HomeMy WebLinkAboutResolutions - 2010.09.01 - 10319MISCELLANEOUS RESOLUTION #10212 September 1, 2010
By: General Government Committee, Christine Long, Chairperson
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES — HOMELAND
SECURITY DIVISION — ACCEPTANCE FOR 2009 MICHIGAN CITIZEN CORPS
PROGRAM GRANT MONROE COUNTY
TO: OAKLAND COUNTY BOARD OF COMMISSIONERS
Chairperson, Ladies and Gentlemen:
WHEREAS funding was released under the U.S. Department of Homeland
Security for the 2009 State of Michigan Citizen Corps Grant Program for funding for
programs to increase domestic preparedness among members of the community; and
WHEREAS the County of Monroe has requested the Oakland County serve as
fiduciary for that county's State Homeland Security Grant Award; and
WHEREAS the State of Michigan has awarded Oakland County as fiduciary for
Monroe County reimbursement for qualified expenses up to, but not exceeding $7,892
during the period of August 1, 2009 through April 30. 2012; and
WHEREAS the funds are to be used for training, planning, educational outreach,
exercise and equipment for the Citizen Corps Program Partners of Community
Emergency Response Teams, Medical Reserve Corps, Neighborhood Watch, Volunteer
in Police Service, and Fire Corps: and
WHEREAS the Michigan Department of State Police Emergency Management
and Homeland Security Division will serve as the administrating agency for this grant;
and
WHEREAS the grant agreement has been reviewed and approved through the
County Contract Review Process.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of
Commissioners accepts the position of Fiduciary and Subgrantee for Monroe County for
the 2009 Citizen Corps Grant and accepts the grant funds in an amount up to $7,892
with no county match or in-kind contribution required.
BE IT FURTHER RESOLVED that the chairperson of the Board of
Commissioners is authorized to execute the grant agreement and to approve any grant
extensions or changes, within fifteen percent (15%) of the original award, which are
consistent with the original agreement as approved.
BE IT FURTHER RESOLVED that acceptance of this grant does not obligate the
County to any future commitment.
Chairperson, on behalf of the General Government Committee, I move the
adoption of the foregoing resolution.
GENERAL GOVERNMENT COMMTEE
GENERAL GOVERNMENT COMMITTEE VOTE:
Motion carried unanimously on a roll call vote,
fl . a
Original Message
From: Kr, Gala [mailto:piirg@oakgov.com]
Sent: Wednesday, July 07, 2010 3:34 PM
To: 'Novak, Gail'', 'Quisenberry, Theodore 'Pearson, Unda'; Pisacreta, Antonio
Subject: Grant Sign Off: Homeland Security - 2009 Citizen Corps Grant Program - Monroe
County Fiduciary - Grant Acceptance
GRANT REVIEW SIGN OFF — Homeland Security
GRANT NAME: 2 Citizen Co s Grant --Monroe Count Fiduciary
FUNDING AGENCY: le .gan Department of State Police
DEPARTMENT CONTACT PERSON: Gail Novak 248-858-5080
STATUS: Grant Acceptance
DATE: July 7, 2010
Pursuant to Misc. Resolution 401320, please be advised the captioned grant materials have
completed internal grant review. Below are the returned comments.
The captioned grant materials and grant acceptance package (which should include the Board of
Commissioners Liaison Committee Resolution, the grant agreement/contract, Finance Committee
Fiscal Note, and this Sign Off email containing grant review comments) may be requested to be
place on the appropriate Board of Commissioners' committee(s) for grant acceptance by Board
resolution.
PROJECT SYrslOPSIS
FEMA provides Federal Homeland Security Grant pass-through funds through the Michigan
Citizen Corps Program to local Emergency Management agencies. The funds are to engage and
actively involve all citizens in hometown security through personal preparedness, training,
exercises and volunteer service and to provide and to provide a structured opportunity for citizens
to augment local emergency response activities, Oakland County will be serving as fiduciary
agent for Monroe County for this grant program.
DEPARTMENT REVIEW
Department of Management and Budget:
Approved. — Laurie Van Pelt (6/28/2010)
Department of Human Resources:
Approved. — Cathy Shallal (6/25/2010)
Risk Management and Safety:
Approved by Risk Management, — Andrea Plotkowski (6/29/2010)
Corporation Counsel;
There are no legal issues that need to be resolved before the above-referenced Grant Agreement is
executed.
— Jody S. Hall (6/29/2010)
COMPLIANCE
rue grant agreement references a nunioer of specific federal and state regulations. Below is a list of the spezifically cited compliance
related documents for this grant.
FEMA - Uniform Administrative Requirements for Grants and Cooperative agreements with State and Local Governments
(44 CFR Part 13)
http://www.access.gpo.gov/narWcfriwaisidx 05/44cfr13 06.html
Cost Principles for State. Local and Indian Tribal Governments (OMB CIRCULAR A-87) (2 CFR Part 225)
http://wwwaceess ,gpo govinara/cfriwaisidx 08/2cfr225 081=1
Federal Office of Management and Budget (OMB) Circular No. A-87, A-102, and A-133
httpliwww.wEitehouse.goviombicircularsfindex.tumj
Single Audit Act of 1984 (with amendments in 19%)
httpliwww.whitehonse.gov/ombifinanciai/fin single audit htmi
Executive Order 13347 - Individuals With Disabilities in Emergency Preparedness
htto://wwwfema.gov/odfiemergcnolcirnsinims executive order 13347 pdf
Title VI of the 1964 Civil Rights Act (42 U.S.0 Section 2000d)
http://www.usdoigov/crticoricoord/titlevistat.litm
Michigan Elliott-Larsen Civil Rights Act — "Act 453 o11976'
http://www.iegislature.mi.gov/(uq31xeelunri5z5572utwv45)/mi1ea.asvx?paree=aetobjeet&obleetname-mcl-Act-453-of-
19768cquervtd-=14718540
Michigan Persons with Disabilities Civil Rights Act —"Act 220 of 1976'
,:/!www.leis}aiuremi.gov/(uq3 Ixgelting5z$572utwv45)/mileg.aspx?page.--getobleet&obiectname=mcl-Act-220-of-
1976&queryld=1471(589
Michigan State Contracts with Certain Employers Prohibited — Act 278 of 1980
;10p://www1cgislature mi.gov/(Stealragy4urtelgblinlOs21355))/rraileg,aspx 9oage=uetObteet&obiectName—mel-Aet-278-of.-1980
Department of Homeland Security — Protected Critical Infrastructure Information (6 CFR Part 29)
http.i/ecfr.apoaccess.govlegiltitextitext-idx?c=eefartpl=/ecfrbrowseiTitic06/6cfr29 main 02 tol
Department or Homeland Security— Protection of Sensitive Security information (49 CFR Part 1520)
hrto://wwwaccess goo poy/nara/cfr/watsidx 04/49cfr1520 04.html
Executive Order 12372- Intergovernmental review of Federal program
http://wwwfws.gov/policvlibrary/rscol2372.pdf
US DoJ Uniform Administrative Requirements for Cranks and Cooperative Agreements (28 CFR Part 66 and 28 CFR Part 70)
http://www access.gpo.govinara/cfr/waisidx 04/28cfrv2_04.html
Office of Justice Programs Hearing and Appeal Procedures (28 CFR Part 18)
http:fiwwwaocess.gpo.gov/nnia/cft!waisidxoli28cfrl 8 01.1und
Con lidentiality of Identifiable Research and Statistical Information (28 CFR Part 22)
httplisvsyw access.gprigovinarniefriwaisidx_04/28cfr22_04.htmi
Criminal Intelligence Systems Operating Policies (28 CFR, Part 23)
http://www access gpo.govinaratefilwaisidx 04/28cfr23 114 htrol
Intergovernmental Review or Department of Justice Programs and Activities (28 CFR Part 30)
hdp://www.aecess.gpo.govinaraiefriwaisidx 01/28efr30 01.html
Nondiscrimination of the basis of Disability in State and Local Government Services (28 (.FR Part 35)
hdp://www.aceess goo oovinarecfriwaisidx 01/28cfr35 01.htinl
Equal Treatment for Faith Based Organizations (28 CFR Part 38)
http://wsvw ,usdoi.eoviovw/docs/asornemoreimplementationof2gcfroart38 oci(
Nondiscrimination; Equal Employment Opportunity; Policies and Procedures (28 CFR Part 42)
http:fiww.access.gpu.gov/nara/cftfwaisidx0lt2cfr42U1.htn
Procedures for Implementing the National Environments! Policy Act 128 CFR Part 61)
htto://www.aecess. o.gov/na ra/cfr/w a is id x 01/28 efr61 01 .html
Flooriplain Management and Wetland Protection Procedures (28 CFR Part 63)
http://www.access.gpo.govinardcfriwaisiclx oir28cfr63 01.hutil
National Historic Preservation Act of 1966 (16 U.S.C. 470)
http://www.rips.uovillistory/local-lawinhpal966.htm
Executive Order 11593 — Protection and enhancement of the cultural environment
h ttO .//WW .gsa.gov/PortabgsafenioontentViewdo?contentTyne=0SA BASIC&contentid=12094
Archeological and Historic Preservation Act of 1974 (16 U.S.C. 469)
http://www.nps ,gov/historvilocal-iftw/FHPU ArchnistPres.pdf
The National Environmental Policy Act of 1969 (42 U.S.0 4321)
http.//wwwnepa.govincpaireas/nepainepaegi ahtm
Omnibus Crime Control and Safe Streets Act of 1968
http//www.usdcj goviert/spitti42visc3789d.htm
Victims of Crime Act (42 USC Section 10604)
http://www tisdoj.govierticerlbyagenesidoj14604.htni
Juvenile Justice and Delinquency Prevention Act
http:goljdp nejrs.org/aboutitidpa2002titlev.pdf
Federal Civil Rights Act of 1964
http;fiwww.usdol.gov/ert/cor/index.htm
The Rehabilitation Act of 1973, Section 504 (29 U.S.C., Section 794)
httpf/www.dol.gov/oa5aTn/regs/stntuLc/sec504.htm
The Americans with Disabilities Act of 1990 (42 U.S.C., See 12101)
Ilttp:/iwww.ada.govipubs/ada.htm
The Education Amendments of 1977 (20 U.S.C., Sec 1681,1683, 1685-86)
hatx/iwww.usdaj govicrticoricoorditideixstatratm
Age Discrimination Act of 1975 42 U.S.C. Sections 6101-6107
tittp://v.ww dol govioasamiregsis I atutesiage act Ian
Executive Order 13279 - Equal Protection of the Laws for Faith-based and Community Organizations
hfto://A-ww.whitehouse govinewsircleasesi2002/12/20021212-6.html
US, Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970
http://www.fhwa.dotaoldrealcstatc/act.htrn
Federal !latch Act - Political Activity of Certain State and Local Employees
hito://www.osc.govihatchact.htm
Restrictions on Lobbying (28 CFR part 69)
httarliwww.ficoess.gpo govinaramr/waisidx 04/28cfr69 04.htrol
Executive Order 12549 - Debarment and Suspension
Imp liwww,archivo-Rov/icdcral-registcr/codLficationicxecutivp-order112549.html
Government-Wide Debarment and Suspension (28 CFR, Part 67)
littp:41wwwilcces.acch.povinarwtfriwaisidx Cfre1128cfr67 04.html
Drug-Free Workplace Act of 1988
him tifrwebgate.access gno.govicgi-biLletdoe,c.Ri?dbname=brovist tisc&docid-Citc:+41USC701
Gain V. Piir
Grants Compliance and Programs Coordinator
Oakland County Fiscal Services Division
Phone (248) 858-1037
Fax (248) 858-9724
piirgeookgov.corn
CAW, AN> rfraNlece,,, State of Michigan FkViu4( mv-7
2009 Homeland Security Grant Program
Grant Agreement for Citizen's Corps Program
August 1, 2009 to April 30, 2012
CFDA Number: 97.067
Grant Number: 2009-SS-T9-0060
This Homeland Security Grant Program Citizen's Coq) Program (HSGP-CCP) Grant Agreement is hereby entered
into between the Michigan Department of State Police, Emergency Management and Homeland Security Division
(hereinafter called the Subgrantor), and
THE COUNTY OF OAKLAND
(hereinafter called the Subgrantee)
I. Purpose
The purpose of this grant agreement is to provide federal pass-through funds to the County of Monroe through the
Subgrantee. The funding under this grant agreement will be allocated to the Subgrantee from the COP allocation to
the State of Michigan. COP funds are intended to engage and actively involve all citizens in hometown security
through personal preparedness, training, exercises, and volunteer service and to provide a structured opportunity
for citizens to augment local emergency response activities.
II. Objectives
The principal objective of this grant agreement is to provide financial assistance for allowable costs in the CCP and
the following specific programs:
1 Community Emergency Response Teams (CERT)
2. Medical Reserve Corps (MRC)
3. Neighborhood Watch
4. Volunteer in Police Service (VIPS)
5. Fire Corps
Allowable Investments made in support of the programs listed aoove must fall into one of the following four
categories:
1, Planning
2. Equipment
J. Training
4. Exercises
For guidance on allowable costs for the CCP program areas, please refer to the FY 2009 Homeland Security Grant
Program (HSGP) Guidance, locatec at http://wwwiemargov/pdfigovernment/grant/hsgpity092isgp_guidance.pdf.
To assist Subgrantees, the Supgrantor, in conjunction with the Michigan Homeland Security Preparedness
Committee. has created a list of priority projects that Subgrantees shall use their FY 2009 HSGP-CCP funds to
support. These projects were delved from thell Investment Justifications developed by Michigan that are to be
implemented at the regional/local level. Additional information is provided in the Michigan FY 2009 HSGP
Supplemental Grant Guidance. Subgrantees must take a regional approach when determining the Pest use of FY
2009 HSGP-CCP funds. Subgrantees must consider the needs of local units of government and applicable
volunteer organizations in the projects and activities included in their FY 2009 HSGP-CCP application.
Statutory Authority
Funding for the Fiscal Year 2009 HSGP is authorized by the Consolidated Security. Dlsaster Assistance, and
Continuing Appropriations Act of 2009 (Public Law 110-329).
2009 Citizen Corps Grant Agreement
County of Oakland (Fiduciary for County of Monroe)
Page 2 of 8
The Subgrantee agrees to comply with all HSGP-CPP program requirements in accordance with the HSGP
Guidance. The Subgrantee also agrees to comply with the following regulations:
A. Administrative Requirements
1. 44 CFR, Part 13, Uniform Administrative Requirements for Grants and Cooperative Agreements to
State and Local Governments, located at http://eCFR.gpoaccess.gov/cgiNtext/text-
id x?c=ecfr&to 1=lecfrbrowse/Titi e44/44cfr13_main_02 .tpi
2. 2 CFR, Part 215, Uniform Administrative Requirements for Grants and Cooperative Agreements to
Institutions of Higher Learning, Hospitals, and Other Non-Profit Organizations (OMB Circular A-110),
located at http://edi .youctL;euss.guvicgi/t/textitext-
id x?c=ocfr&sid =5f90b818356757091bb65ea93f163c0a&tpl =lecfrbrowseiTitle02/2cfr2152n ain_02.tpl
B. Cost principals
1. 2 CFR, Part 225, Cost Principals for State, Local, and Indian Tribal Governments (OMB Circular A-87),
located at http://ecfr.gpoaccess.govicgi/t/text/text-
idx?c=ecfr&tpl=fecfrbrowsefTitle02/2cfr225_main_02.tpl
2. 2 CFR, Part 220 : Cost Principals for Educational Institutions (OMB Circular A-21), iocated at
http://ecfr.gpoaccess.gov/cgiititextitext-idx7c=ecfr&rgn=div5&view=text&node=2:1.1.2.3.48 ,idno--2
3. 2 CFR, Part 230. Cost Principals for Non-Profit Organizations (OMB Circular A-122), located at
httpliecfr.gpoaccess.goviogi/t/text/text-idx?c=ecfr&tplecfrbrowse/Title02/2cfr230_main_02.tol
4. Federal Acquisition Regulations (FAR), Part 31.2 Contract Cost Principles and Procedures, Contracts
with Commercial Organizations, located at
https://www.acquisition.govifarihtml/Subpart%2031_2.htmlltwo1095552
C. Audit Requirements
1. OMB Circular A-1 33, Audits of States, Local Governments, and Non-Profit Organizations, located at
http://www.whitehouse.goviom b/circulars/al 33/8133. html
1V, Homeland Security Grant Program Award Amount and Restrictions
The CouNrr OF OAKLAND, as tne Fiduciary Agent for the County of Monroe, is awarded $7,892.00 in CCP funding
under the FY 2009 HSCP-CCP.
This grant agreement designates CCP funds only for reimbursement of authorized costs that are incurred during
the FY 2009 grant agreement period. Grant agreement funds shall not be used for other purposes. Allocations for
the FY 2009 HSGP-CCP have been determined on a regional basis through a funding inethodpbagy consistent with
current OHS guidance. Regional Boards have been created to ensure that all jurisdictions within a designated
region have an equal say in now funds are spent.
At least $1,973.00 of CCP award funds must be dedicated to strengthening preparedness planning through
planning, training, anc exercising activities. This is a OHS requirement and additional details can be found in the
FY 2009 HSGP Guidance
For any activities involving construction, demolition or installations of equipment; an Environmental and Historic
Preservation (EHP) Review must be completed prior to any work being done. Any activities that have been
initiated without the necessary EHP review and approval will result in a non-compliance finding and will not
be eligible for federal funding.
Final determination on how funds awarded by this grant agreement will be allocated will be determined
through a review process by the Sub grantor of projects submitted by the Region 2 Homeland Security
Planning Board, not by the Sub grantee.
2009 Citizen Corps Grant Agreement
County of Oakland (Fiduciary for County of Monroe)
Page 3 of 8
V. Responsibilities of the Subgrantee
FY 2009 HSGP-CCP funds must supplement, not supplant, state or local funds. Federal funds will be used to
supplement existing funds, and will not replace (supplant) funds that have been appropriated for the same purpose.
Potential supplanting will be carefully reviewed in the application review, in subsequent monitoring, and in the audit
The Subgrantee may oe required to supply documentation certifying that it did not reduce non-federal funds
because of receiving federal funds. Federal funds cannot be used to replace a reduction in non-federal funds or
solve budget shortfalls in general fund programs.
The Subgrantee agrees to act as the designated Fiduciary Agent for the County of Monroe. As the des ignated
Fiduciary Agent, the Subgrartee agrees comply with all applicable federa; and state regulations including, but not
limited to, the following:
A. In addition to this FY 2009 HSGP-CCP grant agreement, the Subgrantee shall complete, sign, and submit
to Subgrantor the following documents, which are incorporated by reference into this grant agreement.
1. Standard Assurances
2. Certifications Regarding Lobbying, Debarment, Suspension and Other Responsibility Matters: and
Drug-Free Workplace Requirement
3. State of Michigan Audit Certification Form (EMD-053)
4. Request for Taxpayer Identification Number and Certification (W-9)
5. Other documents that may be required by federal or state officials
B. The FY 2009 HSGP-CCP Grant covers eligible costs from August 1, 2009 to April 30, 2012. Please refer
to the Fiscal Year 2009 Homeland Security Grant Program Guidance, located at
http://www.fema.gov/pdf/governmentigrant/hsgpify09_hsgp_guidance.pdf., for a detailed list of what costs
are eligible under this grant Allowable costs are specifically addressed in Part VIII of the HSGP Guidance
C. Make all purchases in accordance with grant guidance and local purchasing policies.
D. Submit project applications to the Subgrantor, which have been prepared and approved by the Homeland
Security Regional Boarc, for evaluation and approval of projects prior to starting a project. All projects
must meet OHS and EMHSD grant guidelines and must directly support one of the require° projects from
the regional supplemental guidance, and at least one of tne 37 target capabilities. Projects should be
coordinated with Regional Homeland Security Board activities. Any project that proposes a change in
scope of work during the grant performance period must be resubmitted to the Subgrantor for approval.
E. Submit an Allowable Cost Justification (ACJ) form for ail costs that are part of approved projects prior to the
encumbering of the cost. If an ACJ is not submitted, the Subgrantee will be held responsible for all costs
determined to be ineligible by the Subgrantor or by DHS.
E. Within 30 days of the end of the Subgrantee's fiscai year, the Subgrantee must supply a document to the
other local government agencies reporting the dollar amount spent on their behalf, so the local government
agencies can submit tie information on their Schedule of Expenditures of Federal Awards (SEFA) report.
NOTE: Copies of these documents must also be provided to the Michigan State Police, Emergency
Management and Homeland Security Division, Audit Unit, 4000 Collins Road, Lansing, Michigan 4890-
5883.
F. Create and reacitairi an inventory of all FY 2009 HSGP-CCP ereuiPment purchases that lists, at minimum,
the piece of equipment, the cost of the equipment, what agency tne equipment is assigned to and the
physical location of the equipment for the grant period and for at least three years after the grant is closed
by the awarding Federal Agency. The Subgrantee is advised that, when practicable, any equipment
purchased with grant funding shall be Prominently marked as follows: "Purchased witn funds provided by
the U.S. Department of Homeland Security'. Within 30 days of the end of the Subgrantee's fiscal year, the
Subgrantee must supply a copy of this inventory to the Michigan State Police, Emergency Management
and Homeland Security Division, Aucit Unit, 4000 Collins Road, Lansing, Michigan 48910-5883
2009 Citizen Corps Grant Agreement
County of Oakland (Fiduciary for County of Monroe)
Page 4 of 8
G. Make FY 2009 HSGP-CCP equipment available for pick-up by otner government agencies per equipment
assignments by tne Region 2 Homeland Security Planning Board, This proueba needs to include legal
transfer o4 the equipment to the designated government agencies. At minimum, the Suograntee should
prepare documents, which when signed, will indicate other designated government agencies accept full
legal ano financial responsibility for pieces of equipment.
H. The Subgrartee agrees to prepare the Reimbursement Cover Sheet (EMD-054) and all regLared attached
documentation, including all required authorized signatures, and submit it to the Subgrantor at a minimum
at the end of each quarter (or more frequenty, as needed). Please note: One Reimbursement Cover
Sheet and related forms must be completed for each grant project, solution area, allocation type,
and individual exercise, ReimPursement Cover Sheets must be filled out completely or they will Pe
returned to the Subgrantee for proper completion. Please refer to the Reimbursement Guidance included
with each of the reimbursement forms. The Reimbursement Cover Sheet (EIV1D-054) and other
reimbursement forms can be found on the EMHSD website, boated at
http://www.michigan.gov/msp/0,1607,7-123-1593_3507_41574-21.4684--,00.html . The Subgrantee will not
be reimbursed for funds until all required signed documents and reimbursement documents are received.
I. Submit quarterly progress reports to the Subgrantor on the status of all approved projects. The due dates
for quarterly progress reports are detailed in Section VII of this agreement.
J. Submit updated project and allocation information on a regular basis through the Biannual Strategy
Implementation Reports (BSIR). The BSIR is due within 20 days after the end of the reporting period. The
due dates for the BSIR are on January 20, 2010, July 20, 2010, January 20, 2011, July 20, 2011. January
20, 2012, and July 20, 2012, The reporting periods are from January 1 through June 30 and July 1 through
December 31. The final BSIR is due 90 days after the end date of the FY 2009 HSGP-CCP award period.
K. Comply with FY 2009 National Incident Management System (NIMS) implementation requirements and
move towards completion by September 30, 2012. FY 2009 NIMS requirements must be fully complied
with by September 30, 2012. NIMS information is available at http://wwvvierna.gov/emergencyinims.
Comply with applicable financial and administrative requirements set forth in the current edition of 44 CFR,
Part 13 including the following provisions:
1. Account for receipts and expenditures, maintain adequate financial records, and refund expenditures
disallowed by federal or state audit.
2. Retain all financier records, statistical records, supporting documents, ano other materials pertinent to
the FY 2009 HSGP-CCP for at least three years after the grant is closed by the awarding Federai
Agency, for purposes of federal and/or state examination and audit.
3. Perform the required financial and compliance audits in accordance with the Single Audit Act of 1984.
as amended, and OMB Circular A-133, "Audits of States, Local Governments, and Non-Profit
Organizations." as further described in 44 CFR, Part 13. Random audits shall be performed to ensure
compliance with applicable provisions.
M. integrate individuals with disabilities into emergency planning. per Executive Order 13347.
N. Environmental and Historic Preservation Compliance: The federal government is required to cons;der
the potential impacts to the human and natural environment of projects proposed for federa fundirg. Tne
Environmental and Historic Preservation (EHP) Program, engages in a review process to ensure that
federally-funded activities comply with various federal laws. The goal of these compliance requirements ,s
to protect our nation's water, air, coastal. wildlife, agricultural, historical, and cultural resources, as well as
to minimize potential averse effects to children and low-income and minority populations. The Subgrantee
shall not undertake any project having the potential to impact EHP resources without prior approval.
Any activities that have been initiated without the necessary EHP review and approval will result in
a non-compliance finding and will not eligible for federal funding.
2009 Citizen Corps Grant Agreement
County of Oakland (Fiduciary for County of Monroe)
Page 5 of 8
VI. Responsibilities of Subgrantor
The Subgrantor, in accordance with the general purposes and objectives of this grant agreement, will:
A. Administer the FY 2009 HSGP-CCP in accordance with all applicable federal and state regulations and
guidelines and provide quarterly reports documenting this administration.
B. Provide direction and technical assistance to the Subgrantee,
C. Provide to the Subgrantee any special report forms -zntlisimrtirg-formats (templates) required for operation
of the program,
D. Reimburse the Subgrantee in accordance with this grant agreement, based on appropriate documentation
submitted by the Subgrantee.
E. Independently, or in conjunction with DHS, conduct random on-site reviews.
VII. Reporting Procedures
Submit quarterly progress reports to the Subgrantor on the status of all funding. Quarterly progress reports are
required whether or not expenditures are incurred.
Subgrantees failure to fulfill the quarterly reporting requirements, as required by the grant, may result in the
suspension of grant activities until reports are received.
Reporting quarters for each year are as follows:
January 1 through March 31
April 1 through June 30
July 1 through September 30
October 1 through December 31
The final reporting quarter ends with the end of the grant performance period, which may result in this final quarter
being ,ess than three months in duration.
Quarterly reports are to be submitted by end of the month following the end of each quarter. The first quarterly
progress report for the FY09 HSGP grant is due on April 30, 2010. Reports are to be sent electronically to
ernd_hsgo@micnigan.gov .
SUBGRANTEE WILL NOT BE REIMBURSED FOR FUNDS UNTIL ALL REQUIRED SIGNED DOCUMENTS
AND REIMBURSEMENT DOCUMENTS ARE RECEIVED.
VIII. Payment Procedures
The Subgrantee agrees to prepare the Reimbursement Cover Sheet (EN1D-054) and all required attached
documentation, including all required authorized signatures, and submit it to the Subgrantor at a minimum at the
end of each quarter (or more frequently, as needed). Please note: One Reimbursement Cover Sheet and
related forms must be completed for each grant project, solution area, allocation type, and individual
exercise. Reimbursement Cover Sheets must be filled out completely or they will be returned to the Suograntee
for proper completion. Please refer to the Reimbursement Guidance included with each of the reimbursement
forms. The Reimbursement Cover Sheet (EMD-054) and other reimbursement forms can be found on the EMI-ISD
website at http://www.michigan.govimsp/0,1607,7-123-1593_3507_41574-214684--,00.htrni . The Subgrantee wil
not be reimbursed for funds until a ll required signed documents and reimbursement documents are received.
2009 Citizen Corps Grant Agreement
County of Oakland (Fiduciary for County of Monroe)
Page 6 of 8
Drawdown of Funds in Advance: Subgrantees may request funds (for purchases of $25,000 or more) up to '20
days prior to expenditure. All of tee following requirements must be met to obtain advanced funds: 1) The
Subgrantee must complete a letter stating the reason they are requesting an advance; 2) The Subgrantee must
submit a copy of an approved purchase order showing the aelivery date for the items ordered to be within 120 days
of the purchase order date; 3) These funds must be placed in an interest-bearing account (2CFR, part 215.22k).
The Subgrantee may keep interest up to $100 per year (CFR44, part 13.21h) for administrative expenses for all
federal grants combined (per OHS Financial Management Guide, January 2006). If the Subgrantee is notified by
the vendor of delays in the delivery date of equipment, funds must be returned to the Subgrantor. Advances cannot
be outstanding for more than 120 days: 4) Any interest earned over $100 must promptly, but at least quarterly, be
remitted to: MSPIEMHSO, Financial Section, 4000 Collins Road, Lansing. MI 48910. The Subgrantee must also
notify the Subgrantor in writing of any interest earned over $100 Quarterly.
IX. Employment Matters
Subgrantee shall comply with Title VI of the Civi Rights Act of 1964, as amended, the Elliott-Larsen Civil Rights
Act, 1076 PA 453, as amended, MCL 37.2101 et seq., the Persons with Disabilities Civil Rights Act, 1976 PA 220,
as amended, MCL 37.1101 at seq., and all other federal, state and local fair employment practices and equal
opportunity laws and covenants that it shall not discriminate against any employee or applicant -for emptcryment, to
be employed in the performance of this grant agreement, with respect to his or her hire, tenure, terms, conditions,
or privileges of employment; or any matter directly or indirectly related to employment because of his or her race,
religion, color, national origin ; age, sex, height, weight, marital status, limited English proficiency, or handicap that is
unrelated to the individual's ability to perform the duties of a particular job or position. Subgrantee agrees to
include in every subcontract entered into for the performance of this grant agreement this covenant not to
discriminate in employment. A °reach of this covenant is a material breach of the grant agreement.
The Subgrantee sha I ensure that no subcontractor, manufacturer, or supplier of Subgrantec on this Project
appears in the register compiled by the Michigan Department of Energy, Labor, and Economic Growth, Bureau of
Commercial Services, Licensing and Enforcement Divisions, pursuant to 1980 PA 278, as amended, MCL 423.321
et seq. (State Contractors with Certain Employers Prohibited Act), or on the Federal Excluded Party List database,
located at www,epis.gov .
X. Limitation of Liability
Subgrantor and Subgrantee to this grant agreement agree that each must seek its own legal representative and
bear its own costs, including judgments, in any litigation that may arise from performance of this contract. It is
specificaPy understood anc agreed that neither party will indemnify toe other party in such litigation.
This is not to be construed as a waiver of governmental immunity.
Xl. Third Parties
This grant agreement is not intended to make any person or entity, not a party to this grant agreement, a third party
beneficiary hereof or to confer on a thirc party any rights or obligations enforceable in their favor.
XII. Grant Agreement Period
This grant agreement is in full force and effect from August 1,2009 to April 30, 2012. No costs eligible under this
grant agreement shall be incurred before toe starting'date of this grant agreement except with prior written
approval. This grant agreement consists of two identical sets simultaneously executed, each is considered an
original having identical legal effect. This grant agreement may be terminatea by either party by giving thirty (30)
days written notice to the other party stating reasons for termination and the effective date, or upon the failure of
either party to carry out toe terms of the grant agreement. Upon any such termination, the Subgrantee agrees to
return to the Subgrantor any funds not autaorized for use, and the Subgrantor shall have no further obligation to
2009 Citizen Corps Grant Agreement
County of Oakland (Fiduciary for County of Monroe)
Page 7 of 8
reimburse the Subgrantee. Upon termination of grant agreement, the Subgrantee shall submit documentatior, in a
format specified by the Subgrantor, to formally end its status as fiduciary.
XIII. Entire Grant Agreement
This grant agreement is governed by the laws of the State of Michigan and supersedes all prior agreements,
documents. and representations between Subgrantor and Subgrantee, whether expressed, implied, or oral. This
grant agreement constitutes the entire agreement between the parties and may not be amended except by written
instrument executed by 00th parties prior to the termination date set forth in Section XII above. No party to this
grant agreement may assign this grant agreement or any of his/her/its rights, interest, or obligations hereunder
without the prior consent of the other party. Subgrantee agrees to inform Subgrantor in writing immediately of any
proposed ulianges of dates, Dudget, or services indicated in this grant agreement, as well as cnanges of address or
personnel affecting this grant agreement. Changes in dates, budget, or services are subject to prior written
approval of Su bgrantor. If any provision of this grant agreement shall be deemed void or unenforceable, the
remainder of the grant agreement shall remain valid.
The Subgrantor may suspend or terminate subgrantee funding, in whole or in part, or other measures may be
imposed for any of the following reasons:
• Failure to expend funds in a time)/ manner consistent with the grant milestones, guidance and assurances,
• Failure to comply with tie requirements or statutory objectives of federal or state law.
• Failure to make satisfactory progress toward the goals or objectives set forth in the subgrant application.
• Failure to follow grant agreement requirements or special conditions.
• Proposal or implementation of substantial plan changes to the extent that, if originally submitted, the project would
not have Peen approved for funding,
• Failure to submit required reports.
• Filing of a false certification in the application or other report or document.
• Failure to adequately manage, monitor or direct the grant funding activities of their subrecipients.
Before taking action. the Subgrantor will provide the Subgrantee reasonable notice of intent to Impose corrective
measures and will make every effort to resolve the problem informally.
XIV. Business Integrity Clause
The Subgrantor may immediately cancel the grant without further liability to the Subgrantor or its employees if the
Subgrantee, an officer of the Subgrantee, or an owner of a 25% or greater share of the Su bgrantee is convicted of
a criminal offense incident to the application for or performance of a state, public, or private grant or subcontract; or
convicted of a criminal offense, including but not limited to any of the following: embezzlement, tneft, forgery,
bribery, falsification or destruction of records, receiving stolen property, attempting to influence a public employee
to breach the ethical conduct standards for State of Michigan employees; convicted under state or federa antitrust
statutes; or convicted of any other criminal offense which, in the sole discretion of the Subgrantor. reflects on the
Subgrantee's business integrity.
XV. Freedom of Information Act (FOIA)
Much of toe nformation submitted in the course of applying fo- funding under this program, or provided in the
course of grant management activities, may be considered law enforcement-sensitive or otherwise critical to
national security interests. This may include threat, risk, and needs assessment information; and discussions of
demographics, transportation, public works, and industrial and public health infrastructures. Therefore, each
Subgrantee agency Freedom of Information Officer will need to determine what information is to be withheld on a
case-by-case basis. The Subgrantee should be familiar with the regulations governing Protected Critical
Infrastructure Information (6 CFR Part 29) and Sensitive Security Information (49 CFR Part 1520), as these
designations may provide additional protection to certain classes of homeland security information.
Deputy State Director of Emergency
Management and Homeland Security
Title
Capt. W. Thomas Sands
Printed Name
‘eafte..4titteer--
2009 Citizen Corps Grant Agreement
County of Oakland (Fiduciary for County of Monroe)
Page 8 of 8
Mil, Official Certification
For the Suograntee. The individual or officer signing this grant agreement certifies by his or her signature that he or
she is authorized to sign this grant agreement on behalf of the jurisdiction he or she represents. The Subgrantee
agrees to complete all requirements specified in this grant agreement.
County of Oakland
Name of Jurisdiction
Printed Name Title
Signature Date
For the Subgrantor (Michigan State Police — Emergency Management and Homeland Security Division)
Signature Date
For the County of Monroe: The county official's signature appears on this grant agreement as a certification that
County of Monroe has designated the County of Oakland to serve as the fiduciary agent for the FY 2009 HSGP,
Printed Name Title
Signature Date
OMB APPROVAL NO, 1121-0140
EXPIRES 01,131;2006
STANDARD ASSURANCES
The Applicant hereby assures and certifies compliance with all applicable Federal statutes, regulations,
policies, guidelines, and requirements, including OMB Circulars A-21, A-87, A-102„A.-1:0, A-I22, A-
133; Ex. Order 12372 (intergovernmental review of federal programs); and 28 C.F.R. pts. 66 or 70
(administrative requirements for grants and cooperative agreements). The applicant also specifically
assures and certifies that:
I. It has the legal authority to apply for federal assistance and the institutional, managerial, and financial
capability (including funds sufficient to pay any required non-federal share of project cost) to ensure
proper planning, management, and completion of the project described in this application.
2. It will establish safeguards to prohibit employees from using their positions for a purpose that
constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain.
3. It will give the awarding agency or the General Accounting Office, through any authorized
representative, access to and the right to examine all paper or electronic records related to the financial
assistance.
4. It will comply with all lawful requirements imposed by the awarding agency, specifically including
any applicable regulations, such as 28 C.F.R. pts. 18, 22, 23, 30, 35, 38, 42, 61, and 63.
5. It will assist the awarding agency (if necessary) in assuring compliance with section 106 of the
National Historic Preservation Act of 1966 (16 U.S.C. § 470), Ex. Order 11593 (identification and
protection of historic properties), the Archeological and Historical Preservation Act of 1974 (16 U.S.C.§
469 a-1 et and the National Environmental Policy Act of 1969 (42 U.S.C. § 4321).
6_ It will comply (and will require any subgrantees or contractors to comply) with any applicable
statutorily-imposed nondiscrimination requirements, which may include the Omnibus Crime Control and
Safe Streets Act of 1968 (42 U.S.C. § 3789d); the Victims of Crime Act (42 U.S.C. §10604(e)); The
Juvenile Justice and Delinquency Prevention Act of 2002 (42 U.S.C. § 5672(h)); the Civil Rights Act of
1964 (42 U.S.C. § 2000d); the Rehabilitation Act of 1973 (29 U.S.C. §7 94); the Americans with
Disabilities Act of 1990 (42 U.S.C.§ :2131-34); the Education Amendments of 1972 (20 U.S.C. §§1681,
1683, 1685-86); and the Age Discrimination Act of 1975 (42 U.S.C. §§ 6101-07); see Ex. Order 13279
(equal protection of the laws for faith-based and community organizations).
7. If a governmental entity—
a) it will comply with the requirements of the Uniform Relocation Assistance and Real Property
Acquisitions Act of 1970 (42 U.S.C.§ 4601 et m.), which govern the treatment of persons displaced as a
result of federal and federally-assisted programs; and
b) it will comply with requirements of 5 U.S.C.§§ 1501-08 and §§7324-28, which limit certain
political activities of State or local government employees whose principal employment is in connection
with an activity financed in whole or in part by federal assistance.
Signature Date
U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
OFFICE OF THE COMPTROLLER
CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND
OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS
Applicants should refer to the regulations cited below to determine the certification to which they are required to
attest. Applicants should also review the instructions for certification ircicded in the regulations before completing this
form. Signature of this form provides for complianCe with certification requirements under 28 CFR Part 69, 'New
Restrictions on Lobbying` and 28 CFR Part 67, "Government-wide Debarment and Suspension (Nonpro-curernent) and
Government-wide Requirements for Drug-Free Workplace (Grants)." The certifications shall be treated as a material
representation of fact upon which reliance wril be placed when the Department of Justice cletermines to award the
covered transaction, grant, 07 cooperative agreement.
1. LOBBYING
As required by Section 1352. Title 31 of the US. Code, and
implemented at 28 CFR Part 69, for persons entering into a
grant or cooperative agreement over $10G,000, as defined at
28 CFR Part 69, the applicant certifies that:
(a) No Federal appropriated funds have been pale or will be
paid, by or on behalf of the undersigned. to any person for in-
fluencirg or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or ermeoyee of
Congress, or an employee of a Member of Congress in con-
nection with the making of any Federal grant, the entering into
of any cooperative agreement, and the extension, continuation,
renewa., amendment, or modification of any Feoerai grant or
cooperative agreement;
(b) If any funds other than Federal appropriated funds have
been pairi or will be paid to any person (Or influencing or at-
temptng to influence ar officer or employee of any agency. a
Memoer of Congress, ar officer or employee of Ccrigress, or
an employee of a Member of Congress in cornecton with this
Federal grant or cooperative agreemeat, the undersigned shall
complete and submit Standard Form - LL., 'Disclosure of
Lobbying Activities." in accordance with its instructions:
(c) The undersigned shall require that the language of this cer-
tification be included in the award documents for all sueawards
at all tiers (including subgrants, contracts ureer grants and
cooperative agreerrents, ard subcontracts) and that all sub.
recipients shall certify anti olJscicse accordingly.
2. DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS
(DIRECT RECIPIENT)
As required by Executive Order 12540, Debarment and
Suspension, and implemented at 28 CF R Part 67. for prospec-
tive participants in primary covered transactions, as defined at
28 CFR Part e7, Section 67.510—
A. The appbCant certifies that it aria its principals .
(a) Are not presently deberred, suspended. proposed for debar-
ment, declared me gble. sentenced to a deniai of redera
berefits by a State or Federal court, e voluntarily exclucied
from Covered transactions by any Federal depanment
or agency:
(b; Have not waren a three-year period preceding this applica-
tion been convicted of or had a civa Judgment rendered against
them for cornmissior of fraud or a cminEki offense ri connec-
tion with obtaining, attempting to cetain, or eerform'ng a
public (Fedora', State, orlocai) trensaceon or contract under a
public transaction; v;olation of Federal or State antitrust statutes
or commission of embezzlement, theft, forgery.
bribery, falsification or destruction of recorcs, making falae
statements, or receiving stolen property;
(c) Are not presently Indicted for or otherwise criminally of
civilly charged by a governmental entity (Federal. State. a.-
local) with commission of any of the offenses enumerated in
paragraph (1)(b) of thes certification; and
(d) Have not within a three-year period preceoing this appiice-
tinn had One or more public transactions (Federal : State, o-
local) terminated for cause or default; and
B. Where the appiicant is unable to certify to any of the
statements In this certification, he or she shall attach an
explanation to this application.
3. DRUG-FREE WORKPLACE
(GRANTEES OTHERTHAN INDIVIDUALS)
As required by the Drug-Free Workplace Act of 1988. and
implemented at 28 CFR Part 67, Subpart F. for grantees, as
defined at 26 CFR Part 67 Sections 67.615 and 67.620—
A. The applicant certifies triat it will or will continue to provide
a drug-free workplace by:
(a) Publishing a statement notifying employees Mat the
unlawful manufacture, distribution, dispensing, possession, or
use of a controlled substance is prohibited in the grantee's
workpiace and specifyirg the actions mat wal be taken acainei
orrip'oyees for violation of such prohibition;
(h) Establishing an on-going drug-free awareness program to
inform employees about—
(1) The dangers of drug abuse in the workplace,
(2) The grantee's policy of imaintainire a drug-free workplace
(3) Any available drug counseling, rehabilitation, and employee
assistance programs; and
{4) The penalties that may be imposed upon employees for
drug abuse vialations occurring in the workplace;
(c) Making it a requirement that each employee to be engaged
In the performance of the grant be given a copy of the state
meat required by paragraph (a):
(d) Notifying the employee in the statement required by para-
graph (a) that, as a condition of employment under the grew,
the employee will-
ow FORM 4.361 ,s CD 91 REPLACES C,.P FORMS 2.061,2 AC161,3 AND 4.7,GlIA W141C-1 ARE OB;OLETE.
2. Application Number are/or Project Name 3: Grantee IRS/Vendor Number
(1) Abide by the terms of the staterrer t. and
(2) Notify the employer in writing of his or her conviction for a
violation of a criminal drug statute occurring in the workplace
no later than five calendar days after such conviction:
(e) Notifyirg the agency, in writing, within 1 calendar days
after receiving notice under subparagraph (d)(2) from an
employee or otherwise receiving actual notice of such convic-tioe
Emeloyers of convicted employees must provice Notice, including
Position title, to. Department of Justice. Office of
Justice Programs, ATTN, Control Desk. 633 Indiana Avenue,
NW., Washington; D.C. 20531_ Notice shall include the iden-
tification number(s) of each affected vent;
(0 Taking one of the following actions, withie 3D caierder
days of receiving notion under subparagraph (d)(2), with
respect to any employee who so convicted—
(1 }Taking appropriate personnel action against such an
employee, up to and including termination, consistent with the
requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such erVoyee to participate satisfactorily in a
drug abuse assistance or rehabilitation program approved for
such purposes by a Feueral, State, or local health, law enforce-
ment, or other appropriate agency;
(g) Maeing a good faith effort to continue to maintain a drug-
free workplace through implementation of paragraphs (a). (b),
(c), (d), (e). and (f).
a, The grantee may insert in the space provided below the
site(s) for the performance of work done in connection with
the specific grant:
Place of Performance (Street address, city, county, state, zip
cocie)
Chece D, if there are workplaces on file that are not ineentified
here.
Section 67, 630 of the regulations provides that a grantee that
is a State may elect to make one certification in each Feclerai
fiscal year. A copy of which should be included with each ap-
plication for Department of Justice funding. States and State
agencies may elect to use OJP Form. 4061/7,
Chock E if the Slate has elected to complete OJP Fern'.
4081/7.
DRUG-FREE WORKPLACE
(GRANTEES WHO ARE INDIVIDUALS)
As required by tne Drug-Free Workplace Act of 1g8e, and
implemented at 28 CFR Part 67, Subpart F. for grantees, as
defined at 28 CFR Part 67: Sections 67.615 and 87.620-
A. As a condition of the grant. I certify that! will not engage
in the unlawful manufacture. distribution, dispensing, posses-
sion, or use of a controlled substance in conducting any
activity with the grant; and
B. If convicted of a crimina. drug offense resulting from a
violation occurring during the conduct of any grant activity. I
wilt report the conviction, :n writing. within 10 calendar days
of the conviction, to: Department of Justice, Office of Justice
Programs, .ATTN: Control Desk. 633 inciana Avenue. NW.,
Washington, D.C. 20531:
.0
As the duly authorized representative of the applicant, I hereby certify that the applicant wii comply with the above certifications.
1 Grantee Name and Address:
4. Typed Namean„ d Title of Authorized Representative
5. Signature 6: Date
`U5 ciovenr-e-,t P-rvl Cs. 15 4G5 C37,'4X1g.
EMD-053 W3-2004)
MICHIGAN STATE POLICE
=rrigortp.r.rw ManAnarripnt nnel - - - — -.
STATE OF MICHIGAN
AUDIT CERTIFICATION
_
Federal Audit Requirements
Fiscal Years Beginning After June 30, 1996
Non-Federal organizations which expend $500,000 or more in Federal funds during their fiscal year are required to
have an audit performed in accordance with the Single Audit Act of 1984. as amended, and Office of Management
and Budget (OMB) Circular A-133. Subgrantees rnusLubmit a cony_ofth ei r audit report to: Budget and Financial
Services Division, Michigan Department of State Police, 714 South Harrison Road, East Lansing, Michigan 48823
for each year they meet the funding threshold.
-
Program: pH Emeraencv Manaaement Performance Grant ,
CFDA Number: 97.042
Subgrantee Information
Jurisdiction Name:
Street Address:
City, State, Zip Code:
. _
Certification for Fiscal Year Ending (mmiddlyyyy):
(Check appropriate box)
ii I certify that the subgrantee shown above does not expect it will be required to have an audit performed under
the Single Audit Act of 1984, as amended, and the OMB Circulars as revised, for the above listed program.
0 I certify that the subgrantee shown above expects it will be required to have an audit performed under the Single ,
Audit Act of 1984. as amended, and the OMB Circulars as revised, during at least one fiscal year funds are I
received for the above listed program. Asapv of the audit report will be submitted_to: Budget and Financial
Services Division, Michigan Department of State Police, 714 South Harrison Road, East Lansing, Michigan
48823
(Signature of Subgrantee's Authorized Representative) (Date)
—
Please mail completed form to: Michigan Department of State Police
Emergency Management and Homeland Security Division
Financial Section
4000 Collins Road
Lansing, Michigan 48910
For MSP-EMD Use Only
Reviewed By: Date:
Authority: Act 390, P. A of 1975. as arnenea
Completion: Volunry, but, ccmpieticn
necessary to be considered for
assistance,
—Exempt
— payee
Busino3.5 name, it atterelt tram aoove a
te E D. C.
r
cr.
v7
Crty. state, arid ZIP code at
List abcou:-.1 nUmNIIS) here (optior.ti)
0?
Cheas aporopriate box; .rdividua.ISo e xap'eto L. Ccrooration E Pa.rinershio
0 Limited lieb:rty company. Enter the tax c.asstoator. (D.diarsgarded citty, C.eprooratio7, PrparInersh:p)
Li ()ter Isee irstructors)
Address (number, street. erd apt. or sste no.) Requester's 'ame ad actress (optlene)
;Social security number
or
Employer identification number
•
Forrr W
(Rev, Octobe• 2Ce7 )
Of me 7,Intury
ticorna Rarmnue Sen,n04,
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS.
-9
Name (as 4h4W1 91 your income tax return)
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Lire 1 to avoid
backup withholding. For individuals. ttas is your social security number (SSW However. for a resident
alien, sole proprietor. or disregarded entity, see the Part I instructions on page 3. For other entities, it is
your employer Identification number lEIN). I you do not have a number, see How to get a TIN On page 3.
Note. If tne account Is In more elan one name, see the chart on page 4 for guidelines on whose
number to enter.
PIM C_artification
Under penalties of perjury, I certify that:
. The number shown on vas form is my correct taxpayer Identification number for I arn waiting for a number to be issued to me, are
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest 7 dividends, or (c) the IRS has
notified me that] arr ne !eager subject to backup withholding, and
3. I am a U.S. elem.-, or otner U.S. person (defined below).
Certification instructions. You must cross out item 2 neve if you have been notified by the IRS that you are currently subject to backup
wIteholding because you have failed to report a.I interest and dividends cn your tax return. For real estate transactions. item 2 does not anply.
For mortgage interest paid_ acquisition or abandonment of secured aroperty, cancellation of debt, contributloas to an individual retirement
arrangement (IRA), and generally, payments other than interest an.d dividends. you are not required to sign the Certification, but you must
provide your correct TIN. See tie instractions on. page 4.
Signature of
U.S. person 111.
Sign
Here Date O.
General Instructions
Section references are to the Internal Revenue Code unless
otherwise noted.
Purpose of Form
A person who is required to ti e an information return WWI the
IRS must obtain your correct taxpayer identitcation number (TIN)
to report, for example, Income paid to you, real estate
transactions, mortgage interest you paid, acquisition or
abanoonment of secured property, cancellation of debt, or
aoreatatons you mace to ar IRA.
Use Form W-9 only J you are a U.S. person (ncludirg a
resident alien), to provice your correct TIN to the person
requesting it (the requester) and, when applicab e. to:
1. Certify that the TIN you are giving is correct (or you are
waiting for a number to oe issued).
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholdag if you are a U.S.
exempt payee. If applicable, you are aso certifying that as a
U.S. person, your elocab.e share of any partnership income from
a U.S. trade or buainess is not subject to the withholding tax on
foreign partners' share of effectively connected income_
Note. if a requester gives you a form other than Form W-9 to
request your TIN, you must use the requester's form a it is
substantially similar to this Form W.
Definition of a U.S. person. For feceral tax purposes, you are
considered a U.S. person if you are:
• Ar individual who is a U.S. citizen or U.S. resident e'en,
• A partrership, corporatlon, arompany, or essuciatlon created or
organized in the United States or under the laws of the United
States,
• An estate (other than a foreign estate), or
• A domestic trust (as deaned in Regulations section
301.7701-7).
Special rules for partnerships. Partnershtpa that conduct a
trade or bus nese In the United States are generally requireo to
pay a withholding tax on any foregn partners share of income
from such business. Further, in certain cases where a Form W-9
has not been received, a partnership is required to presume that
a partner is a foreign person, and pay the withholding tax,
Therefore, if you are a U.S. person that is a partner in a
partnership conducting a trade or busireee in the United States.
provide Form W-S to the partnership to estataish your U.S.
status and avoic withholding on your share of partnership
income.
The person who gives Form W-9 to the partnership for
purposes of establishing Its U.S. status arid avoiding witnholdino
ore its allocable share of net income frorr the partnership
conducting a trade or business in the United States is in the
following cases:
• The U.S. owner of a disregarded entity and not the eatily,
Cot. No. 10231x ''orrn W-9 (Rev. 10-2CC7)
e
F'Irrn Ray. 1n-ericel
• The U.S, grantor or other owner of a grantor trust and not the
trust, and
• The U.S. trust (other than a grantor trust) and not the
beneficiaries of the trust.
Foreign person. If you are a foreign Demon, do not use Form
W-9. instead, use the appropeate Form W-5 (see Publ:cation
515, Withholeing of Tax or Nonresident Aliens aree Foreign
Entities).
Nonresident alien who becomes a resident alien. Generally,
only a nonresicent gier, ndivictual may use the terms of a tax
treaty to reduce or slim:nate J.S. tax on certain types ot income.
However, most tax treaties contain a provision known as a
"saving clause." Exceptions specified ir, the saving clause may
permit an exempton from tax to continue for certain types of
income even after the payee has otherwise become a U.S.
resident alien for tax purposes.
It you are a U.S. resident alien who :s relying on an exception
contained in the saving Cause e a tax treaty to claim an
exemption from U.S. tax on certain types of income, you must
attach a statement to Forrr W-9 that speclfies the following five
items:
1. The treaty country: Generally, this must be the same treaty
under which you calmed exemption from tax as a nonresident
alien.
2. The treaty artice addressing the ncorne.
S. The article number (or locatior) in the tax treaty that
contains the saving clause and its exceptions.
4. The type and amount al income that qualflea for the
exemption from tax.
5. Sufficient facts to justify the exemphoe from tax under the
terms of the treaty article,
Example. Article 20 of the U.S.-China income tax treaty allows
an exemption from tax or scholarship income receivec by a
Chinese student temporarily present in the United States. Um:ler
U.S. law, this student w1:1 become a resident aiien for tax
purposes if his or her stay in the tented States exceeds 5
calendar years. However, paragraph 2 of the first Protocol to the
U.SeChina treaty (dated April 30, 1984) al ows the provisione of
Article 20 to continue to apply even after the Chinese student
becomes a resetient a:ien of the United States. A Chinese
student who qualifies for this exception (under paragraph 2 of
the first protocol) and is relying on this exception to claim an
exemption from tax on his or her seholarship or fellowslap
income would attach to Form W-8 a statement that includes the
information oescrbed apove to support that exemption.
If you are a nonresident aqen or a foreign enety not subject to
backup withholding, give the requester the appropriate
competed Form W-8.
What is backup withholding? Persons rnaeirg certain payments
to you must under certain conditions withhold and pay to the
IRS 28% of such payments. This is called "backup wtheolding."
Payments that may be subject to backup withholding include
interest, tax-exempt interest, eivicerds. broker and Darter
exchange transactions, reets, royalties, nonemployee pay, and
certain payments from fishing boat operators. Real estate
transactions are not subject to backup witethold -ng.
You will not be suiceect to eaceub withholding on payments
you receive If you give the requester your correct TIN, make the
proper certifications, and report al; your taxabe interest am.
dividends on your tax return.
Payments you receive will be subject to backup
withholding if:
1. You do riot furrier: your TIN to the requester,
2. You do not certify your 7IN when required (see the Part II
instructons on page 3 for octails),
3. The IRS tolls the requester that you furnished an incorrect
TIN,
Psoe 2
4. The IRS telis you that you are suteeet to baceup
withholding because you did not report all your interest and
dividends on your tax return (for reportable interest and
dividends only), or
5. You do not certify to the requester that you are not subject
to backup withholding uncer 4 above (tor reportable interest are:
dividenc accounts cpened after 1983 en'y).
Certain payees and payments are exempt tom baceup
withrioloing. See the instructions below and the separate
Instructions for the Reaue-ster of Form W-9.
Aiso see Special Ivies for partnersPips on page 1.
Penalties
Failure to furnish TIN. If you fail to furnish your ccrrect TIN to a
requester, you are subject to a penalty of $53 for each such
fakire unless your fai:ure is due to reasonable cause and not to
willful neglect.
Civii penalty for false information with respect to
withholding. If you make a false statement with no reasonable
basis that resets in no backup withholding, you are subject to a
$500 penalty.
Criminal penalty for falsifying information, Willtury falsifying
certifications or affirmations may subject you to crimina
penalties including fines and/or imprisonment.
Misuse of TINs. If the requester discloses or uses TINs in
violation of federal law, the recuester may be subject to civil and
criminal penalties.
Specific Instructions
Name
If you are an individual, you must generally enter the name
shown on your income tax return. However, if you have changed
your last name, for instance, due to marriage without informing
the Social Security Administration of the name change, enter
your first name, the last name snown on your social security
care, and your new last name.
If the account is in joint names, list first, and then circle, the
name of the person or entity whose number you entered in Part I
of the form.
Sole proprietor. Enter your incividua name as shown on your
income tax return on the 'Name" line. You may enter your
business, trade, or "doing business as (DBA)" name on the
"Business name" line.
Limited liability company (LLC), Check the "Limited liability
company" box only and enter the appropriate code for the tax
classification ("D" for disregarded entity. "C" for corporation, "P"
for partnership) in the space provided:
For a singe-member LLC (including a foreign LLC with a
oomestic owner) that is disregarded as an entity separate from
its owner under Regulations section 301.7701-3, enter tee
owner's name on the "Name" line. Enter the LLC's name on the
"Business name" 'me.
For an LLC classified as a partnershie or a corporation, enter
the LLCes name on the "Name" line and any businees, trade, Cr
DBA name on the "Business name" line.
Other entities. Enter your business name as shown or required
federal tax documents on the "Name" line. This name should
match the name shown on the charter Cr other legal eocument
creating the enhty. You may enter any business, trade, or DBA
name on the "Business name- line,
Note. You are requested to check the appropriate box to, your
status (individual/sole proprietor, corporat on etc.):
Exempt Payee
If you are exempt from backup withholding. enter your name as
described above and check the appropeate box for your status,
then cnece the "Exempt payee box n the line toliowing tee
business name, sign and ciate the form.
Exempt payees 1 through 5
Generally, exempt payees
1 tiyough 7
Frtrrr VJ fl 1iiei ir anin7;
Generally, individuals Onc.uding sole proprietors) are not exemot
from backup withho (trig. Corporations are exempt from backup
withholding for cora:in payments. such as interest and dividends.
Note. If you are exempt from, backup withholclirg, you should
still complete this form to avoid possille erroneous backup
withholding.
The following payees a:re exempt from backup withholding:
1. An orgarrzatioe exempt from tax (elder section 501M, any
IRA, or a custodia; account under sect:on 403(b)(7) if the account
satisfies the reouirements of sect:on 401(f)(2).
2. The United States or any of its agencies or
instrumental lies,
3. A state, the District of Columbia, a poseess;on of the United
States, or any of their political subdivisions or instrumentalities,
4. A foreign government or any of Its political subdivisions,
agencies, or instrumentalities, or
5. An international organization or any of Its agencies or
instrumentalities.
Other payees that may be exempt from back= withholding
inc.ude:
6. A corporation,
7. A foreign central bank of issue.
8. A dueler in securities or commodities required to register in
the United States, the District of Columbia, or a possession of
the United States,
9, A futures etemmeeion merchant registered with the
Commodity Futures Trading Commisson,
10. A real estate investment trust.
11. An entty registered at al: tines during the tax year under
the Investment Company Act of 1940,
12. A common trust fend operated ey a bank under section
584(8),
13. A financial institution,
14. A middleman known in the investment community as a
normneeO custodian. or
15. A trust exempt from tax under section 664 or described in
section 4947.
The chart beiow shows types of payments that may be
exempt from backup withhold'ng. The chart apphas to the
exempt payees listed above, 1 through 18.
THEN the payment is exempt
for ...
!merest and divicerd payments All exempt payees except
for 9
' Exempt Payees 1 through 13.
I Also, a person registered under
, tie Investment Advisers Act uf
' 194C who regularly acts as a
broker
Barter exchange transactiors
and patronage CIVidencs
Payments over $600 required
to be reported and direct
*ales over $5 000'
'See Form 1099-MISC, Miscoluneous Income, are its instfuct ,ons.
1-lowever, the fol,ow.rig payments made to a corpuralior, rinciuding gross
proceeds oaie to an attorney Lrlder sector 6045(f), even 't the attorney is a
cOrpilrationl, and reportable on Form 1009-MiSO are not exempt, From
backup wIthholding: medical and health care payments, attorneys fees, and
payments for services pad by a federal execirtive
Page 3
Part I. Taxpayer Identification
Number (TIN)
Enter your TIN in the appropriate box. If you are a resideet
alien and you do not have and are not e:igible to get an SSN,
your TIN is your IRS individual taxpayer :oentifcation rumber
(ITIN). Enter it in the social security numper box. If yo.:. do not
have an MN, see How to get a TIN below.
If you are a sc:e proprietor and you have an EIN, you may
enter either your SSN or EIN. However. tee IRS prefers teat you
use your SSN.
If you VIC a single-member LLC that is cieregarcied as an
entity separate from its owner (see Limited liability company
(LLC) on page 2), enter the owner's SSN (or EIN, if the owner
has one). Do not enter the disregarded entity's EIN. If the LLC is
ciassified as a corporation or partnership, enter the enety's EIN.
Note. See the chart on page 4 for further clarification of name
and TIN combinations.
How to get a TIN. If you do not have a TIN, apply for one
immediately. To apply for an SSN, get Form SS-5, Application
for a Social Security Card, from your local Soda! Security
Administration office or get th!s form oreineat www.ssa.gov. You
may also get this form by calling 1-800-772-1213, Use Form
W-7, Application for IRS Individual Taxpayer Identification
Number, to apply for an ITN, or Form SS-4, Applcation for
Employer Identification Number, to apply for an EIN. You can
apply for an EIN online by accessing the IRS website at
www.ies.gov/businesses and clicking on EmPoyer Identi`ication
Number (EIN) under Starting a Business. You can get F,erms W-7
and SS-4 from the IRS by visiting www.irs.gov or by cal1ng
1-800-TAX-FORM (1-800-629-3676).
If you are asked to complete Form W-9 but do not have a TIN,
write "Applied Fur" in the space for the TIN, sign and date the
form, and give it to the requester. For interest and dividend
payments. end certain payments made with respect to readily
tradable instruments, generally you wiq have 60 days to get a
TIN and give it to the requester before you are subject to backup
withholding on payments. The 60-day rule does not apply to
other types of payments. You will be subject to baceup
withholding on all such payments until you provide your TIN to
the requester.
Note. Entering "Apoliec For means that you nave already
applied for a TIN Or that you intend to aeply for one soon.
Caution: A disregarded domestic entity that nas a foreign owner
must use the appropriate Form W-8.
Part II. Certification
To establish to the withho ding agent that you are a U.S. person,
or resident alien. sign Form W-g. You may be requested to sign
by the withholdieg agent even if items 1, 4. and 5 beiow indicate
otherwise.
For a joint account, only the person whose TIN is shown in
Part I sholid sign (when required). Exempt payees, see Exe.mor
Payee on page 2.
Signature requirements. Complete the certification as !ndicated
in 1 through 5 below.
1. Interest, dividend, and barter exchange accounts
opened before 1984 and broker accounts considered active
during 1993. You must give your correct TIN, but ycu aci not
have to sign the certification.
2. interest, dividend, broker, and barter exchange
accounts opened after 1983 and broker accounts considered
inactive during 1993. You must s!'gn the eertificatier or backup
withholding will apply. If you are subject to oackup withholding
and you are merey providing your correct TIN to the requester.
you must cross out item 2 in the certification before i4ining the
form.
IF the payment Is for ...
Broker transactions
Give name and SSN of:
The rdividual
lne actual owner of tre account or,
t cor•:Pfttect funds. the first
'neiyidual on the account.
The minor
Tne grantor-dustee
The actuai owner
The ewner
Give name and EIN of
Form W-9 fRev. 10-20071 Page 4 1111 11
3, Real estate transactions. You must sign the certification.
YD.:, may erase out item 2 of the certfication.
4. Other payments. You must give your correct TIN, but you
du not have to s,gn the cerefication unless you have been
notified that you nave prev:ously given an incorrect TIN. "Other
payments" inc.ude payments mace in the course of tee
requester's trace or business for rente, royalties, gooce (other
than bIlls for merchandise:, medical an health care services
(including payments to corporations), payments to a
nonemployee for services, payments to certain fehirg boat crew
members and fishermee. and gross proceeds paid to attorneys
(including payments to corporator's).
5. Mortgage interest paid by you acquisition or
abandonment of secured property, cancellation of debt,
qualified tuition program payments (under section 529), IRA,
Coverciell ESA, Archer /VISA or 1-ISA contributions or
distributions, and pension distributions. You must give your
correct TIN, but you do not have to sign the certificatien.
What Name and Number To Give the Requester
For this type Of account;
7, irtdivid4d,
2. Two or mons individuals tioeit
account!
3. Cristo:tan aceoant of a minor
fUniforrn Gift to rylinors Act)
4. a. The usual revocalae savings
trust (granter is also trustee
b, so-eafed trust account that is
not a lege. or valid trust under
state law
5. eete proonetorsnip or disragarceo
entity owned by art individuai
For this type of account:
6. Disregarded entity not awned oy an I The owner
individUal
7. A visfici trust, estate. or pees'on tr,rst Legal ertrty
8. Corporate or Ll_C biourng Tre corpo-atior
corporate status on Form 8832
9. Association, Cub religious, I The organizatiof!
chantaPle. ectioationa„ or Qtret
tax-exempt organizaIron
Partnership or multi-member LLJ
11, A tiroker or reg.istered nominee
12. Account with trtie Department of
AgncuAure in the name of a club ic
entity isuch as a state 07 lenal
catatere'rent, school distect. or
pri5on1 that race yes agricultural
program payments
Secure Your Tax Records from Identity Theft
Identity theft occurs when someone uses your persona_
infermation such as your name, social security number (SSN), or
cther idertifying information, without your permission to commit
fraud or other crimes. An icentity thief may use your SSN to get
a job or may file a tax return using your SSN to receive a mlune.
To reduce your ris le
• Protect your SSN,
e Ensure your employer is protecting your SSN. anc
• Be careful when choosing a tax preparer.
Gar the IRS at 1-e00-829-1040 if you think your identity has
been used inappropriately for tax purposes.
Victims of identey theft who are experiencing economic narm
or a system problem, or are seeking help in resolving tax
problems that have riot been resolved through norma. channels,
may be eligible for Taxpayer Advocate Service (TAS) assistance.
You can reach T.AS by calling the TAS toil-free case :ritake line
at 1-877-777-4778 or TTYtTDD 1 -800-829-4059.
Protect yourself from suspicious smalls or Washing
schemes. Phishing is the creation and use of email and
websites designed to mimic legitimate businese ens us ale
websites. The most common act is sending an email to a user
falsely claiming to be an established legitimate enterprise in an
attempt to scam the user into surrendering private information
that wir be used for identity theft.
The IRS does not initiate contacts with taxpayers vla ernaiis.
Also, the IRS does not request personal detailed information
through email or ask taxpayers for the PIN numbers, passworce,
or similar secret access information for their credit card, bank, or
other financial accounts.
If you receive an unsolicited email c.aim.ng to be from the IRS,
forward this message to phishifigOrtagni. You mey also report
misuse of tee IRS name, logo, or other IRS persona property to
the Treasury Inspector General for Tax Admirstratioe at
1-800-366-4484. You can forward suspicious emai!s to the
Federal Trade Commiseion at: spam@uce.gov or contact them at
www,consurner.govfiotrieft or 1-877-DTHEFT(438 -4334
V:s t the IRS website at wwwirs,gov to earn more about
identity theft and how to reduce your risk.
The partnership
The broker or nominee
Trie. pubic entity
'Lisi arst and circle the name i he persce ;arose number V0U oely one wean
on a :iant aCCPUel has an 5511, that pitraor La rxr,a9,' must ora umarled.
'Cada 1I-e winoe's Nene and KrelSh the en nor's SSN
'You m.st show rata ir0i..e00a. on ar0 y0,1 Tay 060 011er gar 1.,J$0055 0' 'OBA'
name re tie becOad !area Ins you may Jar rather your SSN or EIN r,11. yekl 11558 00/31, tut The i519 encourages you 4-; use goo' FiSrii
L;st lirSI are Gu-cle Ile nerve of fIL,5 liihm, caliae, Cr pe-mcn tbe Flat iurerM the 'rip,
ri eta deraonal represantat.va ' trustee Vii0H toe le(a, Val), east b riot 'Jewett-4rd 'n
Ina aci:Otint tile.) Also see Special rues for COMFAISAOS on page 1
Note. If 70 name is circled when mere than one name is listed,
the number will be conselered to be that of the first name lieteu.
Privacy Act Notice
seeton 6109 of the 'ntorral Revenue code requires you to previde your correct TIN to pera0n3 whe must file informaton returns we the IRS to report interest, dinciends. a-ta certain sthar inaer,a pad to .ye,j, mortgage erteyest you paid. the acquisition or abandonment of secured property, cancellation o! debt. Of
contributions you made to an IRA. or Archer M5A or HSA The IRS uses the numbers tor dentlfroation purposes and to he p verify the acc,racy of ycr no return
Tr e IRS may also provide th s i'fformation to tno Department Of L.L.IStice for ovil &to criminal litigatean and to c:tes states, the Cistrict of Colurma, and U.S.
peasessiocs to carry out their tax iaws. We may ase discdse this infiarroatan to other countries under a tax treaty, to (sclera and orate egencee tc vieeei;
rat,ttax or mina! 'aws, or to federa. aw enforcement arc inteuigenue agencies to combat torter'sm.
You must provice you- TIN wiether or not you are required to 1:ie a tax return. Payers must genera 'y vvithhod 20% of taxabe nterettt, dividend, anti certan ctner
payments to a payee who doee not gose a TIN to a payer. Certain porta:ties may ASO agnaly.
Fund 29330 GR0000000514
Revenue
1060601-115096-610313
FY 2010
Federal Operating Grants 57.892
Expense
1060601-115096-750154 $7,892
a. -0-
FINANCE COMMITTEE
„ger._
Expendable Equip.
Finance Committee Vote.
Motion carried unanimously on a rol; call vote
11'
September 1, 2010
FISCAL NOTE (MISC. 110212)
BY FINANCE COMMITTEE, TOM MIDDLETON. CHAIRPERSON
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES — HOMELAND SECURITY DIVISION —
ACCEPTANCE FOR 2009 MICHIGAN CITIZEN CORPS PROGRAM GRANT — MONROE COUNTY
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS
Chairperson, Ladies and Gentlemen:
Pursuant to Rule X1I-C of this Board, the Finance Committee has reviewed the above-referenced
resolution and finds:
1. The State of Michigan has awarded Oakiand County as f.duciary for Monroe County grant
funding in an amount up to, but not exceeding $7.892 as reimbursement for qualified
expenses related to the Michigan Citizen Corps Program.
2 The grart funds cover the period of August 1, 2009 through April 30. 2312.
3. The graht award is an increase of $4,565 over the prior year grant award of $3,327.
4. The funds will be used to establish Citizen Corps Councils to support the oversight and
outreach functions of the councils and to expand CERT training essential for developing the
Citizen Corps.
5. The Michigan Department of State Police Emergency Management Division will serve as tne
administrating agency for this grant.
6. The FY2010 Budget is amended as follows to reflect the grant award:
Resolution #10212 September 1, 2010
Moved by Nash supported by Gosselin the resolutions (with fiscal notes attached) on the Consent
Agenda be adopted.
AYES: Burns, Coulter, Douglas, Gershenson. Gingen. Gosselin, Greimel, Hatchett, Jackson,
Jacobsen, Long, McGillivray, Middleton. Nash, Potts, Runestad, Schwartz, Scott, Taub,
Woodward, Zack, Bullard. (22)
NAYS: None. (0)
A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the Consent
Agenda were adopted.
OEM
I EBY ergE—TNEIGREGOING RESOLUTION
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, Ruth Johnson. Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true
and accurate copy of a resolution adopted by the Oakland County Board of Commissioners on
September 1, 2010, with the original record thereof now remaining in my office.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of the County of Oakland at
Pontiac, Michigan this 1st day of September, 2010.
ged
Ruth Johnson, County Clerk