HomeMy WebLinkAboutResolutions - 2020.10.21 - 33778MISCELLANEOUS RESOLUTION #20466 October 21, 2020
BY: Commissioner David T. Woodward, Chairperson, Pandemic Response and Economic Recovery
Committee
IN RE: COUNTY EXECUTIVE — ACCEPTANCE OF THE MICHIGAN DEPARTMENT OF TREASURY
FIRST RESPONDER HAZARD PAY PREMIUMS PROGRAM — GRANT ACCEPTANCE
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen
WHEREAS the County of Oakland was allocated $219,438,710 under the Coronavirus Aid, Relief, and
Economic Security (CARES) Act Coronavirus Relief Fund (CRF) to respond directly to the emergency as
well as expenditures incurred to respond to second -order effects of the emergency; and
WHEREAS the Michigan Department of Treasury provided for applications to be submitted for the First
Responder Hazard Pay Premiums Program (FRHPPP); and
WHEREAS the FRHPPP established maximum available limits at $1,000 per eligible employee with a
$5,000,000 cap to any one applicant; and
WHEREAS Oakland County submitted $1,001,276.87 in eligible costs; and
WHEREAS the Michigan Department of Treasury notified Oakland County of an initial award of
$996,069.03 and requested clarification on $5,207.84 in costs; and
WHEREAS Oakland County provided the clarification, and it is expected the County will receive the full
application amount of $1,001,276.87.
NOW THEREFORE BE IT RESOLVED that the Board of Commissioners hereby accepts grant funding
from the Michigan Department of Treasury in the amount of $1,001,276.87 for the First Responder Hazard
Pay Premiums Program.
BE IT FURTHER RESOLVED that the acceptance of this grant does not obligate the County to any further
commitment.
BE IT FURTHER RESOLVED that FY 2020 budget be amended as follows:
GENERAL FUND (#10100)
Project: 10000000 3272
Bud Ref: 2020 Activity: GLB Analysis: GLB
Revenue
4030101-133095-610313
Expenditures
4030301-133095-702320
4030601-133095-702320
4030701-133095-702320
Federal Operating Grants
Total Revenue
Disaster Premium Salaries
Disaster Premium Salaries
Disaster Premium Salaries
Total Expenditures
Chairperson, on behalf of the Pandemic Response and
foregoing resolution.
FY 2020
$1,001,277
$ 1.001.277
$480,903
$454,896
65 478
$ 1.001.277
=e, 1 move a adoption of the
i
David T. Woodward, District #19
Chairperson, Pandemic Response and Economic
Recovery Committee
PANDEMIC RESPONSE AND RECOVERY COMMITTEE VOTE:
Motion carried on a roll call vote with Spisz and Miller absent.
FINANCE AND INFRASTRUCTURE COMMITTEE VOTE:
Motion carried on a roll call vote with Middleton absent.
First Responder Hazard Pay Premiums Program
Application Packet
2020 Public Act 144
Coronavirus Aid, Relief, and Economic Security (CARES) Act,
Public Law 116-136
Application Period: July 7 — September 30, 2020
NOTE: As U.S. Department of the Treasury issues future guidance and clarifications, the specific guidelines listed in
this document are subject to change. Changes will be addendums to this document.
Michigan Department of Treasury
First Responder Hazard Pay Premiums Program (FRHPPP)
Table of Contents
ApplicationInstructions................................................................................................................................................1
ProgramInformation....................................................................................................................................................2
SubrecipientInformation..............................................................................................................................................4
Reimbursement Request (Form 5723).........................................................................................................................9
Hazard Pay Premiums Payment Report— Instructions...............................................................................................12
Hazard Pay Premiums Payment Report......................................................................................................................13
Certification................................................................................................................................................................14
Michigan Department of Treasury
First Responder Hazard Pay Premiums Program (FRHPPP)
Application Instructions
the purpose of this document is to provide guidance to eligible applicants that would like to apply for Coronavirus Relief
Funding under the Michigan Department of Treasury's First Responder Hazard Pay Premiums Program.
"to receive reimbursement, eligible applicants must review, complete, and sign this entire application packet. All pages will
either be initialed or signed. Pages 1 through 15 must be returned to the Michigan Department of Treasury via email or fax
as outlined in the document.
If you need to enter more employees than the Hazard Pay Premiums Payment Report (page 13) will allow, the data for the
remaining employees must be submitted on additional reports. An excel template can be found at
httos://www.nilchlaan,aov/treasuN/0.4679.7-121-1751 2197-532758--.00. htm I
Signatures are required on pages 10 and 15. After verifying the entire application packet and reviewing all the requirements
and terms and conditions of the grant, the same person needs to initial and date each page and sign both pages 10 and 15.
The signatory on form 5723, the page initials, and the certification at the end of the packet must all be the same person,
Questions, contact the Michigan Department of Treasury at: Treas-CARESPmichiean,eov or 517-335-0155.
8/26/2020
Page 1 Initial ____-_ Date
Michigan Department of Treasury
First Responder Hazard Pay Premiums Program (FRHPPP)
Program Information
Proeram Descrintion
The program was created by 2020 Public Act 123 and amended by 2020 Public Act 144, The program is to reimburse and/or
pay for qualifying first responder hazard pay premiums provided to first responders who have performed hazardous duty or
work involving physical hardship related to COVID-19. The program Is funded under the Coronavirus Aid, Relief, and
Economic Security (CARES) Act, Public Law 116-136.
Reimbursements and payments will be on a first -come, first -served basis. An application Is deemed to be submitted when all
required supporting documentation has been emailed or faxed to the Michigan Department of Treasury.
Eligible Expenditures
Eligible hazard pay premiums must be paid to employees by September 30, 2020 to qualify for the program.
Eligible hazard pay premiums are for:
• Law Enforcement Officers
• Firefighters
• Emergency Medical Technicians (EMTs)
• Paramedics
• 9-1-1 Operators
• Local Unit of Government Corrections Officers
• Airport Public Safety Officers
• Eligible personnel associated with ambulance operations licensed under section 20920 of the Public Health Code
(1978 PA 368; MCL 333.20920)
• Private EMTs and paramedics that contract with municipalities or hospitals, if the hazard pay premiums are paid
through the applicant
Eligible ADDlicants
• Cities
• Villages
• Townships
• Counties
• Public Airport Operators
• Ambulance Operations licensed under section 20920 of the Public Health Code (1978 PA 368; MCL 333.20920)
• A local governmental authority, intergovernmental agency, or organization that employs local public safety or local
public health personnel and that was established by a city, village, township, county, or group thereof for the
primary purpose of providing public safety or public health services.
Available P(oRram Amount
• $100,000,000
Maximum Available Limits
• $1,000 per eligible employee
• $5,000,000 to any one applicant
Page 2 Initial DC Date08/26/2020
Michigan Department of Treasury
First Responder Hazard Pay Premiums Program (FRHPPP)
Program Information
Application Period
. July 7— September 30, 2020
Method of Submission
. The entire application packet must be submitted, with all the required forms, signatures, and Initials, to the
Michigan Department of Treasury via Email ITreas-CARES(@nmchIvan.eov) or fax (517-335-3298) by 11:59 p.m. EST
on the last day of the application period.
Distributions
Payments and Reimbursements will be on a first -come, first -served basis.
Advance requests (using Form 5725, First Responder Hazard Pay Premiums Program, Advance Request) may be
submitted to Treasury no later than September 1, 2020
Advance requests will be processed as follows:
o Submissions received on or before August 10, 2020, will be paid on August 24, 2020
o Submissions received on or before September 1, 2020, will be paid on September 15, 2020
Payments will be made no later than November 14, 2020,
Renortine Reowrements
1. Each eligible applicant that applies for a subaward must register with the Federal System for Award Management
(SAM). Applicants that apply after July 26, 2020, must register In the SAM system prior to sending an application to
the Michigan Department of Treasury. The SAM website is: htt s: www.sarn. v ML
2. Each applicant must fully complete and return the application packet by the submission deadline with each page
dated and initialed including the completion of the following documents in the packet:
a. FRHPPP Reimbursement Request (Form 5723)
b. Hazard Pay Premiums Payment Report
c. Certification
3, Applicants that are requesting an advance payment (i.e. hazard pay premiums have not been paid to the employees
yet) must submit Form 5725 "First Responder Hazard Pay Premiums Program, Advance Request' with the
Application Packet.
4. Applicants that were required to submit Form 5725, First Responder Hazard Pay Premiums Program, Advance
Request, must submit to the Michigan Department of Treasury a Final Program Report by October 15, 2020.
The Michigan Department of Treasury may request an applicant to submit detailed backup (including payroll reports) to
support the hazard pay premiums requested to be reimbursed/paid. Please do not submit any detailed backup unless the
Michigan Department of Treasury requests submission from the applicant.
Contact Information
Treasury CARES Grant Programs Hotline
517-335-0155
Email Address
Treas-CARES@michigan.gov
Page 3 Initial _DC Date 08/26/2020 _
Michigan Department of Treasury
First Responder Hazard Pay Premiums Program (FRHPPP)
Subrecipient Information
Subrecinient Information
Funds were awarded to the State of Michigan as Federal Financial Assistance from the U.S. Department of Treasury. The
funds were awarded under the Social Security Act, as amended by section 5001 of the Coronavirus Aid, Relief, and Economic
Security Act ("CARES Act") httr)s://I)onie.ti-ensUN.QOV/Dolicv-issues/cares/state-and-local-aovenvnents as the Coronavirus
Relief Fund (CRT).
CFDA #: 21.019
FAIN #: SLT0040 and SLT0247
Coronavirus Relief Funds are considered federal financial assistance and have been assigned a Catalog of Federal Domestic
Assistance (CFDA) or Assistance Listing Number of 21,019. Fund payments are considered to be federal financial assistance
subject to the Single Audit Act (31 U.S.C. Sections 7501— 7507) and the related provisions of the Uniform Guidance, 2 Code of
Federal Regulations (CFR) Section 200.303 regarding internal controls, Section 200.330— 200,332 regarding Subrecipient
monitoring and management, and subpart F regarding audit requirements. Under the Single Audit Act, local
jurisdictions/applicants will need to report expenditures under this program using the CFDA number 21.019.
The State of Michigan is making these funds available to eligible applicants for reimbursement/payment of first responder
hazard pay premiums provided to first responders who have performed hazardous duty or work involving physical hardship
related to COVID-19. Eligible applicants, including but not limited to the certifying local official/applicant submitting this
application, are required to review the CRT guidance and associated FAQs and other documents to certify their compliance
with the terms and conditions of the grant at httos://home.treasu rv.eov/bolicv-issues/cares/state-and-local-eovern men is.
Coronavirus Relief Funds are considered federal financial assistance subject to the Single Audit Act and the Uniform
Guidance. The following Uniform Guidance provisions have been Identified as significant and summarized below. Applicants
must review the Uniform Guidance at httos://www.ccfr.eov/cRi-bin/text-
idx?SID=6214841a79953f26c5c230d72dGb70a1&tn1=/ecfrbrowse/Title02/2cfr200 main 02.tol for complete requirements.
Use of Funds
The CARES Act requires that the payments from the Coronavirus Relief Fund only be used to cover expenses that:
1. are necessary expenditures incurred due to the public health emergency with respect to the Coronavirus Disease
2019 (COVID-19)
2. were not accounted for in the budget most recently approved as of March 27, 2020 (the date of enactment of the
CARES Act) for the State or government
3. were Incurred during the period that begins on March 1, 2020, and ends on December 30, 2020
Hazard pay means additional pay for performing hazardous duty or work involving physical hardship, in each case that is
related to COVID-19. The Guidance says that funding may be used to meet payroll expenses for public safety, public health,
health care, human services, and similar employees whose services are substantially dedicated to mitigating or responding to
the COVID-19 public health emergency, Hazard pay is a form of payroll expense and Is subject to this limitation, so Fund
payments may only be used to cover hazard pay for such individuals.
Page Initial DC_Date_08/26/2020
Michigan Department of Treasury
First Responder Hazard Pay Premiums Program (FRHPPP)
Subrecipient Information
Utilization of CARES Act for this Program
For this First Responder Hazard Pay Premiums Program (FRHPPP), eligible applicants can request reimbursement/payment
for hazard pay premiums paid or will be paid to eligible employees no later than September 30, 2020. The amount of hazard
pay premiums is limited to $1,000 per employee and $5,000,000 per applicant.
Coronavirus Relief Fund payments are not required to be used as the source of funding of last resort. However, as noted
below, recipients may not use payments from the Fund to cover expenditures for which they will receive reimbursement. For
this reason, the State of Michigan's First Responder Hazard Pay Premiums Program, Reimbursement Request (Form 5723)
requires each applicant to affirm that the amounts for which reimbursement/payment is being requested have not been
submitted or will not be submitted to another federal source of funding (for example, FEMA) for reimbursement/payment.
To obtain a payroll reimbursement for employees that are not normally classified as public safety and public health, but are
"similar" in the context of the guidance (e.g. employees who are substantially dedicated to COVID-19 response), each
jurisdiction's chief administrative officer must decide If their costs are appropriate to charge to the Coronavirus Relief Fund
and document the justification for that decision.
Subaward Period of Performance and Available Funding
Under the First Responder Hazard Pay Premiums Program (FRHPPP), reimbursements/payments from the State of Michigan
will be issued on a first -come, first -served basis and will cover hazard pay premiums paid to eligible employees during the
period of time of March 1, 2020—September 30, 2020, Eligible applicants receiving funding under this program may not use
the proceeds to establish a sub -award to another entity.
The last date of the performance period for the subawards is September 30, 2020.
The total amount of Coronavirus Relief Funds available for the First Responder Hazard Pay Premiums Program is
$100,000,000. Funding will be issued on a first -come, first -served basis once an eligible applicant submits all the required
documentation to the Michigan Department of Treasury.
Pages Initial DC Date_08/2G/2020
Michigan Department of Treasury
First Responder Hazard Pay Premiums Program (FRHPPP)
Subrecipient Information
Responsibilities, Records, Repayments & Future Audits
The U.S. Department of Treasury has Indicated that the two provisions of the Uniform Guidance, 2 Code of Federal
Regulations (CFR) Section 200,303 regarding Internal controls, Section 200.220 through 200.332 regarding subrecipient
monitoring and management, and subpart F regarding audit requirements are applicable to all CRF subawards at this time.
However, guidance is evolving, and jurisdictions will be required to comply with additional guidance as it is published.
Effective internal controls must be established and maintained 12 CFR Section 200,303). All reimbursements requested under
this program should be accounted for with supporting documentation. Eligible applicants should maintain documentation
evidencing that the funds were expended In accordance with federal, state, and local regulations. In accordance with federal
Uniform Guidance, funds received under this program shall be included on the eligible applicant's Schedule of Expenditures
of Federal Awards (SEFA) and included within the scope of the eligible applicant's Single Audit.
Any funds received under the authorizing legislation for this program expended by the eligible applicant in a manner that
does not adhere to the Coronavirus Aid, Relief, and Economic Security Act, Public Law 116-136 or Uniform Guidance 2 CFR
200, as applicable, shall be returned to the state. If it is determined that an eligible applicant receiving funds under this act
expends any funds tinder this act for a purpose that is not consistent with the requirements of the Coronavirus Aid, Relief,
and Economic Security Act, Public Law 116-136, or Uniform Guidance 2 CFR 200, the state budget director is authorized to
withhold payment of state funds, in part or in whole, payable from any state appropriation.
All subawards are subject to future audits and eligible applicants must allow the State of Michigan, any of Its duly authorized
representatives and/or the State of Michigan's Office of the Auditor General access to the eligible applicant's records and
financial statements to ensure compliance with Federal statutes, regulations and the terms and conditions of the grant
award.
Registration
Each eligible applicant that receives a subaward must register with the Federal Systern for Award Management (SAM).
Applicants that apply after July 26, 2020, must register in the SAM system prior to applying to the Michigan Department of
Treasury. The SAM website Is: httns://www.sam.anv/SAM/.
Uniform Guidance
The Coronavirus Relief Fund Frequently Asked Questions accessible at
httDS://home.treasurv.p.ov/system/files/136/Coronavirus-Relief-Fund-Frequently-Asked-Questions,Ddf confirm that CRF
payments are subject to the following requirements in the OMB Uniform Guidance (2 CFR Part 200): section 2 CFR 200.303
regarding internal controls, sections 2 CFR 200.330 through 200.332 regarding subrecipient monitoring and management,
and subpart F- regarding audit requirements. These Uniform Guidance provisions are summarized below. If further
clarification is needed, the Uniform Guidance is available in the electronic Code of Federal Regulations:
httns://www.ecfceov/cei-bin/text-
idx7SID=6214841a79953f26c5c230d72d6b70a1&tol=/ecfrbrowse/Title02/2ch200 main 02.tol
2 CFR 200.303Internal Controls -The non -Federal entity must:
1 Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the
non -Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms
and conditions of the Federal award.
2 Comply with Federal statutes, regulations, and the terms and conditions of the Federal awards.
3 Evaluate and monitor the non -Federal entity's compliance with statutes, regulations and the terms and conditions of
Federal awards.
4 Take prompt action when Instances of noncompliance are identified Including noncompliance identified in audit
findings.
5 Take reasonable measures to safeguard protected personally Identifiable Information.
Page 6 Initial —DC —Date _08/26/2020
Michigan Department of Treasury
First Responder Hazard Pay Premiums Program (FRHPPP)
Subrecipient Information
2 CFR 200.330 — 200.332 Subrecipient Monitoring and Management
The First Responder Hazard Pay Premiums Program subawards are for an individual eligible applicant's direct hazard pay
premiums cost. The eligible applicant receiving the subaward shall not issue any subawards to any other entity.
Subpart F —Audit Requirements
200.501—Audit Requirements.
(a) Audit required. A non -Federal entity that expends $750,000 or more during the non -Federal entity's fiscal year in
Federal awards must have a single or program -specific audit conducted for that year in accordance with the
provisions of this part.
200.508 —Auditee Responsibilities
The auditee must:
1. Procure or otherwise arrange for the audit required.
2. Prepare appropriate financial statements, including the schedule of expenditures of Federal awards.
3. Promptly follow up and take corrective action on audit findings.
4. Provide the auditor with access to personnel, accounts, books, records, supporting documentation, and other
information as needed for the auditor to perform the audit.
Record Retention Requirements
Recipients of Coronavlrus Relief Fund payments shall maintain and make available to the U.S. Department of Treasury, Office
of Inspector General, upon request, all documents and financial records sufficient to establish compliance with subsection
601(d) of the Social Security Act, as amended, (42 U.S.C. 801(d)), which provides;
d) USE OF FUNDS. —A State, Tribal government, and unit of local government shall use the funds provided under a
payment made under this section to cover only those costs of the State, Tribal government, or unit of local government
that-
1. are necessary expenditures incurred due to the public health emergency with respect to COVID-19;
2. were not accounted for in the budget most recently approved as of the dote of enactment of this section for
the State or government; and
3. were incurred during the period that begins on March 1, 2020, and ends on December 30, 2020.
Records to support compliance with subsection 601(d) may include, but are not limited to, copies of the following:
1, general ledger and subsidiary ledgers used to account for (a) the receipt of Coronavirus Relief Fund
payments and (b) the disbursements from such payments to meet eligible expenses related to the public
health emergency dim to COVID-19;
2. budget records for 2019 and 2020;
3. payroll, time records, human resource records to support costs incurred for payroll expenses related to
addressing the public health emergency due to COVID-19;
4. receipts of purchases made related to addressing the public health emergency due to COVID-19;
5. contracts and subcontracts entered into using Coronavirus Relief Fund payments and all documents related
to such contracts;
6, grant agreements and grant subaward agreements entered Into using Coronavirus Relief Fund payments
and all documents related to such awards;
Page 7 Initial ___DC- Date _O8/26/2020
Michigan Department of Treasury
First Responder Hazard Pay Premiums Program (FRHPPP)
Subrecipient Information
7. all documentation of reports, audits, and other monitoring of contractors, including subcontractors, and
grant recipient and subrecipients;
8. all documentation supporting the performance outcomes of contracts, subcontracts, grant awards, and
grant recipient subawards;
9. all internal and external email/electronic communications related to use of Coronavirus Relief Fund
payments; and
10, all investigative files and inquiry reports involving Coronavirus Relief Fund payments.
Records shall be maintained for a period of five (5) years after final payment is made using Coronavirus Relief Fund monies.
These record retention requirements are applicable to prime recipients and their grantees and subgrant recipients,
contractors, and other levels of government that received transfers of Coronavirus Relief Fund payments from prime
recipients.
Page 8 Initial __DC Date _08/26/2020
Michigan Department of Treasury
5723 (Rev o7.2m, Page 1 of 2
First Responder Hazard Pay Premiums Program
Reimbursement Request
Filing is mandatory to qualify for payments under 2020 Public Act 144.
The First Responder Hazard Pay Premiums program Is to reimburse and/or pay for first responder hazard pay premiums provided to first responders
who have performed hazardous duty or work Involving physical hardship related to COVID.19.
Eligible applicants are Cities, Villages, Townships, Counties, Public Airport Operators, Ambulance Operations (licensed under section 20920 of the
Public Health Code, 1978 PA 368, MCL 333.20920), and a local government authority, intergovernmental agency, or organization that employs local
public safely or local public health personnel and that was established by a city, village, township, county, or group thereof for the primary purpose of
providing public safety or public health services.
Applicants must.
1. Submit to the Michigan Department of Treasury (Treasury) a signed First Responder Hazard Pay Premiums Program, Reimbursement Request
(Form 5723).
2. Submit to Treasury a detailed report that supports the requested reimbursement amounts The report shall include by employee, the employees
name, eligible employee type, amount of first responder hazard pay premium being requested, and date the first responder hazard pay piemium
was paid/will be paid to the employee If requesting an advance payment (i.e , the hazard pay premiums payment has not been issued to your
employees yet) also submit Form 5725, First Responder Hazard Pay Premiums Program, Advance Request,
Reimbursement Requests must be submitted to Treasury no later than September 30, 2020; however, reimbursements will be processed on a first -
come, fist -served basis until all funding has been exhausted.
PART 1: APPLICANT INFORMATION
Applicant Name Applicant County Name Federal Identification Number
Oakland County Oakland County 38-6004876
Applicant Local Unit Code Contact Name SAM DUNS Number
63-0000 Sean L. Carlson 136200362
Contact E-Mall Address Contact The Contact Telephone Number Extension
carlsons@oakgov,corn Deputy County Executive (248) 858-1650
PART 2: FIRST RESPONDER HAZARD PAY PREMIUMS
For each Eligible Employee Type, enter the total amount of Hazard Pay Premiums. Attach a report listing the name of each employee, the eligible
employee type, payment date, and the employee's hazard pay amount being requested. Reimbursements are limited to $1,000 per eligible employee.
Eligible Employee Types Number of Employees Total Amount Requested
Law Enforcement Officers 503 $454,895.55
Firefighters
Emergency Medical Technicians
Paramedics
9-1-1 operators 66 $ 65,477.70
Local Unit of Government Corrections Officers 519 $ 480,903.62
Airport Public Safety Officers
Private EMTs/Paramedics (if paid for by the applicant)
Ambulance Operations (licensed under section 20920 of the Public Health Code)
Total Number/Amount Requested 1,088 $ 1,001,276.87
Initial DC Date n8OWN90
Page 9 Continued on the next page
5723, Page 2 of 2
PART 3: QUESTIONS
1. Were/will any of the above entered first responder hazard pay premiums been/be reimbursed or funded by any other federal funds?
11 Yes ® No
2. Were/are any of the above entered first responder hazard pay premiums Included in a reimbursement request under the Public Safely and Public
Flealth Payroll Reimbursement (PSPHPR) program?
11 Yes ®No
3. Did you attach a detailed report to support the reimbursement request?
® Yes No The report shall include by employee, the employees name, eligible employee type, amount of first responder hazard pay
premium being requested, and date the first responder hazard pay premium was paidlwill be paid to the employee.
PART 4: CERTIFICATION
The undersigned hereby certifies to the Michigan Department of Treasury that the above requested hazard pay premium amounts are accurate., that
no more then $1,000 per employee has been requested, and that the hazard pay premiums have been paid to eligible employees of the applicant or
will be paid to eligible employees by September 30, 2020, The undersigned additionally certifies that none of the above hazard pay premium amounts
have been or will be paid for with any other federal funds or are being requested for reimbursement under the State of Michigan's Public Safety and
Public Health Payroll Reimbursement program. The applicant agrees to reimburse the State of Michigan if any of the above amounts are deemed to
be fraudulent or Inaccurate.
ChigrAdmhistra4 Offfcer.Slg furo (as Jne l In M L �141. 2� I Printed Name of Chief Administrative Officer (as defined In C 1 g22p)
�V ^— David Coulter
Title
County Executive
Date
8/26/2020
Completed and signed form (including required documentation) should be E-mailed to: Treas-CARES@michlgan.gov.
If you are unable to submit via E-mail, fax the completed form and required documentation to 517-335-3295.
For questions, call 517-335-0155.
Initial Dale
Page 10
Instructions for First Responder Hazard Pay Premiums Program,
Reimbursement Request (Form 5723)
PART 1: APPLICANT INFORMATION
Applicant Name: Enter the name of the eligible applicant. Eligible applicants are: Cities, Villages, Townships,
Counties, Public Airport Operators, Ambulance Operations (licensed under section 20920 of the Public Health
Code, 1978 PA 368, MCL 333.20920), and a local government authority, intergovernmental agency, or organization
that employs local public safety or local public health personnel and that was established by a city, village, township,
county, or group thereof for the primary purpose of providing public safety or public health services.
Applicant County Name: Enter the county name that the eligible applicant is located in.
Federal Identification Number: Enter the applicant's Federal Employer Identification Number (FEIN).
Applicant Local Unit Code: For Cities, Villages, Townships, and Counties enter the revenue sharing
local unit code. All others can leave this field blank. Go to httas://www.michiaan oov/documents/treasurvl
I ocalUnitNamesCodes 110812 403341 7 Ddf for local unit codes.
Contact Name: Enter the Full name of the individual that can answer any questions related to the form being
submitted, including required attachment.
SAM DUNS Number: Enter the federal System for Award Management (SAM) DUNS Number. All applicants that
apply after July 26, 2020, must register in the SAM system prior to sending an application packet to the Michigan
Department of Treasury.
Contact E-Mail Address/Contact Title/Contact Telephone Number/Extension: Enter the information for the
contact person that can answer any questions regarding the reimbursement request.
PART 2: FIRST RESPONDER HAZARD PAY PREMIUMS
For each of the eligible employee types listed, enter the total number of employees and total amount of first
responder hazard pay premiums being requested for reimbursement.
PART 3: QUESTIONS
Question 3: To complete the Detailed Report, use the form provided in the First Responder Hazard Pay Premiums
Program Application packet.
Initial Dr. Date 66/2612020
Page 11
Michigan Department of Treasury
First Responder Hazard Pay Premiums Program (FRHPPP)
Hazard Pay Premiums Payment Report— Instructions
Hazard Pav Premiums Pavment Report —Instructions
1. Enter the requested information on the Hazard Pay Premiums Payment Report on page 13 for each eligible employee that was or will be paid an eligible hazard pay
premium.
a. There could be multiple lines for the same employee.
b. The total of the chart should equal the hazard pay premiums amounts being requested for reimbursement on Form 5723 First Responder Hozord Pay
Premiums Program, Reimbursement Request.
c Attach additional sheets if needed. Initial and date each additional sheet submitted.
d. Eligible Employee Types are:
I. Law Enforcement Officers
ii. Firefighters
III. Emergency Medical Technicians (EMTs)
iv. Paramedics
v. 9-1-1 Operators
vi. Local Unit of Government Corrections Officers
vii_ Airport Public Safety Officers
viii_ Eligible personnel associated with ambulance operations licensed under section 20920 of the Public Health Code (1978 PA 368; MCL 333.20920)
ix. Private EMTs and paramedics that contract with municipalities or hospitals, if the hazard pay premiums are paid through the applicant
2. Guidelines:
a. Do not include any hazard pay premiums that the eligible applicant requested to be reimbursed under the Public Safety and Public Health Payroll
Reimbursement Program.
b. The program will only reimburse the actual hazard pay premium paid to the employee, not the associated fringes and payroll taxes.
Page 12 Initial DC Date 08/26/2020
I1
2
3
4
S
6
7
8
9
1D
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
j 26
27
28
29
Subtotal from
attached reports
Total
Page 13
See attached
i
Michigan Department of Treasury
First Responder Hazard Pay Premiums Program (FRHPPP)
Hazard Pay Premiums Payment Report
Actual/Estimated
Employee Name Eligible Employee Type Payment Date
04/03/20 - 07/10120
Hazard Pay Amount
i $ 1,001,2766.87
$ 1,D01,276.87
Initial DC
Date nRhgmmn
Michigan Department of Treasury
First Responder Hazard Pay Premiums Program (FRHPPP)
Certification
I, David Coulter , am the chief executive of Oakland County !eligible
applicant's legal name), and I certify that:
1. 1 have the authority on behalf of Oakland (-minty (eligible applicant's legal name)
to request a First Responder Hazard Pay Premiums Program payment from the State of Michigan pursuant to
Section 801 of 2020 Public Act 144, from the allocation of funds to the State of Michigan froin the Coronavirus Relief
Fund as created in the CARES Act.
2. 1 understand that the State of Michigan will rely on this certification as a material representation in issuing a First
Responder Hazard Pay Premiums Program payment to Oakland Countv (eligible
applicant's legal name).
3. Oakland Countv (eligible applicant's legal name) Is receiving the First Responder
Hazard Pay Premiums Program payment as a reimbursement/payment to reimburse and/or pay for first responder
hazard pay premiums provided to first responders who have performed hazardous duty or work involving physical
hardship related to COVID-19 and will be used only to coverthose costs.
4, Any funds provided as a reimbursement/payment from the State of Michigan under the First Responder Hazard Pay
Premiums Program that are found to be based on Inaccurate, non -qualifying, or fraudulent information will be
returned to the State of Michigan.
S. Funds provided as a reimbursement/payment under the First Responder Hazard Pay Premiums Program from the
State of Michigan pursuant to this certification must adhere to official federal guidance (2 CFR 200) issued or to be
issued on what constitutes a necessary expenditure as described in the guidance for the U.S. Treasury Coronavirus
Relief Fund at htti)s://home.treasury.gov/policy-Issues/cares/state-and-local-governments. I reviewed the guidance
prior to completing this request for reimbursement. I understand and agree that any funds expended by an eligible
applicant in any manner that does not adhere to official federal guidance shall be returned to the State of Michigan.
6. Any eligible applicant receiving funds under the First Responder Hazard Pay Premiums Program shall retain
documentation supporting the reimbursement/payment request, including but not limited to payroll records and
tlmesheets. Such documentation shall be provided to the State of Michigan upon request and maintained by the
jurisdiction for five (5) years.
7. Program funds provided pursuant to this application and certification cannot be used as a revenue replacement for
lower than expected tax or other revenue collections.
8. Program funds received pursuant to this application and certification cannot be used for expenditures for which the
eligible applicant has received any other emergency COVID-19 supplemental funding (whether state, federal or
private In nature) for that same expense,
9. Program funds received pursuant to this application and certification cannot be used to reimburse or subaward
another entity or local unit of government.
10, 1 have read and agree on behalf of Oakland County (eligible applicant's legal name)
to comply with all applicable provisions and requirements corresponding to the receipt of funds required in the
Coronavirus Aid, Relief, and Economic Security Act, Public Law 115-136, and Uniform Guidance, 2 CFR 200,
11. Further, that I understand and agree on behalf of Oakland County (eligible
applicant's legal name) that any funds received under this act and expended by itself or a sub -recipient in any
manner that does not comply with the Coronavirus Aid, Relief, and Economic Security Act, Public Law 116-136, or
Uniform Guidance, 2 CFR 200, as applicable shall be returned to the State of Michigan.
Page 14 Initial DC Date 08/26/2020
Michigan Department of Treasury
First Responder Hazard Pay Premiums Program (FRHPPP)
Certification
12. Further, that I understand and agree on behalf of Oakland County (eligible
applicant's legal name) that expenditures are not eligible for reimbursement under this section if such expenses
have been or will be reimbursed by any other federal funds, and if such expenditure is reimbursed by any other
federal funds the undersigned eligible applicant will return said funds to the State of Michigan.
13. The governing body has been notified of the submission of this application, and are aware of the Federal statutes,
regulations and terms and conditions of the grant award.
I certify under the penalties of perjury set forth in the Michigan Penal Code, MCL 750.423, that I have read the above
certification and my statements contained herein are true and correct to the best of my knowledge.
By;
David Coupe
l p
Signature;
County Executive
08/26 /2020
REBECCA REYES
Notary Public — State of Michigan
County of Oakland
My Commission Expires June 21, 2026
Acting In the County of C�"lek
My commission expires
Notary Public
Page 15 Initial Date
Resolution #20466 October 21, 2020
Moved by Gershenson seconded by Weipert the resolution be adopted.
Discussion followed.
Vote on resolution:
AYES: Quarles, Spisz, Taub, Weipert, Woodward, Zack, Gershenson, Hoffman, Jackson,
Kochenderfer, Kowall, Kuhn, Luebs, Markham, McGillivray, Miller, Nelson, Powell. (18)
NAYS: None. (0)
A sufficient majority having voted in favor, the resolution was adopted.
a, i1 Q C
I HEREBY AFPROVETHIS FIFSOLUTION
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 October 21,
2020, 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 Circuit Court at Pontiac,
Michigan this 21s' day of October, 2020.
�CL7<
Lisa Brown, Oakland County