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HomeMy WebLinkAboutResolutions - 2011.04.21 - 18204MISCELLANEOUS RESOLUTION #11070 April 21, 2011 BY: GENERAL GOVERNMENT COMMITTEE, Christine Long, Chairperson IN RE: HEALTH AND HUMAN SERVICES - HOMELAND SECURITY DIVISION - 2010-2011 HAZA I OUS MATERIALS EMERGENCY PREPAREDNESS GRANT AGREEMENT TO: THE OAKLAND COUNTY BOARD OF COMMISSIONERS Mr. Chairperson, Ladies and Gentlemen: WHEREAS the Superfund Amendment and Reauthorization Act (SARA) of 1986, Title III, requires the planning and provisions for community right-to-know on extremely hazardous substances in local communities; and WHEREAS the Oakland County Local Emergency Planning Committee (LEPC) has been organized and meets minimum criteria in performing planning functions; and WHEREAS the Hazardous Materials Emergency Preparedness (HMEP) grant provides funds to LEPCs for the purpose of enhancing hazardous material response planning; and WHEREAS an application was submitted, and Oakland County has been notified that the LEPC is eligible to receive $7,870 for the submittal for new and updated plans during the grant period of October I, 2010 through September 30, 2011; and WHEREAS the required 20% in kind match of $1,968 will be used for PTNE staff salary to support the LEPC planning effort; and WHEREAS no reports are required and the funds will be received upon submittal of the plans as a work product; and WHEREAS the grant agreement has been processed through the County Executive's Contract Review Process and the Board of Commissioners' Grant Acceptance Procedures. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners authorizes acceptance of the Hazardous Materials Emergency Preparedness (HMEP) grant in the amount of $7,870 from the Michigan Department of State Police, Emergency Management and Homeland Security Division. BE IT FURTHER RESOLVED that the Chairperson of the Oakland County Board of Commissioners is authorized to execute the grant agreement of $7,870 and a 20% match of $1,968 for a total of $9,838 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 COMMITTEE GENERAL GOVERNMENT COMMITTEE; Motion carried unanimously on a roll call vote. RA Page 1 of 3 Smith, Laverne R From: Piir, Gala [piirg@oakgov.com ] Sent: Tuesday, March 22, 2011 4:53 PM To: 'Smith, Tricia'; Stoddard, Sara; 'Ted Quisenberry'; 'Pisacreta, Antonio' Subject: GRANT REVIEW SIGN OFF - Homeland Security - 2010 - 2011 Hazardous Materials Emergency Preparedness (HMEP) - Grant Acceptance NT REVIEW SIGN OFF — Homeland Security GRANT NAME: 2010 - 2011 Hazardous Materials Emergency Preparedness (HMEP) FUNDING AGENCY: Michigan State Police Emergency Management and Homeland Security Division DEPARTMENT CONTACT PERSON: Tricia Smith 248 858-5371 STATUS: Grant Acceptance DATE: March 22, 2011 Pursuant to Misc. Resolution #01320, 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, DEPARTMENT REVIEW Department of Management and Budget: Approved. — Laurie Van Pelt (3/7/2011) Department of Human Resources: Approved. — Karen Jones (3/7/2011) Risk Management and Safety: Approved by Risk Management. — Andrea Plotkowski (3/17/2011) Corporation Counsel: After reviewing the above-referenced grant agreement, I found no legal issues that must be resolved before the grant is executed. - Jody S. Hall (3/11/2011) COMPLIANCE The grant agreement references a number of specific federal and state regulations. Below is a list of the specifically cited compliance related documents for this grant. Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments (49 CFR, Part 18) http://www.acces4,9s3o.gov/nara/cfr/waisidx_04/49cfr18_04.html Federal Office of Management and Budget (OMB) Circular No. A-87, A-102, and A-133 http://www.whitehouse ,gov/ornb/circulars/inciex.html 3/22/2011 3 Page 2 of Cost Principles for State, Local and Indian Tribal Governments (OMB CIRCULAR A-87) (2 CFR Part 225) http://www.access.gpo.gov/nara/cfr/waisidxo8/2cfr22508]itrnl NIMS Compliance (National Incident Management System) iii tp ://www. fema.gov/emergency/Mms/ Single Audit Act of 1984 (with amendments in 1996) http://www.whitehouse.gov/omb/financial/firn_single_audit.html Executive Order 13347 - Individuals With Disabilities in Emergency Preparedness http://www.fema.gov/pdfiemergency/nims/nims_executive_order_13347.pdf Title VI of the Civil Rights Act of 1964 (42 U.S.0 Section 2000d) http://www.usdoigov/ert/cor/coordititlevistat.htm Michigan Elliott-Larsen Civil Rights Act — "Act 453 of 1976" http://www.legislature.mt.gov/(uOixgeltmrj5z55z2utwv45)/mileg.aspx7page —getobject&objectname----mel-Act-453-of- 1976&queryid=14718540 Michigan Persons with Disabilities Civil Rights Act — "Act 220 of 1976" http://www.legislature.mi.gov/(uq3lxgeltmrj5z55z2uiwv45)/mileg.aspx?page —getobieet&objectname=mcl-Act-220-of- 1976&queryid=14718589 Michigan State Contracts with Certain Employers Prohibited — Act 278 of 1980 http://www.legis I ature.mi.gov/(S (eal rau4unclgbvh10s21355))/mi I eg.aspx?page=getObjeet8zobj ectN ame—md-Act-278- of-1980 Department of Homeland Security — Protected Critical Infrastructure Information (6 CFR Part 29) http://ecfr.gpoaccess.gov/cgi/t/text/text-idx7c=ecfr841=/ecfrbrowse/TItle06/6efr29_main_02.tpl Department of Homeland Security — Protection of Sensitive Security Information (49 CFR Part 1520) http ://wvvw.access.gpo.gov/nara/cfr/wa is i dx_04/49cfr1520_04.html Standard Assurances Restrictions on Lobbying (28 CFR part 69) lIttp://ww-w.aceess.gpo.gov/nara/cfr/waisidx_04/28cfr69_04.html. Executive Order 12549 — Debarment and Suspension http://vvww. arch ives.gov/federal-regi ster/codi fication/ex ecutive-order/ 2549.html Government-Wide Debarment and Suspension (28 CFR, Part 67) http://www.access.g,po.gov/nara/cfr/wa is idx_04/28cfr67_04.h Drug-Free Workplace Act of 1988 http://frwebgate.access.gpo.gov/egt-bin/getdoe.cgt?dbname=browse_usc&docid=Cite:+41.USC701 Gala V. Piir Grants Compliance and Programs Coordinator Oakland County Fiscal Services Division Phone (248) 858-1037 Fax (248) 858-9724 piirgeoakgoy.com 3/22/2011 4 STATE OF IVI1CHIGAN DEPARTMENT OF STATE POLICE LANSING RICK SNYDER GOVERNOR COL. KRISTE KIBBEY ETUE DRECTOR February 3, 2011 Mr. Theodore Quisenberry, Administrator Oakland County Homeland Security 1200 North Telegraph Road Pontiac, Michigan 48341 Dear Mr. Quisenberry: Enclosed is the 2011 Hazardous Materials Emergency Preparedness (HMEP) Grant package for the County of Oakland. Please return the required grant documentation listed on the enclosed Subgrantee Checklist to our office by March 21, 2011. Documents should be mailed to the following address: ATTN: Mr. Jim Breuker Emergency Management and Homeland Security Division Michigan State Police 4000 Collins Road Lansing, Michigan 48910 Note that the format of the grant agreement document has been updated during the past year. The structure and contents of the document will not be exactly the same as HMEP grant agreements from past years. If you have any questions regarding this correspondence or the 2011 HMEP Grant Program, please contact Mr. Jim Breuker at (517) 333-7776. Sincerely, • W. Thomas Sands, Captain Deputy State Director of Emergency Management and Homeland Security WTS:SB:dl Enclosures (10) cc: LEPC Chairperson (letter only) MSP/EMHSD District Coordinators (letter only) 4000 COLLINS ROAD LANSING, MICHIGAN 48910 www.michigan.govinisp (517) 336-6198 Planning Personnel: whose salary and fringe benefits cost $ 22.13 (name) per hour, will work approximately Glori Macias HMEP 2010-2011 PLANNING GRANT AGREEMENT IN-KIND MATCH The County of Oakland Local Emergency Planning Committee (LEPC) has been allocated the funding amount specified in the attached grant agreement. Therefore, a local fund match of $1968.00 is required. The LEPC agrees to use the following as its in-kind match: (This can be any non-federal money from a government jurisdiction, industry, or other organization represented on the LEPC. Staff paid with EMPG/HSGP funds cannot be used for match.) 1,000 hours on LEPC planning. , El Secretarial: (name of employee or of secretarial service) whose salary and fringe benefits cost $ per hour, will work approximately hours on LEPC business. Office Space: (government jurisdiction or other entity) will provide a square foot office located at to the LEPC at a cost of $ per square foot. Mailing: will provide $ (government jurisdiction or other entity) toward LEPC related mailings Printing: (government jurisdiction or other entity) toward LEPC related printing. Other: (Describe) will provide $ State of Michigan 2011 Hazardous rin aterials Emergency Preparedness Planning Grant Agreement September 30, 2010 to September 30, 2011 CFDA Number: 20.703 Grant Number: HM-HMP-0189-10-01-00 This 2011 Hazardous Materials Emergency Preparedness (HMEP) Grant Program planning 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 HMEP funds to the subgrantee for the review of new Superfund Amendments and Reauthorization Act (SARA), Title ill, Section 302, hazardous materials emergency response plans, as well as for the updating of previously submitted plans. U. Federal Objectives A. Provide assistance to public sector employees through planning grants to states, territories, and Native American tribes for emergency response. B. Increase state, territorial, tribal, and local effectiveness in implementation of the federal Emergency Planning and Community Right-to-Know act of 1986. C. Encourage a comprehensive approach to emergency planning by incorporating the unique challenges of response to transportation situations. Ill. Statutory Authority Funding for the 2011 HMEP Grant Program (for both planning and training) is authorized by the Federal Hazardous Materials Transportation Law (49 U.S.C. 5101 et seq.). Under this law, offerors and transporters of certain types and quantities of hazardous materials, including hazardous wastes, are required to file a registration statement with the U.S. Department of Transportation and to pay an annual fee. This program began in 1992 and is administered by the Associate Administrator for Hazardous Materials Safety, Pipeline and Hazardous Materials Safety Administration (PHMSA). The registration regulations are found at 49 CFR 107.601- 107.620, located at http://www.access.gpo.govinara/cfriwaisidx 04149cfr110_04.html. The Subgrantee agrees to comply with all 2011 HMEP Program requirements. The Subgrantee also agrees to comply with the following regulations: A. Administrative Requirements 1. 49 CFR, Part 18, Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments, iodated at http://www.dot.goviost/m60igrant/49cfrl 8.htm 2. OMB Circular A-102, "Grants and Cooperative Agreements with State and Local Governments", as adopted by DOT in 49 CFR 18, is incorporated by reference into this award. 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&tp1=/ecfrbrowseffitle02/2cfr225_main 02.tpl 2. Federal Acquisition Regulations (FAR), Part 31.2 Contract Cost Principles and Procedures, Contracts with Commercial Organizations, located at https://www.acquisition.gov/far/html/Subpart °/02031_2,html#wp1095552 2011 HMEP Planning Grant County of Oakland Page 2 of 7 C. Audit Requirements 1, OMB Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations, located at http://www.whitehouse.gov/om b/circularsia 1 33/al 33.ntml IV. HMEP Planning Grant Program Award Amount and Restrictions The COUNTY OF OAKLAND is allocated $7870.00 under the 2011 HMEP Planning Grant. This funding will be awarded as described in "Hazardous Materials Emergency Preparedness Planning Grant Instructions 2010-11", attached to this agreement. This allocation is dependant upon the level of federal funding and may be reduced if federal funding is reduced .Any unused HMEP grant funds remaining at the end of the grant year will be used to increase the reimbursement for accepted new SARA Title III plans submitted by participating Local Emergency Planning Committees (LEPCs). The Subgrantee's payment per new plan will be recalculated using these funds and the award to the Subgrantee for the number of new plans it submitted will be adjusted. This may affect the match amount required for this grant. Based on the Subgrantee's application, a match amount of $1968.00 is required. However, the Subgrantee must be prepared to match all funds received through this contract (which equates to 25% of any federal funds received), as noted in Section Ill, D of the "Hazardous Materials Emergency Preparedness Planning Grant Instructions 2010-11", attached to this contract. V. Responsibilities of the Subgrantee 2011 HMEP Planning Grant 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 be 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 comply with all applicable federal and state regulations, including, but not limited to, the following: A. In addition to this 2011 HMEP Planning Grant agreement, the Subgrantee shall complete, sign, and submit to Subgrantor the following documents, which are incorporated by reference into this grant agreement: 1. Hazardous Materials Emergency Preparedness Planning Grant Instructions 201 0-1 1 2. HMEP 2010-2011 Planning Grant Agreement In-Kind Match form 3. Assurance of Compliance with Title VI of Civil Rights Act of 1964 4. Standard Assurances 5. Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirement 6. State of Michigan Audit Certification form (EMD-053) 7. Request for Taxpayer Identification Number and Certification (W-9) 8. Plan Review List HMEP Grant Year 2010-2011 9. Other documents that may be required by federal or state officials B. Meet the LEPC eligibility requirements, as stated in the attached "Hazardous Materials Emergency Preparedness Planning Grant Instructions 2010-11", Section II. C. Submit new and updated SARA Title III (Section 302) community hazardous materials emergency response plans to the Emergency Management and Homeland Security Division no later than July 1, 2011. Support Grant documentation must meet the requirements stated in the attached, "Hazardous Materials Emergency Preparedness Planning Grant Instructions 2010-11", Section IV. B, or forfeit that portion of the grant award. 2011 HMEP Planning Grant County of Oakland Page 3 of 7 D. Expend the planning grant for expenses incurred in developing the off-site response plans including, but not limited to, per diem for LEPC members, printing, general office administrative expenses and equipment, and LEPC planning staff costs. For guidance on allowable costs and program activities, please refer to Section V. B of the "Hazardous Materials Emergency Preparedness Planning Grant Instructions 2010-2011" document attached to this agreement, or contact the SARA program staff at the Emergency Management and Homeland Security Division, Michigan State Police. E. Forfeit a prorated share of the allocation for the number of new plans and updated plans that were not submitted by the Subgrantee. F. The Subgrantee is required to comply with National Incident Management System (NIMS) requirements to be eligible to receive federal preparedness funds awarded through the Department of Commerce. NIMS information is available at http://www.fema.gov/emergency/nims . More information on complying with NIMS is available from the State NIMS Coordinator. G. Comply with applicable financial and administrative requirements set forth in the current edition of 49 CFR, Part 18 including, but not limited to, 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 financial records, statistical records, supporting documents, and other materials pertinent to the 2011 HMEP Planning Grant for at least three years after the grant is closed by the awarding Federal 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 49 CFR, Part 18. H. Integrate individuals with disabilities into emergency planning, in compliance with Executive Order 13347. I. Make all purchases in accordance with federal and state grant guidance and local purchasing policies. J. This agreement covers eligible costs from September 30, 2010 to September 30, 2011. VI. Responsibilities of Subgrantor The Subgrantor, in accordance with the general purposes and objectives of this grant agreement, will: A. Administer the HMEP Planning Grant in accordance with all applicable federal and state regulations and guidelines and provide required reports documenting this administration. B. Provide direction and technical assistance to the Subgrantee. C. Provide to the Subgrantee any special report forms and reporting formats (templates) required for operation of the program. D. Provide copies of plan review standards and other information to be used in determining acceptable work products. E. Review work products against established standards. Reimburse the Subgrantee, in accordance with this grant agreement, based on appropriate documentation submitted by the Subgrantee. 2011 HMEP Planning Grant County of Oakland Page 4 of 7 G. At its discretion, independently, or in conjunction with DOT, conduct random on-site reviews with the Subgrantee. VII. Reporting Procedures Submit new and updated SARA Title III (Section 302) community hazardous materials emergency response plans, and identify which facility plans were updated on the enclosed "Plan Review List" sheet, as stated in the 201 0-201 1 application (attached) to the Emergency Management and Homeland Security Division, no later than July 1, 2011. If a Support Grant was requested, the LEPC must meet the requirements stated in the attached "Hazardous Materials Emergency Preparedness Planning Grant Instructions 2010-2011", Section IV. B, or forfeit that portion of the grant award. VIII. Payment Procedures Upon receipt, review, and acceptance of all work products and other requirements, as referenced in this contract, the Subgrantor will calculate the payment to be made to the Subgrantee and forward such payment to the Subgrantee's fiduciary agent. See the "Hazardous Materials Emergency Preparedness Planning Grant Instructions 2010-11" document attached to this agreement for further information. IX. Employment Matters Subgrantee shall comply with Title VI of the Civil Rights Act of 1964, as amended, the Elliott-Larsen Civil Rights Act, 1976 PA 453, as amended, MCL 37.2101 et seq., the Persons with Disabilities Civil Rights Act, 1976 PA 220, as amended, MCL 37.1101 et 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 employment, 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 breach of this covenant is a material breach of the grant agreement. The Subgrantee shall ensure that no subcontractor, manufacturer, or supplier of Subgrantee 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 System, located at vvvvwepls.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 specifically understood and agreed that neither party will indemnify the other party in such litigation. This is not to be construed as a waiver of governmental immunity. XI, 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 third party any rights or obligations enforceable in their favor. 2011 HMEP Planning Grant County of Oakland Page 5 of 7 XII. Grant Agreement Period This grant agreement is in full force and effect from September 30, 2010 to September 30, 2011, No costs eligible under this grant agreement shall be incurred before the 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 terminated 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 the terms of the grant agreement. Upon any such term,nation, the Subgrantee agrees to return to the Subgrantor any funds not authorized for use, and the Subgrantor shall have no further obligation to reimburse the Subgrantee. 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 both 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 changes of dates, budget, or services indicated in this grant agreement, as well as Changes of address or personnel affecting this grant agreement. Changes in dates, budget, or services are subject to prior written approval of Subgrantor. 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 subgrant funding, in whole or in part, or other measures may be imposed for any of the following reasons: O Failure to expend funds in a timely manner consistent with the grant milestones, guidance, and assurances. • Failure to comply with the 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. O Proposal or implementation of substantial plan changes to the extent that, if originally submitted, the project would not have been 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 Subgrantee 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, theft, 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 federal antitrust statutes; or convicted of any other criminal offense which ; in the sole discretion of the Subgrantor, reflects on the Subgrantee's business integrity. 2011 HMEP Planning Grant County of Oakland Page 6 of 7 XV. Freedom of Information Act (FOIA) Much of the information submitted in the course of applying for 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. Printed Name Title Commissioners Signature Date W. Thomas Sands. Captain Deputy State Director of Emergency Management and Homeland Security Printed Name Title Signature Date 2011 HMLP Planning Grant County of Oakland - Page 7 of 7 XVI, Official Certification For the Su bgrantee 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. Count• of Oakland Name of Jurisdiction Michael J. Gingell Chairman, Oakland County Board of For the Su bgrantor (Michigan State Police, Emergency Management and Homeland Security Division Tricia Smith From: Sent: To: Cc: Subject: Attachments: Piir, Gaia <piirg@oakgov.com > Monday, March 07, 2011 2:10 PM 'VanPelt, Laurie'; 'Davis, Patricia', Jones, Karen; 'Secontine, Julie' 'Smith, Tricia'; Stoddard, Sara; 'Ted Quisenberry'; 'Pisacreta, Antonio' Grant Review: Homeland Security Division - 2010-2011 Hazardous Materials Emergency Preparedness (HMEP) - Grant Acceptance 2011_HMEP_Agreement.pdf GRANT REVIEW FORM TO: REVIEW DEPARTMENTS — Laurie Van Pelt -- Karen Jones — Julie Secontine — Pat Davis RE: GRANT CONTRACT REVIEW RESPONSE — Health & Human Services, Homeland Security Division 2010-2011 Hazardous Materials Emergency Preparedness (IIMEP) Michigan State Police Emergency .Management and Homeland Security Division Attached to this email please find the grant document(s) to be reviewed. Please provide your review stating your APPROVAL, APPROVAL WITH MODIFICATION, or DISAPPROVAL, with supporting comments, via reply (to all) of this email. • Time Frame for Returned Comments: March 21, 2011 GRANT INFORMATION • Date: March 7, 2011 Operating Department: Health & Human Services, Homeland Security Division Department Contact: Tricia Smith Contact Phone: 248 858-5371 Document Identification Number: REVIEW STATUS: Acceptance — Resolution required Funding Period: 9/30/10 through 9/30/11 New Facility / Additional Office Space Needs: None IT Resources (New Computer Hardware / Software Needs or Purchases): None M/WBE Requirements: Yes Level: one Required by: Compliance with OMB Circular A-102 Funding Continuation/New: Continuation • Application Total Project Amount: $7,870 Prior Year Total Funding: $10,800 (pending) New Grant Funded Positions Request: None Changes to Current Positions: None Grantor Funds: $7,870 Total Budget: $9,838 Match and Source: $1,968 is 20% in kind match utilizing PTNE staff salary -M1t14.3nnn Aill161.9n69, _ _ PROJECT SYNOPSIS The purpose of the grant is to assist local communities in preparing federally mandated SARA Title 111, Section 302 Extremely Hazardous Materials (EHS) off-site response plans. Allocations are dependent upon the EFIS facility completing required MDEQ paperwork before a plan can be accepted by IVISP EMEISD, No reports are required. We anticipate receiving $1,000 support grant, $4,950 for plan updates ($25 x 198 plans) and $1,920 for new plans ($160 x 12 plans). The 20% in kind match of $1,968 will be used for PTNE staff salary. Gala V. Piir Grants Compliance and Programs Coordinator Oakland County Fiscal Services Division Phone (248) 858-1037 Fax (248) 858-9724 piirg@oakgov.com 2 1. November 2010 -IAZA I OUS MATERIALS EMERGENCY PREPAREDNESS PLANNING GRANT INSTRUCTIONS 2010-11 GRANT PROGRAM DESCRIPTION The Department of State Police, Emergency Management and Homeland Security Division (EMHSD) has been designated by the Governor's office to administer the Hazardous Material . Emergency Preparedness (HMEP) planning grant program. Grants are being made available to Local Emergency Planning Committees (LEPCs) for the 'purpose of enhancing hazardous material response planning. - ELIGIBILITY REQUIREMENTS In order to be eligible to receive funding through this grant, LEPCs must: A. Be legally appointed by the Michigan Citizen-Community Emergency Response Coordinating Council (otherwise known as the State Emergency. Response Commission - SERC); B. Have an appointed chairperson *; C. Have an appointed information coordinator *; D. Have an appointed emergency management coordinator *; E. Meet at least quarterly and have an established meeting schedule; F. Assure that a 20% in-kind match will be available for all funding received through this grant. In-kind match includes non-federally funded LEPC member time, office space, secretarial support, LEPC office and administrative expenses, etc.; 0. Assure county or municipal compliance with Title VI of the Civil Rights Act of 1964; H. Assure county or municipal compliance with the following certifications: 1. Lobbying; 2. Debarment, suspension and other responsibility matters, and 3. Drug-free workplace requirements. *As vacancies occur in these three positions, new appointments must be made and submitted to the ENIHSD on the proper forms. The forms are available by contacting (517) 333-2749 or on the web at www.mich4,Yan.goviemlisd (click on: Hazardous Materials ---> Local Hazardous Materials Planning). November 2010 Documentation for items B through E must be submitted with the application. (See Section VII.) HI. APPLICATION PROCESS A. Deadline: All applications roust be received at the Emergency Management and Homeland Security Division (EMFISD) by December 17, 2010, and include an LEPC schedule for 2010-11. Applications without a schedule will not be processed. B. Application Mailing Address: Submit the completed application to: ATTN: Jim Breuker, SARA Title III Program, Michigan State Police, Emergency Management and Homeland Security Division, 4000 Collins Road, Lansing, Michigan 48910. C. Agreement Finalized: The EMFISD will review all applications for completeness and accuracy. LEPCs with approved applications will then be sent two signed HMEP Grant Agreements. These agreements will contain specific products which must be submitted by the LEPC to receive HMEP funding. Funding levels stated in the agreement are subject to the availability of federal funds. The LEPC must sign the agreements, return one to the EMHSD, and retain one copy for LEPC files. The original signed agreement must be returned to the EIVIHSD to the attention of the SARA Title III Program (see Item B above) by the date specified in the cover letter received with these instructions. D. Matching Funds Identified: When the LEPC receives the HMEP Grant Agreement, it will also receive a folin on which to document its matching funds. Federal grants require matching funds to be calculated against TOTAL program costs. For grant purposes, total program costs are calculated by dividing the proposed reimbursements from this grant by .80. The resulting amount (total program cost) is then multiplied by .20 to get the match required for this grant. The end result of this calculation is that the match amount required actually comes to 25% of the proposed federal funding specified in the contract. The Matching Funds form must be returned to the Emergency Management and Homeland Security Division with the HMEP Grant Agreement. The form is used to estimate matching funds based upon the proposed agreement amount (also see IT F, above). However, the grantee must be prepared to match funds based on the amount of grant funding actually received for the contract period, including additional funding received in excess of the agreement amount. STAFF POSITIONS AND/OR PROGRAMS SUPPORTED B FEDERAL FUNDS CANNOT BE USED AS MATCH FOR THIS GRANT. 2 November 2010 TV. ALLOCATION FORMULA A. Plan and Update Payments: The EMHSD will reimburse LEPCs for new and updated plans. The estimated reimbursement rate for 2010-2011 is $160 for new plans and $25 for updated plans. Facilities must be on the enclosed 302 site list or be on the 302 site list by June 30, 2011. Plans that are added to the 302 site list after June 30, 2011, may not receive payment from the 2010-2011 HMEP Grant. To receive this funding, items B and/or C on the bottom of the "Local Emergency Planning Committee Application for Hazardous Material Emergency Preparedness Grant" form must be completed. B. Support Grant Payments: Each LEPC is eligible for a $1000 Support Grant. To qualify for the Support grant, an LEPC must: - Meet at least quarterly, and verify that meetings have been held by sending the Emergency Management and Homeland Security Division a copy of the meeting minutes or an attendance roster. - Annually update its officer/membership list and submit it to the EMHSD. -- Incorporate its completed, off-site response plans into the city/county EOP/EAG. - Review the city/county EOP/EAG annually to make sure its hazmat response section is current. Verification of the above items, via a form signed by the LEPC Chair and/or the Local Emergency Management Coordinator, will be requested by EMEISD prior to the end of the grant year. NOTE: It is recommended that during this grant year, each LEPC update all of the Section 302 off-site response plans that it has completed, and develop new off-site response plans for all sites that are not yet complete. V. PLANNING GRANT REQUIREMENTS LEPCs are eligible fbr their allocation, if they meet the following requirements: A. Products: The intent of the planning grant is to accomplish the development of new off- site Hazardous Material Response Plans and updates of previously submitted off-site response plans for each SARA Title III Section 302 site in Michigan. Plans must be submitted to the appropriate EMHSD district coordinator by the date specified in each LEPC's contract. A list of updated plans (a plan update includes verification and updating by the LEPC of the following: Emergency contact information, types of 3 November 2010 extremely hazardous substances (EHS) and their quantities kept on site, storage locations, and any other items which may change over time) for sites on the current 302 site list must also be submitted by that date. The list must include the site name, DNR.E SARA 1.D. number, and name of facility contact that assisted with the review. A form for this submittal is located on the EMHSD website. This list can be submitted directly to the address noted in Item III B above, and does not need to be submitted to the EMLISD District Coordinator. B. Eligible Expenses: Funds received from this grant are to be utilized for expenses that support and facilitate the development and/or updating of required off-site plans. These expenses include, but are not limited to: Training for LEPC members, as long as it relates to the LEPC' s preparation and planning mission. Development, improvement, and implementation of emergency plans required under SARA Title III. Exercises which test LEPC plans. Enhancement of LEPC plans, e.g., improving the hazard analysis, enhancing response procedures involving transportation of hazardous materials (including radioactive materials). Commodity flow studies. Needs analysis for establishing regional response teams. Technical staff to support the planning effort. Assessment of local response capabilities. Types of eligible costs include: Meeting room rental Per Diem for LEPC members Public notices Printing costs Office administrative expenses LEPC staff costs Note: Computer hardware is not an allowable purchase, nor is software because it is usually considered an "operational system," which is any type of system that could be used in an emergency response, e.g., reverse 9-1-1 calling systems, hazmat databases, etc. 4 November 2010 Documentation of expenditures need not be submitted to the Emergency Management and Homeland Security Division, hut must be made available upon request. C. Off-Site Response Plans: New off-site plans must be submitted to the appropriate EMHSD District Coordinator for review by July I, 2011. If an LEPC proposes to complete updates of previous plans, it must submit a list of completed updates to the EMHSD at the address noted in III. B above, by July 1, 2011. If an LEPC completes fewer updates and/or new off-site response plans than it proposes, its award will be prorated according to the number of plans/updates accepted by the EMHSD. Note: Upon request, LEPCs may be required to make updated plans available to the EIVIHSD for verification purposes. D. EMHSD Information Requests The LEPC must provide the EMFISD with information on how HMEP funds were used and what was accomplished, upon request. Other information requests related to LEPC operations may also be sent to LEPCs. VI. REIMBURSEMENT PROCESS Payment to LEPCs will be processed by the EMHSD upon acceptance of the LEPC's products (or a prorated portion, as noted above) as specified in its contract. VII. ITEMS TO INCLUDE WIT II APPLICATION A. HMEP Planning Grant Application form. (Appropriate boxes for the type of grant requested must be checked on the application, and Officer/Emergency Manager information must be included.) 5 November 2010 B. LEPC meeting schedule for the upcoming year. Questions concerning the Hazardous Materials Emergency Preparedness Planning Grant should be directed to Mr. Jim Breuker, Michigan State Police, Emergency Management and Homeland Security Division, at (517) 333-7776, or e-mail at breukerjl (q),michigan.gov . 6 ASSURANCE OF COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 Appendix A, B, and C APPENDIX A ASSURANCE OF COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 DEPARTMENT OF TRANSPORTATION The State/Territory/Native American Tribe of Oakland County (hereinafter referred to as the "Recipient") HEREBY AGREES THAT as a condition to receiving any Federal financial assistance from the Department of Transportation it will comply with Title VI of the Civil Rights Act of 1964,78 Stat. 252,42 U.S.C, 2000d-42 U.S.C. 2000d-4 (hereinafter referred to as the Act) and all requirements imposed by or pursuant to Title 49, Code of Federal Regulations, Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Nondiscrimination in Federally-assisted Programs of the Department of Transportation-Effectuation of Title VI of the Civil Rights Act of 1964 (hereinafter referred to as the Regulations) and other pertinent directives, to the end that in accordance with the Act, Regulations, and other pertinent directives, no person in the United States shall , on the grounds of race, color, sex or national origin, be excluded from participation in, be denied the benefits of or be otherwise subjected to discrimination under any program or activity for which the Recipient receives Federal financial assistance from the Department of Transportation, and HEREBY GIVES ASSURANCE THAT it will promptly take any measures necessary to effectuate this agreement. This assurance is required by subsection 21.7(a) (1) of the Regulations. More specifically and without limiting the above general assurance, the Recipient hereby gives the following specific assurance with respect to the project: 1. That the Recipient agrees that each "program" and each "facility" as defined in subsections 21.23(e) and 21.23(b) of the Regulations, will be (with regard to a :`program") conducted, or will be (with regard to "facility") operated in compliance with all requirements imposed by, or pursuant to, the Regulations. 2. That the Recipient shall insert the following notification in all solicitations for bids for work or material subject to the Regulations and, in adapted form in all proposals for negotiated agreements: The Recipient, in accordance with Title VI of the Civil Rights Act of 1964, 78 Stat. 252, 42 U.S.C. 2000d-4 and Title 49 Code of Federal Regulations, Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Nondiscrimination in Federally-assisted Programs of the Department of Transportation issued pursuant to such Act, hereby notifies all bidders that it will affirmatively insure that in regard to any contract entered into pursuant to this advertisement, minority business enterprises will be afforded full opportunity to submit bids in response to this invitation and will not be discriminated against on the grounds of race, color, sex or national origin in consideration for an award. That the Recipient shall insert the clauses of Appendix B of this assurance in every contract subject to the Act and the Regulations. That this assurance obligates the Recipient for the period during which Federal financial assistance is extended to the project. The Recipient shall provide for such methods of administration for the program as are found by the Secretary of Transportation or the official to whom he delegates specific authority to give reasonable guarantee that it, other recipients, subgrantee.,s, contractors, transferees, successors in interest, and other participants of Federal financial assistance under such program will comply with all requirements imposed or pursuant to the Act, the Regulations and this assurance. The Reeipient agrees that the United States has a right to seek judicial enforcement with regard to any matter arising under the Act, and Regulations, and this assurance. THIS ASSURANCE is given in consideration of and for the purpose of obtaining any and all Federal grants, loans, contrasts, property, discounts or other Federal financial assistance extended after the date hereof to the Recipient by the Department of Transportation and is binding on it, other recipients, subgrantees, contractors, subcontractors, transferees, successors in interest and other participants in the Department of Transportation Program. The person or persons whose signatures appear below are authorized to sign this assurance on behalf of the Recipients. Oakland County Recipient Signature of Authorized Official Date APPENDIX B ASSURANCE OF COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 DEPARTMENT OF TRANSPORTATION During the performance of this contract, the contractor, for itself, its assignees and successors in interest (hereinafter referred to as the "contractor") agrees as follows: 1. Compliance with Regulations: The contractor shall comply with the Regulations relative to nondiscrimination in Federally assisted programs of the Department of Transportation (hereinafter, "DOT") Title 49, Code of Federal Regulations, Part 21, as they may be amended from time to time, (hereinafter referred to as the Regulations), which are herein incorporated by reference and made a part of this contract. 2. Nondiscrimination: The contractor, with regard to the work preformed by it during the contract, shall not discriminate on the grounds of race, color, sex, or national origin in the selection and retention of subcontractors, including procurements of materials and leases of equipment. The contractor shall not participate either directly or indirectly in the discrimination prohibited by Section 21.5 of the Regulations, including employment practices when the contract covers a program set forth in Appendix B of the Regulations. 3. Solicitation for Subcontractors Including Procurements of Materials and Equipment: In all solicitations either by competitive bidding or negotiation made by the contractor for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the contractor of the contractor's obligations under this contract and the Regulations relative to nondiscrimination on the grounds of race, color, sex, or national origin. 4. Information and Reports: The contractor shall provide all information and reports required by the Regulations or directives issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its facilities as may be determined by the State/Territory/Native American Tribe of Oakland County or the Pipeline and Hazardous Materials Safety Administration (PHMSA) to be pertinent to ascertain compliance with such Regulations, orders and instructions. Where any information required of a contractor is in the exclusive possession of another who fails or refuses to furnish this information the contractor shall so certify to the State/Territory/Native American Tribe of Oakland County or the Pipeline and Hazardous Materials Safety Administration as appropriate, and shall set forth what efforts it has made to obtain the information. 5. Sanctions for Noncompliance: In the event of the contractor's noncompliance with nondiscrimination provisions of this contract, the State/Territory/Native American 1ribe of Oakland County shall impose contract sanctions as it or the Pipeline and Hazardous Materials Safety Administration may determine to be appropriate, including, but not limited to: (a) Withholding of payments to the contractor under the contract until the contractor complies; and/or (b) Cancellation, termination, or suspension of the contract, in whole or in part. 6. Incorporation of Provisions: The contractor shall include the provisions of paragraphs (1) through (6) in every subcontract, including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued pursuant thereto. The contractor shall take such action with respect to any subcontract or procurements as the State/Territory/Native American Tribe of Oakland County or the Pipeline and Hazardous Materials Safety Administration may direct as a means of enforcing such provisions including sanctions for noncompliance: Provided, however, that in the event a contractor becomes involved in, or is threatened with, litigation with a subcontract or supplier as a result of such direction, the contractor may request the State/Territory/Native American Tribe of Oakland County to enter into such litigation to protect the interests of the State/Territory/Native American Tribe of Oakland County , and, in addition the contractor may request the United States to enter into such litigation to protect the interest of the United States. APPENDIX C ASSURANCE OF COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 DEPARTMENT OF TRANSPORTATION The following clauses shall be included in all deeds, licenses, leases, permits, or similar instruments entered into by the State/Territory/Native American Tribe of Oakland County The [grantee, licensee, lessee, permittee, etc., as appropriate] for herself/himself, his/her heirs, personal representatives, successors in interest, and assigns, as a part of the consideration hereof, does hereby covenant and agree [in the case of deeds and leases add "as a covenant running with the land"] that in the event facilities are constructed, maintained, or otherwise operated on the said property described in this [deed, license, lease, permit, etc.] for a purpose for which a Department of Transportation program or activity is extended or for another purpose involving the provision of similar services or benefits, the [grantee, licensee; lessee,-pennittee; etc." shall maintainand operate s ,ach- - facilities and services in compliance with all other requirements imposed pursuant to Title . 49, Code of Federal Regulations, Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Nondiscrimination of Federally-Assisted Programs of the Department of Transportation - Effectuation of Title VI of the Civil Rights Act of 1964, and as said Regulations may be amended. [Include in licenses, leases, permits, etc.]* That in the event of breach of the above non discrimination covenants, State/Territory/Native American Tribe of Oakland County shall have the right to terminate the [license, lease, permit, etc.] and to re-enter and repossess said land and the facilities thereon, and hold the same as if said [licenses, lease, permit, etc.] had never been made or issued. [Include in deeds]* That in the event of breach of any of the above nondiscrimination covenants, State/Territory/Native American Tribe of Oakland County shall have the right to re-enter said lands and facilities thereon, and the above described lands and facilities shall thereupon revert to and vest in and become the absolute property of State/Territory/Native American Tribe of Oakland County and it's assigns. 711e following shall be included in all deeds, licenses, leases, permits, or similar agreements entered into by State/Territory/Native American Tribe of Oakland County The [grantee, licensee, lessee, perrnittee, etc., as appropriate] for herself/himself, his/her personal representatives successors in interest, and assigns, as a part of the consideration lereof, does hereby covenant and agree [in case of deeds, and leases add as a covenant gunning with the land"; that (1) no person on the grounds of race, color, sex, or national origin shall be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination in the use of said facilities, (2) that in the construction of any improvements on, over or under such land and the furnishing services thereon, no person on the grounds of race color, sex, or national origin shall be excluded from the participation in, be denied the benefits of, or be otherwise subjected to discrimination, and {3) that the [grantee, licensee, lessee, permittee, etc.] shall use the premises in compliance vith all other requirements imposed by or pursuant to Title 49, Code of Federal Regulations, Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Nondiscrimination in Federally-Assisted Programs of the Department of Transportation - Effectuation of Title VI of the Civil Rights Act of 1964, and as said Regulations may be amended. [Include in licenses, leases, permits, etc. That in the event of breach of any of the above nondiscrimination covenants, State/Tellitory/Native American Tribe of Oakland County shall have the right to terminate the [license, lease, permit, etc.] and to re-enter and repossess aid land and the facilities thereon, and hold the same as if said [license, lease, permit, etc.] had never been made or issued. [Include in deeds]* That in the event of breach of any of the above nondiscrimination covenants, State/Territory/Native American Tribe of Oakland County have the right to re- enter said land and facilities thereon, and the above described lands and facilities shall thereupon revert to and vest in and become the absolute property of State/Territory/Native American Tribe of Oakland County and its assigns. *Reverter clause and related language to be used only when it is determined that such a clause is necessary in order to effectuate the purpose of Title VI of the Civil Rights Act of 1964. OMB APPROVAL NO, 1121-0140 EXPIRES 01/31/2006 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-110, A-122, 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: 1. 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 seq.), 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(b)); 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.§ 12131-34); 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 goverrunental 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 seq.), 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 Program: FY 2011 Hazardous Materials Emergency Preparedness Grant CFDA Number: 20.703 Subgrantee information .Jurisdiction Name: Street Address: City, State, Zip Code: Oakland County 1200 N Telegraph Pontiac MI 48341 For MSP-EMD Use Only Reviewed By: Date: EMD-053 (03-2004) MICHIGAN STATE POLICE Emergency Management & Homeland Security Division 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 must submit a copy of their audit report to: Budget and Financial Services Division, Michigan Department of State Police, 333 South Grand Avenue, P.O. Box 30634, Lansing, Michigan 48909-0634, for each year they meet the funding threshold. Certification for Fiscal Year Ending (mmidd/yyyy): 09/3 0/1 1 (Check appropriate box) ri 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, F 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 received for the above listed program. A copy of the audit report will be submitted to: Budget and Financial Services Division, Michigan Department of State Police, 333 South Grand Avenue, P.O. Box 30634, Lansing, Michigan 48909-0634. (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 Authority: Act 390, P. A. of 1976, as amended Completion: Voluntary, but completion necessary to be considered for assistance. 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 public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c)Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and (d) Have not within a three-year period preceding this applica- tion had one or more public transactions (Federal, State, or local) terminated for cause or default; and B. Where the applicant 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 OTHER THAN 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 28 CFR Part 67 Sections 67.615 and 67.620— A, The applicant certifies that it will or will continue to provide a drug-free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) 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 maintaining 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 violations 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- ment required by paragraph (a); (d) Notifying the employee in the statement required by para- graph (a) that, as a condition of employment under the grant, the employee will- 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 included 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-curement) and Government-wide Requirements for Drug-Free Workplace (Grants)." The certifications shall be treated as a material representation of fact upon which reliance will be placed when the Department of Justice determines to award the covered transaction, grant, or cooperative agreement. As required by Section 1352, Title 31 of the U.S. Code, and implemented at 28 CFR Part 69, for persons entering into a grant or cooperative agreement over $100,000, as defined at 23 CFR Part 69, the applicant certifies that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for in- fluencing 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 con- nection with the making of any Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement; (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or at- tempting 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 Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form - LLL, "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 subawards at all tiers (including subgrants, contracts under grants and cooperative agreements, and subcontracts) and that all sub- recipients shall certify and disclose accordingly. 2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS (DIRECT RECIPIENT) As required by Executive Order 12549, Debarment and Suspension, and implemented at 28 CFR Part 67, for prospec- tive participants in primary covered transactions, as defined at 28 CFR Part 67, Section 67.510— A. The applicant certifies that it and its principals: (a) Are not presently debarred, suspended, proposed for debar- ment, declared ineligible, sentenced to a denial of Federal benefits by a State or Federal court, or voluntarily excluded from covered transactions by any Federal department of agency; (b) Have not within a three-year period preceding this applica- tion been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connec- tion with obtaining, attempting to obtain, or performing a OJP FORM 4061(6 (3-91) REPLACES OJP FORMS 406112, 4061/3 AND 40604 WHICH ARE OBSOLETE. 2. Application Number and/or Project Name 3. Grantee IRS/Vendor Number 3. Signature 4. Date (1) Abide by the terms of the statement; 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) Notifying the agency, in writing, within, 10 calendar days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such convic-tion. Employers of convicted employees must provide 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 grant; (1) Taking one of the following actions, within 30 calendar days of receiving notice under subparagraph (d)(2), with respect to any employee who is 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 employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforce- ment, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug- free workplace through implementation of paragraphs (a), (b), (c), (d), (e), and (f). B. The grantee may insert in the space provided below the site(s) for the performance otwork done in connection with the specific grant: Place of Performance (Street address, city, county, state, zip code) Oakland County 1200 N Telegraph Pontiac MI 48341 Check if there are workplaces on file that are not indentified here. Section 67, 630 of the regulations provides that a grantee that is a State may elect to make one certification in each Federal 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. Check 0 if the State has elected to complete OJP Forrn 4061/7, DRUG-FREE WORKPLACE (GRANTEES WHO ARE INDIVIDUALS) As required by the Drug-Free Workplace Act of 1986, and implemented at 28 CFR Part 67, Subpart F, for grantees, as defined at 28 CFR Part 67; Sections 67.615 and 67.620- A. As a condition of the grant, I certify that i 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 criminal drug offense resulting from a violation occurring during the conduct of any grant activity, I will report the conviction, in writing, within 10 calendar days of the conviction, to: Department of Justice, Office of Justice Programs, ATTN: Control Desk, 810 Seventh Street NW., Washington, DC 20531. As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications. 1. Grantee Name and Address: Oakland County . 1200. N. Telegraph Pontiac MI 48341 2010-2011 Hazardous Materials Emergency Preparedness 38-6004876W Rd. Michael J. Gingell, Chairman, Oakland County Board of Commissioners 4. Typed Name and Title of Authorized Representative *U.S. Government Printing Office: 1996- 405-037/49014, on 7.1 et 2 a 0 e CL C. 0 Ell rll (/) Social security number or Employer L.a.,r+4;,..ti-n number 38 6004876W Form (Rev. ( Depart!' Internal W-9 .Request for Taxpayer Give form to the )ctobcr 2007) Identification Number and Certification requester. Do not send to the IRS. lent of the Trea.sury Revenue Sence Name (as shown on your j000IOC tx return) Business name, if different from abovc Oakland County Cinecic appropriate Pox: Lil Individual/Sole proprietor D Corporation Ed Partnership Exempt L Limited lianilit y company. Enter the tax ciessfication (D=disre garded entity, Ct).-corporation, Pe-partnership) ilt - payee E:i Other (see instructions) Of Government Entity 1 ____ Address (number, street, and apt. or suite no.) Requester's name and address (optional) 1200 N Telegraph Road City. state, aed ZIP code Pontiac MI 48341 List account number(s) here (optional) itz i T a x Daye tIdentification 4 umber (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) i am exempt from backup withholding, or (h) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that l am no longer subject to backup withholding, and 3. I am a U.S. citizen or other U.S. person (defined below). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. See the instructions on page 4. Signature of U.S. person P. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: * An individual who is a U.S. citizen or U.S. resident alien, * A partnership, corporation, company, or association 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 defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign 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 business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid 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 anC avoiding withholding on its allocable share of net income from 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 entity, Cat. No. 102315 Form W-9 (Rev, 10-20071 Sign Hem Date 10, General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9.' Form W-9 (Rev, 10-2037) Page 2 e 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 net the beneficiaries of the trust. Foreign person. If you are a foreign person, do not use Form W-9. Instead, use the appropriate Form W-8 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only .a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income, However, most tax treaties contain a provision known as a "saving clause." Exceptions specified in the. saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items: • 1, The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. • 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that • contains the saving clause and its exceptions. • 4. The type and amount of income that qualifies for the ..exemption .from .tax. 5. Sufficient facts to justify the exemPtion 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 for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien 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 scholarship or feilowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign ehtity not subject to backup withholding, give the requester the appropriate completed Form W-8. What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 28% of such payments. This is called "backup withholding." Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup 'withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return. • Payments you receive will be subject to backup withholding if: 1.-You do not furnish your TIN to the requester, 2. You do not certify your TIN when required (see the Part II instructions on page 3 for details), 3. The IRS tells the requester that you furnished an incorrect TIN,. • 4. The IRS tells you that you are subject to backup 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 under 4 above (for reportable interest and dividend accounts opened after 1983 only). Certain payees and payments are exempt from backup withholding. See the instructions below and the separate Instructions for the Requester of Form W-9. Also see Special rules for partnerships or page 1. Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty. Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester 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 shown on your social security card, and your new last name. If the account is in joint names, list first, and then circie, the name of the person or entity whose number you entered in Part I of the form. Sole proprietor. Enter your individual 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 single-member LUC (including a foreign LLC with a domestic owner) that is disregarded as an entity separate from its owner under Regulations section 301.7701-3, enter the owner's name on the "Name" line. Enter the Was name on the "Business name" line. For an LLC classified as a partnership or a corporation, enter the LLC's name on the "Name" line and any business, trade, or DBA name on the "Business name" line. Other entities. Enter your business name as shown on required federal tax documents on the "Name" line. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on the "Business name" line. Note. You are requested to check the appropriate box for your status (individual/sole proprietor, corporation, etc.). Exempt Payee If you are exempt from backup withholding, enter your name as described above and check the appropriate box for your status, then check the "Exempt payee" box in the line following the business name, sign and date the form. Form W-9 (Rev. 10-2007) Generaliy, individuals (including sole proprietors) are not exempt from backup withholding. Corporations are exempt from backup withholding for certain payments, such as interest and dividends. Note. If you are exempt from backup withholding, you should still complete this form to avoid possible erroneous backup withholaing. The following payees are exempt from backup withholding: 1. An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2), 2. The United States or any of its agencies or instrumentalities, 3. A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or instrumentalities, 4. A foreign government or any of its political subdivisions, agencies, or nstrumentalities, or 5. An international organization or any of its agencies or instrumentalities. Other payees that may be exempt from backup withholding include: 6. A corporation, 7. A foreign central bank of issue, 8. A dealer 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 commission merchant registerea with the Commodity Futures Trading Commission, 10. A real estate investment trust, 11. An entity registered at all times curing the tax year under the Investment Company Act of 1940, 12. A common trust fund operated by a bank under section 584(a), 13. A financial institution, 14. A middleman known in the investment community as a nominee or custodian, or 15. A trust exempt from tax under section 664 or described in section 4947. • The chart below shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 15. IF the payment is for ... THEN the payment is exempt for ... Interest and dividend payments All exempt payees except for 9 Broker transactions Exempt payees 1 through 13. Also, a person registered under the investment Advisers Act of 1940 who regularly acts as a broker Barter exchange transactions Exempt payees 1 through 5 and patronage dividends Payments over $600 required Generally, exempt payees to be reported and direct 1 through 7 sales over $5,000' See Form 1099-MISC, Miscellaneous Income, and its instructions. However, the following payments made to a corporation (including gross proceeds paid to an attorney under section 6045(0, even if the attorney is a corporation) and reportable on Form 1099-M1SC are not exempt from backup withholding: medical and health care payments, attorneys' fees, and payments for services paid by a federal executive agency. Page Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eiigible to get an SSN, your TIN is your IRS individual taxpayer identification number ((TIN). Enter it in the social security number box. If you do rot have an ITIN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter eitner your SSN or EIN. However, the IRS prefers that you use your SSN. If you are a single-member LLC that is disregarded as an entity separate from its owner (see Limited liability company. (LLC) on page 21, enter the owner's ssr,, (or EIN, if the owner has one). Do not enter the disregarded entity's EIN. If the LLC is classified as a corporation or partnership. enter the entity's F.I N. 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, gat Form SS-5, Application for a Social Security Card, from your local Social Security Administration office or get this form online at 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 ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an FIN online by accessing the IRS website at www.irs.govidusinesses and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and SS-4 from the IRS by visiting www.irs.clov cr by calling 1-800-TAX-FORM (1-800-829-3676). If you are asked to complete Form W-9 but do not have a TIN. write "Applied For" in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-clay rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note. Entering "Applied For" means that you have alreaoy applied for a TIN or that you intend to apply for one soon. Caution: A disregarded domestic entity that has a foreign owner must use the appropriate Form W-8. Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if items 1, 4, and 5 below indicate otherwise. For a joint account, only the person whose TIN is shown in Part I should sign (when required). Exempt payees, see Exempt Payee on page 2. Signature requirements. Complete the certification as indicated in 1 through 5 below. . 1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker,, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form. Form W-9 (Rev. 10-20071 3. Real estate transactions. You must sign the certification, You may cross out item 2 of the certification, 4. Other payments,. You must give your correct TIN, but you do not have to sign the certification unless you have been • notified that you have previously given an incorrect TIN. "Other payments" include payments made in the course of the requester's trade or business for rents, idocis (other than bills for merchandise), medical and care services (including payments to corporations), payments to a nonemployee for services, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). 5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to Sign the certification. What Name and Number To Give the Requester For this type of account: Give name and SSN of: 1. Individual The individual 2. Two or more individuals (joint The actual owner of the account or, account) if combined funds, the first individual on the account' S. Custodian account of a minor The minor' (Uniform Gift to Minors Act) 4. a. The usual revocable savings The grantor-trustee l trust (grantor is also trustee) - b,- So-called Irust account that is . The actual owner ' .. not a legal or valid trust under state law 5. Sole proprietorship or disregarded The owner ' entity owned by an individual For this type of account Give name and EIN of: 6. Disreoarded entity not owned by an The owner individual 7. A valid trust, estate, or pension trust Legal entity -4 8. Corporate or LLC electing The corporation corporate status on Form 8832 9. Association, club, religious, • The organization charitable, educational, or other tax-exempt organization 10, Partnership or multi-member LLC The partnership 11, A broker or registered nominee The broker or nominee 12. Account With the Department of The public entity Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments 'List first and circle the name of the person whose number you furnish. It only one person • on a joint account has an SW that person's number must be 'furnished. Circle the minor's name and furnish the minor's SSN. "You must show your individual name and you may also enter your business or "DBA" name on the second name line. You may use either your SSN or SIN (if you have one), but the IRS encourages you to use your SSN. 4 List first and circle the name of the trust, estate, or pension trust. (Do not furnish, the TiN of the personal representative or trustee unless the legal entity itself is not designated in fire account title.) Also see Special rules for partnerships on page 1. Note. If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed. Page 4 Secure Your Tax Records from Identity Theft Identity theft occurs when someone uses your personal information such as your name, social security number (SSN), or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund. To reduce your risk: • Protect your SSN, • Ensure your employer is protecting your SSN, and • Re careful when choosing a tax preparer. Call the IRS at 1-800-829-1040 if you think your identity has been used inappropriately for tax purposes. Victims of identity theft who are experiencing economic harm or a system problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service ([AS( assistance. You can reach TAS by calling the TAS toll-free case intake line at 1-877-777-4778 or I I Y/TDD 1-820-829-4059. Protect yourself from suspicious emails or phishing schemes. Phishing is the creation and use of email and websites designed to mimic legitimate business emails and 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 will be used for identity theft. The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar, secret access information for their credit card, bank, or other financial accounts. • If you receive an unsolicited email claiming to be from the IRS, forward this message to phishing@irs.gov. You may also report misuse of the IRS name, logo, or other IRS personal property to the Treasury Inspector General for Tax Administration at 1-800-366-4484. You can forward suspicious emails to the Federal Trade Commission at: spam@uce.gov or contact them at www.consumergovfidtheft or 1-877-IDTHEFT(438-4338). Visit the IRS website at www.irs.gov to learn more about identity theft and how to reduce your risk. • Privacy Act Notice Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons who must file information returns with the IRS to report interest, dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, canceilation of debt, or contributions you made to an IRA, or Archer MBA or HSA. The IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return. The IRS may also provide this information to the Deoartment of justice for civil and criminal litigation, and to cities, states, the District of Columbia, and U.S. possessions to carry out their tax laws. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal nentax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or riot you are required to file a tax return. Payers must generally withhold 28% of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to a payer. Certain penalties may also apply. SARA ID 1210 1211 1219 1231 1311 1317 1318 1319 1320 Emergency Contact (24hr) Bob Perreault (313) 405-0568 Gary Gig uere (248) 496-2535 Lawrence Staub (800) 566-9347 Dave Muck (586) 268-4655 Ben Warren (810) 656-1830 Jim Clark (248) 760-3821 Josh Hager (248) 841-5983 Mary Morgan (Metal Center) (248) 857-2222 Ralph Deino t8) 753-9111 Yes Yes Yes Yes Yes Yes Plan Finished Yes Yes Yes Fire Department Pontiac FD Pontiac FD Birmingham FD Madison Heights FD Oxford FD Pontiac FD Waterford Township FD Pontiac FD 17 1-1 pf- )rt-i the DNRE, the LEPC can develop a plan for it s. Page 247 of 358 11/1012010 OAKLAND COUNTY LEPC 302 Site Plan Status 'finshed Plans: Unfinshed Plans: Total No. of Plans: 184 17 201 Facility Name/Location Akzonobel Decorative Paints Inc. 25 Brush Street Pontiac Akzo Nobel Coatings Inc. 27 Brush Street Pontiac At&T Facility (A00776) 2203 Holland St Birmingham Commercial Steel Treating Corp 31440 Stephenson Hwy Madison Heights Itw Futura Coatings 2425 North Lapeer Rd Oxford Gm - Pontiac Assembly Center 2100 South Opdyke Road Pontiac Wfg Waterford Warehouse Plant 78 5260 Williams Lake Rd Waterford Gm-Pontiac North Campus 220 East Columbia (Mc483-014-211) Pontiac 660 Sol Pontiac Note: It a farm is not on this lh and submit it to the Emergenc PLEASE NOTE: The "Plan Finished" column on this 302 Site Plan Status List does not reflect the plans completed during the 2009-2010 grant year. The completion of those plans will be noted in the next list update. This list is a copy of what wa .. sent with your application package. Fire Department Pontiac FD Milford Township FD Orion Township FD Milford Township FD Brandon FD Madison Heights FD Madison Heights FD Madison Heights FD South Lyon FD 11110/2010 OAKLAND COUNTY LEPC Flashed Plans: '184 302 Site Plan Status Unfinshed Plans . 17 Total No. of Plans: 201 SARA ID Facility Name/Location 1321 General Motors Lie 1251 Joslyn Avenue Pontiac 1323 General Motors Proving Ground 3300 General Motors Road Milford 1324 Orion Assembly 4555 Giddings Road Lake Orion 1332 Verizon Milford Central Office 324 Union St Milford 1333 Verizon Ortonville Central Office 113 Narren St Ortonville 1338 Henkel Corporation 32100 Stephenson Highway Madison Heights 1339 Howard Finishing LIc 32565 Dequindre Madison Heights 1358 Emerald Steel Processing Plant Ii 31624 Stephenson Hwy Madison Heights 1375 Michigan Seamless Tube, Llc 400 Mcmunn South Lyon Emergency Contact (24hr) Plan Finished Renee Hawatmeh Yes (248) 857-3500 Plant Security Yes (248) 685-5148 Larry Camilleri Yes (248) 377-5260 Ronald K Mak Yes (888) 696-3973 Ronald K Mak Yes (888) 696-3973 Tom Snell Yes (800) 424-9300 Argyri loannou Yes (586) 749-6964 Joseph Ankley Yes (586) 596-4195 Donald F. Comfort Yes (248) 486-0100 Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 248 of 358 11/10/2010 OAKLAND COUNTY LEPC 302 Site Plan Status Finshed Plans: 184 Unfinshed Plans: 17 Total No. of Plans: 201 SARA ID Facility Name/Location Fire Department Emergency Contact (24hr) Plan Finished 5429 Armaly Brands Commerce Township FD Gilbert Armaly Yes 1900 Easy St (248) 670-1898 Commerce Township 5475 Electro-Plating Services Inc. Madison Heights FD Gary Sayers Yes 945 East Ten Mile Rd (248) 477-2122 Madison Heights 5478 Exotic Rubber And Plastics Car Farmington Hills FD Thomas Marino Yes 34700 Grand River Ave (248) 652-4183 Farmington 5480 Foglers Orchard & Farm Market Oakland Township FD Mike Fogler Yes 3985 N Rochester Rd (248) 613-2267 Rochester 5487 Lymtal International, Inc. Orion Township FD Magdy Talaat Yes 4150 South Lapeer Road (248) 858-4895 Lake Orion 5491 Paul Vanroekel (Waterford) Garage Waterford Township ED Russ Curl Yes 2420 Pontiac Lake Road (248) 858-4895 Waterford 5518 Troy Garage Troy FD Mark Hirt Yes 1930 Stephenson Hwy (248) 858-4895 Troy 5519 Southfield Garage Southfield FD Matt Mountai Yes 27900 Franklin Rd (248) 858-4895 Southfield 5520 Milford Garage Milford Township FD Dave Lewis Yes 4353 Duck Lake Rd (248) 858-4895 Milford Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 250 of 358 Milford Township FD 3718 Village Of Milford Wwtp 1000 General Motord Road Milford Milford Police Department Yes (248) 684-1815 11/10/2010 OAKLAND COUNTY LEPC 302 Site Plan Status Finshed Plans: 184 Unfinshed Plans: 17 Total No. of Plans: 201 SARA ID Facility Name/Location Fire Department Emergency Contact (24hr) Plan Finished 1392 Chemical Blending Troy FD John Holloway Yes 1893 Barrett Rd (248) 321-5353 Troy 1407 Plating Specialties Inc Madison Heights FD Thomas Baker Yes 1675 East Ten Mile Rd (586) 979-5327 Madison Heights 1423 Arvinmeritor Troy FD Mark Nowakowski Yes 2135 West Maple Rd (248) 435-1530 Troy 1499 Formtech, Troy Troy FD Ryan Mcgrew Yes 690 West Maple Rd (248) 640-8257 Troy 1502 United Paint & Chemical Corp Smithfield FD Michael Zapalski Yes 24671 Telegraph Rd (248) 866-8182 Southfield 1507 Jhp Pharmaceuticals Rochester FD Annette Sommers Yes 870 Parkdale Rd (248) 656-5400 Rochester 3623 Macciermid Incorporated Ferndale FD Damian Doerfer Yes 1221 Farrow Avenue (248) 778-6694 Ferndale 3716 Village Of Milford Iron Removal Plant Milford Township FD Tim Stewart Yes 195 North Main Street (248) 303-1361 Milford Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 249 of 358 11/10/2010 OAKLAND COUNTY LEPC 302 Site Plan Status Finshed Plans: 184 Unfinshed Plans: 17 Total No. of Plans: 201 SARA ID Facility Name/Location Fire Department Emergency Contact (24hr) Plan Finished 5521 Lake Orion Garage Orion Township FD Neal Far nor Yes 1100 S. Lapeer Road (248) 858-4895 Lake Orion 5522 Davisburg Garage Springfield Township FD Rich Wood Yes 10275 Dixie Hwy (231) 557-8061 Davisburg 5953 Mci Sfldmi Southfield FD Network Management Yes 24901 Northwestern Highway Suite 121 (248) 885-1115 Southfield 5954 Michigan Bell Facility (M53246) Troy FD Lawrence Straub Yes 6950 Crooks Road (517) 304-2430 Troy 5955 Michigan Bell Facility (M57110) Birmingham FD Lawrence Straub Yes 155 Henrietta (248) 885-1115 Birmingham 5956 Michigan Bell Facility (M53211) Independence Township FD Tom Artley Yes 6610 Dixie Hwy (248) 885-1115 Clarkston 5958 Michigan Bell Facility (M57141) Commerce Township FD Lawrence Straub Yes 3022 Messena (517) 304-2430 Commerce Twp 5959 Michigan Bell Facility Waterford Township FD Lawrence Straub Yes 1000 North Williams Lake Road (248) 885-1115 Waterford 5960 Michigan Bell Facility (I1/153219) Waterford Township FD Tom Artley Yes 3059 Sashabaw Rd (248) 885-1115 Drayton Plains Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 251 of 358 Fire Department Farmington DPS Farmington Hills FD North Oakland County Fire Auth Orion Township FD 11/10/2010 OAKLAND COUNTY LEPC Finshed Plans: 184 302 Site Plan Status Unfinshed Plans: 17 Total No. of Plans: 201 Oxford FD Pontiac FD Auburn Hills FD Orion Township FD Waterford Township FD SARA ID Facility Name/Location 5961 Michigan Bell Facility (M54120) 32331 Grand River Farmington 5962 Michigan Bell Facility (M57112) 35300 13 Mile Road Farmington Hills 5963 Michigan Bell Facility (M22214) 109 East Maple Holly 5964 Michigan Bell Facility (M53226) 60 N Flint Lake Orion 5967 Michigan Bell Facility (M53234) 75 S Washington Oxford 5968 Michigan Bell Facility (M53140) 54 North Mill Pontiac 5970 Michigan Bell Facility (M53154) 3385 Five Points Dr Auburn Hills 5972 Michigan Bell Facility (M53151) 3556 Waldon Rd Lake Orion 5973 Michigan Bell Facility (M53122) 3532 Cass- Elizabeth Waterford Emergency Contact (24hr) Plan Finished Lawrence Straub (517) 304-2430 - Lawrence Straub (517) 304-2430 Tom Artley (517) 304-2430 Tom Artley (586) 536-7540 Tom Artley (586) 536-7540 James Skalny (800) 566-9347 James Skalny (517) 304-2430 Tom Artley (586) 536-7540 Torn Artley (248) 885-1115 Yes Yes Yes Yes Yes Yes Yes Yes Yes Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 252 of 358 11/10/2010 OAKLAND COUNTY LEPC 302 Site Plan Status Fished Plans: 184 Unfinshed Plans: 17 Total No. of Plans: 201 Emergency Contact (24hr) James Skalny (517) 304-2430 Lawrence Straub (248) 886-1115 Tom Artley (248) 885-1115 Lawrence Straub (248) 885-1115 Lawrence Straub (248) 885-1115 Lawrence Straub (248) 885-1115 Lawrence Straub (248) 885-1115 Lawrence Straub (231) 873-7413 Lawrence Straub (616) 260-2941 Fire Department Rochester FD Royal Oak FD South Lyon FD Southfield FD Southfield FD Troy ED Troy FD Walled Lake FD West Bloomfield FD Plan Finished Yes Yes Yes Yes Yes Yes Yes Yes Yes SARA ID 5974 5976 5978 5981 5983 5984 5985 5986 5987 Facility Name/Location Michigan Bell Facility (M53274) 400 W Tienken Rd Rochester Michigan Bell Facility (M55310) 421 Williams Street Royal Oak Michigan Bell Facility (M65190) 112 West Liberty Street South Lyon Michigan Bell Facility (M54170) 26555 Greenfield Road Southfield Michigan Bell Facility (M54130) 25189 Lahser Road Southfield Michigan Bell Facility (M55330) 1145 Rochester Road Troy Michigan Bell Facility (M57155) 1670 Axtell Road Troy Michigan Bell Facility (M57150) 1287 S Commerce Walled Lake Michigan Bell Facility (M57160, 7020 Middlebelt West Bloomfield Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 253 of 358 11/10/2010 OAKLAND COUNTY LEPC Finshed Plans: 184 302 Site Plan Status Unfinshed Plans - 17 Total No. of Plans: 201 SARA ID Facility Name/Location Fire Department Emergency Contact (24hr) Plan Finished 6051 Michigan Bell Facility (M64252) Northville FD Lawrence Straub Yes 1045 North Center St (313) 303-1410 Northville 6863 Engineered Heat Treat Inc Madison Heights FD Keith Pilibosian Yes 31271 Stephenson Highway (616) 402-3859 Madison Heights 6866 K.C. Jones Plating Company Hazel Park FD Brian Harrick Yes 321 West Ten Mile Rd (616) 895-5800 Hazel Park 6867 Kag Orion Township FD NA Yes 57 Kay Industrial Dr. (231) 972-0017 Lake Orion 7365 Chrysler Tech Center Auburn Hills FD Hank Murawski Yes 800 Chrysler Drive (616) 293-7218 Auburn Hills 7417 Sprint Pontiac Pop Pontiac FD Cathy Stafford Yes 1685 N Telegraph Rd. (989) 293-8822 Pontiac 8941 Village Of Holly VVwtp Holly FD Tim Stallcup Yes 402 Airport Dr Holly 9662 Bio-Serv Corporation Troy FD John A Rhaesa Yes 1130 Livernois Troy 10292 Palace Sports & Entertainment Inc. Auburn Hills FD Jim Summers Yes 6 Championship Drive (248) 674-0351 Auburn Hills Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 254 of 358 10294 Robert Bosch LIG 38000 Hills Tech Dr Farmington Hills 10307 Waterford Iron Removal Plant 5-1 3725 David K Waterford 10308 Waterford Iron Removal PI-Ms-1 3301 Main Street Waterford Farmington Hills FD Waterford Township FD Waterford Township FD 10313 Waterford Iron Removal P1t19-1 861 Daffodil Waterford 10315 Waterford Iron Removal P1124-1 520 Marion Waterford 10316 Waterford Iron Removal P1t25-1 & 25-2 2945 West Huron St Waterford 11/10i2010 OAKLAND COUNTY LEPC Finshed Plans: 184 302 Site Plan Status Total No. of Plans: 201 Unfinshed Plans: 17 SARA ID Facility Name/Location Fire Department Emergency Contact (24hr) Plan Finished 10310 Waterford Iron Removal Plant 12-1 Waterford Township FD 2829 Golfhill Waterford 10311 Waterford Iron Removal Plant 14-1 Waterford Township FD 3720 Lorena Waterford 10312 Waterford Iron Removal Plant 16-1/16-2 Waterford Township FD 5125 Ridgetop Waterford Waterford Township FD Waterford Township FD Waterford Township FD Jill Kupcak No (248) 674-0351 Geno Brush Yes (248) 674-0531 Geno Brush Yes (248) 674-0531 Geno Brush Yes (248) 674-0351 Geno Brush Yes (248) 674-0531 Geno Brush Yes (248) 674-0351 Geno Brush Yes (616) 669-3260 Geno Brush Yes Gene Brush (269) 506-3886 Yes Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for MEP grant/SARA plan review purposes. Page 255 of 358 Fire Department Emergency Contact (24hr) Plan Finished Waterford Township FD Novi FD Waterford Township FD Walled Lake FD Bloomfield Township FD Southfield FD Farmington Hills FD Royal Oak FD Geno Brush (951) 533-4273 James Demyan (989) 362-2556 Urban Rice (517) 823-2359 Chip Frenak Bob Bishop (734) 254-6779 Barbara Boroughf Bruce Baker Brian Moran (517) 669-9924 Perry Williams (231) 734-5234 Yes Wixom FD Wixom FD Yes Yes Yes Yes Yes Yes Yes Yes 11/10/2010 OAKLAND COUNTY LEPC 302 Site Plan Status Finshed Plans: Unfinshed Plans: Total No. of Plans: 184 17 201 SARA ID 10318 10453 10630 10758 11469 11836 12088 12200 12205 Facility Name/Location Waterford Iron Removal Plant 28-1 5475 Crescent Road Waterford Delta Fuels Of Michigan 40600 Grand River Ave. Novi Lakeland Arena 7330 Highland Waterford American Plastic Toys 799 Ladd Rd Walled Lake Detroit Skating Club 888 Denison Ct. Bloomfeild Hills Corporate Headquarters 21557 Telegraph Rd Southfield Korex Corporation 50000 West Pontiac Trail Wixom Farmington Hills Ice Arena 35500 W 8 Mile Rd Farmington Hills Formtech Royal Oak 2727 W Fourteen Mile Royal Oak Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 256 of 358 11/10/2010 OAKLAND COUNTY LEPC Finshed Plans: 184 302 Site Plan Status Unfinshed Plans: 17 Total No. of Plans: 201 SARA ID Facility Name/Location Fire Department Emergency Contact (24hr) Plan Finished 12229 Excel Electrocircuit Inc Orion Township FD Tim White Yes 50 Northpointe Dr (616) 837-8764 Orion 12328 Recticel Urepp North America Inc Auburn Hills FD Scott Maxson Yes 1653 Atlantic Blvd (269) 325-0628 Auburn Hills 12592 Akzo Nobel Coatings Inc Pontiac FD Tim Evans Yes 120 Franklin Rd (269) 506-0292 Pontiac 12598 Chor Industries Inc Troy FD David Chor Yes 500 Robbins (989) 725-1136 Troy 12603 Meleo Engraving Inc Rochester Hills FD Dave Kulasa Yes 1809 Rochester Industrial Dr (517) 605-8072 Rochester Hills 12940 Eagle Ottawa Rochester Hills Rochester Hills FD Wally Kordalski Yes 2930 West Auburn Rd (989) 479-5274 Rochester Hills 13315 Freiborne Industries Inc. Pontiac FD Kevin M. Gill Yes 15 Silverdome Industrial Park (734) 697-6277 Pontiac 13329 Specialty Steel Treating Inc Farmington Hills FD Scott Verhelle Yes 31610 West Eight Mile Rd (313) 252-6000 Farmington Hills 13594 Cyanic Battery Company Inc. Troy FD Paul Boucard Yes 1414 Combermere St (989) 293-9396 Troy Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 257 of 358 11/10/2010 OAKLAND COUNTY LEPC Finshed Plans: 184 302 Site Plan Status Unfinshed Plans: 17 Total No. of Plans: 201 SARA ID Facility Name/Location Fire Department Emergency Contact (24hr) Plan Finished 13798 J & L Products Inc Hazel Park FD Lynn D. Persyn Yes 21733 Dequindre Hazel Park 13901 Bank Of America - Troy Hq Troy FD David Dearing Yes 2600 West Big Beaver (248) 763-5891 Troy 13982 Michigan Bell Facility (M53145) Auburn Hills FD James Skalny Yes 800 Chrysler Drive (517) 896-3960 Auburn Hills 14025 Blue Cross Blue Shield Of Michigan Lyon Township FD Michael Schneider Yes 53200 Grand River Ave (517) 279-9531 New Hudson 14026 Blue Cross Blue Shield Of Michigan Southfield FD Michael Schneider Yes 27000 West Eleven Mile B620 (989) 657-0736 Southfield 14027 Ahm05 - Auburn Hills Smc Auburn Hills FD Bruce Fisher Yes 885 West Entrance Dr (616) 847-9746 Auburn Hills 14050 Ahm04 - Auburn Hills Smc 2 Auburn Hills FD Bruce Fisher Yes 1035 West Entrance Dr (888) 696-3973 Auburn Hills 14131 Mtso #3 Northwestern & Cell Site - Verizon Wireless Southfield FD Michael Wargo Yes 24065 Northwestern Highway (800) 264-6620 Southfield 14214 Mtso 42 Royal Oak & Cell Site - Verizon Wireless Royal Oak FD Michael Wargo Yes 4550 Delemere Royal Oak Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEF grant/SARA plan review purposes. Page 258 of 308 11/10/2010 OAKLAND COUNTY LEPC 302 Site Plan Status Finshed Plans: 184 Unfinshed Plans: 17 Total No. of Plans: 201 SARA ID Facility Name/Location Fire Department Emergency Contact (24hr) Plan Finished 14223 John Lindell Ice Arena Royal Oak FD Kay Aquiline Yes 1403 Lexington Blvd Royal Oak 14247 Global Crossing Southfield FD Jeanette Tortora Yes 200 Galleria Office Centre (616) 450-6568 Southfield 14330 Comcast Of The South, Inc. Royal Oak FD Carl Erickson Yes 4500 Delemere Blvd (313) 235-9444 Royal Oak 14331 At&T Facility (A06370) Southfield FD Lawrence Straub Yes 1000 Town Center Suite 150 (313) 235-9444 Southfield 14332 At&T Facility (A07362) Troy FD Tom Artley Yes 320 E Big Beaver Rd, Bldg C, Suite 131 (313) 235-9444 Troy 14472 Xo Communications (Mi-1) Southfield FD Gary Hartner Yes 21555 Melrose Ave (517) 294-2969 Southfield 14481 Mci Trbdmi Southfield FD Network Management Yes 3250 West Big Beaver Road Troy 14485 Mci Sofdmi Southfield FD Network Management Yes 21500 Melrose Avenue (888) 696-3973 Southfield 14548 Us Foodservice Inc. Lyon Township FD Bill Smith Yes 28001 Napier Rd (616) 437-2760 Wixom Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 259 of 358 11/10/2010 OAKLAND COUNTY LEPC 302 Site Plan Status Finshed Plans: 184 Unfinshed Plans: 17 Total No. of Plans: 201 SARA ID Facility Name/Location Fire Department Emergency Contact (24hr) Plan Finished 14563 Southfield Switch Southfield FD UnicaII Yes 1000 Town Center, Suite 360 (937) 361-2489 Southfield 14836 Sears Auto Center 6302 Troy FD Francies Teter Yes 300 West 14 Mile Road (248) 344-0580 Troy 14848 Sears Auto Center 6432 Novi FD Roger Raak Yes 27600 Novi Road (616) 217-1286 Novi 14880 Stone Soap Company Inc Pontiac FD Steven Stone Yes 2000 Pontiac Dr (231) 218-6246 Sylvan Lake 14883 Level 3- Southfield - Id# 14883 Southfield FD John Kucherepa Yes 19675 West Ten Mile Road 2Nd Floor Southfield 14969 Global Crossing Southfield FD Jeanette Tortora Yes 200 Galleria Suite 218 (248) 240-0454 - Southfield 15037 Xo Communications (Mi-201) Southfield FD Gary Hartner Yes 21455 Melrose Ave Suite 5 (616) 532-4620 Southfield 15063 Corncast Of Michigan/Mississippi/Tennessee, Inc. Waterford Township FD Ed Smith Yes 1300 Crescent Lake Rd (888) 404-9750 Waterford 15309 Lear Rochester Hills Rochester Hills FD Dragos Serbanescu Yes 3000 Research Drive (989) 375-4663 Rochester Hills Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number f ,om the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 260 of 3513 Fire Department Troy FD SARA ID Facility Name/Location 15366 Mci Triymi 647 Elmwood Drive Troy Emergency Contact (24hr) Plan Finished Network Management Yes (407) 252-7732 11/10/2010 OAKLAND COUNTY LEPC 302 Site Plan Status Finshed Plans: 184 Unfinshed Plans: 17 Total No. of Plans: 201 15369 Depor Industries Inc 1902 Northwood Troy 15464 Michigan Bell Facility (Md3340) 23500 Northwestern Highway Southfield 15498 At&T Facility (A06368) 4000 Town Center Southfield 15535 Bloomfield - 92467 360 Enterprise Court Bloomfield 15594 Level 3- Troymi1A - Troy Pop (Aci) #15594 1950 Crooks Rd Troy 15629 Akzonobel Decorative Paints Inc. 117 Brush Street Pontiac 15830 Denso International America, Inc. 24777 Denso Drive Southfield 15965 Gmpt Wixom Facility 30240 Oak Creek Drive Wixom Troy FD NA Yes (810) 385-7924 Southfield FD Frederick Kucharski Yes (586) 803-1000 Southfield FD Lawrence Straub Yes (888) 696-3973 Bloomfield Township FD Ehs Hotline Yes (616) 899-2678 Troy FD John Kucherepa Yes (989) 277-7380 Pontiac FD Mike Napieraj Yes Southfield FD Gary Godin Yes Wixom FD Russ O'BIones Yes (269) 923-5068 Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 261 of 358 Emergency Contact (24hr) Ryan Pardoski (313) 580-5791 Jim Hvisdas (989) 550-1298 Geoff Bennetts (989) 614-6000 Larry Knapp (231) 883-8733 Kris Barnes (231) 512-0010 Wallace James (734) 983-1200 Ralph Fraga (314) 922-6977 Scott Marazita (269) 687-3904 Ramy Wahby (734) 564-3297 Plan Finished Yes Yes Yes Yes Yes Yes Yes Yes Yes Fire Department Rochester FD Farmington Hills FD Farmington Hills FD Hazel Park FD Novi FD Wixom FD Troy FD Madison Heights FD Waterford Township FD 11/10/2010 OAKLAND COUNTY LEPC 302 Site Plan Status Finshed Plans: 184 Unfinshed Plans: 17 Total No. of Plans: 201 SARA ID 16638 16647 16650 16823 16824 16826 16884 16923 16924 Facility Name/Location Onyx-Rochester Ice Arena 52999 Deguincire Rd Rochester Mcleod Usa 23629 Industrial Park Drive Farmington Hills Suburban Training Center 23996 Freeway Park Dr Farmington Hills Hazel Park Viking Arena 1555 East Woodward Heights Rd Hazel Park Novi Ice Arena 42400 Arena Dr Novi Atmosphere Heat Treating Inc 30760 Century Drive Wixom Sears Technology Center 2240 Cunningham Dr Troy Sam'S Club #6659 31020 John R Road Madison Heights Sam'S Club #6665 495 Summit Drive Waterford Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC: can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for EIMER grant/SARA plan review purposes. Page 262 of 358 11/10/2010 OAKLAND COUNTY LEPC Finshed Plans: 184 302 Site Plan Status Unfinshed Plans: 17 Total No. of Plans: 201 SARA ID Facility Name/Location Fire Department Emergency Contact (24hr) Plan Finished 16926 Sam'S Club #4778 Auburn Hills FD Mike Jones Yes 4350 Joslyn Rd (847) 977-4130 Auburn Hills 16927 Sam'S Club #6454 Southfield FD Marcus Turner Yes 22500 Eight Mile Rd (586) 615-7908 Southfield 16966 Customer Technology Center Michigan Auburn Hills FD Gary Jones No 3000 University Drive (734) 637-6320 Auburn Hills 16982 Recticel Interiors North America LIc Independence Township FD Dale Wilson Yes 5600 Bow Pointe Dr (248) 830-6502 Clarkston 17000 Costco Wholesale #376 Auburn Hills FD Mike Robillard Yes 400 Brown Rd Auburn Hills 17003 Costco Wholesale #1037 Bloomfield Township FD Steven Chamberlain Yes 2343 South Telegraph Road Bloomfield Township 17019 Costco Wholesale #341 Commerce Township FD Lisa Drumb Yes 3000 COMmerce Crossing Rd Commerce Twnshf 17023 Costco Wholesale #393 Madison Heights FD Richard Laurin Yes 30550 Stephenson Highway Madison Heights 17106 Wojo'S Greenhouse-Farm Inc Brandon FD Joe Wojciechowski Yes 2570 Oakwood Rd (800) 264-6620 Ortonville Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 263 of 358 Emergency Contact (24hr) Plan Finished Noc Engineer (800) 530-9924 John W Garner (517) 499-2146 Network Management (517) 256-3712 Jeremiah Scott Scott Grosz (616) 437-2703 NA (269) 449-2233 Ed Smith (800) 530-9924 Kirk Schaeffer (616) 889-7424 Paul Beauregard (313) 922-8433 Yes Yes Yes No Yes Yes Yes Yes Yes 11/10/2010 OAKLAND COUNTY LEPC Finshed Plans: 184 302 Site Plan Status Unfinshed Plans: 17 Total No. of Plans: 201 SARA ID Facility Name/Location Fire Department 17107 Behr America Inc Troy FD 2700 Daley Dr Troy 17172 Mtso #6 Lahser - Verizon Wireless Southfield ED 21009 Lahser Road Southfield 17205 Ferndale Ferndale FD 1200 Farrow Ferndale 17246 Comcast Of Michigan/Mississippi/Tennessee, Inc. Pontiac FD 640 North Saginaw Pontiac 17249 Comcast Of The South, Inc. Southfield FD 21671 Melrose Ave Southfield 17447 Sps Technologies Waterford Company Waterford Township FD 5331 Dixie Hwy Waterford 17453 Level 3 Communications - Sfldmifc01 Southfield FD 23800 West Ten Mile Rd Ste #100 Southfield 17548 Torca Products Inc Auburn Hills FD 2430 East Walton Blvd Auburn Hills 17552 Mci Sujumi Southfield FD 27301 West 11 Mile Rd Southfield or it Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plai and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 264 of 358 OAKLAND COUNTY LEPC 302 Site Plan Status Fire Department Novi FD Waterford Township FD Farmington Hills FD Southfield FD Ferndale ED Southfield FD Wixom FD Southfield FD SouLlifield FD Yes Yes Yes Yes Yes Yes Yes Yes Yes 11110/2010 SARA ID Facility Name/Location 17570 Cvs Distribution Center #0892 43800 Gen Mar Drive Novi 18178 Drayton Pool & Spa Supply Inc 3770 Dixie Hwy Waterford 18213 Sam'S Club #4812 32625 Northwestern Hwy Farmington Hills 18240 Neutral Tandem Inc 21355 Melrose Ave, Bldg 0 Ste J Southfield 18282 Spraytek Inc 2535 Wolcott Ferndale 18289 Level 3 - Detroit 21355 Melrose Ave, Ste D Southfield 18347 Exide Technologies 47087 Cartier Court Wixom 18348 Mtso #7 Lodge - Verizon Wireless 24242 Northwestern Highway Southfield 18382 Cavalier Telephone And TylLdini 300 Galleria Officentre, Ste 100 Southfield Finshed Plans: 184 Unfinshed Plans: 17 Total No. of Plans: 201 Emergency Contact (24hr) Plan Finished Jamie Hawkinson (269) 998-8367 Craig M Remington (313) 402-9916 Deana Howerton (517) 202-0913 Dave Redmon Marvin Hairston (800) 264-6620 John Kucherepa (773) 573-0812 Dennis Rons (248) 431-2698 Scott Grosz (248) 380-2903 Ron Spicer (248) 380-2903 Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 265 of 358 11/10/2010 OAKLAND COUNTY LEPC Finshed Plans. 184 302 Site Plan Status Unfinshed Plans: 17 Total No. of Plans - 201 SARA ID Facility Name/Location Fire Department Emergency Contact (24hr) Plan Finished 18383 Cavalier Telephone Southfield FD Ron Spicer Yes 21314 Melrose Street (248) 380-2903 Southfield 18540 Kraft Foods North America Farmington Hills FD Ron Yes 24100 Research Dr (602) 284-0280 Farmington Hills 18566 Pepsi Bottling Group tic Pontiac FD Scott Siebert Yes 960 Featherstone (920) 639-3087 Pontiac 18582 Placid Station Independence Township FD On Duty Yes 4912 Edgar Road (313) 267-4115 Clarkston 18682 Comcast Of The South, Inc. Southfield FD Frances Danese No 27800 Franklin Road (586) 808-0524 Southfield 19037 Detroit Steel Treating Co. Pontiac FD Janet Fox No 1631 Highwood East (586) 415-9620 Pontiac 19163 Norlight Telecommunications-Southfield Southfield FD Terry Birk Yes 19900 West Nine Mile Rd (586) 997-1411 Southfield 19280 Quality Engineering Center Auburn Hills FD Sam Marchese Yes 2021 Executive Hills Blvd. (888) 696-3973 Auburn Hills 19312 Menlo Worldwide Logistics Auburn Hills FD Jeff Hackney No 60 Corporate Drive (810) 664-4045 Auburn Hills Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 266 of 358 11/10/2010 OAKLAND COUNTY LEPC 302 Site Plan Status Finshed Plans: 184 Unfinshed Plans: 17 Total No. of Plans: 201 SARA ID Facility Name/Location Fire Department Emergency Contact (24hr) Plan Finished 19414 Kellogg Snacks Detroit Distribution Center Lyon Township FD Scott Nielson Yes 30104 Research Drive (231) 342-1895 New Hudson 19445 Sam'S Club #6657 Novi FD Ryan Fraser Yes 27300 Wixom Road (248) 380-2901 Novi 19699 Dte Pontiac North Pontiac FD Donald Januszek Yes 824 Saint Clair Street (989) 551-1832 Pontiac 19948 Switch & Data Mi One LIG Southfield FD Ossc Yes 24660 Lahser Rd. (908) 619-7795 Southfield 20064 Sears Auto Care 2952 Rochester Hills ED Larry Kacilitz Yes 1100 Rochester Road South (888) 368-7372 Rochester Hills 20080 Mi - Metroplex P&Dc Pontiac FD Lynn Jackson Yes 711 N Glenwood Avenue (616) 498-2229 Pontiac 20177 Oxford Forge Oxford FD Roger Mintz Yes 2300 X-Cetsior (734) 368-2455 Oxford 20221 Alta Equipment Company Wixom FD Chris Colwell Yes 28990 S. Wixom Rd. (248) 410-9627 Wixom 20247 East-Lind Heat Treat, Inc. Madison Heights FD Robert Easterbrook, Jr. Yes 32045 Dequindre Rd. (810) 434-1398 Madison Heights Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for i and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 267 of 358 Yes No No No No No 11/10/2010 OAKLAND COUNTY LEPC Finshed Plans. 184 302 Site Plan Status Unfinshed Plans: 17 Total No. of Plans: 201 SARA ID Facility Name/Location Fire Department Emergency C act (24hr) Plan Finished 20299 Enersys 29895 Hudson Drive Novi 20336 Plant 4 30540 Beck Road Wixom 20363 Plant 7 800 Standard Parkway Auburn Hills 20418 Providence Park Hospital 47601 Grand River Ave. Novi 20467 Leonard Plant 180 E. Elmwood St. Leonard 20478 Orion Manufacturing 4872 Lapeer Rd Orion 20492 Sunbelt Rentals Pc 237 48595 Grand River Ave Novi 20528 Alta Equipment Co, 28775 Beck Rd. Wixom 20537 Waterford Iron Removal Plant 31-1 833 S. Williams Lake Rd Waterford Novi FD Alan Brown (231) 271-3194 Wixom FD Auburn Hills FD Leon Klock° No (800) 566-9347 Novi FD Carol Glick No (313) 303-1410 Addison Township FD Sandi Price (248) 770-6350 Orion Township FD Robert Spiller (616) 560-1490 Novi FD Edward Stephenson (248) 674-0531 Wixom FD Matt Parzych (419) 690-6659 Waterford Township FD Chuck Gibson (269) 207-9673 Gene Brush (248) 379-0815 Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 268 of 358 Fire Department West Bloomfield FD Madison Heights FD Waterford Township FD Emergency Contact (24hr) Plan Finished Bill Furlong Ed Smith Quentin Laszyca No No 11/10/2010 OAKLAND COUNTY LEPC 302 Site Plan Status Finshed Plans . 184 Unfinshed Plans: 17 Total No. of Plans: 201 SARA ID Facility Name/Location 20546 Comcast Of The South, Inc.-Orchard Lake Rd. 4925 Orchard Lake Rd. West Bloomfield Township 20550 Corncast Of The South, Inc.-11 Mile Rd. 451 W. 11 Mile Road Madison Heights 20571 Great Lakes Customer Support Center 5400 Perry Dr. Waterford Note: If a farm is not on this list but has received approval from the DNRE to be on the list and has a SARA ID number from the DNRE, the LEPC can develop a plan for it and submit it to the Emergency Management and Homeland Security Division for HMEP grant/SARA plan review purposes. Page 269 of 358 FISCAL NOTE (MISC . #11070) April 21, 2011 BY: FINANCE COMMITTEE TOM MIDDLETON, CHAIRPERSON IN RE: HEALTH AND HUMAN SERVICES — HOMELAND SECURITY DIVISION — 2010-2011 HAZARDOUS MATERIALS EMERGENCY PREPAREDNESS GRANT AGREEMENT TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS Chairperson, Ladies and Gentlemen: Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above-referenced resolution and finds: 1. The resolution recognizes the Superfund Amendment and Reauthorization Act (SARA) of 1986, Title III which requires the planning and provision for community right to know on extremely hazardous substances in local communities. 2. A grant application was submitted and Oakland County has been notified that the Local Emergency Planning Committee (LEPC) was eligible to receive up to $7,870 for the submittal for new and updated plans. 3. This grant requires an in-kind grant match of $1,968 in General Fund expenditures bringing the total program costs to $9,838. 4. The Fiscal Year 2011 Homeland Security General Fund budget includes costs associated with this program, therefore, no budget amendment is recommended. FINANCE COMMITTEE FINANCE COMMITTEE Motion carried unanimously on a roll call vote with Woodward and Greinnel absent. 1 HERE6 APPROVE THE FOREGOI RESOLUTION / Resolution #11070 April 21, 2011 Move by Covey supported by Long the resolutions (with fiscal notes attached) on the Consent Agenda be adopted (with accompanying reports being accepted). AYES: Crawford, Dwyer, Gershenson, Gingell, Gosselin, Greimel, Hatchett, Hoffman, Jackson, Long, Matis, McGillivray, Middleton, Nash, Nuccio, Potts, Quarles, Runestad, Scott, Taub, Weipert, Woodward, Zack, Bosnic, Covey. (25) NAYS: None. (0) A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the Consent Agenda were adopted (with accompanying reports being accepted). STATE OF MICHIGAN) COUNTY OF OAKLAND) I, Bill Bullard Jr., 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 April 21, 2011, 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 21st day of April, 2011. ulL2_er—L_,/ 094, Bill Bullard Jr., Oakland County