HomeMy WebLinkAbout09114
ORDINANCE NO. 9114
AN ORDINANCE APPROVING AN INTERGOVERNMENTAL
AGREEMENT BETWEEN PUEBLO COUNTY, COLORADO
AND THE CITY OF PUEBLO RELATING TO THE USE OF ONE
PRIME MOVER FIRE APPARATUS
BE IT ORDAINED BY THE CITY COUNCIL OF PUEBLO, that:
SECTION 1.
The Intergovernmental Agreement between the County of Pueblo, Colorado and the City
of Pueblo relating to the use of one Prime Mover Fire Apparatus, having been approved as to
form by the City Attorney, is hereby approved. The President of the City Council is authorized
and directed to execute the Agreement for and on behalf of the City, and the City Clerk is
directed to affix the seal of the City thereto and attest same.
SECTION 2.
The officers of the City are directed and authorized to perform any and all acts consistent
with the intent of this Ordinance and the attached Agreement to effectuate the policies and
procedures described therein.
SECTION 3.
This Ordinance shall become effective immediately upon final passage.
INTRODUCED: _ March 27, 2017
BY: Ed Brown
PASSED AND APPROVED: April 10, 2017
City Clerk’s Office Item # R-2
Background Paper for Proposed
Ordinance
COUNCIL MEETING DATE: March 27, 2017
TO: President Stephen G. Nawrocki and Members of City Council
CC: Sam Azad, City Manager
VIA: Gina Dutcher, City Clerk
FROM: Shawn Shelton, Fire Chief – Fire Department
SUBJECT: AN ORDINANCE APPROVING AN INTERGOVERNMENTAL AGREEMENT
BETWEEN PUEBLO COUNTY, COLORADO AND THE CITY OF PUEBLO
RELATING TO THE USE OF ONE PRIME MOVER FIRE APPARATUS
SUMMARY:
Attached is an intergovernmental agreement between the City of Pueblo and Pueblo County,
Colorado relating to the use of one prime mover fire apparatus.
PREVIOUS COUNCIL ACTION:
None.
BACKGROUND:
This intergovernmental agreement between the County of Pueblo and the City of Pueblo allows
the Pueblo Fire Department to store and use a 2016 Ford F-550 prime mover vehicle. The County
purchased the vehicle, using Chemical Stockpile Emergency Preparedness Program (CSEPP)
grant funds. The stipulation on the use of the vehicle is that it must remain in the County of Pueblo
and be available for deployment to any emergency arising from the CESEP program.
FINANCIAL IMPLICATIONS:
None.
BOARD/COMMISSION RECOMMENDATION:
Not applicable.
STAKEHOLDER PROCESS:
Not applicable.
ALTERNATIVES:
None.
RECOMMENDATION:
Approval of the Ordinance.
Attachments: Intergovernmental Agreement
INTERGOVERNMENTAL AGREEMENT
THIS..INTERGOVERNMENTAL AGREEMENT is made and entered into this
/041. day ofL2017 by and between Pueblo County, Colorado ("County") on behalf of the
Pueblo County Sheriff's Office Emergency Services Bureau and the City of Pueblo Fire
Department("City").
WITNESSETH:
WHEREAS, the Colorado Division of Emergency Management (CDEM), through an
agreement with the Federal Emergency Management Agency (FEMA) distributes Chemical
Stockpile Emergency Preparedness Program (CSEPP) funds to affected local governments to
improve the capacity to plan for and respond to all hazard incidents within Pueblo County and;
WHEREAS, the County, through its Pueblo County Sheriffs Office Emergency Services
Bureau and the Chemical Stockpile Emergency Preparedness Program (CSEPP), has been a sub-
grantee recipient of CSEPP funds in the past and was awarded CSEPP funding to purchase one
(1) Prime Mover Fire Apparatus to provide decontamination support to Pueblo County in the
event of a hazardous material incident; and
WHEREAS, the City can staff, maintain and put said vehicle to productive use and assist
County with respect to hazardous material responses and the CSEPP Program; and
WHEREAS, Section 18(2)(a) an (b) of Article XIV of the Constitution of the State of
Colorado and the Colorado Intergovernmental Relations Statute, Section 29-1-201, et seq.,
C.R.S. authorizes political subdivisions to cooperate and contract with one another to provide
any function, service or facility lawfully authorized to each of the contracting units, including the
sharing of costs, if such contract sets forth fully the purposes, powers, rights, obligations, and
responsibilities, financial or otherwise, of the contracting parties.
WHEREAS, City and County are each a political subdivision as defined in Section 29-1-
202(2), C.R.S. and desire to cooperate and contract among themselves with respect to the use of
the vehicle and the CSEPP Program.
NOW, THEREFORE, IN CONSIDERATION of the mutual covenants and promises
contained herein, the parties agree as follows:
I. PROPERTY:
County shall provide for use by City the following described property: One (1) Prime
Mover Fire Apparatus and related equipment itemized and set forth in the attached Exhibit A
("Vehicle").
II. OBLIGATIONS OF CITY:
A. City will provide automobile liability and property damage insurance for the
vehicles and equipment as defined below in Section VII.
B. City shall pay for all fuel utilized by their use of the vehicles and equipment and
provide routine daily/weekly maintenance of the equipment including L.O.F.
(Lube, Oil, Filter) services, minor repairs/replacement of tires, except repairs and
maintenance covered by a manufacturer's warranty.
C. City shall provide inside secure storage at all times for the Prime Mover Fire
Apparatus and either inside or outside safe storage for the related equipment.
D. City shall not remove any signage on the Vehicle without express permission of
the County.
E. City shall provide authorized personnel for the deployment and operation of the
vehicle and equipment and shall use the property in a careful and proper manner
and in cooperation with the County, will maintain the property in good repair and
condition.
F. Compliance with Federal Agreement Terms and Conditions — Federal Law —
Rules and Regulations. City shall comply with all terms and conditions the
County has entered into with the State as a part of the grant application process
and as outlined in the grant agreement between the State of Colorado and FEMA,
and all applicable laws, regulations, policies and guidance related to this program.
These include, but are not limited to, compliance with the following:
i. Exhibit B: FEMA Assurances-Non-Construction Programs
ii. Exhibit C: FEMA Certifications Regarding Lobbying;
Debarment, Suspension and Other Responsibility Matters; and
Drug-Free Workplace Requirement
G. City shall provide the Vehicle for decontamination support to a CSEPP accident
or incident and other hazardous materials responses within their jurisdiction or as
requested under mutual aid agreements; provided, however with a CSEPP
accident or incident taking precedence.
H. At all times during City business hours, County shall have the right to enter the
premises where the property is located for the purpose of inspecting the property.
III. OBLIGATIONS OF COUNTY: County will retain ownership of the vehicle and
equipment and will pay for the costs of licensing.
2
IV. LIMITATIONS WITH RESPECT TO NON-CSEPP RESPONSES:
A. If vehicles and/or equipment are used for a non-CSEPP billable hazardous
material response, any moneys recovered may be used by the City to pay
personnel costs of responders assigned to the response and operating costs of the
equipment. Any excess funds recovered shall be deposited into the Pueblo City-
County Hazardous Materials Committee Recovery Fund.
V. TERM/TERMINATION:
Unless sooner terminated as provided herein, the term of this Intergovernmental Agreement
shall commence on the date of execution and approval by the parties and terminate at the end of
the CSEPP Program or five (5) years, whichever is longer. This Agreement may be renewed for
an additional thirty-six (36) month term only by a separate written agreement signed by the
parties. Either party hereto may terminate this Agreement at any time and for any reason by
giving thirty (30) days prior written notice to the other party. Additionally, if City fails to
perform any of the conditions of this Agreement, County may terminate this Agreement and
City's right to possession of the Vehicle hereunder, and immediately repossess the Vehicle
without prior demand on or notice to the City; provided, however, no such repossession shall
occur at a time when the Vehicle is deployed in an emergency response.
VI. DISCLAIMER OF WARRANTY:
County has not made and does not make any representation, warranty, or covenant,
express or implied, with respect to the condition of the Vehicle or equipment.
VII. INSURANCE:
City shall, at its sole cost and expense, procure and maintain during the entire period of
this Agreement hereunder, the following coverage and limits of insurance with companies
acceptable to the County.
A. Automobile liability insurance for all automobiles and vehicles, whether owned or
hired, with personal injury and property damage limits of no less than
$150,000.00 for any injury to one (1) person in any single occurrence, and
$600,000.00 for any injury to two (2) or more persons in any single occurrence, or
such other limits as may be applicable to City under the Colorado Governmental
Immunity Act naming Pueblo County as an "Additional Insured" as owner of the
Vehicle and the State.
B. Automobile physical damage insurance covering the Vehicle for comprehensive
with a deductible of no more than $1000.00 and collision with a deductible of no
more than $1000.00 naming Pueblo County and State as "Loss Payees."
3
C. Worker's Compensation Insurance. The parties agree that, for purposes of
worker's compensation claims, the City is the primary employer responsible for
its employee and statutory volunteer claims. Each party will provide evidence of
worker's compensation coverage.
Coverages enumerated in this insurance provision represent only the minimum insurance
required by the County and State, and City should rely on its expertise to obtain additional
insurance coverage needed for the County and City in its performance hereunder. The City's
liability insurance must establish Pueblo County and State as "additional insureds." If requested
by County, City shall provide County with certificates of insurance indicating County is covered
by insurance as set forth above and a copy of the "Additional Insured" endorsement, establishing
such additional insured status. Where requested and furnished, such certificates must be
approved by County prior to the commencement of any work hereunder. Each such certificate
shall provide that County shall receive thirty (30) days prior written notice of cancellation of
such insurance coverage.
VIII. NON-DISCRIMINATION:
The City agrees to comply with the letter and spirit of all applicable state and federal
laws, rules and regulations and executive orders of the Governor of Colorado respecting non-
discrimination.
IX. NOTICES:
All notices to be given under this Agreement shall be made in writing and shall be
sufficient if delivered personally or mailed by First Class, United States mail, postage prepaid to
the other party at the following addresses:
City of Pueblo Fire Department
Attn: Chief Shawn Shelton
1551 Bonforte Blvd.
Pueblo, Colorado 81001
And
Pueblo County Sheriff's Office Emergency Services Bureau
Attn: Mark Mears, Bureau Chief
320 West 10`h Street; B1
Pueblo, Colorado 81003
4
IN WITNESS WHEREOF, the parties have executed this Intergovernmental Agreement
the day and year first written above.
BOARD OF COUNTY COMMISSIONERS
PUEBLO COUNTY, COLORADO
By: ,Z7(7/
erry A art, Chair
PUEBLO COUNTY SHERIFF'S OFFICE
By:
Kirk M. Taylor, Sheriff
ATTEST:
Pueblo County Clerk and Recorder
PUEBLO, a Municipal Corporation ATTEST:
By: :ma._ = L nCiC/ OL1t
President, City Council pt' 4 City Clerk
U:\SH-ESB\K\IGA FOR PRIME MOVER FIRE APPARATUS-CITY FIRE DEPT..DOC
5
Exhibit A
Equipment Descriptions
Prime Mover: 2016 F-550 Vin-1FDOW5HY3GEB60
Flat bed,
tool boxes
Water tank and pump.
Pump Engine: Serial#16F0342
Pump: 001-0790 04-15/ 13597
Mobile VHF Radio: Serial # 1641040
Equipment provided:
Portable VHF Radio Serial#1643123
Portable VHF Radio Serial#1643124
Portable VHF Radio Serial#1643177
Portable VHF Radio Serial#1643179
Wick portable Pump-Serial#GCBYT-1037179
Wick portable Pump-Serial#GCBYT-1037180
Stilh 20" Chain Saw-Serial#181612364
Other various hand tools valued at less than$150
DEPARTMENT OF HOMELAND SECURITY O.M.B.No.1660-0025
FEDERAL EMERGENCY MANAGEMENT AGENCY Expires September30,2017
SUMMARY SHEET FOR ASSURANCES AND CERTIFICATIONS
FOR FY CA FOR (Name of Recipient)
2016 Pueblo County,Colorado
This summary sheet Includes Assurances and Certifications that must be read,signed,and submitted as a part of the
Application for Federal Assistance.
An applicant must check each Item that they are certifying to:
Part I X FEMA Form 20-16A,Assurances-Nonconstruction Programs
Part II DX FEMA Form 20-16B,Assurances-Construction Programs
Part III FEMA Form 20-16C,Certifications Regarding Lobbying;
Debarment,Suspension,and Other Responsibility
Matters;and Drug-Free Workplace Requirements
Part IV o SF LLL, Disclosure of Lobbying Activities (If applicable)
As the duly authorized representative of the applicant,I hereby certify that the applicant will comply with the identified
attached assurances and certifications.
Mark Mears CSEPP Manager
Typed Name of r horized Representative Title
/II/ 1 g 5..-
/ Signature of Authorized Representative Date Signed
NOTE: By signing the certification regarding debarment,suspension,and other responsibility matters for primary covered
transaction,the applicant agrees 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 FEMA entering into this transaction.
The applicant further agrees by submitting this application that It will include the clause titled"Certification
Regarding Debarment,Suspension,Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction,"provided by the
FEMA Regional Office entering into this covered transaction,without modification,in all lower tier covered transactions and
in all solicitations for lower tier covered transactions. (Refer to 44 CFR Part 17.)
Paperwork Burden Disclosure Notice
Public reporting burden for this form is estimated to average 1.7 hours per response. The burden estimate includes the time
for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing,and
maintaining the data needed,and submitting this form. You are not required to complete this form unless it displays a valid
OMB control number. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the
burden to: Information Collections Management,Department of Homeland Security,Federal Emergency Management
Agency,500 C Street,SW,Washington DC 20472,Paperwork Reduction Project(1660-0025). NOTE:Do not send your
completed form to this address.
FEMA Form 112-0-3,(10/2014) PREVIOUS EDITION OBSOLETE
%la.GwJ�t.4 dlt,e:a.r
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DEPARTMENT OF HOMELAND SECURITY O.M.B.No.1660-0025
FEDERAL EMERGENCY MANAGEMENT AGENCY Expires September 30,2017
ASSURANCES-NON-CONSTRUCTION PROGRAMS
Paperwork Burden Disclosure Notice
Public reporting burden for this form is estimated to average 1.7 hours per response. The burden estimate includes the time for reviewing instructions,
searching existing data sources,gathering and maintaining the data needed,and completing,and submitting this fort. You are not required to respond to
this collection of information unless it displays a valid OMB control number. Send comments regarding the accuracy of the burden estimate and any
suggestions for reducing the burden to: Information Collection Management,Department of Homeland Security,Federal Emergency Management
Agency,500 C Street,SW,Washington DC 20472,Paperwork Reduction Project(1660-0025). NOTE:Do not send your completed form to this address.
NOTE:
Certain of these assurances may not be applicable to your project or program. If you have any questions,please contact the awarding agency. Further,
certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case,you will be notified.
As the duly authorized representative of the applicant,I certify that the applicant:
1. Has the legal authority to apply for Federal assistance,and the 9. Will comply,as applicable,with the provisions of the Davis-Bacon Act(40
institutional,managerial and financial capability(including funds sufficient U.S.C.Sections 276a to 276a-7),the Copeland Act(40 U.S.C.Section 276c
to pay the non-Federal share of project costs)to ensure proper planning, and 18 U.S.C.Sections 874),and the Contract Work Hours and Safety
management and completion of the project described in this application. Standards Act(40 U.S.C.Sections 327-333),regarding labor standards for
federally assisted construction subagreements.
2. Will give the awarding agency,the Comptroller General of the United
States,and if appropriate,the State,through any authorized representative, 10. Will comply,if applicable,with flood insurance purchase requirements of
access to and the right to examine all records,books,papers,or Section 102(a)of the Flood Disaster Protection Act of 1973(P.L.93-234)
documents related to the award;and will establish a proper accounting which requires recipients in a special flood hazard area to participate in the
system in accordance with generally accepted accounting standards or program and to purchase flood insurance if the total cost of insurable
agency directives. construction and acquisition is$10,000 or more.
3. Will establish safeguards to prohibit employees from using their positions 11. Will comply with environmental standards which may be prescribed
for a purpose that constitutes or presents the appearance of personal gain. pursuant to the following: (a)institution of environmental quality control
measures under the National Environmental Policy Act of 1969(P.L.
4. Will initiate and complete the work within the applicable time frame after 91-190)and Executive Order(EO)11514;(b)notification of violating
receipt of approval of the awarding agency. facilities pursuant to EO 11738;(c)protection of wetlands pursuant to EO
11990;(d)evaluation of flood hazards in floodplains in accordance with EO
5. Will comply with the Intergovernmental Personnel Act of 1970(42 U.S.C. 11988;(e)assurance of project consistency with the approved State
Section 4727-4763)relating to prescribed standards for merit systems for management program developed under the Coastal Zone Management Act
programs funded under one of the nineteen statutes or regulations specified of 1972(16 U.S.C.Section 1451 et seq.);(f)conformity of Federal
in Appendix A of OPM's Standards for Merit System of Personnel actions to State(Clean Air)Implementation Plans under Section 176(c)of
Administration)5 C.F.R.900,Subpart F). the Clear Air Act of 1955,as amended(42 U.S.C.Section et seq.);(g)
protection of underground sources of drinking water under Safe Drinking
6. Will comply with all Federal statutes relating to nondiscrimination. These Water Act of 1974,as amended,(P.L.93-523);and(h)protection of
include but are not limited to:(a)Title VI of the Civil Rights Act of 1964(P.L, endangered species under the Endangered Species Act of 1973,as
88.352)which prohibits discrimination on the basis of race,color,or national amended,(P.L.93.205).
origin;(b)Title IX of the Education Amendments of 1972,as amended(20
U.S.C.Sections 1681-1683,and 1685-1686),which prohibits discrimination 12. Will comply with the Wild and Scenic Rivers Act of 1968(16 U.S.C.
on the basis of sex;(c)Section 504 of the Rehabilitation Act of 1973,as Sections 1271 et seq.)related to protecting components of the national wild
amended(29 U.S.C.Section 794),which prohibits discrimination on the and scenic rivers system.
basis of handicaps;(d)the Age Discrimination Act of 1975,as amended(42
U.S.C.Sections 6101-6107),which prohibits discrimination on the basis of 13. Will assist the awarding agency in assuring compliance with Section
age;(e)the Drug Abuse Office and Treatment Act of 1972(P.L.92.255),as 106 of the National Historic Preservation Act of 1966,as amended(16 U.S.C.
.• amended,relating to nondiscrimination on the basis of drug abuse:'(f)-the 47D),EO 11593'(rdentification and protection of historic properties),and
Comprehensive Alcohol Abuse and Alcoholism Prevention,Treatment and the Archaeological and Historic Preservation Act of 1974(16 U.S.C.469a-
Rehabilitation Act of 1970(P.L.91-616),as amended,relating to 1 et seq.).
nondiscrimination on the basis of alcohol abuse or alcoholism;(g)Sections
523 and 527 of the Public Health Service Act of 1912 (42 U.S.C.290-dd-3 14. Will comply with P.L.93-348 regarding the protection of human subjects
and 290-ee-3),as amended,relating to confidentiality of alcohol and drug involved in research,development,and related activities supported by this
abuse patient records;(h)Title VIII of the Civil Rights Acts of 1968(42 U.S.C. award of assistance.
Section 3601 et seq.),as amended,relating to nondiscrimination in the
sale,rental or financing of housing;(i)any other nondiscrimination provision 15. Will comply with the Laboratory Animal Welfare Act of 1966(P.L.9-544,
in the specific statute(s)under which application for Federal assistance is as amended,7'U.S.C.2131 et seq.)pertaining to the care,handling,and
being made;and(j)the requirements of any other nondiscrimination statute(s) treatment of warm blooded animals held for research,teaching,or other
which may apply to the application. activities supported by this award of assistance.
7. Will comply,or has already complied,with the requirements of Title II and 16. Will comply with the Lead-Based Paint Poisoning Prevention Act(42 U.S.C.
III of the Uniform Relocation Assistance and Real Property Acquisition Sections 4801 et seq.)which prohibits the use of lead based paint in
Policies Act of 1970(P.L.91-646)which provides for fair and equitable construction or rehabilitation of residence structures.
treatment of persons displaced or whose property is acquired as a result of
Federal or Federally assisted programs. These requirements apply to all 17. Will cause to be performed the required financial and compliance audits
interest in real property acquired for project purposes regardless of Federal in accordance with the Single Audit Act of 1984.
participation in purchase.
18. Will comply with all applicable requirements of all other Federal laws,
8. Will comply with provisions of the Hatch Act(5 U.S.C.Sections 1501-1508 executive orders,regulations and policies governing this program.
and 7324-7328)which limit the political activities of employees whose
principal employment activities are funded in whole or in part with Federal 19. It will comply with the minimum wage and maximum hours provisions of
funds. 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.
FEMA Form 112-0-3A,(10/2014) PREVIOUS EDITION OBSOLETE
DEPARTMENT OF HOMELAND SECURITY O.M.B.No.1660-0025
FEDERAL EMERGENCY MANAGEMENT AGENCY Expires September 30,2017
ASSURANCES-CONSTRUCTION PROGRAMS
Paperwork Burden Disclosure Notice
Public reporting burden for this form is estimated to average 1.7 hours per response. The burden estimate includes the time for reviewing instructions,
searching existing data sources,gathering and maintaining the data needed,and completing,and submitting this form. You are not required to respond to
this collection of information unless it displays a valid OMB control number. Send comments regarding the accuracy of the burden estimate and any
suggestions for reducing the burden to: Information Collection Management,Department of Homeland Security,Federal Emergency Management
Agency,500 C Street,SW,Washington DC 20472,Paperwork Reduction Project(1660-0025). NOTE:Do not send your completed form to this address,
NOTE:
Certain of these assurances may not be applicable to your project or program. If you have any questions,please contact the awarding agency. Further,
certain Federal assistance awarding agencies may require applicants to certify to additional assurances. If such is the case,you will be notified.
As the duly authorized representative of the applicant,I certify that the applicant:
1. Has the legal authority to apply for Federal assistance,and the 10. Will comply with all Federal statutes relating to non-
institutional,managerial and financial capability(including funds discrimination. These include but are not limited to:(a)Title VI
sufficientto pay the non-Federal share of project costs)to ensure of the Civil Rights Act of 1964(P.L.88-352)which prohibits
proper planning,management and completion of the project discrimination on the basis of race,color or national origin;
described in this application. (b)Title IX of the Education Amendments of 1972,as amended
(20 U.S.C.Sections 1681-1683,end 1685-1686),which prohibits
2. Will give the awarding agency,the Comptroller General of the discrimination on the basis of sex;(c)Section 504 of the
United States,and If appropriate,the State,through any Rehabilitation Act of 1973,as amended(29 U.S.C.Section 794),
authorized representative,access to and the right to examine all which prohibits discrimination on the basis of handicaps;(d)the Age
records,books,papers,or documents related to the assistance; Discrimination Act of 1975,as amended(42 U.S.C.Sections
and will establish a proper accounting system in accordance with 6101-6107),which prohibits discrimination on the basis of age;
generally accepted accounting standards or agency directives. (e)the Drug Abuse Office and Treatment Act of 1972(P.L.92-255),
drug abuse;(f)the Comprehensive Alcohol Abuse and Alcoholism
3. Will not dispose of,modify the use of,or change the terms of the Prevention,Treatment and Rehabilitation Act of 1970(P.L.
real property title,or other interest in the site and facilities without 91-616),as amended,relating to non-discrimination on the basis
permission and instructions from the awarding agency. Will record of alcohol abuse or alcoholism;(g)Sections 523 and 527 of the
the Federal interest in the title of real property in accordance with Public Health Service Act of 1912(42 U.S.C.290 dd-3 and 290
awarding agency directives and will include a covenant in the title of ee-3),as amended,relating to confidentiality of alcohol and drug
real property acquired in whole or in part with Federal assistance abuse patient records;(h)Title VIII of the Civil Rights Acts of 1968
funds to assure nondiscrimination during the useful Ilfe of the project. (42 U.S.C.Section 3601 et seq.),as amended,relating to non-
discrimination in the sale,rental or financing of housing;(I)any
4. Will comply with the requirements of the assistance awarding other non-discrimination provision in the specific statute(s)
agency with regard to the drafting,review and approval of under which application for Federal assistance is being made;
construction plans and specifications, and(j)the requirements of any other non-discrimination statute(s)
which may apply to the application.
5. Will provide and maintain competent and adequate engineering
supervision at the construction site to ensure that the complete 11. Will comply,or has already complied,with the requirements
work conforms with the approved plans and specifications and will of Title II and III of the Uniform Relocation Assistance and Real
• -furnish progress reports and"such other information ad may be Property Acquisition Policies Act of 1970(P.L.'91-646)which
required by the assistance awarding agency or state. provides for fair end equitable treatment of persons displaced or
whose property is acquired as a result of Federal or Federally
6. Will initiate and complete the work within the applicable time assisted programs. These requirements apply to all interest in
frame after receipt of approval of the awarding agency. real property acquired for project purposes regardless of Federal
participation in purchase.
7.Will establish safeguards to prohibit employees from using their
positions for a purpose that constitutes or presents the appearance 12. Will comply with provisions of the Hatch Act(5 U.S.C.
of personal or organizational conflict of interest,or personal gain. Sections 1501-1508 and 7324-7328)which limit the political
activities of employees whose principal employment
8. Will comply with the Intergovernmental Personnel Act of 1970 activities are funded in whole or in part with Federal funds.
(42 U.S.C.Sections 4728-4763)relating to prescribed standards for
merit systems for programs funded under one of the nineteen 13. Will comply,as applicable,with the provisions of the Davis-
statutes or regulations specified in Appendix A of OPM's Standards Bacon Act(40 U.S.C.Sections 276a to 276a-7),the Copeland Act
for a Merit System of Personnel Administration(5 C.F.R.900, (40 U.S.C.Section 276c and 18 U.S.C.Section 874),the
Subpart F). Contract Work Hours and Safety Standards Act(40 U.S.C.
Sections 327-333)regarding labor standards for federally
9. Will comply with the Lead-Based Paint Poisoning Prevention Act assisted construction subagreements.
(42 U.S.C.Sections 4801 et seq.)which prohibits the use of lead
based paint in construction or rehabilitation of residence structures.
FEMA Form 1120-3B,(10/2014) PREVIOUS EDITION OBSOLETE
14. Will comply with the flood insurance purchase requirements of 23. It will require the facility to be designed to comply with the
Section 102(a)of the Flood Disaster Protection Act of 1973(P.L. "Amencan Standard Specifications for Making Buildings and
93-234)which requires recipients in a special flood hazard area to Facilities Accessible to,and Usable by,the Physically
participate in the program and to purchase flood insurance if the Handicapped,"Number A117.-1961,as modified(41 CFR
total cost of insurable construction and acquisition is$10,000 or 101-17.703). The applicant will be responsible for conducting
more. inspections to ensure compliance with these specifications by
the contractor.
15. Will comply with environmental standards which may be
prescribed pursuant to the following: (a)institution of environmental 24. If any real property or structure thereon is provided or
quality control measures under the National Environmental Policy improved with the aid of Federal financial assistance extended to
Act of 1969(P.L.91-190)and Executive Order(EO)11514; the applicant,this assurance shall obligate the applicant,or in the
(b)notification of violating facilities pursuant to 50 11738; case of any transfer of such property,any transferee,for the
(c)protection of wetlands pursuant to 50 11990;(d)evaluation of period during which the real property or structure is used for a
flood hazards in floodplains in accordance with EO 11988; purpose for which the Federal financial assistance is extended or
(e)assurance of project consistency with the approved State for another purpose involving the provision of similar services or
management programs developed under the Coastal Zone benefits.
Management Act of 1972(16 U.S.C.Section 1451 et seq.);
(f)conformity of Federal actions to State(Clear Air)Implementation 25. In making subgrants with nonprofit institutions under this
Plans under Section 176(c)of the Clear Air Act of 1955,as Comprehensive Cooperative Agreement,it agrees that such
amended(42 U.S.C.Section 7401 et seq.);(g)protection of grants will be subject to OMB Circular A-122,"Cost Principles
underground sources of drinking water under the Safe Drinking for Non-profit Organizations"included in Vol.49,Federal Register,
Water Act of 1974,as amended,(P.L.93-523);and(h)protection of pages 18260 through 18277(April 27,1984).
endangered species under the Endangered Species Act of 1973,
as amended,(P.L.93-205).
16. Will comply with the Wild and Scenic Rivers Act of 1968
(16 U.S.C.Section 1271 et seq.)related to protecting components
or potential components of the national wild and scenic rivers
system.
17. Will assist the awarding agency in assuring compliance with
Section 106 of the National Historic Preservation Act of 1966,as
amended(16 U.S.C.470),EO 11593(identification and
preservation of historic properties),and the Archaeological and
Historic Preservation Act of 1974(16 U.S.C.469a-1 et seq.).
18. Will cause to be performed the required financial and
compliance audits in accordance with the Single Audit Act of 1984.
19. WIII comply with all applicable requirements of all other Federal
laws,Executive Orders,regulations and policies governing this
program.
20. It will comply with the minimum wage and maximum hours
provisions of the Federal Fair Labor Standards Act(29 U.S.C.201),
as they apply to employees of institutions of higher education,
hospitals,end other non-profit organizations.
21. It will obtain approval by the appropriate Federal agencies of the
final working drawings and specifications before the project is
advertised or placed on the market for bidding;that it will construct
the project,or cause it to be constructed,to final completion in
accordance with the application and approved plans and
specifications;that it will submit to the appropriate Federal agency
for prior approval changes that alter the cost of the project,use of
space,or functional layout,that It will not enter into a construction
contract(s)for the project or undertake other activities until the
onditions of the construction grant program(s)have been met.
22. It will operate and maintain the facility in accordance with the
minimum standards as may be required or prescribed by the
applicable Federal,State,and local agencies for the maintenance
and operation of such facilities.
DEPAt<,MENT OF HOMELAND SECURIT'
FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B.No.1660-0025
CERTIFICATIONS REGARDING LOBBYING;DEBARMENT,SUSPENSION AND Expires September 30.2017
OTHER RESPONSIBILITY MATTERS;AND DRUG-FREE WORKPLACE REQUIREMENTS
Paperwork Burden Disclosure Notice
Public reporting burden for this form is estimated to average 1.7 hours per response. The buroen estimate induces the time for reviewing instructions,
searching existing data sources,gathering and maintaining the data needed,ens completing,and submitting this form. You are not reouired to respond to
this collection of information unless a valid OMB control number appears in the upper right corner of this form. Sena comments regarding the accuracy of
the burden estimate ano any suggestions for reducing the burden to: Information Collection Management,Department of Homeland Security,Federal
Emergency Management Agency,500 C Street,SW,Washington DC 20472,Paperwork Reduction Project(1660-0025). NOTE:Do not send your
completed form to this address.
Applicants should refer to the regulations cited below to determine the certification to which they are resulted to attest. Applicants should also review the
instructions for certification incluoed in the regulations before completing this term. Signature of this form provides for compliance with certification
requirements unser 44 CFR Part 18,"New Restrictions on Lobbying;and 28 CFR Part 17,"Govemment-wide Debarment and Suspension
(Nonprocuremenq and Government-wise Requirements for Drug-Free Workplace(Grants)." The certifications shall be treated as a material representation
of tact upon which reliance will be placed when the Federal Emergency Management Agency(FEMA)determines to award the transaction,grant,or
cooperative agreement,
1. LOBBYING (c) Are not presently indicted for or otherwise cdminaliy or civilly charged by e
governmental entity(Federal.State,or local)with commission of any of the
A. As required by section 1352,Title 31 of the U.S.Code,and offenses enumerated in paragraph(1)(b)of this certification:and
implemented at 44 CFR Part 18,for persons entering into a grant
or cooperative agreement over$100,000,as defined at 44 CFR (d) Have not within a three-veer period preceding this application had one or
Part 18,the applicant certifies that: more public transactions(Federal,Stale,or local)terminated for cause or
default;and
(a) No Federal appropriated funds have been paid or will be paid,by or on
behalf of the unoersigned,to any person for influencing or attempting to B. Where the applicant is unable to certify to any of the statements in this
influence an officer or employee of any agency,a Member of Congress,an certification,he or she shall attached an explanation to this application.
officer or employee of congress,or an employee of a Member of Congress in this certification,he or she shall attacnea en explanation to this
in connection with the making of any Federal grant,the entering into of any application.
cooperative agreement,and the extension,continuation,renewal,
amendment,or modification of any Federal grant or cooperative 3. DRUG-FREE WORKPLACE
agreement. (GRANTEES OTHER THAN INDIVIDUALS)
(b) If any other funds than Federal appropriated funds have been paid or will be As required by the Drug-Free Workplace Act of 1988,and imolementea a:
paid to any person for influencing or attempting to influence an officer 44 CFR Part 17,Subpart F,for grantees,as defined at 44 CFR Part 17.61E
or employee of any agency,a Memoer of Congress,an officer or an and 17.620:
employee of Congress,or employee of a member of Congress in
connection with this Federal grant or cooperative agreement,the A. The applicant certifies that it will continue to provide a drug-tree
undersigned shall complete and suomtt Stanoard Form LLL,"Disclosure of workplace by:
Lobbying Activities,"in accordance with its instructions;
(a) Publishing a statement notifying employees that the unlawful
(c)The undersigned shall require that the language of this certification be manufacture,distribution,dispensing,possession,or use of a controlled
included in the award oocuments for all subawards at all tiers(including substance is prohibited in the grantee's workplace ano specifying the
suogrents,contracts unset grants and cooperative agreements,and actions brat will be taken against employees for violation of such
subcontract(s)and that all subrecipients snail certify and disclose prohibition:
accordingly.
;-� (b) Establishing an on-going drug free awareness program to inform
"lStanaard Form LLL."Disclosure of Lobbying Activities"attaches. employees about;
(This torn,must be attached to certification if nonappropriated funds
are to be used to influence activities.) (11 The dangers of drug abuse in the workplace.
2. DEBARMENT,SUSPENSION,AND OTHER RESPONSIBILITY (2) The grantee's policy of maintaining a drug-free workplace,
MATTERS(DIRECT RECIPIENT)
(3) Any available drug counseling,rehabilitation,end
As required by Executive Order 12549,Debarment and Suspension,and employee assistance programs:and
implemented at 44 CFR Part 67,for prospective participants in primary
covered transactions,as defined at 44 CFR Part 17,Section 17.510-A. (4) the penalties that may be imposed upon employees
for drug abuse violations occurnng In the workplace,
A. The applicant certifies that it and its principals:
(c) Making it a requirement that each empiovee to be engaged in the
(a)Are not presently debarred,suspended,proposed for debarment. performance of tire grant to be given a copy of the statement required by
declared ineligible,sentenced to a genial of Federal benefits by a State or paragraph(a);
Federal court,or voluntarily excluded from covered transactions ov one
Feoeral department or agency, (d) Notifying the employee In the statement required by oaraorenh la)that.
as a condition of employment unser the grant,the employee will.
(bl Have not within a three-year panda preceding this application been
convicted of or nae a civilian judgment rendereo epainst them for (1) Abioe oy the terms of the statement:ano
commission of fraud ora cnminal offense in connection with obtaining,
attempting to obtain,or penorm a public(Feoeral.State,or local) (2) Notify the employee in writing of his or her conviction for
transaction or contract unser a public transaction:violation of Federal or violation of a Cnminal drug statute occumng in the Workplace no
State antitrust statutes or commission of empezziement,tnett,forgery, later than five calenoar nays after sucn convictions
bribery.falsification or oestruction of records.making false statements,or
eceiving stolen property, EXHIBIT
FEMA Form 112-0-3C,(1012014) PREVIO .P
(el Notifying the agency.in writing,within 10 calendar days after receiving Place of Pertormance(Street adaress,City,County.State,Zip code)
notice under subparagraph(d)(2)from an employee or otnerwise receiving
actual notice of such conviction. Employers of convicted employees must
provide notice,including position title,to the applicable FEMA awarding
office,i.e.,regional office or FEMA office.
(f) Taking one of the following actions,within 30 calendar days of receiving 101 W.10th Street Pueblo,CO 81003
notice under suoparagraph(d)(2),with respect to any employee who is
convicted: Cneck if there are workplaces on file that are not identified here.
(1)Taking appropriate personnel action against such an employee, Section 17.630 of the reputations provide that a grantee that is a
up to and including termination,consistent with the requirements of State may elect to make one certification in each Feaeral fiscal
the Rehabilitation Act of 1973,as amended;or Year,a copy of which should de included with each application for
FEMA funding. States and State agencies may elect to use a State-
(21 Requiring such employee to participate satisfactorily in a wine certification,
arug abuse assistance or rehabilitation program approved for such
purposes by a Feaeral.State,or local health,law enrorcement,or
otner appropnate agency.
(g) Making a good faith effort to continue to maintain a drug vee workplace
through implementation of paragraphs(a),(b),(c),(d),(e),and M.
B. Tne grantee may insert in the space provided below the site(s)for the
performance of work done in connection will the specific grant: