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HomeMy WebLinkAboutResolutions - 2017.03.30 - 22834MISCELLANEOUS RESOLUTION #17067 March 30, 2017 BY: Commissioner Christine Long, Chairperson, General Government Committee IN RE: HEALTH AND HUMAN SERVICES — HOMELAND SECURITY DIVISION — 2016-2017 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 County is eligible to receive $11,020 for the submittal of new and updated plans during the grant period of September 30, 2016 through September 30, 2017; and WHEREAS the required 25% in-kind match of $2,755 will be met with part-time non-eligible (PINE) 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 completed the Grant Review Process in accordance with 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 $11,020 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 $11,020 and a 25% match of $2,755 for a total of $13,775 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 and continuation of this program is contingent upon continued future levels of grant funding. Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing resolution. LoL Commissioner Christine Long, Disykt Chairperson, General GovernmetkOlommittee GENERAL GOVERNMENT COMMITTEE VOTE: Motion carried unanimously on a roll call vote with Quarles absent. GRANT REVIEW SIGN OFF — Homeland Security GRANT NAME: 2017 Hazardous Materials Emergency Preparedness Planning Program (HMEP-PP) FUNDING AGENCY: Michigan State Police Emergency Management and Homeland Security Division DEPARTMENT CONTACT PERSON: Sara Stoddard 248 858-5080 STATUS: Grant Acceptance DATE: March 6, 2017 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 (3/1/2017) Department of Human Resources: Approved. No HR Committee needed. — Heather Mason (3/1/2017) Risk Management and Safety: Approved by Risk Management. — Robert Erlenbeck (3/1/2017) Corporation Counsel: Approved by Corporation Counsel. — Stephen Rideout (3/3/2017) RICK SNYDER GOVERNOR STATE OF MICHIGAN DEPARTMENT OF STATE POLICE LANSING 7 KRISTE KIBBEY ETUE DIRECTOR February 21, 2017 Ms. Sara Stoddard Homeland Security Assistant Coordinator Oakland County 1200 North Telegraph Road Pontiac, Michigan 48341-0410 Dear Ms. Stoddard: Enclosed is the FY 2016-17 Hazardous Materials Emergency Preparedness (HMEP) Planning Program Grant Agreement package for Oakland County. Please return the required grant documentation listed on the enclosed Subgrantee Checklist to our office at the following address: Attention: Ms. Sara Long Emergency Management and Homeland Security Division Michigan Department of State Police P.O. Box 30634 Lansing, MI 48909 Additional information on the FY 2016-17 HMEP Grant Program can be found at www.phmsa.dot.gov/hazmat/grants. This grant agreement and all required documentation must be completed, signed, and returned no later than May 17, 2017. If this requirement is not met, this grant agreement will be invalid after May 17, 2017 unless a prior written exception is provided by the Michigan Department of State Police, Emergency Management and Homeland Security Division. If you have any questions regarding this correspondence or the FY 2016-17 HMEP Planning Grant Program, please contact Mr. Jay Eickholt at EickholtJl@michigan.gov or 517-284-3982. Sincerely, Ct. Capt. Chris A. Kelenske, Commander Deputy State Director of Emergency Management and Homeland Security Division Enclosures (12) cc: Ms. Sharon Stahl Lt. Timothy Ketvirtis EMERGENCY MANAGEMENT AND HOMELAND SECURITY DIVISION • PO BOX #30634. LANSING, MICHIGAN 48909 www.michigan.govlmsp • 517-284-3745 SUBRECIPIENT CHECKLIST FY 2016-17 HAZARDOUS MATERIALS EMERGENCY PREPAREDNESS (HMEP) TRAINING PROGRAM GRANT AGREEMENT CFDA No: 20.703 Submit the following items as necessary to: Attention: Ms. Sara Long, Emergency Management and Homeland Security Division, Michigan Department of State Police, P.O. Box 30634, Lansing, Michigan 48909 SUBRECIPIENT WILL NOT BE REIMBURSED FOR FUNDS UNTIL ALL REQUIRED SIGNED DOCUMENTS ARE RECEIVED 7 1. Grant Agreement. There are two identical grant agreements enclosed. Please sign both, but retain one signed document for your records and return the other signed document. 2. Standard Assurances ri 3. Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirements 4. Audit Certification (EMD-053) POST REIMBURSEMENT REQUIREMENTS Participate with Recipient in an on-site monitoring of financial documents. Also retain financial records, supporting documents, and all other records pertinent to the grant for at least three years after the grant is closed by the awarding federal agency. Be sure to comply with Single Audit requirements of Subpart F of 2 CFR 200. If required, the Subrecipient submits audit copy to: Michigan Department of State Police, Grants and Community Services Division, PRO. Box 30634, Lansing, Michigan 48909. For GRANT-AGREEMENT-QUESTIONS ',..•PLASE.CONTACTSARA -LON . . • • • • • ••• AT-LONG.S@MICHIG.AN:GOV•;oR1517):. 2843.960. . . . . . . „ Michigan State Police . ,, . 0..4,, I Emergency Management and Homeland Security Division • Grant Agreement FEDERAL AWARD IDENTIFICATION SURRECIPIENT NAME County of Oakland GRANT NAME Hazardous Materials Emergency Preparedness Grant Program CFDA NUMBER 20.703 SUBRECIPIENT IRS/VENDOR NUMBER 38-6004876 FEDERAL AWARD IDENTIFICATION NUMBER (FAIN) HM-HMP-0558-16-01-00 FEDERAL AWARD DATE 09/16/2016 SUBRECIPIENT DUNS NUMBER 136200362 SUBAWARD FROM TO PERFORMANCE PERIOD 09/30/2016 09/30/2017 RESEARCH & DEVELOPMENT N/A Funding Total Federal Funds Obligated by this Action $11,020.00 INDIRECT COST RATE None on file Total Federal Funds Obligated to Subrecipient $11,020.00 Total Amount of Federal Award $521,254,00 FEDERALAWARD PROJECT DESCRIPTION FY 2016-17 Hazardous Materials Emergency Preparedness Planning Program Grant DETAILS 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 Ill, D of the Hazardous Materials Emergency Preparedness Planning Grant Instructions that are attached to this grant agreement. The match amount is located in part III.A of this grant agreement. FEDERAL AWARDING AGENCY U.S. Department of Transportation Pipeline and Hazardous Materials Safety Administration 1200 New Jersey Avenue, SE, E21-316 Washington DC 20590-0001 PASS-THROUGH ENTITY (RECIPIENT) NAME Michigan State Police Emergency Management &Homeland Security Division P.O. Box 30634 Lansing, MI 48909 State of Michigan Fiscal Year 2016-17 Hazardous Materials Emergency Preparedness Planning Program Grant Agreement September 30, 2016 to September 30, 2017 CFDA Number: 20.703 Grant Number: HM-HIVIP-0558-16-01-00 This Fiscal Year (FY) 2016-17 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 Superfund Amendments and Reauthorization Act (SARA), Title Ill, Section 302, hazardous materials emergency response plans, as well as for the updating of previously submitted plans. 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 2016-17 HMEP is authorized by the U.S. Department of Transportation (DOT) Pipeline and Hazardous Materials Safety Administration (PHMSA) and the Federal Hazardous Materials Transportation Law (49 U.S.C. Section 5101 et. seq.), The Subrecipient agrees to comply with all FY 2016-17 HMEP program requirements and 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://vvvvw.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://wvvw,000mov/fdsvs. D. Any other applicable Federal statutes and regulations, including, but not limited to the following: 1. The Recipient must comply with 49 CFR Part 20, "New Restrictions on Lobbying," 49 CFR Part 20 is incorporated by reference in this award. 49 CFR Part 20 is available at wvvw.gpoaccess.goviecfr/ by clicking on Title 49 CFR Part 20. 2. The Recipient must comply with Title VI of the Civil Right Act of 1964, which provides that no person in the United States shall, on the grounds of race, color, or national origin, be excluded from participation in, be denied benefits of, or be subject to discrimination under any program or activity receiving Federal financial assistance, 3. The Recipient must comply with 49 CFR Part 21, "Nondiscrimination in Federally-Assisted Programs of the Department of Transportation—Effectuation of Title VI of the Civil Rights Act of 1964." 49 CFR Part 21 is incorporated by reference into this award. 49 CFR Part 21 is available at; www,gpoaccess.goviecfri by clicking on Title 49 CFR part 21. FY 2016-17 HMEP Planning Grant County of Oakland Page 2 of 7 4. The Recipient must comply with 49 CFR part 32, "Government-wide Requirements for Drug- Free Workplace (Financial Assistance)," which implements the requirements of Public Law 100-690, Title Subtitle D, "Drug-Free Workplace Act of 1988." 49 CFR Part 32 is incorporated by reference in this award. 49 CFR Part 32 is available at: www.gpoaccess.gov/ecfr/ by clicking on Title 49 CFR Part 32. No term or condition of this award is intended to require the Recipient to violate any applicable State, Territorial or Tribal law, III. Award Amount and Restrictions A. The County of Oakland is awarded $11,020.00 under the FY 2016-17 HMEP Planning Program Grant Agreement. This funding will be awarded as described in Hazardous Materials Emergency Preparedness Planning Grant Instructions enclosed with this grant agreement, and is based on information provided in the HMEP grant application submitted for the FY 2016-17 grant year. This allocation is dependent upon the level of federal funding and may be reduced if available 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 III 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 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 $2,756.00 is 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 enclosed with this grant agreement. B. The 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, sub-award, or contract under a grant or sub-award; and 2. Any rights of copyright to which the Recipient, Subreciplent, 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 III Hazardous Materials, Off-site Emergency Response Plan Update List. This form is located on the MSP/EMHSD website at http://www.rnichigan.gov/emhsd . The Plan Update List does not need to be completed and returned with the FY 2016-17 HMEP Planning Program grant agreement. This form is to be used if and when a list of updated plans is submitted for your grant. FY 2016-17 HMEP Planning Grant County of Oakland Page 3 of 7 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 enclosed Hazardous Materials Emergency Preparedness Planning Grant Instructions, Section II. 2. Submit new SARA Title III (Section 302) community hazardous materials emergency response plans to the MSP/EMHSD District Coordinator no later than July 1, 2017. Support grant documentation must meet the requirements stated in the enclosed Hazardous Materials Emergency Preparedness Planning Grant Instructions, Section IV, B., or forfeit that portion of the grant award. 3. Submit a list of updated SARA Title III (Section 302) community hazardous materials emergency response plans to MSP/EMHSD no later than July 1, 2017. The form for submitting these updates is available on the MSP/EMHSD website located at http://www.michigan.gov/emhsd . Support grant documentation must meet the requirements stated in the enclosed 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 $750,000 or more in federal funds during their current fiscal year are required to have an audit performed in accordance with the Single Audit Act of 1984, as amended, and 2 CFR, Part 200.501. 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 2006 (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 2016-17 HMEP 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 enclosed Plan Update List form as stated in the FY 2016-17 application to MSP/EMHSD, no later than July 1, 2017. Complete instructions on how and where to submit required reports can be found in the Hazardous Materials Emergency Preparedness Planning Grant Instructions that are enclosed with this grant agreement. If a support grant was requested, the LEPC must meet the requirements stated in the enclosed 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 enclosed with 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 sent 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 et 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://www.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 40 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 2016-17 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 September 30, 2016 to September 30, 2017. 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. XII. Entire Grant Agreement This grant agreement is governed by the laws of the State of Michigan and supersedes all prior agreements, documents, and representations between 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 2016-17 HMEP Planning Grant County of Oakland Page 6 of 7 XIII. 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 2016-17 1-IMEP 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 Subrecipients DUNS Number Printed Name Title Signature Date For the Recipient (Michigan State Police, Emergency Management and Homeland Security Division) Capt. Chris A. Kelenske, Commander Deputy State Director of Emergency Management and Homeland Security Title Printed Name Cua Ct-.102neJ2-0_ February 22, 2017 Signature Date State of Michigan Fiscal Year 2016-17 Hazardous Materials Emergency Preparedness Planning Program Grant Agreement September 30, 2016 to September 30, 2017 CFDA Number: 20.703 Grant Number: HM-HMP-0558-16-01-00 This Fiscal Year (FY) 2016-17 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 Superfund Amendments and Reauthorization Act (SARA), Title III, 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 2016-17 HMEP is authorized by the U.S. Department of Transportation (DOT) Pipeline and Hazardous Materials Safety Administration (PHMSA) and the Federal Hazardous Materials Transportation Law (49 U.S.C. Section 5101 et. seq.). The Subrecipient agrees to comply with all FY 2016-17 HMEP program requirements and 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://wwvv.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://vvwvv.qpo.gov/fdsys. D. Any other applicable Federal statutes and regulations, including, but not limited to the following: 1. The Recipient must comply with 49 CFR Part 20, "New Restrictions on Lobbying." 49 CFR Part 20 is incorporated by reference in this award. 49 CFR Part 20 is available at www.gpeaccess.gov/ecfr/ by clicking on Title 49 CFR Part 20. 2, The Recipient must comply with Title VI of the Civil Right Act of 1964, which provides that no person in the United States shall, on the grounds of race, color, or national origin, be excluded from participation in, be denied benefits of, or be subject to discrimination under any program or activity receiving Federal financial assistance, 3. The Recipient must comply with 49 CFR Part 21, "Nondiscrimination in Federally-Assisted Programs of the Department of Transportation—Effectuation of Title VI of the Civil Rights Act of 1964." 49 CFR Part 21 is incorporated by reference into this award. 49 CFR Part 21 is available at: www.gpoaccess.gev/ecfr/ by clicking on Title 49 CFR part 21. FY 2016-17 HMEP Planning Grant County of Oakland Page 2 of 7 4. The Recipient must comply with 49 CFR part 32, "Government-wide Requirements for Drug- Free Workplace (Financial Assistance)," which implements the requirements of Public Law 100-690, Title Subtitle D, "Drug-Free Workplace Act of 1988." 49 CFR Part 32 is incorporated by reference in this award. 49 CFR Part 32 is available at: www.gpoaccess.gov/ecfr/ by clicking on Title 49 CFR Part 32, No term or condition of this award is intended to require the Recipient to violate any applicable State, Territorial or Tribal law. III. Award Amount and Restrictions A. The County of Oakland is awarded $11,020.00 under the FY 2016-17 HMEP Planning Program Grant Agreement. This funding will be awarded as described in Hazardous Materials Emergency Preparedness Planning Grant Instructions enclosed with this grant agreement, and is based on information provided in the HMEP grant application submitted for the FY 2016-17 grant year. This allocation is dependent upon the level of federal funding and may be reduced if available 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 III 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 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 $2,755.00 is 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 Ill, D of the Hazardous Materials Emergency Preparedness Planning Grant instructions that are enclosed with this grant agreement. B. The 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, sub-award, or contract under a grant or sub-award; 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: I. 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 2016-17 HMEP Planning Program grant agreement. This form is to be used if and when a list of updated plans is submitted for your grant. FY 2016-17 HMEP Planning Grant County of Oakland Page 3 of 7 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 enclosed Hazardous Materials Emergency Preparedness Planning Grant Instructions, Section 2, Submit new SARA Title ill (Section 302) community hazardous materials emergency response plans to the MSP/EMHSD District Coordinator no later than July 1, 2017. Support grant documentation must meet the requirements stated in the enclosed Hazardous Materials Emergency Preparedness Planning Grant Instructions, Section IV.13., or forfeit that portion of the grant award. 3. Submit a list of updated SARA Title Ill (Section 302) community hazardous materials emergency response plans to MSP/EMHSD no later than July 1, 2017. The form for submitting these updates is available on the MSP/EMHSD website located at http://www.michigan.gov/emhsd . Support grant documentation must meet the requirements stated in the enclosed 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. N1MS information is available at http://vvww.fema.gov/national-incident- management-system . More information on complying with NIMS is available from the State N1MS 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 $750,000 or more in federal funds during their current fiscal year are required to have an audit performed in accordance with the Single Audit Act of 1984, as amended, and 2 CFR, Part 200.501. 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, arid 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 2006 (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 2016-17 HMEP 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 enclosed Plan Update List form as stated in the FY 2016-17 application to MSP/EMHSD, no later than July 1, 2017. Complete instructions on how and where to submit required reports can be found in the Hazardous Materials Emergency Preparedness Planning Grant Instructions that are enclosed with this grant agreement. If a support grant was requested, the LEPC must meet the requirements stated in the enclosed Hazardous Materials Emergency Preparedness Planning Grant Instructions, Section 1V.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 enclosed with 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 sent 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 et 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://vvww.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 2016-17 HMEP Planning Grant County of Oakland Page 6 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. XI. Grant Agreement Period This grant agreement is in full force and effect from September 30, 2016 to September 30, 2017. 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. XII. Entire Grant Agreement This grant agreement is governed by the laws of the State of Michigan and supersedes all prior agreements, documents, and representations between 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 subrecipierits. 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 2016-17 liMEP Planning Grant County of Oakland Page 6 of 7 XIII. 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 Subreolpient, 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 net 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. 1 FY 2016-17 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 Subrecipierit's DUNS Number Printed Name Title Signature Date For the Recipient (Michigan State Police, Emergency Management and Homeland Security Division) Capt. Chris A. Kelenske, Commander Deputy State Director of Emergency Management and Homeland Security Title Printed Name C_Jrvi c/L.113i1i-v)c.14_. February 22, 2017 Signature Date EMD-063 (0912014) MICHIGAN SIAM POLICE Emergency Management and Homeland Security Division HIVIEP PLANNING GRANT AGREEMENT IN-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 $2,755 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.): PLANNING PERSONNEL: (Full Name of Employee) , whose salary and fringe benefits cost $ per hour, will work approximately hours on LEPC planning. n SECRETARIAL: (Full Name of Employee or Secretarial Service) , whose salary and fringe benefits cost $ per hour, will work approximately hours on LEPC business. OFFICE SPACE: (Government Jurisdiction or Other Entity) , will provide a square foot office located at (Address) to the LEPC at a cost of $ per square foot. MAILING: (Government Jurisdiction or Other Entity) , will provide $ toward LEPC related mailings. PRINTING: (Government Jurisdiction or Other Entity) , will provide $ toward LEPC related printing. OTHER (Describe): AUTHORITY: 1976 PA 390, as amended, MCL 30.407a, 42 USC 11002 - 11003 COMPLIANCE: Voluntary, however failure to complete application will result in denial of request OMB 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-1 et seq.), and the National Environmental Policy Act of 1969 (42 U.S.C. § 4321). 6. It will comply (and will require any subgrantees or contractors to comply) with any applicable statutorily-imposed nondiscrimination requirements, which may include the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. § 3789d); the Victims of Crime Act (42 U.S.C. §10604(e)); The Juvenile Justice and Delinquency Prevention Act of 2002 (42 U.S.C. § 5672(b)); the Civil Rights Act of 1964 (42 U.S.C. § 2000d); the Rehabilitation Act of 1973 (29 U.S.C. §7 94); the Americans with Disabilities Act of 1990 (42 U.S.C.§ 12131-34); the Education Amendments of 1972 (20 U.S.C. §§1681, 1683, 1685-86); and the Age Discrimination Act of 1975 (42 U.S.C. §§ 6101-07); see Ex. Order 13279 (equal protection of the laws for faith-based and community organizations). 7. If a 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 treatment of persons displaced as a result of federal and federally-assisted programs; and b) it wi ll comply with requirements of 5 U.S.C.§§ 1501-08 and §§7324-28, which limit certain political activities of State or local government employees whose principal employment is in connection with an activity financed in whole or in part by federal assistance. Signature Date 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" and 28 CFR Part 67, "Government-wide Debarment and Suspension (Nonpro-curement) and Government-wide Requirements for Drug-Free Workplace (Grants)." The certifications shall be treated as a material representation of fact upon which reliance will be placed when the Department of sl us tice 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 cnik 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 OTHER THAN INDIVIDUALS) As required by the Drug-Free Workplace Act of 1988, and Implemented at 28 CFR Part 67, Subpart F, for grantees, as defined at 28 CFR Part 67 Sections 67,615 and 67.620— A. The applicant certifies that it will or will continue to provide a drug-free workplace by: (a) Publishing a statement notifying employees that tha 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 am FORM 408116 (3-91) REPLACES MR FORMS 406112, 400115 AND 406114 WH€CH ARE OBSOLETE. (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; Check 0 if there are workplaces on file that are not indentlfled (e) Notifying the agency, in writing, within 10 calendar days here. after receiving notice under subparagraph (d)(2) from an Section 67, 630 of the regulations provides that a grantee that employee or otherwise receiving actual notice of such convic-tion. is a State may elect to make one certification in each Federal Employers of convicted employees must provide notice, including fiscal year. A copy of which should be included with each ap- position title, to; Department of Justice, Office of plication for Department of Justice funding, States and State Justice Programs, ATTN: Control Desk, 633 Indiana Avenue, agencies may elect to use OJP Form 4061/7. KW., Washington, D.C. 20531. Notice shall include the iden- tification number(s) of each affected grant; Check 0 if the State has elected to complete OJP Form 4061/7. (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— DRUG-FREE WORKPLACE (GRANTEES WHO ARE INDIVIDUALS) (1) Taking appropriate personnel action against such an employee, up to and Including termination, consistent with the As required by the Drug-Free Workplace Act of 1988, and requirements of the Rehabilitation Act of 1973, as amended; or implemented at 28 CFR Part 67, Subpart F, for grantees, as (2) Requiring such employee to participate satisfactorily in a defined at 28 CFR Part 67; Sections 67.615 and 67.620— drug abuse assistance or rehabilitation program approved for A. As a condition of the grant, I certify that I will not engage such purposes by a Federal, State, or local health, law enforce- in the unlawful manufacture, distribution, dispensing, posses- ment, or other appropriate agency; slon, or use of a controlled substance in conducting any (g) Making a good faith effort to continue to maintain a drug- activity with the grant; and free workplace through implementation of paragraphs (a), (b), B. If convicted of a criminal drug offense resulting from a (c), (d), (e), and (f). violation occurring during the conduct of any grant activity, I B. The grantee may insert in the space provided below the will report the conviction, in writing, within 10 calendar days site(s) for the performance of work done in connection with of the conviction, to: Department of Justice, Office of Justice the specific grant: Programs, ATTN: Control Desk, 810 Seventh Street NW., Washington, DC 20531. Place of Performance (Street address, city, county, state, zip code) 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 'U.S. Government Printing 011ice: 1995- 409-037/40014 1.iprOgriemjnfartpationi:: Program Name _.11...SubretipientInformation Subrecipient Name Street Address -.III. Certification for Fiscal Year . EMD-053 (02)2017) MICHIGAN STATE POLICE Emergency Management and Homeland Security Division AUDIT CERTIFICATION AUTHORITY: MCL 30.407a and 2 CFR Part 200, Subpart F; COMPLIANCE: Voluntary, but necessary to be considered for grant assistance, Federal Audit Requirements Non-federal organizations, which expend $750,000 or more in federal funds during their current fiscal year, are required to have an audit performed in accordance with 2 CFR Part 200, Subpart F. Subrecipients 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, P.O. Box 30634, Lansing, Michigan 48909. Submit completed document to: Michigan State Police Emergency Management and Homeland Security Division P.O. Box 30634 Lansing, Michigan 48909 Subreolpient Fiscal Year Period: to I certify that the subrecipient shown above does NOT expect it will be required to have an audit performed under 2 CFR Part 200, Subpart F, for the above listed program. 0 I certify that the subrecipient shown above expects it will be required to have an audit performed under 2 CFR Part 200, Subpart F, 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, P.O. Box 30634, Lansing, Michigan 48909. Signature of Subrecipient's Authorized Representative Date Form W-9 (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. Print or type I See Specific Instructions on page 2. 1 Nemo (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 0 Individual/sole single-member 111 Limited liability Note. For a single-member the tax classification 171 Other (see instructions) box for federal tax classificatlon; check only one of the following seven boxes: El Trust/estate 4 ExemptIons certain entities, instructions Exempt payee Exemption code (if any) (Applies no accotads (codes apply only to not individuals; see on page 3): code 0 any) proprietor or . C Corporation • 5 Corporation E Partnership LW company. Enter the tax classification (C=C corporation, S—S corporation, P,partnership))- LLC that is disregarded, do not check LLC: check the appropriate box in of the single-member owner. 10- from FATCA reporting the lino above for maloteined outstay the U.S.) 5 Address (number, street, and apt. or suite o.) Requester's name and address (optional) S City, state, and ZIP code 7 List account number(s) here (optional) Taxpayer identification Number (TIN) Enter your TIN in the appropriate box, The TIN provided must match the name given on line 1 to avoid Social security number backup withholding. For Individuals, this is generally your social security number (SsN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other • entitles, it is your employer identification number ([IN). If you do not have a number, see How to get a TIN on page 3. or Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for Employer identification number guidelines on whose number to enter. Certification Under penalties of perjury, I certify that: I. 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 rot subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) 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 an exempt from FATCA reporting is correct. Certification InetrUctions. 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. parson Date 0- 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.govitw0. 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 (TN) which may be your social security number (SSN), individual taxpayer identification number (ITN), adoption taxpayer identification number (ATIN), or employer icientlficatton 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) • Form 1 coa-niv (dividends, including those from stocks or mutual funds) • Form losa.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 1009-K (merchant card and third party network transactions) • Form 1098 (home mortgage Interest), 1098-0 (student loan interest), 1098-1 (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. it you do not return Form W-9 to the requester with a TIN, you might be subfect 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 lore number to be issued), 2. Certify that you are not sub!ect 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 1..5 FATC,4 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 4nd 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 similer to this Form W-9. Definitiort 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 orgarleed in the United States or under the laws of the United States; • An estate (other than Et 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 not 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 Li ,S. grantor or other U.S. owner of the grantor trust and riot 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 parson or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person, do riot use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Peblication 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 lax 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 Whole 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 1,4-9 that specifies the following five items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax es 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 exeeeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1964) 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 art 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 requester the 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 26% of such payments. This Is called "backup withholding." Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and bailer exchange transactions, rents, royalties, nonemployee pay, payments made lo 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 riot furnish your TIN to the requester, 2. You do not certify your TIN when required (sec 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 ail your interest and dividends on your tax return (for reportable interest arid dividends only), or 5. You do not certify la the requester that you are riot 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 FATCA reporting. See Exemption from FA TCA 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 make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $600 penalty. Criminal penalty for falsifying Information. Willfully falsifying certifications or affirmations may subject you to criminal peeelties including fines and/or imprisonment. Misuse of TI Ns. If the requester discloses or uses TINs in violation at federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Line l Y must enter one of the following on this lire; 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. ITIN 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 1040/1040A11040EZ you filed with your application. b. Sole proprietor or single-member LLC. Enter your individual name as shown on your 1040/1040N1040EZ on line 1. You may enter your business, trade, or 'doing business as" (DBA) name on lire 2. c. Partnership, LLC that Is not a single-member LUG, 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 Hee 2. id. Other entitles. 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. a. 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." Sae Regulations section 301.7701-2(0(2)R, 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," lithe owner of the disregarded entity is a foreign person, the owner must complete an appropriate Form W-8 instead of a Faun 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 LLC treated as a partnership for U.S. federal tax purposes, check the 'Limited Liability Company" box and enter "P" In the space provided, if the LLC has filed Form 8832 or 2653 to be taxed as a corporation, check the "Limited Liability Company" box and In the space provided enter "0" 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 line 3 '`Individualisole 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 not 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(1)(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 Linked States, the District of Columbia, or a U.S. commonwealth or possession 7—A futures commission merchant registered with the Commodity Futures Trading Commission 8—Ares] 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 bye 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 Ali exempt payees except for 7 Broker transactions Exempt payees 1 through 4 and 6 through 11 and all C corporations. 0 corporations must not enter an exempt payee code because they are exempt only for sales of noncovered 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 $5,0001 Generally, exempt payees 1 through 62 Payments made In settlement of payment card or third party network transactions Exempt payees 1 through 4 1 See Form 1099-MISC, Miscellaneous Income, and Its Instructions. 'However, the following payments made to a corporation and reportable on Form 1090-MIS0 are not exempt from backup withholding: medical and health care payments, attorneys' fees, gross proceeds paid to an attorney reportable under section 6045(1), and payments for services paid by a federal executive agency. Exemption from FATCA reporting code, The following codes Identity 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 held 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 coons or more established securities markets, as described in Regulations section 1.1472-1(0)(1)(1) 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)0i 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) ..1—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 .7.1P 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 get a TIN below. If you are a sole proprietor and you have an FIN, you may enter either your SSN or FIN. However, the IRS prefers that you use your SSN. If you era 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 for [IN, if the owner has one). Do not enter the disregarded entity's EIN. If the LLC Is classified as a corporation or partnership, enter the entity's SIN. Note. See the chart on page 4 for further clarification of name and TIN combinations. How to gate TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form 60-5, 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 ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an [IN. You can apply for an EIN online by accessing the IRS website at www.frs.govlbuskiessos end clicking or Employer Identification Number (UN) under Starting a Business. You can get Forms W-7 and 00-4 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, arid certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply toolbar 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 US, entity that has e foreign owner must use the appropriate Form W-8. Form W-0 (Rev. 12-2014) Page 4 Part II. Certification To establish to the withholding agent that you are a U.S, person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if items 1.4, 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 awie earlier. Signature requirements. Complete the certification as indicated In Items 1 through 6 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 crosscut 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 nonempioyee for services, payments made in settlement of payment card arid third party network transactions, payments to certain fishing boat craw members and fishermen, and gross proceeds paid to attorneys (Including payments to corporations). 8. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 829), IRA, Coverdell ESA, Archer MSA Or RSA 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 $SN of: I. individual 2. Two or more individuals ooint account) 3. Custodian account of a minor (Uniform Sift to Minors Act) 4. a. The usual revocable savings trust (grantor is also trustee) b. So-calied trust account that is not a legal or valid trust under stale 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(h)(2)(I) (A)) The individual The actual owner of the account or, if combined funds, the first individual on the account' The minor' 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 2563 10. Association, club, religious, charitable, educational, or other tax- exempt organization 11. Partnership or multi-member LLD 12. A broker or registered nominee 13. Account with the Department of Agriculture in the name of a public entity (such as a stale 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 Piling Method 2 (see Regulations section 1.671-4(b)(2)(1) (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 an a Inlet account has an SSN, that person's number must ire furnished. 2 Circle the minor's name and furnish the minor's SSW. 3 YOU must show your individual name and you may also enter your business or DBA name on the "Business name/disregarded entity' name line. You may use either your SSN or SIN (If you have one), hut the IRS encourages you to use your SSN. list first and circle the name of the trust, estate, or pension trust. (Do net furnish the TIN of the personal representative or tnistee unless the legal entity itself is not designated in the account title.) Also see Special rules 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 Ile 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 R notice from the IFS, 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-hue case intake line at 1-877-777-4778 or TIY,'TDD 1-800-829-4059. Protect yourself from suspicious smalls or phishing schemes. Phishing is the creation and use of email and websites designed to mimic legitimate business ernaiis and websltes. The most common act Is sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for Identity theft. The IRS does not initiate contacts with taxpayers via °MOHO. 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 chishing@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 1-800-308-4484. You can forward suspicious emalls to the Federal Trade Commission at: sparn@uce.gov or contact them at www.ftc.govildtheft 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 USA. 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 clef 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 3400, payers must generally withheld 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. EMD-454 (0812014) MICHIGAN STATE POLICE Emergency Management and Homeland Security Division SARA TITLE III HAZARDOUS MATERIALS, OFF-SITE EMERGENCY RESPONSE PLAN UPDATE LIST AUTHORITY: 1976 PA 390, MCL 30.407a; 42 USC 11002-11003 COMPLIANCE: Required PENALTY: Civil penalty of not more than $25,000 for each day such violation occurs This form is used for the recording of updated emergency contact information for sites required under 42 USC 11002 (SARA Title Ill, Section 302). DO NOT list new plans on this sheet Please note that the Michigan State Police, Emergency Management and Homeland Security Divisior) may contact facilities to verify the plan review. Local Emergency Planning Committee (LEPC) Name: Date: MI SARA ID Nurriber Facility Name Facility Emergency Contact Emergency Contact Phone Number Date Original Plan Submitted SIGNATURE (LEPC Chair or Local Emergency Management Coordinator) November 2016 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*; D. Have an appointed emergency management coordinator*; E. Meet at least quarterly and have an established meeting schedule; F. Assure that a 20% in-kind match will be available for all funding received through this grant. In- kind match includes non-federally funded LEPC member time, office space, secretarial support, LEPC office and administrative expenses, etc. (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 517-284-3982, Eickholtll@Michigan.gov. III. APPLICATION PROCESS A. Deadline: All applications and 2016 —2017 LEPC meeting schedules must be received by the MSP/EMHSD no later than January 18, 2017. 1 November 2016 ATTACHMENT A B. Application Mailing Address: If you are submitting via mail please address the package to: Attention: Mr. Jay Eidholt SARA Title III Program Michigan State Police, Emergency Management and Homeland Security Division P.O. Box 30634 Lansing, MI 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 letter 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.** 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 2016 - 2017 is $250 for new plans and $30 for updated plans, Facilities must be on the SARA Title III, Section 302 site list or added to 2 November 2016 ATTACHMENT A the 302 site list by July 1, 2017. Plans that are added to the 302 site list after July 1, 2017, may not receive payment from the 2016-2017 HMEP planning grant. To receive this funding, items B and/or C on the bottom of the "Local Emergency Planning Committee Application for Hazardous Material Emergency Preparedness Grant" form must be completed. B. Support Grant Payments: Each LEPC is eligible for a $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 (EAG), • 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. **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. " 3 November 2016 ATTACHMENT A 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 LEPCIs 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: HM EP planning grant funds are to be utilized for expenses that support and facilitate the development and/or updating of required SARA Title III 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 Ill. • 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. Types of eligible costs that must be directly related to SARA Title III planning activities include: • Meeting room rental. • Per Diem for LEPC members. • Public notices. 4 November 2016 ATTACHMENT A • Printing costs. • Office administrative expenses. • LEPC staff costs, **NOTE: Computer hardware or software is not an allowable purchase because it is usually considered an "operational system," which is any type of system that could be used in an emergency response, e.g., reverse 9-1-1 calling systems, hazmat databases, etc. ** C. Off-Site Response Plans: • New off-site plans must be submitted to the appropriate MSP/EMHSD District Coordinator for review by July 1, 2017. • 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 111,8 by July 1,2017. • 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. IVISP/EIVIHSD 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 $300,000, during the previous tax year, the organization is exempt from requirements to report sub-awards and the total compensation of the five most highly-compensated executives. To determine if the public should have access to the compensation information, refer to the U.S. Security and Exchange Comm ission total compensation filing at http://www.sec.gov/answers/execomp.html, F. Reporting of Data Universal Numbering System (DUNS) Number: To comply with federal government reporting requirements, the MSP/EMHSD is required to collect a DUNS number from any recipient of sub-awards provided through the state of Michigan. A DUNS number must 5 November 2016 ATTACHMENT A be submitted before payments can be made. VII. REIMBURSEMENT PROCESS Payment to LEPCs (or a prorated portion) will be processed by the MSP/EMHSD upon acceptance of the LEPC's products, as specified in its contract. VIII. ITEMS TO INCLUDE WITH APPLICATION A. HMEP Planning Grant Application Form: Appropriate boxes for the type of grant requested must be checked on the application, and Officer/Emergency Manager information must be included. B. LEPC Meeting Schedule for 2016 — 2017. Questions concerning the HMEP planning grant should be directed to Mr. Jay Eickhoit at 517-284-3982, or e-mail at Eickholth@rnichigan.gov . 6 Salaries Workers Compensation Retirement Social Security Unemployment Insurance Advertising Total Expenditures ($ 23,425) ($ 52) ($ 651) ($ 340) ($ 49) ($ 1,000) ($25,517) FY 2017 Planned Use of Balance Federal Operating Grants Total Revenues $ 14,497 $ 11,020 $ 25,517 FISCAL NOTE• (MISC . #17067) March 30, 2017 BY: Commissioner Thomas Middleton, Chairperson, Finance Committee IN RE: HEALTH AND HUMAN SERVICES — HOMELAND SECURITY DIVISION — 2016-2017 HAZARDOUS MATERIALS EMERGENCY PREPAREDNESS PLANNING PROGRAM (lMEP-PP) GRANT AGREEMENT ACCEPTANCE 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 $11,020 for the submittal of new and updated plans during the grant period September 30, 2016 through September 30, 2017. 3. This grant requires an in-kind grant match of $2,755 in General Fund expenditures for total program costs of $13,775. 4. The FY 2017 Budget is amended as follows to reflect the grant award: GENERAL FUND (10100) FY 2017 Revenues 9010101-196030-665882 Planned Use of Balance ($ 14,717) 1060601-115180-610313-100000001941 Federal Operating Grants ($ 10,800) Total Revenues ($25,517) Expenditures 1060601-1151 80-702010-1 00000001941 1060601-1151 80-722750-1 00000001941 1060601-1151 80-722770-1 00000001941 1060601-1151 80-722790-1 00000001941 1060601-1151 80-722820-1 00000001941 1060601-115180-730072-100000001941 GENERAL FUND (101001 Budget Reference 2017 Revenues 90101 01-1 96030-665882 1060601-115180-610313-100000002372 Expenditures 1060601-115180-702010-100000002372 Salaries 1060601-115180-722750-100000002372 Workers Compensation 1060601-115180-722770-100000002372 Retirement 1060601-115180-722790-100000002372 Social Security 1060601-115180-722820-100000002372 Unemployment Insurance 1060601-115180-730072-100000002372 Advertising Total Exp di Vies $ 23,425 $ 52 $ 651 $ 340 $ 49 1,00 5 Crnmigsioner Thomas Middleton, Distlict #4 Chairperson, Finance Committee FINANCE COMMITTEE VOTE: Motion carried unanimously on a roll call vote with Long and Bowman absent. Resolution #17067 March 30, 2017 Moved by Fleming supported by Bowman the resolutions (with fiscal notes attached) on the amended Consent Agenda be adopted (with accompanying reports being accepted). AYES: Crawford, Dwyer, Fleming, Gershenson, Hoffman, Jackson, Kochenderfer, KowaII, Long, McGillivray, Middleton, Taub, Tietz, Weipert, Woodward, Zack, Berman, Bowman. (18) NAYS: None. (0) A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the amended Consent Agenda were adopted (with accompanying reports being accepted). P HEREBY AiskrOWTHIS 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 March 30, 2017, 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 30th day of March, 2017. Lisa Brown, Oakland County