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Resolutions - 2013.05.22 - 20846
MISCELLANEOUS RESOLUTION 113125 May 22, 2013 By: General Government Committee, Christine Long, Chairperson IN RE: HEALTH AND HUMAN SERVICES — HOMELAND SECURITY DIVISION - ACCEPTANCE FOR 2010 FEMA STATE HOMELAND SECURITY GRANT PROGRAM TO: OAKLAND COUNTY BOARD OF COMMISSIONERS Chairperson, Ladies and Gentlemen: WHEREAS funding was released from the United States Department of Homeland Security, Federal Emergency Management Agency (FEMA) to the State of Michigan for the 2010 Homeland Security Grant Program; and WHEREAS the grant agreement period is January 1, 2013 to July 31, 2013; and WHEREAS the State Homeland Security Grant award for Oakland County is $467,785 from the Urban Area Security Initiative (UASI); and WHEREAS the funding is for the sole purpose of procuring equipment consisting of one Lenco BearCat vehicle as approved in Allowable Cost Justification #13-0015-01; and WHEREAS the grant agreement has been reviewed and approved through the County Executive Contract Review Process. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners accepts the grant agreement for $467,785 for the equipment purchase of the Lenco BearCat vehicle. BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners authorizes its Chairperson or his designee to execute and enter into this agreement on behalf of the County of Oakland. BE IT FURTHER RESOLVED that the Chairperson of the Board of Commissioners is authorized to execute the Grant Agreement and to approve any grant extensions or changes, within fifteen percent (15%) or the original award, which are consistent with the original agreement as approved. 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 with Hatchett absent. GRANT REVIEW SIGN OFF — Homeland Security Division GRANT NAME: 2010 Homeland Security Grant Program (Lenco BearCat) FUNDING AGENCY: Michigan Department of State Police, Emergency Management and Homeland Security Division DEPARTMENT CONTACT PERSON: Sara Stoddard 8-5080 STATUS: Grant Acceptance DATE: April 22,2013 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 placed on the appropriate Board of commissioners' committee(s) for grant acceptance by Board resolution. DEPARTMENT REVIEW Department of Management and Budget: Approved. — Tim Soave (4/11/2013) Department of Human Resources: Approved. — Karen Jones (4/11/2013) Risk Management and Safety: Approved by Risk Management. — Julie Secontine (4/11/2013) Corporation Counsel: After reviewing the above-referenced grant agreement, I found no legal issues that must be resolved before the grant is executed. Please let me know if you have any other questions. — Jody S. Hall (4122;2013) COMPLIANCE The grant agreement references a number of specific federal and/or state regulations. Below is a list of these specifically cited compliance related documents for this grant. Trafficking Victims Protection Act of 2000, Section 106 hap ://www. state. gov/g itinfrisitinro t/2007/86205. htru Department of Homeland Security Appropriations Act 2010 htto ://www o . go vifci' ws(pkg/PLAW-111pub183/p &ET LAW -111 pth183 .pdf Implementing Recommendations of the 9/11 Commission Act of 2007 hap ://w-vvw. gno . go vifisvs/. ka/PLAW-110Dub153 ipcIfIPLAW-110oub153 .p df Homeland Security Act of 2002 htno://www.dhs.ovixlibrary/assets/hr _5005 enr.pdf Federal Acquisition Regulations (48 CFR Part 31.2) lattp://www.gpo.gov/frisysipic2/CFR-2002-title48-vol1lodf/CFR-2002-title48-yo11.ndf Equal Treatment for Faith Based Organizations (28 CFR Part 38) http://www.usdoi.gov/ovw/docs/asgmernoreimplementatioflof28cfrpart38.pdf Nondiscrimination; Equal Employment Opportunity; Policies and Procedures (28 CFR Part 42) http://www. acc ess. go o.go v/nara/cfew aisidx 01/28 cfr42 01.html Procedures for Implementing the National Environmental Policy Act (28 CFR Part 61) http://w ww. access. gpd.gov/nara/cfr/waisi dx 101 01.html Floodplain Management and Wetland Protection Procedures (28 CFR Part 63) http://www.access.gnO.govinara/cfr/waisidx 01/28 cfr63_ 01.htad National Historic Preservation Act of 1966 (16 U.S.C. 470) http ://www.nps. go v/hi story/local-lawinhpal 966 .htm Executive Order 11593 — Protection and enhancement of the cultural environment http://www. gsa.gov/Portagsa/ep/contentView . do? contentType—GS A B ASIC&contentld--- 12094 Archeological and Historic Preservation Act of 1974 (16 U.S.C. 469) http://www.nps.gov/history/local-law/FEIPL ArchilistPres.pdf The National Environmental Policy Act of 1969 (42 U.S.C. 4321) http://w w w .nepa. o vinepairegs/nepa/nepaegialtrn Omnibus Crime Control and Safe Streets Act of 1968 http://www.usdoi.goviert/split/42usc3789d.htm Victims of Crime Act (42 USC Section 10604) Jattp://www.uscloj.govicrt/coribyagencvldoil0604.htm Juvenile Justice and Delinquency Prevention Act http://o dp.ncirs.o re/a boutijj dpa2002titiev.ndf Federal Civil Rights Act of 1964 http://www.usdoi.gov/crticor/index.htra The Rehabilitation Act of 1973, Section 504 (29 U.S.C. Section 794) http://www. dol. go v/oasam/re s/statutes/sec 504.htrn The Americans with Disabilities Act of 1990 (42 U.S.C., Sec 12101) hap ://www ada jov/pubsiada.htrn The Education Amendments of 1972 (20 U.S.C., Sec 1681, 1683, 1685-86) htto://www.usdei.govicrt/coricoord/titleixstat. htin Age Discrimination Act of 1975 42 U.S.C. Sections 61014107 http://www.dol.gov/oasamiregs/statutes/age actbtm Executive Order 13279 - Equal Protection of the Laws for Faith-based and Community Organizations http://ww-w. whitehouse. go vinews/releaiges/2002/12:20021212-6.html U.S. Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 hap ://www.fhwa. dot. go v/realestate/act.htm Federal Hatch Act - Political Activity of Certain State and Local Employees http://www.osc.gov/hatchact . htm Restrictions on Lobbying (28 CFR part 69) btu: w ww.access.gpo.gov/nara/cfr/waisidx _ 04/28cfr69 04.html Executive Order 12549 — Debarment and Suspension http://wwvv.archives govdederal-register/codification/executive-order/12549.html Government-Wide Debarment and Suspension (28 CER, Part 67) htto://www.access.gpo.govinara/cfr/waisidx 04/28cfr67 04.html Drug-Free Workplace Act of 1988 http ://frw eb gate. a cces s. zoo .go vic gi-b in/g etdoc. c gi?clboarne—browse _ sc &do ci d--Cite:+41US C70 Katie Wes From: Sent: To: Cc: Subject Soave, Tim <soavet@oakgov.com > Thursday, April 11, 2013 11:07 AM 'West, Catherine'; 'Davis, Patricia'; 'Jones, Karen'; 'Secontine, Julie '; 'VanPelt, Laurie' - 'Stoddard, Sara': 'Pisacreta, Antonio': 'Lane, Kathy' RE: Grant Review: Health and Human Services - Homeland Security Division - 2010 State Homeland Security Grant Program - Grant Acceptance Approved From West, Catherine [nnailto:westca(aoakcjov.corn] Sent: Thursday, April 11, 2013 9:21 AM To: 'Soave, Tim`; Davis, Patricia; Jones, Karen; Secontine, Julie ; VanPelt, Laurie Cc: Stoddard, Sara; Pisacreta, Antonio; Lane, Kathy Subject: Grant Review: Health and Human Services - Homeland Security Division - 2010 State Homeland Security Grant Program - Grant Acceptance GRANT REVIEW FORM TO: REVIEW DEPARTMENTS — Laurie Van Pelt Karen Jones —Julie Secontine — Pat Davis RE: GRANT CONTRACT REVIEW RESPONSE — Health and Human Services — Homeland Security Division 2010 State Homeland Security Grant Program Michigan Department of 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: April 18, 2013 GRANT INFORMATION Date: April 11, 2013 Operating Department: Homeland Security Division Department Contact: Sara Stoddard Contact Phone: 8-5080 Document Identification Number: 2010-UA-T0-0016 REVIEW STATUS: Acceptance — Resolution Required Funding Period: January 1, 2013 through July 31, 2013 New Facility / Additional Office Space Needs: None IT Resources (New Computer Hardware / Software Needs or Purchases): No M/WBE Requirements: Yes — Federal Pass-through; compliance with common rule and OMB circular A-102 Funding Continuation/New: Continuation Application Total Project Amount: $467,785.00 Prior Year Total Funding: $1,526,039 (Oakland County's Allocation Only) New Grant Funded Positions Request: No Changes to Current Positions: N/A Grantor Funds: $467,785 Total Budget: $467,785 1 Katie West From: Sent: To: Subject: Jones, Karen <jonesk@oakgov.com > Thursday, April 11, 2013 10:42 AM West, Catherine' RE: Grant Review: Health and Human Services - Homeland Security Division - 2010 State Homeland Security Grant Program 7 Grant Acceptance Approved. From: West, Catherine [mailto:westca©oakoov.com) Sent: Thursday, April 11, 2013 9:21 AM To: 'Soave, Time; Davis, Patricia; Jones, Karen; Secontine, Julie ; VanPelt, Laurie Cc: Stoddard, Sara; Pisacreta, Antonio; Lane, Kathy Subject: Grant Review: Health and Human Services - Homeland Security Division - 2010 State Homeland Security Grant Program - Grant Acceptance GRANT REVIEW FORM TO: REVIEW DEPARTMENTS — Laurie Van Pelt — Karen Jones —Julie Secontine — Pat Davis RE: GRANT CONTRACT REVIEW RESPONSE — Health and Human Services — Homeland Security Division 2010 State Homeland Security Grant Program Michigan Department of 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: April 18, 2013 GRANT INFORMATION Date: April 11, 2013 Operating Department: Homeland Security Division Department Contact: Sara Stoddard Contact Phone: 8-5080 Document Identification Number: 2010-UA-T0-0016 REVIEW STATUS: Acceptance — Resolution Required Funding Period: January 1, 2013 through July 31, 2013 New Facility / Additional Office Space Needs: None IT Resources (New Computer Hardware / Software Needs or Purchases): No M/WBE Requirements: Yes — Federal Pass-through; compliance with common rule and OMB circular A-102 Funding Continuation/New: Continuation Application Total Project Amount: $467,785.00 Prior Year Total Funding: $1,526,039 (Oakland County's Allocation Only) New Grant Funded Positions Request: No Changes to Current Positions: N/A Grantor Funds: $467,785 Total Budget: $467,785 Match and Source: None required 1 Katie West From: Sent: To: Cc: Subject Secontine, Julie <secontinej@oakgov.com > Thursday, April 11, 2013 2:55 PM 'West, Catherine'; 'Soave, Tim'; 'Davis, Patricia'; 'Jones, Karen'; 'VanPelt, Laurie' 'Stoddard, Sara'; 'Pisacreta, Antonio'; 'Lane, Kathy' RE Grant Review: Health and Human Services - Homeland Security Division - 2010 State Homeland Security Grant Program - Grant Acceptance Approved by Risk Management. From West, Catherine [mailto:westca(Thoakoov.corn] Sent: Thursday, April 11, 2013 9:21 AM To: 'Soave, Tim'; Davis, Patricia; Jones, Karen; Secontine, Julie ; VanPelt, Laurie Cc: Stoddard, Sara; Pisacreta, Antonio; Lane, Kathy Subject: Grant Review: Health and Human Services - Homeland Security Division - 2010 State Homeland Security Gan Program - Grant Acceptance GRANT REVIEW FORM TO: REVIEW DEPARTMENTS — Laurie Van Pelt — Karen Jones —Julie Secontine —Pat Davis RE: GRANT CONTRACT REVIEW RESPONSE— Health and Human Services— Homeland Security Division 2010 State Homeland Security Grant Program Michigan Department of 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 Returner' Comments: April 18, 7013 GRANT INFORMATION Date: April 11, 2013 Operating Department: Homeland Security Division Department Contact: cArn ctrIrldArd Contact Phone: 8-5080 Document Identification Number: 2010-UA-T0-0016 REVIEW STATUS: Acceptance — Resolution Required Funding Period: January 1, 2013 through July 31, 2013 New Facility / Additional Office Space Needs: None IT Resources (New Computer Hardware / Software Needs or Purchases): No M/WBE Requirements: Yes — Federal Pass-through; compliance with common rule and OMB circular A-102 Funding Continuation/New: Continuation Application Total Project Amount: $467,785.00 Prior Year Total Funding: $1,526,039 (Oakland County's Allocation Only) New Grant Funded Positions Request: No Changes to Current Positions: N/A Grantor Funds: $467,785 Total Budget: $467,785 Katie West From: Sent: To: Subject: Hall, Jody <halljs@oakgov.com > Monday, April 22, 2013 9:23 AM West, Catherine; 'Quisenberry, Theodore H.'; 'Stoddard, Sara'; 'Secontine, Julie '; 'Laurie Van Pelt'; 'Jones, Karen' Grant Contract Review: Health and Human Services--Homeland Security Division-2010 State Homeland Security Grant Program--Grant Acceptance (Lecno_BearCat_Vehicle) Good Morning All: After reviewing the above-referenced grant agreement, I found no legal issues that must be resolved before the grant is executed. Please let me know if you have any other questions. Jody Jody S.Hall, Assistant Corporation Counsel Department of Corporation Counsel 1200 N. Telegraph Road, Bldg. 14 East Courthouse West Wing Extension, 3rd Floor Pontiac, MI 48341 Phone Number: (248) 858-0555 Fax Number: (248) 858-1003 E-mail: hallisoakoov.com PRIVILEGED AND CONFIDENTIAL — ATTORNEY CLIENT COMMUNICATION, This e-mail is intended only for those persons to whom it is specifically addressed. it is confidential and is protected by the atton .r,..• • client privilege and work product doctrine. This privilege belongs to the County of Oakland, and individual addressees are r::: authorized to waive or modify this privilege in anyway. Individuals are advised that any dissemination, reproduction or unauthorized review of this information by persons Other than those listed above may constitute a waiver of this privilege and is therefore prohibited,. If you have received this message in error, please notify the sender immediately, If you have any questions, please contact the Department of Corporation Counsel at (248) 858-0550, Thank you for your cooperation, GRANT REVIEW SIGN OFF — Homeland Security Division GRANT NAME: 2010 Homeland Security Grant Program (Lenco BearCat) FUNDING AGENCY: Michigan Department of State Police, Emergency Management and Homeland Security Division DEPARTMENT CONTACT PERSON: Sara Stoddard 8-5080 STATUS: Grant Acceptance DATE: April 22, 2013 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 placed on the appropriate Board of Commissioners' committee(s) for grant acceptance by Board resolution. DEPARTMENT REVIEW Department of Management and Budget: Approved. — Tim Soave (4/11/2013) Department of Raman Resources: Approved. — Karen Jones (4/11/2013) Risk Management and Safety: Approved by Risk Management. — Julie Secontine (4/ /2013) Corporation Counsel: After reviewing the above-referenced grant agreement, I found no egal issues that must be resolved before the grant is executed. Please let me lmow if you have any other questions. — Jody S. Hall (4/22/2013) COMPLIANCE The grant agreement references a number of specific federal and/or state regulations. Below is a list of these specifically cited compliance related documents for this grant. Trafficking Victims Protection Act of 200e, Section 106 http://www.state.gov/g/tio/r1sinprpt/2007/862051 -itm Department of Homeland Security Appropriations Act 2010 http://www.npo.gov/fdsys/okg/PLAW-111pub183/pdfPLAW-111 puhlS3 .p d f Implementing Recommendations of the 9/11 Commission Act of 2007 http://www.goo.gov/fdsysipkgfPLAW-110pub153/pdf/PLAW-110pub153.10df Homeland Security Act of 2002 http://www.dhs.gov/xlibrary/assets/hr 5005_enr.pdf Federal Acquisition Regulations (48 CFR Part 31.2) http://www.Rpo.gov/fdsys/pkg/CFR-2002-title48-vollipdfiCFR-2002-title4-8-vol1.pdf RICK SNYDER COVERMOR March 29, 2013 STATE OF MICHIGAN DEPARTMENT OF STATE POLICE LANsretY • n ":"! COL. KRISTE KIB8EY ETUE DIRECTOR Mr. Theodore H. Quisenberry, Manager Oakland County Homeland Security Division 1200 North Telegraph Road Building 47 West Pontiac, Michigan 48341-0410 Dear Mr. Quisenberry: Enclosed is the Fiscal Year 2010 Homeland Security Grant Program (HSGP) Grant Agreement package for the County of Oakland. Please return the required grant documentation listed on the enclosed Subgrantee Checklist to our office at the following address: Attention: Ms. June Martin Emergency Management and Homeland Security Division Michigan Department of State Police 4000 Collins Road Lansing, Michigan 48910 This grant agreement provides funds solely for the procurement of Lenco BearCat vehicles, as represented in the approved allowable cost justification #13-0018-01. Reimbursement for expenditures will be determined using the criteria established in the FY 2010 HSGP Guidance and Application Kit located at http://www.ferne gov/pdfigovemrnentigrant/2010/fy10_hsgp_kit.pdf. Important Note: Procurement must take place ptior to July 31, 2013, If the procurement of the equipment has not been completed by the performance period deadline, then the associated costs will not qualify for reimbursement This grant agreement and ell required attachments must be completed, signed, and returned prior to any reimbursement transactions. It this requirement is not met, any associated reimbursement requests vvill be denied. If you have any questions regarding this correspondence or the 2010 Homeland Semi* Grant Program, please contact M. Kim Richmond at (517) 333-5041. Sincerely, Chris A. Kelenske, Captain Deputy State Director of Emengency Management and Homeland Security Enclosures (8) EMERGENCY MANAGEMENT AND H OMELAND SECURITY OlViSION * 40.00, COLLINS ROM) LANSING, MICH IGAN 46rilo www.friethigan,polgmsp • (a17) 31E41 9.9 SUBGRANTEE CHECKLIST FY 2010 HOMELAND SECURITY GRANT PROGRAM (HSGP) GRANT AGREEMENT CFDA No: 97.067 Submit the followinsi items as neces_sarv to: ATTN: Ms. June Martin, Emergency Management and Homeland Security Division, Michigan Department of Stat,- Police, 4000 Collins Road, Lansing, Michigan 48910 SURGRAN EE WILL N T BE REIMER) SED FOR FUNDS UNTIL ALL REQUIRED SIGNED DOCUMENTS ARE FRECEIYAIE O 1. Grant Agreement (NOTE: There are two (2) sets of the Agreement enclosed. Please sign both, but retain one signed document for your records and return the other signed document to us.) I I 2. Standard Assurances. D 3, Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirement (OJP Form 4061-6) ,te of rchigan Audit Certification Form (EMD-053) 5. Re-quest for Taxpayer Identification Number and Certification (W-9) D 6. Compliance with Federal Special Grant Condition Related to Trafficking Victims Protection Act of 2000, POST REIMBURSEMENT REQUIR.EMENTS Participate with Subgrantor in an on-site monitoring of financial documents. Also retain financiai records, supporting documents, and all other records pertinent to the grant for at least three years after the final grant report. Be sure to comply with Single Audit requirements of OMB Circulai, A-133. If required, the Sub-grantee submits audit copy to: Michigan Department of Education, Office of Audits, Hannah Building, 4 th Floor, P.O. Box 30008, 608 West Allegan, Lansing, Michigan 48909. State of Michigan 2010 Homeland Security Grant Program Grant Agreement January 1, 2013 to July 31, 2013 CFDA Number: 97.067 Grant Number: 2o10-wk-ro-oo16 This fiscal year 2010 (FY 2010) Homeland Security Grant Program (HSGP) grant agreement is hereby entered into between the Michigan Department of State Police, Emergency Management and Homeland Security Division (hereinafter called the Subgrantor), and COUNTY OF OAKLAND (hereinafter called the Subgrantee) Purpose The purpose of HSGP is to provide federal funds to prevent, deter, respond to, and recover from incidents of national significance, including threats and incidents of terrorism. The purpose of this grant agreement is to provide federal pass-through funds to the County of Oakland. The 2010 HSGP is a primary funding mechanism, operated by the United States Department of Homeland Security (OHS) for building and sustaining national preparedness capabilities. HSGP is comprised of live separate grant programs, of which one is covered by this grant agreement: Urban Areas Security Initiative The intent of the Urban Areas Security Initiative (UASI) prograri is to enhance regional preparedness in major metropolitan areas. The UASI program directly supports National Priority on expanding regionalcollaboration in the Aietionai Preparedness Guidelines ars. intended to assist participating jurisdictions in developing integrated regional systems for preventins protection, response, arid recovery. Ultimately, the FY 2010 UASI program is intended to provide financial assistance to address the unique multi-discipline planning, organization, equipment, training, and exercise needs of high-threat, high-density urban areas, and to assist these areas in building and sustaining capabilities to prevent, protect against, respond to, and recover from threats or acts of terrorism. Activities implemented with UASI funds must support terrorism preparedness by building or enhancing capabilities that relate to the prevention of protection from, response to or recovery from terrorism in order to be considered eligible. However, many capabilities which support terrorism preparedness simultaneously support preparedness for other hazards. Grantees must demonstrate the dual-use quality for any activities implemented that are not explicitly focused on terrorism preparedness. It. Objectives The principal objective of this want agreement is to provide financial assistance to the subgraniee to support HSGP allowable activities. Ill Statutory Authority Funding for the FY 2010 HSGP is authorized by the Department of Homeland Security Appropria6ons Act, 2010 (Public Law 111-83); the Implementing Recommendations of the 9111 Commission Adt of 2007 (Public Law 110-53); and the Homeland Security Act of 2002 (13 U.S.C. §101 at seq,). The Sul:grantee agrees to comply with all FY 2010 HSGP program requirements in accordance with the FY 2010 HSGP Guidance. The Sagrantee also agrees to comply with the following regulations: FY 2010 I-ISGP Grant Agreement County of Oakland Page 2 of 7 A. Administrative Requirements 1. 44 CFR, Part 13, Uniform Administrative Requirements for Grants and Cooperative Agreements to State andr Local Governments (OMB Circular A-102) 2. 2 CFR, Part 218, Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitais, and Other Non-Profit Organi2ations (OMB Circular A-110) B. Cost Principles 1. 2 CFR, Part 225, Cost Principles for State, Local, and Indian Taal Governments (OMB Circular A-87) 2. 2 CFR, Part 220, Cost Principles for Educational Institutions (0N1B Circular A-21) 3. 2 CFR., Part 230, Cost Principles for Non-Profit Organizations (OMB Circular A-122) 4. 48 CFR, Part 31.2 Federal Acquisition Regulations (FAR), Contract Cost Principles and Procedures, Contracts with Commercial Organizations C. Audit Requirements and Other Assessments 1. OMB Circular A-133, Audits of States, Local Governments, and Non-Profit Organizations, located at http://www.whitehou se .ç ovisitesidefa ult./files/a mbiassetiOM Bici rcu I a rsia 133la133. html Z Public Law 107-300, Improper Payments Information Act ((PIA) o!2002, located at httpliienerw.dol.goviocfoimedialregsAPIA.pdf Code of Federal Regulations (CFR) document are located online at hdp://www.ecfrgov, IV. Homeland Security Grant Program Award Amount and Restrictions The COUNTY OF OAKLAND is awarded $467,785.00 under the FY 2010 HSGP. This entire amount of UASI program funds. This funding is for the sole purpose of procuring the equipment represented by Allowable Cost Justification *13-0018-01_ V. Responsibilities of the Subgrantee FY 2010 HSGP funds must supplement, not supplant, state or local funds. Federal funds wiil 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 hmiteci to, the following: - A. In addition to this FY 2010 HSGP grant agreement, the Subgrantee shall complete, sign, and submit to Subgrantor the following documents, which are incorporated by reference into this grant agreement: 1. Standard Assurances 2. Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirements 3. State of Michigan Audit Certification Form (EMD-053) 4. Request for Taxpayer Identification Number and Certification (WA) 5. Compliance with Federal Special Grant Condition Related to Trafficking Victims Protection Act of 2000 6. Other documents that may be required by federal or state officials FY 2010 HSGP Grant Agreement County of Oakland Page 3 of 7 B. The FY 2010 HSGP covers eligible costs from January 1, 2013 to July 31, 2013. C. Make all purchases in accordance with federal and state grant guidance and local purchasing policies. 0. Create and maintain an inventory of all equipment purchases in accordance with 44 CFR Part 13.32(d)(1), found at htep://eCFR.gpoaecess_goviegittitextitext- idx?ceecfr&tplrefecfibrawseiTitle4-4/44efrl3 emain_02.tpl. Within 30 days of the end of the Subgrantee's fiscal year, the Subgrantee must Supply a copy of this inventory to the Michigan State Police, Emergency Management and Homeland Security Division, Audit Unit, 4000 Collins Road, Lansing, Michigan 48910-5883. An Equipment Tracking Form is available to assist the Subgrantee in meeting these requirements. The form can be found online at http:fAuww.michigan.govimsp./0,1607,7-123-1593_3507_41574-214684—,00.html. The subgrantee is advised that, when practicable, any equipment purchased with grant funding shall be prominently marked as follows: Purchased with funds provided by the U.S. Department of Homeland Security". E. The Subgrantee agrees to prepare the Reimbursement Cover Sheet (EMD-054) with all required supporting documentation attached, including proof of payment, Reimbursement Cover Sheets must be filled out completely and submitted with original signatures or they will be returned to the Subgrantee for proper completion, The Subgrantee will riot be reimbursed for funds until all required signed documents and reimbursement documentation are received, All reimbursement requests must be submitted to the Subgrantor no later than 30 days after the end of the performance period identified in this grant agreement. Any remaining balance of funds by that date will be reallocated. F. Comply with FY 2010 National Incident Management System (NIMS) implementation requiremente and move towards completion by 2013 NIMS information is available at httpliwww.femac oefemergencyinims G. Comply with applicable financial and administrative requirements set forth in the current edition of 44 CFR, Part 13 including, but not limited to, the following provisions: t 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 FY 2010 HSGP for at least three years after the grant is closed by the awarding federal agency, for purposes of federal end/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, 'Auclitg of States, Local Governments, and Non- Profit Organizations, as further described in 44 CFR, Part 13, K Integrate individuals with disabilities into emergency planning in compliance with Executive Order 13347. VI. Responsibilities of Subgrantor The Subg ranter, in accordance with the general purposes and objectives of this grant agreement, will. A. Administer the FY 2010 HSGP in accordance with all applicable federal and state regulations and guidelines and provide quarterly reports documenting this administration, B. Provide direction and technical assistance to the Subgrantee. C. Provide to the Subgrantee any special report forms and reporting formats (templates.) required for operation of the program, FY 2010 HSGP Grant Agreement County of Oakland Page 4 of 7 D. Reimburse the SuPgrantee, in accordance with this grantagreement, based on appropriate documentation submitted by the Subgrantee. E. Independently, or in conjunction with DHS, conduct random on-site reviews with Subgrantee(s). VII. Payment Procedures The Subgrantee agrees to prepare the Reimbursement Cover Sheet (E.MD-054) with all required supporting documentation attached, including proof of payment. Reimbursement Cover Sheets must be filled out completely and submitted with original signatures or they will be returned to the Sagrentee for proper completion. The Subgrantee will not be reimbursed for funds until all required signed documents and reimbursement documentation are received. All reimbursement requests must be submitted to the Su bgrantor no later than 30 days after the end of the performance period identified this grant agreement. Any remaining balance of funds by that date will be reallocated. VIII. Employment Matters SU:grantee shall comply with Title Vi of the Civil Rights Act of 196.4, 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, NICL 37.1101 et sw., 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 inclucie in every subcontract ente. ea into for thf- 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 Depai &lent of Energy, Labor, and Economic Growth, Bureau of Commercial Services, Licensing and Enforcement Divisions, pursuant to 1060 PA 278, as amended, NICL 423.321 et seq. (State Contractors with Certain Employers Prohibited Act), or on the Federal Excluded Party List System, located at http://www.epls.gov. IX. Limitation of Liability Subgrantor and Sulegrantee 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 Trfis +:e not to be construed as a waiver of governmental 'militia* X. 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. FY 2010 HSGP Grant Agreement County of Caltiand Page 6 of 7 XI. Grant Agreement Period This grant agreement ig in full force and effect from January 1, 2013 to July 31, 2013_ 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; ea& 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 termination, 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, XII. 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 XI above, No party to this grant agreement may assign this grant agreement or any of his/tier/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. Charges 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 Suggrantor may suspend or terminate b nt funding, in whole or in part, or other measures may be imposed for any of the following reasons: 9 Failure to expend funds in a timely manner consistent with the grant milestones, guidance, and aesurances. • 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 eabgrant application. Failure to follow grant agreement requirements or special conditions, • Proposal or implementation of substantial plan changes to the extent that, if originally submitted, the project would not have been approved for funding. Failure to Submit required reports. ▪ Filing of a false certification in the application or other report or document. 9 Failure to adequately manage, monitor or direct the grant funding activities of their subrecipiente. Before taking action, the Subgrantor will provide the Subgrentee reasonable notice of inteat to impose corrective measures and will make every effort to resolve the problem informally, X111. 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 Suberantee, 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. FY 201C HSGP Grant Agreement County of Oakland Page 6 of 7 IV. 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 nformation; 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. FY 2010 HSGP Grant Agreement County of Oakland Page 7 of 7 XV. Official Certification For the $ubarantee The individual or officer signing this grant agreement certifies by his or her signature that he or she is authorized to sign this grant agreement on behalf of the jurisdiction he or she represents. The Subgrantee agrees to complete all requirements specified in this grant agreement. County of Oakland 13620036Z Name of Subgrantee Subgrantee's DUNS Number Michael J. Gingell . Chairperson Oakland County Board of Commissioners Printed Name Title Signature Date For the Sub rantor V1cWan State Police,EmeraencY mama ement and HomeLand Securi ty Chris A. Kelenske, Captain Deputy State Director of Emergency Management and Homeland Security Title Printed Name Sid)ciLL3 OMB APPROVAL NO. 1121-0]40 EXPIRES 0650/209 STANDARD ASSURANCES The Applicant hereby assures and certifies compliance with all applicable Fed.cral 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 requiremeats for grants and eooperative agreements). The applicant also specifically assures and certifies that; 1_ It has the legal authority to apply for federal assistance and the institunonal, inanagerial, and financial capability (including fonds sufficient to pay :any required nun-federal share of project cost) to ensure proper planning, management, and completion of the project described hi this application- 2_ It will establish safeguards to prohibit employees from using their positions fora 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 assistanee, 4. It will comply with all lawful requirements imposed by the awarding, agency, specifically including any applicable regulations, such as 28 C.F.R. 11..-;, 22, 23, 30, 35, 18, 42, 61, and 63, and the award term in 2 C.F.R. g i75.15(b). 5. It will assist the awarding agency (if necessary) in ES4utring compliance with section 106 of the National Historic ?reservation Act of 1966(16 LJS, § 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 &t, hgraritees 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 1_1.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 19454 (42 § 2000d); the Rehabilitation Act of 1973 (29 §7 94); the Americans with Disabilities Act of 1990 (42 U.S.C.§ 12[31-34); the Edueation Amendment of 1972 (20 U.S.C. 1683, 168546); 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, [f a govenimental entity— a) it will comply with the requirements of the Uniform Relocation Assistance and Real Property Acquisitions Act of 11970 (42 U_S.C.§ 4601 et seq.), which govern the treatment of perzons digplaced as z result of federal and federally-assisted programs; and h.) 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 Michaei J. Gingell, Chairperson Oakland County Board of Commissi ners Date EMD-053 (03-2004) MICHIGAN STATE POLICE Erne Maria mint & Ho eland ScuriI ISOMOZHINIIMMO &TATE OF MICHIGAN AUDIT CERTIFICATION Federal Audit Requirements Fiscal Years Beginning After June 30, 1996 Non-Federal organlzations 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: Michigan Department of Education, Office of Audits, Hannah Building, 4Th Floor, P.O. Box 30008, 608 West Aliegar, Lansing, Michigan 48909, for each year they meet the funding threshold. Program: FY 2012 Homeland Security Grant Program CFDA Number: 97.067 Jurisdiction Name: Street Address: City, State, Zip Code: Oakland Coun y 1200 N. Telecraoh Rd Pontiac MI 48341 Certification for Fiscal Year Ending (rnmiddiyyyy): (Check appropriate box) 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 1964, as amended, and the OMB 'Circulars as revised, for the above listed procram. ri I certify that the subgrantee shown above expects it will be required to have an audit performed Linder the Single Audit Act of 1984, as amended, and the OMB Circulars as revised, during at least one fiscal year funds are received tor the above listed program. A copy of the audit report will be submitted to: Michigan Department of Education, Office of Audits, Hannah Building, 4th Floor, P.O. Box '30008, SOB West Allegan, Lansing, Michigan 48909-. (Signature of Subgrantee's Authorized Representative) Michael Ging& 1, Chairperson, 0.0 Board of Commissioners (Date') Please mall completed form to: Attention: Ms, June Martin Emergency Management and Homeland Security Division Michigan Department of State Police 4000 Collins Road Lansing, Michigan 48910 For MSP-EMD Use Only Reviewed By: Datg.: Authority: Act 390, P, A, of 1976, as amended Completion: Voluntary, but completion necessary to be considered tor essiStonce, -9 41:tev, Deteinhier n11) PvLiirrn IFlt TrreawrY Inte-n* Revenve Sorvbe Request for Taxpayer Identification Number and Certification Gitio Farm to the regoestor. Do not send to the IRS. NaTie (as shown on your ,noon e tax return) Oakland County ,,,,ines3mmeif.di$.remrdea 0,14 name, if erent from above CerrEV.C. aDpfarpreis box it:If faderal tax. classfcalion; Li Indvis.tol.iWe. proprietor C Corpwation D S Corporation C] PartnerWin El Trutt/00We Limited liability company, Enter Ino tad, t:la-ssifi?-ati-ron (C;.0 curporatinn. t;-,S corpo(aton, p.partlersh; tEl EX•Cerird fraye•H I. E Otrer ee .nstructions) over n n o.) m ent Erti Aorees (wmber, sreet, and apt. or site 41°1120D N. Telegraph Rd (Ay, state, 8,141 ZIP rode ontiac MI 48341 List account numberis) hiammtOnr.113 eq.estv's name and adcirOsk; OpliOeu,Q Taxpayer Ittenttfication Number (TIN Enter your TIN in the appropriate box. The TIN provided mist match the name olven on the "Name' pn to avoid bacl<luo withholding. For indiridua1s , thig Is yeicIr social security number {SSN), However, tor a resident alien, sole proprietor, Or disregarded entity, see the Part I insYuctions on page 3. For other entities, It Is your employer identification number (El N), IF you do not have a number, see prilow to get a TIN on page 3, Note. If the awount is in more than one name, see the chart on page 4 for guidelines on whose number to enter. 11 Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpa yer identification number (cc I am waitiog for a number to be issued to me), and 2. I am not subject to backup withMoldIng because: (a) I am exempt from beqkup withudding. or )b) h,eVe sot boon notified by the Internal Fleveriu Service (IRS) trist I am subject to backup withholdin g as a result of a failure to report all iiterer.,t or d Mdends, Or o) the IRS has notified me Mat i .1117 no longer sublect to backup withholding, and 3, I arna U.Scitizen or other U. S. perSon (defined below). Certification Instructions. you must cross out iterri 2. above it you have been notified by the IRS that you Ne currently 94lbject to backup withholding because you lime tailed to report all interest and dividends on your tax return. For real estate transactions, tern 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property. cancellation of debt, .GQritributians ari individual retirement arrangement (IRA), and generally, payments other than Intonsst and dividends, you are act required to si gn the certilicwien, but you must provide your correct TIN. See the Instructions on page 4. Sign Here Signature of t.r.S. parson Deur lk angjigyor ide-ntilic.16or$ rignber 7 General Instructions Section references are to the Internal Revenue COda unless athgtWise nOted- Purpose of Form A person who is requited to file an information return with the WS must obtain your correct taxpayer identification number 11N) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, ac quisition ic4 abandonrrient of secured property. cancellation ol debt, or contributions you made to an IRA, Use Form only if you area U.S. person (inoludin g a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. CArtIfy that the TIN you are giving is correct (or you are viaitin g for a nurrther to be issued), 2. Certify that you are not subject to backup withholding, or 3, Claim exemption front backup withholding if you are a U.S. exempt payee. II applicable, you are also certifying that as a Lt,5. person, your allocable share oi an y partnership income from a U.S. trade or business Is not subject to the withholdin g tax on foreign partners' share of effectively connected inconie. Note. If a requester gives you a form Other than Form W-9 to rF....quest your 1151, you must use the requester's form if it is substantially similar to this Form W-0. Definition et a IJ.S, person, For federal Lax purposes, you are considered a U.S. person if you are: • An. individual wino Is a U.S. citizen oril,S, resident alien, • A partnership, corporation, company, or association Creatod or organized in the United States or under the laws of the United States, • An estate (other then 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 busines.s in the United States are generally required to pay or w'rthrolclin g tax on err/ foreign partnere' share of income From such business. Further, In cettaii cases where a F{}rah W-P has not been received, a partnership is required to presume that a partner is a foreign person, and pay the with-hording 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 roan to the partnership to establish your U.S. status and ow .0. withholding on your share of partnership iriorrie. Cat. rto 10231X arm W4 . 12-20 Fcem te-s {Fiev. 17 -7,511 Pa 9e 2 The person who gives Form W-9 to the partnership for pewees ql e5tabii5hirkg it9 U.S. etatue end avoiding withholding on its elk:cable share of net income from the partnership cortclu(ting a trade or business In the United States is irt the followieg Cases. • Thel.J.S. owner of a disregarded enfrty arid not the entity, • The U.S. grantor or other owner of a grantor trust and not the trust, arid • The U.S. trust Miler than a grantor rest) and not the beneficiaries of the trust. Foreign perteen.11 you are a foreign persori, do not use Form Wee Instead, use the appropriate Form W. (see PublIc-atIon 515, Withholding of Tax on Nonresident Aliens and Foreign Entities), Nonresidenrt alien who becomes a resident alien. Jeenerally, only a nonresident alien individual may use the terms or a tee treaty to reduce or eliminate U.S. tax on certain types of Income. However, most tax treaties contain a provlsbo known as a "sawing ciaese," Exeeptions specified in the saving clause may permit an exemption Inern tax to continue for certain types of income even after the payee has otherwise beourne a U.S. reskient 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 tee-kern an exemption from U.S. tax on certain types of income, you must attach a statement to kern W9 teat specifies the following five items; 1. The treaty country. Cienereely, thie muel bathe same treaty under which you ciaimed exemption from tax as a nonresident alien. Z. The treaty article addressing the income. -3, The extiole number (or leeefiien) in the tax treaty that contains- the saving clause and ite exceptions. 4. The type and amount of Income that qualifies for the exemption from tax- 5. Sufficient facts toiuetify the exemption- from tax under the terrne of the treaty article. E,eareofe. Artiele 20 Of the U.S.-Chine income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily o.rent in the United States. Under tee. law, this student will become resident alien for tax purposes if his or her stay In the United States exceeds 5 calendar years.. However, paragraph 2 al tere first Protocol to the U.S.-China treaty (dated April ao, 1964). allows the previeione of Article 20 to continue to apply even after the Chinese student beGorneis a residere alien of the United States, A Chinese student who qualifies for this exception (under paragraph 2 of the lira' protooteli and is retying on this exceptive to claim an exemption from tax on his or her scholarship or felk)Wship Income would attach to Form W-2 a statement that Includes the information described above to supper/ that exemption. If you are a nonresident alien or a foreign entity not subject to backup withholdingr give the requester the appropriate completed Form Vir-8. What Is backup withholding? Perspire making certain payrrtenls to you must under certain OOrtelitiona withhold and pay to the IRS a percentage Pt such payrnerite. This is called 'backup withholding." Payrrierts that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties. npnemplayee pay, and certain payments from fishing tecet operators. Real estate traosactlene are not subject to backup withholding. You will riot be eubjeet to backup withholding on payments you reoeive if you glwe the requeeter your correct TIN, make the proper certifications, and report all your taxable interest and dividends en your tax return. Payments you receive will be subject to backup withholding if: 1. You do net furnish your TIN to the requester, 2- You. do nal certify yourTIN when required (see the Part II instructions on page 3 for details), S. The IRS tells the requester that you erniehed an incorrect 4. The IRS tells you that you are sublect to backup 'withholding because you did riot report all your ieterest and dividends on your tax retina tee reportable Interest and dividends only), Or You do not certify to the requester that you are nct subject to backup withholding under 4 above (for reportable interest and cilvideed accounts opened after 1 l)Ot only). Certain payee-s and payments are exempt from backup withholding. See the instruetione below arid tire separate instructions for the Requester of Form W-D. Also sae Specie? reles for earteersNes on page 1. Updating Your I nfnrmation YOU must provide updated information to any person to whore you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future tract thIS person. For example, you nay need to provide updated information if you are a C. corporation that elects to be eri S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Forrn W-9 if the name or TIN changes for the account, for example, if the grantor of a 9rantor trust dies. Penalties Failure- ta furnish Tile if you fail to furnish your correct TIN to a requester. you We subject to a penalty of $50 for each such failure -unless your failure is due to reasonable cause and not to vie/Iful neglect. Civil penalty far false itiferrnatiori with respect to withholding. II you make a false statement with no reasonable beets that results In no backup withholding, you are subject to a .S.500 penalty. Criminal penalty tar falsifying information. Willfully falsifying certifications ix affirmations may subject you to criminal penalties including tines aeclior Imprisonment, Misuse of TINS. if we requester discloses or uses TtNs in violation of federal law, Me requester may be subject to civil end Criminal penaltiee„ Specific Instructions Name If you are an individual, you must generally enter the. narne sheksat on your income tax return, 14owever, if you have enaneed your last remu. for instance, due to marriage without inlorroine the Social Sereeity Administration ci tric llama change, enter your first name, the last name shown On your social security card, and your new last name. tf the account is in }Dint reeves. list first, and then circle, tbe name 01' the person Vf unlit'? whose Curnt.Xt, you entered in Part I of the form, Sole proprietor. Enter your in,dividual name as shown on your income tax return on the "Name" 416. You rnay enter yous do5ineas, trade. or "doing business as (OSA)" name on the eleusinesa rerneellsregarded amity name' ene, Partnership, C Corporatibb, or S Corporation. Enter the entity's nuns on the `Narrie" ito anti any business, trade, Or "doing business as pee) name' on the "euainess narne/ditnegarPiJel entity name" line. Disregarded entity. n ter the owner's carne on the 'Name" line. The name of the entity entered on the "Name" line should never be a disregarded entity, The name on the 'Name" lino must be the name shown errs the inoorne tax return on which the income will be reported. For example, if a foreign LLC. that is treated as a disregarded entity to U.S. federal tax ourposes has a domestic owner, the ciornin.tic name is required lobe provided on the "'Name - line, If the direct CPNnrg Of the entity i at5o a disregarded entity, enter the first owner that is not disregarded tar federal tax purposes. Enter the diereearcied entity's name on the "Business narn&diseegarded entity narne- line. If the owner of the disregarded entity ix a roceign parson, you (mist complete an Note Gheeappropriate box for the federal tax classification of tee aPlerO.PliatekForth:talerpr-e. person whose mama Is entered on the "Name" fire (Individual/sole proprietor, Partnership, C Corporation, 8 Corporal.on, Trust/estate). Limited Liability Company (LLC). If the person identified on the °Name" line is art LIG, check the 'Limited liability company' box enly and enter the appropriate coda iPr the tax cias,s1ficetion in the space provided. If you are an LLC than is treated ass partnership for federal tax purposes, elerer "P" for partnership, If you are an LLC teat has filed a Form 32 or a Form 2553 to be taxed as a corporation, enter "C" for C corporation or "S" for 5 corporation. II you are an LLC that is disregarded as an entity separate from its owner under Regulation sectbn e01:7701-3 (except for employment and excise tee), do not deice the t_LC tox unless the owner ol the LW (received to be • identified on the "Name' line) is another LLC trate not disregarded for federal tax purposes. If the LUG is disregarded as an entity separate frorn its owner, enter the appropriate tax classification of the owner identified on the 'Name" line. Feyen vrr-e I:Rev..12.20re Other entities. Enter your business name as shown on required federal tax documents on the "Name' line. This name should rnetch the Rune shown on the charter Or other legal document creating the entrty. You may enter any business, trade, Or C1LBA name on the "Bueine,ss named dleregarded entity name" line. Exempt Payee If you are exenript from backup with enter your name as described above arid check the appropriate box for your sP.atus, then check the "Exempt payee" box in the line fotlowirkie die "Business name/ disregarded entity name," sign and date the form, Generally, individuate (including eorie proprietors} are not exempt Foe' backup withholding. Corporations are exempt from barAup withholding for tertain payrrients, such as interest and dividends. Note, If you are exempt from backup withholding, you shoed still complete this form to ovoid possible erroneous backup withholding. The fOlkIWIng payees are exempt from backup wIthh.olcilrig: 1. An organization exempt freer tax under section 501(a), any IRA, or a custodial acoeunt under section 403.(b)(7) if the account satisfies Ihe requirements of section 401(N2), 2. The United States or any of Its agendas or instrumentaliti, 3. A state, the Cistrict 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 instrumentalities, or 5. An international organleaeoe or any of Its agencies or instrunientalltiee. OMer payees that may be exempt from backup withholding include: 6. A corporatiore 7. A foreign central bank of issue, B. A dealer in securities or cornmOditiee re.4 uirod to register In the United States, the District of Columbia, or a possession of the United States, 9. A futures commission merchant registered with the CeirrimodIty Futuree, Trading Commission, 10. A reel estate investment trust, 11. An entity registered at all times during the tax year under the Investment Company Are of 1340, 12. A common (rust fund operated by a bank under section 584(a), 13. A financial institution, 14. A middleman known in Me investment community as. a nominee or custodian, or 15. A trust exempt from tax under section 664 or described in section 491,57. The following chart Shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through S. IF the PaYMBIlt is or - - - TI-IEN the payment Is exempi Interest and dividend payments All exempt payees except for 9 Broker transactions Exempt payees 1 through 5 and 7 through 13., Also, C corporetkene. Barter exchange transact ionic and patronage diviciends Exempt payees 1 through 5 Payments over 5600 required to be reported arid direct sales over 55.000 ' Generally, exempt pieyees 1 through 7 ' gee Form OUg-hdil5C, Misca!a.leous Income, and its instructions. 'However, the follueing paymaes Male has corporation and reportable on Form ingg-Ml$C, are not exempk from backup withholding: rredia.al and neah care oayrreots, attoraeys fees, grass proceeds paid to an attorney, and payments for services paid by a federal ex.ecutive agency. Part 1. Taxpayer Identification Number 1TN) Enter your TIN in the appropriate box. If you are a resident alien arid you do not have and are not eligible to get an SSN, your TIN is your IS individual taxpayer identification number (1T1N). En!er it in the sccial security eurnber box_ If you do not have an IT IN, see Hew to get a TIN beiow. If you are a sore proprietor and you have ark E1N, you may enter either your SSN or ON. Howeeer, the IRS prefers that you use your SSN. If you are a single-member I. LC that is disregarded as an entity separate from its owner (see flahlteci LiabRey Corriparry(LEC) Ora page 21, enter the owner's SGN (or EIN, If the owner has One). Do not enter the disregarded entity's El N, if the LIG is olzieeified as a corporation or partnership, enter the entity's EN. Note, See the chart on page 4 for further clarification ce name and TIN combinations. How to get a TN. if you do not have a TIN, apply for one harnedlately. TO apply tor an S.511. get Form 55-5. AppItcatiori for a Social Security Card, earn your focal Social Security Administration office or get this form online at WIrvw.ssa.gov , 'You may also get this term by calling 1-800-772-121e. Use Form W-7, Appficatiork for IRS individual Taxpayer Identification Number, to apply far an I Ti el, or Form SS-4, Application ter Employer Identification Number, to apply for an EIN, Y04,1 can apply for an El N online by accessing the IRS wetes:rte at wevvrenegorebusirressee and clicking on Ernpkryer Identification Number (EIN1under Starting a Eueinese. You min gat Forms IN-7 and SS-4 from the IRS by visiting IRG.gov or by calling 1-300-TAX-FORM tin -800-82-9-.367B1. If you are asked to complete Form iN-9 but do not have a TIN, write `Applied For- in the space for the TIN, sign and date the form, arid give it to the requester. For Interest and dividend payments, end certain payments made with respect to readily tradable insearriente, generally you will have €0 days to get a TIN and give it to the requester before yee erre subject Ca backup withholding On payments, The 60-day rule dorm not apiary to ether types of payments. You will be subject to backup withholding on at such payments until you provide your TIN to the requester, Note. Entering "Applied For insane that ycu have akeedy appliecit: TIN or that you intend to apply for one so:A-, Caution'. A disregarded donee:see' eerily that has E. (vrefur; Vilill0( mere- use the ep,orcnnete F-orrn 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 itern I : below, and items 4 ancl 5 on page 4 indicate otherwise. For a joint account, only the person ienose TIN is shown in Part I should sign (when required), In the ceee el a disragarcled entity, the person identified on the 'Name - line must sign. Eeempt payees, see reamer' Payee on page 3. Signature requiremente. Complete the certification as Indicated in items 1 through a, below, and items 4 and 5 on page 4. 1, Interest, dividend, and barter 6.xchange accounts opened before 11934 and broker accounts considered active during 1933. 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 tam and broker accounts considered inactive during 198. You must sign the certification or bathup eilteholding will apply. If you are subject to backup withholding and you are merely providing your oorroct TIN to the requester, you must cross our item 2 imatte certification before signing the form. 3- Real eutatetreneactiona. You must sign the certification. You may cress out item 201 the certifirration. Form Vi-Ij 12-2011 Roe 4 4, Other payments. YOU Must give your correct TIN, but You do rrOt I lave 10 in the oertification unless you have been notified that you have pr eviously given an incorrect TN. "Other payrnerits" include paymer its made In the course el tine requester's trade or business for rents, royalties, goods (other than bills tor merchandise), medical and health clue services (including payments to corporations). PaYrrler't 5 to a rionemployee for services, payments to pertain fishing boat crew trerrther,S and lithermen, and grata pro-L.—zeds paid to attorneys (irrcluaing 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), FRA., Cpsrerdell ESA, Archer MBA or 115A contributions or distributions, and pension disVibutions. 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 irjps of account Give .rem SSN et; 1. Individual 2. Twrstir Were iririviduht {joint accox-rt) 3. Custodian account of a minor (uniform Gift lo Minors Ach 4. a. The usual revocab'e savinp trUst4granior is also frustee b. Set•callec.1 lruSt 0.0e0..6r1 Vial iS not a legal of valid trust UtrolEr stain inw . SiS: prOprieturehip Or CliSregertleCI entity awned by an indhioluai G. Grantor trust filing under Crolicret form 1049 Firing Metnod 1 rsee Regulation section 1671 -4(b)12XMi The individual The aclueJ owuldi of the account oi. if comtirruet funds, tne first indvidual on the account ' -rho !minor' The 9reltoe-trusrtee ' The ;104 Owner ' The Crrerer ' • The vernor For lisle type of account 6luue nameand lf oft C. Drsregarcaad ently not errried by an in El. R. valid trust, estate, or peralon tie...et 9 Cortuoral.Ot or 11.0 electing corporate status on Form 8e32 or Form 21155 id. Association, club, cegioua. rti lariteOle , erfuticelar, or ether tek-exemot organization II, Parinorolip ry nrx,1--rnerp040 I. I. 0 12, A broker or ecvoislcred rip•riiriet la. Recant with the Depairriant al Agriculture in the rkirrIU of o Public entry tsupb as a state or local envernmezir, achno: ci strict, or prison) that receives vritxatural ispgrarr; poymelts 14. Gramm-in:1Si Uin9 undtir thuFurm 1041 Fiiing Method or the °Kona' Fern i 1099 Fling Method 2 Isle Regulation section 1.G71-40g0B) The owner Lws entitv ' I The COrpOratirth I The rization The parinerehio The Croke( Ur rominee TM'. pu olic entity The trust Note. If no narna iuCirCled when more than one narne is listed, the number will be considered to be that of the lirst name listed. Secure Your Tax Records from Identity Theft Identity theft acmes when someone uses your personal information such as your name, social security nUMber (N), or other identifying information, without your permission, to commit fraud Or other onmes. An identity thief may use your SSF) to got a job or may file ,a tax return using your SSN to receive a refund, To reduce your risk: F' Protect your Ensure your employer Is protecting your SSIlit, and Re careful when choosing a tax prepare'. if your tax records are affected by Identity theft and you receive a notice from the IRS, respond right away to the name and phone narthrar printed on the IRS notice or letter, It your too< records are not currently -affected by Identity theft byt you, think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the FRS Identity Theft hotline at 1.130.0-906-4490 or submit Form 1 c103€5. For more infoirnation, see Publication 452,5, Identity Theft Prevention end Vctirn Assistance. Victims of identity theft wt-l0 are en,Ferienoins 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 (TAS) assistance. You can reach TAS by ceiling the TA5 loll-Free case intake line at 1-871-F777-4778 or TTY/TDD -80171-529-43051. Protect yourself from suspicious entails or phial-ring schemes. Phishing is the creation and use et ernail and websites designed to mimic legitimate business errkails and websites. The Most common act Ic sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user linto en enduring private information that will be used for Identity theft, The FRS does not initiate contacts with taxpayers via emalls. Also, the IRS does not request personal detailed inforenatiOn ItirouQ0 entaii or ask =payers for the Piti numbers, passF. Yords., 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 FS, iorward this rries-aca to ph,ishincAirs,gov, You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration at 1-BOO-366-21484. You can forward suspicious ernals to the Faderal Trade Convnission at: sparnRociegov of contact them at WWW.fIc.govfidtheft or 1-177-1DTHEFT (I -377-43S-433aF. Visit 1R.S.gov Is learn more about identity theft and how to reduce your risk 'List frsl ard oiree Ste rums oi the per sal whote number yeti iuerfE#1.14 Of.{}. We. Otisllier, .10Int acexiiint has ;r N, Slat porson'sesmbor. m. o.:.bc fumehed, • Ole mimics 'owls ort0 furriSti l'ete Neter', SSAI. You rnust show yol.r rid idud narro and you ma", else min- your businesses 'OOP Munn Ori the '15oSineee refreidi&nardeXI Entity" rinfrie line 'ft....may use etier yo,v $e.ol or Ein ft you na rcf,b Ens IRS enosuarassr.ulo use rsur 55N. Usl cyst erd Or•cl4tr.a nWra +Nat, eirena or nai.9.0i trine. st,S1 l'arcsh the Tlhl DI InE personal roors-.cirdratho or tiunlee uniess the legal carry riteif it eat stet OULE.0 11 the acco..na title ) Aso see T7;neene'rvhss fio-parreanhyis On Peg/ "Now- 0•eirricir airo nun t provide a For o VY.S to surtco tel trust. Privacy Act Notioe Section 6109 of the internar Pe,ionuo edoe requires you to prov.de your CCHT&C4 TIN to peruom (including federal agencies) who are reouired to hie informaton returns wth the IRS to report interest, dividends, of oert4n other income poid 10 you; rnorinor)e interest you Cele; the acquisition abancbnthent of seoxed ofooOrly; the iailealistroi of debt: 5 cua1r.e3utions you wade to an IJl, Archer MSA, or inSA. The PE4Saln collecting this form usos tie nformation en the kcal' to tile informaton returns with its. IRS, repricing the above information. Routine uses of this information include Owirini it 10 the Derafirlieflk of Justice for CIVH and crimmal litigation and to citius,s.tetes. the cetrict of Coluntia, And ho. posseaskins for use in oreninistering their laws. The information also may be riisoleeel to other countries under a treaty, to federal arid state agencies toi enforce civil and criminal laws, or to federal tarn aninroarnieni arm,' intelugerue agencies to combat terrorism. YOU rn-tat provide your TIN whether or Pot you aie required to T.Ic z to lc reluril, under section wa, payers 'rust gene'slly with hold a oaraeritage of taxable interest, clixdand, and certain (Ithev Payments to a payee sits C/Ce$ PC49Ne a TIN to are payer. Certain penalties rhay also apptyr for woviding fa:T.e Cr frudblerit U.S. DEPAR.TNINT OF JLIIS TICE OFHOG OF JUSTICE PROGRAMS OFFLC OF THE COMPTROLLER CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS Applicants should refer to the regulations cited below to determine the certification to which they are required to attest. Applicants should also review the inetrucrions for certification included in the regulations befere 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 repreSentalion of fact upon which reliance will be placed when the Department of Justice determines to award the covered transaction, grant, or cooperative agreement. 1. LOBBYING 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 aver Si 00,000, as defined at C.FR Part 89, the appilcant certifies that: (a) No Poderal appropriated funds have been paid Of 1,1411 be paid. by or on behalf of the undersigned, lo any person for in- fluencing or attempting to Influence an officer or employee of any agency. a Member el Congress, an OffiPer or emplOyee of Congress, or an employee of a Member of Congress in con- nection with the making of arty Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or co-operative agreement; t)), 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 er employee of Congress, or an employee of a Member of Congress In connection with this Federal grant or cenperative 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 alt setbawardS 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 RESPONsisiLITy MATTERS (DIRECT RECIPIENT) As required by Executive Order 12549, Debarment arid Suspension, and implemented at 28 CFR Part 67, ter prospec- tive participants in primary COverer/ transactions, as defined at 28 CFR Part 67, Section 67.510— A. I ha applicant certifies that lt and its principals! (a) Are not presently debarred, suspended, proposed for debar- ment, declared ineligible, sentenced To 3 denial or Federal benefits by a State or Federal court, or voluntarily excluded from covered transactions by any Federal department or agency; (NI Have not within a three-year period preceding this applica- tion been GorroiCted of or had a civil judgment rendered against them for commission cif fraud or a criminal offense in mincer lion with obtaning, attempting to obtain, or performing a public (Federal, Slate, or local) transaction or contract under a public transaction: violati.on of Federal or State antitrust statutes Or commission of embezziernent, 'haft, forgery. bribery, falsification or destruction of records, making (aloe statements, or resolving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, Stale, or local) with commission of any of the offenses enumerated in paragraph OW of this oertilication: and (cif Have net within a three-year period preceding llil opplica- hair hQd nO or more public tran5actiont (Federvi, State, Or local) terminated fOr cause OF default; and Where the applicant is unable to certify tC, any of the staternents in this certification, he or she shah anach en explanation to this apprica hon. 3. DRUG-FR Er WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS1 As required by the Drug-Free WorkplaCe Act o(198, end implemented at 28 CFR Part 67, Subpart F, for grantees, as defined at 28 CFR Part. 67 Sections 67,61 and 57.620-- A. Tine applicant nertifies that It will or will continue to prOvitLe a drug-free workplace by (a) Publishing a statement notifying employees that the unlawful manufacturer, 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 or drug abuse in the workplace; ' (2) The grantae'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 tor drug abuse violationS occurring in the workplace: (c) Making it a requirement that each employee to be engaged in the ffrforrnance of the grant be given a copy of the state- ment required by paragraph (B): (d) Notifying the employee In the statement required by pare . graph (a) that, as a conditiOn of employment under the grant, the employee will— Urn F1:1 11.4 4141.16 (341) REPLo\CES 0...P FORMS 6061.e, 4 G.E•la A NiD Lava WrilCli A ti) Aticle by the terms of tho statement: and (2) Notify the employer In writing of ills or her conviction for a violation of a criminal drug statute occurring in the workplace no later than fiive calendar days after such conviction; (e) Notifying the agency, in writing, within 16 caleitdar days affer reoeiving notice under subparagraph (02) from an employee or otherwise receiving actual notice of such Dow/Jo-lion. Employers of convicted employees most provide notice, including position lille, to; Department of Ju5tice, Office of Justice Programs, ATTN: Control Oesk, 633 Mt:lane Avenue, Washington, D.C. 20534. NOtice shalt include the iden- tification number(s) of each affected grant; (f) Taking one of the following actions, within 30 calendar days of receiving notice under subparagraph (rJ)(2), with respect to any employee who is sq convicted— (1) Taking appropriate personnel action against such an employee, up lo and including termination, consistent with the requirements of the Rehabiiiletion At cif 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 oontinue lo maintain a riru g- free workplace through implementation of paragraphs (a), {6), (c), (d), .(e), and (f), B. The grantee may insert in the space provided below the site(s) for the perforrnanou of work done in connection wilt the specific grant: place of Performanoe (Street address, city, county, slate, zip code) Check 0 if here are workplaces on file that are not indlentiried here. Section 67. 630 of the regulations provides that a grantee that is a Stata 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 °JR Faun 406117. Check F.,1 if the Slate has elected to complete OJP Form, 4061(7. DRUG-FREE WORKPLACE (GRANTEES WHO ARE IRDIVIDIJALS) As required by the Drug-Free Workplace Act of 1988, and implemented at 28 CFR Part 67, Subpart F, for grantees, as defined at 2B CFR Part 61: Sections 437.015 and 67620.- A. As a condition of the grant, I certify that I will not engage in the uetcreful manufacture, distribution, dispensing, posses. Sion, or use of a controlled substance in card tiding any activity with the grant; and B. if oorwicted of a od mina! drug offense res Wiling from a violation occurring during the conduct of any grant activity, will report the conviction, in writing, within 10 calendar days of the conviction, to: Department of Justice, Office of Justice Programs, ATTN: Control Desk, et0 Ssiwanth Street NW.. Washington, DC 20531. As the duty authorized representative of the applicant, I herohy certify that the applicant will comply with the above certifications. 1. Grantee Name and Address: Oakland County 1200 N. Telegraph Rd Pontiac MI 48341 2. Application Nu Tiber andlor Project Name 3 Grantee IRS(Vendor Number Grant # 2010-UA-T0-0016 Michael J. Gingen, Chairperson Oakl of Commiioner5 4. Typed Name and Title of Authorizer! Representative 5. Signature 6. Date Compliance with Federal Special Grant Condition Related to Trafficking Victims Protection Act of 2000 The Subgrantee must certify that they have reviewed the following special grant condition. The special condition requires compliance with the Trafficking ViCtirns Protection Act of MO, as amended. This condition specifies that the federal government may unilateraliy terminate grant awards to the Subgrantee in case of non-compliance, A. Provisions applicable to a recipient that is a private entity, 1. You as the recipient, your employees, subrecipients under this award, and subrecipients; employees may not: a. Engage in severe forms of trafficking in persons during the period of time that the award is in effect; b. Procure a commercial sex apt during the period of time that the award is in effect: or c. Use forced labor in the performance of the award or subawards under the award. 2. We as the Federal awarding agency may unilaterally terminate this award, without penalty, it you or a subrecipient that is a private entity: a is determined to have violated a prohibition in paragraph A.1 of this award term; or Has an employee who is determined by the agency official authorized to terminate the award to have violated a prohibition in paragraph A.1 of this award term through conduct that is either I. Associated with performance under this award; or ii. Imputed to you or the subrecipient using the standards and due process for imputing the conduct of an individual to an organization that are provided in 2 CFR Part 180, OMB Guidelines to Agencies on Govemmentavide Debarment and Suspension (Non procurement as implemented by our agency at 2 ; CFR Part 3000. . Provisions applicable to a recipient other than a private entity. We as the Federal awarding agency may unilaterally terminate this award, without penalty, if a subrecipient that is a private entity: 1. Is determined to have violated an applicable prohibition in paragraph Al of this award term; or 2. Has an employee who is determined by the agency official authorized to terminate the award to have violated an applicable prohibition in paragraph A.1 of this award term through conduct that is either: a. Associated with performance under this award; or b. Imputed to the subreoipient using the standards and due process for imputing the conduct of an individual to an organization that are provided in 2 CFR part 180, OIVIB Guidelines to Agencies on Governmentwide Debarment and Suspension (Non-procurement), as implemented by our agency at CFR part 3000. C. Provisions applicable to any recipient. 1. You must inform us immediately of any information you receive from any source alleging a violation a a prohibition in paragraph Al of this award term. 2. Our right to terminate unilaterally that is described in paragraph A.2 or B of this section: a. Implements section 106(g) of the Trafficking Victims Protection Act of 2000 (TWA), as amended (22 U.S.C. 7104(g)), and b. Is in addition to all other remedies for noncompliance that are available to us under this award. 3 You must include the requirements of paragraph A.1 of this award term in any subaward you make to a private entity. D. Definitions_ For purposes of this award term: 1. "Employee" means either: a. An individual employed by you or a subrecipient who is engaged in the performance of the project or program urrder this award; or b. Mother person engaged in the performance of the project or program under this award and not compensated by you including, but not limited to, a volunteer or individual whose services are contributed by a third party as an in-kind contribution toward cost sharing or matching requirements. 2. "Forced labor' means labor obtained by any of the following methods: the recruitment harboring, transportation, provision, or obtaining of a person for labor on services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery_ . "Private entity" means: a. My entity other than a State, local government, tndian Tribe, or foreign public entity, as those terms are, defined in 2 CFR 175.25. b. Includes: I. A nonprofit organization, including any nonprofit institution of higher education, hospital, or tribal organization other than one included in the definition of Indian Tribe at 2 CFR 175.25(b). ii. A for-profit organization, 4, "Severe forms of trafficking in persons," ''commercial sex act." and "coercion' have the meanings given at section 103 of the TVPA, as amended (22 LI.S C. 7102) The individual or officer signing this gr-ant--ag-reereentsbecial condition certifies by nis or her signature that he or she is authorized to sign thic grant agreementdocumentation on behalf of the jurisdiction he or she represents. The signing individual or officer certifies that he or she has reviewed the special condition for compliance with the Trafficking Victims Protection Act of 2000 on behalf of the jurisdiction he or she represents. Micliael J, Gintieli OhairDers.on •E i. Oakland Countv Printed Name Title Signature Date FISCAL NOTE (MISC. #13125) May 22, 2013 BY: FINANCE COMMITTEE, TOM MIDDLETON], CHAIRPERSON IN RE: HEALTH AND HUMAN SERVICES — HOMELAND SECURITY DIVISION - ACCEPTANCE FOR 2010 FEMA STATE HOMELAND SECURITY GRANT PROGRAM 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 U.S. Department of Homeland Security Federal Emergency Management Agency (FEMA) has released funding to the Michigan Department of State Police, Emergency Management and Homeland Security Division which has awarded Oakland County funding in the amount of $467,785. The grant period is January 1, 2013 through July 31, 2013. 3. The grant funding will be used to procure one Lenco BearCat vehicle. 4. The FY 2013 Special Revenue Budget is amended as follows: FEMA GRANTS (Fund 29340) FY 2013 GR0000000638 / Bud Ref 2010 Expenses 1060601-115095-760126-62000 Capital Outlay Miscellaneous Total Expenses Revenue 1060601-115095-610313 Federal Operating Grants Total Revenues $ 467,785 $ 467,785 $ 467,785 $ 4_67,785 FINANCE COMMITTEE VOTE: Motion carried unanimously on a roll call vote with Matis absent. Resolution #13125 May 22, 2013 Moved by Spisz supported by Quarles the resolutions (with fiscal notes attached) on the amended Consent Agenda be adopted (with accompanying reports being accepted). AYES: Dwyer, Gershenson, Gingell, Gosselin, Hoffman, Jackson, Long, Matis, McGillivray, Middleton, Quarles, Runestad, Scott, Spisz, Taub, Weipert, Woodward, Zack, Bosnic, Crawford. (20) NAYS: l'Aone. (0) A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the amended Consent Agenda were adopted (with accompanying reports being accepted). ; APPROVE THIS RESOLUTION DEPUTY COUNTY EXECUTIVE i:V7,7ING PURSUANT TO MCL 45.559A (7) STATE OF MICHIGAN) COUNTY OF OAKLAND) I, Lisa Brown, 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 May 22, 2013, 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 22nd day of May, 2013. Lisa Brown, Oakland County