HomeMy WebLinkAboutAmendment AWashington State Military Department
AMENDMENT
1 . SUBRECIPIENT NAME/ADDRESS: 2 . GRANT AGREEMENT NUMBER: 3 . AMENDMENT NUMBER:
Kittitas, County of E17-156 A Kittitas County Sheriff's Office
307 W. Umptanum Rd
Ellensburg, WA 98926-6720
4 . SUBRECIPIENT CONTACT, PHONE/EMAIL: 5 . DEPARTMENT CONTACT, PHONE/EMAIL:
Darren Higashiyama, (509) 933-8206 Michael Alston, (253) 512-7083
darren.higashiyama@co.kittitas.wa.us michael.alston@mil.wa.gov
6. TIN or SSN: 7 . CATALOG OF FEDERAL DOMESTIC 8. FUNDING SOURCE NAME/AGREEMENT #:
NA ASST. (CFDA) #: 97.042 (16EMPG) EMS-2016-EP-00002-S01
9 . FUNDING AUTHORITY:
Washington State Military Department (Department) and the U.S. Department of Homeland Security (DHS)
10. DESCRIPTION/JUSTIFICATION OF AMENDMENT:
The end date is extended until September 30, 2017, to ensure full expenditure of funds within the
performance period.
11. AMENDMENT TERMS AND CONDITIONS:
1. The overall Grant Agreement amount $24,465 remains unchanged.
2. Replace original Timeline Exhibit D with revised Timeline Exhibit D. attached to this amendment.
3 . Extend original agreement end date from August 31,2017 to September 30,2017.
This Amendment is incorporated in and made a part of the Grant Agreement. Except as amended herein, all other terms
and conditions of the Grant Agreement remain in full force and effect. Any reference in the original Grant Agreement or an
Amendment to the "Grant Agreemenf shall mean "Grant Agreement as amended". The Department and Subrecipient
acknowledge and accept the terms of this Amendment as identified above, effective on the final date of execution below.
By Signing this Amendment, the signatories warrant they have the authority to execute this Amendment.
IN WITNESS WHEREOF, the parties have executed this Amendment:
FOR THE DEPARTMENT: FOR THE §.uaRECI~NT: ')
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Signature Date Signature Date
Dan Swisher, Chief Financial Officer Gene Dana, Sheriff
Washington State Military Department l<ittitas Coun . Sheriffs Office
..-_.k
("/
·"APPROVED S T O FO if applicable):
BOILERPLATE APPROVED AS TO FORM: --) <il i ll/'Jr-Brian E. Buchholz (signature on file) 6113/2012
.... \
Assistant Attorney General Applicant's Legal Review
J
1 ( Date
Form Date: 10/27/00 7
DHS-FEMA-EMPG-FFY 16 Page 1 of2 Kittitas, County of, E17-156 Amendment A
I '
Exhibit 0
Revised TIMELINE
FFY 2016 Emergency Management Performance Grant Program
DATE TASK
June 1,2016 Grant Agreement Start Date
April 30, 2017 Submit reimbursement request
July 30, 2017 Submit reimbursement request
August 31 September 30,
2017 Grant Agreement End Date
October +a-30, 2017 Submit final reimbursement request, additional reports, and/or
de/iverables.
DHS-FEMA-EMPG-FFY 16 Page 2 of 2 Kittitas, County of, E17-156 Amendment A
- ------------------------------------
SIGNATURE AUTHORIZATION FORM
WASHINGTON STATE MILITARY DEPARTMENT
Camp Murray, Washington 98430-5122
Please read instructions on reverse side before completing this form.
NAME OF ORGANIZATION DATE SUBMITTED
Kittitas County Sheritrs Office 8/23/17
PROJECT DESCRIPTION CONTRACT NUMBER
EMPG FFY-16 E17-156A
1. AUTHORIZING AUTHORITY
SIGNATURE PRINT OR TYPE NAME TITLEfTERM OF OFFICE
&-
r
"\ Gene Dana Sheriff/12/31/18
....----:-
2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE PRINT OR TYPE NAME TITLE
/ ~ Gene Dana
"-1 . <'"._
Sheriff
~ ....
3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT
~NATURE PRINT OR TYPE NAME TITLE
~ 1jL ~ -~ Darren Higashiyama Commander
f-"') 1~~ Heather Seibert Chief Financial Manager
\\NAC-1\VOL1\HOME\KARENB\ .... IWPISIGNAUTH Revised 3/03
Today's Date
September 6,2017
Fund/Department
37 / Sheriff
Kittitas County
Review Form
Grants & Contract Agreement
Agenda Date
Octobe r/, 2017
')
Contract/Grant Information
Contract /Grant Agency: Washington State Military Department and U.S. Department of Homeland
Security FFY16 EMPG E17-156 (c/r SH16-045) Amendment A
Period Begin Date: 6/1/2016 I I Period End Date: 09/30/2017
Total Grant/Contract Amount: $24,465
Grant/Contract Number: E17-156 (SH16-045)
Contract/Grant Summary: The Homeland Security Grant Program is part ofthe ongoing Homeland
Security grants that are managed through the Region 7 Interlocal Agreement. This Amendment A extends
the deadline for spending grant money from August 31, 2017 to September 30, 2017. The timeline Exhibit
D was also replaced to reflect the time extension. There are no other changes.
Financial Information
Total Amount $24,465 State Funds $0 Federal Funds $24,465
Percentage County Funds 0% Matching Funds $0 CFDA# 97.042 EMPG
In-Kind $0
Explain
Is Equipment being purchased? YES Who owns equipment? Kittitas County, per contract.
HAM radio equipment, antenna,
and base station (to provide EOC
with redundant communications
devices); FUR camera; ballistic
vests and plates.
New Personnel being hired? NO Contact HR hiring -reporting requirements
Future impacts or liability to Kittitas County: Compliance and audit requirements.
Budget Information
Budget Amendment Needed? Yes D attach budget form No~ Why not -Already budgeted.
New Division Created? NO
Revenue Code 001-3720165XXXX
Expense Code 001-37201633397042
Grant/Contract Review Page 1
Pass Through Information
Agency to Pass Through NA
Amount to Pass Through $0
Sub-Contract Approved Date:
Prosecutor Review
I Has the Prosecutor reviewed this agreement? I Yes [i] No D CAMAS# 40467
County Departments Impacted
Auditor Facilities Maintenance
Information Services Human Resource
Prosecutor Treasurer
Submitted
Signature: Date:
Department: Sheriff
Assignment of Tracking Information
Auditor's Office
Human Resource I
Prosecutor's Office < -; /.. .# '-I...-8 =1-1-'t/I fl(?-
, Who Signed the grant application J I
(
I Reviewer I Date
Grant/Contract Review Page 2