HomeMy WebLinkAboutResolutions - 2021.12.09 - 35119q01,AKLAND`F27
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BOARD OF COMMISSIONERS
December 9, 2021
MISCELLANEOUS RESOLUTION #21-505
Sponsored By: Penny Luebs
IN RE: Emergency Management &Homeland Security - Grant Amendment Emergency Management
Program Grant Amendment #1
Chairperson and Members of the Board:
WHEREAS the State of Michigan Department of State Police. Emergency Management and Homeland
Security Division has awarded Oakland County the FY 2021 Emergency Management Performance Grant
(EMPG) - American Rescue Plan Act Supplemental funding in the amount of $31.918 for the period of October
1, 2020, through September 30.2021; and
WHEREAS the Homeland Security Division was notified of available grant funding via a letter dated
November 5, 2021; and
WHEREAS the original allocation was approved by Miscellaneous Resolution #21458 in the amount of
S61,242; and
WHEREAS the 50%thatch requirement of $93A60 is met by the salaries and fringe benefits of the Director of
Emergency Management & Homeland Security; and
WHEREAS the purpose of the program is to encourage the development and comprehensive disaster
preparedness and assistance plans, programs, capabilities, and organizations by the states and local
governments; and
WHEREAS this grant is a pass -through of Federal funds and represents a reimbursement for a portion of
salaries with an additional 31% in the amount of S31.918: and
NV'HEREAS the FY 2021 Supplemental award is a one-time increase of S31,918; and
WHEREAS the grant agreement has completed the Grant Review Process according to the Board of
Commissioners Grant Procedures.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners accepts grant
funding from the State of Michigan Department of State Police. Emergency Management and Homeland
Security Division for the FY 2021 Emergency Management Performance Grant (EMPG) — American Rescue
Plan Act Supplemental in the amount of $31,918 for total funding of S 186.320 for the period of October 1.2020
through September 30, 2021.
BE IT FURTHER RESOLVED that the Chairperson of the Oakland County Board of Commissioners is
authorized to execute the grant agreement and to approve any grant extensions or changes, within fifteen
percent (15° o) 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 fixture
commitment including continuation of any special revenue positions if/when the grant expires.
BE IT FURTHER RESOLVED that the budget for the FY 2022 Special Revenue budget be amended as
detailed in the attached Schedule A.
Chairperson, the following Conmussioners are sponsoring the foregoing Resolution: Penny Luebs,
Date: December 09, 2021
David Woodward, Commissioner
6�
au Date: December 14, 2021
Hilarie Chambers, Deputy County Executive A
f
Date: December 15, 2021
Lisa Brown, County Clerk ( Register of Deeds
COMMITTEE TRACKING
2021-11-30 Public Health & Safety - recommend to Board
1021-12-09 Full Board
VOTE TRACKING
Motioned by Commissioner William Miller III seconded by Commissioner Robert Hoffinan to adopt the
attached Grant Amendment: Emergency Management Program Grant Amendment # L
Yes: David Woodward, Michael Gingell. Michael Spisz. Karen Joliat, Kristen Nelson. Eileen Kolvall,
Christine Long, Philip Weipert, Gwen Mark-hant, Angela Powell, Thomas Kuhn, Charles Moss, Marcia
Gershenson, William Miller III, Yolanda Smith Charles. Charles Cavell. Penny Luebs, Janet Jackson, Gary
McGillivray. Robert Hoffman, Adam Kochenderfer (21)
No: None (0)
Abstain: None (0)
Absent: (0)
The Motion Passed.
ATTACHMENTS
1. Grant Review Sign -Off (2)
2. Schedule A _ EMCE FY2021 EMG Performance Grant Amendment#1
3. FY 21 EMPG ARPA Grant Agreement Packet - Oakland County (2 )
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 Conunissioners on December 9,2021.
with the original record thereof now remaining in my office.
In Testimony Whereof. I have hereunto set my hand and affixed the seat of the Circuit Court at Pontinr.
Michigan on Thursday, December 9, 2021.
Lisa Brown, Oakland Cormh Clerk' Register ofDeeels
GRANT REVIEW SIGN -OFF — Emergency Management & Homeland Security, Emergency
Management Division
GRANT NAME: FY 2021 Emergency Management Performance Grant (EMPG) — ARPA Supplemental Agreement
FUNDING AGENCY: Michigan State Police Emergency Management and Homeland Security Division
DEPARTMENT CONTACT: Rob Seeley / 248-858-5080
STATUS: Grant Amendment #1 (Greater than or Equal to 15% Variance from Current Award)
DATE: 1 1/ 16/21
Please be advised the captioned grant materials have completed internal grant review. Below are the returned comments
The Board of Conunissioners' liaison committee resolution and grant amendment package (which should include this
sign -off and the grant amendment with related documentation) may be requested to be placed on the agenda(s) of the
appropriate Board of Commissioners' committee(s) for grant amendment by Board resolution.
DEPARTMENT REVIEW
Management and Budget:
Approved by M & B — Lynn Sonkiss 1 1 / 16/2021.
Draft resolution to be updated with applicable budget amendment and 2021 resolution information.
Human Resources:
Approved by Human Resources, with the attached change to the resolution. -Heather Mason 11/10/2021
The resolution refers to the Manager Homeland Security, however the position was retitled to
Director Emergency Management & Homeland Security on 10/24/2020.
No actual change in positions, so this grant amendment does not need HR action.
[Draft Resolution has been revised per comment above]
Risk Management:
Approved by Risk Management. R.E. 11/15/2021
Corporation Counsel:
Approved by Corporation Counsel (no legal issues). Sharon Kessler— 1 1/15/21.
From: Sonkiss. Lynn C �
�v. nrJPi-nuwir indrply R SCCrCv- nuuert v.r uru, rvu'un. Jd Wnu,'nn)""i't un UtPr; ridsbrF-d LI riCKE tMLW(orn.
Diana E.; Frlenhrrk. Rnhert Carl
Cc: Adnalu-inner. Fhm: Elarably. Kim K; Conforti Holly M: Guzzv, Scott N; Jen, Kyle Isaac; Joss, Edward P;
Matthews, Hailev; Powers, Andrea; sanrhel. Kriatina i_; Sat, Ju ie; Shover. Aaron G ; Stool, Connie L;
Stnnofellnw 7nAnn; stnbanfeid Trer+r Ward, Chris; Winter, Barbara; Worthington Pamela L; Zhou, Jenny
Subject: RE: GRANT REVIEW FORM - Emergency Management & Homeland Security, Emergency Management Division-
FY 2021 Emergency Management Performance Grant (EMPG) — ARPA -Amendment #1 (Greater than 15%)
Date: Tuesday, November 16, 2021 8:05:27 AM
Attachments: GRANT REVIEW FORM - Emeroanry Management Homeland Securitv Emernenry Mananamant Division- FY 2021
Emergencv Management Perfnrmanra Grant (EMPG) ARPA -Amendment #1 (Greater than 19-%o mco
Approved by M & B — 11/16/2021.
Draft resolution to be updated with applicable budget amendment and 2021 resolution Information.
Thanks,
Lynn Sonkiss
Fiscal Services Officer
Oakland County, Michigan
Phone 248.858.0940
Fax 248.858.9724
sonkissl(@oakanv com
From: Keyes -Bowie, Tlfanny B <keyesbowiet@oakgov.com>
Sent: Tuesday, November 09, 2021 3:09 PM
To: Seeley, Robert Arold <seeleyr@oakgov.com>; Nelson, Jawun <nelsonjaw@oakgov.com>;
Corporate Counsel <corpcounsel@oakgov.com>; Mason, Heather L <masonh@oakgov.com>;
McBroom, Diana E. <mcbroomd@oakgov.com>; Erlenbeck, Robert Carl <erlenbeckr@oakgov.com>;
Sonkiss, Lynn C <sonkissl@oakgov.com>
Cc: Adoglu-Jones, Ebru <adoglu-jonese@oakgov.com>; Elgrably, Kim K <elgrablyk@oakgov.com>;
Conforti, Holly M <confortih@oakgov.com>; Guzzy, Scott N <guzzys@oakgov.com>; Jen, Kyle Isaac
<jenl<@oakgov.com>, Joss, Edward P <josse@oakgov.com>; Matthews, Hailey
<matthewshd@oakgov.com>; Powers, Andrea <powersa@oal<gov.coln>; Sanchez, Kristina L
<sanchezk@oakgov.com>; Shih, Julie <shihj@oakgov.com>; Keyes -Bowie, Tlfanny B
<keyesbowiet@oakgov.com>; Snover, Aaron G. <snovera@oakgov.com>; Srogl, Connie L
<srogic@oal<gov.com>; Stringfellow, JoAnn <stringfellowj@oakgov.com>, Stolzenfeld, Tracy
<stolzenfeldt@oakgov.com>; Ward, Chris <wardcc@oakgov.com>; Winter, Barbara
<wlnterb@oakgov.com>; Worthington, Pamela L <worth i ngton p@oa kgov.com>; Zhou, Jenny
<zhouj@oal<gov.com>
Subject: GRANT REVIEW FORM - Emergency Management & Homeland Security, Emergency
Management Division- FY 2021 Emergency Management Performance Grant (EMPG) —ARPA -
Amendment #1 (Greater than 15%)
Please Note: Miscellanerlus Resolution is subject to review by Human Resources and Fiscal
Services for persmmel changes and/or budget amendment.
From: Mason Heather I
To: Keves-BnWle- -nfannv BSeelev Robert Amid: Nelson, Jawun; Corporate Counsel; McBroom Diana F : Erlenbeck.
Robert Carl; Sonkiss. Lunn C
Cc: Adnalu-Innas, Phru: Elgrably. Kim K; Conforti Holly M: Guzzv. Scott N; Jen. Kyle Isaac, Joss. Edward P;
Matthews, Hailev; Powers, Andrea; Sanrhe7. Krishna I , Shih Julie; Snover. Aaron G ; Stool, Connie L;
Stnnofellnw InAnn: Stolzenfeld, Tracv; Ward, Chris; Winter, Barbara; Wnrthinoton. Pamela t, Zhou, Jenny
Subject: RE: GRANT REVIEW FORM - Emergency Management & Homeland Security, Emergency Management Division-
FY 2021 Emergency Management Performance Grant (EMPG) - ARPA -Amendment #1 (Greater than 15%)
Date: Wednesday, November 10, 2021 9:08:29 AM
Attachments: 2021 Misr Rasnluhnn FMPG Grant AMENDMENT #1 - HLM .dog
Approved by Human Resources, with the attached change to the resolution.
The resolution refers to the Manager Homeland Security, however the position was retitled to
Director Emergency Management & Homeland Security on 10/24/2020.
No actual change in positions, so this grant amendment does not need FIR action.
Heather L. Mason
Supervisor Human Resources
Oakland County Hurrian Resources
L. Brooks Patterson Building - 2100 Pontiac Lake Road, Waterford MI 48328
P: 248.858.2581 I C: 248,568.2738 1 F: 248.975.9742
masonl,O)o lepov co m I vevaw nal,Pnv rnm/robs
Schedule: M,W,F onsite. T, Th remote
From: Keyes -Bowie, Tifanny B <keyesbowiet@oakgov.com>
Sent: Tuesday, November 9, 2021 3:09 PM
To: Seeley, Robert Arold <seeleyr@oakgov.com>; Nelson, Jawun <nelsonjaw@oakgov.com>;
Corporate Counsel <corpcounsel@oakgov.com>; Mason, Heather L <masonh@oakgov.com>;
McBroom, Diana E. <mcbroomd@oakgov.com>; Erlenbeck, Robert Carl <erlenbecl<r@oakgov.com>;
Sonkiss, Lynn C <sonkissl@oakgov.com>
Cc: Adoglu-Jones, Ebru <adoglu-jonese@oakgov.com>; Elgrably, Kim K <elgrablyk@oakgov.com>;
Conforti, Holly M <confortih@oakgov.com>; Guzzy, Scott N <guzzys@oakgov.com>; Jen, Kyle Isaac
<jenk@oakgov com>, Joss, Edward P <josse@oakgov.com>; Matthews, Hailey
<matthewshd@oakgov.com>; Powers, Andrea <powersa@oakgov.com>; Sanchez, Kristina L
<sanchezk@oakgov.com>; Shlh, Julie <shihj@oakgov.com>; Keyes -Bowie, Tifanny B
<keyesbowiet@oal<gov,com>; Snover, Aaron G. <snovera@oal<gov.com>; Srogl, Connie L
<sroglc@oal<gov.com>; Stringfellow, JoAnn <stringfellowj@oakgov.com>; Stolzenfeld, Tracy
<stolzenfeldt@oakgov.com>; Ward, Chris <wardcc@oakgov.com>; Winter, Barbara
<winterb@oakgov.com>; Worthington, Pamela L <worth i ngtonp@ oakgov.com>; Zhou, Jenny
<zhoaj@oakgov.com>
Subject: GRANT REVIEW FORM - Emergency Management & Homeland Security, Emergency
Management Division- FY 2021 Emergency Management Performance Grant (EMPG)-ARPA-
Amendment #1 (Greater than 15%)
From: Frlenherk. Rnhart Carl
To: Keves-Bowie. Tifannv B, Seelev. Robert Arold: Nelson Jawun; Corporate Counsel, Mason Heather I_; McBroom
Diana E ; Sonktss, Lynn C
Cc: Adoolu-loos, Fhrir. Elgrably, Kim K; Cori Holiv M, Guzzv, Scott N; Jen, Kyle Isaac; loss, Edward P;
Matthews Hailev: Powers. Andrea; sanrhe] Krishna I ih Julie; Snover. Aaron G.; Sroui, Connie L;
Stnnofellow, JoAnn; Stol]enfeld. Trarv: Ward, Chris; Winter. Bat bars; Worthimotnn. Pamela I : Zhou, Jennv
Subject: RE: GRANT REVIEW FORM - Emergency Management & Homeland Security, Emergency Management Division-
FY 2021 Emergency Management Performance Grant (EMPG) — ARPA -Amendment #1 (Greater than 15%)
Date: Monday, November 15, 2021 2:29:30 PM
Approved by Risk Management. R.E. 11/15/2021
Robert Erlenbeck, Insurance Risk Administrator
Risk Management
Office 248-858-1694
Cell 248-421-9121
Office schedule: Monday through Thursday 7:00 to 5:00
From: Keyes -Bowie, Tifanny B <keyesbowiet@oakgov.com>
Sent: Tuesday, November 09, 2021 3:09 PM
To: Seeley, Robert Arold <seeleyr@oakgov.com>; Nelson, Jawun <nelsonjaw@oakgov.com>;
Corporate Counsel <corpcounsel@oakgov.com>; Mason, Heather L <masonh@oakgov.com>;
McBroom, Diana E. <mcbroomd@oakgov.com>; Erlenbeck, Robert Carl <erlenbeckr@oakgov.com>;
Sonkiss, Lynn C <sonkissl@oakgov.com>
Cc: Adoglu-Jones, Ebru <adoglu-jonese@oakgov.com>, Elgrably, Kim K <elgrablyk@oal<gov.com>;
Conforti, Holly M <confortih@oal<gov.com>; Guzzy, Scott N <guzzys@oakgov.com>; Jen, Kyle Isaac
<jenk@oakgov.com>; Joss, Edward P <Josse@oakgov.com>; Matthews, Halley
<matthewshd@oakgov.com>; Powers, Andrea <powersa@oakgov.com>; Sanchez, Kristina L
<sanchezk@oakgov.com>; Shih, Julie <shihj@oakgov.com>; Keyes -Bowie, Tifanny B
<keyesbowiet@oakgov.com>; Snover, Aaron G. <snovera@oakgov.com>; Srogi, Connie L
<srogic@oakgov.com>; Stringfellow, JoAnn <stringfellowj@oakgov.com>; Stolzenfeld, Tracy
<stolzenfeldt@oakgov.com>; Ward, Chris <wardcc@oakgov.com>; Winter, Barbara
<winterb@oakgov.com>; Worthington, Pamela L <worth i ngton p@oa kgov.com>; Zhou, Jenny
<z h ouj @ oa kgov.co m>
Subject: GRANT REVIEW FORM - Emergency Management & Homeland Security, Emergency
Management Division- FY 2021 Emergency Management Performance Grant (EMPG) —ARPA -
Amendment #1 (Greater than 15%)
Please Note: Miscellaneous Resolution is subject to review by Human Resources and Fiscal
Services for personnel changes and/or budget amendment.
GRANT REVIEW FORM
TO: REVIEW DEPARTMENTS — Lynn Sonkiss — Heather Mason— Diana MCBrocurn —
Sharon Cullen
RE: GRANT CONTRACT REVIEW RESPONSE — Emergency Management & Homeland
Security, Emeigency Management Division
From: Kessler Sharon Barnes
To: Keves-Bowie Tifannv B. seelev. Robert Arold: Nelson. Jawun; ( oroorate <.ounsel; Mason. Heatner L, Mcbroom,
Diana E.; Prlenherk. Robert Carl: Sonkiss Lynn C; Grafton Holly L.; Phillms Solon M.
Cc: _ Adool i-lops. Fhru; Elorably. Kim K; Cnnfnrti Hollv M: Guzzv. Scott N; Jen Kyle Isaac; Joss, Edward P;
Matthew5. Hailev: Powers, Andrea; Sanrhez Krishna 1-7 Shih, Julie; Snover, Aaron G.; Sroai Connie L;
Strinafellnw. JnAnn; Stolzenfeld. Tracy, Ward, Chris; Winter, Barbara; Worthinatnn, Pamela I : Zhou. Jenny
Subject: RE: GRANT REVIEW FORM - Emergency Management & Homeland Security, Emergency Management Division-
FY 2021 Emergency Management Performance Grant (EMPG) — ARPA -Amendment #1 (Greater than 15%)
Date: Monday, November 15, 2021 2:11:17 PM
Approved by Corporation Counsel (no legal issues). Sharon Kessler — 11/15/21.
OAKIANt?
Sharon Barnes Kessler, Senior Assistant Corporation Counsel
Oakland County Corporation Counsel
1200 N. Telegraph Road, Bldg. 14 East, Courthouse West Wing Extension, 3" Floor, Pontiac, MI 45341
P: 2-'S 555-543a I F 243 S53, 100= I hsrnP• svuna1,Pm, rrm
Hours: Monday - Friday; 7:30 a.m. to 4:00 p.m.
PRIVILEGFD AND OnNFIDENIIAL—ATTORNEY ri IFNT rOMMI IMrATi0h.
The —m,:il is nLrrded s-ly for mi;� per•.om11) whom It I e.i It is cnrfidential anC P•omcmr:rv>h� atinr ^,=y-d•est l:nvticgr a•:d ",o ricd�rct
d��l. u:e This In:vleg<• belong, to tna Cou^t�'vf Onksid, and n�d�vid�al m'd�emac�, oi^ not do:h•rimu :o ,00i�m nr,•.,xlty tr , p•^,Ae�e :n airy waq 'nJm„!• ial: av
adatsaJ that airy dm: m;netm,, : ap•odmtion o, ananthnnr. •d rea,e: � of .LI. ifioi mason Ly pmonc ether than thna li.[e' .:Lme may m cGtete a ese •ci of thi-
F:reilegeanoisther,f•�rre PioidhiteJ l`, you have recerv�c this m=.:�i?-me:rvPleasc. orP�the,ei'.Ja.mmeda:ely G.f�::ri..va a. p'yo�sner� Plea=.e mn-oaihr
DFf n.ment M C"Poretnn Cau uel a: ('.9) .355--os 0
I henl, y,m fcr , •ur coo Pe: atinn
From: Keyes -Bowie, Tifanny B <keyesbowiet@oakgov.com>
Sent: Tuesday, November 9, 2021 3:09 PM
To: Seeley, Robert Arold <seeleyr@oakgov.com>; Nelson, Jawun <nelsonjaw@oakgcv.com>;
Corporate Counsel <corpcounsel@oakgov.com>; Mason, Heather L <mason h @ oa kgov.com>,
McBroom, Diana E. <mcbroomd@oakgov.com>; Erlenbeck, Robert Carl <erlenbeckr@oakgov.com>;
Sonkiss, Lynn C <sonkissl@oal<gov.com>
Cc: Adoglu-Jones, Ebru <adoglu-jonese@oakgov.com>; Elgrably, Kim K <elgrablyl<@oakgov.com>;
Conforti, Holly M <confortih@oakgov.com>; Guzzy, Scott N <guzzys@oal<gov.com>; Jen, Kyle Isaac
<jenl<@oakgov.com>; Joss, Edward P <josse@oakgov.com>; Matthews, Halley
<matthewshd@oakgov.com>; Powers, Andrea <powersa@oal<gov.com>; Sanchez, Kristlna L
<sanchezk@oakgov.com>; Shih, Julie <shihj@oakgov.com>; Keyes -Bowie, Tifanny B
<keyesbowiet@oakgov.com>; Snover, Aaron G. <snovera@oakgov.com>; Srogl, Connie L
<srogic@oakgov.com>; Stringfellow, JoAnn <stringfellowj@oakgov.com>; Stolzenfeld, Tracy
<stolzenfeldt@oakgov.com>; Ward, Chris <wardcc@oakgov.com>; Winter, Barbara
<winterb@oakgov.com>, Worthington, Pamela L <worthingtonp@oakgov.com>; Zhou, Jenny
<zhouj@oakgov.com>
Subject: GRANT REVIEW FORM - Emergency Management & Homeland Security, Emergency
Management Division- FY 2021 Emergency Management Performance Grant (EMPG) — ARPA -
Amendment #1 (Greater than 15%)
Please Note: Miscellaneous Resolution is subject to review by Human Resources and Fiscal
Services for personnel changes and/or budget amendment.
ency Management Performance Grant
Oakland county, Michigan Fm
Security - FY 2021 Emer9
gland Amendment Title
ency Management & ty°m Account
Emerg Fund #1 Account#
IFund #I Division # Affiliate) Pr°gran"'
Oivision Name
pie Fund Name sis: GLB
Analy 115120
UND #1010 Bud Ref 2022 Activity', GLB 1110101
G NERA Management& 90100
GRANT,'06D0000359 Emergency
Homeland Security 196030
R General Fund g010101
10100
GEN RAL FUN #1010 znmenc
R General Fund Non-O'P
FY 2023 FY 2024
ent Amendmenndm�^t-
FY 2022
Amendm t Ame
610210 Disaster Control Fed Subsidy
665882 Planned Use of Balance
Total Revenues
GRETCHEN WHITMER
GOVERNOR
November 5, 2021
STATE OF MICLUCAN
DEPARTMENT OF STATE POLICE
LANSING
Dear Local Emergency Management Coordinator:
COL. JOSEPH M. GASPER
DIRECTOR
Enclosed is the Fiscal Year 2021 Emergency Management Performance Grants American Rescue Plan
Act (EMPG ARPA) Grant Agreement package. Please return the required grant documentation listed on
the enclosed Subrecipient Checklist to our office via email:
Attention: Mr. Paul Lounsberry
Emergency Management and Homeland Security Division
Michigan Department of State Police
LounsberryP@michigan.gov
Reimbursement for the EMPG program is contingent upon completion of the activities in the signed
Emergency Management Annual Work Agreement. To remain eligible for EMPG funding, current and
adequate plans must be maintained, and exercise requirements must be met. If a work activity is not
completed in the designated quarter, reimbursement may not be made until the work is completed. The
Emergency Management and Homeland Security Division District Coordinators may make
recommendations on reimbursement, but final approval remains with the Commander of the Emergency
Management and Homeland Security Division, who may or may not approve a delay in the completion of
the activity. If work activities (for which funds have been withheld) have not been completed by the end of
the fiscal year, forfeiture of those funds may be required. For specific responsibilities and requirements,
please refer to Section II (Statutory Authority) and Section IV (Responsibilities of the Subrecipient) in the
Fiscal Year 2021 EMPG ARPA Grant Agreement.
This grant agreement and all required attachments must be completed, signed, and returned no later
than January 4, 2021. If this requirement is not met, this grant agreement will be invalid unless a prior
written exception is provided by the Michigan State Police, Emergency Management and Homeland
Security Division.
Sincerely,
Capt. Kevin Sweeney
Deputy State Director of Emergency Management
MICHIGAN STATE POLICE HEADQUARTERS e 7150 HARRIS DRIVE s DIMONDALE, MICHIGAN 48821
MAILING ADDRESS n P.O. BOX 30634 e LANSING, MICHIGAN 48909
w w.michigan gov/msp a 517-332-2521
gin
i ■' \ ■ •
GRANT AGREEMENT
CFDA No: 97.042
Email the following items to: LounsberryP@michigan.gov
SUBRECIPIENT WILL NOT BE REIMBURSED FOR FUNDS UNTIL ALL REQUIRED SIGNED DOCUMENTS ARE RECEIVED
❑ 1. Grant Agreement
❑ 2. FY 2021 EMPG ARPA Supplemental Match Certification
❑ 3. Subrecipient Risk Assessment Certification
❑ 4. Standard Assurances
❑ 5. Certifications Regarding Lobbying; Debarment, Suspension and Other
Responsibility Matters; and Drug -Free Workplace Requirements
❑ 6. Audit Certification (EMD-053)
❑ 7. Request for Taxpayer Identification Number and Certification (W-9)
---------------------------------------------------------
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, PO Box
30634, Lana, Michigan 48909.
' For GRANT AGREEMENT QUESTIONS, PLEASE CONTACT PAUL LOUNSBERRY
AT 517-4567 3920-OR LOUNSBERRYP@MICHIGAN.GOV
„i�et mn�
EmergencyMichigan State Police
. • "s .�cxmyy s
a �
HomelandSecurity
Y
Division
FEDERAL AWARD IDENTIFICATION
SUBRECIPIENT NAME GRANT NAME
County of Oakland
SUBRECIPIENT IRSNENDOR NUMBER
38-6004876
SUBRECIPIENT DUNS NUMBER
136200362
RESEARCH $ DEVELOPMENT
N/A
INDIRECT COST RATE
None on file
FEDERAL AWARD PROJECT DESCRIPTION
Grant Agreement
Emergency Management
Performance Grants
American Rescue Plan Act
FEDERAL AWARD IDENTIFICATION
NUMBER (FAIN)
EMC-2021-EP-00006
SUBAWARD FROM
PERFORMANCE
PERIOD
10/1 /2020
Funding
Federal Funds Obligated by
this Action
Total Federal Funds
Obligated to Subrecipient
Total Amount of Federal
Award Committed
CFDA NUMBER
97.042
FEDERAL AWARD DATE
9/02/2021
TO
9/30/2021
Total
$31,918
$31,918
$31,918
2021 Emergency Management Performance Grants American Rescue Plan Act
DETAILS
The 2021 EMPG ARPA allocation is 17.13% of the Subrecipient's emergency program
manager's salary and fringe benefits., A cost -match is required under this program. The
Federal share used towards the EMPG budget shall not exceed 50% of the total budget.
FEDERAL AWARDING AGENCY PASS -THROUGH ENTITY (RECIPIENT) NAME
Federal Emergency Management Agency - GPD Michigan State Police
400 C Street, SW, 3rd floor Emergency Management and
Washington, D.C. 20472-3645 Homeland Security Division
P.O. Box 30634
Lansing, MI 48909
State ofi1flchigan
FY 2021 Emergency ManagementPerformance
AmericanPlan Act
Grant Agreement
October 1, 2020 to September 30, 2021
CFDA Number: 97.042
Grant Number:
EMC-2021-EP-00006
This Fiscal Year (FY) 2021 Emergency Management Performance Grants American Rescue Plan Act
(EMPG ARPA) grant agreement is hereby entered into between the Michigan Department of State Police,
Emergency Management and Homeland Security Division (MSP/EMHSD) (hereinafter called the
Recipient), and the
COUNTY OF OAKLAND
(hereinafter called the Subrecipient)
I. Purpose
The purpose of this grant agreement is to provide federal pass -through funds to the Subrecipient for the
development and maintenance of an emergency management program capable of protecting life,
property, and vital infrastructure in times of disaster or emergency.
The FY 2021 EMPG program plays an important role in the implementation of the National Preparedness
System (NPS) by supporting the building, sustainment, and delivery of core capabilities essential to
achieving the National Preparedness Goal of a secure and resilient Nation. The objective of the NPS is
to facilitate an integrated, all-of-nation/whole community, risk driven, capabilities -based approach to
preparedness.
In support of the National Preparedness Goal, the FY 2021 EMPG supports a comprehensive, all -hazard
emergency preparedness system to build and sustain core capabilities across the Prevention, Protection,
Mitigation, Response, and Recovery mission areas.
For more information on the NPS, federally designated priorities, and the FY 2021 EMPG objectives, as
well as guidance on allowable costs and program activities, please refer to the FY 2021 EMPG Notice of
Funding Opportunity (NOFO) and the FEMA Preparedness Grants Manual located at
littt)s://www.fema.qov/ci, ants.
Ill. Statutory Authority
Funding for the FY 2021 EMPG is authorized by Section 662 of the Post -Katrina Emergency
Management Reform Act of 2006 (PKEMRA), as amended, (Pub. L. No. 109-295) (6 U.S.C. § 762), the
Robert T. Stafford Disaster Relief and Emergency Assistance Act, as amended (Pub. L. No. 93-288) (42
U.S.C. §§ 5121 at seq.); the Earthquake Hazards Reduction Act of 1977, as amended (Pub. L. No. 95-
124) (42 U.S.C. §§ 7701 et seq.); and the National Flood Insurance Act of 1968, as amended (Pub. L.
No. 90-448) (42 U.S.C. §§ 4001 et seq.).
Appropriation authority is provided by the Department of Homeland Security Appropriations Act, 2021,
(Pub. L. No. 116-260).
FY 2021 EMPG ARPA
County of Oakland
PaaP J of q
The Subrecipient agrees to comply with all FY 2021 EMPG program requirements in accordance with the
FY 2021 EMPG NOFO, and the FEMA Preparedness Grants Manual; both are located at
httDs://www.fema.aov/orants/oreDaredness/ernergencv-management-Detformance: the Michigan
Emergency Management Act of 1976, as amended (Public Act 390) at
htto://www.leaislature.mi.gov/doc.aspx?mcl-Act-390-of-1976, the Robert T. Stafford Disaster Relief and
Emergency Assistance Act, as amended (Pub. L. No. 93-288) (42 U.S.C. §§ 5121 at seq.) located at
httos://www.fema.aov/disaster/stafford-act; and the FY 2021 EMPG Agreement Articles Applicable to
Subrecipients. The FY 2021 EMPG Agreement Articles Applicable to Subrecipients document is included
for reference in the grant agreement packet.
The Subrecipient shall also comply with the most recent version of:
A. 2 CFR, Part 200 of the Code of Federal Regulations (CFR), Uniform Administrative
Requirements, Cost Principles, and Audit Requirements for Federal Awards located at
httD://www.ecf r. gov.
B. FEMA Policy #108-023-1 Grant Programs Directorate Environmental Planning and Historic
Preservation Policy Guidance.
III. Award Amount and Restrictions
A. The County of Oakland is awarded $31,918 or 17.13% of the Subrecipients local emergency
manager's salary and fringe benefits under the FY 2021 EMPG. The Subrecipient may receive
less than the allocated amount if the Subrecipient's cost share (match) of wages and fringe
benefits paid to the local emergency manager are less than the total allocation. The
Subrecipient's EMPG program budget must be documented on the Local Budget for Emergency
Management Performance Grant form (EMD-17).
B. The FY 2021 EMPG covers eligible costs from October 1, 2020 to September 30, 2021. The
funds awarded in the grant agreement shall only be used to cover allowable costs that are
incurred during the agreement period. Grant funds shall not be used for other purposes. For
guidance on allowable costs, please refer to the EMPG Appendix in the FEMA Preparedness
Grants Manual.
C. This grant agreement designates EMPG funds for the administration and oversight of an
approved emergency management program. The Subrecipient may utilize grant funds for
the reimbursement of salary, overtime, compensatory time off, and associated fringe
benefits for the local emergency manager, and up to 5% of the total allocation may be
utilized for other allowable organization costs. No other expenditures are allowed. If other
organization costs are requested, a narrative must be submitted detailing the expenses that are
included in these costs.
D. The FY 2021 EMPG program has a 50% cost share (cash or in -kind) requirement, as authorized
by the Robert T. Stafford Disaster Relief and Emergency Assistance Act, as amended, (Pub. L.
No. 93-288) (42 U.S.C. §§ 5121 et seq.), specifically, Title VI, sections 6110) and 613. Federal
funds cannot exceed 50% of eligible costs. Unless otherwise authorized by law, federal funds
cannot be matched with other federal funds.
The Federal Emergency Management Agency (FEMA) administers cost sharing requirements in
accordance with 2 CFR § 200.306. To meet matching requirements, the Subrecipient
contributions must be reasonable, allowable, allocable, and necessary under the grant program
and must con ply with all federal requirements and regulations.
FY 2021 EMPG ARPA
County of Oakland
PAgp'Anfq
See the FY 2021 EMPG NOFO and FEMA Preparedness Grants Manual for additional cost
share guidance, definitions, basic guidelines, and governing provisions.
E. All EMPG funded personnel must complete either the Independent Study courses identified in
the Professional Development Series or the National Emergency Management Basic Academy
delivered either by the Emergency Management Institute or a sponsored state, local, tribal,
territorial, regional, or other designated location and record proof of completion. All EMPG
funded personnel must also participate in exercises consistent with the requirements outlined in
the EMPG Guidebook and work agreement.
The EMPG programs are required to complete a quarterly training and exercise report identifying
training and exercises completed during the quarter. Guidance for accomplishing these
requirements is provided by the Recipient-
F. Upon request, the Subrecipient must provide to the Recipient information necessary to meet any
state or federal subaward reporting requirements.
G. In the event that the U.S. Department of Homeland Security (DHS) determines that changes are
necessary to the award document after an award has been made, including but not limited to,
changes to period of performance or terms and conditions, Subrecipients will be notified of the
changes in writing. Once notification has been made, any subsequent request for funds will
indicate Subrecipient acceptance of the changes to the award.
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. 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. The Subrecipient agrees to comply with all applicable federal and state regulations; the FY 2021
EMPG NOFO; the FEMA Preparedness Grants Manual Version 2; the Agreement Articles
Applicable to Subrecipients: Fiscal Year 2021 Emergency Management Performance Grants,
included with the grant agreement package for reference; and the EMPG Guidebook (EMD-PUB
208),
C. The subrecipient shall not use FY 2021 EMPG funds to generate program income.
D. 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. Subrecipient Risk Assessment Certification
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. Other documents that may be required by federal or state officials
E. Complete and submit quarterly work reports, the Quarterly Training and Exercise Worksheet, and
the Annual Training and Exercise Plan Worksheet in accordance with the schedule outlined in the
FY 2021 EMPG Work A"ement/Quarterly Report (EMHSD-31).
FY 2021 EMPG ARPA
County of Oakland
Paaa 4 of q
F. Enact enabling legislation establishing the local emergency management program and ensure a
copy of the local resolution or ordinance is on file with the Recipient.
G. Appoint an emergency management program manager who is able to assume responsibility for
the functions outlined in section 4 of the EMPG Guidebook.
H. Provide the Recipient with a complete job description for the federally funded EMPG local
emergency manager, including non-EMPG duties if applicable.
I. Notify the Recipient immediately of any changes in the EMPG funded local emergency manager's
position.
J. The Subrecipient will contribute to the development and maintenance of the state's multi -year
Training and Exercise Plan (TEP). This will include conducting exercises that comply with local,
state, and federal requirements, including the Homeland Security Exercise and Evaluation
Program (HSEEP) and the EMPG Guidebook, to accomplish this goal.
K. Ensure the EMPG funded local emergency manager completes training as required by the annual
EMPG Work Agreement.
L. Have an approved and current emergency operations plan on file with the MSP/EMHSD District
Coordinator.
M. The Subrecipient agrees to prepare the form EMHSD-007 - EMPG Quarterly Billing Cover Sheet.
The Subrecipient agrees to submit this form with supporting documentation, including all required
authorized signatures and required reimbursement documentation to the appropriate
MSP/EMHSD District Coordinator by the due date following the end of each quarter, as identified
in FY 2021 Emergency Management Report Schedule. The most current EMHSD-007 form must
be used and can be obtained from the MSP/EMHSD District Coordinator, or by visiting
httos://www.michigan.aov/msr)/0,4643,7-123-72297 60152 95164 95317---,00.1html under
Finance Forms.
N. 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:
1. Account for receipts and expenditures, maintain adequate financial records, and refund
expenditures disallowed by federal or state audit.
2. Retain all financial records, statistical records, supporting documents, and other 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.
3. Non-federal organizations which expend $750,000 or more in all 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.
O. Comply with all reporting requirements, including special reporting, data collection, and evaluation
requirements, as prescribed by law or program guidance.
P. Maintain a valid Data Universal Numbering System (DUNS) number at all times during the
performance period of this grant.
Q. The Subrecipient must acknowledge and agree to comply with applicable provisions governing
DHS access to records, accounts, documents, information, facilities, and staff. The Subrecipient
also agrees to require any subrecipients, contractors, successors, transferees, and assignees to
acknowledge and agree to comply with these same provisions. Detailed information on record
access provisions can be found in the DHS Standard Administrative Terms and Conditions
FY 2021 EMPG ARPA
County of Oakland
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located at httns://www.dhs.gov/oublication/fvl5-dhs-standard-terms-and-conditions, specifically in
the DHS Specific Acknowledgements and Assurances on page 1.
R. Subrecipients must carry out their programs and activities in a manner that respects and ensures
the protection of civil rights for protected populations. These populations include but are not
limited to individuals with disabilities and others with access and functional needs, individuals with
limited English proficiency, and other diverse racial and ethnic populations, in accordance with
Section 504 of the Rehabilitation Act of 1973, Title VI of the Civil Rights Act of 1964, and
Executive Order 13347.
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).
VI. Reporting Procedures
A. The Subrecipient agrees to prepare quarterly work reports using the FY 2021 EMPG Work
Agreement/Quarterly Report (EMHSD-31) and submit them through EMHSD's online reporting
tool by the due date following the end of each quarter. Reimbursement of expenditures by the
Recipient is contingent upon the Subrecipient's completion of scheduled work activities.
Reporting periods and due dates are listed in the FY 2021 EMPG Work Agreement/Quarterly
Report (EMHSD-31). A copy of the FY 2021 EMPG Work Agreement can be obtained via email
at EMD_HSGP@michigan.gov.
B. If the Subrecipient fails to complete the scheduled work activities during a quarter, the Recipient
will withhold reimbursement until either the work is completed, or the Deputy State Director of
Emergency Management and Homeland Security approves a delay in the completion of the
activity. Forfeiture of funds may result if scheduled work activities are not completed according to
established deadlines.
C. A Subrecipient that fails to complete the annual exercise requirements, as scheduled within the
FY 2021 EMPG Work Agreement/Quarterly Report, may be ineligible for EMPG funding for that
quarter and all subsequent quarters-
D. The Subrecipient's failure to fulfill the quarterly reporting requirements, as required by the grant,
may result in the suspension or loss of grant funding.
FY 2021 EMPG ARPA
County of Oakland
VII. Payment Procedures
A. The Subrecipient agrees to prepare the form EMHSD-007 - EMPG Quarterly Billing Cover Sheet.
The Subrecipient agrees to submit this form with supporting documentation, including all required
authorized signatures and required reimbursement documentation, to the MSP/EMHSD District
Coordinator by the due date following the end of each quarter, as identified in FY 2021
Emergency Management Report Schedule. The most current EMHSD-007 form must be used
and can be obtained from the MSP/EMHSD District Coordinator, or by visiting
www.michigan.gov/emhsd under Grant Programs, EMPG, Grant Forms, Finance Forms.
B. If the Subrecipient submits required quarterly reports that are late or incomplete, the
reimbursement may not be processed until the following quarter. Forfeiture of funds may result if
quarterly reports are not completed according to established deadlines.
C. The Subrecipient agrees to return to the Recipient any unobligated balance of funds held by the
Subrecipient at the end of the agreement period or handle them in accordance with the
instructions provided by the Recipient.
Vlll. 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; Titles I, 11 and III of the Americans with Disabilities Act of 1990;
the Elliott -Larsen Civil Rights Act, 1976 PA 453, as amended, MCL 37.2101 et seq.; the Persons with
Disabilities Civil Rights Act, 1976 PA 220, as amended, MCL 37.1101 et seq., and all other federal, state
and local fair employment practices and equal opportunity laws and covenants. 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 contract or 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 shall ensure that no subcontractor, manufacturer, or supplier of the Subrecipient for
projects related to this grant agreement appears on the Federal Excluded Parties List System located at
https://www.sam.gov.
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.
FY 2021 EMPG ARPA
County of Oakland
Paaa 7 of 9
Xf. Grant Agreement Period
This grant agreement is in full force and effect from October 1, 2020 to September 30, 2021. 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 may be terminated by either party by giving thirty
(30) days written notice to the other parry 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 make satisfactory progress toward the goals or objectives set forth in the annual
EMPG Work Agreement.
D. Failure to follow grant agreement requirements or special conditions.
E. Failure to submit required reports.
F. Filing of a false certification in the application or other reports or documents.
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.
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.
FY 2021 EMPG ARPA
County of Oakland
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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 2021 EMPG ARPA
County of Oakland D-oc D ..F D
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.
County of Oakland 136200362
Subrecipient Name Subrecipient's DUNS Number
For the Chief Elected Official
Printed Name
Signature
For the Local Emeraencv Manager
Thomas Hardesty
Printed Name
Signature
Title
Date
Director, Emergency Management
Title
Date
For the Recipient (Michigan State Police. Emeraencv Management and Homeland Security
Division
Commander, Emergency Management
Capt. Kevin Sweeney and Homeland Securitv Division
Printed Name Title
(' November 5, 2021
Signature Date
FY 2021 EMPG ARPA Supplemental Match Certification
The American Rescue Plan Act of 2021 (ARPA) was signed into law on March 11, 2021, to provide
approximately $350 billion in additional federal funding for state and local governments to aid in the
recovery from budgetary, economic, and financial impacts of the COVID-19 pandemic. The Emergency
Management Performance Grant (EMPG) Program was one of the federal grant programs that received
additional, non -recurring funding through the ARPA. The Michigan State Police, Emergency
Management and Homeland Security Division (MSP/EMHSD) has committed additional funds received
through ARPA to the local emergency management programs that support Michigan residents. The
supplemental allocations have been calculated based on the fiscal year 2021 EMPG local allocations and
the budget details submitted by each program.
The initial allocation under the standard EMPG 21 grant program was 32.86920% of the total local
emergency management coordinator payroll costs submitted to MSP/EMHSD. With this one-time,
additional funding, each EMPG funded local emergency management program will receive supplemental
funding to bring the 2021 percentage to 50%. This ARPA supplemental award under EMPG 21 has the
same requirements as the standard EMPG program with a 50% cost match requirement (cash or in -kind)
as authorized by the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Public Law 93-
288), as amended, 42 USC 5121-5207. Specifically, Title VI, sections 6110) and 614. Unless otherwise
authorized by law, federal funds cannot be matched with other federal funds.
To ensure the local match requirement of 50% is met, the amended percentage of 50% has been applied
to the initial EMPG 2021 allocation. The supplemental amount that your local program will receive is the
difference between the initial allocation at 32.86920% and 50%. A table detailing this calculation follows.
This is one-time funding provided by the ARPA law and all future allocations will be based on funding
made available to the state in future awards and will not be based on or in comparison to this percentage.
County of Oakland
Original Fundinq Allocation at 32.86920% $61,242
Supplemental ARPA Awarded Allocation at 17.1308% $31,918
Total Awarded Funds for FY 21 EMPG at 50% $93,160
Signature below and acceptance of the grant agreement certifies 50% of local EMPG funded
emergency coordinators salary and fringe costs are local general funds, are not from federal
funds, and have not been used as a match for any other federal grant program.
Printed Name Title
Signature Date
If the supplemental funding cannot be matched, please email LounsberrvP(cbmichioanxiov and CC
Richmond 'Ki5michiaan.cov proposing a reduced percentage for the ARPA allocation.
EMHSD-RA (04/2019)
MICHIGAN STATE POLICE
Emergency Management and Homeland Security Division
SUBRECIPIENT RISK ASSESSMENT CERTIFICATION
As required by 2 CFR §200.331(b), the purpose of this assessment is to evaluate subrecipient's risk of noncompliance with
federal statutes, regulations, and the terms and conditions of a subaward, and to determine appropriate subrecipient
monitoring during the grant performance period. Limited program experience, results of previous audits and site monitoring
visits, new personnel or new or substantially changed systems, may increase a subrecipient's degree of risk.
Subrecipient:
County: I DUNS #:
Questions
1. How many federal grant awards has your organization managed in the past 5 years regardless of awarding agency?
❑ No grants
❑ 1-3 grants
❑ 4-5 grants
❑ 6+ grants
2. What percentage of your grant management staff has fewer than 2 years of grant experience?
❑ 0-25% of staff
❑ 26-50% of staff
❑ 51-75% of staff
❑ 76-100% of staff
3. Has your organization had a new or substantially changed financial/accounting system(s) in the past 2 years?
❑ Yes
❑ No
4. What types of findings (audit, site monitoring, etc.) has your organization received within the past 5 years?
(Attach a separate sheet explaining any findings resulting in questioned costs or a return of funds.)
❑ Never Audited or No
❑ Unsupported costs (lack of documentation)
❑ Unreasonable use of funds
❑ Questioned costs or required to return funds
5. Does your agency have staff primarily dedicated (>50%) to grants management activities?
❑ Yes
❑ No
Certification
I certify the information provided in this assessment is true and accurate, and that all occurrences of prior grant
non-compliance have been disclosed.
Authorized Representative Signature:
Authorized Representative Printed Name:
Date:
Title:
Point of Contact Printed Name: I Title: Email:
OMB APPROVAL NO. 1 121-140
EXPIRES 5/31/2019
STANDARD ASSURANCES
The Applicant hereby assures and certifies compliance with all applicable Federal statutes, regulations, policies,
guidelines, and requirements, including 2 C.F.R. Part 2800 (Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards by the Department of Justice), and Ex. Order 12372
(intergovernmental review of federal programs). 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 Government Accountability 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. § 469a-1 et seq.), and the
National Environmental Policy Act of 1969 (42 U.S.C. § 4321).
6. It will comply (and will require any subrecipients or contractors to comply) with any applicable
nondiscrimination provisions, 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 Violence Against Women Act (42 U.S.C. § 13925(b)(13)); the
Civil Rights Act of 1964 (42 U.S.C. § 2000d); the Indian Civil Rights Act (25 U.S.C. §§ 1301-1303); the
Rehabilitation Act of 1973 (29 U.S.C. § 794); 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). It will also comply with Ex. Order 13279, Equal Protection of the Laws for
Faith -Based and Community Organizations; Executive Order 13559, Fundamental Principles and Policymaking
Criteria for Partnerships With Faith -Based and Other Neighborhood Organizations; and the DOI implementing
regulations at 28 CF.R. Part 38.
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 will comply with requirements of 5 U.S.C.§§ 1501-08 and §§7324-28, which limit certain political
activities of State or local government employees whose principal employment is in connection with an
activity financed in whole or in part by federal assistance.
Signature Date
_ U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
OFFICE OF THE COMPTROLLER
Applicants should refer to the regulations cited below to determine the certification to which they are required to
attest. Applicants should also review the instructions for certification included in the regulations before completing this
form. Signature of this form provides for compliance with certification requirements under 28 CFR Part 69, "New
Restrictions on Lobbying" and 28 CFR Part 67, "Government -wide Debarment and Suspension (Nonpro-curement) and
Government -wide Requirements for Drug -Free Workplace (Grants)." The certifications shall be treated as a material
representation of fact upon which reliance will be placed when the Department of Justice determines to award the
covered transaction, grant, or cooperative agreement.
1. LOBBYING
As required by Section 1352, Title 31 of the U S. Code, and
public (Federal, State, or local) transaction or contract under a
public transaction; violation of Federal or State antitrust statutes
implemented at 28 CFR Part 69, for persons entering into a
or commission of embezzlement, theft, forgery,
grant or cooperative agreement over $100,000, as defined at
bribery, falsification or destruction of records, making false
28 CFR Part 69, the applicant certifies that
statements, or receiving stolen property;
(a) No Federal appropriated funds have been paid or will be
paid, by or on behalf of the undersigned, to any person for in-
fluencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in con-
nection with the making of any Federal grant, the entering into
of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal grant or
cooperative agreement,
(b) If any funds other than Federal appropriated funds have
been paid or will be paid to any person for influencing or at-
tempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with this
Federal grant or cooperative agreement, the undersigned shall
complete and submit Standard Form - LLL, "Disclosure of
Lobbying Activities," in accordance with its instructions;
(c) The undersigned shall require that the language of this cer-
tification be included in the award documents for all subawards
at all tiers (including subgrants, contracts under grants and
cooperative agreements, and subcontracts) and that all sub -
recipients shall certify and disclose accordingly.
2. DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS
(DIRECT RECIPIENT)
As required by Executive Order 12549, Debarment and
Suspension, and implemented at 28 CFR Part 67, for prospec-
tive participants in primary covered transactions, as defined at
28 CFR Part 67, Section 67.510—
A. The applicant certifies that it and its principals.
(a) Are not presently debarred, suspended, proposed for debar-
ment, declared ineligible, sentenced to a denial of Federal
benefits by a State or Federal court, or voluntarily excluded
from covered transactions by any Federal department
or agency;
(b) Have not within a three-year period preceding this applica-
tion been convicted nt or had a civil judgment rendered agamM
them for commission of fraud or a criminal offense in connec-
tion with obtaining, attempting to obtain, or performing a
(c) Are not presently indicted for or otherwise criminally or
civilly charged by a governmental entity (Federal, State, or
local) with commission of any of the offenses enumerated in
paragraph (1)(b) of this certification; and
(d) Have not within a three-year period preceding this applica-
tion had one or more public transactions (Federal, State, or
local) terminated for cause or default; and
B Where the applicant is unable to certify to any of the
statements in this certification, he or she shall attach an
explanation to this application.
3. DRUG -FREE WORKPLACE
(GRANTEES OTHERTHAN INDIVIDUALS)
As required by the Drug -Free Workplace Act of 1988, and
implemented at 28 CFR Part 67, Subpart F, for grantees, as
defined at 28 CFR Part 67 Sections 67.615 and 67.620—
A. The applicant certifies that it will or will continue to provide
a drug -free workplace by:
(a) Publishing a statement notifying employees that the
unlawful manufacture, distribution, dispensing, possession, or
use of a controlled substance is prohibited in the grantee's
workplace and specifying the actions that will be taken against
employees for violation of such prohibition;
(b) Establishing an on -going drug -free awareness program to
inform employees about—
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug -free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance programs; and
(4) The penalties that may be imposed upon employees for
drug abuse violations occurring in the workplace;
(c) Making it a requirement that each employee to be engaged
in the performance of the grant be given a copy of the state-
ment required by paragraph (a),
(d) Notifying the employee in the statement required by para-
graph (a) that, as a condition of employment under the grant,
the employee will —
OUP FORM 4061/6 (3-91) REPLACES OJP FORMS 4061/2, 4061/3 AND 406114 WHICH ARE OBSOLETE.
( t) 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;
(a) Notifying the agency, in writing, within 10 calendar days
after receiving notice under subparagraph (d)(2) from an
employee or otherwise receiving actual notice of such conviction.
Employers of convicted employees must provide notice, including
position title, to: Department of Justice, Office of
Justice Programs, ATTN Control Desk, 633 Indiana Avenue,
N.W., Washington, D.C. 20531, Notice shall include the iden-
tification number(s) of each affected grant;
(f) Taking one of the following actions, within 30 calendar
days of receiving notice under subparagraph (d)(2), with
respect to any employee who is so convicted—
(1) Taking appropriate personnel action against such an
employee, up to and including termination, consistent with the
requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a
drug abuse assistance or rehabilitation program approved for
such purposes by a Federal, State, or local health, law enforce-
ment, or other appropriate agency;
(g) Making a good faith effort to continue to maintain a drug -
free workplace through implementation of paragraphs (a), (b),
(c), (d), (e), and (f).
B. The grantee may insert in the space provided below the
site(s) for the performance of work done in connection with
the specific grant:
Place of Performance (Street address, city, county, state, zip
code)
Check ❑ if there are workplaces on file that are not indentified
here.
Section 67, 630 of the regulations provides that a grantee that
is a State may elect to make one certification in each Federal
fiscal year. A copy of which should be included with each ap-
plication for Department of Justice funding. States and State
agencies may elect to use OJP Form 406117,
Check ❑ if the State has elected to complete OJP Form
4061/7,
DRUG -FREE WORKPLACE
(GRANTEES WHO ARE INDIVIDUALS)
As required by the Drug -Free Workplace Act of 1988, and
implemented at 28 CFR Part 67, Subpart F, for grantees, as
defined at 28 CFR Part 67; Sections 67.615 and 67.620—
A. As a condition of the grant, I certify that 1 will not engage
in the unlawful manufacture, distribution, dispensing, posses-
sion, or use of a controlled substance in conducting any
activity with the grant; and
B. If convicted of a criminal drug offense resulting from a
violation occurring during the conduct of any grant activity, I
will report the conviction, in writing, within 10 calendar days
of the conviction, to: Department of Justice, Office of Justice
Programs, ATTN Control Desk, 810 Seventh Street NW.,
Washington, DC 20531.
As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications.
1. Grantee Name and Address:
2. Application Number and/or Project Name
4, Typed Name and Title of Authorized Representative
5. Signature
3. Grantee IRS/Vendor Number
6. Date
'U.S. Govemment Panting Ofime 1996- 405-037/40074
EMD-053 (04/2018)
MICHIGAN STATE POLICE
Emergency Management and Homeland Security Division
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.
1. Program Information
Program Name CFDA Number
11. Subrecipient Information
Subrecipient Name
Street Address - I City
III. Certification for Fiscal Year
State ZIP Code
Subrecipient 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.
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
Submit audit report to:
Michigan State Police
Grants and Community Services Division
P.O. Box 30634
Lansing, Michigan 48909
Submit this completed audit certification form and return with your grant agreement to:
Michigan State Police
Emergency Management and Homeland Security Division
P.O. Box 30634
Lansing, Michigan 48909
Form ® I Request for Taxpayer ( Give Form to the
(Rev. October 2018) Identification Number and Certification requester. Do not
..�..n,., T.�— cand to the, IRS
Internal Revenue Service ► Go to www.irs.gov/FormW9 for instructions and the latest information.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank
2 Business name/disregarded entity name, if different from above
0
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the
4 Exemptions (codes apply only to
following seven boxes.
certain entities, not individuals; see
a
instructions on page 3)
p
❑ Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate
m
ai c
single -member LLC
Exempt payee code (if any)
ao
❑ Limited liability company. Enter the tax classification (C-C corporation, S=S corporation, P=Partnership) ►
`p
Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check
Exemption from FATCA reporting
y
c c
LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is
code ( if any)
another LLC that is not disregarded from the owner for U S. federal tax purposes Otherwise, a single -member LLC that
a or
E
is disregarded from the owner should check the appropriate box for the tax classification of its owner
u
v
❑ Other (see instructions)►
Orppfier ruacccuols mamra,oedours,do mo us7
N
5 Address (number, street, and apt. or suite no I See instructions. Requester's name and address (optional)
m
o
6 City, state, and ZIP code
7 List account number(s) here (optional)
KiM Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box The TIN provided must match the name given on line 1 to avoid
I 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 instructions for Part I, later. For other
m
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN, later. or
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Employer identification number
Number To Give the Requester for guidelines on whose number to enter. m
tj� Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (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. 1 am a U S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later.
Sign Signature of
Here U.S. person► Date►
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www irs.gov/FormW9.
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 (TIN) which may be your social security number
(SSN), individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returns include, but are not limited to, the following.
• Form 1090-INT (interest earned or paid)
• Form 1099-DIV (dividends, including those from stocks or mutual
funds)
• Form 1099-MISO (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do not return Form IN to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat No 10231X Form W-9 (Rev. 10-2018)
Form W-9(Rev 10-2018)
Page 2
By signing the filled -out form, you:
I ro youarecorrec(oryou
number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S. exempt
payee. If applicable, you are also certifying that as a U.S. person, your
allocable share of any partnership income from a U.S. trade or business
is not subject to the withholding tax on foreign partners' share of
effectively connected income, and
4. Certify that FATCA code(s) entered on this form (if any) indicating
that you are exempt from the FATCA reporting, is correct. See What is
FATCA reporting, later, for further information.
Note: If you are a U.S. person and a requester gives you a form other
than Form W-9 to request your TIN, you must use the requester's form if
it is substantially similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S. person if you are
• An individual who is a U.S. citizen or U.S. resident alien;
A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United States;
• An estate (other than a foreign estate); or
• A domestic trust (as defined in Regulations section 301.7701-7).
Special rules for partnerships. Partnerships that conduct a trade or
business in the United States are generally required to pay a withholding
tax under section 1446 on any foreign partners' share of effectively
connected taxable income from such business Further, in certain cases
where a Form W-9 has not been received, the rules under section 1446
require a partnership to presume that a partner is a foreign person, and
pay the section 1446 withholding tax. Therefore, if you are a U.S. person
that is a partner in a partnership conducting a trade or business in the
United States, provide Form W-9 to the partnership to establish your
U.S. status and avoid section 1446 withholding on your share of
partnership income.
In the cases below, the following person must give Form W-9 to the
partnership for purposes of establishing its U.S. status and avoiding
withholding on its allocable share of net income from the partnership
conducting a trade or business in the United States.
• In the case of a disregarded entity with a U.S. owner, the U S. owner
of the disregarded entity and not the entity;
• In the case of a grantor trust with a U.S. grantor or other U.S. owner,
generally, the U.S grantor or other U.S. owner of the grantor trust and
not the trust; and
• In the case of a U.S. trust (other than a grantor trust), the U.S. trust
(other than a grantor trust) and not the beneficiaries of the trust.
Foreign person. If you are a foreign person or the U S branch of a
foreign bank that has elected to be treated as a U S. person, do not use
Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see
Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign
Entities).
Nonresident alien who becomes a resident alien. Generally, only a
nonresident alien individual may use the terms of a tax treaty to reduce
or eliminate U.S. tax on certain types of income. However, most tax
treaties contain a provision known as a "saving clause." Exceptions
specified in the saving clause may permit an exemption from tax to
continue for certain types of income even after the payee has otherwise
become a U.S. resident alien for tax purposes.
If you are a U.S resident alien who is relying on an exception
contained in the saving clause of a tax treaty to claim an exemption
from U.S. tax on certain types of income, you must attach a statement
to Form W-9 that specifies the following five items.
1. The treaty country. Generally, this must be the same treaty under
which you claimed exemption from tax as a nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that contains the
saving clause and its exceptions
4. The type and amount of income that qualifies for the exemption
from tax.
5. Sufficient facts to justify the exemption from tag finder the terms of
the treaty article.
Example. Article 20 of the U.S.-China income tax treaty allows an
exemption from tax for scholarship income received by a Chinese
student temporarily present in the United States. Under U.S. law, this
student will become a resident alien for tax purposes if his or her stay in
the United States exceeds 5 calendar years. However, paragraph 2 of
the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows
the provisions of Article 20 to continue to apply even after the Chinese
student becomes a resident alien of the United States. A Chinese
student who qualifies for this exception (under paragraph 2 of the first
protocol) and is relying on this exception to claim an exemption from tax
on his or her scholarship or 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 24% of such
payments. This is called "backup withholding " Payments that may be
subject to backup withholding include interest, tax-exempt interest,
dividends, broker and barter exchange transactions, rents, royalties,
nonemployee pay, payments made in settlement of payment card and
third party network transactions, and certain payments from fishing boat
operators. Real estate transactions are not subject to backup
withholding
You will not be subject to backup withholding on payments you
receive if you give the requester your correct TIN, make the proper
certifications, and report all your taxable interest and dividends on your
tax return.
Payments you receive will be subject to backup withholding if
1. You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the instructions for
Part II for details),
3. The IRS tells the requester that you furnished an incorrect TIN,
4. The IRS tells you that you are subject to backup withholding
because you did not report all your interest and dividends on your tax
return (for reportable interest and dividends only), or
5. You do not certify to the requester that you are not subject to
backup withholding under 4 above (for reportable interest and dividend
accounts opened after 1983 only).
Certain payees and payments are exempt from backup withholding.
See Exempt payee code, later, and the separate Instructions for the
Requester of Form W-9 for more information.
Also see Special rules for partnerships, earlier.
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 FATCA
reporting code, later, and the Instructions for the Requester of Form
W-9 for more information.
Updating Your Information
You trust 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 $500 penalty.
Farm W-9 (Rev. 10-2018)
Page 3
Criminal penalty for falsifying information. Willfully falsifying
certifications or affirmations may subiect you to criminal penalties
including fines and/or imprisonment.
Misuse of TINS. If the requester discloses or uses TINS in violation of
federal law, the requester may be subject to civil and criminal penalties.
Specific Instructions
Line 1
You must enter one of the following on this line; do not leave this line
blank The name should match the name on your tax return.
If this Form W-9 is for a joint account (other than an account
maintained by a foreign financial institution (FFI)), list first, and then
circle, the name of the person or entity whose number you entered in
Part I of Form W-9. If you are providing Form W-9 to an FFI to document
a joint account, each holder of the account that is a U.S person must
provide a 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 1 a. This should also be the same as the
name you entered on the Form 1040/1040A/1040EZ you filed with your
application.
b. Sole proprietor or single -member I.L.C. Enter your individual
name as shown on your 1040/1040A/1040EZ on line 1. You may enter
your business, trade, or "doing business as" (DBA) name on line 2.
c. Partnership, LLC that is not a single -member LLC, C
corporation, or S corporation. Enter the entity's name as shown on the
entity's tax return on line 1 and any business, trade, or DBA name on
line 2.
d. Other entities. Enter your name as shown on required U.S. federal
tax documents on line 1. This name should match the name shown on the
charter or other legal document creating the entity. You may enter any
business, trade, or DBA name on line 2.
e. Disregarded entity. For U.S. federal tax purposes, an entity that is
disregarded as an entity separate from its owner is treated as a
"disregarded entity." See Regulations section 301.7701-2(c)(2)(iii). Enter
the owner's name on line 1. The name of the entity entered on line 1
should never be a disregarded entity. The name on line 1 should be the
name shown on the income tax return on which the income should be
reported. For example, if a foreign LLC that is treated as a disregarded
entity for U.S. federal tax purposes has a single owner that is a U.S.
person, the U.S. owner's name is required to be provided on line 1. If
the direct owner of the entity is also a disregarded entity, enter the first
owner that is not disregarded for federal tax purposes. Enter the
disregarded entity's name on line 2, "Business name/disregarded entity
name." If the owner of the disregarded entity is a foreign person, the
owner must complete an appropriate Form W-8 instead of a Form W-9.
This is the case even if the foreign person has a U.S TIN.
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 on line 3 for the U.S. federal tax
classification of the person whose name is entered on line 1. Check only
one box on line 3.
IF the entity/person on line 1 is THEN check the box for ...
Sit-) .. .
• Corporation Corporation
• Individual
Individual/sole proprietor or single-
• Sole proprietorship, or
member LLC
• Single -member limited liability
company (LLC) owned by an
individual and disregarded for U S.
federal tax purposes.
• LLC treated as a partnership for
Limited liability company and enter
U.S. federal tax purposes,
the appropriate tax classification.
• LLC that has filed Form 8832 or
(P= Partnership; C= C corporation;
2553 to be taxed as a corporation,
or S= S corporation)
or
• LLC that is disregarded as an
entity separate from its owner but
the owner is another LLC that is
not disregarded for U.S federal tax
purposes.
• Partnership Partnership
• Trust/estate Trust/estate
Line 4, Exemptions
If you are exempt from backup withholding and/or FATCA reporting,
enter in the appropriate space on 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(f)(2)
2—The United States or any of its agencies or instrumentalities
3—A state, the District of Columbia, a U.S. commonwealth or
possession, or any of their political subdivisions or instrumentalities
4—A foreign government or any of its political subdivisions, agencies,
or instrumentalities
5—A corporation
6 — A dealer in securities or commodities required to register in the
United States, the District of Columbia, or a U.S. commonwealth or
possession
7—A futures commission merchant registered with the Commodity
Futures Trading Commission
8—A real estate investment trust
9—An entity registered at all times during the tax year under the
Investment Company Act of 1940
10—A common trust fund operated by a bank under section 584(a)
11—A financial institution
12—A middleman known in the investment community as a nominee or
custodian
13—A trust exempt from tax under section 664 or described in section
4947
Form W-9 (Rev. 10-2018)
page 4
The following chart shows types of payments that may be exempt
from backup withholdina. The chart applies to the exempt payees listed
above, 1 through 13
IF the payment is for ... THEN the payment is exempt
for...
Interest and dividend payments All exempt payees except
for 7
Broker transactions
Barter exchange transactions and
patronage dividends
Payments over $600 required to be
reported and direct sales over
$5,000'
Exempt payees 1 through 4 and 6
through 11 and all C corporations
S corporations must not enter an
exempt payee code because they
are exempt only for sales of
noncovered securities acquired
prior to 2012.
Exempt payees 1 through 4
Generally, exempt payees
1 through 52
Payments made in settlement of Exempt payees 1 through 4
payment card or third party network
transactions
1 See Form 1099-MISC, Miscellaneous Income, and its instructions
2 However, the following payments made to a corporation and
reportable on Form 1099-MISC are not exempt from backup
withholding: medical and health care payments, attorneys' fees, gross
proceeds paid to an attorney reportable under section 6045(f), and
payments for services paid by a federal executive agency.
Exemption from FATCA reporting code. The following codes identify
payees that are exempt from reporting under FATCA. These codes
apply to persons submitting this form for accounts maintained outside
of the United States by certain foreign financial institutions. Therefore, if
you are only submitting this form for an account you hold in the United
States, you may leave this field blank. Consult with the person
requesting this form if you are uncertain if the financial institution is
subject to these requirements. A requester may indicate that a code is
not required by providing you with a Form W-9 with "Not Applicable" (or
any similar indication) written or printed on the line for a FATCA
exemption code
A —An organization exempt from tax under section 501(a) or any
individual retirement plan as defined in section 7701(a)(37)
B—The United States or any of its agencies or instrumentalities
C—A state, the District of Columbia, a U.S. commonwealth or
possession, or any of their political subdivisions or instrumentalities
D—A corporation the stock of which is regularly traded on one or
more established securities markets, as described in Regulations
section 1.1472-1(c)(1)(1)
E—A corporation that is a member of the same expanded affiliated
group as a corporation described in Regulations section 1.1472-1(c)(1)(i)
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 at any state
G—A real estate investment trust
H—A regulated investment company as defined in section 851 or an
entity registered at all times during the tax year under the Investment
Company Act of 1940
I —A common trust fund as defined in section 584(a)
J—A bank as defined in section 581
K—A broker
L—A trust exempt from tax under section 664 or described in section
4947(a)(1)
M—A tax exempt trust under a section 403(b) plan or section 457(g)
plan
Note: You may wish to consult with the financial institution requesting
this form to determine whether the FATCA code and/or exempt payee
code should be completed.
Line 5
Enter your address (number, street, and apartment or suite number).
This is where the requester of this Form W-9 will mail your information
returns. If this address differs from the one the requester already has on
file, write NEW at the top. If a new address is provided, there is still a
chance the old address will be used until the payor changes your
address in their records.
Line 6
Enter your city, state, and ZIP code.
Part I. Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. If you are a resident alien and
you do not have and are not eligible to get an SSN, your TIN is your IRS
individual taxpayer identification number (ITIN). Enter it in the social
security number box. If you do not have an ITIN, see How to get a TIN
below
If you are a sole proprietor and you have an EIN, you may enter either
your SSN or FIN.
If you are a single -member LLC that is disregarded as an entity
separate from its owner, enter the owner's SSN (or FIN, 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 FIN.
Note: See What Name and Number To Give the Requester, later, for
further clarification of name and TIN combinations.
How to get a TIN. If you do not have a TIN, apply for one immediately.
To apply for an SSN, get Form SS-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 EIN. You can apply for an EIN
online by accessing the IRS website at www.irs.gov/Businesses and
clicking on Employer Identification Number (EIN) under Starting a
Business. Go to www.irs.gov/Forms to view, download, or print Form
W-7 and/or Form SS-4. Or, you can go to www.im.gov/OrderForms to
place an order and have Form W-7 and/or SS-4 mailed to you within 10
business days.
If you are asked to complete Form W-9 but do not have a TIN, apply
for a TIN and write "Applied For" in the space for the TIN, sign and date
the form, and give it to the requester. For interest and dividend
payments, and certain payments made with respect to readily tradable
instruments, generally you will have 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 to other types of payments
You will be subject to backup withholding on all such payments until
you provide your r TIN to the requester.
Note: Entering "Applied For" means that you have already applied for a
TIN or that you intend to apply for one soon.
Caution: A disregarded U.S. entity that has a foreign owner must use
the appropriate Form W-8.
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 item 1, 4, or 5 below indicates otherwise.
For a joint account, only the person whose TIN is shown in Part I
should sign (when required). In the case of a disregarded entity, the
person identified on line 1 must sign. Exempt payees, see Exempt payee
code, earlier.
Signature requirements. Complete the certification as indicated in
items 1 through 5 below.
Fain W-9(Rev _10-2018)
Page 5
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.
S. Real estate transactions. You must sign the certification. You may
cross out Item 2 of the certification.
4. Other payments. You must give your correct TIN, but you do not
have to sign the certification unless you have been notified that you
have previously given an incorrect TIN. "Other payments" include
payments made in the course of the requester's trade or business for
rents, royalties, goods (other than bills for merchandise), medical and
health care services (Including payments to corporations), payments to
a nonemployee for services, payments made in settlement of payment
card and third party network transactions, payments to certain fishing
boat crew members and fishermen, and gross proceeds paid to
attorneys (including payments to corporations).
5. Mortgage interest paid by you, acquisition or abandonment of
secured property, cancellation of debt, qualified tuition program
payments (under section 529), ABLE accounts (under section 529A),
IRA, Coverdell ESA, Archer MSA or HSA contributions or
distributions, and pension distributions. You must give your correct
TIN, but you do not have to sign the certification.
What Name and Number To Give the Requester
For this type of account: Give name and SSN of:
1. Individual The individual
2 Two or more individuals Qoint
The actual owner of the account or, If
account) other than an account
combined funds, the first individual on
maintained by an FFI
the account'
3. Two or mote U.S. persons
Each holder of the account
faint account maintained by an FFI)
4. Custodial account of a minor
The minor
(Uniform Gift to Minors Act)
5 a The usual revocable savings trust
The grantor -trustee
(grantor is also trustee)
b So-called trust account that is not
The actual owner
a legal or valld trust under state law
6 Sole proprietorship or disregarded
The owners
entity owned by an individual
7 Grantor trust filing under Optional
The grantor`
Form 1099 Filing Method 1 (see
Regulations section 1.671-4(b)(2)(i)
(A))
For this type of account:
Give name and EIN of:
8. Disregarded entity not owned by an
The owner
individual
9. A valid trust, estate, or pension trust
Legal entityt
10 Corporation or ITC; electing The corporation
corporate status on Form 8832 or
Form 2553
11. Association, club, religious, The organization
charitable, educational, or other tax-
exempt organization
12. Partnership or multi -member LLC The partnership
11 A broker or registered nominee The broker or nominee
For this type of account: Give name and EIN of:
~ Agriculture in the name of a public Y V y
entity (such as a state or local
government, school district, or
prison) that receives agricultural
program payments
15 Grantortmst filing under the Form The bust
1041 Filing Method orthe Optional
Form 1099 Filing Method 2 (see
Regulations section 1.671-4(b)(2)(Q(8))
' List first and circle the name of the person whose number you furnish.
If only one person on a joint account has an SSN, that person's number
must be furnished.
r Circle the minor's name and furnish the minor's SSN.
' You must show your individual name and you may also enter your
business or DBA name on the "Business name/disregarded entity"
name line. You may use either your SSN or EIN (if you have one), but the
IRS encourages you to use your SSN.
4 List first and circle the name of the trust, estate, or pension trust. (Do
not furnish the TIN of the personal representative or trustee unless the
legal entity itself is not designated in the account title.) Also see Special
rules for partnerships, earlier.
*Note: The grantor also must provide a Form W-9 to trustee of trust.
Note: If no name is circled when more than one name is listed, the
number will be considered to be that of the first name listed.
Secure Your Tax Records From Identity Theft
Identity theft occurs when someone uses your personal Information
such as your name, SSN, or other Identifying Information, without your
permission, to commit fraud or other crimes. An identity thief may use
your SSN to get a job or may file a tax return using your SSN to receive
a refund.
To reduce your risk:
• Protect your SSN,
Ensure your employer is protecting your SSN, and
Be careful when choosing a tax preparer.
If your tax records are affected by identity theft and you receive a
notice from the IRS, respond right away to the name and phone number
printed on the IRS notice or letter.
If your tax records are not currently affected by identity theft but you
think you are at risk due to a lost or stolen purse or wallet, questionable
credit card activity or credit report, contact the IRS Identity Theft Hotline
at 1-800-908-4490 or submit Form 14039.
For more information, see Pub. 5027, Identity Theft Information for
Taxpayers.
Victims of identity theft who are experiencing economic harm or a
systemic problem, or are seeking help in resolving tax problems that
have not been resolved through normal channels, may be eligible for
Taxpayer Advocate Service (TAS) assistance. You can reach TAS by
calling the TAS toll -free case intake line at 1-877-777-4778 or TTY/TDD
1-800-829-4059.
Protect yourself from suspicious emails or phishing schemes.
Phishing is the creation and use of email and websites designed to
mimic legitimate business emails and websites. The most common act
is sending an email to a user falsely claiming to be an established
legitimate enterprise in an attempt to scam the user into surrendering
private information that will be used for identity theft.
Form W-9 (Rev 10-2018)
Page 6
The IRS does not initiate contacts with taxpayers via emails. Also, the
IRS does not request personal detailed information through email or ask
taxpayers for the PIN numbers, passwords, or similar secret access
information for their credit card, bank, or other financial accounts.
If you receive an unsolicited email claiming to be from the IRS,
forward this message to phishing@irs.gov. You may also report misuse
of the IRS name, logo, or other IRS property to the Treasury Inspector
General for Tax Administration TIGTA) at 1-800-366-4484. You can
forward suspicious emails to the Federal Trade Commission at
Spam@uce.gov or report them at www.ftc.gov/complaint. You can
contact the FTC at www.ftc.govlidtheft or 877-IDTHEFT (877-438-4338).
If you have been the victim of identity theft, see www.IdentityTheft.gov
and Pub. 5027.
Visit w Jrs.govlldentityTheft to learn more about identity theft and
how to reduce your risk.
Privacy Act Notice
aecuon b iuu or me mrernai hevenue �ooe requires you co povide your
correct TIN to persons (including federal agencies) who are required to
file information returns with the IRS to report interest, dividends, or
certain other income paid to you; mortgage interest you paid; the
acquisition or abandonment of secured property; the cancellation of
debt; or contributions you made to an IRA, Archer MSA, or HSA. The
person collecting this form uses the information on the form to file
information returns with the IRS, reporting the above information.
Routine uses of this information include giving it to the Department of
Justice for civil and criminal litigation and to cities, states, the District of
Columbia, and U.S. commonwealths and possessions for use in
administering their laws. The information also may be disclosed to other
countries under a treaty, to federal and state agencies to enforce civil
and criminal laws, or to federal law enforcement and intelligence
agencies to combat terrorism. You must provide your TIN whether or
not you are required to file a tax return. Under section 3406, payers
must generally withhold a percentage of taxable interest, dividend, and
certain other payments to a payee who does not give a TIN to the payer.
Certain penalties may also apply for providing false or fraudulent
information.
AgreementApplicable • Subrecipients
Article I - Activities Conducted Abroad
Subrecipients must ensure that project activities carried on outside the United States are coordinated as
necessary with appropriate government authorities and that appropriate licenses, permits, or approvals are
obtained.
Article II - Reporting of Matters Related to Subrecipient Integrity and Performance
If the total value of any currently active grants, cooperative agreements, and procurement contracts from all
federal awarding agencies exceeds $10,000,000 for any period of time during the period of performance of this
federal award, then the Subrecipients must comply with the requirements set forth in the government -wide Award
Term and Condition for Recipient Integrity and Performance Matters located at 2 C.F.R. Part 200, Appendix XII,
the full text of which is incorporated here by reference in the award terms and conditions.
Article III -Trafficking Victims Protection Act of 2000 (TVPA)
Subrecipients must comply with the requirements of the government -wide financial assistance award term which
implements Section 106(g) of the Trafficking Victims Protection Act of 2000 (TVPA), codified as amended at 22
U.S.C. section 7104. The award term is located at 2 C.F.R. section 175.15, the full text of which is incorporated
here by reference.
Article IV - Federal Leadership on Reducing Text Messaging while Driving
Subrecipients are encouraged to adopt and enforce policies that ban text messaging while driving as described in
E.O. 13513, including conducting initiatives described in Section 3(a) of the Order when on official government
business or when performing any work for or on behalf of the federal government.
Article V - Debarment and Suspension
Subrecipients are subject to the non -procurement debarment and suspension regulations implementing Executive
Orders (E.O.) 12549 and 12689, which are at 2 C.F.R. Part 180 as adopted by DHS at 2 C.F.R. Part 3000. These
regulations restrict federal financial assistance awards, subawards, and contracts with certain parties that are
debarred, suspended, or otherwise excluded from or ineligible for participation in federal assistance programs or
activities,
Article VI - Fly America Act of 1974
Subrecipients must comply with Preference for U.S. Flag Air Carriers (air carriers holding certificates under 49
U.S.C. section 41102) for international air transportation of people and property to the extent that such service is
available, in accordance with the International Air Transportation Fair Competitive Practices Act of 1974, 49
U.S.C. section 40118, and the interpretative guidelines issued by the Comptroller General of the United States in
the March 31, 1981, amendment to Comptroller General Decision B-138942.
Article VII - Americans with Disabilities Act of 1990
Subrecipients must comply with the requirements of Titles I, II, and III of the Americans with Disabilities Act, Pub.
L. No. 101-336 (1990) (codified as amended at 42 U.S.C. sections 12101-12213), which prohibits Subrecipients
from discriminating on the basis of disability in the operation of public entities, public and private transportation
systems, places of public accommodation, and certain testing entities.
Article Vill - Duplication of Benefits
Any cost allocable to a particular federal financial assistance award provided for in 2 C.F.R. Part 200, Subpart E
may not be charged to other federal financial assistance awards to overcome fund deficiencies; to avoid
restrictions imposed by federal statutes, regulations, or federal financial assistance award terms and conditions;
or for other reasons. However, these prohibitions would not preclude Subrecipients from shifting costs that are
allowable under two or more awards in accordance with existing federal statutes, regulations, or the federal
financial assistance award terms and conditions.
Article IX - Copyright
Subrecipients must affix the applicable copyright notices of 17 U.S.C. sections 401 or 402 and an
acknowledgement of U.S. Government sponsorship (including the award number) to any work first produced
under federal financial assistance awards.. -
Article X - Civil Rights Act of 1968
Subrecipients must comply with Title VIII of the Civil Rights Act of 1968, Pub. L. No. 90-284, as amended through
Pub. L. 113-4, which prohibits Subrecipients from discriminating in the sale, rental, financing, and advertising of
dwellings, or in the provision of services in connection therewith, on the basis of race, color, national origin,
religion, disability, familial status, and sex (see 42 U.S.C. section 3601 et seq.), as implemented by the U.S.
Department of Housing and Urban Development at 24 C.F.R. Part 100. The prohibition on disability discrimination
includes the requirement that new multifamily housing with four or more dwelling units-i.e., the public and
common use areas and individual apartment units (all units in buildings with elevators and ground -floor units in
buildings without elevators) -be designed and constructed with certain accessible features. (See 24 C.F.R. Part
100, Subpart D.)
Article XI - Best Practices for Collection and Use of Personally Identifiable Information (PII)
Subrecipients who collect PII are required to have a publicly available privacy policy that describes standards on
the usage and maintenance of the PII they collect. DHS defines personally identifiable information (PII) as any
information that permits the identity of an individual to be directly or indirectly inferred, including any information
that is linked or linkable to that individual. Subrecipients may also find the DHS Privacy Impact Assessments:
Privacy Guidance and Privacy Template as useful resources respectively.
Article XII - Limited English Proficiency (Civil Rights Act of 1964, Title VI)
Subrecipients must comply with Title VI of the Civil Rights Act of 1964, (42 U.S.C. section 2000d et seq.)
prohibition against discrimination on the basis of national origin, which requires that Subrecipients of federal
financial assistance take reasonable steps to provide meaningful access to persons with limited English
proficiency (LEP) to their programs and services. For additional assistance and information regarding language
access obligations, please refer to the DHS Recipient Guidance: https://www.dhs.gov/guidance-published-help-
department-supported-organizations-provide-meaningful-accesspeople- limited and additional resources on
http://www.lep.gov.
Article XIII - Hotel and Motel Fire Safety Act of 1990
In accordance with Section 6 of the Hotel and Motel Fire Safety Act of 1990, 15 U.S.C. section 2225a,
Subrecipients must ensure that all conference, meeting, convention, or training space funded in whole or in part
with federal funds complies with the fire prevention and control guidelines of the Federal Fire Prevention and
Control Act of 1974, (codified as amended at 15 U.S.C. section 2225.)
Article XIV -Disposition of Equipment Acquired Under the Federal Award
When original or replacement equipment acquired under this award by the Recipient or its sub -recipients is no
longer needed for the original project or program or for other activities currently or previously supported by
DHS/FEMA, you must request instructions from DHS/FEMA to make proper disposition of the equipment pursuant
to 2 C.F.R. Section 200.313.
Article XV - Patents and Intellectual Property Rights
Subrecipients are subject to the Bayh-Dole Act, 35 U.S.C. section 200 et seq, unless otherwise provided by law.
Subrecipients are subject to the specific requirements governing the development, reporting, and disposition of
rights to inventions and patents resulting from federal financial assistance awards located at 37 C.F.R. Part 401
and the standard patent rights clause located at 37 C.F.R. section 401.14.
Article XVI - DHS Specific Acknowledgements and Assurances
All recipients, subrecipients, successors, transferees, and assignees must acknowledge and agree to comply with
applicable provisions governing DHS access to records, accounts, documents, information, facilities, and staff. 1.
Subrecipients must cooperate with any compliance reviews or compliance investigations conducted by DHS. 2.
Subrecipients must give DHS access to, and the right to examine and copy, records, accounts, and other
documents and sources of information related to the federal financial assistance award and permit access to
facilities, personnel, and other individuals and information as may be necessary, as required by DHS regulations
and other applicable laws or program guidance. 3. Subrecipients must submit timely, complete, and accurate
reports to the appropriate DHS officials and maintain appropriate backup documentation to support the reports. 4.
Subrecipients must comply with all other special reporting, data collection, and evaluation requirements, as
prescribed by law or detailed in program guidance.
Article XVII - Procurement of Recovered Materials
States, political subdivisions of states, and their contractors must comply with Section 6002 of the Solid Waste
Disposal Act, Pub. L. No. 89-272 (1965), (codified as amended by the Resource Conservation and Recovery Act,
42 U.S.C. section 6962.) The requirements of Section 6002 include procuring only items designated in guidelines
of the Environmental Protection Agency (EPA) at 40 C.F.R. Part 247 that contain the highest percentage of
recovered materials practicable, consistent with maintaining a satisfactory level of competition.
Article XVIII - Terrorist Financing
Subrecipients must comply with E.O. 13224 and U.S. laws that prohibit transactions with, and the provisions of
resources and support to, individuals and organizations associated with terrorism. Subrecipients are legally
responsible to ensure compliance with the Order and laws.
Article XIX - Civil Rights Act of 1964 - Title VI
Subrecipients must comply with the requirements of Title VI of the Civil Rights Act of 1964 (codified as amended
at 42 U.S.C. section 2000d et seq.), which provides that no person in the United States will, on the grounds of
race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to
discrimination under any program or activity receiving federal financial assistance. DHS implementing regulations
for the Act are found at 6 C.F.R. Part 21 and 44 C.F.R. Part 7.
Article XX - Prior Approval for Modification of Approved Budget
Before making any change to the DHS/FEMA approved budget for this award, you must request prior written
approval from DHS/FEMA where required by 2 C.F.R. Section 200.308. DHS/FEMA is also utilizing its discretion
to impose an additional restriction under 2 C.F.R. Section 200.308(e) regarding the transfer of funds among direct
cost categories, programs, functions, or activities. Therefore, for awards with an approved budget where the
Federal share is greater than the simplified acquisition threshold (currently $250,000), you may not transfer funds
among direct cost categories, programs, functions, or activities without prior written approval from DHS/FEMA
where the cumulative amount of such transfers exceeds or is expected to exceed ten percent (10%) of the total
budget DHS/FEMA last approved. You must report any deviations from your DHS/FEMA approved budget in the
first Federal Financial Report (SF-425) you submit following any budget deviation, regardless of whether the
budget deviation requires prior written approval.
Article XXI -Acknowledgement of Federal Funding from DHS
Subrecipients must acknowledge their use of federal funding when issuing statements, press releases, requests
for proposal, bid invitations, and other documents describing projects or programs funded in whole or in part with
federal funds.
Article XXII - Acceptance of Post Award Changes
In the event FEMA determines that changes are necessary to the award document after an award has been
made, including changes to period of performance or terms and conditions, Subrecipients will be notified of the
changes in writing. Once notification has been made, any subsequent request for funds will indicate Subrecipient
acceptance of the changes to the award.
Article XXIII - Rehabilitation Act of 1973
Subrecipients must comply with the requirements of Section 504 of the Rehabilitation Act of 1973, Pub. L. No. 93-
112 (1973), (codified as amended at 29 U.S.C. section 794,) which provides that no otherwise qualified
handicapped individuals in the United States will, solely by reason of the handicap, be excluded from participation
in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal
financial assistance.
Article XXIV - False Claims Act and Program Fraud Civil Remedies
Subrecipients must comply with the requirements of the False Claims Act, 31 U.S.C. sections 3729-3733, which
prohibits the submission of false or fraudulent claims for payment to the federal government. (See 31 U.S.C.
sections 3801-3812, which details the administrative remedies for false claims and statements made.)
Article XXV - Nondiscrimination in Matters Pertaining to Faith -Based Organizations
It is DHS policy to ensure the equal treatment of faith -based organizations in social service programs
administered or supported by DHS or its component agencies, enabling those organizations to participate in
providing important social services to beneficiaries. Subrecipients must comply with the equal treatment policies
and requirements contained in 6 C.F.R. Part 19 and other applicable statues, regulations, and guidance
governing the participations of faith -based organizations in individual DHS programs.
Article XXVI - Lobbying Prohibitions
Subrecipients must comply with 31 U.S.C. section 1352, which provides that none of the funds provided under a
federal financial assistance award may be expended by the Subrecipient to pay any person to influence, or
attempt 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 any federal action related to a federal
award or contract, including any extension, continuation, renewal, amendment, or modification.
Article XXVII - Education Amendments of 1972 (Equal Opportunity in Education Act) - Title IX
Subrecipients must comply with the requirements of Title IX of the Education Amendments of 1972, Pub. L. No.
92-318 (1972) (codified as amended at 20 U.S.C. section 1681 et seq.), which provide that no person in the
United States will, on the basis of sex, be excluded from participation in, be denied the benefits ot, or be
subjected to discrimination under any educational program or activity receiving federal financial assistance. DHS
implementing regulations are codified at 6 C.F.R. Part 17 and 44 C.F.R. Part 19.
Article XXVIII - Age Discrimination Act of 1975
Subrecipients must comply with the requirements of the Age Discrimination Act of 1975, Pub. L. No. 94-135
(1975) (codified as amended at Title 42, U.S. Code, section 6101 et seq.), which prohibits discrimination on the
basis of age in any program or activity receiving federal financial assistance.
Article XXIX - National Environmental Policy Act
Subrecipients must comply with the requirements of the National Environmental Policy Act of 1969 (NEPA), Pub.
L. No. 91-190 (1970) (codified as amended at 42 U.S.C. section 4321 et seq.) and the Council on Environmental
Quality (CEQ) Regulations for Implementing the Procedural Provisions of NEPA, which require Subrecipients to
use all practicable means within their authority, and consistent with other essential considerations of national
policy, to create and maintain conditions under which people and nature can exist in productive harmony and fulfill
the social, economic, and other needs of present and future generations of Americans.
Article XXX - Assurances, Administrative Requirements, Cost Principles, Representations and
Certifications
DHS financial assistance Subrecipients must complete either the Office of Management and Budget (OMB)
Standard Form 424B Assurances - Non -Construction Programs, or OMB Standard Form 424D Assurances -
Construction Programs, as applicable. Certain assurances in these documents may not be applicable to your
program, and the DHS financial assistance office (DHS FAO) may require applicants to certify additional
assurances. Applicants are required to fill out the assurances applicable to their program as instructed by the
awarding agency. Subrecipients are required to follow the applicable provisions of the Uniform Administrative
Requirements, Cost Principles, and Audit Requirements for Federal Awards located at Title 2, Code of Federal
Regulations (C.F.R.) Part 200, and adopted by DHS at 2 C.F.R. Part 3002.
Article XXXI - USA PATRIOT Act of 2001
Subrecipients must comply with requirements of Section 817 of the Uniting and Strengthening America by
Providing Appropriate Tools Required to Intercept and Obstruct Terrorism Act of 2001 (USA PATRIOT Act), Pub
L. No. 107-56, which amends 18 U.S.C. sections 175-175c.
Article XXXII - Non -Supplanting Requirement
Subrecipients receiving federal financial assistance awards made under programs that prohibit supplanting by law
must ensure that federal funds do not replace (supplant) funds that have been budgeted for the same purpose
through non-federal sources.
Article XXXIII - Drug -Free Workplace Regulations
Subrecipients must comply with drug -free workplace requirements in Subpart B (or Subpart C, if the Subrecipient
is an individual) of 2 C.F.R. Part 3001, which adopts the Government -wide implementation (2 C.F.R. Part 182) of
Sec. 5152-5158 of the Drug -Free Workplace Act of 1988 (41 U.S.C. sections 8101-8106).
Article XXXIV - Universal Identifier and System of Award Management
Subrecipients are required to comply with the requirements set forth in the government -wide financial assistance
award term regarding the System for Award Management and Universal Identifier Requirements located at 2
C.F.R. Part 25, Appendix A, the full text of which is incorporated here by reference.
Article XXXVI - Energy Policy and Conservation Act
Subrecipients must comply with the requirements of the Energy Policy and Conservation Act, Pub. L. No. 94- 163
(1975) (codified as amended at 42 U.S.C. section 6201 et seq.), which contain policies relating to energy
efficiency that are defined in the state energy conservation plan issued in compliance with this Act.
Article XXXVII - Whistleblower Protection Act
Subrecipients must comply with the statutory requirements for whistleblower protections (if applicable) at 10
U.S.0 section 2409, 41 U.S.C. section 4712, and 10 U.S.C. section 2324, 41 U.S.C. sections 4304 and 4310.
Article XXXVIII - Federal Debt Status
M
All Subrecipients are required to be non -delinquent in their repayment of any federal debt. Examples of relevant
debt include delinquent payroll and other taxes, audit disallowances, and benefit overpayments. (See OMB
Circular A-129.)
Article XXXIX - Use of DHS Seal, Logo and Flags
Subrecipients must obtain permission from DHS FAO prior to using the DHS seal(s), logos, crests or
reproductions of flags or likenesses of DHS agency officials, including use of the United States Coast Guard seal,
logo, crests or reproductions of flags or likenesses of Coast Guard officials.
Article XL - Notice of Funding Opportunity Requirements
All the instructions, guidance, limitations, and other conditions set forth in the Notice of Funding Opportunity
(NOFO) for this program are incorporated here by reference in the award terms and conditions. All Subrecipients
must comply with any such requirements set forth in the program NOFO.
Article XLI - SAFECOM
Subrecipients receiving federal financial assistance awards made under programs that provide emergency
communication equipment and its related activities must comply with the SAFECOM Guidance for Emergency
Communication Grants, including provisions on technical standards that ensure and enhance interoperable
communications.