HomeMy WebLinkAboutGrant Agreement E19-111Washington State Military Department
HOMELAND SECURITY GRANT PROGRAM AGREEMENT FACE SHEET
1. Subrecipient Name and Address: 2. Grant Agreement Amount: 3. Grant Agreement Number:
Kittitas County Sheriff's Office $48,409 E19-111
307 West Umptanum Road
Ellensburg, WA 98926-6720
4. Subrecipient Contact, phone/email: 5. Grant Agreement Start Date: 6. Grant Agreement End Date:
Darren Higashiyama, (509) 933-8206 September 1, 2018 November 30, 2020
darren.higashivama@co.kittitas.wa.us
7. Department Contact, phone/email: 8. Data Universal Numbering System (DUNS): 9. UBI # (state revenue):
Michael Alston, (253) 512-7083 010202547 192002673
michael.alston@mil.wa.aov
10. Funding Authority:
Washington State Military Department (the 'Department') and the U.S. Department of Homeland Security (DHS)
11. Federal Funding Identification #: 1 12. Federal Award Date: 1 13. Catalog of Federal Domestic Assistance (CFDA) # & Title:
EMW-2018-SS-00088-501 08/28/2018 97.067 -18HSGP (SHSP)
14. Total Federal Award Amount: 115. Program Index# & OBJ/SUB-OBJ:
$13,788,000 7835B, 783SC, 783SH, 783SL, 783SN, 783SQ, 783SZ I NZ
16. Service Districts: 17. Service Area by County(ies): 18. Women/Minority-Owned, State
BY LEGISLATIVE DISTRICTS: 13 Kittitas Certified? X N/A • NO
BY CONGRESSIONAL DISTRICTS: 8 • YES, OMWBE#
19. Agreement Classification 20. Contract Type (check all that apply): • Personal Services • Client Services X Public/Local Gov't • Contract X Grant X Agreement • Research/Development • A/E • Other • lnteri:iovernmental (RCW 39.34) • lnteragency
21. Subrecipient Selection Process: 22. 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? DYES ONO •CONTRACTOR X SUBRECIPIENT • OTHER
23. PURPOSE & DESCRIPTION:
The purpose of the Federal Fiscal Year (FFY) 2018 Homeland Security Grant Program (18HSGP) 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. 18HSGP
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. 18HSGP supports core capabilities across the five mission areas of Prevention, Protection, Mitigation, Response, and Recovery
based on allowable costs. HSGP is comprised of three interconnected grant programs: State Homeland Security Program (SHSP), Urban Areas Security
Initiative (UASI), and Operation Stonegarden (OPSG). Together, these grant programs fund a range of preparedness activities, including planning,
organization, equipment purchase, training, exercises, and management and administration.
The Department is the Recipient and Pass-through Entity of the 18HSGP OHS Award Letter for Grant No. EMW-2018-55-00088-S01, which is incorporated
in and attached hereto as Attachment 1, and is making a subaward of funds to the Subrecipient pursuant to this Agreement. The Subrecipient is accountable
to the Department for use of Federal award funds provided under this Agreement. The Subrecipient's Work Plan, nmeline, and Budget for the subaward are
detailed in Attachment 2.
IN WITNESS WHEREOF, the Department and Subrecipient acknowledge and accept the terms of this Agreement, including all referenced Exhibits and
Attachments which are hereby incorporated in and made a part hereof, and have executed this Agreement as of the date below. This Agreement Face Sheet;
Special Terms & Conditions (Exhibit A); General Terms and Conditions (Exhibit B); Attachments 1 and 2; and all other documents, exhibits and attachments
expressly referenced and incorporated herein contain all the terms and conditions agreed upon by the parties and govern the rights and obligations of the
parties to this Agreement. No other understandings, oral or otherwise, regarding the subject matter of this Agreement shall be deemed to exist or to bind any
of the oarties hereto.
I n the event of an 'lnconsJstency In this Agreement, unless othe,wise provided herein, th~ in~nsistency s hall 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. Work Pl_an, Timellne, and Budget 6. Other provis ions of the Agree ment incorpor~ted by reference.
WHEREAS , the parties hereto have executed this Agreement on the day and year last specified below.
FOR T2_EPAR~NT: 11
11 /LlltY FOR~BRSLJ,_
1 ..,,,,, ... , ...J ..... ~ ..i. /, ... -~ lft L/JdV
Slgnatur~ / ~ Date Signa ure Date
Regan Anhe Hesse, Chief Financial Officer Gene Dana, Sheriff
Washington State Military Department Kittitas County Sheriff's Office
BOILERPLATE APPROVED TO FORM: APPROVED AS TO FORM (if applicable):
Brian E. Buchholz 9/18/2018
Sr. Assistant Attorney General Applicant's Legal Review Date
DHS-FEMA-HSGP-SHSP-FFY18 Kittitas County Sheriff's Office, E19-111
Washington State Military Department
HOMELAND SECURITY GRANT PROGRAM AGREEMENT FACE SHEET
1. Subrecipient Name and Address: 2. Grant Agreement Amount: 3. Grant Agreement Number:
Kittitas County Sheritrs Office $48,409 E19-111
307 West Umptanum Road
Ellensburg , WA 98926-6720
4 . Subrecipient Contact, phone/email: 5. Grant Agreement Start Date : 6 . Grant Agreement End Date :
Darren Higashiyama, (509) 933-8206 September 1, 2018 November 30, 2020
darren.higashiyama@co.kittitas.wa.us
7 . Department Contact, phone/email: 8. Data Universal Numbering System (DUNS): 9. UBI# (state revenue):
Michael Alston, (253) 512-7083 010202547 192002673
michael.alston@mil.wa.gov
10. Funding Authority:
Washington State Militarv Department (the "Department") and the U.S. Department of Homeland Security (DHS)
11. Federal Funding Identification #: 112. Federal Award Date: 13. Catalog of Federal Domestic Assistance (CFDA) # & Title:
EMW-2018-55-00088-501 08/28/2018 97.067 -18HSGP (SHSP)
14. Total Federal Award Amount: 1 15. Program Index# & OBJ/SUB-OBJ:
$13,788,000 7835B, 7835C, 7835H, 7835L, 7835N, 7835Q, 78352 / NZ
16. Service Districts: 17. Service Area by County(ies): 18. Women/Minority-Owned, State
BY LEGISLATIVE DISTRICTS : 13 Kittitas Certified? X N/A • NO
BY CONGRESSIONAL DISTRICTS : 8 • YES, OMWBE#
19. Agreement Classification 20. Contract Type (check all that apply): • Personal Services • Client Services X Public/Local Gov't • Contract X Grant X Agreement
D Research/Development • A/E • Other • lntemovernmental (RCW 39.34) • lnter~g_ency
21. Subrecipient Selection Process: 22. Subrecipient Type (check all that apply)
X "To all who apply & q\,Jalify" • 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? DYES •NO •CONTRACTOR X SUBRECIPIENT • OTHER
23 . PURPOSE & DESCRIPTION :
The purpose of the Federal Fiscal Year (FFY) 2018 Homeland Security Grant Program (18HSGP) 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 . 1 BHSGP
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. 1 BHSGP supports core capabilities across the five mission areas of Prevention, Protection , Mitigation, Response, and Recovery
based on allowable costs. HSGP is comprised of three interconnected grant programs : State Homeland Security Program (SHSP), Urban Areas Security
Initiative (UASI), and Operation Stonegarden (OPSG). Together, these grant programs fund a range of preparedness activities, including planning ,
organization, equipment purchase, train ing, exercises, and management and administration .
The Department is the Recipient and Pass-through Entity of the 1 BHSGP DHS Award Letter for Grant No. EMW-2018-SS-00088-S01, which is incorporated
In and attached hereto as Attachment 1, and is making a subaward of funds to the Subrecipient pursuant to this Agreement. The Subrecipient is accountable
to the Department for use of Fede ral award funds provided under this Agreement. The Subrecipient's Work Plan, Timeline, and Budget for the subaward are
detailed In Attachment 2.
IN WITNESS WHEREOF, the Department and Subrecipient acknowledge and accept the terms of this Agreement, including all referenced Exhibits and
Attachments which are hereby incorporated In and made a part hereof, and have executed this Agreement as of the date below. This Agreement Face Sheet ;
Special Terms & Conditions (Exhibit A); General Terms and Conditions (Exhibit B); Attachments 1 and 2; and all other documents, exhibits and attachments
expressly referenced and incorporated herein contain all the terms and conditions agreed upon by the parties and govern the rights and obligations of the
parties to this Agreement. No other understandings, oral or otherwise, regarding the subject matter of this Agreement shall be deemed to exist or to bind any
of the oarties hereto.
In the event of an i n consistency rn this Agreement, unless otherwise provided herein, the inconsistency shall be resolved by g iving
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. Work Plan , Timelin e, and Budget 6. Other provisions of the Agree ment incorporated bv reference.
WHEREAS, the parties hereto have executed this Agreement on the day and year last specified below.
FORTHEDEPARTMEN~ FORTH~E~~ II'/ ?J/7.bl ,J
Signature Date Signature Date
Regan Anne Hesse, Chief Financial Officer Gene Dana, Sheriff
Washington State Military Department Kittitas County Sheriff's Office
BOILERPLATE APPROVED TO FORM: APP~rA'e.JP-~)°RM'(if applicable(( 7.-q,( I~
Brian E . Buchholz 9/18/2018
Sr. Assistant Attorney Gen~ral A p plicant's Legal Re~ 10w Date
DHS-FEMA-HSGP-SHSP-FFY18 Page 1 of 40 Kittitas County Sheriffs Office, E19-111
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.
S UB RECIPIENT DEPARTMENT
Name Darren Higashiyama Name Michael Alston
Title Commander Title Program Coordinator
E-Mail darren.higashiyama@co.kittitas.wa.us E-Mail michael.alston@mil .wa.gov
Phone 509-933-8206 Phone 253-512-7083
Name Heather Seibert Name Kathryn Zetzer
Title Chief Financial Manager Title Program Manager
E-Mail heather.seibert@co.kittitas.wa.us E-Mail kathryn.zetzer@mil.wa._gov
Phone 509-962-7099 Phone 253-512-7140
Name Name Sierra Wardell
Title Title Section Supervisor
E-Mail E-Mail sierra.wardell@mil.wa.gov
Phone Phone 253-512-7121
ARTICLE II --ADMINISTRATIVE AND/OR FINANCIAL REQUIREMENTS
The Subrecipient shall comply with all applicable state and federal laws, rules , regulations, requirements and
program guidance identified or referenced in this Agreement and the informational documents published by
DHS/FEMA applicable to the 18HSGP Program, including, but not limited to, all criteria, restrictions, and
requirements of "The U.S . Department of Homeland Security (DHS) Notice of Funding Opportunity (NOFO)
Fiscal Year (FY) 2018 Homeland Security Grant Program (HSGP)" document, the DHS Award Letter for Grant
No . EMW-2018-SS-00088-S01, and the federal regulations commonly applicable to DHS/FEMA grants, all of
which are incorporated herein by reference. The OHS Award Letter is incorporated in this Agreement as
Attachment 1 .
The Subrecipient acknowledges that since this Agreement involves federal award funding , the period of
perfonnance described here in 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 detennination whether each agreement it makes for
the disbursement of 18HSGP 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 18HSGP 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 informational documents published by DHS/FEMA applicable to the
18HSGP Program, including, but not limited to, all criteria , restrictions, and requirements of
the "The U.S. Department of Homeland Security (OHS) Notice of Funding Opportunity
(NOFO) Fiscal Year (FY) 2018 Homeland Security Grant Program (HSGP)" document, the
DHS-FEMA-HSGP-SHSP-FFY18 Page 2 of 40 Kittitas County Sheriffs Office, E19-111
OHS Award Letter for Grant No. EMW-2018-SS-00088-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 18HSGP
federal award funds provided to its subrecipient are used in accordance with appl icable
federal and state statutes and regulations, and the terms and conditions of the federal award
set forth in Attachment 1 of this Agreement.
2. BUDGET, REIMBURSEMENT, AND TIMELINE
a. Within the total Grant Agreement Amount, travel, subcontracts, salaries, benefits, printing,
equipment, and other goods and services or other budget categories will be reimbursed on an
actual cost basis unless otherwise provided in this Agreement.
b . The maximum amount of all reimbursement requests permitted to be submitted under this
Agreement, including the final reimbursement request, is limited to and shall not exceed the total
Grant Agreement Amount.
c. If the Subrecipient chooses to include indirect costs within the Budget {Attachment 2), an indirect
cost rate agreement negotiated between the federal cognizant agency for indirect costs and the
Subrecipient establishing approved indirect cost rate(s) as described in 2 CFR 200.414 and
Appendix VII to 2 CFR 200 must be submitted to the Department. However, under 2 CFR
200.414{f), if the Subrecipient has never received a negotiated indirect cost rate agreement
establishing federally negotiated rate(s), the Subrecipient may negotiate a rate with the
Department or charge a de minimis rate of 10% of modified total direct costs. The Subrecipient's
actual indirect cost rate may vary from the approved rate, but must not exceed the approved
negotiated indirect cost rate percentage for the time period of the expenditures. If a Subrecipient
chooses to charge the 10% de minimis rate, but did not charge indirect costs to previous
subawards, a request for approval to charge indirect costs must be submitted to the Department's
Key Personnel for approval with an explanation for the change.
d. For travel costs, the Subrecipient shall comply with 2 CFR 200.474 and should consult their
internal policies, state rates set pursuant to RCW 43 .03.050 and RCW 43.03.060 as now existing
or amended, and federal maximum rates set forth at http://www.gsa.gov, and follow the most
restrictive. If travel costs exceed set state or federal limits, travel costs shall not be reimbursed
without prior written approval by Department Key Personnel.
e. Reimbursement requests will include a properly completed State A-19 Invoice Form and
Reimbursement Spreadsheet (in the format provided by the Department) detailing the
expenditures for which reimbursement is sought. Reimbursement requests must be submitted to
Reimbursements@mil.wa.gov no later than the due dates listed within the Timeline {Attachment
2).
Reimbursement request totals should be commensurate to the time spent processing by the
Subrecipient and the Department. If the reimbursement request isn't substantial enough, the
Subrecipient should request prior written approval from Department Key Personnel to waive the
due date in the Timeline (Attachment 2) and once approved submit those costs on the next
scheduled reimbursement due date contained in the Timeline (Attachment 2).
f . Receipts and/or backup documentation for any approved items that are authorized under this
Agreement must be maintained by the Subrecipient consistent with record retention requirements
of this Agreement, and be made available upon request by the Department, and federal, state, or
local auditors.
g. Any request for extension of a due date in the Timeline (Attachment 2) will be treated as a request
for Amendment of the Agreement. This request must be submitted to Department Key Personnel
sufficiently in advance of the due date to provide adequate time for Department review and
consideration, and may be granted or denied within the Department's sole discretion.
h. All work under this Agreement must end on or before the Grant Agreement End Date, and the
final reimbursement request must be submitted to the Department within 45 days after the Grant
Agreement End Date, except as otherwise authorized by written amendment of this Agreement
and issued by the Department.
DHS-FEMA-HSGP-SHSP-FFY18 Page 3 of 40 Kittitas County Sheriff's Office , E19-111
i. No costs for purchases of equipmenUsupplies 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 submit timely, accurate, and complete reports as required by this Agreement (including,
but not limited to, those reports in the Timeline [Attachment 2]) will prohibit the Subrecipient from
being reimbursed until such complete reports are submitted and the Department has had
reasonable time to conduct its review.
k. Final reimbursement requests will not be approved for payment until the Subrecipient is current
with all reporting requirements contained in this Agreement.
I. A written amendment will be required if the Subrecipient expects cumulative transfers among
project budgets , as identified in the Work Plan and Budget (Attachment 2), to exceed 10% of the
Grant Agreement Amount. Any adjustments to project totals other than in compliance with this
paragraph will not be reimbursed.
m. Subrecipients shall only use federal award funds under this Agreement to supplement existing
funds and will not use them to replace (supplant) non-federal funds that have been budgeted for
the same purpose. The Subrecipient may be required to demonstrate and document that the
reduction in non-federal resources occurred for reasons other than the receipt or expected receipt
of federal funds.
3. REPORTING
a. With each reimbursement request, the Subrecipient shall report how the expenditures, for which
reimbursement is sought, relate to the Work Plan (Attachment 2) activities in the format provided
by the Department.
b. With the final reimbursement request, the Subrecipient shall submit to the Department Key
Personnel a final report describing all completed activities under this Agreement.
c. The Subrecipient shall comply with the Federal Funding Accountability and Transparency Act
(FFATA) and related 0MB 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/qrants/reg ui redqrantforms; which is incorporated by reference and made a part of this
Agreement.
d. SHSP and UASI Subrecipients shall participate in the Stakeholder Preparedness Review (SPR)
process, formerly known as the State Preparedness Report.
4. EQUIPMENT AND SUPPLY MANAGEMENT
a. The Subrecipient and any non-federal entity to which the Subrecipient makes a subaward shall
comply with 2 CFR 200.318 -200.326 when procuring any equipment or supplies under this
Agreement, 2 CFR 200.313 for management of equipment, and 2 CFR 200.314 for management
of supplies, to include, but not limited to:
i. Upon successful completion of the terms of this Agreement, all equipment and supplies
purchased through this Agreement will be owned by the Subrecipient, or a recognized non-
federal entity to which the Subrecipient has made a subaward, for which a contract,
subrecipient grant agreement, or other means of legal transfer of ownership is in place.
ii. All equipment, and supplies as applicable, purchased under this Agreement will be recorded
and maintained in the Subrecipient's inventory system.
iii. Inventory system records shall include:
A . description of the property
B . manufacturer's serial number, model number, or other identification number;
C. the source of funding for the equipment, including the Federal Award Identification
Number (FAIN)
D. Catalog of Federal Domestic Assistance (CFDA) number
E. who holds the title
F. acquisition date
DHS-FEMA-HSGP-SHSP-FFY18 Page 4 of 40 Kittitas County Sheriffs Office, E19-111
G. cost of the equipment and the percentage of federal participation in the cost
H. location, use and condition of the equipment at the date the information was reported,
and
I. disposition data including the date of disposal and sale price of the property.
iv. The Subrecipient shall take a physical inventory of the equipment and reconcile the results
with the property records at least once every two years. Any differences between quantities
determined by the physical inspection and those shown in the records shall be investigated
by the Subrecipient to determine the cause of the difference. The Subrecipient shall, in
connection with the inventory, verify the existence, current utilization, and continued need
for the equipment.
v. The Subrecipient shall be responsible for any and all operational and maintenance
expenses and for the safe operation of their equipment and supplies including all questions
of liability. The Subrecipient shall develop appropriate maintenance schedules and
procedures to ensure the equipment, and supplies as applicable, are well-maintained and
kept in good operating condition.
vi. The Subrecipient shall develop a control system to ensure adequate safeguards to prevent
loss, damage, and theft of the property. Any loss, damage, or theft shall be investigated,
and a report generated and sent to the Department.
vii. The Subrecipient must obtain and maintain all necessary certifications and licenses for the
equipment.
viii. If the Subrecipient is authorized or required to sell the property, proper sales procedures
must be established and followed to ensure the highest possible return. For disposition, if
upon termination or at the Grant Agreement End Date, when original or replacement
supplies or equipment acquired under a federal award are no longer needed for the original
project or program or for other activities currently or previously supported by a federal
awarding agency, the Subrecipient must comply with the following procedures:
A. For Supplies: If there is a residual inventory of unused supplies exceeding $5,000 in
total aggregate value upon termination or completion of the project or program and the
supplies are not needed for any other federal award, the Subrecipient must retain the
supplies for use on other activities or sell them, but must, in either case, compensate
the federal government for its share. The amount of compensation must be computed
in the same manner as for equipment.
B. For Equipment:
1) Items with a current per-unit fair-market value of $5,000 or less may be retained,
sold, or otherwise disposed of with no further obligation to the federal awarding
agency.
2) Items with a current per-unit fair-market value in excess of $5,000 may be retained
or sold. The Subrecipient shall compensate the federal awarding agency in
accordance with the requirements of 2 CFR 200.3 13 (e) (2).
ix. Records for equipment shall be retained by the Subrecipient for a period of six years from
the date of the disposition, replacement, or transfer. If any litigation, claim, or audit is started
before the expiration of the six-year period, the records shall be retained by the Subrecipient
until all litigation, claims, or audit findings involving the records have been resolved.
b. The Subrecipient shall comply with the Department's Purchase Review Process, which is
incorporated by reference and made part of this Agreement. No reimbursement will be provided
unless the appropriate approval has been received.
c. Allowable equipment and supply categories for 18HSGP are listed on the Authorized Equipment
List (AEL) located on the FEMA website at http://www.fema .gov/authorized-equibment-1ist. It is
important that 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
DHS-FEMA-HSGP-SHSP-FFY18 Page 5 of 40 Kittitas County Sheriff's Office, E19-111
to the federal, state, local, and tribal definitions of equipment. The Subrecipient is 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, the Subrecipient must contact
the Department Key Personnel for assistance in seeking FEMA approval prior to acquisition.
d . Unless expressly provided otherwise, all equipment must meet all mandatory regulatory and/or
OHS/FE MA adopted standards to be eligible for purchase using federal award funds.
e . For OPSG Subrecipients, equipment purchased with OHS federal award funds is to be marked
prominently with "Purchased with OHS funds for Operation Stonegarden Use" when practicable.
f. Procurement of medical countermeasures must be conducted in collaboration with state, city, or
local health departments that administer Federal funds from Health and Human Services (HHS)
for this purpose and with existing Metropolitan Medical Response System (MMRS) committees
where available, in order to sustain their long-term planning for appropriate, rapid, and local
medical countermeasures, including antibiotics and antidotes for nerve agents, cyanide, and other
toxins . Procurement must have a sound threat-based justification with an aim to reduce the
consequences of mass casualty incidents during the first crucial hours of a response. 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 18HSGP. The cost of disposal cannot be
carried over to another DHS/FEMA grant or grant period.
g. The Subrecipient must pass on equipment and supply management requirements that meet or
exceed the requirements outlined above to any non-federal entity to which the Subrecipient
makes a subaward of federal award funds under this Agreement.
5. ENVIRONMENTAL AND HISTORICAL PRESERVATION
a. The Subrecipient shall ensure full compliance with the DHS/FEMA Environmental Planning and
Historic Preservation (EHP) Program. EHP program information can be found at
https://www.fema .gov/media -llbrary/assets/documents/85376 all of which are incorporated in and
made a part of this Agreement.
b. Projects that have historical impacts or 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 OHS/FEMA EHP review process prior to project initiation. Modification of existing buildings,
including minimally invasive improvements such as attaching monitors to interior walls, and
training or exercises occurring outside in areas not considered previously disturbed also require
a OHS/FEMA EHP review before project initiation.
c. The EHP review process involves the submission of a detailed project description that includes
the entire scope of work , incl uding any alternatives that may be under consideration, along with
supporting documentation so FEMA may determine whether the proposed project has the
potential to impact environmental resources and/or historic properties.
d. The Subrecipient agrees that, to receive any federal preparedness funding, all EHP compliance
requirements outlined in applicable guidance must be met. The EHP review process must be
completed and approval received by the Subrecipient before any work is started for which
reimbursement will be later requested . Expenditures for projects started before completion of the
EHP review process and receipt of approval by the Subrecipient may not be reimbursed.
6. PROCUREMENT
a. The Subrecipient shall comply with all procurement requirements of 2 CFR Part 200.318 through
200.326 and as specified in the General Terms and Conditions, Exhibit B, A.10.
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
DHS-FEMA-HSGP-SHSP-FFY18 Page 6 of 40 Kittitas County Sheriffs Office , E19-111
requests for proposals, invitations for bids and independent cost estimates . This requirement must
be passed on to any non-federal entity to which the Subrecipient makes a subaward, at which
point the Subrecipient will be responsible for reviewing and approving sole source justifications of
any non-federal entity to which the Subrecipient makes a subaward.
7. SUBRECIPIENT MONITORING
a. The Department will monitor the activities of the Subrecipient from award to closeout. The goal of
the Department's monitoring activities will be to ensure that agencies receiving federal pass-
through funds are in compliance with this Agreement. federal and state audit requirements,
federal grant guidance, and applicable federal and state financial regulations, as well as 2 CFR
Part 200 Subpart F.
b. To document compliance with 2 CFR Part 200 Subpart F requirements, the Subrecipient shall
complete and return to the Department the "2 CFR Part 200 Subpart F Audit Certification Form"
located at http://mil. wa.qov/emerqency-management-division/grants/reguiredgrantforms 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 and Budget (Attachment 2), and federal requirements;
v. Observation and documentation of Agreement-related activities, such as exercises, training,
funded events, and equipment demonstrations; and
vi. On-site visits to review equipment records and inventories , to verify source documentation for
reimbursement requests and performance reports, and to verify completion of deliverables.
d. The Subrecipient is required to meet or exceed the monitoring activities, as outlined above and in
2 CFR Part 200, for any non-federal entity to which the Subrecipient makes a subaward as a
pass-through entity under this Agreement.
e. Compliance will be monitored throughout the performance period to assess risk. Concerns will be
addressed through a Corrective Action Plan.
8. LIMITED ENGLISH PROFICIENCY {CIVIL RIGHTS ACT OF 1964 TITLE VI)
The Subrecipient must comply with the Title VI of the Civil Rights Act of 1964 (Title VI) prohibition
against discrimination on the basis of national origin, which requires that Subrecipients of federal
financial assistance take reasonable steps to provide meaningful access to persons with limited
English proficiency (LEP) to their programs and services. Providing meaningful access for persons
with LEP may entail providing language assistance services, including oral interpretation and written
translation. Executive Order 13166, Improving Access to Services for Persons with Limited English
Proficiency (August 11, 2000), requires federal agencies to issue guidance to recipients, assisting
such organizations and entities in understanding their language access obligations. DHS published
the required recipient guidance in April 2011, OHS 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 OHS Recipient Guidance at https://www.dns .gov/quidance-published-
help-department-supported-organizations-provide-meaningful-access-people-limited and additional
resources on http://www.lep.gov.
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9. NIMS COMPLIANCE
a. The National Incident Management System (NIMS) identifies concepts and principles that answer
how to manage emergencies from preparedness to recovery regardless of their cause, size,
location, or complexity. NIMS provides a consistent, nationwide approach and vocabulary for
multiple agencies or jurisdictions to work together to build, sustain, and deliver the core
capabilities needed to achieve a secure and resilient nation.
b. Consistent implementation of NIMS provides a solid foundation across jurisdictions and
disciplines to ensure effective and integrated preparedness, planning, and response . NIMS
empowers the components of the National Preparedness System, a requirement of Presidential
Policy Directive 8, to guide activities within the public and private sector and describes the
planning, organizational activities, equipping, training and exercising needed to build and sustain
the core capabilities in support of the National Preparedness Goal.
c. In order to receive FY 2018 federal preparedness funding, to include HSGP, the Subrecipient will
ensure all NIMS objectives have been initiated and/or are in progress toward completion. NIMS
Implementation Objectives are located at https://www.fema.gov/medla-
library/assets/documetns/1307 43.
B. HSGP SPECIFIC REQUIREMENTS
1. 18HSGP stipulates the following requirements for overall grant funding which are managed at the
State Administrative Agency (SAA) level; specific caps or thresholds for this Agreement may differ.
a. Up to 5% percent of the HSGP award received by the Department may be used for management
and administrative (M&A) purposes directly related to administration of the HSGP grant. The
maximum percentage of the Grant Agreement Amount that may be used by the Subrecipient for
M&A costs under this Agreement is identified in the Budget (Attachment 2), and may be less than,
but will not exceed, the maximum 5%.
b. At least 25% of the combined HSGP award allocated under SHSP and UASI must be dedicated
towards law enforcement terrorism prevention activities (LETPA). The LETPA percentage of the
Grant Agreement Amount that must be met as a minimum requirement of this Agreement by the
Subrecipient is identified in the Budget (Attachment 2) and may differ from the combined 25%
requirement. If the Subrecipient anticipates spending less than the indicated amount on LETPA
activities as indicated in the Budget (Attachment 2), a budget amendment is required.
c. The total of personnel expenses may not exceed 50% percent of the individual program awards
received by the Department unless a Personnel Cap Waiver has been received from DHS. The
maximum percentage of the Grant Agreement Amount that may be used by the Subrecipient for
personnel expenses under this Agreement is identified in the Budget (Attachment 2) and may
differ from the 50% limit. If the Subrecipient anticipates spending more on personnel costs than
what is in the Budget (Attachment 2), a budget amendment is required. Additional approval steps
may be required for each program before the personnel percentage can be increased.
2. SHSP-funded projects must address high-priority preparedness gaps across all core capabilities that
support terrorism preparedness.
3. UASl-funded projects must build and sustain the capabilities necessary for high-threat, high-density
Urban Areas to prevent, protect against, mitigate , respond to, and recover from acts of terrorism.
4. OPSG-funded projects must enhance cooperation and coordination among Customs and Border
Protection, United States Border Patrol. and local, tribal, territorial, state, and federal law enforcement
agencies in a joint mission to secure the United States' borders along routes of ingress from
international borders to include travel corridors in states bordering Mexico and Canada. as well as
states and territories with international water borders.
5. The Subrecipient shall use HSGP funds only to perform tasks as described in the Work Plan
(Attachment 2), as approved by the Department, and in compliance with this Agreement.
6. Subrecipients are encouraged to participate in the State's annual Training and Exercise Planning
Workshop (TEPW) or may conduct their own local/regional TEPW.
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7. Subrecipients must request prior approval from Department Key Personnel to attend non-DHS/FEMA
training courses per DHS/FEMA Grant Programs Directorate Policy FP 207-008-064-1
(https://www.fema.gov/media -library/assets/documents/34856 ). This requirement only applies to
training courses and does not include attendance at conferences . Furthermore, additional federal
approvals are needed for courses that relate to Countering Violent Extremism.
8. Subrecipients will provide reports and/or assist with the completion of reports required by the HSGP
federal award , including, but not limited to, the Stakeholder Preparedness Review (SPR), Threat and
Hazard Identification and Risk Assessment (THIRA), core capabilities assessment, and data calls.
C. DHS TERMS AND CONDITIONS
As a subrecipient of 18HSGP program funding, the Subrecipient shall comply with all applicable OHS
terms and conditions of the 18HSGP Award Letter and its incorporated documents for DHS Grant No.
EMW-2018-SS-00088-S01, which are incorporated in and made a part of this Agreement as Attachment
1.
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A .1 DEFINITIONS
Washington State Military Department
GENERAL TERMS AND CONDITIONS
Department of Homeland Security (OHS)/
Federal Emergency Management Agency (FEMA)
Grants
Exhibit B
As used throughout this Agreement, the terms will have the same meaning as defined in 2 CFR 200
Subpart A (which is incorporated herein by reference), except as otherwise set forth below:
a. "Agreement" means this Grant Agreement.
b. "Department" means the Washington State Military Department, as a state agency, any division ,
section, office, unit or other entity of the Department, or any of the officers or other officials lawfully
representing that Department. The Department is a recipient of a federal award directly from a
federal awarding agency and is the pass-through entity making a subaward to a Subrecipient
under this Agreement.
c. "Subrecipient" when capitalized is primarily used throughout this Agreement in reference to the
non-federal entity identified on the Face Sheet of this Agreement that has received a subaward
from the Department. However, the definition of "Subrecipient" is the same as in 2 CFR 200 .93
for all other purposes.
d. "Monitoring Activities" means all administrative, financial, or other review activities that are
conducted to ensure compliance with all state and federal laws, rules, regulations, authorities and
policies.
e. "Investment" means the grant application submitted by the Subrecipient describing the project(s)
for which federal funding is sought and provided under this this Agreement. Such grant
application is hereby incorporated into this Agreement by reference .
A.2 ADVANCE PAYMENTS PROHIBITED
The Department shall make no payments in advance or in anticipation of goods or services to be provided
under this Agreement. Subrecipient shall not invoice the Department in advance of delivery and invoicing
of such goods or services.
A.3 AMENDMENTS AND MODIFICATIONS
The Subrecipient or the Department may request, in writing, an amendment or modification of this
Agreement. However, such amendment or modification shall not be binding, take effect or be
incorporated herein until made in writing and signed by the authorized representatives of the Department
and the Subrecipient. No other understandings or agreements, written or oral, shall be binding on the
parties.
A.4 AMERI CANS W ITH D ISABI LITIES ACT (ADA} OF 19901 PUBLIC LAW 101-336, 42 U.S.C. 12 10 1 ET
SEQ. A ND rTS IMP LE M ENTING REGULAT IONS ALSO REFERRED TO AS THE "ADA" 28 CFR Part
35.
The Subrecipient must comply with the ADA, which provides comprehensive civil rights protection to
individuals with disabilities in the areas of employment, public accommodations, state and local
government services, and telecommunication.
A.5 ASSURANCES
The Department and Subrecipient agree that all activity pursuant to this Agreement will be in accordance
with all the applicable current federal, state and local laws, rules and regulations.
A.6 C E RT IFICAT ION R EGARDI NG DEBARME NT, S USPENSION . OR INELIGIBILITY
As federal funds are a basis for this Agreement, the Subrecipient certifies that the Subrecipient is not
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participating in this Agreement by any federal department or agency.
The Subrecipient shall complete, sign, and return a Certification Regarding Debarment, Suspension ,
Ineligibility, and Voluntary Exclusion form located at http://mil.wa.gov/emergency-management-
division/q rant s/requiredgrantforms. Any such form completed by the Subrecipient for this Agreement
shall be incorporated into this Agreement by reference.
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Further, the Subrecipient agrees to comply with all applicable federal regulations concerning the federal
debarment and suspension system, including 2 CFR Part 180. The Subrecipient certifies that it will
ensure that potential contractors or Subrecipients or any of their principals are not debarred, suspended ,
proposed for debarment, declared ineligible , or voluntarily excluded from participation in "covered
transactions" by any federal department or agency. "Covered transactions" include procurement
contracts for goods or services awarded under a non-procurement transaction (e.g. grant or cooperative
agreement) that are expected to equal or exceed $25,000, and subawards to Subrecipients for any
amount. With respect to covered transactions, the Subrecipient may comply with this provision by
obtaining a certification statement from the potential contractor or Subrecipient or by checking the System
for Award Management {https://sam.gov/portal/SAM/##11) 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"
(https://secure.lni.wa .gov/debarandstrike/ContractorDebarlist.asox). 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/servicesfContractingPurchasing /Business/PagesNendor~Debarment.aspx:}.
A .7 CERTIFICAT ION REGAR D ING REST RI CTIONS O N 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 subcontracts, sub-grants , and contracts under grants ,
loans, and cooperative agreements} and that all Subrecipients shall certify and disclose accordingly. This
certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into and is a prerequisite for making or entering into this transaction imposed by section
1352, title 31, U.S. Code.
A.8 CO MPLIANCE W ITH APPLIC ABLE S TATUTES, RU LES AND DEPARTMENT POLICIES
A.9
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, 0MB 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,
0MB 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, 0MB Circulars or policies.
CO NFLICT O F INTERES T
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
DHS-FEMA-HSGP-SHSP-FFY18 Page 11 of 40 Kittitas County Sheriffs Office, E19-111
undertaken or located; and no other official of the Subrecipient who exercises any functions or
responsibilities with respect to the project during his or her tenure, shall have any personal or pecuniary
gain or interest, direct or indirect, in any contract , subcontract, or the proceeds thereof, for work to be
performed in connection with the project assisted under this Agreement.
The Subrecipient shall incorporate, or cause to incorporate , in all such contracts or subawards, a
provision prohibiting such interest pursuant to this provision .
A.10 CONTRACTI NG & PROCUREMENT
a . The Subrecipient shall use a competitive procurement process in the procurement and award of
any contracts with contractors or subcontractors that are entered into under the original
agreement award . The procurement process followed shall be in accordance with 2 CFR Part
200.318 General procurement standards through 200.326 Contract provisions.
As required by Appendix 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 affected 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 ass isted construction contract" in 41 CFR Part
60-1.3 must include the equal opportunity clause provided under 41 CFR 60-1.4(b), in
accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319,
12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375,
"Amending Executive Order 11246 Relating to Equal Employment Opportunity," and
implementing regulations at 41 CFR part 60 , "Office of Federal Contract Compliance
Programs, Equal Employment Opportunity, Department of Labor."
4) Davis-Bacon Act, as amended (40 U.S.C . 3141-3148). When required by Federal program
legislation, all prime construction contracts in excess of $2,000 awarded by non-federal
entities must include a provision for compliance with the Davis-Bacon Act (40 U.S.C. 3141-
3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Part
5, "Labor Standards Provisions Applicable to Contracts Covering Federally Financed and
Assisted Construction "). In accordance with the statute, contractors must be required to pay
wages to laborers and mechanics at a rate not less than the prevailing wages specified in a
wage determination made by the Secretary of Labor. In addition, contractors must be
required to pay wages not less than once a week. The non-federal entity must place a copy
of the current prevailing wage determination issued by the Department of Labor in each
solicitation. The decision to award a contract or subcontract must be conditioned upon the
acceptance of the wage determination. The non-federal entity must report all suspected or
reported violations to the federal awarding agency . The contracts must also include a
provision for compliance with the Copeland "Anti-Kickback" Act (40 U.S .C. 3145), as
supplemented by Department of Labor regulations (29 CFR Part 3, "Contractors and
Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or
Grants from the United States"). The Act provides that each contractor or Subrecipient must
be prohibited from inducing, by any means, any person employed in the construction,
completion, or repair of public work, to give up any part of the compensation to which he or
she is otherwise entitled. The non-federal entity must report all suspected or reported
violations to the federal awarding agency.
5) Co ntract W ork Hours and Safety Stand ards Act (40 U.S.C . 3701-3708). Where applicable ,
all contracts awarded by the non -fede ral 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
DHS-FEMA-HSGP-SHSP-FFY18 Page 12 of 40 Kittitas County Sheriffs Office , E19-111
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 0MB guidelines at 2 CFR 180
that implement Executive Orders 12549 (3 CFR part 1986 Comp ., p. 189) and 12689 (3 CFR
part 1989 Comp., p. 235), "Debarment and Suspension." SAM Exclusions contains the
names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties
declared ineligible under statutory or regulatory authority other than Executive Order 12549.
9) Byrd Anti-Lobbying Amendment (31 U.S.C. 1352}-Contractors that apply or bid for an award
exceeding $100,000 must file the required certification. Each tier certifies to the tier above
that it will not and has not used federal appropriated funds to pay any person or organization
for influencing or attempting to influence an officer or employee of any agency, a member of
Congress, officer or employee of Congress, or an employee of a member of Congress in
connection with obtaining any federal contract, grant or any other award covered by 31
U.S.C. 1352. Each tier must also disclose any lobbying with non-federal funds that takes
place in connection with obtaining any federal award. Such disclosures are forwarded from
tier to tier up to the non-federal award.
10) Procurement of recovered materials --As required by 2 CFR 200 .322 , a non-federal entity
that is a state agency or agency of a political subdivision of a state and its contractors must
comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource
Conservation and Recovery Act. The requirements of Section 6002 include procuring only
items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part
247 that contain the highest percentage of recovered materials practicable, consistent with
maintaining a satisfactory level of competition, where the purchase price of the item exceeds
$10,000 or the value of the quantity acquired during the preceding fiscal year exceeded
$10,000; procuring solid waste management services in a manner that maximizes energy
and resource recovery; and establishing an affirmative procurement program for
procurement of recovered materials identified in the EPA guidelines.
11) Notice of awarding agency requirements and regulations pertaining to reporting.
12) Federal awarding agency requirements and regulations pertaining to copyrights and rights in
data.
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 ,
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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's procurement plans and
documents and require the Subrecipient to make changes to bring its plans and documents into
compliance with the requirements of 2 CFR Part 200.318 through 200.326 . The Subrecipient
must ensure that its procurement process requires contractors and subcontractors to provide
adequate documentation with sufficient detail to support the costs of the project and to allow both
the Subrecipient and Department to make a determination on eligibility of project costs.
c. All contracting agreements entered into pursuant to this Agreement shall incorporate this
Agreement by reference
A.11 DISCLOSURE
The use or disclosure by any party of any information concerning the Department for any purpose not
directly connected with the administration of the Department's or the Subrecipient's responsibilities with
respect to services provided under this Agreement is prohibited except by prior written consent of the
Department or as required to comply with the state Public Records Act, other law or court order.
A.12 DISPUTES
Except as otherwise provided in this Agreement, when a bona fide dispute arises between the parties
and it cannot be resolved through discussion and negotiation, either party may request a dispute
resolution panel to resolve the dispute. A request for a dispute resolution board shall be in writing, state
the disputed issues, state the relative positions of the parties, and be sent to all parties. The panel shall
consist of a representative appointed by the Department, a representative appointed by the Subrecipient
and a third party mutually agreed upon by both parties. The panel shall, by majority vote, resolve the
dispute. Each party shall bear the cost for its panel member and its attorney fees and costs and share
equally the cost of the third panel member.
A.13 LEGAL RELATIONS
It is understood and agreed that this Agreement is solely for the benefit of the parties to the Agreement
and gives no right to any other party. No joint venture or partnership is formed as a result of this
Agreement.
To the extent allowed by law, the Subrecipient, its successors or assigns, will protect, save and hold
harmless the Department, the State of Washington, and the United States Government and their
authorized agents and employees, from all claims, actions, costs, damages or expenses of any nature
whatsoever by reason of the acts or omissions of the Subrecipient, its subcontractors, 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 the 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
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part of a federal agency or an employee of the Federal government in carrying out the provisions of the
Stafford Act.
A.14 LIMI T ATIO N OF AUTHORITY-AUTH O RIZE D S IGNATURE
The signatories to this Agreement represent that they have the authority to bind their respective
organizations to this Agreement. Only the Department's Authorized Signature representative and the
Authorized Signature representative of the Subrecipient or Alternate for the Subrecipient, formally
designated in writing, shall have the express, implied, or apparent authority to alter, amend, modify, or
waive any clause or condition of this Agreement. Any alteration, amendment, modification, or waiver of
any clause or condition of this Agreement is not effective or binding unless made in writing and signed
by both parties ' Authorized Signature representatives.
Further, only the Authorized Signature representative or Alternate for the Subrecipient shall have
signature authority to sign reimbursement requests , time extension requests, amendment and
modification requests, requests for changes to projects or work plans , and other requests, certifications
and documents authorized by or required under this Agreement.
A.15 LOSS OR REDUCTION OF FUNDING
In the event funding from state , federal, or other sources is withdrawn, reduced, or limited in any way
after the effective date of this Agreement and prior to normal completion or end date, the Department
may unilaterally reduce the work plan and budget or unilaterally terminate all or part of the Agreement as
a "Termination for Cause" without providing the Subrecipient an opportunity to cure . Alternatively , the
parties may renegotiate the terms of this Agreement under "Amendments and Modifications" to comply
with new funding limitations and conditions, although the Department has no obligation to do so.
A.16 NONASSIGNABILITY
Neither this Agreement, nor any claim arising under this Agreement, shall be transferred or assigned by
the Subrecipient.
A.17 NONDISCRIMINATION
The Subrecipient shall comply with all applicable federal and state non-discrimination laws, regulations ,
and policies. No person shall, on the grounds of age, race, creed, color, sex, sexual orientation, religion,
national origin, marital status , honorably discharged veteran or military status, or disability {physical,
mental, or sensory) be denied the benefits of, or otherwise be subjected to discrimination under any
project, program, or activity, funded, in whole or in part, under this Agreement.
A.18 NOTICES
The Subrecipient shall comply with all public notices or notices to ind ividuals required by applicable local,
state and federal laws and regulations and shall maintain a record of this compliance .
A.19 OCCU PAT IONAL SAFETY/HEALTH ACT and WASHINGTON INDUSTRI AL SAFETY/ HEALT H ACT
(O S HA/WIS HA)
The Subrecipient represents and warrants that its work place does now or will meet all applicable federal
and state safety and health regulations that are in effect during the Subrecipient's performance under this
Agreement. To the extent allowed by law, the Subrecipient further agrees to indemnify and hold harmless
the Department and its employees and agents from all liability, damages and costs of any nature,
including, but not limited to, costs of suits and attorneys' fees assessed against the Department, as a
result of the failure of the Subrecipient to so comply .
A.20 OWNERSHI P OF PRO JECT/CAPITAL FACILI T lES
The Department makes no claim to any capital facilities or real property improved or constructed with
funds under this Agreement, and by this subaward of funds does not and will not acquire any ownership
interest or title to such property of the Subrecipient. The Subrecipient shall assume all liabilities and
responsibilities arising from the ownership and operation of the project and agrees to indemnify and hold
the Department, the State of Washington and the United States government harmless from any and all
causes of action arising from the ownership and operation of the project.
A.21 POLI TICAL A CT IVITY
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 .
DHS-FEMA-HSGP-SHSP-FFY18 Page 15 of 40 Kittitas County Sheriffs Office, E19-111
A.22 P RO HIB ITI ON AGAIN ST PAYMENT OF BONUS OR COMMISSION
The assistance provided under this Agreement shall not be used in payment of any bonus or commission
for the purpose of obtaining approval of the application for such assistance or any other approval or
concurrence under this Agreement provided, however, that reasonable fees or bona fide technical
consultant, managerial, or other such services, other than actual solicitation, are not hereby prohibited if
otherwise eligible as project costs.
A.23 PUBLICITY
The Subrecipient agrees to submit to the Department prior to issuance all advertising and publicity
matters relating to this Agreement wherein the Department's name is mentioned, or language used from
which the connection of the Department's name may , in the Department's judgment, be inferred or
implied . The Subrecipient agrees not to publish or use such advertising and publicity matters without the
prior written consent of the Department. The Subrecipient may copyright original work it develops in the
course of or under this Agreement; however, pursuant to 2 CFR Part 200.315, FEMA reserves a royalty-
free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize
others to use the work for government purposes.
Publication resulting from work performed under this Agreement shall include an acknowledgement of
FEMA's financial support, by CFDA number, and a statement that the publication does not constitute an
endorsement by FEMA or reflect FEMA's views.
A.24 RECAPTURE PROVISION
In the event the Subrecipient fails to expend funds under this Agreement in accordance with applicable
federal , state, and local laws, regulations, and/or the provisions of the Agreement, the Department
reserves the right to recapture funds in an amount equivalent to the extent of noncompliance . Such right
of recapture shall exist for the life of the project following Agreement termination. Repayment by the
Subrecipient of funds under this recapture provision shall occur within 30 days of demand. In the event
the Department is required to institute legal proceedings to enforce the recapture provision, the
Department shall be entitled to its costs and expenses thereof, including attorney fees from the
Subrecipient.
A.25 RECORDS
a. The Subrecipient agrees to maintain all books, records, documents, receipts, invoices and all
other electronic or written records necessary to sufficiently and properly reflect the Subrecipient's
contracts, subawards, grant administration, and payments, including all direct and indirect
charges , and expenditures in the performance of this Agreement (the "records").
b. The Subrecipient's records related to this Agreement and the projects funded may be inspected
and audited by the Department or its designee, by the Office of the State Auditor, OHS, 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 fund ing
to be paid under the Agreement.
c. The records shall be made available by the Subrecipient for such inspection and audit, together
with suitable space for such purpose , at any and all times during the Subrecipient's normal
working day.
d. The Subrecipient shall retain and allow access to all records related to this Agreement and the
funded project(s) for a period of at least six (6) years following final payment and closure of the
grant under this Agreement. Despite the minimum federal retention requirement of three (3)
years, the more stringent State requirement of six (6) years must be followed.
A.26 RES PON SIBILITY FOR PR OJECT/STATE MENT OF WORK/WORK PLAN
While the Department undertakes to assist the Subrecipient with the project/statement of work/work plan
(project) by providing federal award funds pursuant to this Agreement, the project itself remains the sole
responsibility of the Subrecipient. The Department undertakes no responsibility to the Subrecipient, or
to any third party , other than as is expressly set out in this Agreement.
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.
DHS-FEMA-HSGP-SHSP-FFY18 Page 16 of 40 Kittitas County Sheriffs Office , E19-111
Prior to the start of any construction activity, the Subrecipient shall ensure that all applicable federal,
state , and local permits and clearances are obtained, including, but not limited to , FEMA compliance with
the National Environmental Policy Act, the National Historic Preservation Act, the Endangered Species
Act, and all other environmental laws, regulations, and executive orders.
The Subrecipient shall defend, at its own cost, any and all claims or suits at law or in equity, which may
be brought against the Subrecipient in connection with the project. The Subrecipient shall not look to the
Department, or to any state or federal agency, or to any of their employees or agents. for any
performance, assistance, or any payment or indemnity, including, but not limited to, cost of defense
and/or attorneys' fees, in connection with any claim or lawsuit brought by any third party related to any
design, development, construction, implementation, operation and/or maintenance of a project.
A.27 SEVERABILITY
If any court of rightful jurisdiction holds any provision or condition under this Agreement or its application
to any person or circumstances invalid, this invalidity does not affect other provisions, terms or conditions
of the Agreement, which can be given effect without the invalid provision. To this end, the terms and
conditions of this Agreement are declared severable.
A.28 SIN G LE A UDIT ACT REQ UIREME NT S (incl uding all AM END MENTS)
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 0MB
Compliance Supplement. The Subrecipient has the responsibility of notifying its auditor and requesting
an audit in compliance with 2 CFR Part 200 Subpart F, to include the Washington State Auditor's Office,
a federal auditor, or a public accountant performing work using GAGAS, as appropriate. Costs of the
audit may be an allowable grant expenditure as authorized by 2 CFR Part 200.425.
The Subrecipient shall maintain auditable records and accounts so as to facilitate the audit requirement
and shall ensure that any subcontractors also maintain auditable records . The Subrecipient is
responsible for any audit exceptions incurred by its own organization or that of its
subcontractors. Responses to any unresolved management findings and disallowed or questioned costs
shall be included with the audit report. The Subrecipient must respond to Department requests for
information or corrective action concerning audit issues or findings within 30 days of the date of
request. The Department reserves the right to recover from the Subrecipient all disallowed costs
resulting from the audit.
After the single audit has been completed, and if it includes any audit findings, the Subrecipient must
send a full copy of the audit and its Corrective Action Plan to the Department at the following address no
later than nine (9) months after the end of the Subrecipient's fiscal year(s):
Contracts Office
Washington Military Department
Finance Division, Building #1 TA-20
Camp Murray, WA 98430-5032
If the Subrecipient claims it is exempt from the audit requirements of 2 CFR Part 200 Subpart F, the
Subrecipient must send a completed "2 CFR Part 200 Subpart F Audit Certification Form"
(https://www.mil.wa .gov/emerqency-manaqement-division/q rants/regulredgrantforms ) to the Department
at the address listed above identifying this Agreement and explaining the criteria for exemption no later
than nine (9) months after the end of the Subrecipient's fiscal year(s).
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.
DHS-FEMA-HSGP-SHSP-FFY18 Page 17 of 40 Kittitas County Sheriffs Office, E19-111
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 requ irements may result
in one or more of the following actions in the Department's sole discretion: a percentage of federal awards
being withheld until the audit is completed in accordance with 2 CFR Part 200 Subpart F; the withholding
or disallowing of overhead costs; the suspension of federal awards until the audit is conducted and
submitted; or termination of the federal award.
A.29 SUBRECIPIENT NOT EMPLOYEE
The parties intend that an independent contractor relationship will be created by this Agreement. The
Subrecipient, and/or employees or agents performing under this Agreement are not employees or agents
of the Department in any manner whatsoever. The Subrecipient will not be presented as, nor claim to
be , an officer or employee of the Department by reason of this Agreement, nor will the Subrecipient make
any claim, demand, or application to or for any right or privilege applicable to an officer or employee of
the Department or of the State of Washington by reason of this Agreement, including, but not limited to,
Workmen's Compensation coverage, unemployment insurance benefits, social security benefits,
retirement membership or credit, or privilege or benefit which would accrue to a civil service employee
under Chapter 41 .06 RCW.
It is understood that if the Subrecipient is another state department, state agency, state university, state
college, state community college, state board, or state commission, that the officers and employees are
employed by the State of Washington in their own right and not by reason of this Agreement.
A .30 TAXES, FEES AND LICENSES
Unless otherwise provided in this Agreement, the Subrecipient shall be responsible for, pay and maintain
in current status all taxes, unemployment contributions, fees, licenses, assessments , permit charges and
expenses of any other kind for the Subrec ipient or its staff required by statute or regulation that are
applicable to Agreement performance.
A.31 TERMINATION F O R CO NVENIENCE
Notwithstanding any provisions of this Agreement, the Subrecipient may terminate this Agreement by
providing written notice of such termination to the Department Key Personnel identified in the Agreement,
specifying the effective date thereof, at least thirty (30) days prior to such date.
Except as otherwise provided in this Agreement, the Department, in its sole discretion and in the best
interests of the State of Washington, may terminate this Agreement in whole or in part by providing ten
(10) calendar days written notice , beginning on the second day after mailing to the Subrecipient. Upon
notice of termination for convenience, the Department reserves the right to suspend all or part of the
Agreement, withhold further payments, or prohibit the Subrecipient from incurring additional obligations
of funds. In the event of termination, the Subrecipient shall be liable for all damages as authorized by
law. The rights and remedies of the Department provided for in this section shall not be exclusive and
are in addition to any other rights and remedies provided by law.
A.32 TERMlNATJON OR SUSPENS ION 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 t ime in which to cure . The Department is not required to allow the Subrecipient an opportunity
to cure if it is not feasible as determined solely within the Department's discretion. Any time allowed for
cure shall not diminish or eliminate the Subrecipient's liability for damages or otherwise affect any other
remedies available to the Department. If the Department allows the Subrecipient an opportunity to cure,
the Department shall notify the Subrecipient in writing of the need to take corrective action. If the
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.
DHS-FEMA-HSGP-SHSP-FFY18 Page 18 of 40 Kittitas County Sheriffs Office, E19-111
The Department reserves the right to suspend all or part of the Agreement, withhold further payments,
or prohibit the Subrecipient from incurring additional obligations of funds during investigation of the
alleged compliance breach, pending corrective action by the Subrecipient, if allowed, or pending a
decision by the Department to terminate the Agreement in whole or in part.
In the event of termination, the Subrecipient shall be liable for all damages as authorized by law, including,
but not limited to, any cost difference between the original Agreement and the replacement or cover
Agreement and all administrative costs directly related to the replacement Agreement, e.g., cost of
administering the competitive solicitation process, mailing, advertising and other associated staff time.
The rights and remedies of the Department provided for in this section shall not be exclusive and are in
addition to any other rights and remedies provided by law .
If it is determined that the Subrecipient: (1) was not in default or material breach, or (2) failure to perform
was outside of the Subrecipient's control , fault or negligence, the termination shall be deemed to be a
"Termination for Convenience".
A.33 TERMINATION PROCEDURES
In addition to the procedures set forth below, if the Department terminates this Agreement, the
Subrecipient shall follow any procedures specified in the termination notice. Upon termination of this
Agreement and in addition to any other rights provided in this Agreement, the Department may require
the Subrecipient to deliver to the Department any property specifically produced or acquired for the
performance of such part of this Agreement as has been terminated.
If the termination is for convenience , the Department shall pay to the Subrecipient as an agreed upon
price, if separately stated, for properly authorized and completed work and services rendered or goods
delivered to and accepted by the Department prior to the effective date of Agreement tem,ination, the
amount agreed upon by the Subrecipient and the Department for completed work and services and/or
equipment or supplies provided for which no separate price is stated, partially completed work and
services and/or equipment or supplies provided which are accepted by the Department, (iii) other work,
services and/or equipment or supplies which are accepted by the Department, and (iv) the protection and
preservation of property.
Failure to agree with such amounts shall be a dispute within the meaning of the "Disputes" clause of this
Agreement. If the termination is for cause, the Department shall determine the extent of the liability of
the Department. The Department shall have no other obligation to the Subrecipient for termination. The
Department may withhold from any amounts due the Subrecipient such sum as the Department
determines to be necessary to protect the Department against potential loss or liability.
The rights and remedies of the Department provided in this Agreement shall not be exclusive and are in
addition to any other rights and remedies provided by law.
After receipt of a notice of termination, and except as otherwise directed by the Department in writing,
the Subrecipient shall:
a. Stop work under the Agreement on the date, and to the extent specified, in the notice;
b. Place no further orders or contracts for materials, services, supplies, equipment and/or facilities
in relation to this Agreement except as may be necessary for completion of such portion of the
work under the Agreement as is not terminated;
c. Assign to the Department, in the manner, at the times, and to the extent directed by the
Department, all of the rights, title, and interest of the Subrecipient under the orders and contracts
so terminated, in which case the Department has the right, at its discretion, to settle or pay any
or all claims arising out of the termination of such orders and contracts;
d. Settle all outstanding liabilities and all claims arising out of such termination of orders and
contracts, with the approval or ratification of the Department to the extent the Department may
require, which approval or ratification shall be final for all the purposes of this clause;
e . Transfer title to the Department and deliver in the manner, at the times, and to the extent directed
by the Department any property which , if the Agreement had been completed, would have been
required to be furnished to the Department;
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
DHS-FEMA-HSGP-SHSP-FFY18 Page 19 of 40 Kittitas County Sheriff's Office, E 19-111
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 BUSI NESS ENTERPRISES (MWBE)
The Subrecipient is encouraged to utilize business firms that are certified as minority-owned and/or
women-owned in carrying out the purposes of this Agreement. The Subrecipient may set utilization
standards, based upon local conditions or may utilize the State of Washington MWBE goals, as identified
in WAC 326-30-041 .
A.35 VENUE
This Agreement shall be construed and enforced in accordance with , and the validity and performance
shall be governed by , the laws of the State of Washington. Venue of any suit between the parties arising
out of this Agreement shall be the Superior Court of Thurston County, Washington. The Subrecipient,
by execution of this Agreement acknowledges the jurisdiction of the courts of the State of Washington .
A.36 WAIVERS
No conditions or provisions of this Agreement can be waived unless approved in advance by the
Department in writing. The Department's failure to insist upon strict performance of any provision of the
Agreement or to exercise any right based upon a breach thereof, or the acceptance of any performance
during such breach, shall not constitute a waiver of any right under this Agreement.
DHS-FEMA-HSGP-SHSP-FFY1 8 Page 20 of 40 Kittitas County Sheriff's Office , E19-111
Awari Let18r
FFY18 HSGP Award Documents
EMW-2018-SS-00088-S01
ATTACHMENT 1
US Department of Homeland Security
W ashington, D.C . 20472
Bret Daugherty
Washington Military Department
Building 20
Camp Murray, WA98430 -5122
Re: Grant No.EMW-2018-SS-00088
Dear Bret Daugherty:
Congratulations, on behalf of the Department of Homeland Security, your application for financial assistance submitted under
the Fiscal Year (FY) 2018 Homeland Security Grant Program has been approved in the amount of$13,788,000.00 . 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 2018 Homeland Security Grant Program Notice of Funding Opportunity.
Please make sure you read, understand, and maintain a copy of these documents in your official file for this award .
In order to establish acceptance of the award and its terms, please follow these instructions:
Step 1 : Please log in to the ND Grants system at https://portal.fema.gov .
Step 2 : .After logging in, you will see the Home page with a Pending Tasks menu . C lick on the Pending Tasks menu, select the
Application sub-menu, and then click the link for "Awa rd Offer Review• tasks . This li nk w il navigate you to Award Packages
that are pending review .
Step 3 : Click the Review Award Package icon (wrench) to review the A~ard Package and accept or de d ine the award Please
save or print the Award Package for your records .
Syste m for Awa r d Ma n ageme nt (SAlvf); Grant re cip ients are to keep all of th eir in formati on up .to date in SAM, in pa rt icu la r ,
your org anization 's n~rne, ad dr e.ss. DU N S number, EIN and banking infomia llon. Please ensu re that th e DUN S nu mb er used
in SAM is th e s ame on e used to apply for all FEMA awards. Future p ay ments wi ll be coniinge nt on the in fo rm ation p ro vid e d
in the SAM; therefore, it is imperative that the information is correct The System for Award Management is lo cate d at .b1m.Jl
www .sam .gov .
If you have any questions or have updated your information in SA/vi, please let your Grants Management Specialist (GMS)
know as soon as possible. This will help use to make the necessary updates and avoid any interruptions in the payment
process .
DHS-FEMA-HSGP-SHSP-FFY18 Page 21 of 40 Kittitas County Sheriffs Office, E19-111
'I 1 7Z'~_A::;] ~/Yau,{)
THOMAS GEORGE DINAN NO GPD Assistant Administrator
DHS-FEMA-HSGP-SHSP-FFY18 Page 22 of 40 Kittitas County Sheriffs Office, E19-111
Acne•ut A:dldrs
sit Sep 01 00:00 :00 Grvif 201s
GRANTEE:
PROGRAM:
AGREEMENT NUMBER:
Artide I
Article II
Article Ill
Article IV
Article V
Article V1
Article VII
Miele VIII
Article IX
ArtideX
Article XI
Article XII
Article XIII
DHS-FEMA-HSGP-SHSP-FFY18
U .S Department of Homeland Security
Washington, 0 .C 20472
AGREEMENT ARTICLES
Homeland Security Grant Program
Washington Military Department
Homeland Security Grant Program
EMW-2018-SS-00088-SJ 1
TABLE OF CONTENTS
Page 23 of 40
Summary Description of Award
Operation Stonegarden Program Hold
Disposition of Equipment Acquired Under the Federal Award
Acceptance of Post Award Changes
Procurement of Recovered Materials
Wh istle blowe r Protection .Act
Use ofOHS Seal, Logo and Flags
USA Patriot Act of2001
Universal Identifier and System of Award Management
(SM!)
Reporting of Matters Related to Recipient Integrity and
Performance
Rehabilitation Act of 1973
Trafficking Victims Protection Act of 2000
Terrorist Financing
Kittitas County Sheriffs Office, E19-111
Article XIV
Article XV
Article XVI
Article XVII
Article XVIII
Article XIX
Article XX
Article XXI
Article XXI I
Article XXII I
Article XXIV
Article XXV
Article XXVI
Article XX\/I I
Article XXVI 11
Article XXIX
Article XXX
Article XXXI
Article XXXI I
Article XXXI 11
Article XXXIV
Article XXXV
Article XXXVI
DHS-FEMA-HSGP-SHSP-FFY18 Page 24 of 40
SAFECOM
Reporting Subawards and Executive Compensation
Debarment and Suspension
Copyright
Civil Rights Act of 1964 -Title VI
Best Practices for Collection and Use of Personally
Identifiable Information (Pl I)
Americans with Disabilities Act of 1990
Age Discrimination Act of 1975
Activities Conducted Abroad
Acknowledgment of Federal Funding from OHS
OHS Specific Acknowledgements and Assurances
Assurances, Administrative Requirements, Cost Principles,
and Audit Requirements
Patents and Intellectual Property Rights
Notice of Funding Opportunity Requirements
Non-supplanting Requirement
Nondiscrimination in Matters Pertaining to Faith-Based
Organizations
National Environmental Policy Act
Lobbying Prohibitions
Limited English Proficiency (Civil Rights Act of 1964, Title VI)
Hotel and Motel Fire Safety Act of 1990
Fly America Act of 1974
Federal Leadership on Reducing Text Messaging while
Driving
Federal Debt Status
Kittitas County Sheriff's Office, E19-111
Article XXXVII
Article XXXVIII
Article XXXIX
Article XL
Article XL!
Article XLII
Article Xl...111
Article I -Summary Description of Award
False Claims Act and Program Fraud Civil Remedies
Energy Policy and Conservation Act
Education Amendments of 1972 (Equal Opportunity in
Education Act) -Title IX
Duplication of Benefits
Drug-Free Workplace Regulations
Civil Rights Act of 1968
Prior Approval for Modification of Approved Budget
The purpose of the FY 2018 HSGP is to support state and local efforts to prevent terrorism and other catastrophic events
and to prepare the Nation for the threats and hazards that pose the greatest risk to the security of the United States. The
HSGP provides funding to implement investments that build, sustain, and deliver the 32 core capabilities essential to
achieving the National Preparedness Goal of a secure and resilient Nation. Among the five basic homeland security missions
noted in the DHS Quadrennial Homeland Security Review, HSGP supports the goal to Strengthen National Preparedness
and Resilience. The building, sustainmen~ 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 COt"fUT'Unlty. This HSGP award
consists of S tate Homeland Security Program (SHSP) funding in the amount of $6 ,208,000, Urban Area Security Initiative
(UASI) funding in the amount of $5,000,000, a nd Opera tion S tonegarden (OPSG) funding in the amount of $2,580,000. The
following counties sh all receive Operation S toneg~r.den subawaros-fgn the foll owing amounts: Clallam, $400,00 0; Colville
Tribe, $200,000; Ferry, $200,000; Island, $200,000; Jefferson, $80,000; Nooksack; $90,000 ; Okan ogan , $200,000; Pen d
Oreille, $150,000; San Juan, $160,000 ; Skagit, $100,000 ; Spokane, $150,000; Stevens, $150,000; Swinomish Tribe, $90,000;
Whatcom, $410,000. These grant programs fund a range of activities, including planning, organization , equipment purchase,
training, exercises, and management and administration across all core capabilities and mission areas.
Article II • Operation Stonegarden Program Hold
The recipient is prohibited from drawing down or reimbursing sub-recipients of Operation Stonegarden (OPSG) funding
provided th roush this award wntll ecich unique, -Speciffc-, or modified county leve l, triba l or equivalent Operations Order or
Fragmentary Order (Frago) has bee n re:vl ewed by FEM A/GPD a nd Customs and Border Protectlon/United States Border
Pafro l (CBP/USBP). The reaipl_en t will receive the offTcla l notlflcatian o f approva l rrom FEMA/G PD.
Article Ill -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
instruct ions from DHS/FEMA to make proper disposition of the equipment pursuant to 2 C .F.R. Section 200.313.
Article IV -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-GMD@dhs gov if you have any questions.
Article V -Procurement of Recovered Materials
Recipients must comply with Section 6002 of the Salid Waste Disposal Act, as amended by the Resource Conservation and
Recovery Act. The requirements of Section 6002 include proclJing only items designated in guidelines of the Environmental
OHS-FEMA-HSGP-SHSP-FFY18 Page 25 of40 Kittitas County Sheriff's Office, E19-111
Protection Agency (EPA) at 40 C.F R_ Part 247 that contain the highest percentage of recovered materials practicable,
consistent with maintaining a satisfactory level of competition.
Article VI -Whistleblo'Ner Protection Act
Recipients must comply with the statutory requirements forwhistleblower protections (if applicable) at 10 U.S .C Section 2409,
41 U .S .C. 4712, and 10 U S.C. Section 2324, 41 U .S.C. Sections 4304 and 4310.
Article VII -Use of OHS Seal, Logo and Flags
Recipients must obtain permission from their DHS FAO, prior to using the DHS seal(s), logos, crests or reproductions of flags
or likenesses of OHS agency officials, including use of the United States Coast Guard seal, logo, crests or reproductions of
flags or likenesses of Coast Guard officials.
Article VIII -USA Patriot Act of 2001
Recipients must comply with requirements of the Uniting and Strenglhenfnq Amenca by Providing Appropriate Tools Required
to Intercept and Obstruct Terrorism Act (USA PATRIOT Act). which amends 18 U.S.C . Sections 175-1 ?Sc.
Article IX -Universal Identifier and System of Award Management (SAM)
Recipients are required to comply with the requirements set forth in the government-wide financial assistance award term
regarding the System for Award Management and Universal Identifier Requirements located at 2..C..E.REart2S .... A~
Article X -Reporting of IVlatters Related to Recipient Integrity and Performance
If the total value of the recipient's currently active grants, cooperative agreements, and procurement contracts from all federal
assistance offices exceeds $10,000,000 for any period of time during the period of performance of this federal financial
assistance award, the recipient must comply with the requirements set forth in the government-wide Award Term and
Condition for Recipient Integrity and Performance Matters located at 2 CER Part 200 Appendix XII , the full text of which is
incorporated here by reference in the award terms and conditions.
Article XI -Rehabilitation Act of 1973
Recipients must comply with the requirements of Section 504 of the Rehabilitation Act of 1973, (29 U .S . C. Section 794), as
amended, which provides that no otherwise qualified handicapped individuals in the United States will, solely by reason of the
handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or
activity receiving federal financial assistance.
Article XII -Trafficking Victims Protection Act of 2000
Recipients must comply with the requirements of the government-wide award term which implements Section 106(g) of the
Trafficking Victims Protection Act of 2000, (TVPA) as amended by 22 U .S .C . Section 7104. The award term is located at 2
C F R Section 175.15, the full text of which is incorporated here by reference.
Article XIII -Terrorist Financing
Recipients must comply with E. 0 . 13224 and U.S. law that prohibit transactions with, and the provisions of resources and
support to, individuals and organizations associated with terrorism. Recipients are legally responsible to ensure compliance
with the Order and laws.
Article XIV -SAFECOM
Recipients receiving federal financial assistance awards made under programs that provide emergency communication
equipment a nd its rel ated a ctivities must comply with the SAFECOM Guidance for Emergency Communication Grants,
in cluding provis ions on technical standards that ensure and enhance interoperable communica tion s .
Article XV -Reporting Subawards and Executive Compensation
Recipients are required to comply with the requirements set forth in the government-wide Award Term on Reporting
Subawards and Executive Compensation located at 2 C.F R Part 170, Appendix A, the full text of which is incorporated here
by reference in the aw ard terms and conditions.
DHS-FEMA-HSGP-SHSP-FFY18 Page 26 of 40 Kittitas County Sheriffs Office, E19-111
Article XVI -Debarment and Suspension
Recipients are subject to the non-procurement debarment and suspension regulations implementing Executive Orders (E.O.)
~and ~. and 2 C F.R Part 180 These regulations restrict federal financial assistance awards, subawards, and
contracts with certain parties that are debarred, suspended, or otherwise excluded from or ineligible for participation in federal
assistance programs or activities.
Article XVII -Copyright
Recipients must affix the applicable COP/right notices of 17 U.S.C. Sections 401 or 402 and an acknowledgement of U.S
Government sponsorship (including the award number) to any work first produced under federal financial assistance awards.
Article XVIII -Civil Rights Act of 1964-Title VI
Recipients must comply with the requirements of Title VI of the Civil Rights Act of 1964 (42 U.S.C. Section 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
p~rtlcipation ii\ be dented the benefits of, or be subjected to discrimination under any program or aotiviiy receMng federal
financial assistance. OHS implementing regulatfons for the Act are found at 6 C.F R. Part 21 and 44 C.F R. Pa rt 7 .
Article XIX -Best Practices for Collection and Use of Personally Identifiable Information (PII)
Recipients who collect Pl I are required t.o have a publically-ava1lable privacy policy t hat describes stand.clrds on the usage
and maln~nance or PII they collect OHS defines personally identifiable l nformatlon (PII) as any !nfonrration that permits the
identity of an individual to be directly or indirectly inferred, including any Information that is linked or linkable to that individua l.
Recipients may also find the OHS Privacy Impact Assessments: Privacy Guidance and Privacy template as useful resources
respectively.
Article XX-Americans with Disabilities Act of 1990
Recipients must comply with the requirements of Titles I, II, and Ill of the Americans with Disabilities Act, which prohibits
recipients from discriminating on the basis of disability in the operation of public entities, public and private transportation
systems, places of public accommodation, and certain testing entities. (42 U.S.C. Sections 12101-12213).
Article XXI -Age Discrimination Act of 1975
Recipients must comply with the requirements of the Age Discrimination Act of 1975 (Title 42 U.S. Code, section 6 101 et
seq.), which prohibits discrimination on the basis of age in any pro.gram or activity receiving federal financial assistance.
Article XXII -Activities Conducted Abroad
Recipients must ensure that project activities-carried on outside the United States are coordinated as necessary with
appropriate government authorities and lhatappropriate licenses, permits, orapprovals are obtained.
Article XXIII -Acknowledgment of Federal Funding from OHS
Recipients must acknowledge their u~ of feCEral funding when issuing statements, press re!e?lses requests for proposals,
bid invitations, and other documents describing projects or programs funded in whole or in part with federal funds_
Article XXIV -OHS Specific Acknowledgements and Assurances
All recipients, subrecipients, successors, transferees, and assignees must acknowledge and agree to comply with applicable
provisions governing OHS access to records, accounts, documents, information, facilities, and staff.
1. Recipients must cooperate with any compliance reviews or compliance investigations conducted by OHS.
2. Recipients must give OHS access to, and the right to examine and copy, records, accounts, and other documents and
sources of information related to the federal financial assistanc:;e award and permit access to facilities, personrel, and otter
individuals and information as may be necessa,y , as required by OHS regulations and other applicable laws or program
guidance.
DHS-FEMA-HSGP-SHSP-FFY18 Page 27 of 40 Kittitas County Sheriff's Office, E19-111
3 . Recipients must submit timely, complete, and accurate reports to the appropriate OHS officials and maintain appropriate
backup documentation to support the reports.
4. Recipients must comply with all other special reporting, data collection, and evaluation requirements, as prescribed by law
or detailed in program guidance.
5. If, during the past three years, recipients have been accused of discrimination on the grounds of race, color, national origin
(including limited English proficiency (LEP)), sex, age, disability, religion, or familial status, recipients must provide a list of all
such proceedings, pendng or completed, including outcome and copies of settlement agreements to the OHS FAO and the
OHS Offloe of Civil Rights and CJvO Wbertles (CRCL) by e-mail at crcl@bQ dhs.gov or by mail at U .S . Department of Homeland
Security Office for Civil Rights and Civil Liberties Building 410, Mail Stop #0190 Washington, 0. C . 20528.
6 . In the event courts or administrative agencies make a finding of discrimination on grounds of race, color, national origin
(including LEP), sex, age, disability, religion, or familial status against the recipient, or recipients settle a case or matter
alleging such discrimination, recipients must forward a copy of the complaint and findings to the OHS FAO and the CRCL
office by e-mail or mail at the addresses listed above.
The United States has the right to seek judicial enforcement of these obligations.
Article XXV -Assurances, Administrative Requirements, Cost Principles, and Audit Requirements
OHS financial assistance recipients must complete either the 0MB Standard Form) Standard Form 424B AssuraJ1Ces -
Non-Construction Programs or 0MB Standard Form 424D Assurances -Construction Programs as applicable. Certain
assurances in these docmients may not be applicable to your program, and the OHS financial assistance office (OHS FAO)
may require applicants to certify additional assurances. Applicants are required to fill out the assurances applicable to their
program as instructed by the awarding agency. Please contact the OHS FAO if you have any questions.
OHS financial assistance recipients are required to follow the applicable provisions of the Uniform Administrative
Requirements, Cost Principles, and Audit Requirements for Federal Awards located at Tit1e 2, Code of Federal Regulations.
Part 200 and adopted by OHS at 2 C.F. R. Part 3002 .
Article XX.VI -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. Seetion 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 federal financial assistance awards located at 37 C F.R. Part
~ and the standard patent rights clause located at 37 C . F.R. Section 401 .14.
Article XX.VII -Notice of Funding Opportunity Requirements
All of the instructions, guidance, limitations, and other conditions set forth in the Notice of Funding Opportunity (NOFO) for
this program are incorporated here by reference in the award terms and conditions. Recipients must comply with any such
requirements set forth in the program NOFO.
Article XXVIII -Non-supplanting Requirement
Recipients receiving federal financial assistance awards made under programs that prohibit supplanting by law must ensure
that federal funds do not replace (supplant) funds that have been budgeted for the same purpose through non-federal
sources.
Article XXIX -Nondiscrimination in Matters Pertaining to Faith-Based Organizations
It is OHS policy to ensure the equal treatment a faith-based organizations in social service programs adrrinistered or
supported 1:,/ OHS or its component agencies, enabling those organizations to participate in providing important social
services to beneficiaries. Recipieris must co"l)ly with the equal treatment policies and requiremeris oortained in 6 C. F. R.
BYt19. and other applicable statues, reguations, and guidance governing the participations of faith-based organizations in
individual OHS programs.
Article XXX -National Environmental Policy Act
Recipients must comply w ith the requirements of the Nat1ona1 Enylronmental policy Act (NEPA) and the Cou~I on
Envirorrnental Quality (CEO) Regulations for lmplerrenting the Procedural Provisions of NEPA, which requires recipients to
DHS-FEMA-HSGP-SHSP-FFY18 Page28 of40 Kittitas County Sheriff's Office, E19-111
use all practicable means within their authority, and consistent with other essential considerations of national pol icy, to create
and maintain conditions under which people and nature can exist in productive harmony and fulfill the social, economic, and
other needs of present and future generations of Americans.
Article XXXI -Lobbying Prohibitions
Recipients must comply with 31 U .S.C. Section 1352, which provides that none of the funds provided under an federal
financial assistance award may be expended by the recipient to pay any person to influence, or attempt to influence an officer
or employee of any agency, a Member of Congress , an officer or employee of Congress, or an employee of a Member of
Congress in connection with any federal action related to a federal award or contrac~ including any extension, continuation,
renewal , amendment, or modification .
Article XXXII -Limited English Proficiency (Civil Rights Act of 1964, Title VI)
Recipients must comply with the Title VI of the Civil Rights Act of 1964 (42 U.S.C. Section 2000d et seq.) prohibition against
discrimination on the basis of national origin, which requires that recipients of federal financial assistance take reasonable
steps to provide meaningful access to persons with limited English proficiency (LEP) to their programs and services. For
additional assistance and information regarding language access obligations, please refer to the OHS Recipient Guidance
https://www,dhs,gov/quidance;publlslW:l•help.department--suoported-organizations-provide-meaningtuI. access-people-limited
and additional resources on http-//www jep.gov.
Article XXXIII -Hotel and Motel Fire Safety Act of 1990
In accordance with Section 6 of the Hotel and Motel Fire Safety Act of 1990, (15 U .S .C . Section 2225a), 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 Pf8'Jention and Control Act of 1974, as amended, (15
U.S.C. Section 2225).
Article XXXIV -Fly America Act of 1974
Recipients must comply with Preference for U.S. Flag Air Carriers (air carriers holding certificates under 49 U.S.C . Section
41102) for international air transportation of people and property to the extent that such service is available, in accordance
with the International Air Transportation Fair Competitive Practices Act of 1974 (49 U.S.C. Section 40118) and the
interpretative guidelines issued by the Comptroller General of the United States in the March 31, 1981 amendment to
Comptroller General Decision B--138942.
Article XXXV -Federal Leadership on Reducing Text Messaging while Driving
Recipients are encouraged to adopt and enforce policies that ban text messaging while driving as described in E O 13513,
including conducting initiatives described in Section 3(a) of the Order when on official government business or when
performing any work for or on behalf of the federal government.
Article XXXVI -Federal Debt Status
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 0MB Cjrcq la r A-129 .)
Article XXXVII -False Claims Act and Program Fraud Civil Remedies
Recipients must comply with the requirements of The False Claims Act (31 U.S.C. Section 3729--3733) which prohibits the
submission of false or fraudulent claims for payment to the federal government (See 31 U.S.C. Section 3801-3812 which
details the administratiVe remedies for false claims and statements made.)
Article XXXVIII -Energy Policy and Conservation Act
Recipients must comply with the requirements of The Energy Policy and Conservation Act (42 U.S. C . Section 6201) which
contain policies relating to energy efficiency that are defined in the state energy conservation plan issued in compliance with
this Act
Article XXXIX -Education Amendments of 1972 (Equal Opportunity in Education Act) -Title IX
DHS-FEMA-HSGP-SHSP-FFY18 Page 29 of40 Kittitas County Sheriff's Office , E 19-111
Recipients must comply with the requirements ofTitle IX of the Education Amendments of 1972 (20 U.S.C. Section 1681
et seq.), which provide 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. OHS implementing regulations are codified at 6 C,FR. Part 17 and 44 C F .R. Part 19
Article XL -Duplication of Benefits
Any cost allocable to a particular federal financial assistance award provided for in 2 C, FR. Part 200 Subpart E .may not
be charged to other federal financial assistance awards to overcome fund deficiencies, to avoid restrictions imposed by
federal statutes, regulations, or federal financial assistance award terms and conditions, or for other reasons. However, these
prohibitions would not preclude recipients from shifting costs that are allowable under two or more awards in accordance with
existing federal statutes, regulations, or the federal financial assistance award terms and conditions.
Article XLI -Drug-Free Workplace Regulations
Recipients must comply with drug-free workplace requirements in Subpart B (or Subpart C, if the recipient is an individual) of
2 CFR part 3001 , which adopts the Government-wide implementation (2 CFR part 182) of sec. 5152-5158 of the Drug-Free
Workplace Act of 1988 (Pub. L 100-690, Title V, Subtitle D ; 41 U .S.C. 8101).
Article XLII -Civil Rights Act of 1968
Recipients must comply with T itle 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 (See 42 U .S .C. Section 3601 et seq.), as implemented by the
Department of Housing and Urban Development at 24 C .F R. Part 100. The prohibtion on disability discrimination includes the
requirement that new multifamily housing with four or more dwelling units-Le., the public and common use areas and individual
apartment units (all units in buildings with elevators and ground-floor units in buildings without elevators)-be designed and
constructed with certain accessible features. (See 24 C, FR Sect[on 100.201 ,)
Article XLIR -Prior Approval for Modification of Approved Budget
Before making any change to the DHS/FEMA approved budget for this award, you must request prior written approval from
DHS/FEMA where required by 2 C.F.R. Section 200.308. For awards with an approved budget greater than the simplified
acquisition threshold as defined at 2 C .F.R Section 200.88 (currently $250,000), you may not transfer funds among direct cost
categones, programs, functions, or activities without prior written approval from DHSJFEMA where the cumulative amount
of such transfers exceeds or is expected to exceed ten percent (10%) of the total budget OHSJFEMA 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.
Personnel
Fringe Benefits
Travel
Equipment
Supplies
Contractual
Construction
Indirect Charges
DHS-FEMA-HSGP-SHSP-FFY18
BUDGET COST CATEGORIES
Page 30 of 40
SO .DO
S0.00
$0.00
S0 .00
$0.00
$13,645,245.00
$0.00
$142,755.00
Kittitas County Sheriffs Office, E19-111
Other $0.00
DHS-FEMA-HSGP-SHSP-FFY18 Page 31 of 40 Kittitas County Sheriff's Office, E19-111
Obligating Document for Award/Amendment
la. AGREEMENT NO. 2. AMENDMENT NO . 3 . 4. TYPE OF ACTION 5. CONTROL NO.
WX03515N2018T,
WX03516N2018T,
EMW-2018-SS-00088-SOI ••• RECIPIENT AWARD
6. RECIPIENT NAME AND
ADDRESS
Washington Militacy
Department
Building 20
Camp Murray, WA. 98430 -
5122
9. NAME OF RECIPIENT
PROJECT OFFICER
Gail Cram
11. EFFECTIVE DATE OF
TillSACTION
09/01/2018
NO .
916001095G
7. ISSu'lNG FEMA OFFICE AND
ADDRESS
FEMA-GPD
400 C Street, SW, 3rd floor
Washington, DC 20472-3645
FOC: 866-927-5646
WX03930N2018T
8. PAYMENT OFFICE AND ADDRESS
FEMA Finance Center
430 Marlcet Street
Winchester, VA ?'?603
PHONENO.
2535127472
10. NAME OF FEMA PROJECT COORDINATOR
Central Scheduling and Information Desk
Phone :800-368-6498
12.
METHOD
OF
PAYMENT
PARS
Email: Askcsid@dhs.gov
13. ASSISTANCE ARRANGEMENT 14. PERFORMANCE PERIOD
Cost Reimbursement From:
09/01/2018
Budget Period
To:
08/31/2021
09/01/2018 08/31/2021
15. DESCRIPTION OF ACTION
a. (Indicate funding data for awards or financial changes)
PR.OGRAM CFDANO. ACCOUNTING DATA
NAME (ACCS CODE)
PRIOR
TOTAL
AWARD
AMOUNT
AWARDED
nns
ACTION
+OR(-)
CURRENT
TOTAL
AWARD
CUMULATIVE NON-
FEDERAL COMMITMENT
ACRONYM XXXX-XXX-.XXXXXX-
XXXXX-XXXX-XXXX-X
Homeland 97.067 2018-FA-GG01-P410-$0.00 $6,208,000 .00 $6,208,000.1~ See Totals
Security -4101-D
Grant
Program
Homeland 97.067 2018-FA-GH01-P410-$0.00 $5,000,000 .00 $5,000,000.00 See Totals
Security -4101-D
Grant
Program .
Homeland 97.067 2018-FA-GG02-P410-$0.00 $2,580,000.00 $2,580,000.00 See Totals
Security -4101-D
Grant
Program
TOTALS S0.00 $13,788 000.0I $13,788,000 .0I S0.00
b. To ooscribe changes other than funding data or financial changes, attach schedule and check here.
NIA
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 recipiem ere not required to sign and return copies of this document . However, rc:cipients should
print and keep a copy of this document for their records.
16b. FOR DISASTER. PROGRAMS: RECIPIENT IS NOT REQUlRED 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)
Gail Cram,
DHS-FEMA-HSGP-SHSP-FFY18 Page 32 of 40
DATE
Kittitas County Sheriff's Office, E19-111
18 FElvi~ SIGNATORY OffiCLL>,L (Name and Title)
J fl,,,.
, ~ ~"'.,.~~-1--c;~~--.. _ --
BERTP~A.}tf NMN MCKEITHEN JR, Ass1st.ance Officer
DHS-FEMA-HSGP-SHSP-FFY18 Page 33 of 40
Wed Soep 12 23 49 00 GlvIT
2018
DATE
Thu Aug 16 1911 01 GlYIT
2018
Kittitas County Sheriff's Office, E19-111
ATTACHMENT 2
18SHSP Investment and Regional Project
Investment Justification
Washington is comprised of 39 counties with geography including forests, mountains, islands, rainforests, rivers, lakes,
and plains. The U.S. Bureau of Economic Analysis ranked Washington 13 of SO states for gross domestic product in
2017; several world-class organizations headquarter their operations within the state. Washington has marine,
aviation, ra ii, and road transportation infrastructure to support its position as a bustling trade center.
Approximately halfof Washington's 7.5 million population lives in the Seattle metropolitan area located along the
Puget Sound. This area is the center of transportation, business, and industry and is the fastest growing region in the
state. Over three-fourths of the state's population lives in densely settled urbanized areas. Understanding
Washington's population is critical in order to mitigate vulnerabilities, respond to incidents, and effectively concentrate
recovery efforts.
Washington is subject to ten natural hazards and seven human-caused hazards. The THIRA focuses on eight of those
risks: earthquake, tsunami, flood, biological [communicable disease], wildfire, radiological, cyber incident, and
terrorism . Planning, training, and exercise efforts are being restructured to encompass the entire spectrum of
catastrophic incidents within this context
Washington saw few significant changes in the 2017 Capabilities Assessment.
-Public Information and Warning, which had been consistently among the state's highest-rated capabilities since the
beginning of core capability-based SPR reporting, no longer is present as a top-rated capability.
-The lowest rated capabilities were Economic Recovery, Health and Social Services, Community Resilience, and
Housing-all essential during a catastrophic incident.
-The strongest capabilities lie in Response and lowest rated capabilities lie in Recovery.
The 2017 SPR results repeated the overarching theme of prior years: Stakeholders at every level struggle to sustain
emergency response capabilities with dwindling resources and are significantly challenged to prepare for catastrophic
disasters. Since the early 2000's, emergency management funding at the state and local levels have reduced
significantly causing an increased dependence on federal grants to meet necessary emergency management
requirements. As a result, many areas are in a sustainment mode when it comes to emergency management capability
and capacity.
Investment #3 -Regional Homeland Security Projects
The State is divided into 9 Homeland Security Regions, made up of 39 counties, which differ in many respects including
geography (from marine to desert), major industry (from large business to agricultural), and population (from dense
urban settings to rural areas). Each Region develops projects to address their specific risks and hazards which sustain
previously built capabilities or close identified gaps.
While the communities may differ, emergency management priorities are similar across the state and most initiatives
can be tied back to building regional capability to respond and recover, and be in "a state of readiness" through
planning, training, equipping, or exercising, should a natural or human-caused catastrophic incident occur. As
communicated in the 2017THIRA, Capabilities Estimation, & SPR, gaps have been identified in the following core
capabilities.
DHS-FEMA-HSGP-SHSP-FFY18 Page 34 of 40 Kittitas County Sheriff's Office, E19-111
All jurisdictions have targeted efforts related to Operational Coordination. The foremost gaps are:
1) PLANNING : Plans lack horizontal and vertical integration and need adjusting to be
scalable for use during a catastrophic incident. Recovery needs to be incorporated .
2) ORGANIZATION: Response and recovery to catastrophic incidents will require additional trained personnel to
support either large-scale or long-term activations.
3) EQUIPMENT: There is a lack of integration and interoperability of tools to form a Common Operating Picture for all
stakeholders. Additionally, equipment continues to age, with subsequent degradation occurring with routine usage,
and there is a lack of funding to sustain and/or replace.
Resiliency is still an evolving concept without a formalized statewide, whole community approach to focus efforts.
While the State is introducing initiatives to combat that reality, local jurisdictions still struggle with gaps related to
Community Resilience:
1) TRAINING: Individuals and businesses need to move from awareness to action.
2) EXERCISE: Communities are dependent on volunteers to exercise this capability and do not have the tools or
expertise to engage stakeholders.
Related to Resilience, jurisdictions recognize the need to communicate with all stakeholders and continue to expand
the reach of their messaging. Initiatives are ongoing to address the identified Public Information and Warning gap
related to:
1) PLANNING: Plans do not fully address communicating with non-English speaking populations, immigrant groups, and
individuals with disabilities.
Regional Hazards and Risks • Reasons for the Work
Terro~stta ~ets include:
• Hydroelectric facilities
• Transportation
• Public Events
• Industry
!ri-"-1~!')' a!l-~~~a_rd ri~_ks inclu~e:
• Wildland Fi res
• Landslides
• Floods
• Winter Storms
• Wind Storms ---
• Earthquakes
• Pandemic Incidents
------------
DHS-FEMA-HSGP-SHSP-FFY18 Page 35 of 40 Kittitas County Sheritrs Office, E19-111
18SHSP Work Plan and Budget
Kittitas County Sheriff's Office
SHSP Investment #3 -Regional Homeland Security Projects, Project #7 Description
Region 7 will sustain past efforts to improve the entire preparedness cycle and incorporate a regional
aspect to county-based small unmanned aerial systems (sUAS). The program will assist with threat and
hazard detection, critical infrastructure surveillance, and search and rescue. The objective is to have assets
in place to deploy for immediate response.
Activities will include:
1) Develop a regional sUAS program.
2) Strengthen and harden aitical infrastructure.
3) Assess the regional communication systems. Equipment will be replaced as identified and all
communications investments will align with the Statewide Communication Interoperable ?Ian (SCIPJ and
will be coordinated with the Statewide Interoperability Coordinator (SWIC).
4) Upgrade mass notification systems and continue to target diverse populations especially those with
limited English proficiency.
5) Continue training on active shooter scenarios.
6) Replace outdated equipment for special teams as required and sustain specialized training.
7) Ensure effective Operational Coordination across the Region by dedicating planning efforts to regional
initiatives, equipping EOCs as needed, and implementing a robust regional training program to address
personnel shortages specifically related to staffing EOC operations.
SUBPROJECT_#l SWAT Equipment and Training
PRIMARY CORE t;JIPA8IU11/:S BEING ADDRESSED
lntllnlldfon ond Dknlpllan
WHY IS THE WORK NEEDED?
GAP !dJ: . t!d
PLANNING
So .00
lackofequiPmentandtrainingforSWATTea-;; ----··
ORGANIZA11ON
so.oo
-The Ellensburg Police Department (EPO) is joining the ICitt~as County Regiona I SWAT team, t he primary resource foT
fnterdiction and dlsrupticn of foreign and domestic t h reats. EPD 's communic.ations equipment is old and anti~
and is not interoperable with the Kittitas County Reg fonal SWAT team. Th is has aeated an unsafe, unusable situation.
EPD's ballistic protection isn"t sufficient aeating a life safety fssue.
-Taa ic,;"'1<1~~<!f'Jl••ixl•1tedand d..,.Joc~ _
CAPAB/UTY suSlllined or enhanced
Specialized Tea mclnhance the interdiction and disruf!ion3 pabi~ies oft~ Co~ll!Y R~~ SWAT team
EQIJIPMEITT
$18.375.00
AGREEMENT AMOUNT $48,409
AMOUNT
TRAINING
$10,154:00
LETPA S40.529 .00
84¾ of the agrt!em~t to tal
PERSONNEL $0 .00
0% of the agree;;;en ttcrtol
BUDGET
AMOUNT ----
SUBPROJECT #1 $28,529.00
SUBPROJECT "2 $6,480.00
SUBPROJECT#3 ~00 ,00
SUBPROJECT #4 ~~-4(11),~
M&A $0,CO
SUBTOTAL S'18)1()9.00
INDUI.ECT SM0
!!)!A~ $48 41!9:~
EXERCISE
$0.00'
--------,
TOTAL
$28,529.00
DHS-FEMA-HSGP-SHSP-FFY18 Page 36 of 40 Kittitas County Sheriffs Office, E19-111
AcnvmES TO BE PERFORMED
-Purchase six (6) interoperable communications headsets to upgrade EPO's current antiquated com;-unications
equipment
-Purchase six (6) heavy vests to bring EPO 1s members up to date with the current ballistic protection needed to
perform their dirties.
-Inventory equipment.
-DlStnbute equipment to usl!f's with requirements for we/disposition.
-Identify training courses.
-SWAT members attend training~
~~1FD D£/!VERA~jo_lJTPIJ!!
• The SWAT members are better equipped and able to perform their duties more safely.
-Updated communications equipment, Interoperable witli other jurisdictions.
• Knowledge of latest tactics and techniques.
DESIRED OUTCOMES ------------~-
A more effectiw and capable SWAT Team.
-Physically protected and able to communicate with all jurisdictions when responding to incidents to include
terrorism.
-Tactical training will greatly enhance the Kittitas County Regional SWAT team's capabflities to be more effective in
their missions.
SUBPROJECT #2. Storage of EM Assets
PRIMARY CORE CAPABIUTIES BEING ADDRESSED
Mm.Sir:,p-d'I ;a'l"ld Jit&KutCOPlllmian:r
~ Hea ~~re!l!'d Em&r1ency Medlcal Service$
WHY IS THE WORK NEEDED?
CAPABIUTY sustained ar enhance.!!,_
-Mas.s search&. Rescue Operations
-~":.31th, healthcare and Emergency medical servf~
ACTWmES TO BE PERFORMED
PLANNING ORGANIZATION
$0.00 -$6,480.00
Over the years, Kittitas County Emergency Management has a~quired disaster response equip~such as UNred
lights, mobne command posts, N-95 stockpile, body bag stockpile, etc. The equipment needs to be stored OU[ of the
elements and there is limited space at the Sheriff's Office.
• Pay f~ a year of storage~
ASSOCIA1FDDWVERABl:ES/OUTPUTS
Storage of emergency response equip~nt and stockpiles.
~ED OUTCOMES __ -~
Disaster response equipment and supplies will be safe and ready for use l.Dltil needed.
-soumoNMEA
EQUIPMENT
$0.00'
TRAINING
Sf!,00
DHS-FEMA-HSGP-SHSP-FFY18 Page 37 of 40 Kittitas County Sheriffs Office, E19-111
EXEROSE
$0.00
TOTAL
$6,480Jl0
SUBPROJECT #3 Vessel Equipment Upgrade
PRIMARY CORE CAPABILITIES BEING ADDRESSED
M ~~ RescueOe!_ratlons
SOLUTION AREA
ORGANIZATION PLANNING
S0.00 --~-
WHY IS THE WORK NEEDED?
GAP lilct1Cl/ied
Lack of e,n;.'1>111,tv during water-based Search and Rescue: Kittitas County has numer.;;;-s w~rways. The m;rine patrol
does net have night .!!_me operations capabilities or underwater search caoabilities.
CAPA8IUTY Ju,;tain ed or enhanc«J
f.nh--;-mtql of M•~~;;;hi R~~ operations
ACT/VmES TO BE PERFORMED
-~ spedffcs for equipment to be purchased,
• Complete EHP paperwork and submit to EMO.
• Purchase and install night vision sights, lights, and sonar or ~rmal imaging equipment on marine vessel.
ASSOCIATED DWVERABLES/OUTPUTS
Water operations ocwr at night and underwater'; abilftv ~ctsearc~~ations dutfng.ho1 1B cf
limited or no visibilit'(. The marine unit is a night and day, above and below water asset.
SUBPROJECT #4 Courthouse/Govemment Building Harde'ning
PRIMARY CORE CAPAS/UT/ES BEING ADDRESSED
PLANNING 0RGANJZATl0N
SOLUTION AREA
Phy~Prateellva M~ $0-00 ---$0.W EQUIPMENT
Sl.400.00,
WHY IS THE WORK NEEDED?
GAP Identified
Oan"tmanl19' 1h~ <1nertQ• of lhe e1JR ,ide of lhn l(i 11fm C<luol\' CowthGl.isc:: Thie·~ui lding ho\ile< r>0t only the courts
but also key government departments. The second main entrance and a back door to the IT ~rtment are located
on thfs sfde: an ideal entry spot for anvone wanting to enter undetected.
CAPABIUTY sustained or enhanced
!hvsical Protective _!'.'1easures -enhance the security of the building
ACTrVmES TO 9E PERFORMED
-Complei;° EHP p;perwork and submit to EMO.
• Purchase and install Gilmer-a on the eastsfde of the courthouse
• Inventory equipment as required.
-Monitor the exterior entrance to the courthouse and IT d :arrm~_;_ __ ~
TRAINING EXERCISE TOTAL
§0.DO --~~ ~
TRAINING EXEROSE TOTAL
---SO:oo ________ $o_oo ___ SJ..400.00
DHS-FEMA-HSGP-SHSP-FFY18 Page 38 of 40 Kittitas County Sheriffs Office, E19-111
ASSOC/A TEJJ DI!l.'IVERA'BLES/OUTPUTS
-A~d ltJorti! . ~I of raf~l\l nnd ~eo.irl1y of key go•11rnmu-n t fadll1 (es-.
-Ability to view people coming and going.
DESIRED OUTCOMES
Po!e!,fl l~I ch~au or dangers will be identified leading to a safe work environment for those that work and visit the
cou nho~l!..
DHS-FEMA-HSGP-SHSP-FFY18 Page 39 of 40 Kittitas County Sheriff's Office, E19-111
DATE
September 1, 2018
January 2019
J~LY 31, 2019
Jan uary, 31, 2020
July 31, 2020
November 30, 2020
January 14, 2021
DHS-FEMA-HSGP-SHSP-FFY18
18SHSP TIMELINE
Kittitas County Sheriff's Office
TASK
Grant As!"eem ent start date
Estimated date work scheduled for c;,ne o~ mote Subprojects
Submit Reimbursement Request an·d Pro_gress Report
Submit ~eim!>ursernent ~equest ~nc!_Pr9gress Report
Submit Reimbursement Request and Progress Report ..
Grant Agreement end date
Submit Pinal R-eimburs.en:ient_~equest and Closeout Report
HSGP Performance Period: September 1, 2018 to August 31, 2021
Page 40 of 40 Kittitas County Sheriff's Office, E19-111
SIGN ATU RE 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 l I /16 (ri
PROJECT DESCRIPTION CONTRACT NUMBER
18 SHSP Homeland Security E19-111
1. AUTHORIZING AUTHORITY
SIGNATURE PRINT OR TYPE NAME TITLEfTERM OF OFFICE
0-\) Gene Dana Sheriff/ 12/31/18
2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE PRINT OR TYPE NAME TITLE
~Q_ Gene Dana Sheriff
3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT
-SIG ~TURE PRINT OR TYPE NAME TITLE
/J )r 1/h ' -Darren Higashiyama Commander
---I.... -v ') r\~ ~~----Kim Dawson Sheriff Admin
\\NAC-1\VOL 1\HOME\KARENB\ .... \WP\SIGNAUTH Revised 3/03
INSTRUCTIONS FOR SIGNATURE AUTHORIZATION FORM
This form identifies the persons who have the authority to sign contracts , amendments,
and requests for reimbursement. It is required for the management of your contract with
the Military Department (MD). Please complete all sections. One copy with original
signatures is to be sent to MD with the signed contract, and the other should be kept with
your copy of the contract.
When a request for reimbursement is received, the signature is checked to verify that it
matches the signature on file . The payment can be delayed if the request is
presented without the proper signature. It is important that the signatures in MD's files
are current. Changes in staffing or responsibilities will require a new signature
authorization form.
1. Authorizing Authority. Generally, the person(s) signing in this box heads
the governing body of the organization, such as the board chair or mayor. In
some cases, the chief executive officer may have been delegated this
authority.
2 . Authorized to Sign Contracts/Contract Amendments. The person(s) with
this authority should sign in this space. Usually, it is the county
commissioner, mayor, executive director, city clerk, etc.
3. Authorized to Sign Requests for Reimbursement. Often the executive
director, city clerk, treasurer, or administrative assistant have this authority.
It is advisable to have more than one person authorized to sign
reimbursement requests. This will help prevent delays in processing a
request if one person is temporarily unavailable.
If you have any questions regarding this form or to request new forms, please call your
MD Program Manager.
2 CFR Part 200 Subpart F Audit Certification Form
Audits of States, Local Governments, Indian Tribes, and Non-Profit Organizations
Contact Information
Subrecipient Name (Agency, Local Government, or Organization): Kittitas County
Authorized Chief Financial Officer (central accounting office): Judy Pless
Address: 205 W. 5th Suite 105 Ellensburg, WA 98926
Email: judy.pless@co.kittitas.wa.us Phone#: 509-962-7502
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 MIUEMD 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 i£.r!s!1 subject to these requirements, you must complete Section A of
this Form. If your entity~ 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 subiect to the audit reauirements of 2 CFR Part 200 Suboart F
Our entity is not subject to the requirements of 2 CFR Part 200 Subpart F because (check all that apply):
0 We did not expend $750,000 or more of total federal awards during the fiscal year.
0 We are a for-profit agency.
0 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·subtect ta the audlt.reg_ulrements of 2 CFR Part 200 Su!l_rgrt F '
·,comolete the information below and check the aoorooriate box)
~ We completed O\Jr last 2 CFR Part 200 Subpa.r;t F Audit on (et1ter date] I J.f ,, I J 7 for Fiscal Year ending [e nter date] z_;,, , . There
were no findings related to federal awards from WMD/EMD. No follow-up action is required by WMD/EMD as the pass-through entity.
A complete copy of the audit report, which includes exceptions, corrective action plan and management response, is
either provided electronically to contracts.offlce@mil.wa.gov or provide the state auditor report number:
/¥ j,:;)J 2 ;f'v
D 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 p lan and management response, is either
provided electronically to contracts .offic e@mll .wa .gov or provide the state auditor report number:
• Our completed 2 CFR Part 200 Subpart F Audit will be available on [enter date] for Fiscal Year ending
renter date]. We will provide electronic copy of the audit report to cohtracts.office@mlLwa.gov at that time or
provide the state auditor reoort 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 ~ d.
Signature of Authorized Chief Financial Officer:
,-'\
' I
11 I ·x. ,., Print Name & Title: ....... '
0
l I ,,.-'I -I· ," _ I~ , • 1 •
'1!~> Date:
I .. /I //t.•/t.Y '
. ' /Ji_ •
'NMO Fcrm 1009-13, 9/19/2013. Updated 9/9/2015
Washington Military Department Contract Number: E19-111
Debarment, Suspension, Ineligibility or Voluntary Exclusion Certification Form
NAME C
a /' k.,-ttft,__) Doing business as (OBA)
CunJ7 J(._ :f_ I -) C"'"' -I ,, ....
ADDRESS Applicable Procurement WA Uniform Business Federal Employer Tax
205 W. 5 Ave Suite 105 or Solicitation #, if any: Identifier (UBI) Identification #::
Ellensburg, WA 98926 /11....vc:L<, I"'> ()! Lo l ·t1 f y
This certification is submitted as part of a re quest 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
indirectl'y 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 dause titled
··certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower ner 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.
1), .,
Bidder or Contractor Signature: -~-'--+-r:{_?j-+ ... L .:::.~---=-aa..-----.:::c...---------
Print Name and Title: J ... "17'-tt?lo~J b u-l1f·,( {f•l t:,-tC ! 11,,1 ,,,,-~ /
./ ' /1 . Date : __ ,_, _t _/_; ,5 __
Washington Military Department Contract Number: __ _
FEDERAL DEBARMENT, SUSPENSION
INELIGIBILITY and VOLUNTARY EXCLUSION
(FREQUENTLY ASKED QUESTIONS)
What Is "Debarment. Suspension, Ineligibility, and Voluntary Exclusion"?
These terms refer to the status of a person or company that cannot contract with or receive grants from a federal agency.
In order to be debarred, suspended, ineligible, or voluntarily excluded, you must have:
• had a contract or grant with a federal agency, and
• gone through some process where the federal agency notified or attempted to notify you that you could not contract
with the federal agency.
• Generally, this process occurs where you, the contractor, are not qualified or are not adequately performing under a
contract, or have violated a regulation or law pertaining to the contract.
Why am J requfred to sign this certification?
You are requesting a contract or grant with the Washington Military Department. Federal law (Executive Order 12549)
requires Washington Military Department ensure that persons or companies that contract with Washington Military
Department are not prohibited from having federal contracts.
What is Executive Order 12549?
Executive Order 12549 refers to Federal Executive Order Number 12549. The executive order was signed by the
President and directed federal agencies to ensure that federal agencies, and any state or other agency receiving federal
funds were not contracting or awarding grants to persons, organizations, or companies who have been excluded from
participating in federal contracts or grants. Federal agencies have codified this requirement in their individual agency
Code of Federal Regulations (CFRs).
What is the purpose of this certification?
The purpose of the certification is for you to tell Washington Military Department in writing that you have not been
prohibited by federal agencies from entering into a federal contract.
What does the word "proposal" m.ean when referred to In this certification?
Proposal means a solicited or unsolicited bid, application, request, invitation to consider or similar communication from
you to Washington Military Department.
What or who is a "lower tier participant"?
Lower tier participants means a person or organization that submits a proposal, enters into contracts with, or receives a
grant from Washington Military Department, OR any subcontractor of a contract with Washington Military Department. If
you hire subcontractors, you should require them to sign a certification and keep it with your subcontract.
What is a covered transaction when referred to in this certification?
Covered Transaction means a contract, oral or written agreement, grant, or any other arrangement where you contract
with or receive money from Washington Military Department. Covered Transaction does not include mandatory
entitlements and individual benefits.
Sample Debarment, Suspension, Ineligibility, Voluntary Exclusion Contract Provision
Debarment Certification. The Contractor certifies that the Contractor is not presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from participating in this Contract by any
Federal department or agency. If requested by Washington Military Department, the Contractor shall complete
a Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion form. Any such form
completed by the Contractor for this Contract shall be incorporated into this Contract by reference.
FFATA FORM
Subrecipient Agency: Kittitas Countv
Grant and Year: 18 SHSP Homeland Security Gra Agreement Number: E19-111
Completed Darren Higashiyama Commander 509-933-8206 by:
Name Ti lle Tel eJ:JhOM
Date Completed: 10/30/18
---, ---• =--~ . --__ ... _ -~ :::! -•-----
YES STOP, no further NO
Is your grant agreement less than $25,000? • analysis needed, [Z] GO to Step 2
GO to .Step 6
~..::_-----:n i -------------~ -• ---a
In your preceding fiscal year, did your YES NO STOP, no further
organization receive 80% or more of its annual • GO to STEP 3 [Z] analysis needed, GO to
gross revenues from federal funding? Step 6
r~ -----l:Jit ,c:t' 3 , -::.. -----=-z-=-.-• ~ .•'1 ---.. ---------
In your preceding fiscal year, did your YES NO STOP, no further
organization receive $25,000,000 or more in • GO to STEP4 • analysis needed, GO to
federal funding? Step 6
G ---------I :t!f •ltf'!.ll!.. ---.... , • ··• ... • • -I ~ -
Does the public have access to infomiation about YES STOP, no further NO
the total compensation* of senior executives in • analysis needed, • GO to STEPS
your organization? GO to step 6
,.----... ---..----, --iJ'.I Cll":'5 ;. ------=---
Executive #1 Name:
Total Compensation amount: $
Executive #2 Name:
Total Campensati on amount: $
Executive #3 Name:
Total Compensation amount: $
Executive #4 Name:
Total Compensatio n amount: $
Executive #5 Name:
Total 0-o mpensatio n amount: $
Eii -------• ff~ -r--£: • • •• ~ ---·-------~ --If your organization does not meet these criteria, specifically identify below !!£h criteria that is not met for your
organization: For Example : "0ur orqaniza•tion received less than $25,0.00 , •
-/I
Signature: /J ) ~-11--, -10/30/18 -Date: -/-Y ~ • 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 temiination payments
• Life insurance value paid on behalf of the employee
Additional Resources:
hl1p://www.wh itehouse.gov/omb/open
http-Jiwww.hrsa .gov/grantslffatahtml'
http://www.gpo.gov/fdsys/okq/FR-2010-09-14/pdf/2010-22705 .pdf
http:l/www.qrarits ,qov/
Page 1 of 3
' I
FFATA PROVISIONS AND INSTRUCTIONS
For Compliance With The
Federal Funding Accountability and Transparency Act of 2006 (P .L. 109-282) (FF AT A)
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
FF AT A 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 (0MB). Public Law l 09-282 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 0MB Guidance.
B. The FFATA requires the 0MB 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 0MB 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 0MB Guidance.
D. As a Federal grant subawardee under this contract, your organization is required by FFATA,
0MB 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 0MB Guidance, subawardee DUNS
number, and relevant executive compensation data, as applicable.
1. Data about your organization will be provided to USASpending.gov by the WMD.
System for Award Management (SAM) is a government wide registration system for
organizations that do business with the Federal Government. SAM stores information
about awardees including financial account information for payment purposes and a link
to D&B for maintaining current DUNS information, www.sam.gov. WMD requires SAM
registration and annual renewal by your organization to minimize unnecessary data entry
Page 1 of 2
and re-entry required by both WMD and your organization. It will also reduce the
potential of inconsistent or inaccurate data entry.
2. Your organization must have a Data Universal Numbering System (DUNS) number
obtained from the firm Dun and Bradstreet (D&B) (www.dnb.com). A DUNS number
provides a method to verify data about your organization. D&B is responsible for
maintaining unique identifiers and organizational linkages on behalf of the Federal
Government for organizations receiving Federal assistance.
E. The WMD, as the prime awardee, is required by FFATA to report names and total
compensation of the five (5) most highly compensated officers of your organization (as the
subawardee) if:
1. 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 0MB 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
Form W-9 Request for Taxpayer Give Form to the
(Rev. December2014) I dentification Number and Certification requester. Do not
Depeament ot l~e Treasury send to the IRS.
lnlamDI Rewnoo Service
1 Name (as shown on your income tax rerum). Name ls required on tills lln!': do ·nor leave this Jll'\o blank.
Cou n ty of Kittitas
C\i 2 B1;1Sfncss name/disregarded entity name, lt different from above
GI Kittitas C o unty g>
C. 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions (codes apply only to
C:
0 0 Individual/sole proprietor or 0 C Corporation 0 S Corporation 0 Partnership 0 Trust/estate certain entitles . not individuals; see
GI II slngle-mcmber L.1.C instructions on page 3):
c. a Exempt payee code flf any) 3 ~:g 0 Um.11.ed HablTity company. Enter the tax classification (C--C corporation, S=S corporation, P=partnership) •
~ i:! Nate. For .tsln9le-m ember LLC that is dlsregar.de d, do not check L.1.C; check the appropriate box in the line above for Exemption from FATCA reporting .... ·lhu tax cl8S!)~kl(I of the single-mem ber OW/1<!1", code flf any) C: ID ·c ..5 0 Other (eee IN!rudticns) • (Appl/Nlo1--..-elhoU.S) a. .2
13 5 Address (number, street, and apt. or suite no.) Reql.l!IStel"s name !11\d address (optlon:nJ)
CII 205 W 5th Ave, Ste 105 C.
UJ 6 City, state, and ZIP code GI
GI Ellensburg, WA 98926 (I)
7 List account number(s) here (optional)
11111• Taxpayer Identification Number (TIN)
I ~.cl.ii security numlat I Enter you~ TIN in_ the app_ropri_:=Ite box. :'1~ TIN provided must. match t~e name given on line 1 to avoid
backup withholding. For 1ndivIduals, thJS IS generally your sacral security number (SSN). However, for a
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
T1N on page 3.
0JJ -[I] ~1 I I I I
or
Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for
guidelines on whose number to enter.
l ~pt0y11rldenttft<:a1!on number
91 -6001349
I
Certification
Under penalties of perjury, I certify that:
1. Toe 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. I 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 ORS) 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. I am a U.S. citizen or other U.S. person (defined below); and
4. Toe 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 Sisnatul'e o1
Here U.S. person •
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments. Information about developments affecting Form W-9 (such
as legislation enacted after we release it) is at www.irs.gov/fw9.
Purpose of Form
An individual or entity (Form W-9 requestef) who is required to file an information
return with the IRS must obtain your correct taxpayer identification rnmber (TIN)
which may be yotX social security number (SSN), individual taxpayer identification
number (TTIN), adoption taxpayer identification number (AllN), or employer
identification number (EINJ, to report on an information return the amount paid to
you, or other amount reportable on an information return. Examples of information
nmans include, but ara not llmited to, the following:
• Form 1099-INT (interest earned or paid)
• Form 1099-DIV (llvfdends, including those from stocks or mutual uids)
• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)
• Form 1099-B (stock or mutual fund sales and certain other transactions by
brokers)
• Form 1099-S (proceeds from rear estate transactions)
• Form 1 099-K (merchant card and third party network transactions)
Date •
• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T
(luition)
• Form 1099-C (canceled debt)
• Ferm 1oil9-A (at:qulsllk!n o, abal'ldcn/1'1ent of secured property)
Use Form W-9 only if you are a U.S. person (1T1Cluding a resident alien), to
provide your correct TIN.
ff you do not return Form W-9 lo the requester wtth a 11N, you might be subject
to backup withholding. See What is backup withholding? on page 2.
By sq,ing the filed-out form, you:
1. Certify that the TIN you are giving is correct (or you are waiting for a number
to be issued),
2. Certify that you are not subject to backup wtthholdlng, or
3. Claim exemption from backup withholding if you are a U.S. exempt payee. If
applicable, you are also certifying that as a U.S. person, your allocable share of
any partnership income from a U.S. trade or business is not subject to the
withholding tax on foreign partners' share of effectively connected income, and
4. Certify that FATCA code(s) entered on this form (If anyj indicating that you are
exempt from the FATCA reporting, Is correct. See What is FATCA reporting? on
page 2 forti.ther infonnatlon.
Cat. No. 10231X Form W-9 (Rev. 12-2014)
Form W•9 Request for Taxpayer Give Form to tho
r,ov, Oeoombor 2014) Identification Number and Certification requester, Do not
OP!ll~an l of Iha T~Oll,Y &Gnd to the IRS.
1lll!Tlll Aovonue So eo
1 Nnm~ (QO thown 01\ your ltlCO!r!O llll!.'rolUm), Nlllll ll lil r«1u1rod on l llfu llt\lll (l o no l loali'alhfil lh,10 b~11k.
COUl"lly or Kittitas
"1 2 eu ulllou nomn/<11a r9Q!lrddd on tlly 11001 0, II dllfelartt'frrlni o\J o'{o
I Kittitas Counl}'
.3 ptjool< npproprl!tld ~OX for lu dol'QI lllx ~oul/lc4llb o1 ohsck onl y ona ol lha lolowlng no 'l nn boxue\ 4 Ex~mpt/0110 {o odaa Oll ~~nly lo
8 Q 1ndMduoV6o1tl 11roP1lulor or 0 O Cotpoio llO/\ 0 8 Co1po ru llon O P~r ~,orahl 11 0 TruaVaalulo uo,tn1111: 1t1go, nol Jridl\lt d l m lnij ll'II P na n po.o a•S): tj attlgfo-mom bor LLo
[J Umltotl lhtb lNly c~m pDn y, Enlor tlt o llll! cf119D!01r.11l on (C•O corpora\lun, &8 onrprirnUnn, P.'pllrl nar9hlpl • l:xnmpt payoo code .~f any) __ 3_
Noto, 11~ a i 11lo-mo~bp1 ~LC lh ~I llJ dlsr/lll n(dod, do not ohook LLO: oheok the ap~roprlate box In tho lln~or Examptlon from FATOA reporting
:a U,e lnx 0S1 un tloo o lho • lnolo•mom bor ow ner. ood 0 \If any)
0 Ol lio r t900 111ntiuolfenel • (App/fo r to mount, nM lnt,ln«/ oultlde /ho /J .. SJ ~t 8 AddrGH Vt\:«llbo r, otrool, and op l, or 1ul!M II Q,) flq11,1111Dlar'o name an d oaaros u (opll,moQ
20G West Gth Ava Suite 10!i
"' 8 Cl(y,·u,t~lo, and ZlP oodo ~ Ellensburg, WA 90926
V Ll lrt acoounl.numb or{o) hGrO {o pllMllQ
lil!H nl • Taxpayer Identification Number ITINI
Elller ybur TIN In.the app~~~te box. The TIN pf'.OV l.dod muat match the name gfvon on ltn e 1 to avoid Soofql -suour flY numbar
b11o k!1p•vfllh{io lcllno , For ., I~ <1u11la , t,hlB Is 9eno·l'lllly Y.our 00 01111 seoU JllY numbor.(S SNJ , k owowor, for u I I I ~DJ-I I I I roaldon l ollo n, oolo pru prl ol gr, .or_pla(eoar<J i,d ant ny, a~o l hi> P!lrt fl na tru oUo ns·on page 3, For other
·e11 Ut{o a, It I~ your omployor ldentlllr.,n!IQ n number (EfN), If you do not have 11 number, sea How to get ,i
T/N onAa~G.
Note, If the account Is In mor e than ;on a name, soe the Jnstruotlona for Una 1 and the ohart on page 4 for
guldellnoa on whose num bor fci 'en tei:
-6001340
CertUlontlon
Under penaltlea ol perjury, I cartlry thal:
1, The number show11 on thl:i form I.~ my correct taxpayer !dontlil_oa~!on number (?r I am waiting for a number to ba Issued to me); ond
2, I am ri ot subleo t to b11o f1JJ(> wft hholdlno b110!ll)a &:Ja) .I am exem pt from 'beokup 1Yllh l10ldln g, or (b), I have not bean ,fl.Qll'/l ed by the 111\umw Ravonu a
SwYlo e ((flS) thn t I am e1,1~)oct to ba okup w(thh ol Ing as a reau lt of a fall i,ro to re port all tn to rest or dlvldonda, or (o). tho IRS has noll tted mo Hint l am
no lon ge r subfect to bn.okup wlthhoi dlno: Md •
3, I am a U,S, citizen or other u.e, person (denned below); and
4, The FATCA oode(e) entered on Ihle form (II any) lndlontlng that I am exempt from FATOA reporting le correct,
Certffloatlon fnstruotlons, You must cross out Item 2 above If you h11ve baen notifi ed by lha IR S that yo1.1 qro ourt enll y aubJ oot to backup wlt11Holdln g
beoause you have failed lo report all Interest and dividends on your IA)< return, For .real ea tH\e.!rM secllonu, lt11A1 2 does 11ot'apptv, For mortgage
lht ore:et pai d, acquisition or abandonment of secured property, oanoellatlon or dobt oonl r!bullons·to on lnd!vlduoJ rotl1e n1an l orrn11 gem ent (I AAl , Md
oonaroll y, pamonf:1 other lhon Interest and dividends, you ere not required to alan the cerll nQ;itlo n, but you must pro vl do your 11orro ol TI N, Sa a U10
lrisl ru ollo na 011 pogo _3,
Sign s1u nn1wra 11 ,
Here u.11. polllOO • :J H,l["r,t,~ Dato •
General Instructions
Section rolerenooa are to tho lntarnol RovonLlo Codo unloss otheiwlaB noted,
ruture d9valopmenlll, lnfom1111l011 about dev ol.ol)ments n!hrollng Form W-9 (such
as legle)a tldn eneoted un,;r wq rgflla n II) la al WI.V\V,{(J,gov/M ,
Purpose of Form
All lndlvlduol or onl ijy (i-orm W·O r,,q1,oata~who la l'(.-q \ltnrd ta rn.o a,, ln lllf10 nUQf1
rotum with tho IRS mutt ob W.Jn \loltt'oDITOO tlll(pt1yor ld onljllo nllon n\lmb lir (TlN)
which may bo yoO r.eool «I aoou d'iy nLJ111 be1 SS f'II, lndMdu11 lilxpaylll' ldol'\IIOottUon
n4ml;l or (ITIM,,nfkipllQrtto~p~yut ldon ll/lon too number (Al'INJ;or employer
ldo11t Ul0Ji t1 0n numbor(EIN), (o ro po rt on 1m lrt fo!Tll nll on rot lltn tho omo 1111I paid to
you, or ~lhor omou nt rop o!lablo 0/1 an !nfomi\\\lorr return, EKampliJ11 ol ln f01ma tloo
retume lnb!U d!!, bUt aro not lmlt od to, tho lollowln n:
• f'orm 1080-INT (lnloreet earned or p~ld)
• Fom, 1099•DIV (dlvldanda, lncfudlng thouo Iron, atooka or mutunl funds)
• l'orm 10BO•MISO (various types ol lnoome, p(lteo, aw~rde, or gro~a prooesda)
• Fom, 1099•B (stook or mutu~l lund aQles Qnd certain ot11or transactions by
btokore)
• Form 1098-S (proooada rrom ran I estate tronaaollontil '
• Form 1099-K (merohant oord and lhlrd party n~twork tranaaotl(ins)
• ronn 1oae (home mortgaao lntereatl, 1098•!! (student loan lntaraat), 1090·T
(tuition)
• Form 1088•0 (canceled deb~
• Form 1 O!lll-A (aoquIaI11on or abandonmont or aoourod property)
Use r-ll(,n W-9 only l(you aro a u,s, pereon (lnoludlng a roaldont allan), to
provide your corroot TIN,
/f yoil do r!b f ~r11;n Form W-9 lo lh n 111q uo4fo r Wll h a TIN, you m/o/JI l,11 a11b/eol
to baakup wt tl lho ld/11t1. 800 Whal Is bno/rtJp W/lhho /dlt10 ? on pooe 2,
By signing Iha llllad-oul form, you:
1, Co rtlry th at lho TIN you aro giving Is oorreot (or you era waiting for a number
lo bo lasuod),
2. Cert~y U1nt you Hrn ~at subJool to bJ1 okup Wlll)holdl/\11 or
3, Olclm OXtJm pUon from bil\l~Up y1mi1at df~O' II you nro I\ U,8 , OX.Dlll pt P,OYOO, It
ap f>Qoobfo, you aro nla o o~fl lfylng lljn t au ll.9, pDra on, your olloauhl ~ 4)11#U ol
~ny PM11cn1(11p rncomo 11cm ~ U.$, lrndo or bU11ftio sa Is no1 -eu1Jioo"t 10 lli9
l'illhhokijng I/IJ\ an fo,ol gn pnrjn or•' •llarll of o[foo UVoly oonnaotod Inc ome, ond
-~· Co,1~y _that FATOA o. o~a(o! ontored on this form (If an1).lc1dloilttno Unll yolJ nre
oKorr,pl r10111 U1 0 Fi\TOII ropo(I ng, le oo rrool, Sae Whal 13 FM'OA 1qportlng1 on
png_o l! lut rmhor lllfO!mllllen.
I
I
'.d'at. No, 10231X Porm W-9 (Flciv, 12-20141