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.HOMELAND SECURITY GRANT AGREEMENT FACE SHEET
1. Subrecipient Name and Address: 2. Grant Agreement Amount: 3. Grant Agreement Number.
County of Mason
Division of Emergency Management $13,001 E16-221
100 W Public Works Drive,Building 1
Shelton,WA 98684-9714
4. Subrecipient Contact,phone/email: 5. Grant Agreement Start Date: 6. Grant Agreement End Date:
Ross McDowell,(360)427-9670 x806 g/1/2015 3/31/2017
rmcdowell co.mason.wa.us
7. Department Program Coordinator, phone/email: 8. Data Universal Numbering System 9. UBI#(state revenue):
Matt Robbins,(253)512-7472 (DUNS): 232.002-101
matt.robbins atmil.wa.gov 069580751
10, Funding Authority:
Washington State Military De artment 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-2015SS-00013S01 08/12/2015 1 97.067—HSGP(15SHSP)
14. Total Federal Award Amount: 15. Program Index#&OBJ/SUB-OBJ: 16. TIN:
$13,612,908 753SZ,753SH,753SB,753SL,753SC,753SQ I NZ 91-6001354
17. Service Districts: 18. Service Area by County(les): 19. Women/Minority-Owned,State
BY LEGISLATIVE DISTRICTS:35 Mason County 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 ElOther ❑ 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 FFY 2015 Homeland Security Grant Program(I5HSGP) 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. 15HSGP
provides funding to implement investments that build,sustain,and deliver the core capabilities essential to achieving the National Preparedness
Goal of a secure and resilient,Nation.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.15HSGP 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,training,exercises,
and management and administration,
The Department is the Recipient and Pass-through Entity of the 15HSGP Award,which is incorporated in and attached hereto as Attachment#1,
and has made 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 preparedness activities(scope),timeline(schedule) and budget for the
subaward are detailed in Exhibits C,D,and E.Highlighted information in Exhibit C,Work Plan/Approved Projects,denote project scope that needs
further development.This will be completed through amendment of this Agreement and by the timespecified in Exhibit D,Timeline.
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);Work Plan/Approved Projects(Exhibit C);Timeline(Exhibit D);
Budget(Exhibit E);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. Approved Projects 6.Other provisions of the Agreement incorporated by
reference.
WHEREAS,the parties hereto have executed this Agreement on the day a year last specified below.
FOR THE DEPARTM T: '21FO HE RECI I NT
G - ,
Signature Date Signature Date
Richard A.Woodruff,Contracts Officer Ross McDowell
Washington State Military Department Mason County Division of Emergency Management
BOILERPLATE APPROVED TO FORM: APPROV S TO FORM(if applicable):
Brian E. Buchholz(signature on file 919/2015)
Assistant Attomey General =7q�is nfs L aLR view (� to `C
Form 09/09/2015 mil
DHS-FEMA-HSGP-SHSP-FFY15 Page 1 of 25 Mason County,E16-221
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 Ross McDowell Name Matt Robbins
Title Emergency Management Manager Title Program Coordinator
E-Mail rmcdowell(a)-co.mason.wa.us E-Mail matt.robbinsamil.wa.gov
Phone (360) 427-9670 x806 Phone (253) 512-7472
Name I Frank Pinter Name Sierra Wardell
Title Budget Director Title Section Supervisor
E-Mail fpinter(q-)co.mason.wa.us E-Mail sierra.wardell@mil.wa.gov
Phone (360) 427-9670 x530 Phone (253) 512-7121
Name Name Dalton Gamboa
Title Title Program Assistant
E-Mail E-Mail dalton.gamboa(a)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 FEMA applicable to the 15HSGP Program, including, but not limited to, all
criteria, restrictions, and requirements of the "Department of Homeland Security Notice of Funding
Opportunity Fiscal Year 2015 Homeland Security Grant Program" document published by FEMA,
the DHS Award Letter for Grant No. EMW-2015-SS-00013-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 15HSGP 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:
i. The Subrecipient must comply with all federal laws and regulations
applicable to pass-through entities of 15HSGP funds, including but not
limited to those contained in 2 CFR 200.
ii. 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
DHS-FEMA-HSGP-SHSP-FFY15 Page 2 of 25 Mason County, E16-221
informational documents published by DHS/FEMA applicable to the
15HSGP Program, including, but not limited to, all criteria, restrictions,
and requirements of the "Department of Homeland Security Notice of
Funding Opportunity Fiscal Year 2015 Homeland Security Grant
Program" document published by FEMA, the DHS Award Letter for
Grant No. EMW-2015-SS-00013-S01 in Attachment #1, and the
federal regulations commonly applicable to DHS/FEMA grants
iii. The Subrecipient shall be responsible to the Department for ensuring
that all 15HSGP 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. REIMBURSEMENT & BUDGET REQUIREMENTS
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(Exhibit
E), 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 VI 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 indirect cost rate percentage identified
in Exhibit E, Budget. 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 Key
Personnel for approval with an explanation for the change.
d. For travel costs, Subrecipients 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 local, state, or federal
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 ReimbursementsC@,mil.wa.gov no later than the due
dates listed within the Milestone Timeline (Exhibit D), but not more frequently
than monthly.
DHS-FEMA-HSGP-SHSP-FFY15 Page 3 of 25 Mason County, E16-221
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
Milestone Timeline (Exhibit D) and instead submit those costs on the next
scheduled reimbursement due date contained in the Milestone Timeline.
g. Any request for extension of a due date in the Milestone Timeline (Exhibit D)
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.
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 and reimbursement requests as
required by this Agreement (including but not limited to those reports in the
Milestone Timeline) will prohibit the Subrecipient from being reimbursed until
such complete reports and reimbursement requests 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 between budget categories, as identified in the Budget (Exhibit E)
and Work Plan/Approved Project (Exhibit C), to exceed 10% of the Grant
Agreement Amount. Any adjustments to budget category totals not 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.
2. REPORTING REQUIREMENTS
a. The Subrecipient shall submit with each reimbursement request a report
indicating the status of Work Plan activities for which reimbursement is sought
in the format provided by the Department.
b. The Subrecipient shall also 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/requiredgrantforms; which is incorporated by reference
and made a part of this Agreement.
C. The Subrecipient shall participate in the State's annual capabilities
assessment for the State Preparedness Report,
DHS-FEMA-HSGP-SHSP-FFY15 Page 4 of 25 Mason County, E16-221
3. EQUIPMENT AND SUPPLY MANAGEMENT
a. Subrecipients and any non-federal entity to which the Subrecipient makes a
subaward shall comply with 2 CFR 200.318 — 200.326, 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. Equipment records shall include: a description of the property; the
manufacturer's serial number, model number, or other identification
number; the source of the equipment, including the Federal Award
Identification Number (FAIN); Catalogue of Federal Domestic
Assistance (CFDA) number; who holds the title; the acquisition date;
the cost of the equipment and the percentage of Federal participation
in the cost; the location, use and condition of the equipment at the date
the information was reported; and disposition data including the date of
disposal and sale price of the property.
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 are well maintained and kept in good
operating condition.
vi. The Subrecipient must obtain and maintain all necessary certifications
and licenses for the equipment.
vii. 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.
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.
ix. If, upon termination or at the Grant Agreement End Date, there is a
residual inventory of unused supplies exceeding $5,000 in total
aggregate value which will not be needed for any other Federal award,
or when original or replacement equipment is no longer needed for the
original project or program or for other activities currently or previously
supported by a Federal agency, the Subrecipient must comply with
following procedures:
DHS-FEMA-HSGP-SHSP-FFY15 Page 5 of 25 Mason County, E16-221
A. The Subrecipient may retain the supplies for use on other non-
Federal related activities or sell them, but must compensate the
Federal sponsoring agency for its share.
B. The Subrecipient must dispose of equipment as follows:
i. Items of equipment with a current per-unit fair market
value of less than $5,000 may be retained, sold or
otherwise disposed of by the Subrecipient with no further
obligation to the awarding agency.
ii. Items of equipment with a current per-unit fair market
value of more than $5,000 may be retained or sold and
the Subrecipient shall compensate the Federal-
sponsoring agency for its share.
X. 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 guidelines. No
reimbursement will be provided unless the appropriate approval has been
received.
C. Allowable equipment and supply categories for 15HSGP are listed on the
Authorized Equipment List (AEL) located on the FEMA website at
http://www.fema.,qov/preparedness-non-disaster-grants. 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. Subrecipients are solely responsible for ensuring
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,
Subrecipients must contact the Department Key Personnel for assistance in
seeking FEMA approval prior to acquisition.
Subrecipients are solely responsible for ensuring equipment eligibility in
accordance with the AEL.
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. 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.
f. 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 15HSGP.
The cost of disposal cannot be carried over to another DHS/FEMA grant or
grant period.
DHS-FEMA-HSGP-SHSP-FFY15 Page 6 of 25 Mason County, E16-221
g. As a subrecipient of federal funds, 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.
4. ENVIRONMENTAL AND HISTORICAL PRESERVATION
The Subrecipient shall ensure full compliance with the DHS/FEMA Environmental
Planning and Historic Preservation (EHP) Program. Subrecipients are required to
comply with DHS/FEMA EHP Policy Guidance which can be found at
https://www.fema.gov/office-environmental-planning-and-historic-preservation; FP
108-023-1 Environmental Planning and Historic Preservation Policy Guidance at
http://www.fema.,qov/media-library/assets/documents/85376; and FP 108.24.4
Environmental Planning and Historical Preservation Policy at
https://www.fema.gov/media-library/assets/documents/101537, all of which are
incorporated in and made a part of this Agreement.
a. Subrecipients 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 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 explains the goals and objectives of the proposed project
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 before funds are reimbursed.
Expenditures for projects started before EHP process review completion
approval is received will not be reimbursed.
5. 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.
6. 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-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.
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b. To document compliance with 2 CFR Part 200 Subpart F requirements, the
Subrecipient shall complete and return to the Department 2 CFR Part 200
Subpart F Audit Certification Form" located at http://mil.wa.gov/emergenc -
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 Agreement work plan, budget,
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. Compliancy will be monitored throughout the performance period to assess
risk. Concerns will be addressed through a Corrective Action Plan.
7. LIMITED ENGLISH PROFICIENCY(CIVIL RIGHTS ACT OF 1964 TITLE VI)
All subrecipients 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/guidance-published-help-department-supported-
organizations-provide-meaningful-access-people-limited and additional resources on
http://www.lep.gov.
8. 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 orjurisdictions to work together to build, sustain, and deliver the core
capabilities needed to achieve a secure and resilient nation.
DHS-FEMA-HSGP-SHSP-FFY15 Page 8 of 25 Mason County, E16-221
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 Policy Directive (PPD)-
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. The Subrecipient agrees that in order to receive FFY 2015 federal
preparedness funding, to include HSGP, NIMS compliance requirements for
2015 must be met.
B. HSGP SPECIFIC REQUIREMENTS
1. 15HSGP 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 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 management
and administration costs under this Agreement is identified in the Budget
(Exhibit E), 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 (Exhibit E) and may differ from the combined 25%
requirement.
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(Exhibit E) and may
differ from the 50% HSGP limit.
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 (CBP), United States Border Patrol (USBP), 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
Work Plan, 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@fema.dhs.gov and emd.training�ic.mil.wa.gov no
later than June 1st annually.
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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(afema.dhs.gov and emd.trainingCa.mil.wa.gov. Further information regarding
the use of HSEEP can be found at https:Hhseep.preptoolkit.org/.
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 FFY15 HSGP TERMS AND CONDITIONS
As a subrecipient of 15HSGP Program funding, the Subrecipient shall comply with all applicable
DHS terms and conditions of the FFY15 HSGP Award Letter and its incorporated documents for
DHS Grant No. EMW-2015-SS-00013-S01, which are incorporated in and made a part of this
Agreement as Attachment#1.
DHS-FEMA-HSGP-SHSP-FFY15 Page 10 of 25 Mason County, E16-221
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 Grant Agreement, 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 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.
f. "Investment" means the grant application submitted by the Subrecipient describing
the project(s) for which federal funding is sought and provided under this Agreement.
Such grant application is hereby incorporated into this Agreement by reference.
A.2 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 Subpart F.
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.
DHS-FEMA-HSGP-SHSP-FFY15 Page 11 of 25 Mason County, E16-221
Once the single audit has been completed and it includes any audit findings,the Subrecipient
must send a full copy of the audit to the Department and its corrective action plan no later
than 9 months after the end of the Subrecipient's fiscal year(s) to:
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 letter identifying this Grant Agreement and explaining the
criteria for exemption no later than nine (9) months after the end of the Subrecipient's fiscal
year(s) to the address listed above.
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.3 ADVANCE PAYMENTS PROHIBITED
The Department shall make no payments in advance or in anticipation of goods or services
to be provided under this Agreement. The Subrecipient shall not invoice the Department in
advance of delivery and invoicing of such goods or services.
A.4 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.5 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.6 ASSURANCES
The Department and Subrecipient agree that all activity pursuant to this Agreement will be
conducted in accordance with all the applicable current federal, state and local laws, rules
and regulations.
A.7 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 Grant 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.qov/emergency-management-division/qrants/reguiredgrantforms.
DHS-FEMA-HSGP-SHSP-FFY15 Page 12 of 25 Mason County, E16-221
Any such form completed by the Subrecipient for this Agreement shall be incorporated into
this Agreement by reference.
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"
. (http://www.Ini.wa.gov/TradesLicensing/PrevWage/AwardingAgencies/DebarredContractors
/). 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.gov/services/Contracting Purchasing/Business/Pages/Vendor-
Debarment.aspx).
A.8 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.9 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.
DHS-FEMA-HSGP-SHSP-FFY15 Page 13 of 25 Mason County, E16-221
A.10 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), 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.
AA 1 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
2CFR Part 200.318 General procurement standards through 200.326 Contract Provisions.
As required by Appendix II 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 FIR 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
DHS-FEMA-HSGP-SHSP-FFY15 Page 14 of 25 Mason County, E16-221
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
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.
DHS-FEMA-HSGP-SHSP-FFY15 Page 15 of 25 Mason County, E16-221
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 Federal awarding agency requirements and regulations pertaining to
reporting.
12) Federal awarding agency requirements and regulations pertaining to copyrights and
rights in data.
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 sub-contracting agreements entered into pursuant to this Agreement shall incorporate
this Agreement by reference.
A.12 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.13 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 Contractor and a third party mutually agreed
upon by both parties.
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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.14 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:
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.15 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.16 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.
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A.17 NONASSIGNABILITY
Neither this Agreement, nor any claim arising under this Agreement, shall be transferred or
assigned by the Subrecipient.
A.18 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.19 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.20 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.21 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.22 POLITICAL ACTIVITY
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.23 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.24 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.
DHS-FEMA-HSGP-SHSP-FFY15 Page 18 of 25 Mason County, E16-221
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.25 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 Subecipient.
A.26 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.27 RESPONSIBILITY FOR PROJECT/STATEMENT OF WORKNVORK 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.
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,
DHS-FEMA-HSGP-SHSP-FFY15 Page 19 of 25 Mason County, E16-221
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.28 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.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's 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
DHS-FEMA-HSGP-SHSP-FFY15 Page 20 of 25 Mason County, E16-221
1
Department's discretion. Any time allowed for cure shall not diminish or eliminate the
Subrecipient 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 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 Grant 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 sub-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
DHS-FEMA-HSGP-SHSP-FFY15 Page 21 of 25 Mason County, E16-221
sub-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;
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 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.
A.36 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.
DHS-FEMA-HSGP-SHSP-FFY15 Page 22 of 25 Mason County, E16-221
Exhibit C
WORK PLAN/APPROVED PROJECTS
2015 Homeland Security Grant(HSGP)
State Homeland Security Program (SHSP)
Agency: MASON COUNTY EMERGENCY MANAGEMENT DIVISION
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 programs implemented in full accordance with governing law and regulations. Eighty-percent of the state's
award is allocated to local and tribal units of government in accordance with Federal guidelines. Washington State is
divided into nine Homeland Security Regions. Funding is allocated to Regions according to a county base, population, and
population density funding formula. The remaining twenty percent is allocated to state agencies using a sustainment
funding model.
Region 3 is vulnerable to numerous catastrophic events. Probably the most significant is the Cascadia Subduction Zone
earthquake and ensuing tsunami. This event will cause massive loss of life, injury and destruction while leaving portions of
Region 3 uninhabitable for years. Region 3 is also susceptible to shallow earthquakes and their aftershocks. Although not
as severe, this type of earthquake will also cause significant loss of life, injury, property damage, economic hardship, and
environmental degradation.
Frequently, Region 3 experiences winter storms and wind storms that include widespread flooding, landslides and lengthy
power outages. Because Region 3 is home to the State capital, as well as key infrastructure and environmentally sensitive
habitat there is potential for political activism and terrorist activity. Other risks include epidemic, hazmat incidents, dam
failure,wildfire, heat wave, volcano, and drought.
This investment supports the THIRA and SPR by improving Operational Coordination and Operational Communications. It
addresses several capability gaps including the need to develop more Incident Management Teams (IMT), increase
participation in multi-jurisdictional statewide exercises, integrate RACES and other communication teams into planning, and
use available grant funding to support local and regional communications interoperability.
PROJECT#1 Secondary Power 1 $7,601
This project will continue work to provide alternative EOC operations locations. This purchase
would allow us to utilize a southeastern location for an alternate EOC.
Goals:
• Establish an alternate EOC location to be used during emergency situations by providing Fire
DESCRIPTION: Station 4-1 with emergency power through the purchase of two 12K generators with 200 amp
switches.
Gaps to address:
• Currently the secondary EOC is located inside the city limits of Shelton and may become
unusable during a disaster. This alternative EOC location would be accessible from the
southeast portion of the county if blocked off due to a disaster.
PROJECT#2 Personal Protection Equipment(PPE) $5,400
This project includes the replacement of a past FY2006 SHSP purchase of MSA masks for law
enforcement. The original 98 canisters have expired and need to be replaced.
Goals:
DESCRIPTION: Law Enforcement personnel protected through MSA Millennium CBRN Mask canisters when
needed.
Gaps to address:
• Currently Mason County Sheriff's Office MSA masks canisters are expired and need to be
replaced for personal protective measures.
DHS-FEMA-HSGP-SHSP-FFY15 Page 23 of 25 Mason County, E16-221
Exhibit D
TIMELINE
FFY15 Homeland Security Grant Program (HSGP),
State Homeland Security Program (SHSP)
DATE TASK
September 1, 2015 Start of Agreement performance period
March 31, 2017 All work ceases. Grant Agreement End Date.
May 15, 2017 Submit Closeout Report and Final Reimbursement Request.
** Reports are due before final invoice will be reimbursed.
DHS-FEMA-HSGP-SHSP-FFY15 Page 24 of 25 Mason County, E16-221
Exhibit E
BUDGET
FFY15 Homeland Security Grant Program (HSGP)
State Homeland Security Program (SHSP)
PROJECT SOLUTION AREA AMOUNT PERSONNEL LETPA
Planning $ $ $
PROJECT#1 Organization $
Interoperable Equipment $ 13,001 ;:$ii:: :',•;: :;: : ::; :: : $ 5,400
Communications Training $ - $ $
Improvements-Mason Exercise $ $ $
County Indirect0% $
Subtotal $ 13,001 $ $ 5,400
TOTAL Grant Agreement AMOUNT: $ 13,001 $ $ 5,400
GRANT AGREEMENT CAPS&THRESHOLDS
The Subgran tee ensures
.................................................................................................................................................................................
The Personnel expenditures under this agreement will not exceed the percentage established within this budget. If the percentage
is greater than 50%,the personnel costs over 50%will not be reimbursed unless a personnel cap waiver is approved by DHS.
Personnel Expenses: $0 0% of Agreement Amount
The total expenditures meeting the Law Enforcement Terrorism Prevention(LETPA)el i gi bi I ity wi I I equal or exceed the percentage
established within this budget.
LETPA: $5,400 42% of Agreement Amount
Cumulative transfers to Projects in excess of 10%of Grant Agreement amountwill not be reimbursed without prior written
authorization from the Department
DHS-FEMA-HSGP-SHSP-FFY15 Page 25 of 25 Mason County, E16-221
ATTACHMENT #1 Award
Letter
15HSGP Award Documents
Award EMW-2015-SS-00013-S01
U:S. Department of-Homeland Security
Washington, D.C. 20472
IV D �x
Bret Daugherty
Washington State Military Department
Building 20
Camp Murray, WA 98430
Re: Grant No. EMW-2015-SS-00013
Dear Bret Daugherty:
Congratulations, on behalf of the Department of Homeland Security, your application for financial assistance submitted under
the Fiscal Year(FY) 2015 Homeland Security Grant Program has been approved in the amount of$ $13,512,908.00. 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 2015 Homeland Security Grant Program Funding Opportunity Announcement.
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 go on-line to the ND Grants system at https://portal.fema.gov. After logging in, you will see a subtitle Grants
Management. Under this subtitle, you will see a link that says Award Package(s). Click this link to access your award
packages. Click the Review Award Package link to review and accept the award package for your award. Please print your
award package for your records.
Step 2: Please fill out and have your bank complete and sign the SF 1199A, Direct Deposit Sign-up Form. The information on
the 1199A must match your SAM record. Be sure to include your DUNS and grant number on the form in Section 1 F"Other."
The SF 1199A should be sent directly from your financial institution to the FEMA Finance Center, via fax or mail to the
Vendor Maintenance Office (see address below). The 1199A form will not be accepted unless it is received directly from the
financial institution. Please pay careful attention to the instructions on the form.
FEMA Finance Center
Attn: Vendor Maintenance
P.O. Box 9001
Winchester, VA 22604
Secured Fax: (540) 504-2625
Email: FEMA-Finance@FEMA.DHS.gov
System for Award Management(SAM): Please ensure that your organization's name, address, DUNS number, EIN, and
banking information are up to date in SAM and that the DUNS number used in SAM is the same one used to apply for all
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FEMA awards. The System for Award Management is located at http://www.sam.gov. Future payments will be contingent
on the information provided in the SAM; therefore it is imperative that the information is correct.
If you have any questions or concerns regarding the process to request your funds, please call (866) 927-5646.
BRIAN KAMOIE, GPD Assistant Administrator
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Agreement Articles
2015-09-01 00:00:00.0
U.S. Department of Homeland Security
Washington, D.C. 20472
c�
1 NLS S
AGREEMENT ARTICLES
Homeland Security Grant Program
GRANTEE: Washington State Military Department
PROGRAM: Homeland Security Grant Program
AGREEMENT NUMBER: EMW-2015-SS-00013-S01
TABLE OF CONTENTS
Article I Summary Description of Award
Article II Operation Stonegarden Program Hold
Article III Acknowledgement of Federal Funding from DHS
Article IV Activities Conducted Abroad
Article V Age Discrimination Act of 1975
Article VI Americans with Disabilities Act of 1990
Article VII Best Practices for Collection and Use of Personally Identifiable
Information (PII)
Article VIII Title VI of the Civil Rights Act of 1964
Article IX Civil Rights Act of 1968
Article X Copyright
Article XI Assurances, Administrative Requirements and Cost Principles
Article XII Debarment and Suspension
Article XIII Drug-Free Workplace Regulations
Article XIV Duplication of Benefits
Article XV Energy Policy and Conservation Act
Article XVI Reporting Subawards and Executive Compensation
Article XVII False Claims Act and Program Fraud Civil Remedies
Article XVIII Federal Debt Status
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Article XIX Fly America Act of 1974
Article XX Hotel and Motel Fire Safety Act of 1990
Article XXI Limited English Proficiency (Civil Rights Act of 1964, Title VI)
Article XXII Lobbying Prohibitions
Article XXIII Non-supplanting Requirement
Article XXIV Patents and Intellectual Property Rights
Article XXV Procurement of Recovered Materials
Article XXVI Contract Provisions for Non-federal Entity Contracts under
Federal Awards
Article XXVII SAFECOM
Article XXVIII Terrorist Financing E.O. 13224
Article XXIX Title IX of the Education Amendments of 1972 (Equal
Opportunity in Education Act)
Article XXX Trafficking Victims Protection Act of 2000
Article XXXI Rehabilitation Act of 1973
Article XXXII System of Award Management and Universal Identifier
Requirements
Article XXXIII USA Patriot Act of 2001
Article XXXIV Use of DHS Seal, Logo and Flags
Article XXXV Whistleblower Protection Act
Article XXXVI DHS Specific Acknowledgements and Assurances
Article XXXVII Disposition of Equipment Acquired Under the Federal Award
Article XXXVI I I Prior Approval for Modification of Approved Budget
Article XXXIX Acceptance of Post Award Changes
Article I - Summary Description of Award
The purpose of the FY 2015 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 31 core
capabilities essential to achieving the National Preparedness Goal (the Goal) of a secure and resilient Nation. 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$6,493,000.00, Urban Areas
Security Initiative (UASI) funding in the amount of$5,500,000.00, and Operation Stonegarden (OPSG) funding in
the amount of$1,519,908.00. The following counties received Operation Stonegarden funds: Clallam County,
$310,045.00; Colville Tribe, $70,000.00; Ferry County, $100,000.00; Island County, $150,092.00; Jefferson
County, $74,000.00; Okanogan County, $140,000.00; Pend Oreille County, $78,000.00; San Juan County,
$140,000.00;Stevens County, $90,000.00; and Whatcom County, $367,771.00
Article II - Operation Stonegarden Program Hold
The recipients are 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 Frag Order has been reviewed, and approved by official notification by DHS/FEMA and
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Customs and Border Protection/United States Border Patrol (CBP/USBP). Each Operations Order will be
transferred via the secure portal (CBP/USBP) BPETS system from each respective AOR Sector HQ to CBP/USBP
HQ in Washington DC for review and pre-approval for Operational continuity, then forwarded to DHS/FEMA
GPD/PGD OPSG Program Office for final review/approval. Official notification of approval will be sent by
DHS/FEMA via email to the respective State Administrative Agency (SAA) and CBP/ USBP HQ in Washington
DC.
Article III -Acknowledgement 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 IV-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 V-Age Discrimination Act of 1975
All recipients must comply with the requirements of the Age Discrimination Act of 1975(42 U.S.C. § 6101 et sec.),
which prohibits discrimination on the basis of age in any program or activity receiving Federal financial assistance.
Article VI -Americans with Disabilities Act of 1990
All recipients must comply with the requirements of Titles I, ll, and III 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.
12101-12213).
Article VII - Best Practices for Collection and Use of Personally Identifiable Information (PII)
All recipients who collect PII are required to have a publically-available privacy policy that describes what PII they
collect, how they use the PII, whether they share PII with third parties, and how individuals may have their PII
corrected where appropriate.
Award recipients may also find as a useful resource the DHS Privacy Impact Assessments: Privacy Guidance
and Privacy template respectively.
Article VIII - Title VI of the Civil Rights Act of 1964
All recipients must comply with the requirements of Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d
et seq.), 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. Implementing regulations for the Act are found at 6
C.F.R. Part 21 and 44 C.F.R. Part 7.
Article IX- 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. § 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
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buildings with elevators and ground-floor units in buildings without elevators)—be designed and constructed
with certain accessible features (see 24 C.F.R. § 100.201).
Article X - Copyright
All recipients must affix the applicable copyright notices of 17 U.S.C. 401 or 402 and an acknowledgement of
Government sponsorship (including award number) to any work first produced under Federal financial assistance
awards, unless the work includes any information that is otherwise controlled by the Government (e.g., classified
information or other information subject to national security or export control laws or regulations).
Article XI -Assurances, Administrative Requirements and Cost Principles
Recipients of DHS federal financial assistance must complete OMB Standard Form 424B Assurances— Non-
Construction Programs. Certain assurances in this document may not be applicable to your program, and the
awarding agency may require applicants to certify additional assurances. Please contact the program awarding
office if you have any questions.
The administrative and audit requirements and cost principles that apply to DHS award recipients originate from 2
C.F.R. Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal
Awards, as adopted by DHS at 2 C.F.R. Part 3002.
Article XII - Debarment and Suspension
All recipients must comply with Executive Orders 12549 and 12689, which provide protection against waste, fraud
and abuse by debarring or suspending those persons deemed irresponsible in their dealings with the Federal
government.
Article XIII - Drug-Free Workplace Regulations
All recipients must comply with the Drug-Free Workplace Act of 1988 (41 U.S.C. � 701 et seq.), which requires
that all organizations receiving grants from any Federal agency agree to maintain a drug-free workplace. DHS
has adopted the Act's implementing regulations at 2 C.F.R Part 3001.
Article XIV- Duplication of Benefits
Any cost allocable to a particular Federal award provided for in 2 C.F.R. Part 200, Subpart E may not be
charged to other Federal awards to overcome fund deficiencies, to avoid restrictions imposed by Federal
statutes, regulations, or terms and conditions of the Federal awards, or for other reasons. However, this
prohibition would not preclude the non-Federal entity from shifting costs that are allowable under two or more
Federal awards in accordance with existing Federal statutes, regulations, or the terms and conditions of the
Federal awards.
Article XV- Energy Policy and Conservation Act
All recipients must comply with the requirements of 42 U.S.C. � 6201 which contain policies relating to energy
efficiency that are defined in the state energy conservation plan issues in compliance with this Act.
Article XVI - Reporting Subawards and Executive Compensation
a. Reporting of first-tier subawards.
1. Applicability. Unless you are exempt as provided in paragraph d. of this award term, you must report each
action that obligates $25,000 or more in Federal funds that does not include Recovery funds (as defined in
section 1512(a)(2) of the American Recovery and Reinvestment Act of 2009, Pub. L. 111-5) for a subaward to an
entity (see definitions in paragraph e. of this award term).
2. Where and when to report.
i. You must report each obligating action described in paragraph a.1. of this award term to
http://www,fsrs.cLov.
ii. For subaward information, report no later than the end of the month following the month in which the
- 6 -
obligation was made. (For example, if the obligation was made on November 7, 2010, the obligation
must be reported by no later than December 31, 2010.)
3. What to report. You must report the information about each obligating action that the submission instructions'
posted at http.-Ilwww.fsrs.gov specify.
b. Reporting Total Compensation of Recipient Executives.
1. Applicability and what to report. You must report total compensation for each of your five most highly
compensated executives for the preceding completed fiscal year, if—
i. the total Federal funding authorized to date under this award is $25,000 or more;
ii. in the preceding fiscal year, you received—
(A) 80 percent or more of your annual gross revenues from Federal procurement contracts (and
subcontracts) and Federal financial assistance subject to the Transparency Act, as defined at 2
CFR 170.320 (and subawards); and
(B) $25,000,000 or more in annual gross revenues from Federal procurement contracts (and
subcontracts) and Federal financial assistance subject to the Transparency Act, as defined at
2 CFR 170.320 (and subawards); and
iii. The public does not have access to information about the compensation of the executives through
periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C.
78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986. (To determine if the public has
access to the compensation information, see the U.S. Security and Exchange Commission total
compensation filings at http://www.sec.govlanswerslexecomp.htm.)
2. Where and when to report. You must report executive total compensation described in paragraph b.1. of this
award term:
i. As part of your registration profile at https✓lwww.sam.gov.
ii. By the end of the month following the month in which this award is made, and annually thereafter.
c. Reporting of Total Compensation of Subrecipient Executives.
1. Applicability and what to report. Unless you are exempt as provided in paragraph d. of this award term,
for each first-tier subrecipient under this award, you shall report the names and total compensation of
each of the subrecipient's five most highly compensated executives for the subrecipient's preceding
completed fiscal year, if—
i. in the subrecipient's preceding fiscal year, the subrecipient received—
(A) 80 percent or more of its annual gross revenues from Federal procurement contracts (and
subcontracts) and Federal financial assistance subject to the Transparency Act, as defined at 2
CFR 170.320 (and subawards); and
(B) $25,000,000 or more in annual gross revenues from Federal procurement contracts (and
subcontracts), and Federal financial assistance subject to the Transparency Act (and subawards);
and
J. The public does not have access to information about the compensation of the executives through
periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C.
78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986. (To determine if the public has
access to the compensation information, see the U.S. Security and Exchange Commission total
compensation filings at httpalwww.sec.govlanswerslexecomp.htm.)
2. Where and when to report. You must report subrecipient executive total compensation described in
paragraph c.1. of this award term:
i. To the recipient.
H. By the end of the month following the month during which you make the subaward. For example, if a
subaward is obligated on any date during the month of October of a given year (i.e., between October 1
and 31), you must report any required compensation information of the subrecipient by November 30 of
that year.
d. Exemptions
If, in the previous tax year, you had gross income, from all sources, under$300,000, you are exempt from the
requirements to report:
- 7 -
i. Subawards,
And
ii. The total compensation of the five most highly compensated executives of any subrecipient.
e. Definitions. For purposes of this award term:
1. Entity means all of the following, as defined in 2 CFR part 25:
i. A Governmental organization, which is a State, local government, or Indian tribe;
ii. A foreign public entity;
iii. A domestic or foreign nonprofit organization;
iv. A domestic or foreign for-profit organization;
v. A Federal agency, but only as a subrecipient under an award or subaward to a non-Federal entity.
2. Executive means officers, managing partners, or any other employees in management positions.
3. Subaward:
i. This term means a legal instrument to provide support for the performance of any portion of the
substantive project or program for which you received this award and that you as the recipient award to
an eligible subrecipient.
ii. The term does not include your procurement of property and services needed to carry out the project or!
program (for further explanation, see Sec. .210 of the attachment to OMB Circular A-133, "Audits of
States, Local Governments, and Non-Profit Organizations").
A subaward may be provided through any legal agreement, including an agreement that you or a
subrecipient considers a contract.
4. Subrecipient means an entity that:
i. Receives a subaward from you (the recipient) under this award; and
H. Is accountable to you for the use of the Federal funds provided by the subaward.
5. Total compensation means the cash and noncash dollar value earned by the executive during the recipient's
or subrecipient's preceding fiscal year and includes the following (for more information see 17 CFR
229.402(c)(2))
i. Salary and bonus.
H. Awards of stock, stock options, and stock appreciation rights. Use the dollar amount recognized for
financial statement reporting purposes with respect to the fiscal year in accordance with the Statement of;
Financial Accounting Standards No. 123 (Revised 2004) (FAS 123R), Shared Based Payments.
Earnings for services under non-equity incentive plans. This does not include group life, health,
hospitalization or medical reimbursement plans that do not discriminate in favor of executives, and are
available generally to all salaried employees.
iv. Change in pension value. This is the change in present value of defined benefit and actuarial pension
plans.
v. Above-market earnings on deferred compensation which is not tax-qualified.
vi. Other compensation, if the aggregate value of all such other compensation (e.g. severance, termination
payments, value of life insurance paid on behalf of the employee, perquisites or property) for the
executive exceeds $10,000.
Article XVII - False Claims Act and Program Fraud Civil Remedies
All recipients must comply with the requirements of 31 U.S.C. § 3729 which set forth that no recipient of federal
payments shall submit a false claim for payment. See also 38 U.S.C. § 3801-3812 which details the
administrative remedies for false claims and statements made.
Article XVIII - 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 and form
SF-42413, item number 17 for additional information and guidance.
- 8 -
,
Article XIX - 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. § 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. § 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 XX - 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. _.22� 25a, 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. §2225.
Article XXI - 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. Providing meaningful access for persons with LEP may entail providing language
assistance services, including oral interpretation and written translation. In order to facilitate compliance with
Title VI, recipients are encouraged to consider the need for language services for LEP persons served or
encountered in developing program budgets. 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 https://www.dhs.gov/quidance-published-help-department-supported-organizations-
provide-meaningful-access- people-limited and additional resources on http://www.lep.gov.
Article XXII - Lobbying Prohibitions
All recipients must comply with 31 U.S.C. §1352, which provides that none of the funds provided under an 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 XXIII - Non-supplanting Requirement
All recipients who receive 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. Where federal statues for a particular program prohibits supplanting, applicants or recipients
may be required to demonstrate and document that a reduction in non-Federal resources occurred for reasons
other than the receipt of expected receipt of Federal funds.
Article XXIV - 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. � 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 are in 37 C.F.R. Part 401 and the standard patent rights clause in 37 C.F.R. § 401.14.
- 9 -
Article XXV- 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,
where the purchase price of the item exceeds $10,000 or
the value of the quantity acquired by 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.
Article XXVI - Contract Provisions for Non-federal Entity Contracts under Federal Awards
a. Contracts for more than the simplified acquisition threshold set at $150,000.
All recipients who have contracts exceeding the acquisition threshold currently set at $150,000, which is the
inflation adjusted amount determined by Civilian Agency Acquisition Council and the Defense Acquisition
Regulation Council as authorized by 41 U.S.C. §1908, must address administrative, contractual, or legal
remedies in instance where contractors violate or breach contract terms and provide for such sanctions and
penalties as appropriate.
b. Contracts in excess of$10,000.
All recipients that have contracts exceeding $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.
Article XXVII -SAFECOM
All recipients who receive 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 XXVIII -Terrorist Financing E.O. 13224
All recipients must comply with U.S. Executive Order 13224 and U.S. law that prohibit transactions with, and the
provisions of resources and support to, individuals and organizations associated with terrorism. It is the legal
responsibility of recipients to ensure compliance with the E.O. and laws.
Article XXIX -Title IX of the Education Amendments of 1972 (Equal Opportunity in Education Act)
All recipients must comply with the requirements of Title IX of the Education Amendments of 1972 (20 U.S.C.
1681 et sep.), which provides that no person in the United States will, on the basis of sex, be excluded from.
participation in, be denied the benefits of, or be subjected to discrimination under any educational program or
activity receiving Federal financial assistance. Implementing regulations are codified at 6 C.F.R. Part 17 and 44
C.F.R. Part 19
Article XXX- Trafficking Victims Protection Act of 2000
All recipients must comply with the requirements of the government-wide award term which implements
Section 106(g) of the Trafficking Victims Protection Act(TVPA) of 2000, as amended (22 U.S.C. 7104). This
is implemented in accordance with OMB Interim Final Guidance, Federal Register, Volume 72, No. 218,
November 13, 2007. Full text of the award term is located at 2 CFR 1� 75.15.
Article XXXI - Rehabilitation Act of 1973
All recipients of must comply with the requirements of Section 504 of the Rehabilitation Act of 1973, 29 U.S.C.
794, as amended, which provides that no otherwise qualified handicapped individual in the United States will,
- 10
F
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. These requirements pertain to
the provision of benefits or services as well as to employment.
Article XXXII - System of Award Management and Universal Identifier Requirements
A. Requirement for System of Award Management
Unless you are exempted from this requirement under 2 CFR 25.110, you as the recipient must maintain the
currency of your information in the SAM until you submit the final financial report required under this award or
receive the final payment, whichever is later. This requires that you review and update the information at least
annually after the initial registration, and more frequently if required by changes in your information or another
award term.
B. Requirement for unique entity identifier
If you are authorized to make subawards under this award, you:
1. Must notify potential subrecipients that no entity (see definition in paragraph C of this award term) may
receive a subaward from you unless the entity has provided its unique entity identifier to you.
2. May not make a subaward to an entity unless the entity has provided its unique entity identifier to you.
C. Definitions
For purposes of this award term:
1. System of Award Management(SAM) means the Federal repository into which an entity must provide
information required for the conduct of business as a recipient. Additional information about
registration procedures may be found at the SAM Internet site (currently at http://www.sam.gov).
2. Unique entity identifier means the identifier required for SAM registration to uniquely identify business
entities.
3. Entity, as it is used in this award term, means all of the following, as defined at 2 CFR part 25, subpart C:
a. A Governmental organization, which is a State, local government, or Indian Tribe;
b. A foreign public entity;
c. A domestic or foreign nonprofit organization;
d. A domestic or foreign for-profit organization; and
e. A Federal agency, but only as a subrecipient under an award or subaward to a non-Federal entity.
4. Subaward.
a. This term means a legal instrument to provide support for the performance of any portion of
the substantive project or program for which you received this award and that you as the
recipient award to an eligible subrecipient.
b. The term does not include your procurement of property and services needed to carry out the
project or program (for further explanation, see 2 CFR 200.330).
C. A subaward may be provided through any legal agreement, including an agreement that you
consider a contract.
5. Subrecipient means an entity that:
a. Receives a subaward from you under this award; and
b. Is accountable to you for the use of the Federal funds provided by the subaward.
Article XXXIII - USA Patriot Act of 2001
tents 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. M 175-175c. Among other things, the USA PATRIOT Act prescribes criminal penalties for possession
of any biological agent, toxin, or delivery system of a type or in a quantity that is not reasonably justified by a
prophylactic, protective, bona fide research, or other peaceful purpose
- 11
Article XXXIV- Use of DHS Seal, Logo and Flags
All recipients must obtain DHS's approval 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 XXXV-Whistleblower Protection Act
All recipients must comply with the statutory requirements for whistleblower protections (if applicable) at 10
U.S.0 § 2409, 41 U.S.C. 4712, and 10 U.S.C. § 2324, 41 U.S.C. M 4304 and 4310.
Article XXXVI - DHS Specific Acknowledgements and Assurances
All recipients must acknowledge and agree—and require any sub-recipients, contractors, successors,
transferees, and assignees 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 review or complaint investigation 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 grant and permit access to facilities, personnel, and other
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, the recipient has been accused of discrimination on the grounds of race,
color, national origin (including limited English proficiency), sex, age, disability, religion, or familial status, the
recipient must provide a list of all such proceedings, pending or completed, including outcome and copies of
settlement agreements to the DHS awarding office and the DHS Office of Civil Rights and Civil Liberties.
6. In the event any court or administrative agency makes a finding of discrimination on grounds of race, color,
national origin (including limited English proficiency), sex, age, disability, religion, or familial status against the
recipient, or the recipient settles a case or matter alleging such discrimination, recipients must forward a copy of
the complaint and findings to the DHS Component and/or awarding office.
The United States has the right to seek judicial enforcement of these obligations.
Article XXXVII - 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. § 200.313.
Article XXXVIII - 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. § 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.
- 12
r
Article XXXIX -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-GMDCcDdhs.gov if you have any questions.
- 13
Obligating Doeument for Award/Amendment
1 a.AGREEMENT NO. 2. 3. RECIPIENT NO. 4. TYPE OF 5. CONTROL NO.
EMW-2015-SS-00013-SO1 AMENDMEN1916001095G ACTION W510950N,W510952N,
NO. AWARD W510953N
6.RECIPIENT NAME AND 7. ISSUING FEMA OFFICE AND 8.PAYMENT OFFICE AND ADDRESS
ADDRESS ADDRESS Financial Services Branch
Washington State Military Grant Operations 500 C Street, S.W.,Room 723
Department 245 Murray Lane-Building 410, SW Washington DC,20472
Building 20 Washington DC,20528-7000
Camp Murray,WA,98430 POC: 866-927-5646
9.NAME OF RECIPIENT PHONE NO. 10.NAME OF FEMA PROJECT COORDINATOR
PROJECT OFFICER 253-512-7083'Cenh•al Scheduling and Information Desk
Michael Alston ',Phone: 800-368-6498
Email:Askcsid@dhs.gov
11.EFFECTIVE DATE OF 12. 13.ASSISTANCE ARRANGEMENT 14.PERFORMANCE PERIOD
THIS ACTION METHOD Cost Reimbursement From: To:
09/01/2015 OF 09/01/2015 08/31/2018
PAYMENT Budget Period
PARS 09/01/2015 08/31/2018
15.DESCRIPTION OF ACTION
a.(Indicate funding data for awards or financial changes)
PROGRAM CFDA NO. ACCOUNTING DATA PRIOR AMOUNT CURRENT CUMULATIVE NON-
NAME (ACCS CODE) TOTAL AWARDED TOTAL FEDERAL COMMITMENT
ACRONYM XXXX-XXX-XXXXXX- AWARD THIS AWARD
XXXXX-XXXX-XXXX-X ACTION
+OR(-)
Homeland 97.067 2015-SL-B112-P410- $0.00$13,512,908.00$13,512,908.00 $0.00',
Security 4101-D:W 510952N
Grant $ 1,519,908.00;2015-
Program SL-B 111-P410--4101-
D:W51095ON$
6,493,000.00;2015-
SL-13211-P410--4101-
D:W510953N$
5.500.000.00
TOTALS $0.00$13,512,908.00$13,512,908.00 $0.00
b.To describe changes other than funding data or financial changes,attach schedule and check here.
N/A
16 a.FOR NON-DISASTER PROGRAMS:RECIPIENT IS REQUIRED TO SIGN AND RETURN THREE(3)COPIES OF THIS
DOCUMENT TO FEMA(See Block 7 for address)
Homeland Security Grant Program recipients are not required to sign and return copies of this document.However,recipients should
print and keep a copy of this document for their records.
16b.FOR DISASTER PROGRAMS:RECIPIENT IS NOT REQUIRED TO SIGN
This assistance is subject to terms and conditions attached to this award notice or by incorporated reference in program legislation cited
above.
17.RECIPIENT SIGNATORY OFFICIAL(Name and Title) DATE
Bret Daugherty,The Adjutant General 08/12/2015
18.FEMA SIGNATORY OFFICIAL(Name and Title) DATE
08/10/2015
- 14
f ANDREA GORDON,Assistance Officer
- 15
2 CFR Part 200 Subpart F Audit Certification Form
Audits of States, Local Governments, Indian Tribes, and Non-Profit Organizations
Contact Information
Subreciplent Name(Agency,Local Government,or organization):Mason County Division of Emergency Management
Authorized Chief Financial Officer(central accounting office): Frank Pinter
Address:411 N. 5th Street, Shelton, WA 98584
Email: FPinter@co.mason.wa.us Phone#:360-427-9670 ext 530
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 MILIEMD 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 is not 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 Sub art F
Our entity is not subject to the requirements of 2 CFR Part 200 Subpart F because(check all that apply):
C1 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 subject 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]]L'A for Fiscal Year ending[enter date] 7 3/ / , There
were no findings related to federal awards from WMD/EMD. No follow-up ad ion is required by WMD/EMD as the pass-th ough entity.
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:
❑ 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.officeComil.waxtov 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.office aOmil,wa.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.
'Q j% ftce Date: �uiy s,2ots
Signature of Authorized C r: .%
Print Name &Title: Frank Pinter,Budget Manager
WMD Form W09.13,WW9/2013,Updated 9/9=15
FFATA FORM
Subrecipient Agency: Mason County DEM
Grant and Year: SHSP FY-2015 Agreement Number: E16-221
Completed Ross McDowell DEM Manager 360-427-7535
by: g
Name Title Telephone
Date Completed: JuIV 5, 2016
YES STOP, no further NO
Is your grant agreement less than$25,000? Z
analysis needed, ❑ GO to Step 2
GO to Step 6
STEP,2 _
In your preceding fiscal year,did your YES NO STOP, no further
organization receive 80%or more of its annual GO to STEP 3 analysis needed, GO to
gross revenues from federal funding? ❑ ❑ Step 6
;S 1EP'3
In your preceding fiscal year, did your YES NO STOP, no further
organization receive$25,000,000 or more In GO to STEP 4 ❑ analysis needed, GO to o
federal funding? Step 6
STEP A'
Does the public have access to information about YES STOP, no further NO
the total compensation*of senior executives in ❑ analysis needed, ❑ GO to STEP 5
your organization? GO to step 6
ST;EP`6 .
Executive#1 Name:
Total Compensation amount: $
Executive#2 Name:
Total Compensation amount: $
Executive#3 Name:
Total Compensation amount: $
Name:
Executive#4 Total Compensation amount: $
Name:
Executive#5 Total Compensation amount: $
'SifjEP�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 less than $25,000.
Signature: k`, �4L f--1 l' L` '( l '�� Date:
July 5, 2016
*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
http://www.hrsa.gov/qrants/ffata.htmi
hftp://www.ql)o.gov/fdsys/pkq/FR-2010-09-14/pdf/2010-22705.pd
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
Govermnent 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. 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
Washington Military Department Contract Number; E16-221
Debarment, Suspension, Ineligibility or Voluntary Exclusion Certification Form
NAME Doing business as(DBA)
Mason County
ADDRESS Applicable Procurement WA Uniform Business Federal Employer Tax
100 W. Public Works Drive, Bldg#1 Shelton, or Solicitation#,if any: Identifier(UBI) Identification#:
WA 98584 232-002-101 91-6001354
This certiflcatlon 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.
T
4� ,+�/ //r:
Bidder or Contractor Signature. /� ,Q July 5, 2016
/ �( L(41 4 C f L(�� Date.
Print Name and Title; G. Ross McDowell
SIGNATUREUTH I Ti
WASHINGTON STATE MILITARY DEPARTMENT
Camp Murray, Washington 98430-5122
Please read instructions on reverse side before completing this form.
NAME OF ORGANIZATION DATE SUBMITTED
Mason County Division of Emergency Management July 5, 2016
PROJECT DESCRIPTION CONTRACT NUMBER
FY-15 SHSP Grant E16-221
1. AUTHORIZING AUTHORITY
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
Terri Jeffreys Commissioner
VV
Randy Neatherlin Commissioner
Tim Sheldon Commissioner
2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE PRINT OR TYPE NAME TITLE
Ross McDowell DEM Manager
/ Frank Pinter Budget Manager
3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT
SIGNATURE PRINT OR TYPE NAME TITLE
Ross McDowell DEM Manager
Frank Pinter Budget Manager
11NAC-11VOL1\HOME\KARENBI...,1WMSIGNAUTH Revised 3103
Form Request for 'taxpayer Give Form to the
(Rev.DecemDepartment of
the
Identification Number and Certification requester.Do not
l7epartmentof the Treasury send to the IRS.
Intemal Revenue Service
1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank.
Mason County
c\i 2 Business name/disregarded entity name,if different from above
OM ro Division of Emergency Management
3 Check appropriate box for federal tax classification;check only one of the following seven boxes: 4 Exemptions(codes apply only to
❑IndlviduaVsole proprietor or certain entities,not Individuals;see
p p ❑ C Corporation ❑ S Corporation ❑ Partnership ❑TrusVestate
y instructions on page 3):
c single-member LLC
u [3 Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)b. Exempt payee code(if any)
`o d Note.For a single-member LLC that Is disregarded,do not check LLC;check the appropriate box in the line above for Exemption from FATCA reporting
c the tax classification of the single-member owner. code(if any)
pC, c ❑✓ Other(see instructions)► Government OPP,cesro•aoums�Ni•r„�dom�.a•1t.usl
0
w 5 Address(number,street,and apt.or suite no.) Requester's name and address(optional)
y 100 W.Public Works Drive,Building#1
m 6 City,state,and ZIP code
in Shelton,WA 98584
7 List account numbers)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 FM —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 Employer identification number
guidelines on whose number to enter.
M91 _ _1610101 1 3 5 4
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® 7
General Instructio s •Form 1098(home mortgage interest),1098-E(student loan interest),1098-T
(tuition)
Section references are to the Internal Revenue Code unless otherwise noted. •Form 1099-C(canceled debt)
Future developments.Information about developments affecting Form W-9(such •Form 1099-A(acquisition or abandonment of secured property)
as legislation enacted after we release it)is at www.irs.gov/fw9,
Use Form W-9 only If you are a U.S.person(including a resident alien),to
Purpose of Form provide your correct TIN.
An Individual or entity(Form W-9 requester)who Is required to file an Information If you do not retum Form W-9 to the requester with a TIN,you might be subject
return with the IRS must obtain your correct taxpayer identification number(TIN) to backup withholding.See What is backup withholding?on page 2.
which may be your social security number(SSN),Individual taxpayer identification By signing the filled-out form,you:
number(ITIN),adoption taxpayer Identification number(ATIN),or employer 1.Certify that the TIN you are giving Is correct(or you are waiting for a number
Identification number(EIN),to report on an Information return the amount paid to to be Issued),
you,or other amount reportable on an Information return.Examples of Information
returns Include,but are not limited to,the following: 2.Certify that you are not subject to backup withholding,or
•Form 1099-INT(Interest earned or paid) 3.Claim exemption from backup withholding if you are a U.S.exempt payee.If
•Form 1099-DIV(dividends,including those from stacks or mutual funds) applicable,you are also certifying that as a U.S.person,your allocable share of
•Form 1099-MV( various any partnership Income from a U.S.trade or business is not subject to the
( types of Income,prizes,awards,or gross proceeds) withholding tax on foreign partners'share of effectively connected income,and
•Form 1099-8(stock or mutual fund sales and certain other transactions by 4.Certify that FATCA code(s)entered on this form(if any)indicating that you are
brokers) exempt from the FATCA reporting,is correct.See What Is FATCA reporting?on
•Form 1099-S(proceeds from real estate transactions) page 2 for further information.
•Farm 1099-K(merchant card and third party network transactions)
Cat.No.10231X Form W-9(Rev.12.2014)