HomeMy WebLinkAboutAgreementToday's Date
November 25, 2019
Fund/Department
37 / Sheriff
Kittitas County
Review Form
Grants & Contract Agreement
Agenda Date
December 3, 2019
Contract/Grant Information
Contract /Grant Agency: Washington State Military Dept. and the U.S. Department of Homeland Security
FFY19 EMPG E20-156 (SH19-037)
Period Begin Date: 06/01/2019 I I Period End Date: 08/31/2020
Total Grant/Contract Amount: $25,100
Grant/Contract Number: E20-156 (SH19-037)
Contract/Grant Summary: FFY19 EMPG is part of the ongoing Homeland Security Grants that are managed
through the Region 7 lnterlocal Agreement.
Financial Information
Total Amount $25,412 State Funds $0 Federal Funds $25,412 (pass-thru
from WA State Mil Dept.)
Percentage County Funds 0% Matching Funds $0 CFDA# 97 .042 EMPG
In-Kind $0
Explain
Is Equipment being purchased? Who owns equipment? Kittitas County or subrecipients, per grant
Yes, pending Cmdr. Higashiyama
New Personnel being hired? NO Contact HR hiring-reporti ng requirements NA
Future impacts or liability to Kittitas County: Compliance and audit requirements.
Budget Information
Budget Amendment Needed? Yes D attach budget form No[J Already budgeted .
New Division Created? NO
Revenue Code 1 37201933397042
Expense Code
Pass Through Information
Agency to Pass Through NA
Amount to Pass Through $0
-
Sub-Contract Approved Date:
Grant/Contract Review Page 1
Prosecutor Review
I Has the Prosecutor reviewed this agreement? I Yes Ixl No O CAMAS# 47899
County Departments Impacted
Auditor Facilities Maintenance
Information Services Human Resource
Prosecutor Treasurer
Submitted
Si gnatu re: Date:
Department: Sheriff
Assignment of Tracking Information
Auditor's Office
Human Resource
Prosecutor's Office ,--\~ rt -i 1-o{ -'-\ [ °2"°1 r °i
Who Signed tne grant application -
,, \ -1 ~
\
I Reviewer I Date
Grant/Contract Review Page 2
CE I VE
Washington State Military Department NOV 1 9 2019
EMERGENCY MANAGEMENT PERFORMANCE GRANT AGREEMENT FACE sHe:1::r
1. Subrecipient Name and Address: 2. Grant Agreement Amount: 3,t~~ ~~er: Kittitas County Sheriffs Office $25,412
307 W Umptanum Road
Ellensburg, WA 98926-6720
4. Subreclplent Contact, phone/email: 5. Grant Agreement Start Date: 6. Grant Agreement End Date:
Darren Hlgashlyama, 509-933-8206 June 1, 2019 August 31, 2020
darren.hlaashl.vama@co.kittJtas.wa.us
7. Department Contact, phone/email: 8. Data Universal Numbering System (DUNS): 9. UBI # (state revenue):
Michael Alston, 253-512-7083 010202547 192-002-673
mlchael.alston@mll.wa.gov
10. Funding Authority:
Washlnaton State Military Department (the "DEPARTMENr) and the U.S . Deoartmant of Homeland Security (DHS)
11. Federal Funding IC!~ntllioatlon #: I 12. Federal Award Date: 113. Assistance Listings# (formerly CFDA) & Title:
EMS~019-EP-00003-S01 08/05/2019 97.042 (19EMPG)
14. Total Federal Amount#: I1 s. Program Index# & OBJ/SUB-OBJ:
$7,409,645 793PT NZ
16. Service Districts: 17. Service Area by County(ies): 18. Women(Minority-Owned, State
(BY LEGISLATIVE DISTRICT): 13 Kittitas Certified: ~ NIA O NO
(BY CONGRESSIONAL DISTRICT): 8 0 YES, OMWBE #
19. Agreement Classification 20. Co nlract Type (check all that apply):
D Personal Services · 0 Client Services 181 Public/Local Gov't · D Contracr · 181 Grant · 181 Agreement
0 Research/Develooment 0 A/E 0 Other D lnleraovemrn ental (RCW 39.34) 0 lnte raaency
21. Subreclplent SelecUon F'r(?CeS-s:
D Competitive Bidding
22. Sub rec{ple nt Type (check all that apply)
181 "To all who apply & quallfy" D Ptlva.te Organ fzalion/l ndividual 0 For-Profit
0 Sole Source 0 A/ERCW 0 NIA 181 Public Organization/Jurisdiction O Non-Profit
0 Flied w/OFM? 0 Advertised? 0 YES 0 NO 0 CONTRACTOR 181 SUBRECIPIENT O OTHER
23. PURPOSE & DESCRIPTION:
The purpose of the Flscal Year (FY) 2019 Emergency Management Performance Grant (19EMPG) program Is to provide U.S.
Department of Homeland Security (DHS)/Fed.eral Emergency Management Agency (FEMA) Federal award funds to states to
assist state, local, territorial, and tribal governments In preparing for all hazards through sustainment and enhancement of
those programs as described In the Work Plan.
The Department Is the Recipient and Pass-through Entity of the 19EMPG OHS Award Letter for Grant No. EMS-2019-EP-00003-
S01, which Is Incorporated In and attached hereto as Exhibit F and has made a subaward of Federal award funds to the
Subreclplant pursuant to this Agreement. The Subreclplent Is accountable to the Department for use of Federal award funds
provided under this Aareement and the associated match Ina funds.
IN WITNESS WHEREOF, the Department and Subrecipient acknowledge and accept the tenns of this Agreemen t; 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 Fae& Sheet Special Terms & Conditions (Exhibit A); Gene~I T~rms and Conditions (Exhlbit B); Work Pla n (e<l:llbll C):
Tiineltl'IE! (Exhlblr D}; Budget (Exhibit E); 19EMPG Award uitter EMS-2019-EP-00003-S01 (Exhibit F); and all other documents expres~ly
referenced and Incorporated herein contain all the terms and conditions agreed Ui)on· 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 a.nv of the oartles hereto.
In the event of an Inconsistency in this Agree,n13rit, Unless otherwise provided herein, the Inconsistency shall be resolved by giving
precedence in the following order:
1. Applicable Federal and State Statutes and Regulations 4. Speclal Terms and Conditions
2. DHS/FEMA Award and program documents 5. General Terms and Conditions, and,
3. Work Plan , Timellne, and Budget 6. Other provisions-of the Aareement lncoroorated by reference
WHEREAS, the parties hereto have executed this Agreement on the day and year fast specified below.
~~,THE DEPARTMENT) FOR THE SUBRECIPIENT:
I t IJ:11. Ld d·t ~ ~"'-1 :i'.1 (tr'', ry&&::::--l I :V&----r ,
Date Sign t re 1 Signal~-Date
Regan Anne Hesse, Chief Financial Officer ....(3ene-0~f:1arSheriff Ct(l ~ :'\1.,~us
Washington State Military Department Kittitas County Sheriffs O ce
BOILERPLATE APPROVED AS TO FORM: APPR0\JED S JO ~RM (If ai)pl~b'.~:
Brian E. Buchholz 6/27/2019 . ' ''\•'-" \
Sr. Assistant Attomev General Appllcanl'& Legal Re~ i -, Date
DHS-FEMA-EMPG-FY 19 Page 1 of 34 Kittitas County Sheriffs Office, E20-156
Exhibit A
SPECIAL TERMS AND CONDITIONS
ARTICLE I. KEY PERSONNEL
The lndlvlduals listed below shall be consldereo key personnel (or point of contact under this Agreement. Any
supstltution of key personnel by either party shall be made by written notification to the current key personnel.
SUBRECIPl'ENT DEPAR TMEN T
Name Darren Hlgashlyama Name Michael Alston
Title Commander Title Program Coordinator
E-Mail darren.hlgashlyama@co.klttltas.wa.us E-Mail mlchael.alston@mll.wa.gov
Phone 509-933-8206 Phone 253-512-7083
Name Gene Dana Name Tlrzah Kincheloe
Title Sheriff Title Program Manager
E-Mail gene.dana@co.klttitas.wa.us E-Mail tirzah.kincheloet@mll.wa.gov
Phone 509-962-7615 Phone 253-512-7456
Name Sharrle McPherson Name
Title Chief Flnanclal Manager Title
E-Mail sharrie.mcpherson@co.kittltas.wa.us E-Mail
Phone 509-962-7056 Phone ------~
ARTICLE 11. 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 19EMPG Program, including, but not limited to, all criteria, restrictions, and
requirements of The Department of Homeland Security (OHS) Notice of Funding Opportunity (NOFO) Fiscal
Year 2019 Emergency Management Performance Grant (EMPG) document, the FEMA Preparedness Grants
Manual document, the OHS Award Letter for Grant No. EMS-2019-EP-00003-S01, and the federal regulations
commonly applicable to DHS/FEMA grants, all of which are incorporated herein by reference. The DHS Award
Letter is incorporated in this Agreement as Exhibit F.
The Subrecipient acknowledges that since this Agreement involves federal award funding, the period of
performance described herein may begin prior to the availability of appropriated federal funds. The Subrecipient
agrees that it will not hold the Department, the state of Washington, or the United States liable for any damages,
claim for reimbursement, or any type of payment whatsoever for services performed under this Agreement prior
to distribution of appropriated federal funds, or if federal funds are not appropriated or in a particular amount.
A. STATE AND FEDERAL REQUIREMENTS FOR DHS/FEMA PREPAREDNESS GRANTS:
The following requirements apply to all DHS/FEMA Preparedness Grants administered by the
Department.
1. SUBAWARDS & CONTRACTS BY SUBRECIPIENT
a. The Subrecipient must make a case-by-case determination whether each agreement it
makes for the disbursement of 19EMPG 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:
DHS-FEMA-EMPG-FY 19
i. The Subrecipient must comply with all federal laws and regulations applicable to
pass-through entities of 19EMPG funds, including, but not limited to, those
contained in 2 CFR 200.
ii. The Subrecipient shall require Its subrecipient(s) 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 19EMPG Program, including, but not
Page 2 of 34 Kittitas County Sheriffs Office, E20-156
limited to, all criteria, restrictions, and requirements of The Department of
Homeland Security (OHS) Notice of Funding Opportunity (NOFO) Fiscal Year
2019 Emergency Management Performance Grant (EMPG) document, the OHS
Award Letter for Grant No. EMS-2019-EP-00003-S01 in Exhibit F, and the
federal regulations commonly applicable to DHS/FEMA grants.
iii. The Subrecipient shall be responsible to the Department for ensuring that all
19EMPG federal award funds provided to its subreclpients, and associated
matching funds, are used in accordance with applicable federal and state
statutes and regulations, and the terms and conditions of the federal award set
forth in Exhibit F 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 upon completion unless otherwise provided In this Agreement.
b. The maximum amount of all reimbursement requests permitted to be submitted under this
Agreement, including the final reimbursement request, is limited to and shall not exceed
the total Grant Agreement Amount.
c. If the Subrecipient chooses to include indirect costs within the Budget (Exhibit E), an
· indirect cost rate agre·ement negotiated· between the federal cognizant agency 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 Key Personnel.
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 minim is 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 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 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@mll.wa .gov no later than the due dates listed within the
Timeline (Exhibit D).
Reimbursement request totals should be commensurate to the time spent processing by
the Subreclpient and the Department.
f. Receipts and/or backup documentation for any approved items that are authorized under
this Agreement must be maintained by the Subreciptent consistent with record retention
requirements of this Agreement and be made available upon request by the Department
and auditors.
g. The Subrecipient should request prior written approval from Department Key Personnel
to waive the due date in the Tlmeline (Exhibit D) and, once approved, submit those costs
on the next scheduled reimbursement due date contained in the Timeline. Waiving or
missing deadlines serves as an indicator for assessing an agency's level of risk of
noncompliance with the regulations, requirements, and the terms and conditions of the
agreement and may increase required monitoring activities. Any request for a waiver or
extension of a due date in the Timeline (Exhibit D) will be treated as a request for
DHS-FEMA-EMPG-FY 19 Page 3 of 34 Kittitas County Sheriff's Office, E20-156
Amendment of the Agreement. This request must be submitted to the 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.
i. No costs for purchases of equipment/supplies will be reimbursed until the related
equipment/supplies have been received by the Subrecipient, its contractor, or any non-
federal entity to which the Subrecipient makes a subaward and is invoiced by the vendor.
j . Failure to submit timely, accurate, and complete reports and reimbursement requests as
required by this Agreement (including, but not limited to, those reports in the Tlmeline) will
prohibit the Subrecipient from being reimbursed until such reports and reimbursement
requests 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 Subreclplent is
current with all reporting requirements contained in this Agreement.
I. Awritten amendment wm be required if the Subrecipient expects cumulative transfers-to
budget categories, as identified In the Budget (Exhibit E), to exceed 10% of the Grant
Agreement Amount. Any changes to budget category totals not In compliance with this
paragraph will not be reimbursed without approval from the Department.
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 a 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 (Exhibit C) 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. In conjunction with the final report, the Subrecipient shall submit a separate report detailing
how the EMPG Training requirements were met for all personnel funded by federal or
matching funds under this Agreement.
d. 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/emergencv-
managemenl-d ivi sion/grants/reguiredgrantform s, which is incorporated by reference and
made a part of this Agreement.
e. The Subrecipient shall participate in the State's Stakeholder Preparedness Review (SPR)
as well as the State's Threat and Hazard Identification and Risk Assessment (THIRA), as
needed.
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:
DHS-FEMA-EMPG-FY 19
i. Upon successful completion of the terms of this Agreement, all equipment and
supplies purchased through this Agreement will be owned by the Subrecipient.
Page 4 of 34 Kittitas County Sheriffs Office, E20-156
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. funding source for the equipment, including the Federal Award
Identification Number (FAIN)
D. Assistance Listings Number (formerly CFDA Number)
E. who holds the title
F. acquisition date
G. cost of the equipment and the percentage of federal participation in the cost
H. location, -i:rse, and conaition of the equipment at the date the Information
was reported
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 supplies
as applicable, 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 Subreciplent 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:
DHS-FEMA-EMPG-FY 19
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
Page 5 of 34 Kittitas County Sheriff's Office, E20-156
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 200.313 (e) (2).
ix. Records for equipment shall be retained by the Subrecipient for a period of six
years from the date of the disposition, replacement, or transfer. If any litigation,
claim, or audit is started before the expiration of the six-year period, the records
shall be retained by the Subrecipient until all litigation, claims, or audit findings
involving the records have been resolved.
b. The Subreciplent 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 categories for the EMPG Program are listed on the Authorized Equipment List
(AEL) located on the FEMA website at http ://www.fema.gov/authorlzed -eguipment-list. It
is important that the Subrecipient and any non-federal entity to which the Subreciplent
makes a subaward regard the AEL as an authorized purchasing list identifying Items
allowed under the specific grant program and includes items that may not be categorized
as equipment according to the federal, state, local, and tribal definitions of equipment.
The Subrecipient is solely responsible for ensuring and documenting 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 EMPG, the Subrecipient must
contact the Department Key Personnel for assistance in seeking FEMA approval prior to
acquisition.
d. Unless expressly provided otherwise, all equipment must meet all mandatory regulatory
and/or DHS/FEMA adopted standards to be eligible for purchase using federal award
funds.
e. 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 under this Agreement.
6. 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 :t/www.fema .gov/media -library/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 limlted to, construction of communication towers; modification or renovation of
existing buildings, structures and facilities; or new construction including replacement of
facilities, must participate in the DHS/FEMA EHP review process prior to initiation.
Modification of existing buildings, including minimally invasive improvements such as
attaching monitors to interior walls, and training or exercises occurring outside in areas
not considered previously disturbed, also require a DHS/FEMA EHP review before project
initiation.
c. The EHP review process involves the submission of a detailed project description that
includes the entire scope of work, including any alternatives that may be under
consideration, along with supporting documentation so FEMA may determine whether the
DHS-FEMA-EMPG-FY 19 Page 6 of34 Kittitas County Sheriffs Office, E20-156
proposed project has the potential to impact environmental resources and/or historic
properties.
d. The Subreclpient 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 Subreclplent 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
Subreclpient will not be reimbursed.
6. PROCUREMENT
a. The Subrecipient shall comply with all procurement requirements of 2 CFR Part 200.318
through 200.326 and as specified in the General Terms and Conditions, Exhibit B, A.10.
b. For all sole source contracts expected to exceed $250,000, the Subreclpient must submit
to the Department for pre-procurement review and approval the procurement documents,
such as requests for proposals, Invitations for bids and Independent cost estimates. This
requirement must be passed on to any non-federal entity to which the Subrecipient makes
a subaward, at which point the Subrecipient will be responsible for reviewing and
approving sole source justifications of any non-federal entity to which the Subreclplent
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 :l/miLwa .gov/emergency-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.g. agendas, sign-in sheets, meeting
minutes), e-mails and correspondence
iv. Review of reimbursement requests and supporting documentation to ensure
allawability and consistency with Agreement work plan, budget, and federal
requirements
v . Observation and documentation of Agreement related activities, such as
exercises, training, funded events, and equipment demonstrations
vi. On-site visits to review equipment records and inventories, to verify source
documentation for reimbursement requests and performance reports, and to verify
completion of deliverables.
d. The Subrecipient is required to meet or exceed the monitoring activities, as outlined
above, 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.
DHS -FEMA-EMPG-FY 19 Page 7 of 34 Kittitas County Sheriffs Office, E20-156
8. LIMITED ENGLISH PROFIENCY (CIVIL RIGHTS ACT OF 1964 TITLE VI)
a. 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. OHS
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 bttps:/Jwww,dhs.gov/guidance-ptJblished-help-
department-supported-organizations-provide-meanlngftJl-access~people -limited and
additional resources on http://www.lep.gov.
9. NIMS COMPLIANCE
a. The National Incident Management System (NIMS) identifies concepts and principles that
answer how to manage emergencies from preparedness to recovery regardless of their
cause, size, location, or complexity. NIMS provides a consistent, nationwide approach
and vocabulary for multiple agencies or jurisdictions to work together to build, sustain, and
deliver the core capabilities needed to achieve a secure and resilient nation.
b. Consistent implementation of NIMS provides a solid foundation across jurisdictions and
disciplines to ensure effective and integrated preparedness, planning, and response.
NIMS empowers the components of the National Preparedness System, a requirement of
Presidential 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 2019 federal preparedness funding, to include EMPG, 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/n,edia-library/assets/documents/1307 43.
B. EMPG PROGRAM SPECIFIC REQUIREMENTS
1. The Department receives EMPG Program funding from DHS/FEMA, which is provided to assist
state, local, and tribal governments to enhance and sustain all-hazards emergency management
capabilities as authorized by Robert T. Stafford Disaster Relief and Emergency Assistance Act,
as amended (42 U.S.C. §§ 5121 et seq.) and Section 662 of the Post Katrina Emergency
Management Act (6 U.S.C. § 762).
2. A portion of the 19EMPG is passed through to local jurisdictions and tribes with emergency
management programs to supplement their local/tribal operating budgets to help sustain and
enhance emergency management capabilities pursuant to Washington Administrative Code
(>MAC) 118-09.
3. The Subrecipient shall use the EMPG funds authorized under this Agreement only to perform
tasks as described in the Work Plan of the Subrecipient's application for funding, as approved by
the Department and incorporated into this Agreement.
4. Funding may not be used to replace or supplant existing local or tribal government funding of
emergency management programs.
DHS-FEMA-EMPG-FY 19 Page 8 of 34 Kittitas County Sheriffs Office, E20-156
5. The Subrecipient shall provide a fifty percent match of non-federal origin. The Federal share
applied toward the EMPG budget shall not exceed fifty percent of the total budget as submitted
in the application and approved in Budget, Exhibit E. To meet matching requirements, the
Subrecipient's cash matching contributions must be considered reasonable, allowable, allocable,
and necessary under the grant program and must comply with all Federal requirements and
regulations, Including, but not limited to, 2 CFR Part 200. An appropriate mechanism must be in
place to capture, track, and document matching funds. In the final report, the Subreclpient shall
identify how the match was met and documented.
6. All personnel funded in any part through federal award or matching funds under this Agreement
shall:
a. Complete and record proof of completion for the NIMS training requirements outlined in
the NIMS Training Program located at
https ;//www Jema .gov/pdf/emergency/nlms /nlms tralninq prog ram .pdf (to Include ICS-
100, ICS-200, IS-700, and IS-800 for most personnel). The Subrecipient will report
training course completion by Individual personnel along with the final report; and
b. Complete either (1) the FEMA Professional Development Series IS-120, IS-230, IS-235,
IS-240, IS-241, IS-242, and IS-244, or (2) the National Emergency Management Basic
Academy. The Subreclplent will report training course completion by Individual personnel
along with the final report
C. OHS TERMS AND CONDITIONS
As a Subrecipient of 19EMPG program funding, the Subrecipient shall comply with all applicable OHS
terms and conditions of the 19EMPG Award Letter and its Incorporated documents for OHS Grant No.
EMS-2019-EP-00003-S01, which are incorporated and made a part of this Agreement as Exhibit F.
DHS-FEMA-EMPG-FY 19 Page 9 of 34 Kittitas County Sheriffs Office, E20-156
A.1 DEFINITIONS
Exhibit B
Washington State MIiitary Department
GENERAL TERMS AND CONDITIONS
Department of Homeland Security (OHS)/
Federal Emergency Management Agency (FEMA)
Grants
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. "Subreclplent· 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 PAYM ENTS PROHIBITED
The Department shall make no payments In advance or in anticipation of goods or services to be provided
under this Agreement. Subrecipient shall not invoice the Department In advance of delivery and Invoicing
of such goods or services.
A.3 AMENDMENTS AND MODIFICATIONS
The Subrecipient or the Department may request, in writing, an amendment or modification of this
Agreement. However, such amendment or modification shall not be binding, take effect or be
incorporated herein until made In writing and signed by the authorized representatives of the Department
and the Subrecipient. No other understandings or agreements, written or oral, shall be binding on the
parties.
A.4 AMERICANS WITH DISABILITIES ACT {ADA) OF 1990; PUBLIC LAW 101-336, 42 U.S.C. 12101 ET
SEQ. AND ITS IMPLEMENTING REGULATIONS ALSO REFERRED TO AS THE MADN 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
Th.e Department and Subrecipient agree that all activity pursuant to this Agreement will be in accordance
with all the applicable current federal, state and local laws, rules and regulations.
A.6 CERTIFICATION REGARDING DEBARMENT. SUSPENSION , OR INELIGIBILITY
As federal funds are a basis for this Agreement, the Subrecipient certifies that the Subrecipient Is not
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participating in this Agreement by any federal department or agency.
The Subrecipient shall complete, sign, and return a Certification Regarding Debarment, Suspension,
Ineligibility, and Voluntary Exclusion form located at http ://m ll .wa .gov/emergency-managemenl·
dlvision/grants/reguiredgrantforms . Any such form completed by the Subreciplent for this Agreement
shall be incorporated into this Agreement by reference.
DHS-FEMA-EMPG-FY 19 Page 10 of 34 Kittitas County Sheriffs Office, E20-156
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 ://s am .gov/SAM/) 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 .ln l.wa .gov/debarandstrike/ConlractorDebarLlst.aspx). The Subrecipient also agrees not
to enter into any agreements or contracts for the purchase of goods and services with any party on the
Department of Enterprise Services' Debarred Vendor List
(hltp ://www des .wa .gov/services/ContractlngPurchasing/Business/PagesMendor-Debarment.aspx).
A.7 CER TIFICATlON REGARDING RESTRICTIONS ON LOBBYING
As required by 44 CFR Part 18, the Subrecipient hereby certifies that to the best of its knowledge and
belief: (1) no federally appropriated funds have been paid or will be paid by or on behalf of the
Subreciplent 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 Subreciplent 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, subgrants, 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 COMPLIANCE WITH APPLICAB LE STAT UTES, RULES AND DEPARTMENT POLICIES
The Subreclpient and all its contractors and subreclpients 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 Environ mental 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 Subreciplent, 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.
A.9 CO NFLI CT OF INTEREST
No officer or employee of the Department; no member, officer, or employee of the Subrecipient or Its
designees or agents; no member of the governing body of the jurisdiction in which the project ls
DHS-FEMA-EMPG-FY 19 Page 11 of 34 Kittitas County Sheriffs Office, E20-156
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 CONTRACTING & 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 $250,000, 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 assisted construction contract• in 41 CFR Part
60-1.3 must include the equal opportunity clause provided under 41 CFR 60-1.4(b), in
accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319,
12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375,
"Amending Executive Order 11246 Relating to Equal Employment Opportunity," and
implementing regulations at 41 CFR part 60, "Office of Federal Contract Compliance
Programs, Equal Employment Opportunity, Department of Labor."
4) Davis-Bacon Act, as amended (40 U.S.C. 3141-3148). When required by Federal program
legislation, all prime construction contracts in excess of $2,000 awarded by non-federal
entities must include a provision for compliance with the Davis-Bacon Act (40 U.S.C. 3141-
3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Part
5, "Labor Standards Provisions Applicable to Contracts Covering Federally Financed and
Assisted Construction"). In accordance with the statute, contractors must be required to pay
wages to laborers and mechanics at a rate not less than the prevailing wages specified In a
wage determination made by the Secretary of Labor. In addition, contractors must be
required to pay wages not less than once a week. The non-federal entity must place a copy
of the current prevailing wage determination issued by the Department of Labor In each
solicitation. The decision to award a contract or subcontract must be conditioned upon the
acceptance of the wage determination. The non-federal entity must report all suspected or
reported violations to the federal awarding agency. The contracts must also include a
provision for compliance with the Copeland "Anti-Kickback" Act (40 U.S.C. 3145), as
supplemented by Department of Labor regulations (29 CFR Part 3, "Contractors and
Subcontractors on Public Building or Public Work Financed In Whole or In Part by Loans or
Grants from the United States"). The Act provides that each contractor or Subrecipient must
be prohibited from inducing, by any means, any person employed in the construction,
completion, or repair of public work, to give up any part of the compensation to which he or
she is otherwise entitled. The non-federal entity must report all suspected or reported
violations to the federal awarding agency.
5) Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). Where applicable,
all contracts awarded by the non-federal entity in excess of $100,000 that involve the
employment of mechanics or laborers must include a provision for compliance with 40 U.S.C.
3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under
40 U.S.C. 3702 of the Act, each contractor must be required to compute the wages of every
DHS-FEMA-EMPG-FY 19 Page 12 of 34 Kittitas County Sheriff's Office, E20-156
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 Subreciplent
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.
1 O) 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,
DHS-FEMA-EMPG-FY 19 Page 13 of 34 Kittitas County Sheriffs Office, E20-156
of 2 CFR Part 200 Subpart F, the Subrecipient's failure to comply with said audit requirements may result
in one or more of the following actions in the Department's sole discretion: a percentage of federal awards
being withheld until the audit is completed in accordance with 2 CFR Part 200 Subpart F; the withholding
or disallowing of overhead costs; the suspension of federal awards until the audit is conducted and
submitted; or termination of the federal award.
A.29 SUBRECIPIENT NOT EMPLOYEE
The parties intend that an independent contractor relationship will be created by this Agreement. The
Subrecipient, and/or employees or agents performing under this Agreement are not employees or agents
of the Department in any manner whatsoever. The Subrecipient will not be presented as, nor claim to
be, an officer or employee of the Department by reason of this Agreement, nor will the Subrecipient make
any claim, demand, or application to or for any right or privilege applicable to an officer or employee of
the Department or of the state of Washington by reason of this Agreement, including, but not limited to,
Workmen's Compensation coverage, unemployment insurance benefits, social security benefits,
retirement membership or credit, or privilege or benefit which would accrue to a civil service employee
under Chapter 41.06 RCW.
It is understood that if the Subrecipient is another state department, state agency, state university, state
college, state community college, state board, or state commission, that the officers and employees are
employed by the state of Washington in their own right and not by reason of this Agreement.
A.30 TAXES. FEES AND LICENSES
Unless otherwise provided in this Agreement, the Subrecipient shall be responsible for, pay and maintain
in current status all taxes, unemployment contributions, fees, licenses, assessments, permit charges and
expenses of any other kind for the Subrecipient or Its staff required by statute or regulation that are
applicable to Agreement performance.
A.31 TERMINATION FOR CONVENIENCE
Notwithstanding any provisions of this Agreement, the Subrecipient may terminate this Agreement by
providing written notice of such termination to the Department Key Personnel identified in the Agreement,
specifying the effective date thereof, at least thirty (30) days prior to such date.
Except as otherwise provided in this Agreement, the Department, in its sole discretion and in the best
interests of the state of Washington, may terminate this Agreement in whole or in part by providing ten
(10) calendar days written notice, beginning on the second day after malllng to the Subrecipient. Upon
notice of termination for convenience, the Department reserves the right to suspend all or part of the
Agreement, withhold further payments, or prohibit the Subrecipient from incurring additional obligations
of funds. In the event of termination, the Subrecipient shall be liable for all damages as authorized by
law. The rights and remedies of the Department provided for in this section shall not be exclusive and
are In addition to any other rights and remedies provided by law.
A.32 TERMINATION OR SUSPENSION FOR CAUSE
In the event the Department, in its sole discretion, determines the Subrecipient has failed to fulfill in a
timely and proper manner its obligations under this Agreement, is in an unsound financial condition so
as to endanger performance hereunder, is In violation of any laws or regulations that render the
Subrecipient unable to perform any aspect of the Agreement, or has violated any of the covenants,
agreements or stipulations of this Agreement, the Department has the right to immediately suspend or
terminate this Agreement in whole or in part.
The Department may notify the Subrecipient in writing of the need to take corrective action and provide
a period of time In which to cure. The Department is not required to allow the Subrecipient an opportunity
to cure if it Is not feasible as determined solely within the Department's discretion. Any time allowed for
cure shall not diminish or eliminate the Subrecipient's liability for damages or otherwise affect any other
remedies available to the Department. If the Department allows the Subrecipient an opportunity to cure,
the Department shall notify the Subrecipient in writing of the need to take corrective action. If the
corrective action is not taken within ten (10) calendar days or as otherwise specified by the Department,
or if such corrective action is deemed by the Department to be insufficient, the Agreement may be
terminated In whole or In part.
The Department reserves the right to suspend all or part of the Agreement, withhold further payments,
or prohibit the Subrecipient from incurring additional obligations of funds during investigation of the
DHS-FEMA-EMPG-FY 19 Page 18 of 34 Kittitas County Sheriff's Office, E20-156
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 urtderthis 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 Subreciplent
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 Subreciplent'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-llabllily. 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
DHS-FEMA-EMPG-FY 19 Page 14 of 34 Kittitas County Sheriffs Office, E20-156
part of a federal agency or an employee of the Federal government In carrying out the provisions of the
Stafford Act.
A.14 LIMITATION OF AUTHORITY-AUTHORIZED SIGNATURE
The signatories to this Agreement represent that they have the authority to bind their respective
organizations to this Agreement. Only the Department's Authorized Signature representative and the
Authorized Signature representative of the Subrecipient or Alternate for the Subrecipient, formally
designated In writing, shall have the express, Implied, or apparent authority to alter, amend, modify, or
waive any clause or condition of this Agreement. Any alteration, amendment, modification, or waiver of
any clause or condition of this Agreement is not effective or binding unless made in writing and signed
by both parties' Authorized Signature representatives.
Further, only the Authorized Signature representative or Alternate for the Subrecipient shall have
signature authority to sign reimbursement requests, time extension requests, amendment and
modification requests, requests for changes to projects or work plans, and other requests, certifications
and documents authorized by or required under this Agreement.
A.15 LOSS _OR REDUCTION OF FUNDING
In the event funding from state, federal, or other sources is withdrawn, reduced, or limited in any way
after the effective date of this Agreement and prior to normal completion or end date, the Department
may unilaterally reduce the work plan and budget or unilaterally terminate all or part of the Agreement as
.. a_'.'Termlnation for Cause" withoutproviding the _Subreciplent.an opportunity to.cure. Alternatively, the .
parties may renegotiate the terms of this Agreement under "Amendments and Modificationsn to comply
with new funding limitations and conditions, although the Department has no obligation to do so.
A.16 NONASSIGNABILITY
Neither this Agreement, nor any claim arising under this Agreement, shall be transferred or assigned by
the Subrecipient.
A.17 NONDISCRIMINATION
The Subrecipient shall comply with all applicable federal and state non-discrimination laws, regulations,
and policies. No person shall, on the grounds of age, race, creed, color, sex, sexual orientation, religion,
national origin, marital status, honorably discharged veteran or military status, or disability (physical,
mental, or sensory) be denied the benefits of, or otherwise be subjected to discrimination under any
project, program, or activity, funded, in whole or in part, under this Agreement.
A.18 NOTICES
The Subrecipient shall comply with all public notices or notices to Individuals required by applicable local,
state and federal laws and regulations and shall maintain a record of this compliance.
A.19 OCCUPATIONAL SAFETY/HEAL TH ACT and WASHINGTON INDUSTRIAL SAFETY/HEAL TH ACT
(OSHA/WI SHA)
The Subreclplent represents and warrants that its work place does now or will meet all applicable federal
and state safety and health regulations that are in effect during the Subrecipient's performance under this
Agreement. To the extent allowed by law, the Subrecipient further agrees to indemnify and hold harmless
the Department and Its employees and agents from all liability, damages and costs of any nature,
Including, but not limited to, costs of suits and attorneys' fees assessed against the Department, as a
result of the failure of the Subrecipient to so comply.
A.20 OWNERSHIP OF PROJECT/CAPITAL FACILITIES
The Department makes no claim to any capital facilities or real property improved or constructed with
funds under this Agreement, and by this subaward of funds does not and will not acquire any ownership
interest or title to such property of the Subrecipient. The Subrecipient shall assume all liabilities and
responsibilities arising from the ownership and operation of the project and agrees to Indemnify and hold
the Department, the state of Washington, and the United States government harmless from any and all
causes of action arising from the ownership and operation of the project.
A.21 POLITICAL ACTIVITY
No portion of the funds provided herein shall be used for any partisan political activity or to further the
election or defeat of any candidate for public office or influence the approval or defeat of any ballot issue.
A.22 PROHIBITION AGAINST PAYMENT OF BONUS OR COMMISSION
DHS-FEMA-EMPG-FY 19 Page 15 of 34 Kittitas County Sheriffs Office, E20-156
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 the Assistance Listings Number (formerly 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 ei~pend funds und~r tbis Ag ~ee ment in acc9rdance 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 deslgnees, or by other
state or federal officials authorized by law, for the purposes of determining compliance by the
Subrecipient with the terms of this Agreement and to determine the appropriate level of funding
to be paid under the Agreement.
c. The records shall be made available by the Subrecipient for such inspection and audit, together
with suitable space for such purpose, at any and all times during the Subrecipient's normal
working day.
d. The Subrecipient shall retain and allow access to all records related to this Agreement and the
funded project(s) for a period of at least six (6) years following final payment and closure of the
grant under this Agreement. Despite the minimum federal retention requirement of three (3)
years, the more stringent State requirement of six (6) years must be followed.
A.26 RESPONSIBILITY FOR PROJECT/STATEMENT OF WORK/WORK PLAN
While the Department undertakes to assist the Subrecipient with the project/statement of work/work plan
(project) by providing federal award funds pursuant to this Agreement, the project itself remains the sole
responsibility of the Subreclpient. The Department undertakes no responsibility to the Subrecipient, or
to any third party, other than as is expressly set out In this Agreement.
The responsibility for the design, development, construction, Implementation, operation and maintenance
of the project, as these phrases are applicable to this project, is solely that of the Subrecipient, as is
responsibility for any claim or suit of any nature by any third party related in any way to the project.
Prior to the start of any construction activity, the Subrecipient shall ensure that all applicable federal,
state, and local permits and clearances are obtained, including, but not limited to, FEMA compliance with
DHS-FEMA-EMPG-FY 19 Page 16 of34 Kittitas County Sheriff's Office, E20-156
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 Subreciplent in connection with the project. The Subreclplent 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 SINGL E AUDIT ACT REQU IREMEN TS (includi ng all A MENDMENTS)
The Subreclpient shall comply with and include the following audit requirements in any subawards.
Non-federal entities, as Subreciplents 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 nonprofit organization
that carries out a federal award as a recipient or subreclpient.
Subreciplents 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 Subreciplent 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 Subreciplent 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 reseives 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 Subreciplent 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 MIiitary Department
Finance Division, Building #1 TA-20
Camp Murray, WA 98430-5032
The Subreciplent must send a completed "2 CFR Part 200 Subpart F Audit Certification Form"
(https:l/www.rnil .wa.gov/emergencv-management-dlvislon/grants/reguiredgranfforms) to the Department
al the address listed above before this Agreement is executed and timely submit annual updates to the
Department every year thereafter, and if the Subrecipient is claiming it is exempt from the audit
requirements of 2 CFR Part 200 Subpart F include an explanation of the criteria for exemption.
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.
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
DHS-FEMA-EMPG-FY 19 Page 17 of34 Kittitas County Sheriffs Office, E20-156
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 Subreclpient as an agreed upon
pri~e. iJsepE1rat~Jy st~ted, fe>r properly aut_h9rized ~net Q.Qmpleted work and _ s~rv.lces rendered or goods
delivered to and accepted by the Department prior to the effective date of Agreement termination, the
amount agreed upon by the Subrecipient and the Department for (i) completed work and services and/or
equipment or supplies provided for which no separate price is stated, (ii) partially completed work and
services and/or equipment or supplies provided which are accepted by the Department, (iii) other work,
services and/or equipment or supplies which are accepted by the Department, and (iv) the protection and
preservation of property.
Failure to agree with such amounts shall be a dispute within the meaning of the "Disputes" clause of this
Agreement. If the termination Is for cause, the Department shall determine the extent of the liability of
the Department. The Department shall have no other obligation to the Subrecipient for termination. The
Department may withhold from any amounts due the Subrecipient such sum as the Department
determines to be necessary to protect the Department against potential loss or liability.
The rights and remedies of the Department provided in this Agreement shall not be exclusive and are in
addition to any other rights and remedies provided by law.
After receipt of a notice of termination, and except as otherwise directed by the Department in writing,
the Subrecipient shall:
a. Stop work under the Agreement on the date, and to the extent specified, in the notice;
b. Place no further orders or contracts for materials, services, supplies, equipment and/or facilities
in relation to this Agreement except as may be necessary for completion of such portion of the
work under the Agreement as Is not terminated;
c. Assign to the Department, in the manner, at the times, and to the extent directed by the
Department, all of the rights, title, and Interest of the Subrecipient under the orders and contracts
so terminated, In which case the Department has the right, at its discretion, to settle or pay any
or all claims arising out of the termination of such orders and contracts;
d. Settle all outstanding liabilities and all claims arising out of such termination of orders and
contracts, with the approval or ratification of the Department to the extent the Department may
require, which approval or ratification shall be final for all the purposes of this clause;
e. Transfer title to the Department and deliver in the manner, at the times, and to the extent directed
by the Department any property which, if the Agreement had been completed, would have been
required to be furnished to the Department;
f. Complete performance of such part of the work as shall not have been terminated by the
Department In compliance with all contractual requirements; and
g. Take such action as may be necessary, or as the Department may require, for the protection and
preservation of the property related to this Agreement which Is in the possession of the
Subreclplent and in which the Department has or may acquire an interest.
DHS-FEMA-EMPG-FY 19 Page 19 of34 Kittitas County Sheriff's Office, E20-156
A.34 UTILIZATION OF MINORITY AND WOMEN BUSINESS ENTERPRISES (MWBE)
The Subrecipient is encouraged to utilize business firms that are certified as minority-owned and/or
women-owned in carrying out the purposes of this Agreement. The Subrecipient may set utilization
standards, based upon local conditions or may utilize the state of Washington MWBE goals, as identified
in WAC 326-30-041.
A.35 VENUE
This Agreement shall be construed and enforced in accordance with, and the validity and performance
shall be governed by, the laws of the state of Washington. Venue of any suit between the parties arising
out of this Agreement shall be the Superior Court of Thurston County, Washington. The Subreciplent,
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-EM PG -FY 19 Page 20 of 34 Kittitas County Sheriffs Office , E20-156
Exhibit C
WORK PLAN
FY 2019 Emergency Ma nagem ent Performance Grant
Emergency Management 0111anlzation Kittitas County Sheriff's Office
The purpose of EMPG Is to assist with the enhancement, sustainment and Improvement of state, local, and trlbal emergency management
programs. Activities conducted using EMPG funding should relate directly to the five elements of emergency management: prevention,
protection, response, recovery, end mitigation. Washington State does not require a specific number of activities to receive EMPG funding.
However, there are required capabllltles that must be sustained In order to remain ellglble for EMPG funding, lndudlng but not llmlted to
the ablllty to communicate and warn, educate the publlc, train and exercise, plan, and be NIMS compllant. The Work Plan delineates the
Emergency Management Organization's emergency management program planning and priority focus for this grant cycle (to Include
19EMPG grant and local funds).
l'rollr.:im /<rod 1/1
rmerweMv COmmu nlCIOons
WORK PlANNED WHY THE WORK IS BEING DONE RESULT OF THE WORK
l Support the Everbrlde;e, mass notification system
for the County.
Emer1ency Mass notification Is new to the County The County wlll have a mass notification system In
(2019), Kittitas County has had a cap In mass place that all municipal EM and county EM will be
notifications for decades, with the new Everbrldce able to utilize In case of an emeraency. The county
-
Pm11r.1m Ama 112
Training
WORK PLANNED
1. • Plan and Instruct active shooter training.
• Conduct and participate In EOC tralnln1.
• Continually train In Emergency Management (for
i hreats such HazMat)
l Support and participate In tralnln1s/conferences
(ICS 300, 400, HazMat, Active Shooter, WSEMA,
and PIEPC) Purchases will consist of markine
munitions, travel, and registrations costs.
T.11ctf(I I tt!l m boots
WORK PLANNED
system, that gap will be filled, will be able to notify citizens when emer1ency
situations are pendln1 and occurrlna; to help
reduce the potential ne1atlve Impacts to lives and
property,
WHVTHE WORK IS BEING DONE RESULT OFTHE WORK
Continual tr1lnlne ls .needed to be"er pfel)!lte flls! S(tlf are better prepared to handle response and
responders and EOC staff for emer,e11cl~, EOC operations,
threats, ind huard& that affect klttltuC01rnty
Numerous wlldland fires hal!c concluded ,th;it the
C(!unty ~ds a ·~eeptii' bench~ of EOC n_iem~ars
tralncll ln ICS..The reo1J-word actlvuhooter even t
on the ·cwu Clmpuse~po,ed ne.eded trelnlne In
reJpOMe_,
WHY THE WORK IS BEING DONE
The fundine will help supply needed tralnlne aids
and material, pay for registration and travel for
trainln1 so that the County will have enough ready
and trained staff to respond to emercenclu that
occur.
RESULT OF THE WORK
1. Purchase new boots for the reelonal tactical team The current footwear for the team Is obsolete and The regional tactical team will be equipped to be
able to responded to threats In Kittitas County.
The team will have the necessary supplies to
respond to threats for many years to come.
which will be used for tralnln1 and for mission-new boots will brldee this 1ap In response
specific SWAT operations such as e>Cploslv11 capabllittes.
response or chemical environment response.
Procram i\rt?n /Ill
Command vehicle
WORK PLANNED WHY THE WORK IS BEING DONE RESULT OF THE WORK
1. Purchase mobile command trays· modular The current vehlcle Is not equipped with the The new vehicle will be equipped to become a
cabinets for storace of computers, easels, and mobile command trays In the rear which severely mobile command post anywhere it can drive to.
other office related Items· for the new mobile Inhibits response capabilities. This will Increase the response capabllltyfor the
command vehicle for the emereency mana1ement emer1ency mana1ement coordinator to respond
coordinator. to any threat or hazard In the county.
DHS-FEMA-EMPG-FY 19 Page 21 of34 Kittitas County Sheriffs Office, E20-156
Exhibit D
TIMELINE
FY 2019 Emergency Management Performance Grant
DATE TASK
June 1, 2019 Grant Agreement Start Date
April 30, 2020 Submit reimbursement request
August 31, 2020 Grant Agreement End Date
October 15, 2020 Submit final reimbursement request, final report, training
requirement report, and/or other deliverables.
DHS-FEMA-EMPG-FY 19 Page 22 of34 Kittitas County Sheriffs Office, E20-156
BUDGET
FY 2019 Emergency Management Performance Grant
19EMPG AWARD ,_! $ ______ 25-=--,4_1_2._oo ...... [
SOLUTION
AREA BUDGET CATEGORY
·,i,· .~
Sal arl es & Benefits-
EMPGAMOUNT
$
MATCH AMOUNT
$
~ Overti me/Backfill $
z _c_o_ns_u ___ lt_a __ n __ ts.._c_.o_n_tr_a_ct_o_rs _________ $...__ _____ _
~ ...:G:,.::.o..::.o.:;.;ds:...&""'""'S"""er..c.v.;_;lc"".es.__ _______ --'$'----------.1
ci. _T~ra~v_el~Pe~r_D_ie_m ________ ~~-----~
Subtotal $ .
z Salar les & Benefits $ -0 'Overttme/Ba ckfl 11 $ ~ -
Consulta nts/Contra.cto rs s -
$
$
$
$
$
I $
: $
'$
~ Goods & Services $ 1a ooo ~ $
i Tri v..el/Pef 0l'eiii ---s $ .
0 Subtotal $ 16,000 $
Sa la ri es & Benefits. $ -. ...L w Overt I me/Ba ckfl II $ . J Cl) u Consulta nts/Co ntractors $, -$
.
.
-------
-. .
CIC: $ I··~---~ Goods & Servi ces .
$ -Travel /P,~r Diem -.
l -Subtotal s --
Salaries & Benefits $ -J J ___ ·-65,458
(!> overtime/Ba ckfl 11 ,$ -II $ -z --z Consvltants/Contractors $ ~
S G.oods & Services $ , .$
I== _Tr_a_v_e..._1/_P_er_D_l_em __________ $ ________ ____,I $_
.Subtot al $ -r,..$ ____ 6_5.._,4_5_8_
9 ;412 l $
9,412 $
~-'-------------1s
e. Eq ui pment $ 5 w Subtotal $
Salaries & Benefits $
--~-~-------~-----~' ~ $
Overt I me/Back.fill $
~ Consultan~/Contractors s ca
::i: Goods & Services $ $
Travel/Per Di em $ $
----------------------Ii--!-----Subtotal $
Indirect .. s
Indirect Cost Rate on file 0%
TOTAL Grant Agreement AMOUNT: $ 25,412 _ $ 65,458
Exhibit E
• The Subrecipient will provide a match of $25,412 of non-federal origin, 50% of the total project cost (local
budget plus EMPG award).
• Cumulative transfers to budget categories in excess of 10% of the Grant Agreement Amount will not be
reimbursed without prior written authorization from the Department.
Funding Source: U.S. Department of Homeland Security -Pl# 793PT-EMPG
DHS-FEMA-EMPG-FY 19 Page 23 of 34 Kittitas County Sheriffs Office, E20-156
Award Letter
19EMPG Award Letter
EMS-2019-EP-00003-S01
Exhibit F
U.S. Department of Homeland Security
Washington, D.C. 20472
Tlrzah Kincheloe
Washington Mllltary Department
Build ing 20
Camp Murray, WA 98430 • 5122
Re: Grant No,EMS-2019-EP-00003
Dear Tlrzah Kincheloe:
Congratulations, on behalf of the Department of Homeland Security, your application for flnanclal assistance submitted under
the Flscal Year (FY) 2019 Emergency Management Performance Grants has been approved In the amount of $7,409,645.00.
As a condiUon of this award, you are required to contribute a cost match In the amount of $7,409,645.00 of non-Federal funds,
or 50 percent of the total approved project costs of $14,819,290.00.
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 Leiter)
• FY 2019 Emergency Management Performance Grants Notice of Funding Opportunity.
, FEMA Preparedness Grants Manual
Please make sure you read, understand, and maintain a copy of these documents In your offlclal file for Chis 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 togging In, you will see the Home page With a Pending Tasks menu. CIiek on the Pending Tasks menu, select the
Application sub-menu, and then click the link for "Aw iJrd Offer Review" tasks. This link will navigate you to Award Packages
that are pending review.
Step 3: Cilek the Review Award Package Icon (wrench) to review the Award Package and accept or decline the award. Please
save or print the Award Package for your records.
System ror Award Management (SAM): Gra nt re cip ients are to keep all of their information up to date in SAM, in particular,
your organization's name, address , DUNS numb er, EIN and banking information. Please ensure that the DUNS number used
in SAM Is the same one used to apply for an FEMA awards . Future payments will be contingent on the Information provided
in the SAM; therefore, It Is Imperative that the information is correct. The-System for Award Management Is located at http ://
www sam.gov.
If you have any questions or have updated your information in SAM, please let your Grants Management Specialist (GMS)
know as soon as possible. This will help us to make the necessary updates and avoid any interruplions In the payment
process.
DHS-FEMA-EMPG-FY 19 Page 24 of 34 Kittitas County Sheriff's Office , E20-156
l (i
i r
KIMBERLY ERIN PENFOLD Assistance Officer
DHS-FEMA-EMPG-FY 19 Page 25 of34 Kittitas County Sheriffs Office, E20-156
Agreement Articles
Mon Oct 01 00:00:00 GMT 2018
ORANTEE:
PROGRAM:
AGREEMENT NUMBER:
Article I
Article II
Article Ill
Article IV
Article V
Article VI
Article VII
Article VIII
Article IX
Article X
Article XI
Article XII
Article XIII
OHS-FEMA-EMPG-FY 19
U.S. Department of Homeland Security
Washington, D.C. 20472
AGREEMENT ARTICLES
Emergency Management Performance Grants
Washington MIiitary Department
Emer_gericy_ Man~g~IT_!~nt Performance
Granls
EMS-2019-EP-00003-S01
TABLE OF CONTENTS
Assurances, Administrative Requirements, Cost Prlnclples,
Representation and Certifications
Acknowledgement of Federal Funding from OHS
OHS Specific Acknowledgements and Assurances
Activities Conducted Abroad
Age Dlscrimlnatlon Act or 1975
Americans with Disabilities Act of 1990
Best Pracllces for Collection and Use of Personally
Identifiable lnrormallon (PII)
Civil Rights Act or 1964 -Title VI
Civil Rights Act of 1968
Copyright
Debarment and Suspension
Drug-Free Workplace Regulations
Duplication of Benefits
Page 26 of34 Kittitas County Sheriffs Office, E20-156
Article XIV
Article XV
Article XVI
Article XVII
Article XVIII
Article XIX
Article XX
ArtlcleXXI
Article XXII
Article ><XIII
ArUcleXXIV
ArticleXXV
Article XXVI
Article ><XVII
Article XXVIII
Article XXIX
Article XXX
Article XXXI
Article XXXII
Article XXXIII
Artlcle XXXIV
Article XXXV
Article XXXVI
DHS-FEMA-EMPG-FY 19
Education Amendments of 1972 (Equal Opportunity In
Education Act) -TiUe IX
Energy Policy and Conservation Act
False Claims Act and Program Fraud Civil Remedies
Federal Debt Status
Federal Leadership on Reducing Text Messaging while
Driving
Fly America Act of 197 4
Hotel and Motel Fire Safety Act of 1990
limited English Prollclency (Clvll Rights Act of 1964, Title VI)
Lobbying Prohibitions
Nalional Environmenlal Polley Acl
Nondiscrimination in Matters Pertaining to Faith-Based
Organizations
Non-Supplanting Requirement
Notice of Funding Opportunity Requirements
Patents and Intellectual Property Rights
Procurement of Recovered Materials
Rehabilitation Act of 1973
Reporting of Matters Related to Recipient Integrity and
Performance
Reporting Subawards and Execulive Compensation
SAFECOM
Terrorist Financing
Trafficking Victims Protection Act of 2000
Universal Identifier and System for Award Management
USA Patriot Act of 2001
Page 27 of34 Kittitas County Sheriffs Office, E20-156
Article XXXVII
Article XXXVIII
Article XXXIX
Article XL
Article XU
Article XLII
Use of OHS Seal, Logo and Flags
Whistleblower Protection Act
Environmental Planning and Historic Preservation
Acceptance of Post Award Changes
Disposition of Equipment Acquired Under the Federal Award
Prior Approval for Modification of Approved Budget
Article I-Assurances, Administrative Requirements, Cost Prlnclples, Representation and Certifications
OHS financial assistance recipients must complete either the Office of Management and Budget (0MB) Standard Form 424B
Assurances -Non-Construction Programs, or 0MB Standard _F~r.lll ~~4Q As$urance~ -<;911s~gtio11 Prog~m_s._a~ apP.Q~ble ..
. . . Certain assurances fn these documents may not be appilcabie lo your program, and the DHS Rnanc!al assistance office (DHS
FAO) may require applicants to certify additional assurances. Applicants are required lo fill out the assurances applicable to
their program as Instructed by the awarding agency. Please contact the DHS FAO If you have any questions.
DHS flnanclal assistance recipients are required to follow the applicable provisions of the Unlfonn Administrative
Requirements, Cost Principles, and Audit Requirements for Federal Awards located at Title 2, Code of Federal Regulatlons
(C.F.R.) Part 200, and adopted by OHS at 2 C.F.R. Part 3002,
Article II • Acknowledgement of Federal Funding from OHS
Recipients must acknowledge their use of federal funding when issuing statements, press releases, requests for proposal, bid
Invitations, and other documents describing projects or programs funded in whole or in part with federal funds.
Artlcle Ill -OHS Specific Acknowledgements and Assurances ·
All recipients, subreciplents, successors, transferees, and assignees must acknowledge and agree to comply with applicable
provisions governing OHS access to records, accounts, documents, information, faclllties, and staff.
1. Recipients must cooperate with any compliance reviews or compliance Investigations conducted by DHS.
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 assistance award and pennit access to facilities, personnel, and other
Individuals and Information as may be necessary, as required by OHS regulations and other applicable laws or program
guidance.
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. Recipients of federal financial assistance from DHS must complete the DHS Civil Rights Evaluatlon Tool within thirty (30)
days of receipt of the Notice of Award or, for State Administering Agencies, thirty (30) days from receipt of the OHS Civil
Rights Evaluation Tool from OHS or Its awarding component agency. Recipients are required to provide this informaUon once
every two (2) years, not every time an award is made. After the Initial submission for the first award under which this term
applies, recipients ere only required to submit updates every two years, not every time a grant Is awarded. Recipients should
submit the completed tool, Including supporting materials, to CivilRightsEvalualion@hq.dhs.gov. This tool clarifies the civil
rights obligations and related reporting requirements contained In the OHS Standard Terms and Conditions . Subrecipients are
not required to complete and submit this tool to OHS. The evaluation tool can be found at https://www.dhs.gov/publication/dhs-
civil-rlghls-evaluation-tool.
Article IV -Activities Conducted Abroad
OHS-FEMA-EMPG-FY 19 Page 28 of34 Kittitas County Sheriff's Office, E20-156
Recipients must ensure that project activities carried on outside the United Slates are coordinated as necessary with
appropriate government authorilles and that appropriate licenses, permils, or approvals are obtained.
Article V -Age Discrimination Act of 1975
Recipients must comply with the requirements of the Age Discrimination Acl of 1976, Pub. L. No. 94-135 (1975) (codified as
amended at Title 42, U.S. Code, section 6101 et seq.), which prohibits discrimination on the basis of age in any program or
activity receiving federal financial assistance.
Article VI -Americans with Disabilities Act of 1990
Recipients must comply with the requirements ofTltles I, II, and Ill of the Americans with Disabilities Act, Pub. L. No. 101-336
(1990) (codified as amended at42 U.S.C. sections 12101-12213), which prohibits recipients from discriminating on the basis
of disability In the operation of public entities, public and private transportation systems, places or public accommodation, and
certain testing entities.
Article VII -Bast Practices for Collection and Use of Personally Identifiable Information (PII)
Recipients who collect PII are required to have a publicly available privacy policy that describes standards on the usage and
maintenance of the PII they collect. OHS defines personally Identifiable infonnatlon (PII) as any Information that permits the
·· Identity ofan lndMdualto be-directly or Indirectly inferred, including any Information tliat Is linked-or linkable to tliaflridivldual.-
Reciplents may also find the OHS Privacy Impact Assessments: Privacy Guidance and Privacy Template as useful resources
respecHvely.
Article vm • Civil Rights Act of 1964 -Title VI
Reclplenls must comply with the requirements of Tille VI of the Civil Rights Act of 1964 (codified as amended at 42 U.S.C.
section 2000d et seq.), which provides that no person In the United States wlll, on the grounds or race, color, or national origin,
be excluded from participation In, be denied the benefits of, or be subjected to discrimination under any program or activity
receiving federal financial assistance. OHS Implementing regulations for the Act are found at 6 C.F.R. Part 21 and 44 C.F.R.
Part 7.
Article IX -Civil Rights Act of 1968
Recipients must comply with Title VIII of the Civil Rights Act of 1968, Pub. L. No. 90-284, as amended through Pub. L. 113-4,
which prohibits recipients from discriminallng In the sale, rental, financing, and advertising or dwellings, or In the provision of
services in connection therewith, on the basis of race, color, nalional origin, religion, disability, familial status, and sex (see
42 U.S.C. section 3601 et seq.), as implemented by the U.S. Department of Housing and Urban Development at 24 C.F .R.
Part 100. The prohibition on dlsablllty discrimination Includes the requirement that new multifamily housing with four or more
dwelling unils-1.e., the public and common use areas and individual apartment units (all units in buildings with elevators and
ground-floor units In buildings without elevators)-be designed and constructed with certain accessible features. (See 24
C.F.R. Part 100, Subpart D.)
Article X • Copyright
Recipients must arnx the applicable copyright notices of 17 U.S.C. sections 401 or 402 and an acknowledgement or U.S.
Government sponsorship (including lhe award number) to any work first produced under federal financial assislance awards.
Article XI -Debarment and Suspension
Reciplenls are subject to the non-procurement debarment and suspension regulations Implementing Executive Orders (E.O.}
12549 and 12689, which are at 2 C.F.R. Part 180 as adopted by OHS at 2 C.F.R. Part 3000. These regulatlons restrict
federal llnanclal assistance awards, subawards, and contracts with certain parlles that are debarred, suspended, or olherwlse
excluded from or ineligible for participation In federal assistance programs or activities.
Article XII -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
C.F .R. Part 3001, which adopts the Government-wide Implementation (2 C.F .R. Part 162) of sec. 5152-5158 of the Drug-Free
Workplace Act of 1988 (41 U.S.C. sections 8101-8106).
Article XIII -Dupllcatlon of Benefits
DHS-FEMA-EMPG-FY 19 Page 29 of34 Kittitas County Sheriffs Office, E20-156
Any cost allocable to a particular federal financial assistance award provided for in 2 C.F.R. Part 200, Subpart E may not
be charged to other federal financial assistance awards to overcome fund deficiencies; to avoid reslricllons imposed by
federal statutes, regulatlons, 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, regulallons, or the federal financial assistance award terms and condlUons.
Article XIV -Education Amendments of 1972 (Equal Opportunity in Education Act) -Title IX
Recipients must comply with the requirements ofTille IX of the Education Amendments of 1972, Pub. L. No . 92~18 (1972)
(codified as amended at 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 acllvily receiving federal financial assistance. OHS Implementing regulations ere codified el 6 C.F.R. Part 17 and
44 C.F.R. Part 19
Article XV -Energy Polley and Conservation Act
Recipients must comply with the requirements of lhe Energy Policy and Conse,vation Act, Pub. L. No. 94-163 (1975) (codined
as amended at 42 U.S.C. section 6201 et seq.), which contain policies relating to energy efficiency that are defined In the state
~n~rgy 5=0_ns~rva tl q_n planJ ~~~ed in corT1pliar1c_e wl!h _thi~ Act.
Article XVI -False Claims Act and Program Fraud Civil Remedies
Recipients must comply with the requirements of the False Claims Act, 31 U.S.C. sections 3729-3733, which prohibits the
submission of false or fraudulent claims ror payment to the federal government. (See 31 U.S.C. sections 3801-3812, which
detans the administrative remedies for false claims and statements made.)
Article XVII • Federal Debt Status
All recipients are required to be non-delinquent In their repayment of any federal debt. Examples of relevant debt Include
delinquent payroll and other taxes, audit dlsallowances, and benefit overpayments. (See 0MB Clrcular A-129.)
Article XVIII -Federal Leadership on Reducing Text Messaging while Driving
Recipients are encouraged to adopt and enforce policies that ban text messaging white 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 XIX -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 lnternallonal 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 XX• Hotel and Motel Fire Safety Act of 1990
In accordance with Section 6 of the Hotel and Motel Fire Safety Act of 1990, 15 U.S.C. 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 Prevention and Control Act of 1974, codified as amended at 15 U.S.C.
section 2225.
Article XXI -Limited English Proficiency (Clvll Rights Act of 1964, Tltle VI)
Recipients must comply with the Tille 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 flnanclel assistance take reasonable
steps to provide meaningful access lo 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/guldance-publlshed-help-department-supported-organizaUons-provlde-meanlngful-access-people-llmlted
and additional resources on http://www.lep.gov.
DHS-FEMA-EMPG-FY 19 Page 30 of 34 Kittitas County Sheriffs Office, E20-156
Article XXII -Lobbying Prohibitions
Recipients must comply with 31 U.S.C. section 1352, which provides that none of the funds provided under a federal financial
assistance award may be expended by the recipient to pay any person to inHuence, 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 contract, including any extension, conlinualion,
renewal, amendment, or modification.
Article XXIII • National Environmental Policy Act
Recipients must comply with the requirements of the Natlonal Environmental Policy Act of 1969, Pub. L. No. 91-190 (1970)
(codified as amended at 42 U.S.C. section 4321 et seq.) (NEPA) and the Council on Environmental Quality (CEQ) Regulations
for Implementing the Procedural Provisions of NEPA, which requires recipients to use all practlcable means within their
aulhorily, and consistent with other essential considerations or national policy, to create and maintain conditions under which
people and nature can exist In productive harmony and fulfill the social, economic, and other needs of present and future
generations of Americans.
Article XXIV -Nondiscrimination In Matters Pertaining to Faith-Based Organizations
It Is OHS policy to !'Insure the !qua! tre~t~e~t: of ~al)h_:!'a~~~~~nlZ!_tlQ_~s In s_qctal !eNfce prog"rns administered or
supp orted by DHS or It s co mponent agencies, enabli ng those orgar11z atlons tq partfcipa te In pl'o¥ldlng Important social
services to banaficl1;1rles . Recipients must comply with the equal treatment policies and requirements contained In 6 C.F.R.
Part 19 and other appllcable statues, regulations, and guidance governing the participations of faith-based organizations In
lndlvldual OHS programs.
Article XXV -Non-Supplanting Requirement
Recipients receiving federal financial assistance awards made under programs that prohibit supplanUng by law must ensure
that federal funds do not replace (supplant) funds that have been budgeted for the same purpose through non-federal
sources.
A~lcle XXVI -Notice of Funding Opportunity Requirements
All of the Instructions, guidance, llmltallons, and other conditions set forth In the Notice of Funding Opportunity (NOFO) for
this program are Incorporated here by reference in the award terms and conditions. All recipients must comply with any such
requirements set forth In the program NOFO.
Article XXVII • Patents and ln~ellectual Property Rights
Unless otherwise provided by law, recipients are subject to the Bayh-Dole Act, 35 U.S.C. section 200 et seq. 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 401 and the standard patent rights clause located
at 37 C.F.R. section 401.14.
Article XXVIII -Procurement of Recovered Materials
States, pollllcal subdivisions of states, and their contractors must comply with Section 6002 of the Solid Waste Disposal Act,
Pub. L. No. 89-272 (1965) (codified as amended by the Resource Conservation and Recovery Act, 42 U.S.C. section 6962.
The requirements of Section 6002 include procuring only Items designated In guidelines of the Environmental Protection
Agency (EPA) at 40 C.F.R. Part 247 that contain the highest percentage of recovered materials practicable, consistent with
maintaining a satisfactory level of competition.
Artlcle XXIX -Rehabilitation Act of 1973
Recipients must comply with the requirements of Section 504 of the Rehabilitation Act of 1973, Pub. L. No. 93-112 (1973)
(codified as amended at 29 U.S.C. section 794 ), which provides that no otherwise qualified handicapped lndlvlduals In
the United Slates will, solely by reason of the handicap, be excluded from participation in, be denied the benefits or, or be
subjected to discrimination under any program or activity receiving federal financial assistance.
Article XXX -Reporting of Matters Related to Recipient Integrity and Performance
DHS-FEMA-EMPG-FY 19 Page 31 of 34 Kittitas County Sheriffs Office, E20-156
If the total value of any currently active grants, cooperative agreements, and procurement contracts from all Federal awarding
agencies exceeds $10,000,000 ror any period of time during the period of performance of this Federal award, then the
recipients must comply with the requirements sel forth In the government-wide Award Term and Condition for Recipient
Integrity and Performance Matters located at 2 C.F.R. Part 200, Appendix XII, the full text of which Is Incorporated h ere by
reference In the award terms and conditions.
Article XXXI • 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 al 2 C.F.R. Part 170, Appendix A, the full text of which Is Incorporated here by reference
In the award terms and conditions.
Article XXXII • SAFECOM
Recipients receiving federal financial assistance awards made under programs that provide emergency communication
equipment and Its related aclivltles must comply with the SAFECOM Guidance for Emergency Communication Grants,
Including provisions on technical standards that ensure and enhance interoperable communications.
Arttcle XXXIII • Terrorist Financing
---Recipients must <»mply With-e.o. 13224 -and u:s: 1aws tharprohlbtrtransact10,rsw11r,; and tile provisions of resources arid ----
support to, Individuals and organizations associated with terrorism. Recipients are legally responsible to ensure compliance
with the Order and laws.
Article XXXIV. Trafficking Victims Protection Act of 2000
Recipients must comply with the requirements of the government-wide financial assistance award term which implements
Section 106(g) of the Trafficking Victims Protection Act of 2000 (TVPA), codified as amended at 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 XXXV. Universal Identifier and System for Award Management
Recipients are required to comply with lhe requirements set forth in the government-wide financial assistance award term
regarding the System for Award Management and Universal Identifier Requirements located at 2 C.F.R. Part 25, Appendix A,
the full text of which Is Incorporated here by reference.
Article XXXVI • USA Patriot Act of 2001
Recipients must comply with requirements of Section 817 of the Uniting and Strengthening Amerfca by Provfdlng Appropriate
Tools Required to Intercept and Obstruct TellOrism Act of 2001 (USA PATRIOT Act), which amends 18 U.S.C. sections
175-175c.
Article XXXVII • Use of OHS Seal, Logo and Flags
Recipients must obtain permission from their OHS FAO prior to using the OHS 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 XXXVIII • Whlstleblower Protection Act
Recipients must comply with the statutory requirements forwhistleblower protections (If applfcable) at 10 U.S.C section 2409,
41 U.S.C. section 4712, and 10 U.S.C. section 2324, 41 U.S.C. sections 4304 and 4310.
Artlcla XXXIX. Environmental Planning and Historic Preservation
DHS/FEMA funded aclivities that may require an EHP review are subject to FEMA's Environmental Planning and Historic
Preservation (EHP) review process. This review does not address all federal, state, and local requirements. Acceptance of
federal funding requires recipient to comply with all federal, state, and local laws. Failure to obtain all appropriate federal,
state, and local environmental pennits and clearances may Jeopardize federal funding .
DHS/FEMA is required to consider the potential Impacts to natural and cultural resources of all projects funded by OHS/
FEMA grant funds, through Its EHP Review process, as mandated by the National Environmental Polley Act; National Historic
Preservation Act of 1986, as amended; National Flood Insurance Program regulations; and, any other applicable laws and
DHS-FEMA-EMPG-FY 19 Page 32 of 34 Kittitas County Sheriff's Office, E20-156
Executive Orders. To access the FEMA's EHP screening form and Instructions, go lo the DHS/FEMA website at: ~!1
www.fem_a.go_vlmgdi~-library/as.s.e.ts/d Qcv menLsl8018-5. In order to lnlUate EHP review of your project(s), you musl complete
all relevant sections of this form and submit It to the Grant Programs Directorate (GPD) along with all other pertinent project
Information. Failure to provide requisite Information could result In delays In the release of grant funds.
If ground disturbing activities occur during construction, applicant will monitor ground disturbance, and if any potential
archeological resources are discovered, applicanl will Immediately cease work in thal area and notify the pass-through entity,
If applicable, and DHS/FEMA.
Article XL • 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 wlll be notified of the changes In writing. Once
nolificallon has been made, any subsequent request for funds will Indicate recipient acceptance of lhe changes to the award.
Please call the FEMA/GMD Call Center at (866) 927-5648 or via e-mail to ASK-GMQ@dh~-9Q',{ If you have any questions.
Article XLI • 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 acUvities currently or previously supported by DHS/FEMA, )'OU must rEtqut!st ..
Instructions from DHS/FEMA to mike proper alsposltlon oTthe equlj:mie·nt pursuant to 2 C.F .R. -Section 200.:H 3;
Article XLII • Prior Approval for Modification of Approved Budget
Before making any change to the DHS/FEMA approved budget for this award, you must request prior wrillen approval from
DHS/FEMA where required by 2 C.F.R. Section 200.308. DHS/FEMA Is also utilizing Its discretion to Impose an additional
restriction under 2 C.F.R. Section 200.308(8) regarding the transfer of funds among direct cost categories, programs,
functions, or activities. Therefore, for awards with an approved budget where the Federal share Is greater than the simplified
acquisition threshold (currently $250,000), you may not transfer funds among direct cost categories, programs, functions,
or activities without prior written approval from DHS/FEMA where the cumulative amount of such transfers exceeds or Is
expected to exceed ten percent (10%} of the total budget OHS/FEMA last approved. You must report any deviations from
your DHS/FEMA approved budget in the first Federal Financial Report (SF-425) you submit following any budget deviation,
regardless of whether the budget deviation requires prior written approval.
Personnel
Fringe Benefits
Travel
Equipment
Supplies
Contraclual
Construction
Indirect Charges
Other
DHS-FEMA-EMPG-FY 19
BUDGET COST CATEGORIES
Page 33 of 34
$4,057,037.00
$1,489,217.00
$19,383.00
$0.00
$15,597.00
$8,805,562.00
$0.00
$432,494.00
$0.00
Kittitas County Sheriff's Office, E20-156
Oblig111ing Document ror Award/Amendment
I a. AGR F.F.M F.NT NO.
EMS-20 l 9-EP-00003-S0 1
6. RECIPIENT NAME AND
ADDllliSS
Wushington Military
Department
Building20
Camp Murray, WA, 98430-
5122
2. AMF.NDMF.NTNO. 3.
••• RECCPIENT
NO .
9160010950
7. ISSUING FEMA OFFICE AND
ADDRESS
FEMA-GPD
400 C Street, SW, 3rd floor
Washington, DC 20472-3645
POC: 866-927-5646
4. TYPF. OF ACTION
AWARD
S. CONTROL NO.
FY20 I 9Rl 0EMPG
8. PAYMENT OFFICE AND ADDRESS
fl:::MA finance Center
430 Market Street
Winchester, VA 22603
9. NAME OF RECIPIENT
PROJECT OFFICER
Tir.L.ah Kincheloe
PHONE NO.
2535127456
I 0. NAME OJI FEMA PROJECT COORDINATOR
Central Scheduling and Information Desk
Phone: 1100-368-6498
F.mall: Askc~id@dhs.gov
11. EFFECTJVR DA TE OF
THISACTCON
12.
MBtflOD
OP
PAYM F.NT
PARS
13. ASSISTANCE ARRANGEMENT 14. PERFORMANCTi PERIOD
Cost Reimbursement
10/01/2018
I S. DESCRIPTION OF ACTION
a. (Indicate funding data for awards or financial changes)
PROGRAM
NAME
ACRONYM
F'.mer11ency
M1nu"cmun1
l'crrormance
Ol'llnts
CFDA NO.
97.042
ACCOUNTING DATA
(J\CCSCODE)
XXXX-XXX-XXXXXX-
XXXXX-XXXX-XXXX-X
20l'>·FA-OA0I-R107--4120·D
PRIOR
TOTAL
AWAJUJ
so.no
AMOUNT
AWARDED
THIS
ACTION
+OR(-)
$7,409,645.00
From:
10101/2018
Budget Period
To:
09/30/2021
10/01 /201 8 09/3012021
CURRENT
TOTAL
AWARD
$7,409,645.00
CUMULATIVE NON-
FEDERAL COMMfl'MENT
SeeTntal•
SO.DO S7,409,6-15.00 SM0!l,~5.IIO S7,.W!l,645.00
b. To describe changes other than funding data or financial changes, attach schedule and check here.
NIA
16 11. FOR NON-nISASTER PROGRAMS: RECIPffiNT IS RtQUIRED TO SIGN ANT) RETURN THREE (3) COPIES OF THIS
DOCUMENT TO FEMA (See Block 7 for address)
Emergency Management Performance Grants recipients are nol required to Rign and return copies of this document. However, recipients
should print 11nd keep a copy of this document for their records .
16b. FOR DISASTER PROGRAMS: RECIPIENT IS NOT REQUIRED TO SIGN
This assislance is subject to terms and conditions attached to this award Mticc or by lncorporotcd rcfi:rencc in program legislation cited
above.
17. RECIPIENT SIGNATORY OFFICIAL (Name and Title)
Tir.t.ah Kincheloe, Mrs
HI. FRMA SIGNATORY OFFICIAL (Name and Titlt:)
KIMBERLY ERIN PEN\<OLD, Assi8lancc Officer
DHS-FEMA-EMPG-FY 19 Paga 34 of34
DATE
Tue Aug 06 23:35:35 GMT
2019
DATF.
Mon Aug OS 17:05:05 GMT
2019
Kittitas County Sheriff's Office, E20-156
SIGNATURE AUTHORIZATION FORM
WASHINGTON STATE MILITARY DEPARTMENT
Camp Murray, Washington 98430-5122
Please read instructions on reverse side before completing this form.
NAME OF ORGANIZATION DATE SUBMITTED
Kittitas County (Sheriffs Office)
PROJECT DESCRIPTION CONTRACT NUMBER
EMPG FFY-19
E20-156
1. AUTHORIZING AUTHORITY
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
/Jb~ ~-""'\...
Clayton Myers Sheriff/2020
2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE PRINT OR TYPE NAME TITLE
~.?-~~ ~"? Clayton Myers Sheriff
...... ?'
3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT
SIGNATURE PRINT OR TYPE NAME TITLE ~),Ut----...
Darren Higashiyama Commander ----' .
____ -4.)JjdU---Sharrie McPherson Fiscal Analyst
\\NAC -1\VOL 1\HOME\KARENB\ .... \WP\SIGNAUTH Revised 3/03
FFATA FORM
Subreclplent Agency : Kittitas County
Grant and Year: 2019 Agreement Number: E20-156
Completed Darren Higashiyama Commander (509) 933-8206 by:
Name Title T_e/~pflone
Dale Completed: 11/08/19
r STEP ,11! ---
--. -. -• ----------n STOP, no further NO
Is your grant agreement less than $25,000? analysis needed , [l] GO to Step 2
GO toSl~p 6
--:r-=-----· -REP -2 .. -
-~. I _. - • -·.a. ._..,,.. ~ ,·_ -----:: =--L. ---= -' _ .. -----In your preceding fiscal year, did your YES NO STOP, no further
organization receive 80% or more of its annual D GO to STEP 3 [{] analysis needed, GO to
gross revenues from federal funding? Step6 .. -.. ----__:_--=-~ .~.._ ;;..:_. I
. . -----,SJ!SP 3 --·-=-' .. ---.!. - --------. --
In your preceding fiscal year, did your YES NO STOP, no further
organlzatton receive $25,000,000 or more In D GO.to STEP4 D ~rialy~ls ne~ded, GO IQ
federal "funclln_g_? Step6
--------,l-_ .. l I 1"': ,-. ? --·-~-1-c.-.. ---1 -~--:JI' ··-----.rrr: ~-._ -r _ ·1;-_ ~
Does the public have access to Information about YES STOP, no further NO
the total compensation* of senior executives in D analysis needed, D GO to STEP 5
your organization? GO to step 6
' --_ -. - I - -._. •_ ---81EP.5--------·-. . ~ -----.-.--, lia... ----
Executive #1 Name:
Total Compensation amount: $
Executive #2 Name:
Total Compensa.Uon amount: $
Executive #3 Name:
Total Compensation amount: $
Executive 'lt4 Name:
Total Compensation amount: $
Executive #5 Name:
Total Compensation amount: $
~ T ·SJEp.ye· -------------
---.. --. ---·-.• -
If your organization does not meet these criteria, specifically Identify below !!!:h criteria that Is not met for your
organization: For Exati:u;ile: "Our Qrganlzatlon received less than i25,0QQ ,"
Kittitas County did not receive 80% or more annual gross revenues from federal funding
Signature: _____________________ _ Date: 11 /08/19
"Total compensation refers to:
• Salary and bonuses
• Awards of stock, stock options, and stock appreciation rights
• Other compensation fncludlng, but not limited to, severance and termination payments
• Life insurance value paid on behalf of the employee
Additional Resources:
http;flwww,whltehouse.gov/ombtopen
bttp:ltwww.hrsa .gov/qrants/ffata.html
http://WWW.gpo.gov/fdsys/pkg/FR-2010-09-14/pdf/2010-22705.pdf
http://www,arants.aoy/
Page 1 of3
--.--
I
-
Washington Military Department Contract Number: E20-156
Debarment, Suspension, lneligiblJity or Voluntary Exclusion Certification Form
NAME Doing business as (DBA)
County of Kittitas Kittitas County
ADDooss Applicable Procurement WA Unifomi Business Federal Employer Tax 205 . 5th Ave Sta. 105 or Solicitation #, If any: ldenlifier (UBI) Identification #:.
Ellensburg, WA 98926 192002673 91-6001349
This certification Is submitted as part of a niquaat to contract.
Instructions For Certification Regarding Debarment, Suspension, lnellglblllty and Voluntary Excluslon--Lower
Tier Covered Transactions
READ C-AREFlJLL Y BEFORE SIGNING THE CERTIFICATION. Federal regulations require contractors and bidders to sign and
abide by the terms of this certification, without modification, In order to participate In certain transactions directly or
Indirectly Involving federal funds.
1. By signing and submitting this proposal, the prospective lower tier participant Is providing the certification set out
below.
2. The certification In this clause is a material representation of faGl' upor.i Which rellance . was placed when this
transaction was entered into. If it is later determined that the ptosp_eoUve lower tier participant knowingly rendered an
erroneous certification, In addition to other remedies available to the Fedetal Gc;>Vernment the department or agency
with which this transaction origlnateC, may pursue available remedies, Including suspension and/or debarment.
-3. The _prospecUve lower lier participant shall provicte Immediate wrflten-no0ce -fo lhe depai1m-enl~ Tnslltullon~ or offlcato
Whleh this proposal Is submitted If at any time Iha prospeoUve lower tier participant 'learns that its -certiflcatjon was
erroneous ·Whei'I submltted or had becom& erroneous by reason of changed circumstances.
4. The terms covered ~a11sacUon, deb~rred, suspended, lneflglbte, lower lier covered trans~ctlon, participant, person,
primary, covered transaction , prlnofpal, proposal, and voluntarily excluded , as used In this clause, ~ave lh:e meaning
set out In the. Definitions and Coverage sectic,ms of rules lmplementlng Executive Order 12549 . You may contact U,e
person to which this proposal Is submitted for assistance In obt~lnlng a copy of those regula\lons.
5. The prospective lower tier participant agre.es by submitting th is proposal that, shollfd the proposed covered
transaction be entered Jnto, It shall not kr,i~wlngty e.nter Into any lower tier covered transaction with a person who Is
proposed for debarment under the applicable CFR, debarred, suspended , declared lnellglbfe, ot voluntarUy excluded
from partlcfpatfon In this covered transaction . unless authorized by the department or agency with wnlch this
transaction originated.
6. The prospective lower tier partltlpant fu rther agrees by submitting this proposal U,at It will Include this clause titled
"Certification Regarding Debarment, Suspension, lnellgiblllty and Voluntary Exclusion-Lower Tier Covered
Transaction," without modification, In all lower lier covered transactions and In all sollcllations for lower tier cove re d
transactions.
7. A partlclpant In a covered tr1:1nsaction may rely upon a certification of a prosp.e.c~ve partlcipaht In ~ lower tler ·covered
transaction that It Is not proposed for deb"arr:nent un.der appllcable CFR , debarred , suspended , Ineligible, or voluntarily
excluded from covered transactions, unless It kno~ that the certification Is erroneous. A part icipant may declde ·1he
method and frequency by which It determines the eligibility ot Its prlnCIP.ats. !=ach 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 re.cords In order to
render In good faith the certlflcallon required by this claus_e. The knowledge and Information of a participant Is not
required to exceed that which Is normally possessed by a prugen ( person In the ordinary course of business actlvlty.
9. Except for transactions authorized under paragraph 6 of these Instru ctio ns, If a participant In a covered transaction
knowingly enters Into a low~r tier covered transaction with a person who Is proposed fQr debarment under applicable
CFR, suspended, debarred, ineligible, at voluntarily excluded from partiolpaflon In this transaction, In ~ddltlon to other
rernedl8$ 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, lnellgibllity and Voluntary Excluslon--Lower Tier
Covered Transactions
The prospective-lower tter participant certifies, by submission of this proposal or contract, that neither It nor Its
principals Is presently debarred, suspended, proposed for d.eb~rment, declared lnellglble, or voluntatlly excluded
from participation In this transactron by any Federal department or ,gency. Where the prospective tower tier
participant I$ unable to certify to any of the statements In this certlflcatlon, such prospective participant shall
attach an explanation to this form.
J ') ' I l ,""{, I I Bidder or Contractor Signature: ___ ct-,-_,,,,+--'----.;-"-:---------
Print Name and Title: Judy Pless f ., t ' I if:
Date:
.
•re-,· C-< Iv ! rl .. -.,9, ,,_
2 CFR Part 200 Subpart F Audit Certification Form
Audits of States, Local Governments, Indian Tribes, and Non-Profit Organizations
Contact Information
Subreciplent Name (Agency, Local Government, orOrganlzation):Kittitas County
Authorized Chief Financial Officer (central accounting otnce):Judy Pless
Address:305 West 5th Ave Ste. 105 Ellensburg, WA 98926
Email: judy.pless@co.kittitas.wa.us Phone #:(509) 962-7504
Purpose: As a pass-through entity of federal grant funds, the Washlnglon Military OepartrrienVEi:nergency Managem.ent Division (Department)
Is required by 2 CFR Part 200 Subpart F to monitor activities of subreclplents to ensure federal awards are use~ for authotlzed purposes and
verify that subreclpients expending $750,000 or more In federal awar4 ~ during lt]eir fiscal year have met the 2 CFR P-art 200 Subpart F Audit
Re ,qutrinile,nts. Your e,-itlly Is a sub recipient subject to such monitoring by MIUEMD because It Is a non-federal enUly that ,expehds federal grant
runds received from the Department as a pass--lhrough 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 en.UUes that e.xpend $750,000 In federal awards In a fiscal year shall have
a slngle or program-specific audit conducted for that year. If your entity ls not·subJect to these requirements, you must complete Section A or
this Form. If your entity[! subject to these requirements, you must cQ_mpl~l~ &~cl!o.r\~ o.t 11:its (orm. When .completed, you must slgn, date,
· and return thliflc;il'in 'wllti , yo i.ii' ·graol agreement ana e\(e.ry fiscal year lhereaner untll the grant ~greement Is closed. Fe ll.I.Ire to re tum ·fhls
completed Audit Certllicat!on Form may result In delay of grant agree'ment proce·ss1ng, wllhholdlng or federal awards or dlsaUowance of costs,
and s1.1speni,lon or fennlnalion of federal awards. ·
SECTION A: Entitles NOT sublecf'to the audit reaulrements of 2 CFR Part 200 Suboarl F
Our entity is not subject to the requirements of 2 CFR Part 200 Subpart F because (check all that apply):
O 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 requl~ements, laws' arid regulaliol\S govemrng the program(s) In
which we participate, that we are require d' to maintain records of federal funding and to provide access to such re¢ords l>y red er al ar,d state
agencies and their deslgnees, and that WMD/EMD may request and b,e provided access t9 addltlor,al lnfonnatlon and/or documentation to
ensure proper stewardship of federal funds.
g~ttON Bi Entitles that AR& syb{'J,ct lo tl!.e au~t !~!l.U{C!laments ol 2 CEB Pat:1, 2~Q ~!:lbll,a(1. E
(CQmolete the lnformatton below and check the-aooroorlate bOx)
Iii We completed our last 2 CFR Part 200 Subpart F Audit on [enter date] 9/30/2019 for Fiscal Year ending [enter date] 2018 • 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 contracfs .otfloe@mll.wa .gov or provide the stale auditor report number:
# 1024778
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 plan and management response, Is either
provided electronically to con1racts.offic11@mll.wa.goy or provide the state auditor report number:
D Our completed 2 CFR Part 200 Subpart F Audit will be available on [enter date] for Fiscal Year ending
[enter date]. We will provide electronic copy of the audit report to contracts .offlce@rnll.wa.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.
Addltlonally, I understand this Form Is to be submitted every fiscal year for which this entity Is a subreclplent of federal award
funds from the Department until the grant agreement Is closed,
Signal\Jre of Authorized ChlefFinancial Officer: ; . -,J'f I /7_.i, __ "-' Date: / tf j/o , iJ
Print Name & Title: Judy Pless Budget Financial Manger '""
WMD rorm 1009-13, et1w201 a, UpdlllOd 91'11120111
Form W-9 Request for Taxpayer Give Form to the
requester. Do not (Rav. Oeoo~er 2014)
Dtportlnenl of tho Trejuury Identification Number and Certification send to the IRS.
lnlarnal .RalltnUO SJIMce
1 N11me,(H shown on yourlnc omo lQ)notum}. Namo _ls·requlrelf on 1h11 Rne; do not 1911111 lhla U110 blank.
county of Kittitas
t.J 2 Busjrit1111 mmv/dlsn!gardod entll)' nama, If dlllonmt from abo1111
f l<lttl!as County
0. 3 Check appropriate box for federal tax classiffcallon: check only one of Iha foUowfng seven boxes: 4 E-xo111ptlo~ (oodas lft'~ qnfy ~-g certa11\enlllles, not Ind v dliml,; uil ! ., 0 lridlvllfual/10le proprietor or D C Corporation O S Corporation O Partnership
slngle-momber Llo
0 TrusVastate !Mtruc Joni on page a):
Exempt payee code 01 .1111y) 3 ii O Limited Uablllly company. Enter the tax classlllcaUon (C•C corporatlon, S•S corporation, p .. partnarshlp) II>
Exemption from FATCA reporting Noto. Fora l!lngltM'nember LLC that Is dlsr~gard.od, do not check LLC: check the appropriate box In Iha llna above for
. lh11lax olaaslffcatlon of the sing le-mambo~ owoer. coda ~f any)
0 Other (1M lnstructlOJ1s} JI,, f'il,pllolfollH:IUll/1--..,..,...i.i. h lJ.IJ
I S AddteS'S (IIUmbar, litr~t. and apt. or eulta no .) 'R0<iuo.atar'• name and addreas (opt!o"'°
205 West 5th Ave Suite 105
! 8 Olty, tiel•, lllld ZIP c:pdo
Ellens~rg, WA 98926
7 Uat account number(9) hero (opl!on·lll)
.!Sil •• Taxr:>~ver Identification Nutnber (TIN)
Enter your TIN In ltio el)p~~Jra!_e pox, Thi, 'flN p,:ovlded must matQh the nome git/en on line 1 to avoid Soolaf ,aourlly hllmher
backup withholding, For I lv(dual11, this Is gen&rally your aa~al security numbet (SSN). However, font I I l-[D -1 I I I resldent al!en, 1ole p,:oprletor, or dlsregordad enllty, see the Part I lnslruo.tlons on page 3. For o{her
8flll(fes, 11 Is your employer ldenUfleatk>n number &JN). Ir you do not have a nUl11ber, soo How to QGI "
TIN on page 3. F.o::-r-,..--..,..,......,,.,:--:-:---..,.-..-----.
Note. If the account Is In more than one name, see the Instructions for Rne 1 and the chart on page 4 for I flmpioyor ldtntlfl011llon nwnt,er
guldellnes oo Whose number to enter.
'l 1
Certification
Under penalties of pe~ury, I certify that:
1. The number shown on this form Is my correct taxpayer ldentlflcatlon number (or I am waiting for a number to be Issued to me); and
2. I am not subfect to baokup wlthholdlnQ because: {a) I am exempt from backup wlthlloldlng, or (b) I have not been notified by the Internal Revenue
Service .OBS) that I am subJact to baokup Wlthhold;lng as a result of a failure to report all Interest or dividend!!, or (c) the IRS has notified me .that I am
no longer aubJe.ot lo blioKUp wllhholqlng; and
3. I am a U.S.,oltlzen or other U.S. person (clefln-ed below); 11nd
4. Tha FATOA coda(s) entered oo this form Or any) lndlc~tlng that I am exempt from FATCA reporting Is correct.
Certlfloatlon Instructions. You must cross out Item 2 abova If yoµ have been noll/led by the I~ that you ,re currently auJ:>)eot to backup wltl'lholdlog •
be_causa Yol.l have falled to report Qff Interest and dlvlde)'lds on your tax .return , For real ,eslate tre,nsac.tloo&, Item 2 dO&S not apply. For mQrtgage
lnterqsti pold, acquisition or abandonment o,f sewred proper1y, cancellatlon of debt, conl(lpuUo.ns to an Individual retirement ~~ngernoot QRA), and
generally, payments other th~n Interest and dividends, you IU'& not required t9 etgn tho certmoation. but you must provide your correct TIN. See the
lhstruo11o~on p~gi, 3.
Sign Sign ature of
HQre U.S. petaon
Section references ara to the In! ·al Revenue Coda unless otherwise noted.
Futlll'e diivelopm.-n\a. lnfo«natlon about davelopmen\a affecting Fonn W-9 (such
as leglalatlo11 •l'.lacled alterW• rete•s• It) la at www./,a;gov/fW9.
Purpose of Form
kl ·JndlvJ:l!tlll or entity (F<ll'fl1 W·9 requ,~t~ .who JI required to flla1111 lnformi1Uon
relum ,l#lih th• ~s mu,t obtain your correct ~y,r ldorilllloatlon n~mbot (rlN)
which m•i, b,11 YoiAI' aoolal aiitrurky number (SSN), tn.dMd~·taxpayer kl1nt1nca.tlon
oumbe'r(ITIN),edoplkln laxpay,r ldan!IIIClltlQn number (ATIN)l,cr amployer
1&n11ilaQtlon n11mbff (EiN), lo·r"pott on an ln(llf1TlaUon rolllfl) he amount paid to
, you, or oth'or amolll\l ~pOttehla on an lnformaUon NII.um. Ei<J!mplas of, ln(ormaU@
riltuma lnr;lud&. b!Jt-aye not llmltod to, lhl lollowlng :
• Fonn 1099-INT Onterast earned or paid)
• Form 1()99.01\f (dMdendt, lncfudlno lhoao from lilocks 011rnut11al I\Jl)dil)
, form 1099•MISO,(vatlova typu or Income. prlzoir; 11w1rds1 or grou fftoaoad s)
, F«m 1099-B (ato~ or mutu41 ru™natea and cer1aip ottt,ir tra~clfons by
brokllto}
• Fonn 1099-S fproceeds from real estate transactions)
• Form 1099-K (merchant ca<d and third party network transactions)
• Form 1098 (home mortgage Interest), 1098-E (student loan Interest}, 1098-T
(tuition)
• Fonn 1099-C (canceled debt)
• Fonn 1099-A (acqll!efllon or lbll\dOl)m.1~1 of 1Gc11rad proper\Y)
Uie Form W-9 only rr .vau are a lJ,S. p~aon QIICludl,:ig a Aslden l alien). to
provide vour comiot TIN.
If you do not t11Um Form W,9 to tho requH/er with• TIN, you might be sub/act
to baclttlp wlthholdlll1J., Sile W,,1t 'ls ber:Avp wl//lholdlng? on page 2.
By ,l1,J11lrig th• tllllld·out ror:m, you :
1, Certlty that Iha TIN you are giving ls correct (or you 11ra waiting for a number
lo ~ luufd\',
2 . Certify 1h11 yw 1ra-not aUbfeot to backup wltt,lioldfng, or
3. Olalm exemption from baoliup withholdl.,g If y~IJ ara it lJ,S. e)lempt payH. II
app1Jcabl11,, yo~ ore 1!~i> ~wtll'lfog I.ha\ ~ a U.S. person, yriur aKocablo fflaro ol
any partt1erst1lp ~a,ne kon1 1 u,a, trade or b1.111inoss It! not •ublecl lo !ht
wlthhold1ng (al( on foreign pannoni' 1h11n1 o! e(feoUvely connected ln~omi, and
4. Cef11fy Uiat FATCA code(sl tnllf'9CI on lllls foll!l Of lfly) lr,dloatlnQ tt1a.l you ll'e
ex~mpt f,om the FATCA rciportfno, ls cotrect, Se,Whal.1£ FATCA 111ponlnr,'! on
pago ,2 IOI' rUrth&r lnlom'utitlon.
Cat. No. 10231X Form W-9(Rev. 12-2014)
l.
I
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