10-0415_SANTA ANA, CITY OF_Agr for Transf or PurchINSURANCE NOT REQUIRED
WORK MAY PROCEED
CLERK OF COUNCIL
DATE:
SUB -RECIPIENT
City Contract Number
AGREEMENT
SAN JUAN CAPISTRANO
0
A-2009-123-021
TABLE OF CONTENTS
Section Description Paae
INTRODUCTION
§101. Parties to the Agreement 3
§102. Representatives of the Parties and Service of Notices 3
§103. Independent Party 4
§104. Conditions Precedent to Execution of this Agreement 4
TERM AND SERVICES TO BE PROVIDED
§201. Time of Performance
§202. Use of Grant Funds
III
PAYMENT
§301. Payment of Grant Funds and Method of Payment
IV
STANDARD PROVISIONS
§401.
Construction of Provisions and Titles Herein
9
§402.
Applicable Law, Interpretation and Enforcement
9
§403.
Integrated Agreement
9
§404.
Excusable Delays
9
§408.
Breach
10
§406.
Prohibition Against Assignment or Delegation
10
§407.
Permits
10
§408.
Non Discrimination and Affirmative Action
10
§409.
Bonds
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Section Description
TABLE OF CONTENTS
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§410. Indemnification
§411. Conflict of Interest
§412. Restriction on Disclosures
§413. Statutes and Regulations Applicable to All Grant Contracts
§414. Federal, State, and Local Taxes
§415. Inventions, Patents and Copyrights
§416. MBENVBE
V
DEFAULTS, SUSPENSION, TERMINATION, AND AMENDMENTS
§501. Defaults
§502. Amendments
V
ENTIRE AGREEMENT
§601. Complete Agreement
§602. Number of Pages and Attachments
Execution (Signature) Page
EXHIBITS
Exhibit A Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion Lower Tier Covered Transactions
Exhibit B Certification Regarding Lobbying
Exhibit C Grant Assurances
Exhibit D Reimbursement Request for Grant Expenditures
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Paqe
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Agreement Number:
AGREEMENT FOR TRANSFER OR PURCHASE OF EQUIPMENT/SERVICES OR FOR
REIMBURSEMENT OF TRAINING COSTS
FOR FY2009 URBAN AREAS SECURITY INITIATIVE (UASI)
BETWEEN
THE CITY OF SANTA ANA
AND THE CITY OF SAN JUAN CAPISTRANO
{�
April 2010
THIS AGREEMENT is made and entered into this /5 day of Becembef,4ee"y and
between the CITY OF SANTA ANA, a municipal corporation (the "CITY'), and the CITY
OF SAN JUAN CAPISTRANO (the "SUB -RECIPIENT' or "Contractor").
WITNESSETH
WHEREAS, CITY, acting through the Santa Ana Police Department in its
capacity as a Core City for the Anaheim/Santa Ana Urban Area under the FY09 Urban
Areas Security Initiative, has applied for, received and accepted a grant entitled "FY
2009 Urban Areas Security Initiative" from the federal Department Of Homeland
Security — Office of Grants and Training, through the State of California Emergency
Management Agency, to enhance countywide emergency preparedness (the "grant'),
as set forth in the grant guidelines and assurances that are incorporated to this
Agreement by reference and located at:
hftp://www.ohs.ca.gov/pdf/FY09_Fed—Guidance.pdf
http://www.ohs.ca.gov/pdf/FY09_HSGP_Supplement—Guidance final.pdf
Copies of the grant guidelines shall be retained in the Anaheim/Santa Ana
Grant Office.
WHEREAS, this financial assistance is administered by the CITY OF SANTA
ANA ("CITY') and is overseen by the California Emergency Management Agency
("Cal-EMA"); and
WHEREAS, this financial assistance is being provided to address the unique
equipment, training, planning, and exercise needs of large urban areas, and to assist
them in building an enhanced and sustainable capacity to prevent, respond to, and
recover from threats or acts of terrorism; and
WHEREAS, the Anaheim/Santa Ana Urban Area ("ASAUK) consists of 34 cities
in Orange County, including the City of Santa Ana and the City of Anaheim, the County
of Orange, including the unincorporated area of the County of Orange, Santa Ana
School Police, California State University, Fullerton, University of California, Irvine, and
the Orange County Fire Authority; and
WHEREAS, the Office of Grants and Training ("G&T") awarded a FY09 UASI
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Grant of $10,218,440 ("Grant Funds") to the CITY OF SANTA ANA, as a Core City, for
use in the ASAUA; and
WHEREAS, the CITY has designated the Chief of Police and the Santa Ana
Police Department, Homeland Security Division ("UASI Grant Office") to provide for
terrorism prevention and emergency preparedness; and
WHEREAS, the UASI Grant Office now wishes to distribute FY09 UASI Grant
Funds throughout the ASAUA, as further detailed in this Agreement ("Agreement') to
the CITY OF SAN JUAN CAPISTRANO ("SUB -RECIPIENT') and others;
WHEREAS, the CITY and SUB -RECIPIENT are desirous of executing this
Agreement as authorized by the City Council and the City Manager which authorizes
the CITY to prepare and execute the Agreement.
NOW, THEREFORE, IT IS MUTUALLY AGREED AS FOLLOWS:
INTRODUCTION
§101. Parties to the Agreement
The parties to this Agreement are:
A. The CITY, a municipal corporation, having its principal office at 20 Civic Center
Plaza, Santa Ana, CA 92702; and
B. CITY OF SAN JUAN CAPISTRANO, a municipal corporation, 32400 Paseo
Adelanto, San Juan Capistrano, CA 92675
§102. Representatives of the Parties and Service of Notices
A. The representatives of the respective parties who are authorized to administer
this Agreement and to whom formal notices, demands and communications
shall be given are as follows:
1. The representative of the City of Santa Ana shall be, unless otherwise
stated in the Agreement:
Ken Gominsky, Commander
Santa Ana Police Department
Homeland Security Division
60 Civic Center Plaza
Santa Ana, CA. 92702
Phone: (714) 245-8040
Fax: (714) 245-8745
kgominsky@santa-ana.org
2. The representative of the CITY OF SAN JUAN CAPISTRANO shall be:
Daniel Dwyer, Lieutenant
City of San Juan Capistrano Police Services
32400 Paseo Adelanto
San Juan Capistrano, CA 92676
Phone: 949-425-1840
ddwyer@sanjuancapistrano.org
B. Formal notices, demands and communications to be given hereunder by
either party shall be made in writing and may be effected by personal
delivery or by registered or certified mail, postage prepaid, return receipt
requested and shall be deemed communicated as of the date of mailing.
C. If the name of the person designated to receive the notices, demands or
communications or the address of such person is changed, written notice
shall be given, in accord with this section, within five (5) business days of
said change.
§103. Independent Party
SUB -RECIPIENT is acting hereunder as an independent party, and not as an
agent or employee of the CITY OF SANTA ANA. No employee of SUB -
RECIPIENT is, or shall be an employee of the CITY OF SANTA ANA by virtue of
this Agreement, and SUB -RECIPIENT shall so inform each employee organization
and each employee who is hired or retained under this Agreement. SUB -
RECIPIENT shall not represent or otherwise hold out itself or any of its directors,
officers, partners, employees, or agents to be an agent or employee of the CITY
OF SANTA ANA.
§104. Conditions Precedent to Execution of This Agreement
SUB -RECIPIENT shall provide copies of the following documents to the CITY OF
SANTA ANA, unless otherwise exempted.
A. Grant Assurances in accordance with section 415C of this Agreement attached
hereto as Exhibit C and made part hereof.
B. Certifications Regarding Ineligibility, Suspension and Debarment as required
by Executive Order 12549 in accordance with Section 415Al2 of this
Agreement and attached hereto as Exhibit A and made a part hereof.
C. Certifications and Disclosures Regarding Lobbying in accordance with Section
415C of this Agreement and attached hereto as Exhibit B and made a part
hereof. SUB -RECIPIENT shall also file a Disclosure Form at the end of each
calendar quarter in which there occurs any event requiring disclosure or
which materially affects the accuracy of the information contained in any
Disclosure Form previously filed by SUB -RECIPIENT.
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TERM AND SERVICES TO BE PROVIDED
§201. Time of Performance
The term of this Agreement shall commence on September 29, 2009 and end
on March 31, 2012 or upon the final disbursement of all of the Grant Amount
(as defined in Section 301) and any additional period of time as is required to
complete any necessary close out activities. Said term is subject to the
provisions herein.
§202. Use of Grant Funds
A. CITY may, a) transfer to SUB -RECIPIENT, equipment or services
purchased with grant funds and in accordance with grant guidelines set
forth above; or, b) reimburse SUB -RECIPIENT for purchase of authorized
equipment, exercises, services or training upon receiving prior written
approval from CITY or its designee and in accordance with grant guidelines
and in full compliance with all of the SUB -RECIPIENT'S purchasing and
bidding procedures. SUB -RECIPIENT shall specify the equipment,
services, exercises and training to be purchased using the Application for
Project Funding. A paper copy of this document will be provided to SUB -
RECIPIENT by CITY. In addition, a compact disc with a copy of the
document will be provided to SUB -RECIPIENT by CITY. Further, CITY will
e-mail a copy of the document to SUB -RECIPIENT. If additional copies of
the document are needed, SUB -RECIPIENT may contact the Santa Ana
Grant Coordinator and it will be provided.
B. SUB -RECIPIENT shall provide any reports requested by the CITY regarding
the performance of the Agreement. Reports shall be in the form requested by
the CITY, and shall be provided in a timely manner.
C. The Authorized Equipment List (AEL) is a list of the allowable equipment
which may be purchased pursuant to this Agreement and is located at
httos://www.rkb.us, and incorporated to this Agreement by reference. A
copy of the AEL shall be retained in the Anaheim/Santa Ana Grant Office.
Unless otherwise stated in program guidance any equipment acquired
pursuant to this Agreement shall meet all mandatory regulations and/or
DHS -adopted standards to be eligible for purchase using grant funds. SUB -
RECIPIENT shall provide the CITY a copy of its most current procurement
guidelines and follow its own procurement requirements as long as they
meet the minimum federal requirements. Federal procurement requirements
for the FY 09 UASI Grant can be found at OMB Circular A-102, Title 44
C.F.R. Part 13.36, and the Office of G&T Financial Management Guide.
Any equipment acquired or obtained with Grant Funds:
1. Shall be made available under the California Disaster and Civil
Defense Master Mutual Aid Agreement in consultation with
representatives of the various fire, emergency medical, hazardous
materials response services, and law enforcement agencies within
the jurisdiction of the applicant;
Shall be consistent with needs as identified in the State Homeland
Security Strategy and deployed in conformance with that plan;
Shall be made available pursuant to applicable terms of the
California Disaster and Civil Defense Master Mutual Aid Agreement
and deployed with personnel trained in the use of such equipment in
a manner consistent with the California Law Enforcement Mutual Aid
Plan or the California Fire Services and Rescue Mutual Aid Plan;
4. Shall be subject to the requirements of Title 44, C.F.R. 13.32, 13.33
and Office of G&T Financial Management Guide. For the purposes of
this subsection, "Equipment" is defined as nonexpendable property
that is not consumed or does not lose its identity by being
incorporated into another item of equipment, which costs $5,000 or
more per unit, or is expected to have a useful life of one (1) year or
more. Items costing less than $5,000, but falling into the following
categories are also considered Equipment: (1)electronics
communications equipment for stationary or vehicular use, including
cellular telephones acquired by lease or purchase, and (2) electronic
office equipment, including facsimile machines, copiers, electric
typewriters, personal computers (monitors and CPU's), terminals and
printers;
5. Shall be used by SUB -RECIPIENT in the program or project for
which it was acquired as long as needed, whether or not the project
or program continues to be supported by Federal funds. When no
longer useful for the original program or project, the Equipment may
be used in other activities currently or previously supported by a
Federal agency.
6. Shall be made available for use on other projects or programs
currently or previously supported by the Federal Government,
providing such use will not interfere with the work on the projects or
program for which it was originally acquired. First preference for
other use shall be given to other programs or projects supported by
the awarding agency.
7. Shall be recorded on a ledger. This record must be updated bi-
annually and forwarded to the City. The record shall include: (a)
description of the item of Equipment, (b) manufacturer's model and
serial number, (c) Federal Stock number, national stock number, or
other identification number; (d) the source of acquisition of the
Equipment, including the award number, (e) date of acquisition; (f)
the per unit acquisition cost of the' Equipment, (g) records showing
maintenance procedures to keep the Equipment in good running
order, and (h) location and condition of Equipment. Records must be
retained pursuant to 44 C.F.R. Part 13.42, and Office of G&T.
8. All equipment obtained under this Agreement shall have an ASAUA
identification decal affixed to it, and, when practical, shall be affixed
where it is readily visible.
9. A physical inventory of the Equipment shall be taken and the results
reconciled with the Equipment records at least once every year.
Inventory shall also be taken prior to any UASI, State or Federal
monitor visits.
10. SUB -RECIPIENT shall exercise due care to preserve and
safeguard equipment acquired with grant funds from damage or
destruction and shall provide regular maintenance and such repairs
for said equipment as necessary, in order to keep said equipment
continually in good working order. Such maintenance and servicing
shall be the sole responsibility of SUB -RECIPIENT, who shall
assume full responsibility for maintenance and repair of the
equipment throughout the life of said equipment.
D. Any training paid pursuant to this Agreement shall conform to the guidelines
as listed in FY 2009 Homeland Security Grant Program, as set forth above.
All training expenses must be pre -authorized by Cal-EMA at
http://www.firstrespondertraining.gov/admin. A catalogue of Grantor
approved and sponsored training courses is available at
http://www.firstrespondertraining.gov/odp_webforms.
E. Any exercise paid pursuant to this Agreement shall conform to the guidelines as
listed in FY 2009 Homeland Security Grant Program, as set forth above.
Detailed Homeland Security Exercise and Evaluation Program Guidance is
available at http://hseep.dhs.gov.
F. Any planning paid pursuant to this Agreement shall conform to the guidelines
as listed in FY 2009 Homeland Security Grant Program, as set forth above.
G. Any organizational activities paid pursuant to this Agreement shall conform to
the guidelines as listed in FY 2009 Homeland Security Grant Program, as set
forth above.
III
PAYMENT
§301. Payment of Grant Funds and Method of Payment
A. CITY may, a) transfer to SUB -RECIPIENT, equipment or services purchased
with grant funds; or, b) reimburse SUB -RECIPIENT for the purchase of
authorized equipment, exercises, services or training upon receiving prior written
approval from CITY or its designee and in accordance with grant guidelines and
in full compliance with all of the SUB -RECIPIENT'S purchasing and bidding
procedures. SUB -RECIPIENT shall specify the equipment, exercises, services
or training to be purchased using the Application for Project Funding. A paper
copy of this document will be provided to SUB -RECIPIENT by CITY. In
addition, a compact disc with a copy of the document will be provided to SUB -
RECIPIENT by CITY. Further, CITY will e-mail a copy of the document to
SUB -RECIPIENT. If additional copies of the document are needed, SUB -
RECIPIENT may contact the Santa Ana Grant Coordinator and it will be
provided. Funds may be used for planning, exercises, organizational and
training activities, and the purchase of equipment as described in Section 202
above.
B. SUB -RECIPIENT shall provide quarterly invoices to the CITY requesting
payment and all supporting documentation. Each reimbursement request shall
be accompanied by the Reimbursement Request for Grant Expenditures
(attached hereto as Exhibit D) detailing the expenditures made by SUB -
RECIPIENT as authorized by Section 202 above. For equipment for which
SUB -RECIPIENT is requesting reimbursement, all appropriate back-up
documentation must be attached to the reimbursement form, including
invoices, proof of payment and packing slips. For training reimbursements,
SUB -RECIPIENT must include a copy of any certificates issued or a copy of
the class roster verifying training attendees, proof that an Cal-EMA tracking
number has been assigned to the course, timesheets and payroll registers for
all training attendees, and receipts for travel expenses related to the training.
For regional project reimbursements, SUB -RECIPIENT must include approval
from the lead agency for all submitted invoices.
C. Payment of final invoice shall be withheld by the CITY until the SUB -
RECIPIENT has turned in all supporting documentation and completed the
requirements of this Agreement.
D. It is understood that the CITY makes no commitment to fund this
Agreement beyond the terms set forth herein.
E. Funding for all periods of this Agreement is subject to the continuing
availability to the CITY of federal funds for this program. The Agreement may
be terminated immediately upon written notice to SUB -RECIPIENT of a loss or
reduction of federal grant funds.
IV
STANDARD PROVISIONS
§401. Construction of Provisions and Titles Herein
All titles or subtitles appearing herein have been inserted for convenience and
shall not be deemed to affect the meaning or construction of any of the terms or
provisions hereof. The language of this Agreement shall be construed according
to its fair meaning and not strictly for or against either party. The word
"Sub -recipient" herein and in any amendments hereto includes the party or
parties identified in this Agreement. The singular shall include the plural. If
there is more than one Sub -recipient as identified herein, unless expressly
stated otherwise, their obligations and liabilities hereunder shall be joint and
several. Use of the feminine, masculine, or neuter genders shall be deemed to
include the genders not used.
§402. Applicable Law, Interpretation and Enforcement
Each party's performance hereunder shall comply with all applicable laws of the
United States of America, the State of California, and the CITY. This
Agreement shall be enforced and interpreted under the laws of the State of
California and the CITY.
If any part, term or provision of this Agreement shall be held void, illegal,
unenforceable, or in conflict with any law of a federal, state or local government
having jurisdiction over this Agreement, the validity of the remaining portions of
provisions shall not be affected thereby.
§403. Integrated Agreement
This Agreement sets forth all of the rights and duties of the parties with respect to
the subject matter hereof, and replaces any and all previous agreements or
understandings, whether written or oral, relating thereto. This Agreement may be
amended only by a written instrument executed by both parties hereto.
§404. Excusable Delays
In the event that performance on the part of any party hereto shall be delayed or
suspended as a result of circumstances beyond the reasonable control and
without the fault and negligence of said party, none of the parties shall incur any
liability to the other parties as a result of such delay or suspension.
Circumstances deemed to be beyond the control of the parties hereunder shall
include, but not be limited to, acts of God or of the public enemy; insurrection;
acts of the Federal Government or any unit of State or Local Government in
either sovereign or contractual capacity; fires; floods; epidemics; quarantine
restrictions; strikes, freight embargoes or delays in transportation; to the extent
that they are not caused by the party's willful or negligent acts or omissions and
to the extent that they are beyond the party's reasonable control.
§405. Breach
Except for excusable delays, if any party fails to perform, in whole or in part, any
promise, covenant, or agreement set forth herein, or should any representation
made by it be untrue, any aggrieved party may avail itself of all rights and
remedies, at law or equity, in the courts of law. Said rights and remedies are
cumulative of those provided for herein except that in no event shall any party
recover more than once, suffer a penalty or forfeiture, or be unjustly
compensated.
§406. Prohibition Against Assignment or Delegation
SUB -RECIPIENT may not, unless it has first obtained the written permission of
the CITY:
A. Assign or otherwise alienate any of its rights hereunder, including the right
to payment; or
B. Delegate, subcontract, or otherwise transfer any of its duties hereunder.
§407. Permits
SUB -RECIPIENT and its officers, agents and employees shall obtain and
maintain all permits and licenses necessary for SUB -RECIPIENT performance
hereunder and shall pay any fees required therefore. SUB -RECIPIENT further
certifies to immediately notify the CITY of any suspension, termination, lapses,
non renewals or restrictions of licenses, certificates, or other documents.
§405. Nondiscrimination and Affirmative Action
SUB -RECIPIENT shall comply with the applicable nondiscrimination and
affirmative action provisions of the laws of the United States of America, the
State of California, and the CITY. In performing this Agreement, SUB -
RECIPIENT shall not discriminate in its employment practices against any
employee or applicant for employment because of such person's race,
religion, national origin, ancestry, sex, sexual orientation, age, physical
handicap, mental disability, marital status, domestic partner status or medical
condition. SUB -RECIPIENT shall comply with Executive Order 11246,
entitled "Equal Employment Opportunity," as amended by Executive Order
11375, and as supplemented in Department of Labor regulations (41 CRF
Part 60).
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If required, SUB -RECIPIENT shall submit an Equal Employment Opportunity
Plan ("EEOP") to the DOJ Office of Civil Rights'("OCR") in accordance with
guidelines listed at hftp://www.ojp.usdoj.gov/ocr/eeop.htm,
Any subcontract entered into by the SUB-RICIPIENT relating to this Agreement,
to the extent allowed hereunder, shall be subject to the provisions of this § 408.
§409. Bonds
SUB -RECIPIENT must purchase a performance bond for any equipment item
over $250,000 or any vehicle (including aircraft or watercraft) financed with
homeland security funds.
§410. Indemnification
Each of the parties to this Agreement is a public entity. In contemplation of the
provisions of Section 895.2 of the Government Code of the State of California
imposing certain tort liability jointly upon public entities, solely by reason of such
entities being parties to an Agreement as defined by Section 895 of said Code, the
parties hereto, as between themselves, pursuant to the authorization contained in
Section 895.4 and 895.6 of said Code, will each assume the full liability imposed
upon it or upon any of its officers, agents; or employees by law, for injury caused
by a negligent or wrongful act or omission occurring in the performance of this
Agreement, to the same extent that such liability would be imposed in the absence
of Section 895.2 of said Code. To achieve the above- stated purpose, each party
indemnifies and holds harmless the other party solely by virtue of said Section
895.2. The provision of Section 2778 of the California Civil Code is made a part
hereto as if fully set forth herein. SUB -RECIPIENT certifies that it has adequate
self insured retention of funds to meet any obligation arising from this Agreement.
§411. Conflict of Interest
A. The SUB -RECIPIENT covenants that none of its directors, officers,
employees, or agents shall participate in selecting, or administrating any
subcontract supported (in whole or in part) by Federal funds where such
person is a director, officer, employee or agent of the subcontractor; or where
the selection of subcontractors is or has the appearance of being motivated by
a desire for personal gain for themselves or others such as family business,
etc.; or where such person knows or should have known that:
1. A member of such person's immediate family, or domestic partner
or organization has a financial interest in the subcontract;
2. The subcontractor is someone with whom such person has or is
negotiating any prospective employment; or
3. The participation of such person would be prohibited by the
California Political Reform Act, California Government Code
§87100 et seq. if such person were a public officer, because such
person would have a "financial or other interest" in the subcontract.
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B. Definitions:
The term "immediate family" includes but is not limited to domestic
partner and/or those persons related by blood or marriage, such as
husband, wife, father, mother, brother, sister, son, daughter, father
in law, mother in law, brother in law, sister in law, son in law,
daughter in law.
2. The term "financial or other interest" includes but is not limited to:
a. Any direct or indirect financial interest in the specific
contract, including a commission or fee, a share of the
proceeds, prospect of a promotion or of future employment,
a profit, or any other form of financial reward.
b. Any of the following interests in the subcontractor
ownership: partnership interest or other beneficial interest of
five percent or more; ownership of five percent or more of
the stock; employment in a managerial capacity; or
membership on the board of directors or governing body.
C. The SUB -RECIPIENT further covenants that no officer, director, employee, or
agent shall solicit or accept gratuities, favors, anything of monetary value from
any actual or potential subcontractor, supplier, a party to a sub agreement, (or
persons who are otherwise in a position to benefit from the actions of any
officer, employee, or agent).
D. The SUB -RECIPIENT shall not subcontract with a former director, officer, or
employee within a one year period following the termination of the relationship
between said person and the Contractor.
E. Prior to obtaining the CITY'S approval of any subcontract, the SUB -
RECIPIENT shall disclose to the CITY any relationship, financial or
otherwise, direct or indirect, of the SUB -RECIPIENT or any of its officers,
directors or employees or their immediate family with the proposed
subcontractor and its officers, directors or employees.
F. For further clarification of the meaning of any of the terms used herein, the
parties agree that references shall be made to the guidelines, rules, and laws
of the SUB -RECIPIENT, State of California, and Federal regulations
regarding conflict of interest.
G. The SUB -RECIPIENT warrants that it has not paid or given and will not pay or
give to any third person any money or other consideration for obtaining this
Agreement.
H. The SUB -RECIPIENT covenants that no member, officer or employee of
SUB -RECIPIENT shall have interest, direct or indirect, in any contract or
subcontract or the proceeds thereof for work to be performed in connection
with this project during his/her tenure as such employee, member or officer or
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for one year thereafter.
I. The SUB -RECIPIENT shall incorporate the foregoing subsections of this
Section into every agreement that it enters into in connection with this project
and shall substitute the term "subcontractor" for the term "SUB -RECIPIENT"
and "sub subcontractor' for "Subcontractor".
§412. Restriction on Disclosures
Any reports, analysis, studies, drawings, information, or data generated as a
result of this Agreement are to be governed by the California Public Records Act
(California Government Code Sec. 6250, et seq.).
§413. Statutes and Regulations Applicable To All Grant Contracts
A. SUB -RECIPIENT shall comply with all applicable requirements of state, federal,
county and SUB -RECIPIENT laws, executive orders, regulations, program and
administrative requirements, policies and any other requirements governing this
Agreement. SUB -RECIPIENT shall comply with state and federal laws and
regulations pertaining to labor, wages, hours, and other conditions of
employment. SUB -RECIPIENT shall comply with new, amended, or revised
laws, regulations, and/or procedures that apply to the performance of this
Agreement. These requirements include, but are not limited to:
Office of Management and Budget (OMB) Circulars
SUB -RECIPIENT shall comply with OMB Circulars, as applicable:
OMB Circular A-21 (Cost Principles for Educational Institutions);
OMB Circular A-87 (Cost Principles for State, Local, and Indian
Tribal Governments); OMB Circular A-102 (Grants and Cooperative
Agreements with State and Local Governments); Common Rule,
Subpart C for public agencies or OMB Circular A-110 (Uniform
Administrative Requirements for Grants and Other Agreements with
Institutions of Higher Education, Hospitals and Other Non -Profit
Organizations); OMB Circular A-122 (Cost Principles for Non -Profit
Organizations); OMB Circular A-133 (Audits of States, Local
Governments, and Non -Profit Organizations.
Single Audit Act
If Federal funds are used in the performance of this Agreement,
SUB -RECIPIENT shall adhere to the rules and regulations of the
Single Audit Act, 31 USC Sec. 7501 et seq.; and any
administrative regulation or field memos implementing the Act.
3. Americans with Disabilities Act
SUB -RECIPIENT hereby certifies that it will comply with the
Americans with Disabilities Act, 42 USC §§ 12101, et seq., and its
implementing regulations. SUB -RECIPIENT will provide reasonable
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accommodations to allow qualified individuals with disabilities to
have access to and to participate in its programs, services and
activities in accordance with the provisions of the Americans with
Disabilities Act. SUB -RECIPIENT will not discriminate against
persons with disabilities or against persons due to their relationship
to or association with a person with a disability. Any subcontract
entered into by the SUB -RECIPIENT, relating to this Agreement, to
the extent allowed hereunder, shall be subject to the provisions of
this paragraph.
4. Political and Sectarian Activity Prohibited
None of the funds, materials, property or services provided directly or
indirectly under this Agreement shall be used for any partisan political
activity, or to further the election or defeat of any candidate for public
office. Neither shall any funds provided under this Agreement be
used for any purpose designed to support or defeat any pending
legislation or administrative regulation. None of the funds provided
pursuant to this Agreement shall be used for any sectarian purpose or
to support or benefit any sectarian activity.
If this Agreement provides for more than $100,000 in grant funds or
more than $150,000 in loan funds, SUB -RECIPIENT shall submit to
the CITY a Certification Regarding Lobbying and a Disclosure Form,
if required, in accordance with 31 USC §1352. A copy of the
Certificate is attached hereto as Exhibit B. No funds will be released
to SUB -RECIPIENT until the Certification is filed.
SUB -RECIPIENT shall file a Disclosure Form at the end of each
calendar quarter in which there occurs any event requiring disclosure
or which materially affects the accuracy of any of the information
contained in any Disclosure Form previously filed by SUB -
RECIPIENT. SUB -RECIPIENT shall require that the language of this
Certification be included in the award documents for all sub -awards
at all tiers and that all subcontractors shall certify and disclose
accordingly.
5. Records Inspection
At any time during normal business hours and as often as the CITY,
the U.S. Comptroller General, and/or the Auditor General of the
State of California may deem necessary, SUB -RECIPIENT shall
make available for examination all of its records with respect to all
matters covered by this Agreement. The CITY, the U.S. Comptroller
General and/or the Auditor General of the State of California shall
have the authority to audit, examine and make excerpts or
transcripts from records, including SUB -RECIPIENT'S invoices,
materials, payrolls, records of personnel, conditions of employment
and other data relating to all matters covered by this Agreement.
14
SUB -RECIPIENT agrees to provide any reports requested by the
CITY regarding performance of the Agreement.
6. Records Maintenance
Records, in their original form, shall be maintained in accordance with
requirements prescribed by the CITY with respect to all matters
covered on file for all documents specified in this Agreement.
Original forms are to be maintained on file for all documents specified
in this Agreement. Such records shall be retained for a period of
three (3) years after termination of this Agreement and after final
disposition of all pending matters. "Pending matters" include, but are
not limited to, an audit, litigation or other actions involving records.
The CITY may, at its discretion, take possession of, retain and audit
said records. Records, in their original form pertaining to matters
covered by this Agreement, shall at all times be retained within the
County of Orange unless authorization to remove them is granted in
writing by the CITY.
Subcontracts and Procurement
SUB -RECIPIENT shall comply with the federal and SUB -
RECIPIENT standards in the award of any subcontracts. For
purposes of this Agreement, subcontracts shall include but not
be limited to purchase agreements, rental or lease agreements,
third party agreements, consultant service contracts and
construction subcontracts.
SUB -RECIPIENT shall ensure that the terms of this Agreement with
the CITY are incorporated into all Subcontractor Agreements. The
SUB -RECIPIENT shall submit all Subcontractor Agreements to the
CITY for review prior to the release of any funds to the
subcontractor. The SUB -RECIPIENT shall withhold funds to any
subcontractor agency that fails to comply with the terms and
conditions of this Agreement and their respective Subcontractor
Agreement.
8, Labor
SUB -RECIPIENT shall comply with the Intergovernmental
Personnel Act of 1970 (42 U.S.C. §§4728-4763) relating to
prescribed requirements for merit systems for programs funded
under one of the 19 statutes or regulations specified in Appendix A
of OPM's Standards for a. Merit, System Personnel Administration
(5 C.F.R. 900, Subpart F).
SUB -RECIPIENT shall comply, as applicable, with the provisions of
the Davis -Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act
(40 U.S.C. §276c and 18 U.S.C. §874), the Contract Work Hours and
Safety Standards Act (40 U.S.C. §§327-333), regarding labor
15
standards for federally -assisted construction subagreements, and the
Hatch Act (5 USC §§1501-1508 and 7324-7328).
SUB -RECIPIENT shall comply with the Federal Fair Labor Standards
Act (29 USC §201) regarding wages and hours of employment. None
of the funds shall be used to promote or deter Union/labor organizing
activities. CA Gov't Code Sec. 16645, et seq.
Civil Rights
SUB -RECIPIENT shall comply with all Federal statutes relating to
nondiscrimination. These include but are not limited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88-352) which prohibits
discrimination on the basis of race, color or national origin; (b) Title IX
of the Education Amendments of 1972, as amended (20 U.S.C.
§§1681- 1683, and 1685-1686), which prohibits discrimination on the
basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as
amended (29 U.S.C. §794), which prohibits discrimination on the
basis of handicaps; (d) The Age Discrimination act of 1975, as
amended (42 U.S.C. §§6101-6107), which prohibits discrimination on
the basis of age; (e) the Drug Abuse Office and Treatment Act of
1972 (P.L. 92-255), as amended, relating to nondiscrimination on the
basis of drug abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation act of 1970
(P.L. 91-616) as amended, relating to nondiscrimination on the basis
of alcohol abuse or alcoholism; (g) §§523 and 527 of the Public
Health Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee 3), as
amended, relating to confidentiality of alcohol and drug abuse patient
records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C.
§§3601, et seq.), as amended, relating to non-discrimination in the
sale, rental or financing of housing; (i) any other nondiscrimination
provisions in the specific statute(s) under which application for
Federal assistance is being made; (j) the requirements of any other
nondiscrimination statute(s) which may apply to the application; and
(k) P.L. 93-348 regarding the protection of human subjects involved
in research, development, and related activities supported by this
award of assistance.
10. Environmental
SUB -RECIPIENT shall comply, or has already complied, with the
requirements of Titles II and III of the Uniform relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646)
which provide for fair and equitable treatment of persons displaced
or whose property is acquired as a result of Federal or federally -
assisted programs. These requirements apply to all interests in real
property acquired for project purposes regardless of Federal
participation in purchases.
SUB -RECIPIENT shall comply with environmental standards which
16
may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National
Environmental Policy Act of 1969 (P.L. 91-190) and Executive
Order (EO) 11514; (b) notification of violating facilities pursuant to
EO 11738; (c) protection of wetlands pursuant to EO 11990; (d)
evaluation of flood hazards in floodplains in accordance with EO
11988; (e) assurance of project consistency with the approved
State management program developed under the Coastal Zone
Management Act of 1972 (16 U.S.C. §§1451, et seq.); (f)
conformity of Federal actions to State (Clean Air) Implementation
Plans under Section 176(c) of the Clean Air Act of 1955, as
amended (42 U.S.C. §§7401, et seq.); (g) protection of
underground sources of drinking water under the Safe Drinking
Water Act of 1974, as amended (P.L. 93-523); (h) protection of
endangered species under the Endangered Species Act of 1973,
as amended (P.L. 93205); and (i) Flood Disaster Protection Act of
1973 §102(a) (P.L. 93-234).
SUB -RECIPIENT shall comply with the Wild and Scenic Rivers Act of
1968 (16 U.S.C. §§1271, et seq.) related to protecting components or
potential components of the national wild and scenic rivers system.
SUB -RECIPIENT shall comply with the Lead -Based Paint Poisoning
Prevention Act (42 U.S.C. §§4801, et seq.) which prohibits the use of
lead- based paint in construction or rehabilitation of residence
structures.
SUB -RECIPIENT shall comply with the Federal Water Pollution
Control Act (33 U.S.C. § 1251, at seq.) which restores and maintains
the chemical, physical and biological integrity of the Nation's waters.
SUB -RECIPIENT shall ensure that the facilities under its ownership,
lease or supervision which shall be utilized in the accomplishment of
this project are not listed in the Environmental Protection Agency's
(EPA) list of Violating Facilities and that it will notify the Federal
Grantor agency of the receipt of any communication from the
Director of the EPA Office of Federal Activities indicating that a
facility to be used in the project is under consideration for listing by
the EPA.
By signing this Agreement, SUB -RECIPIENT ensures that it is in
compliance with the California Environmental Quality Act (CEQA),
Public Resources Code §21000, at seq. and is not impacting the
environment negatively.
SUB -RECIPIENT shall comply with the Energy Policy and
Conservation Act (P.L. 94-163, 89 Stat. 871).
SUB -RECIPIENT shall comply, if applicable, with the provision of the
Coastal Barrier Resources Act (P.L. 97-348) dated October 19, 1982
17
(16 USC 3501, et. seq.),
Federal funds within the
System.
11. Preservation
0
which prohibits the expenditure of most new
units of the Coastal Barrier Resources
SUB -RECIPIENT shall comply with Section 106 of the National
Historic Preservation Act of 1966, as amended (16 U.S.C. §470), EO
11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C.
§§469a-1, et seq.).
12. Suspension and Debarment
SUB -RECIPIENT shall comply with Federal Register, Volume 68,
Number 228, regarding Suspension and Debarment, and SUB -
RECIPIENT shall submit a Certification Regarding Debarment required
by Executive Order 12549 and any amendment thereto. Said
Certification shall be submitted to the CITY concurrent with the
execution of this Agreement and shall certify that neither SUB -
RECIPIENT nor its principals are presently debarred, suspended,
proposed for debarment, declared ineligible or voluntarily excluded
from participation in this transaction by any federal department head
or agency. SUB -RECIPIENT shall require that the language of this
Certification be included in the award documents for all sub -award at
all tiers and that all subcontractors shall certify accordingly.
13. Drug -Free Workplace
SUB -RECIPIENT shall comply with the federal Drug -Free
Workplace Act of 1988, 41 USC §701, 44 CFR Part 67; the
California Drug -Free Workplace Act of 1990, CA Gov't Code §§
8350-8357.
14. Miscellaneous
SUB -RECIPIENT shall comply with the Laboratory Animal Welfare Act
of 1966, as amended (P.L. 89-544, 7 USC §§2131, et seq.).
B. Statutes and Regulations Applicable To This Particular Grant
SUB -RECIPIENT shall comply with all applicable requirements of state and
federal laws, executive orders, regulations, program and administrative
requirements, policies and any other requirements governing this particular
grant program. SUB -RECIPIENT shall comply with new, amended, or revised
laws, regulations, and/or procedures that apply to the performance of this
Agreement. These requirements include, but are not limited to:
Title 44 Code of Federal Regulations (CFR) Part 13; EO 12372;
Department of Justice (DOJ) Office of Judicial Programs (OJP) Office
of the Comptroller, U.S. Department of Homeland Security,
Preparedness Directorate Financial Management Guide; U.S.
Department of Homeland Security, Office of Grants and Training, FY
W.
2009 Homeland Security Grant Program — Program Guidance and
Application Kit; ODP WMD Training Course Catalogue; and DOJ Office
for Civil Rights.
Standardized Emergency Management System (SEMS)
requirements as stated in the California Emergency Services Act,
Government Code Chapter 7 of Division 1 of Title 2, § 8607.1(e) and
CCR Title 19, §§ 2445-2448.
Provisions of 44 CFR applicable to grants and cooperative
agreements, including Part 18, Administrative Review Procedures;
Part 20, Criminal Justice Information Systems; Part 22,
Confidentiality of Identifiable Research and Statistical Information;
Part 23, Criminal Intelligence Systems Operating Policies; Part 30,
Intergovernmental Review of Department of Justice Programs and
Activities; Part 35, Nondiscrimination on the Basis of Disability in
State and Local Government Services; Part 38, Equal Treatment of
Faith -based Organizations; Part 42, Nondiscrimination/Equal
employment Opportunities Policies and Procedures; Part 61,
Procedures for Implementing the National Environmental Policy Act;
Part 63, Floodplain Management and Wetland Protection
Procedures; Part 64, Floodplain Management and Wetland
Protection Procedures; Federal laws or regulations applicable to
federal Assistance Programs; Part 69, New Restrictions on Lobbying;
Part 70, Uniform Administrative Requirements for Grants and
Cooperative Agreements (including sub -awards) with Institutions of
Higher Learning, Hospitals and other Non -Profit Organizations; and
Part 83, Government- Wide Requirements for a Drug Free
Workplace (grants).
Nondiscrimination requirements of the Omnibus Crime Control and
Safe Streets Act of 1968, as amended, 42 USC 3789(d), or the
Juvenile Justice and Delinquency Prevention Act, or the Victims of
Crime Act, as appropriate; the provisions of the current edition of the
Office of Justice Programs Financial and Administrative Guide for
Grants, M7100.1, and all other applicable federal laws, orders,
circulars, or regulations.
2. Travel Expenses
SUB -RECIPIENT as provided herein may be compensated for SUB -
RECIPIENT'S reasonable travel expenses incurred in the
performance of this Agreement, to include travel and per diem,
unless otherwise expressed. Travel including in -State and out -of -
State travel shall not be reimbursed without prior written
authorization from the UASI Grant Office.
SUB -RECIPIENT'S travel and per diem reimbursement costs shall
19
be reimbursed based on the SUB -RECIPIENT'S travel policies
and procedures. If SUB -RECIPIENT does not have established
travel policies and procedures, SUB -RECIPIENT'S reimbursement
rates shall not exceed the amounts established by the State
Department of Personnel Administration Rules and Regulations,
PML 97-024, Section 599.619, dated July 1, 1997 and Section
599.631, and as amended from time to time.
3. Noncompliance
SUB -RECIPIENT understands that failure to comply with any of the
above assurances may result in suspension, termination or reduction
of grant funds, and repayment by SUB -RECIPIENT to CITY of any
unlawful expenditures.
C. Compliance With Grant Assurances
To obtain the Grant Funds, the Grantor required an authorized representative
of the CITY to sign certain promises regarding the way the Grant Funds would
be spent ("Grant Assurances'), attached hereto as Exhibit C. By signing these
Grant Assurances, the CITY became liable to the Grantor for any funds that
are used in violation of the grant requirements. SUB -RECIPIENT shall be
liable to the Grantor for any funds the Grantor determines SUB -RECIPIENT
used in violation of these Grant Assurances. SUB -RECIPIENT shall indemnify
and hold harmless the CITY for any sums the Grantor determines SUB -
RECIPIENT used in violation of the Grant Assurances.
§414. Federal, State and Local Taxes
Federal, State and local taxes shall be the responsibility of SUB -RECIPIENT as
an independent party and not as a CITY employee.
§415. Inventions. Patents and Copyrights
A. Reporting Procedure for Inventions
If any project produces any invention or discovery (Invention) patentable or
otherwise under title 35 of the U.S. Code, including, without limitation,
processes and business methods made in the course of work under this
Agreement, the SUB -RECIPIENT shall report the fact and disclose the
Invention promptly and fully to the CITY. The CITY shall report the fact and
disclose the Invention to the Grantor. Unless there is a prior agreement
between the CITY and the Grantor, the Grantor shall determine whether to
seek protection on the Invention. The Grantor shall determine how the rights in
the Invention, including rights under any patent issued thereon, will be
allocated and administered in, order to protect the public interest consistent
with the policy ("Policy') embodied in the Federal Acquisition Regulations
System, which is based on Ch. 18 of title 35 U.S.C. Sections 200, et seq.
(Pub. L. 95-517, Pub. L. 98-620, 37 CFR part 401); Presidential Memorandum
on Government Patent Policy to the Heads of the Executive Departments and
WC
Agencies, dated 2/18/1983); and Executive�Order 12591, 4/10/87, 52 FR
13414, 3 CFR, 1987 Comp., p. 220 (as"amended by Executive Order 12618,
12/22/87, 52 FR 48661, 3 CFR, 1987 Comp., p. 262). SUB -RECIPIENT
hereby agrees to be bound by the Policy, and will contractually require its
personnel to be bound by the Policy.
B. Rights to Use Inventions
CITY shall have an unencumbered right,
royalty- free license, to use, manufacture,
do so for all government purposes, any
Agreement.
C. Copyright Policy
and a non-exclusive, irrevocable,
improve upon, and allow others to
Invention developed under this
Unless otherwise provided by the terms of the Grantor or of this
Agreement, when copyrightable material ("Material") is developed
under this Agreement, the author or the CITY, at the CITY'S
discretion, may copyright the Material. If the CITY declines to
copyright the Material, the CITY shall have an unencumbered right,
and a non-exclusive, irrevocable, royalty- free license, to use,
manufacture, improve upon,and allow others to do so for all
government purposes, any Material developed under this Agreement.
2. The Grantor shall have an unencumbered right, and a non-exclusive,
irrevocable, royalty -free license, to use, manufacture, improve upon,
and allow others to do so for all government purposes, any Material
developed under this Agreement or any Copyright purchased under
this Agreement.
SUB -RECIPIENT shall comply with 24 CFR 85.34.
D. Rights to Data
The Grantor and the CITY shall have unlimited rights or copyright license to
any data first produced or delivered under this Agreement. "Unlimited rights"
means the right to use, disclose, reproduce, prepare derivative works,
distribute copies to the public, and perform and display publicly, or permit
others to do so; as required by 48 CFR 27.401. Where the data are not first
produced under this Agreement or are published copyrighted data with the
notice of 17 U.S.C. Section 401 or 402, the Grantor acquires the data under a
copyright license as set forth in 48 CFR 27.404(f)(2) instead of unlimited
rights. (48 CFR 27.404(a)).
E. Obligations Binding on Subcontractors
SUB -RECIPIENT shall require all subcontractors to comply with the
obligations of this section by incorporating the terms of this section into all
subcontracts.
21
E
§416. Minority, Women, And Other Business Enterprise Outreach Program
It is the policy of the CITY to provide minority business enterprises (MBEs),
women business enterprises (WBEs) and all other business enterprises an equal
opportunity to participate in the performance of all SUB -RECIPIENT contracts,
including procurement, construction and personal services. This policy applies to
all Contractors and Sub -Contractors.
22
V
DEFAULTS, SUSPENSION, TERMINATION, AND AMENDMENTS
§501. Defaults
Should SUB -RECIPIENT fail for any reason to comply with the contractual
obligations of this Agreement within the time specified by this Agreement, the
CITY reserves the right to terminate the Agreement, reserving all rights under
state and federal law.
§502. Amendments
Any change in the terms of this Agreement, including changes in the services to
be performed by SUB -RECIPIENT and any increase or decrease in the amount of
compensation which are agreed to by the CITY and SUB -RECIPIENT shall be
incorporated into this Agreement by a written amendment properly executed and
signed by the person authorized to bind the parties thereto.
SUB -RECIPIENT agrees to comply with all future CITY Directives, or any rules,
amendments or requirements promulgated by the CITY affecting this
Agreement.
23
E
VI
ENTIRE AGREEMENT
§601. Complete Agreement
0
This Agreement contains the full and Complete Agreement between the two
parties. Neither verbal agreement nor conversation with any officer or employee
of either party shall affect or modify any of the terms and conditions of this
Agreement.
§602. Number of Pages and Attachments
This Agreement is executed in two (2) duplicate originals, each of which is
deemed to be an original. This Agreement includes twenty-five (25) pages and
five (4) Exhibits which constitute the entire understanding and agreement of the
parties.
24
IN WITNESS WHEREOF, the City and the CITY OF SAN JUAN CAPISTRANO have
caused this Agreement to be executed by their duly authorized representatives on the
date first set forth above.
ATTEST:
By: /N72r a_ i fj{irac
Maria D. Huizar
Clerk of the Council
RECOMMENDED FOR APPROVAL:
By: L
Paul
M. Wafters
Chief of Police
CITY OF SANTA ANA, a municipal
Corporation of the State of California
By:
David N. Ream
City Manager
SUB -RECIPIENT
CITY OF SAN JUAN CAPISTRANO
APPRO AS TO FORM: By:tyP
Printe 2 e hoc-- Z-41 T
By:
Ryan . o Title C/T
Depu City A omey '
APPROVED•-
Printed Name
Title miry /�o�P�yEY
25
0
EXHIBIT A
CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER
RESPONSIBILITY MATTERS
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 the applicable CFR covering New Restrictions on Government -wide Debarment and Suspension
(Nonprocurement). The certification shall be treated as a material representation of fact upon which reliance
will be placed when the Agency determines to award the covered transaction or cooperative agreement.
As required by Executive Order 12549, Debarment and Suspension, and implemented under the applicable
CFR, for prospective participants in covered transactions, as defined in the applicable CFR
A. The applicant certifies that it and its principals:
(a) Are not presently debarred, suspended, proposed for debarment, 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 application been convicted of or had a civil
judgment rendered against thein for commission of fraud or a criminal offense in connection
with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction
or contract under a public transaction; violation of Federal or State antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or civilly charged by a government entity
(Federal State or local) with commission of any of these offenses enumerated in paragraph (1)
(b) of this certification; and
(d) Have not within a three-year period preceding this application 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.
'_L�
Wthorized Agent Signature
E 7;2! % 7 -
Printed
Printed or Typed Name
Title
Address: C'yjSTie.
26
�2 yew
,SIflyv'o-f1/ C'101Z T71"I✓oj C4 726 _7J_
1. By signing and submitting this document, the prospective recipient of Federal assistance funds is
providing the certification as set out below.
2. The certification in this clause is a material representation of fact upon which reliance was placed
when this transaction was entered into. If it is later determined that the prospective recipient of
Federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the department or agency with which this transaction originated
may pursue available remedies, including suspension and/or debarment.
3. The prospective recipient of Federal assistance funds shall provide immediate written notice to the
person to whom this agreement is entered, if at any time the prospective recipient of Federal
assistance funds learns that its certification was erroneous, when submitted or has become
erroneous by reason of changed circumstances.
4. The terms "covered transaction," "debarred," "suspended," "Ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549.
5. The prospective recipient of Federal assistance funds agrees by submitting this proposal that, should
the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier
covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily
excluded from participation in this covered transaction, unless authorized by the department or
agency with which this transaction originated.
6. The prospective recipient of Federal assistance funds further agrees by submitting this proposal that
it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion Lower Tier Covered Transactions," without modification, in all lower tier covered
transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective participant in a
lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded
from the covered transaction, unless it knows that the certification is erroneous. A participant may
decide the method and frequency by which it determines the eligibility of its principals. Each
participant may, but is not required to, check the List of Parties Excluded from Procurement or Non
Procurement Programs.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of records
in order to render in good faith the certification required by this clause. The knowledge and
information of a participant is not required to exceed that which is normally possessed by a prudent
person in the ordinary course of business dealings.
9. Except for transactions authorized under Paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntary excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the department or agency with which
this transaction originated may pursue available remedies, including suspension and/or debarment.
27
0
EXHIBIT B
CERTIFICATION REGARDING LOBBYING
Certification for Contracts. Grants. Loans
and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
1, No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of an agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with the awarding of any
Federal contract, the making of any Federal grant, the making of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal contract, grant, loan or
cooperative agreement.
2, If any funds other than Federal appropriated funds have been paid or will be paid to
any person for influencing 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 connection with this Federal contract, grant,
loan, or cooperative agreement, the undersigned shall complete and submit
Standard Form LLL "Disclosure Form to Report Lobbying" in accordance with its
instructions.
3, The undersigned shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subcontracts, subgrants,
and contracts under grants, loans, and cooperative agreements) and that all
subrecipients shall certify and disclose accordingly.
4. This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by Section 1352
Title 31, U.S. Code. Any person who fails to file the required certification shall be
subject to a civil penalty of not less that $10,000 and not more than $100,000 for
each such failure.
AGREEMENT NUMBER
G/7yO,1= .S W1.rhfV CArJSTi",W
CONTRACTOR/BORROW ER/AGENCY
NAME AND T11L&OF AUTHORIZED REPRESENTATIVE
/-a
K-3
EXHIBIT C
California Emergency Management Agency
FY09 Grant Assurances
Name of Applicant: Cl
(All HSGP Applicants)
<SirNJY4N C.9pr `re4NO
Address: .a2 yoc) 44,5,?0 44.4Nr0
City: State: G:Q Zip Code: T267S
Telephone Number: 9y9- 519 //7/ Fax Number: Y y9- Y97 -387X'
E -Mail Address: MCAA1To/L cis v ✓s✓ rn�4�+f��s r�aut'- �R�
As the duly authorized representative of the applicant, I certify that the applicant named
above:
1. Has the legal authority to apply for Federal assistance and has the institutional,
managerial and financial capability to ensure proper planning, management and
completion of the grant provided by the U.S. Department of Homeland Security
(DHS)/Federal Emergency Management Agency (FEMA) and sub -granted through the
State of California, California Emergency Management Agency (Cal EMA).
2. Will assure that grant funds are used for allowable, fair, and reasonable costs
only and will not be transferred between programs (State Homeland Security Program,
Urban Area Security Initiative, Citizen Corps Program, and Metropolitan Medical
Response System) or fiscal years.
3. Will comply with any cost sharing commitments included in the FY09
Investment Justifications submitted to DHS/FEMA/Cal EMA, where applicable.
4. Will give the Federal government, the General Accounting Office, the
Comptroller General of the United States, the State of California, through any authorized
representative, access to, and the right to examine, all paper or electronic records, books,
or documents related to the award; and will establish a proper accounting system in
accordance with generally accepted accounting standards and/or awarding agency
directives.
5. Agrees that funds utilized to establish or enhance State and Local fusion centers
must support the development of a statewide fusion process that corresponds with the
Global Justice/Homeland Security Advisory Council (HSAC) Fusion Center Guidelines
and achievement of a baseline level of capability as defined by the Fusion Capability
Planning Tool.
6. Will provide progress reports, and other such information as may be required
by the awarding agency, including the Initial Strategy Implementation Plan (ISIP) within
45 (forty-five) days of the award, and update via the Grant Reporting Tool (GRT) twice
each year.
7. Will initiate and complete the work within the applicable time frame after
receipt of approval from Cal EMA.
29
0
0
8. Will maintain procedures to minimize the time elapsing between the award of
funds and the disbursement of funds.
9. Will comply with all provisions of DHS/FEMA's codified regulation 44,
including Part 13, Uniform Administrative Requirements for Grants and Cooperative
Agreements to State and Local Governments, including the payment of interest earned on
advances.
10. 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 for themselves or others, particularly those with
whom they have family, business, or other ties.
11. Agrees that, to the extent contractors or subcontractors are utilized, grantees
and subgrantees shall use small, minority, women -owned, or disadvantaged business
concerns and contractors or subcontractors to the extent practicable.
12. Will notify Cal EMA of any developments that have a significant impact on
award -supported activities, including changes to key program staff.
13. Will comply, if applicable, with the Lead -Based Paint Poisoning Prevention
Act (42 U.S.C. §§ 4801 et seq.) which prohibits the use of lead based paint in
construction or rehabilitation of residence structures.
14. Understands and agrees that Federal funds will not be used, directly or
indirectly, to support the enactment, repeal, modification or adoption of any law,
regulation, or policy, at any level of government, without the express prior written
approval from DHS/FEMA/Cal EMA.
15. Will comply with all Federal Statues relating to Civil Rights and
Nondiscrimination. These include, but are not limited to:
a. Title VI of the Civil Rights Act of 1964 (P.L. 88-352), as amended, which
prohibits discrimination on the basis of race, color or national origin.
b. Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§
1681-1683 and 1685-1686), which prohibits discrimination on the basis of gender.
c. Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. § 794),
which prohibits discrimination on the basis of handicaps.
d. The Age Discrimination Act of 1975, as amended (42 U.S.C. §§ 6101-6107),
which prohibits discrimination on the basis of age.
e. The Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended,
relating to nondiscrimination on the basis of drug abuse.
f The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and
Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on
the basis of alcohol abuse or alcoholism.
MI
g. §§ 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290 dd-3
and 290 ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient
records.
h. Title VIII of the Civil Rights Act of 1968 (42 U.S.C. § 3601 et seq.), as
amended, relating to nondiscrimination in the sale, rental or financing of housing.
i. Title 44 Code of Federal Regulations (CFR) Parts 7, 16, and 19 relating to
nondiscrimination.
j. The requirements on any other nondiscrimination provisions in the specific
statute(s) under which the application for Federal assistance is being made.
k. Will, in the event that a Federal or State court or Federal or State administrative
agency makes a finding of discrimination after a due process hearing on the grounds or
race, color, religion, national origin, gender, or disability against a recipient of funds, the
recipient will forward a copy of the finding to the Office of Civil Rights, Office of Justice
Programs.
1. Will provide an Equal Employment Opportunity Plan, if applicable, to the
Department of Justice Office of Civil Rights within 60 days of grant award.
in. Will comply, and assure the compliance of all its subgrantees and contractors,
with the nondiscrimination requirements and all other provisions of the current edition of
the Office of Justice Programs Financial and Administrative Guide for Grants, M7100.1.
16. Will comply with the requirements of Titles II and III of the Uniform
Relocation Assistance and Real Property Acquisition Policies Act of 1970 (42 U.S.C. §
4601 et seq. [P.L. 91-646]) which provides for fair and equitable treatment of persons
displaced or whose property is acquired as a result of Federal or Federally assisted
programs. These requirements apply to all interested in real property acquired for project
purposes regardless of Federal participation in purchases. Will also comply with Title 44
CFR, Part 25, Uniform Relocation Assistance and Real Property Acquisition for Federal
and Federally -assisted programs.
17. Will comply, if applicable, with the flood insurance purchase requirements of
Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires
recipients in a special flood hazard area to participate in the program and to purchase
flood insurance if the total cost of insurable construction and acquisition is ten thousand
dollars ($10,000) or more.
18. Will comply with all applicable Federal, State, and Local environmental and
historical preservation (EHP) requirements. Failure to meet Federal, State, and Local
EHP requirements and obtain applicable permits may jeopardize Federal funding. Will
comply with all conditions placed on any project as the result of the EHP review; any
change to the scope of work of a project will require reevaluation of compliance with
these EHP requirements.
19. Agrees not to undertake any project having the potential to impact the EHP
resources without the prior written approval of DHS/FEMA/Cal EMA, including, but not
limited to, communications towers, physical security enhancements, new construction
and modifications to buildings that are fifty (50) years old or more. Any construction
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related activities initiated prior to full EHP review will result in a noncompliance finding.
If ground -disturbing activities occur during the project implementation, the recipient
must ensure monitoring of the disturbance. If any potential archeological resources are
discovered, the recipient will immediately cease activity in that area and notify
DHS/FEMA/Cal EMA and the appropriate State Historic Preservation Office.
20. Will ensure that the facilities under its ownership, lease or supervision, which
shall be utilized in the accomplishment of this project, are not on the Environmental
Protection Agency's (EPAs) List of Violating Facilities, and will notify Cal EMA and the
Federal Grantor agency of the receipt of any communication from the Director of the
EPA Office of Federal Activities indicating if a facility to be used in the project is under
consideration for listing by the EPA.
21. Will provide any information requested by DHS/FEMA/Cal EMA to ensure
compliance with applicable laws, including the following:
a. Institution of environmental quality control measures under the National
Environmental Policy Act, National Historical Preservation Act, Archaeological and
Historic Preservation Act, Endangered Species Act, and Executive Orders on Floodplains
(11988), Wetlands (11990) and Environmental Justice (EO12898) and Environmental
Quality (EO11514).
b. Notification of violating facilities pursuant to EO 11738.
c. Assurance of project consistency with the approved state management program
developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §§ 1451 et seq.).
d. Conformity of Federal actions to State (Clean Air) Implementation Plans under
Section 176(c) of the Clean Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.).
e. Protection of underground sources of drinking water under the Safe Drinking
Water Act of 1974, as amended, (P.L. 93-523).
f. California Environmental Quality Act (CEQA). California Public Resources
Code Sections 21080-21098. California Code of Regulations, Title 14, Chapter 3 Section
15000-15007.
g. Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§ 1271 et.seq.) related to
protecting components or potential components of the national wild and scenic rivers
system.
h. Applicable provisions of the Coastal Barrier Resources Act (P.L. 97-348) dated
October 19, 1982 (16 USC 3501 et seq.) which prohibits the expenditure of most new
Federal funds within the units of the Coastal Barrier Resources System.
22. Will comply with Standardized Emergency Management System (SEMS)
requirements as stated in the California Emergency Services Act, Government Code,
Chapter 7 of Division 1 of Title 2, Section 8607.1(e) and CCR Title 19, Sections 2445,
2446, 2447, and 2448.
23. Agrees that all publications created or published with funding under this grant
shall prominently contain the following statement: "This document was prepared under a
grant from FEMA's Grant Programs Directorate, U.S. Department of Homeland
Security. Points of view or opinions expressed in this document are those of the authors
32
and do not necessarily represent the official position or policies of FEMA's Grant
Programs Directorate or the U.S. Department of Homeland Security. "The recipient also
agrees that, when practicable, any equipment purchased with grant funding shall be
prominently marked as follows: "Purchased with funds provided by the U.S. Department
of Homeland Security. "
24. Acknowledges that DHS/FEMA reserves a royalty -free, nonexclusive, and
irrevocable license to reproduce, publish, or otherwise use, and authorize others to use,
for Federal government purposes: a) the copyright in any work developed under an award
or sub -award; and b) any rights of copyright to which a recipient or sub -recipient
purchases ownership with Federal support.
25. The recipient agrees to consult with DHS/FEMA/Cal EMA regarding the
allocation of any patent rights that arise from, or are purchased with, this funding.
26. Has requested through the State of California, Federal financial assistance to
be used to perform eligible work approved in the submitted application for Federal
assistance and after the receipt of Federal financial assistance, through the State of
California, agrees to the following:
a. Promptly return to the State of California all the funds received which exceed
the approved, actual expenditures as accepted by the Federal or State government.
b. In the event the approved amount of the grant is reduced, the reimbursement
applicable to the amount of the reduction will be promptly refunded to the State of
California.
c. Separately account for interest earned on grant funds, and will return all interest
earned, in excess of $100 per Federal Fiscal Year.
27. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S C.
Sections 4728-4763) relating to prescribed standards for merit systems for programs
funded under one of the nineteen statutes or regulations specified in Appendix A of
OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart
F).
28. Will comply with provisions of the Hatch Act (5 U.S.C. Sections 1501-1508
and 7324-7328) which limit the political activities of employees whose principal
employment activities are funded in whole or in part with Federal funds.
29. Will comply, if applicable, with P.L. 93-348 regarding the protection of
human subjects involved in research, development, and related activities supported by
this award of assistance.
30. Will comply, if applicable, with the Laboratory Animal Welfare Act of 1966
(P. L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the care, handling, and
treatment of warm blooded animals held for research, teaching, or other activities
supported by this award of assistance.
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31. Will comply with the minimum wage and maximum hour provisions of the
Federal Fair Labor Standards Act (29 U.S.C. 201), as they apply to employees of
institutions of higher education, hospitals, and other non-profit organizations.
32. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40
U.S.C. Section 276a to 276a-7), the Copeland Act (40 U.S.C. Section 276c and 18 U.S.C.
Sections 874), and the Contract Work Hours and Safety Standards Act (40 U.S.C.
Sections 327-333), regarding labor standards for Federally assisted construction sub -
agreements.
33. Agrees that:
a. No Federal appropriated funds have been paid or will be paid, by or on behalf
of the undersigned, to any person for influencing 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 connection 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 other funds than Federal appropriated funds have been paid or will be
paid to any person for influencing or attempting to influence an officer or employee of
any agency, a Member of Congress, an officer or an employee of Congress, or employee
of a Member of Congress in connection with the 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 certification be included
in the award documents for all sub awards at all tiers including subgrants, contracts under
grants and cooperative agreements, and subcontract(s) and that all sub recipients shall
certify and disclose accordingly.
d. This certification is a material representation of fact upon which reliance was
placed when this transaction was made or entered into. Submission of this certification is
prerequisite for making or entering into this transaction imposed by section 1352, Title
31, U.S. Code. Any person who fails to file the required certification shall be subject to a
civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
34. Agrees that equipment acquired or obtained with grant funds:
a. Will be made available pursuant to applicable terms of the California Disaster
and Civil Defense Master Mutual Aid Agreement in consultation with representatives of
the various fire, emergency medical, hazardous materials response services, and law
enforcement agencies within the jurisdiction of the applicant, and deployed with
personnel trained in the use of such equipment in a manner consistent with the California
Law Enforcement Mutual Aid Plan or the California Fire Services and Rescue Mutual
Aid Plan.
b. Is consistent with needs as identified in the State Homeland Security Strategy
and will be deployed in conformance with that Strategy.
9M
35. Agrees that funds awarded under this grant will be used to supplement
existing funds for program activities, and will not supplant (replace) non -Federal funds.
36. Will comply with all applicable Federal statutes, regulations, policies,
guidelines and requirements, including OMB Circulars A102 and A-133, E.O. 12372 and
the current Administrative Requirements, Cost Principles, and Audit Requirements. Will
also comply with Title 28, Code of Federal Regulations, Parts 66 and 70, that govern the
application, acceptance and use of Federal funds for Federally assisted projects.
37. Will comply with Subtitle A, Title II of the Americans with Disabilities Act
(ADA) 1990.
38. Agrees to cooperate with any assessments, national evaluation efforts, or
information or data collection requests, including, but not limited to, the provision of any
information required for the assessment or evaluation of any activities within this
agreement.
39. Will comply with all provisions of 2 CFR, including: Part 215 Uniform
Administrative Requirements for Grants and Agreements with Institutions of Higher
Education, Hospitals, and Other Non -Profit Organizations (OMB Circular A-110); Part
225 Cost Principles for State, Local and Indian Tribal Governments (OMB Circular A-
87); Part 220 Cost Principles for Educational Institutions (OMB Circular A-21); Part 230
Cost Principles for Non -Profit Organizations (OMB Circular A-122).
40. Will comply with Federal Acquisition Regulations (FAR), part 31.2 Contract
Cost Principles and Procedures, Contracts with Commercial Organizations.
41. Will comply with the financial and administrative requirements set forth in the
current edition of the Office of Justice Programs (OJP) Financial Guide and the current
DHS Financial Management Guide.
42. Agrees that all allocations and use of funds under this grant will be in
accordance with the FY 2009 Homeland Security Grant Program Guidance and
Application Kit, and the California Supplement to the FY 2009 Homeland Security Grant
Program Guidance and Application Kit. All allocations and use of funds under this grant
will be in accordance with the Allocations, and use of grant funding must support the
goals and objectives included in the State and/or Urban
Area Homeland Security Strategies as well as the investments identified in the
Investment Justifications which were submitted as partof the California FY2009
Homeland Security Grant Program application. Further, use of FY09 funds is limited to
those investments included in the California FY09 Investment Justifications submitted to
DHS/FEMA/Cal EMA and evaluated through the peer review process.
43. Will not make any award or permit any award (subgrant or contract) to any
party which is debarred or suspended or is otherwise excluded from or ineligible for
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participation in Federal assistance programs under Executive Order 12549 and 12689,
"Debarment and Suspension".
44. As required by Executive Order 12549, Debarment and Suspension, and
implemented at 44 CFR Part 17, for prospective participants in primary covered
transactions,
a. The applicant certifies that it and its principals:
i. Are not presently debarred, suspended, proposed for debarment, 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.
ii. Have not within a three-year period preceding this application been convicted
of or had a civil judgment rendered against them for commission of fraud or a criminal
offense in connection with obtaining, attempting to obtain, or performing a public
(Federal, State, or local) transaction or contract under a public transaction; violation of
Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery,
falsification or destruction of records, making false statements, or receiving stolen
property.
iii. 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 have not within a three-year
period preceding this application 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.
45. Agrees to comply with the Drug -Free Workplace Act of 1988, and 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:
i. The dangers of drug abuse in the workplace;
ii. The grantee's policy of maintaining a drug-free workplace;
iii. Any available drug counseling, rehabilitation, and employee assistance
programs; and
iv. 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 statement required by paragraph (a).
36
d. Notifying the employee in the statement required by paragraph (a) that, as a
condition of employment under the grant, the employee will
i. Abide by the terms of the statement; and
ii. Notify the employer in writing of his or her conviction for a violation of a
criminal drug statute occurring in the workplace no later than five calendar days after such
conviction.
e. Notifying the agency, in writing, within 10 calendar days after receiving notice
under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such
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 identification 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.
i. 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
ii. 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 enforcement, 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).
46. Will comply with all applicable requirements of all other Federal laws,
executive orders, regulations, program and administrative requirements, policies and any
other requirements governing this program.
47. Understands that failure to comply with any of the above assurances may result
in suspension, termination, or reduction of grant funds.
The undersigned represents that he/she is authorized by the above named applicant to enter
into this agreement for and on behalf of the said applicant.
Signature of Authorized Agent:
Printed Name of Authorized Agent:
Title: Date: /A
37
• EXHIBIT D •
Anaheim and Santa Ana Urban Areas Security Initiative
Reimbursement Request for Grant Expenditures
Mail Reimbursement Request To:
Sgt. Enrique Esparza, Grant Coordinator
Santa Ana Police Department
Homeland Security Division
60 Civic Center Plaza-P.O. Box 1981
Santa Ana, CA 92702
Agency/ City Requesting Reimbursement
This is the £mal reimbursement request.
Cindy Nickel, Grant Fiscal Coordinator
Anaheim Police Department
East Station -Homeland Security Bureau
425 S. Harbor Boulevard
CA 92805
Payroll Tota] Salaries, Overtime, Backfill, etc
Travel Total (Tuition, Meals, Lodging, etc)
E ui ment & Su lies Total
Total Amount Requested
Under Penalty of petjury, I certify that:
I am the duly authorized officer of the claimant herein. This claim is in all respects true, correct, and all
expenditures were made in accordance with applicable laws, rules, regulations, and grant conditions and
assurances. All attached documents for items and/or services have been received in full.
Printed Name
Title
Mailing Address
City, State, Zip Code
Phone Number
E -Mail Address
Fax Number
Signature (Please sign in blue ink) Date
W