HomeMy WebLinkAboutResolutions - 2016.05.05 - 22339MISCELLANEOUS RESOLUTION # 16115 May 6, 2016
BY: General Government Committee, Christine Long, Chairperson
IN RE: HEALTH AND HUMAN SERVICES - HOMELAND SECURITY DIVISION - 2016-2016
HAZARDOUS MATERIALS EMERGENCY PREPAREDNESS PLANNING PROGRAM (HMEP-PP)
GRANT AGREEMENT ACCEPTANCE
To the Oakland County Board of Commissioners
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 Planning Program (HMEP-PP) grant
provides funds to Oakland County for the purpose of enhancing hazardous material response planning;
and
WHEREAS an application was submitted, and Oakland is eligible to receive $10,800 for the submittal of
new and updated plans during the grant period of October 1, 2015 through September 30, 2016; and
WHEREAS the required 25% in kind match of $2,700 will be met with 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 Grant Review Process according to 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 Planning Program (HMEP-PP) grant in
the amount of $10,800 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 $10,800 and a 25% match of $2,700 for a total of $13,500
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.
GRANT REVIEW SIGN OFF — Homeland Security
GRANT NAME: 2016 Hazardous Materials Emergency Preparedness Planning Program (IMEP-PP)
FUNDING AGENCY: Michigan State Police Emergency Management and Homeland Security
Division
DEPARTMENT CONTACT PERSON: Sara Stoddard 248 858-5080
STATUS: Grant Acceptance
DATE: April 11,2016
Pursuant to Misc. Resolution #13180, 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 (4/11/2016)
Department of Human Resources:
HR Approved (No Committee) Continues Position — Lori Taylor (4/4/2016)
Risk Management and Safety:
Approved by Risk Management. — Robert Erlenbeck (4/5/2016)
Corporation Counsel:
Approved by Corporation Counsel. — Stephen Rideout (4/5/2016)
From:
To:
Cc:
Subject:
Date:
Van Pelt, Laurie M
West, Catherine A
atoddard, Sara D
Re: GRANT REVIEW: Health & Human Services/Homeland Security Division - 2016 Hazardous Materials
Emergency Preparedness Planning Program (HMEP-PP) - Grant Acceptance
Monday, April U, 2016 1:12:56 PM
Approved. Thanks, Katie.
Sent from my iPhone
> On Apr 11,2016, at 8:52 AM, West, Catherine A <westca@oakgov.com > wrote:
> Hi Laurie,
> I apologize, I just realized that I included the department instead of the review individuals on the "To" field so you
never received this email. I see that you are out of the office until Thursday; the cutoff for items to make the next
General Government agenda is Friday, Apr. 15 so as long as I have a response by then we should be all set. I'm
sorry for the mix-up.
> Thank you
> Katie
> From: West, Catherine A
> Sent: Monday, April 04, 2016 11:53 AM
> To: Quisenberry, Theodore H; Stoddard, Sara D; Pisacreta, Antonio S; Scalf, Bonnie L
> Subject: GRANT REVIEW: Health & Human Services/Homeland Security Division - 2016 Hazardous Materials
Emergency Preparedness Planning Program (HMEP-PP) - Grant Acceptance
> GRANT REVIEW FORM
> TO: REVIEW DEPARTMENTS — Laurie Van Pelt — Lori Taylor — Dean Schultz — Pat Davis
> RE: GRANT CONTRACT REVIEW RESPONSE — Health & Human Services, Homeland Security Division
> 2016 Hazardous Materials Emergency Preparedness Planning Program (HMEP-PP)
> 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: April 11, 2016
> GRANT INFORMATION
> Date: 4/4/2046
> Operating Department: Health & Human Services, Homeland Security Division
> Department Contact: Sara Stoddard
> Contact Phone: 248-858-5080
> Document Identification Number: HM-HMP-0471-15-01-00
> REVIEW STATUS: Acceptance — Resolution Required
> Funding Period: 10/1/2015 through 9/30/2016
> Original source of funding: FEMA, CFDA 20.703
> Will you issue a sub award or contract: No
From:
To:
Subject:
Date:
Attachments:
Taylor, Lori,
West, Catherine A
FW: GRANT REVIEW: Health & Human Services/Homeland Security Division - 2016 Hazardous Materials
Emergency Preparedness Planning Program (HMEP-PP) - Grant Acceptance
Monday, April 04, 2016 1:30:22 PM
HMEP Grant Agreement 2016,Ddr
HR Approved (No Committee) Continues Position
From: Russell, Roosevelt F
Sent: Monday, April 04, 2016 12:49 PM
To: Taylor, Lori; Mason, Heather L
Subject: FW: GRANT REVIEW: Health & Human Services/Homeland Security Division - 2016 Hazardous
Materials Emergency Preparedness Planning Program (HMEP-PP) - Grant Acceptance
This grant continues the partial funding of Technical Assistant Position #00006893, no new positions
are being created, no need for HR Committee Action on this item,
From: West, Catherine A
Sent: Monday, April 04, 2016 11:53 AM
To: Quisenberry, Theodore H; Stoddard, Sara 0; Pisacreta, Antonio S; Scalf, Bonnie L
Subject: GRANT REVIEW: Health & Human Services/Homeland Security Division - 2016 Hazardous
Materials Emergency Preparedness Planning Program (HMEP-PP) - Grant Acceptance
GRANT REVIEW FORM
TO: REVIEW DEPARTMENTS — Laurie Van Pelt — Lori Taylor— Dean Schultz — Pat Davis
RE: GRANT CONTRACT REVIEW RESPONSE — Health & Human Services, Homeland Security
Division
2016 Hazardous Materials Emergency Preparedness Planning Program (HMEP-PP)
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: April 11, 2016
GRANT INFORMATION
Date: 4/4/2016
Operating Department: Health & Human Services, Homeland Security Division
Department Contact: Sara Stoddard
Contact Phone: 248-858-5080
From:
To:
Cc:
Subject:
Date:
Erlenheck, Robert
West, Catherine A; Quisenberry, Theodore H; Stoddard, Sara D; Pisacreta, Antonio S; Scalf, Bonnie
Schultz, Dean.]
RE: GRANT REVIEW: Health & Human Services/Homeland Security Division - 2016 Hazardous Materials
Emergency Preparedness Planning Program (HMEP-PP) - Grant Acceptance
Tuesday, April 05, 2016 12:40:02 PM
Approved by Risk Management. RE. 4/5/16,
From: Johnson, Sandra K
Sent: Tuesday, April 05, 2016 10;19 AM
To: West, Catherine A; Quisenberry, Theodore H; Stoddard, Sara D; Pisacreta, Antonio S; Scalf, Bonnie L
Subject: RE: GRANT REVIEW: Health & Human Services/Homeland Security Division - 2016 Hazardous
Materials Emergency Preparedness Planning Program (1MEP-PP) - Grant Acceptance
Please be advised that your request for Risk Management's assistance has been assigned to Bob
Erienbeck (ext. 8-1694). If you have not done so already, please forward all related and future
information, documentation, and correspondence to Terri Easterling and Sandy Johnson.
Also, please include Risk Management's assignment number RM16-0233 regarding this matter.
Thank you.
From West, Catherine A
Sent: Monday, April 04, 2016 11:53 AM
To: Quisenberry, Theodore H; Stoddard, Sara D; Pisacreta, Antonio S; Scalf, Bonnie L
Subject: GRANT REVIEW: Health & Human Services/Homeland Security Division - 2016 Hazardous
Materials Emergency Preparedness Planning Program (HMEP-PP) - Grant Acceptance
GRANT REVIEW FORM
TO: REVIEW DEPARTMENTS — Laurie Van Pelt — Lori Taylor — Dean Schultz — Pat Davis
RE: GRANT CONTRACT REVIEW RESPONSE — Health & Human Services, Homeland Security
Division
2016 Hazardous Materials Emergency Preparedness Planning Program (H MEP-PP)
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: April 11, 2016
GRANT INFORMATION
Date: 4/4/2016
From:
To:
Cc:
Subject:
Date:
Ricleout, Stephen M
West, Catherine A; Quisenberry, Theodore H; Stoddard, Sara D
Guzzv, Scott
FY2016 Hazardous Materials Emergency Preparedness (HMEP) - Grant Acceptance (MSPEMHSD)
Tuesday, April 05, 2016 8:49:25 AM
Approved by Corporation Counsel.
Stephen Rideout
Department of Corporation Counsel
1200 N. Telegraph Road, Bldg. 14 East
Courthouse West Wing Extension, 3rd Floor
Pontiac, MI 48341
Phone Number: (248) 858-4097
Fax Number: (248) 858-1003
E-mail: rideoutseoakgov.corn
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
attorney-client privilege and work product doctrine. This privilege belongs to the County of Oakland, and individual
addressees are not authorized to waive or modify this privilege in any way. 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.
State of Michigan
Fiscal Year 2015 Hazardous Materials Emergency
Preparedness Planning Program Grant Agreement
October 1, 2015 to September 30, 2016
CFDA Number: 20.703
Grant Number: I-IM-I-IIIAP-0471-15-01-00
This Fiscal Year (FY) 2015 Hazardous Materials Emergency Preparedness (HMEP) Planning Program grant
agreement is hereby entered into between the Michigan Department of State Police, Emergency Management
and Homeland Security Division (hereinafter called the Recipient), and the
COUNTY OF OAKLAND
(hereinafter called the Subrecipient)
Purpose
The purpose of this grant agreement is to provide federal funds to the Subrecipient for the development of new
Super-fund Amendments and Reauthorization Act (SARA), Title Ill, Section 302, hazardous materials emergency
response plans, as well as for the updating of previously submitted plans. This grant agreement provides
financial assistance to first responders (fire, law enforcement, emergency medical services, etc.) for allowable
costs in the following areas:
A. Provision of assistance to public sector employees through planning grants to states, territories, and
Native American tribes for emergency response.
B. Increased state, territorial, tribal, and local effectiveness in implementation of the federal Emergency
Planning and Community Right-to-Know Act of 1986.
C. Encouragement of a comprehensive approach to emergency planning by incorporating the unique
challenges of response to transportation situations.
II. Statutory Authority
Funding for the FY 2015 HMEP is authorized by the Federal Hazardous Materials Transportation Law (49 U.S.C.
Section 5101 et. seq.).
The Subrecipient agrees to comply with all FY 2015 HMEP program requirements and the most recent version of:
A. 2 CFR, Part 200 of the Code of Federal Regulations (CFR), Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards located at http://vvww.ecfr.gov .
B. 49 CFR, Part 110 Hazardous Materials Public Sector Training and Planning Grants.
C. 49 U.S.C. 5116 et seq. located at https://www.gpo.gov/fdsys
III. Award Amount and Restrictions
A. The County of Oakland is awarded $10,800.00 under the FY 2015 HMEP Planning Program Grant
Agreement. This funding will be awarded as described in Hazardous Materials Emergency Preparedness
Planning Grant Instructions attached to this grant agreement, and is based on information provided in the
HMEP grant application submitted for the FY 2015 grant year. This allocation is dependent upon the
level of federal funding and may be reduced if federal funding is reduced. Any unused grant funds
remaining at the end of the grant year will be used to increase the reimbursement for accepted new
SARA Title Ill plans submitted by participating Local Emergency Planning Committees (LEPCs). The
Subrecipient's payment per new plan will be recalculated using these funds and the award to the
FY 2015 HMEP Planning Grant
County of Oakland
Page 2 of 7
Subrecipient for the number of new plans submitted will be adjusted. This may affect the match amount
required for this grant.
Based on the Subrecipient's application, a match amount of $2,700.00 required. However, the
Subrecipient must be prepared to match all funds received through this contract (which equates to 25% of
any federal funds received), as noted in Section III, D of the Hazardous Materials Emergency
Preparedness Planning Grant instructions that are attached to this grant agreement.
B. The United States Pipeline and Hazardous Materials Safety Administration (PHMSA) reserves a royalty-
free, nonexclusive, and irrevocable license to reproduce, publish, or otherwise use, and to authorize
others to use, for federal government purposes:
1. The copyright in any work developed under this grant, subaward, or contract under a grant or
subaward; and
2. Any rights of copyright to which the Recipient, Subrecipient, or a contractor purchases ownership with
grant support.
IV. Responsibilities of the Subrecipient
A. Grant funds must supplement, not supplant, state or local funds. Federal funds must be used to
supplement existing funds, not replace (supplant) funds that have been appropriated for the same
purpose. Potential supplanting will be carefully reviewed in subsequent monitoring reviews and audits.
The Subrecipient may be required to supply documentation certifying that it did not reduce non-federal
funds because of receiving federal funds. Subrecipients may be required to supply documentation
certifying that a reduction in non-federal resources occurred for reasons other than the receipt or
expected receipt of federal funds.
B. In addition to this grant agreement, the Subrecipient shall complete, sign, and submit to the Recipient the
following documents, which are incorporated by reference into this grant agreement
1. HMEP Planning Grant Agreement In-Kind Match form (EMD-063)
2. Standard Assurances
3. Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and
Drug-Free Workplace Requirements
4. Audit Certification (EMD-053)
5. Request for Taxpayer Identification Number and Certification (W-9)
6. SARA Title Ill Hazardous Materials, Off-site Emergency Response Plan Update List This form is
located on the MSP/EMHSD website at http://www ,michigan.gov/emhsd . The Plan Update List does
not need to be completed and returned with the FY 2015 HMEP Planning Program grant agreement.
This form is to be used if and when a list of updated plans is submitted for your grant. The Plan
Update List form can be submitted directly to the SARA Title Ill Planner at the Michigan State Police,
Emergency Management and Homeland Security Division (MSP/EMHSD) when plan updates have
been completed for the grant year.
7. Other documents that may be required by federal or state officials
C. The Subrecipient agrees to comply with all applicable federal and state regulations, including, but not
limited to, the following:
1. Meet the LEPC eligibility requirements, as stated in the attached Hazardous Materials Emergency
Preparedness Planning Grant Instructions, Section II.
2. Submit new SARA Title Ill (Section 302) community hazardous materials emergency response plans
to the MSP/EMHSD no later than July 1, 2016. Support grant documentation must meet the
requirements stated in the attached Hazardous Materials Emergency Preparedness Planning Grant
Instructions, Section IV.B., or forfeit that portion of the grant award.
FY 2015 HMEP Planning Grant
County of Oakland
Page 3 of 7
3. Submit a Fist of updated SARA Title Ill (Section 302) community hazardous materials emergency
response plans to MSP/EMHSD no later than July 1,2016. The form for submitting these updates is
available on the MSP/EMHSD website located at http://vvww.michigan.gov/emhsd . Support grant
documentation must meet the requirements stated in the attached Hazardous Materials Emergency
Preparedness Planning Grant Instructions, Section IV.B., or forfeit that portion of the grant award.
4. Comply with National Incident Management System (NIMS) requirements to be eligible to receive
federal preparedness funds. NI MS information is available at http://www.fema.gov/national-incident-
management-system. More information on complying with NIMS is available from the State NIMS
Coordinator.
5. Integrate individuals with disabilities into emergency planning in compliance with Executive Order
13347 and the Rehabilitation Act of 1973.
6. Comply with applicable financial and administrative requirements set forth in the current edition of 2
CFR, Part 200, including, but not limited to, the following provisions:
a. Account for receipts and expenditures, maintain adequate financial records, and refund
expenditures disallowed by federal or state audit.
b. Retain all financial records, statistical records, supporting documents, and other pertinent
materials 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.
c. Non-federal organizations which expend $500,000 or more in federal funds during their current
fiscal year or expend $750,000 or more in federal funds in a fiscal year beginning on or after
December 26, 2014, 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 or 2
CFR, Part 200 after December 26, 2014.
7. Comply with the Department of Transportation's policy for contracting with small and minority
businesses, women-owned business enterprises, veteran owned, and HubZone business firms. The
Recipient and any of the Recipient's subrecipients are encouraged to take all necessary affirmative
steps to assure that small, women-owned, minority disadvantaged businesses, veteran, and
HubZone business firms are used when possible.
8. Complete federally-mandated reporting requirements, including, but not limited to, requirements
related to the Federal Funding Accountability and Transparency Act of 2006 (FFATA) (Public Law
109-282), as amended by Section 6202(a) of the Government Funding Transparency Act of 2008
(Public Law 110-252) and program specific reporting requirements.
V. Responsibilities of the Recipient
The Recipient, in accordance with the general purposes and objectives of this grant agreement, will:
A. Administer the grant in accordance with all applicable federal and state regulations and guidelines and
submit required reports to the awarding federal agency.
B. Provide direction and technical assistance to the Subrecipient.
C. Provide to the Subrecipient any special report forms and reporting formats (templates) required for
administration of the program.
D. Reimburse the Subrecipient, in accordance with this grant agreement, based on appropriate
documentation submitted by the Subrecipient.
E. At its discretion, independently, or in conjunction with the federal awarding agency, conduct random on-
site reviews of the Subrecipient(s).
FY 2015 H MEP Planning Grant
County of Oakland
Page 4 of 7
VI. 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 attached Plan Update List form as stated in the FY
2015 application to MSP/EMHSD, no later than July 1, 2016. Complete instructions on how and where to submit,
required reports can be found in the Hazardous Materials Emergency Preparedness Planning Grant Instructions
that are attached to this grant agreement.
If a support grant was requested, the LEPC must meet the requirements stated in the attached Hazardous
Materials Emergency Preparedness Planning Grant Instructions, Section IV. B., or forfeit that portion of the grant
award.
VII. Payment Procedures
Upon receipt, review, and acceptance of all work products and other requirements, as referenced in this contract,
the Recipient will calculate the payment to be made to the Subrecipient and will forward this information to the
Subrecipient. See the Hazardous Materials Emergency Preparedness Planning Grant Instructions document
attached to this grant agreement for further information.
All Subrecipients in the HMEP grant program must submit documentation on the associated costs being charged
to the $1,000.00 HMEP support grant. The eligible expenses are laid out in the HMEP $1,000.00 Support Grant
Certification Form, which will be mailed to each LEPC at the close of the federal fiscal year. When a LEPC enters
information into this form, the cost will need to be supported by a receipt, time sheet (reflecting hours worked on
SARA related planning issues), purchase order or a paid invoice. The support grant form and attachments must
be returned to MSP/EMHSD by the assigned due date.
VIII. Employment Matters
The Subrecipient shall comply with Title VI of the Civil Rights Act of 1964, as amended; Title VIII of the Civil
Rights Act of 1968; Title IX of the Education Amendments of 1972 (Equal Opportunity in Education Act); the Age
Discrimination Act of 1975; the Elliott-Larsen Civil Rights Act, 1976 PA 453, as amended, MCL 37.2101 at seq.;
and all other federal, state and local fair employment practices and equal opportunity laws and covenants. The
Subrecipient 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. The Subrecipient 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 Subrecipient must comply with 2 CFR, Part 1200, Nonprocurement Suspension and Debarment, located at
http://wvvw.ecfr.gov . The Subrecipient shall ensure that no subcontractor, manufacturer, or supplier of the
Subrecipient for projects related to this grant agreement appears on the Active Exclusions list on the System for
Award Management (SAM) website located at http://www.sam.gov (previously this search was performed in the
Excluded Parties List System — EPLS).
The Subrecipient must comply with regulation 49 CFR, Part 21, Nondiscrimination in Federally-Assisted Programs
of the Department of Transportation — Effectuation of the Title VI of the Civil Rights Act of 1964 (see related
certification form contained in this grant agreement package).
The Subrecipient must comply with regulation 49 CFR, Part 20, New Restrictions on Lobbying (see related
certification form contained in this grant agreement package).
FY 2015 HMEP Planning Grant
County of Oakland
Page 5 of 7
IX. Limitation of Liability
The Recipient and the Subrecipient 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 for either party.
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.
Xl. Grant Agreement Period
This grant agreement is in full force and effect from October 1, 2015 to September 30, 2016. 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 package consists of two identical grant agreements, 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
termination, the Subrecipient agrees to return to the Recipient any funds not authorized for use, and the Recipient
shall have no further obligation to reimburse the Subrecipient.
X11. 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 the Recipient and the Subrecipient, 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 grant end date. 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. The Subrecipient agrees to inform the Recipient 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 the Recipient. If any provision of this grant agreement shall be deemed void or unenforceable, the
remainder of the grant agreement shall remain valid.
The Recipient may suspend or terminate grant funding to the Subrecipient, in whole or in part, or other measures
may be imposed for any of the following reasons:
A. Failure to expend funds in a timely manner consistent with the grant milestones, guidance, and
assurances.
B. Failure to comply with the requirements or statutory objectives of federal or state law.
C. Failure to follow grant agreement requirements or special conditions.
D. Proposal or implementation of substantial plan changes to the extent that, if originally submitted, the
project would not have been approved for funding.
E. Failure to submit required reports.
F. Filing of a false certification in the application or other report or document
G. Failure to adequately manage, monitor or direct the grant funded activities of its subrecipients.
Before taking action, the Recipient will provide the Subrecipient reasonable notice of intent to impose corrective
measures and will make every effort to resolve the problem informally.
FY 2015 HMEP Planning Grant
County of Oakland
Page 6 of 7
X111. Business Integrity Clause
The Recipient may immediately cancel the grant without further liability to the Recipient or its employees if the
Subrecipient, an officer of the Subrecipient, or an owner of a 25% or greater share of the Subrecipient 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
Recipient, reflects on the Subrecipient's business integrity.
XIV. 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
Subrecipient agency Freedom of Information Officer will need to determine what information is to be withheld on a
case-by-case basis. The Subrecipient 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 2015 HMEP Planning Grant
County of Oakland
Page 7 of 7
XV. Official Certification
For the Subrecipient
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 organization he or she represents. The Subrecipient agrees to
complete all requirements specified in this grant agreement.
Subrecipient Name Subrecipient's DUNS Number
Printed Name Title
Signature Date
For the Recipient (Michigan State Police, Emergency Management and Homeland Security Division)
Chris A. Kelenske, Captain
Deputy State Director of Emergency
Management and Homeland Security
Title Printed Name
C.,.3-;.4 a. trLOsnict 3/18/2016
Date Signature
EMD-063 (0912014)
MICHIGAN STATE POLICE
Emergency Management and Homeland Security Division
HMEP PLANNING GRANT AGREEMENT 1N-KIND MATCH
The Oakland County Local Emergency Planning Committee (LEPC) has been allocated the funding amount specified in the
attached grant agreement. Therefore, a local fund match of $2,700 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/HGSP funds CANNOT be
used for match.):
Li PLANNING PERSONNEL: (Full Name of Employee) ,
whose salary and fringe benefits cost $ per hour, will work approximately hours on LEPC planning.
SECRETARIAL: (Full Name of Employee or Secretarial Service) ,
whose salary and fringe benefits cost $ per hour, will work approximately hours on LEPC business.
0 OFFICE SPACE: (Government Jurisdiction or Other Entity) ,
will provide a square foot office located at (Address) to the LEPC at a cost of $ per square foot.
D MAILING: (Government Jurisdiction or Other Entity) ,
will provide $ toward LEPC related mailings.
Fl PRINTING: (Government Jurisdiction or Other Entity) ,
will provide $ toward LEPC related printing.
0 OTHER (Describe):
AUTHORITY: 1976 PA 390, as amended, MCL 30.407a, 42 LlSC 11002 - 11003
COMPLIANCE: Voluntary, however failure to complete application will result in denial of request
OIVIB APPROVAL NO. 1121-0140
EXPIRES 06/30/2009
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, and the award term in
2 C.F.R. § 175.15(b).
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-I 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. §I0604(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 governmental entity—
a) it will comply with the requirements of the Uniform Relocation Assistance and Real Property
Acquisitions Act of 1970 (42 U.S.C.§ 4601 et seq.), which govern the treannent 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 eniployees whose principal employment is in connection
with an activity financed in whole or in part by federal assistance.
Signature Date Date
U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
OFFICE OF THE COMPTROLLER
CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND
OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS
Applicants should refer to the regulations cited below to determine the certification to which they are required to
attest. Applicants should also review the instructions for certification 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" arid 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.
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 over $100,000, as defined at
28 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
or 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
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 OTHERTHAN INDIVIDUALS)
As required by the Drug-Free Workplace Act of 1988, and
implemented at 28 CFR Part 67, Subpart F, for grantees, as
defined at 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-
0.1P FORM 406116 (3-S1) REPLACES CLIP FORMS 4061)2, 406113 AND 41261/4 WHICH ARE OBSOLEM.
(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;
(f) 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 of work done in connection with
the specific grant:
Place of Performance (Street address, city, county, state, zip
code)
Check 0 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 Form
4061/7,
DRUG-FREE WORKPLACE
(GRANTEES WHO ARE 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, 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:
2. Application Number and/or Project Name 3. Grantee IRS/Vendor Number
4. Typed Name and Title of Authorized Representative
5. Signature 6. Date
'11.5. Government Printing Office: 1996- 405-037140014
EMD-053 (1212014)
MICHIGAN STATE POLICE
Emergency Management and Homeland Security Division
AUDIT CERTIFICATION
AUTHORITY: 1976 PA 390, MCL 30.407a, Single Audit Act of 1984, PL 98-502, as amended;
COMPLIANCE: Voluntary, but necessary to be considered for grant assistance
Federal Audit Requirements
Non-federal organizations which expend $500,000 or more in federal funds during their current fiscal year or expend
$750,000 or more in federal funds in a fiscal year beginning on or after December 26, 2014, 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 or 2 CFR 200 after December 26, 2014. Subgrantees MUST submit a copy of their audit report for each
year they meet the funding threshold to: Michigan State Police, Grants and Community Services Division, 333 South
Grand Avenue, Lansing, Michigan 48933.
Program Name CFDA Number
.:-SiitigranteelinforrnatiOn.
Jurisdiction Name
to
E 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 Circular, as revised, for the above listed program.
I=1
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 Circular 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: Michigan State Police, Grants
and Community Services Division, 333 South Grand Avenue, Lansing, Michigan 48933.
Signature of Subgrantee's Authorized Representative Date
Submit Completed Document To:
Emergency Management and Homeland Security Division
Michigan Department of State Police
Attention: Grants Development Unit
PLEASE NOTE:
The Emergency Management and Homeland
Security Division mailing address has changed to:
PO Box #30634
Lansing, MI 48909
Form W-91
(Rev. December 2014)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS. I Print or type See Specific Instructions on page 2. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
2 Business name/disregarded entity name, if different from above
3 Check appropriate box for federal tax classification; check only one of the following seven boxes:
0 Individual/sole proprietor or p C Corporation D S Corporation D Partnership
single-member LLC
El Limited iiablitty company. Enterthe tax classification (C=C corporation, S =S corporation, P=partnership)
Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the tax classification of the single-member owner.
0 Other (see instructions) lo•
0 Trust/estate
> "
4 Exemptions
certain entities,
instructions
Exempt payee
Exemption
code (if any)
(Acplies le amounts
(codes apply only to
not individuals; see
on page 3):
code (if any)
from FATCA reporting the line above for
resintained outside the U.S.)
5 Address (number, street, and apt. or suite no,) Requester's name and address (optional)
6 City, state, and ZIP code
7 List account number(s) here (optional)
axpayer Identification Number (TIN
Enter your TIN in the appropriate box. The TIN provided must match the name given on line Ito avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, fora
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other
entities, it Is your employer identification number (EN). 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 instructions for line 1 and the chart on page 4 for
guidelines on whose number to enter.
112= Certification
Social security number
or
Employer identification number
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 (b) I have not been notified by the Internal Revenue
Service (1RS) that 1 am subject to backup withholding as a result of a failure to report all interest or dividends, or (0) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage
interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and
generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the
instructions on page 3.
Sign
Here Signature of
U.S. person Date n
General Instructions
Section references are to the internal Revenue Code unless otherwise noted.
Future developments. Information about developments affecting Form W-9 (such
as legislation enacted after we release it) is at www.irs.golaw9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an Information .
return with the IRS must obtain your correct taxpayer identification number (T1N)
which may be your social security number (SSN), individual taxpayer identification
number (ITIN), adoption taxpayer identification number (ATIN), or employer
Identification number (EIN), to report on an information return the amount paid to
you, or other amount reportable on an information return. Examples of information
returns Include, but are not limited to, the following:
• Form 1099-INT (interest earned or paid)
• Perm 1099-DIV (dividends, including those from stocks or mutual funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)
• Form 1099-B (stock or mutual fund sales and certain other transactions by
brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T
(tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident alien), to
provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might be subject
to backup withholding. See What is backup withholding? on page 2.
By signing the filled-out form, you:
1. Certify that the TIN you are giving is correct (or you are waiting for a number
to be issued),
2. Certify that you are not subject to backup 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, and
4. Certify that FATCA code(s) entered on this form (If any) indicating that you are
exempt from the FATCA reporting, is correct. See What is FATCA reporting? on
page 2 for further information.
Cat, No. 10231X Form W-9 (Rev. 12-2014)
Form W-9 (Rev, 12-2014) Page 2
Note. If you are a U.S. person and 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.
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 under section
1446 on any foreign partners' share of effectively connected taxable Income from
such business. Further, in certain cases where a Form W-9 has not been received,
the rules under section 1446 require a partnership to presume that a partner Is a
foreign person, and pay the section 1446 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 section 1446 withholding on your share of partnership income.
In the cases below, the following person must give Form W-9 to the partnership
for purposes of establishing its U.S. status and avoiding withholding on its
allocable share of net income from the partnership conducting a trade or business
In the United States:
• In the case of a disregarded entity with a U.S. owner, the U.S. owner of the
disregarded entity and not the entity;
• In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally,
the U.S. grantor or other U.S. owner of the grantor trust and not the trust; and
• In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a
grantor trust) and not the beneficiaries of the trust.
Foreign person. If you are a foreign person or the U.S. branch of a foreign bank
that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use
the appropriate Form W-8 or Form 8233 (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 6 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 fellowship 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 entity, give the requesterthe
appropriate completed Form W-8 or Form 8233.
Backup Withholding
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, payments made In
settlement of payment card and third party network transactions, 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 Exempt payee code on page 3 and the separate Instructions for the Requester of Form
W-9 for more information.
Also see Special rules for partnerships above.
What is FATCA reporting?
The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign
financial Institution to report all United States account holders that are specified
United States persons. Certain payees are exempt from EATCA reporting. See
Exemption from FATOA reporting code on page 3 and the Instructions for the
Requester of Form W-9 for more information.
Updating Your Information
You must provide updated information to any person to whom you claimed to be
an exempt payee if you are no longer an exempt payee and anticipate receiving
reportable payments In the future from this person. For example, you may need to
provide updated information if you are a C corporation that elects to be an S
corporation, or if you no longer are tax exempt. In addition, you must furnish a new
Form W-9 if the name or TIN changes for the account; for example, if the grantor
of a grantor trust dies.
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 makes
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
Line 1
You must enter one of the following on this line; do not leave this line blank. The
name should match the name on your tax return.
If this Form W-9 is for a joint account, list first, and then circle, the name of the
person or entity whose number you entered in Part I of Form W-9.
a. Individual. Generally, enter the name shown on your tax return. If you have
changed your last name without informing the Social Security Administration (SSA)
of the name change, enter your first name, the last name as shown on your social
security card, and your new last name.
Note. MN applicant: Enter your individual name as It was entered on your Form
W-7 application, line la. This should also be the same as the name you entered on
the Form 1040/1040A/1040EZ you filed with your application.
b. Sole proprietor or single-member LLC. Enter your individual name as
shown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade,
or 'doing business as" (DBA) name on line 2.
c. Partnership, LLC that is not a single-member LLC, C Corporation, or S
Corporation. Enter the entity's name as shown on the entity's tax return on line 1
and any business, trade, or DBA name on line 2.
d. lather entities. Enter your name as shown on required U.S. federal tax
documents on line 1. 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 line 2.
e. Disregarded entity. For U.S. federal tax purposes, an entity that is
disregarded as an entity separate from its owner is treated as a "disregarded
entity." See Regulations section 301.7701-2(c)(2)(iii). Enter the owner's name on
line 1. The name of the entity entered on line 1 should never be a disregarded
entity. The name on line 1 should be the name shown on the income tax return on
which the income should be reported. For example, if a foreign LLC that is treated
as a disregarded entity for U.S. federal tax purposes has a single owner that is a
U.S. person, the U.S. owner's name Is required to be provided on line 1. If the
direct owner of the entity is also a disregarded entity, enter the first owner that is
not disregarded for federal tax purposes. Enter the disregarded entity's name on
line 2, ''Business name/disregarded entity name." If the owner of the disregarded
entity Is a foreign person, the owner must complete an appropriate Form W-8
Instead of a Form W-9. This is the case even if the foreign person has a U.S. TIN.
Form W-9 (Rev. 12-2014)
Page 3
Line 2
If you have a business name, trade name, DBA name, or disregarded entity name,
you may enter it on line 2.
Line 3
Check the appropriate box in line 3 for the U.S. federal tax classification of the
person whose name is entered on line 1. Check only one box in line 3.
Limited Liability Company (LLC). If the name on line 1 is an LLO treated as a
partnership for U.S. federal tax purposes, check the "Limited Liability Company'
box and enter "13" in the space provided. If the LLC has flied Form 8832 or 2553 to
be taxed as a corporation, check the 'Limited Liability Company" box and in the
space provided enter "C" for C corporation or "S" for S corporation. If it Is a
single-member LLC that Is a disregarded entity, do not check the "Limited Liability
Company' box; instead check the first box In fine 3 "IndividuaVsoie proprietor or
single-member LLC."
Line 4, Exemptions
If you are exempt from backup withholding and/or FATCA reporting, enter in the
appropriate space in line 4 any code(s) that may apply to you.
Exempt payee code.
• Generally, individuals (including sole proprietors) are net exempt from backup
withholding.
• Except as provided below, corporations are exempt from backup withholding
for certain payments, including interest and dividends.
• Corporations are not exempt from backup withholding for payments made in
settlement of payment card or third party network transactions.
• Corporations are not exempt from backup withholding with respect to attorneys'
fees or gross proceeds paid to attorneys, and corporations that provide medical or
health care services are not exempt with respect to payments reportable on Form
1099-MISC.
The following codes identify payees that are exempt from backup withholding.
Enter the appropriate code in the space In line 4.
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(t)(2)
2—The United States or any of Its agencies or Instrumentalities
3—A state, the District of Columbia, a U.S. commonwealth or possession, or
any of their political subdivisions or instrumentalities
4—A foreign government or any of its political subdivisions, agencies, or
Instrumentalities
5—A corporation
6—A dealer in securities or commodities required to register in the United
States, the District of Columbia, or. a U.S. commonwealth or possession
7—A futures commission merchant registered with the Commodity Futures
Trading Commission
$—A real estate investment trust
9—An entity registered at all times during the tax year under the Investment
Company Act of 1940
10—A common trust fund operated by a bank under section 584(a)
11—A financial institution
12—A middleman known In the Investment community as a nominee or
custodian
13—A trust exempt from tax under section 664 or described in section 4947
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 13.
IF the payment is for ... THEN the payment is exempt for ...
Interest and dividend payments All exempt payees except
for 7
Broker transactions Exempt payees 1 through 4 and 6
through 11 and all C corporations. S
corporations must not enter an exempt
payee code because they are exempt
only for sales of nonoovered securities
acquired prior to 2012.
Barter exchange transactions and
patronage dividends
Exempt payees 1 through 4
Payments over $600 required to be
reported and direct sales over $5,000 1
Generally, exempt payees
1 through e
Payments made In settlement of
payment card or third party network
transactions
Exempt payees 1 through 4
See Form 1099-MISC, Miscellaneous Income, and its instructions.
2However, the following payments made to a corporation and reportable on Form
1099-MISC are not exempt from backup withholding: medical and health care
payments, attorneys' fees, gross proceeds paid to an attorney reportable under
section 6045(f), and payments for services paid by a federal executive agency.
Exemption from FATCA reporting code. The following codes identify payees that are exempt from reporting under FATCA. These codes apply to persons
submitting this form for accounts maintained outside of the United States by
certain foreign financial institutions. Therefore, if you are only submitting this form
for an account you hold in the United States, you may leave this field blank.
Consult with the person requesting this form if you are uncertain if the financial
Institution is subject to these requirements. A requester may Indicate that a code is
not required by providing you with a Form W-9 with "Not Applicable" (or any
similar Indication) written or printed on the line for a FATCA exemption code.
A—An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a)(37)
B—The United States or any of its agencies or instrumentalities
C—A state, the District of Columbia, a U.S, commonwealth or possession, or
any of their political subdivisions or Instrumentalities
D—A corporation the stock of which is regularly traded on one or more
established securities markets, as described In Regulations section
1.1472-1(c)(1)(i)
E—A corporation that is a member of the same expanded affiliated group as a
corporation described in Regulations section 1.1472-1(0(1)0
F—A dealer in securities, commodities, or derivative financial instruments
(including notional principal contracts, futures, forwards, and options) that is
registered as such under the laws of the United States or any state
G—A real estate investment trust
H—A regulated investment company as defined in section 851 or an entity
registered at all times during the tax year under the Investment Company Act of
1940
I—A common trust fund as defined in section 584(a)
J—A bank as defined In section 581
K—A broker
L—A trust exempt from tax under section 664 or described in section 4947(a)(1)
M—A tax exempt trust under a section 403(b) plan or section 457(g) plan
Note. You may wish to consult with the financial institution requesting this form to
determine whether the FATCA code and/or exempt payee code should be
completed.
Line 5
Enter your address (number, street, and apartment or suite number). This is where
the requester of this Form W-9 will mail your Information returns.
Line 6
Enter your city, state, and ZIP code.
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 eligible to get an SSN, your TIN is your IRS individual taxpayer
identification number (iTiN). Enter it In the social security number box. If you do not
have an ITIN, see How to gets TIN below.
If you are a sole proprietor and you have an EIN, you may enter either your SSN
or BIN. 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 this page), enter the owner's SSN
(or BIN, If the owner has one). Do not enter the disregarded entity's EIN. If the LLO
Is classified as a corporation or partnership, enter the entity's EiN.
Note. See the chart on page 4 for further clarification of name and TIN
combinations.
How to get a TIN. If you do not have a TIN, apply for one immediately. To apply
for an SSN, get Form 35-5, Application for a Social Security Card, from your local
SSA 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 !TIN, or Form 85-4, Application for Employer
Identification Number, to apply for an E1N. You can apply for an BIN online by
accessing the IRS websitta at www.irs.govlbusinesses 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 IFIS.gov or 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, apply for a TIN
and 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 50 days to get
a TIN and give it to the requester before you are subject to backup withholding on
payments. The 60-day rule does not apply to other types of payments. You will be
subject to backup withholding on all such payments until you provide your TIN to
the requester.
Note. Entering "Applied For" means that you have already applied for a TIN or that
you Intend to apply for one soon.
Caution: A disregarded U.S. entity that has a foreign owner must use the
appropriate Form W-8.
Form W-9 (Rev. 12-2014)
Page 4
Part H. 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, or 5 below indicate otherwise.
For a joint account, only the person whose TIN is shown In Part I should sign
(when required). In the case of a disregarded entity, the person Identified on line 1
must sign. Exempt payees, see Exempt payee code earlier.
Signature requirements. Complete the certification as indicated in Items 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.
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, royalties, goods (other than bills for
merchandise), medical and health care services (including payments to
corporations), payments to a nonemployee for services, payments made in
settlement of payment card and third party network transactions, 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, Coverdeil ESA, Archer MSA or IISA 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
2. Two or more individuals /joint
account)
3. Custodian account of a minor
(Uniform Gift to Minors Act)
4. a. The usual revocable savings
trust (grantor is also trustee)
b. So-called trust account that Is
not a legal or valid trust under
state law
5. Sole proprietorship or disregarded
entity owned by an individual
6. Grantor trust filing under Optional
Form 1099 Filing Method 1 (see
Regulations section 1,671-4(b)(2)(1)
(A))
The Individual
The actual owner of the account or,
if combined funds, the first
individual on the account'
The minorr'
The grantor-trustee'
The actual owner'
The owner'
The grantor'
For this type of account Give name and EIN of:
7. Disregarded entity not owned by an
individual
8. A valid trust, estate, or pension trust
9. Corporation or LLC electing
corporate status on Form 8832 or
Form 2553
10. Association, club, religious,
charitable, educational, or other tax-
exempt organization
11. Partnership or multi-member LLC
12. A broker or registered nominee
13. Account with the Department of
Agriculture in the name of a public
entity (such as a state or local
government, school district, or
prison) that receives agricultural
program payments
14. Grantor trust filing under the Form
1041 Filing Method or the Optional
Form 1099 Filing Method 2 (see
Regulations section 1.671-4(b)(2)(i)
(B))
The owner
Legal entity'
The corporation
The organization
The partnership
The broker or 'nominee
The public entity
The trust
'List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person's number must be furnished.
2 CirCie the minor's name and furnish the minor's SSIW
a You must show your individual name and you may also enter your business or 0E3A name on the "Business name/disregarded entity name line. You may use either your SSN or EIN (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 the account title.) Also see Special mien for partnerships on page 2.
*Note. Grantor also must provide a Form W-9 to trustee of trust.
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.
Secure Your Tax Records from Identity Theft
Identity theft occurs when someone uses your personal information such as your
name, 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
• Be careful when choosing a tax preparer.
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 number printed on the IRS
notice or letter.
If your tax records are not currently affected by identity theft but you think you
are at risk due to a lost or stolen purse or wallet, questionable credit card activity
or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit
Form 14039.
For more information, see Publication 4535, Identity Theft Prevention and Victim
Assistance.
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 (TAS)
assistance. You can reach TAS by calling the TAS toll-free case intake line at
1-877-777-4778 or TTY/TDD 1-800-829-4059.
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 119$ does not initiate contacts with taxpayers via ernails. 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 property to the Treasury Inspector General for Tax Administration
(TIGTA) at 1 -1300-366-4484. You can forward suspicious emails to the Federal
Trade Commission at: spamftce.gov or contact them at wwwitc.govlicitheft or
1-877-IDTHEFT (1-877-438-4338).
Visit 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 (including federal agencies) who are required to file information
returns with the IRS to report interest, dividends, or certain other income paid to
you; mortgage interest you paid; the acquisition or abandonment of secured
property; the cancellation of debt; or contributions you made to an IRA, Archer
MSA, or HSA. The person collecting this form uses the information on the form to
file Information returns with the IRS, reporting the above information, Routine uses
of this information include giving It to the Department of Justice for civil and • criminal litigation and to cities, states, the [District of Columbia, and U.S.
commonwealths and possessions for use in administering their laws. The
Information also may be disclosed to other countries under a treaty, to federal and
state agencies to enforce civil and criminal laws, or to federal law enforcement and
intelligence agencies to combat terrorism. You must provide your TIN whether or
not you are required to file a tax return. Under section 3406, payers must generally
withhold a percentage of taxable interest, dividend, and certain other payments to
a payee who does not give a TIN to the payer. Certain penalties may also apply for
providing false or fraudulent information.
November 2015 ATTACHMENT A
HAZARDOUS MATERIALS EMERGENCY PREPAREDNESS
PLANNING GRANT INSTRUCTIONS
I. GRANT PROGRAM DESCRIPTION
The Michigan State Police, Emergency Management and Homeland Security Division (MSP/EMHSD)
has been designated by the Governor's office to administer the Hazardous Materials Emergency
Preparedness (HMEP) planning grant program. HMEP planning grants are being made available to
Local Emergency Planning Committees (LEPCs) for the purpose of enhancing hazardous material
response planning.
II. ELIGIBILITY REQUIREMENTS
In order to be eligible to receive funding through the HMEP planning grant, LEPCs must:
A. Be legally appointed by the Michigan Citizen-Community Emergency Response Coordinating
Council (MCCERCC);
B. Have an appointed chairperson*;
C. Have an appointed information coordinator*;
Co. 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. (See item III.D);
G. Assure county or municipal compliance with Title VI of the Civil Rights Act of 1964;
H. Assure county or municipal compliance with lobbying, debarment, suspension, and other
responsibility matters certifications, as well as drug-free workplace requirements.
*If individuals holding these positions change please update the LEPC Roster and submit to the
MSP/EMHSD. The forms are available by contacting Mr. Jay Eickholt at 517-248-3982,
Eickholtli@Michigan.gov, or on the web at www.michigan.gov/emhsd (click on: Hazardous Materials
4 LEPC Officer Member Record).
November 2015
ATTACH ME NT A
III. APPLICATION PROCESS
A. Deadline: All applications and 2015 —2016 LEPC meeting schedules must be received by the
MSP/EMHSD no later than January 15, 2016.
B. Application Mailing Address: If you are submitting via mail please mail by December 31, 2015.
Anything mailed past this date may not be received by MSP/EMHSD by the due date.
Attention: Mr. Jay Eickholt
SARA Title III Program
Michigan State Police, Emergency Management and Homeland Security Division
P.O. Box 30634
Lansing, Ml 48909
C. Agreement Finalized: The MSP/EMHSD will review all applications for completeness and
accuracy. LEPCs with approved applications will then be sent two 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 MSP/EMHSD, and retain one copy
for their LEPC files by the date specified in the cover fetter mailed with these instructions. The
original signed agreement and attachments,must be returned as prescribed in the grant
agreement.
D. Matching Funds Identified: When the LEPC receives the HMEP Grant Agreement, it will also
receive a form 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 the HMEP planning grant by .80. The
resulting amount (total program cost) is then multiplied by .20 to calculate the match required.
The "Hazardous Materials Emergency Preparedness (HMEP) Planning Grant Agreement In-Kind
Match" form must be returned to the MSP/EMHSD with the HMEP Grant Agreement packet.
This form is used to estimate matching funds based on the proposed agreement amount (see
Item II.F). However, the subrecipient 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.
**NOTE: Staff positions and/or programs supported by other federal funds
cannot be used as match for this grant.**
2
November 2015 ATTACHMENT A
IV. ALLOCATION FORMULA
A. New Plan and Plan Update Payments: The MSP/EMHSD will reimburse LEPCs for new and
updated plans. The estimated reimbursement rate for 2015 — 2016 is $250 for new plans and
$30 for updated plans. Facilities must be on the SARA Title Ill, Section 302 site list or added to
the 302 site list by July 1, 2016. Plans that are added to the 302 site list after July 1, 2016, may
not receive payment from the 2015 — 2016 HMEP planning grant. To receive this funding, items
B and/or Con 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 $1,000 support grant. To qualify for the
support grant, a LEPC must:
• Meet at least quarterly and verify that meetings have been held by sending the
MSP/EMHSD a copy of the meeting minutes or an attendance roster.
• Annually update the LEPCs officer/membership list and submit the completed form to the
MSP/EMHSD.
• Incorporate completed off-site response plans into the city/county Emergency Operations
Plan (EOP) or Emergency Action Guidelines ([AG).
• Review the city/county EOP/EAP annually to make sure the hazmat response section is
current.
Verification of the above items, via a form signed by the LEPC Chair and/or Local Emergency
Management Coordinator, will be requested by the MSP/EMHSD prior to the end of the grant
year.
V. PROOF OF PURCHASE AND ASSOCIATED WORK
All subrecipients in the HMEP planning grant program must submit documentation on the associated
costs being charged to the $1,000 HMEP Support Grant. The eligible expenses are laid out in the
"HMEP $1,000 Support Grant Certification Form", which will be sent to each LEPC at the close of the
fiscal year. Costs entered on this form need to be supported by a receipt, time sheet (reflecting
hours worked on SARA (Superfund Amendment and Reauthorization Act) related planning issues),
purchase order, or a paid invoice. The "HMEP $1,000 Support Grant Certification Form" and
attachments must be returned to the MSP/EMHSD by the assigned due date.
3
November 2015 ATTACHMENT A
**NOTE: It is recommended that during this grant year, each LEPC update all of the SARA Title III
Section 302 off-site response plans that the LEPC has completed and develop new
off-site response plans for all sites that are not yet complete.**
VI. PLANNING GRANT REQUIREMENTS
LEPCs are eligible for allocation if they meet the following requirements:
A. Products: The intent of the planning grant is to encourage the development of new off-site
hazardous material response plans and complete updates to previously-submitted off-site
response plans for each SARA Title III Section 302 site in Michigan. Plans must be submitted to
the appropriate MSP/EMHSD District Coordinator by the date specified in each LEPC's contract.
A list of updated plans for sites on the current 302 site list must also be submitted by that date.
A plan update includes verification and updating of a facility's emergency contact information,
on-site extremely hazardous substances (EHS) and their quantities, storage locations, and any
other items which may change over time. The list must include the site name, MDEQ SARA
identification number, and name of facility contact who assisted with the review. The "Plan
Review List Form" for this submittal is located on the MSP/EMHSD website. This list can be
submitted directly to the address noted in Item III.B and does not need to be submitted to the
MSP/EMHSD District Coordinator.
B. Eligible Expenses: HMEP planning grant funds are to be utilized for expenses that support and
facilitate the development and/or updating of required SARA Title Ill off-site plans. These
expenses include, but are not limited to:
• Training for LEPC members, as long as it relates to the LEPC's planning mission.
• Development, improvement, and implementation of emergency plans required under
SARA Title III.
• Exercises that test LEPC plans.
• Enhancement of LEPC plans, e.g., improving the hazard analysis or transportation of
hazardous materials (including radioactive materials) response procedures.
• Commodity flow studies.
• Needs analysis for establishing regional response teams.
• Technical staff to support the planning effort.
• Assessment of local response capabilities.
4
November 2015 ATTACHMENT A
Types of eligible costs that must be directly related to SARA Title Ill planning activities include:
• Meeting room rental.
• Per Diem for LEPC members.
• Public notices.
• Printing costs.
• Office administrative expenses.
• LEPC staff costs.
**NOTE: Computer hardware or software is not an allowable purchase because it is usually considered art
"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. **
C. Off-Site Response Plans:
• New off-site plans must be submitted to the appropriate MSP/EMHSD District Coordinator
for review by July 1, 2016.
• If the LEPC proposes to complete updates of previous plans, a list of completed updates
must be submitted to the MSP/EMHSD at the address noted in Item III.B by July 1, 2016.
• If the LEPC completes fewer updates and/or new off-site response plans than it proposes,
their award will be prorated according to the number of plans/updates accepted by the
MSP/EMHSD.
**NOTE: Upon request, LEPCs may be required to make updated plans available to the
MSP/EMHSD for verification purposes.**
D. MSP/EMI-ISD Information Requests: Upon request, the LEPC must provide the MSP/EMHSD with
information on how HMEP funds were spent and what was accomplished. Other information
requests related to LEPC operations may also be sent to LEPCs.
E. Federal Reporting of Sub-awards and Executive Compensation: Upon request, the Subrecipient
shall supply information to the MSP/EMHSD to address federal reporting requirements relevant
to the Federal Funding Accountability and Transparency Act of 2006 (FFATA) (Public Law 109-
282), as amended by Section 6202(a) of the Government Funding Transparency Act of 2008
(Public Law 110-252). If your organization had a gross income from all sources under $300,000,
during the previous tax year, the organization is exempt from requirements to report sub -awards
and the total compensation of the five most highly-compensated executives. To determine if the
public should have access to the compensation information, refer to the U.S. Security and
Exchange Commission total compensation filing at http://www.sec.gov/answers/execomp.html.
5
November 2015 ATTACHMENT A
F. Reporting of Data Universal Numbering System (DUNS) Number: To comply with federal
government reporting requirements, the MSP/EMHSD is required to collect a DUNS number
from any recipient of sub-awards provided through the state of Michigan. A DUNS number must
be submitted before payments can be made.
VII. REIMBURSEMENT PROCESS
Payment to LEPts (or a prorated portion) will be processed by the MSP/EMHSD upon acceptance of
the LEPC's products, as specified in its contract.
VIII. ITEMS TO INCLUDE WITH 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.
B. LEPC Meeting Schedule for 2015 — 2016.
Questions concerning the HMEP planning grant should be directed to Mr. Jay Eickholt at
517-284-3982, or e-mail at Eickholtli@michigan.gov .
6
FISCAL NOTE , #16115 May 5, 2016
BY: Finance Committee, Torn Middleton, Chairperson
IN RE: HEALTH AND HUMAN SERVICES — HOMELAND SECURITY DIVISION — 2015-2016
HAZARDOUS MATERIALS EMERGENCY PREPAREDNESS PLANNING PROGRAM (HMEP-PP)
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) is eligible to receive up to $10,800 for the submittal of
new and updated plans during the grant period October 1, 2015 through September 30, 2016.
3. This grant requires an in-kind grant match of $2,700 in General Fund expenditures for total
program costs of $13,500.
4. The FY 2016 Budget is amended as follows to reflect the grant award:
GENERAL FUND (10100)
FY 2016
Revenue
1060601-115180-610313
1060601-115180-610313-100000001941
1060601-115180-610313-100000001941
9010101-196030-665882
Federal Operating Grants
Federal Operating Grants
Federal Operating Grants
Planned Use of Balance
Total Revenue
($ 9,000)
$ 9,000
($ 580)
$ 580
$ 0
FINANCE COMMITTEE VOTE:
Motion carried unanimously on a roll call vote with Woodward absent.
Resolution #16115 May 5, 2016
Moved by Fleming supported by Quarles the resolutions (with fiscal notes attached) on the Consent
Agenda be adopted (with accompanying reports being accepted).
AYES: Dwyer, Fleming, Gershenson, Gingell, Gosselin, Hoffman, Jackson, KowaII, Long,
McGillivray, Middleton, Quarles, Scott, Spisz, Taub, Weipert, Woodward, Zack, Crawford. (19)
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).
HEREBY APPROVE THIS RESOLUTION
CHIEF DEPUTY COUNTY EXECUTIVE
ACTING 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 5, 2016,
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 5th day of May, 2016.
Lisa Brown, Oakland County