. §§ 290 dd-3 and 290 ee 3), as amended, relating to confidentiality of
alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. § 3601 et
seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other
nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is
being made; and (j) the requirements of any other nondiscrimination statute(s) which may apply to the
application.
7. Will comply, or has already complied, with the requirements of Titles II and ill of the uniform
Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for
fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or
federally assisted programs. These requirements apply to all interests in real property acquired for
project purposes regardless of Federal participation in purchases.
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. 01501-1508 and 7324- 7328)
which limit the political activities of employees whose principal employment activities are funded in
whole or in part with Federal funds.
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §§276a to 276a-7),
the Copeland Act (40 U.S.C. §276c and 18 U.S.C. 0874) and the Contract Work Hours and Safety
Standards Act (40 U.S.C. §§ 327-333), regarding labor standards for federally assisted construction
subagreements.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood
Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to
participate in the program and to purchase flood insurance if the total cost of insurable construction and
acquisition is $10,000 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a)
institution of environmental quality control measures under the National Environmental Policy Act of
1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO
11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplalns in
accordance with EO 11988; (e) assurance of project consistency with the approved State management
program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. 01451 et seq.); (f)
conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear
Air Act of 1955, as amended (42 U.S.C. 07401 et seq.); (g) protection of underground sources of
drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection
of endangered species under the Endangered Species Act of 1973, as amended, (P.L, 93-205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§1721 et seq.) related to
protecting components or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic
Preservation Act of 1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of
historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §§469a1 et
seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research,
development, and related activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C.
§§2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for
research, teaching, or other activities supported by this award of assistance,
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §§4801 et seq.) which
prohibits the use of lead- based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the
Single Audit Act Amendments of 1996 and OMB Super circular 2CFR200, Subpart F.
18. Will comply with 2CFR200.216 - Prohibition on certain telecommunications and video surveillance
services or equipment - as amended effective August 13, 2020, and any amendments to this section
thereafter
19. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations
and policies governing this program.