Agreement between the WA State Military Department for FFY 2019 State Homeland Security Grant program BEFORE THE BOARD OF COUNTY COMMISSIONERS
LEWIS COUNTY, WASHINGTON
IN THE MATTER OF: RESOLUTION NO. 19-301
APPROVING AN AGREEMENT BETWEEN THE
WASHINGTON STATE MILITARY DEPARTMENT AND
LEWIS COUNTY DEPARTMENT OF EMERGENCY
SERVICES, RADIO SERVICES DIVISION, FOR FFY 2019
STATE HOMELAND SECURITY GRANT PROGRAM
(19HSGP) FUNDING ASSISTANCE
WHEREAS, it has been brought to the attention of the Board of County Commissioners
(BOCC) that the Lewis County Department of Emergency Services, Radio Services
Division, has received a contract with the Washington State Military Department for
funding under the FFY 2019 HSGP for Homeland Security Projects; and
WHEREAS, funds are available and approved for use by the Department of Emergency
Services, Radio Services Division in the amount up to $32,231.00, contract # E20-070,
for the contract period from 9/01/2019 through 08/31/2021; and
WHEREAS, the Department of Emergency Services, Radio Services Division, wishes to
enter into this agreement to receive the funds for Homeland Security projects that will
enhance operational communications and information sharing by improving the shared
first responder radio system; and
WHEREAS, it appears to be in the best public interest to authorize the execution of
said agreement for Lewis County.
NOW THEREFORE BE IT RESOLVED that the aforesaid agreement #E20-070 between
Lewis County Department of Emergency Services and the Washington State Military
Department in the amount of $32,231 is hereby approved by the BOCC, and hereby
authorizes the Emergency Management Director to sign the same on behalf of the
BOCC
DONE IN OPEN SESSION this 21st day of October, 2019
APPROVED AS TO FORM: BOARD OF COUNTY COMMISSIONERS
Jonathan Meyer, Prosecuting Attorney LEWIS COUNTY, WASHINGTON
Kevin McDowell Robert C. Jackson
By Kevin McDowell, Robert C Jackson, Chair
• u N T 'p,'
Deputy Prosecuting Attorney /ors R �F ti.
ATTEST: 51NC' ' Gary Stamper
1%45 j Gary Stamper, Vice Chair
'�qs `O" ' `• Edna J J . Fund
Rieva Lester .;J'�c�TOa;��.•
Rieva Lester, Edna J. Fund, Commissioner
Clerk of the Lewis County Board of
County Commissioners
RECEIVED
Washington State Military Department NOV 05 ?d�9
HOMELAND SECURITY GRANT PROGRAM AGREEMENT FACE SHEE
1. Subrecipient Name and Address: 2. Grant Agreement Amount: 3. Grant rie t Number:
Lewis County,Department of Emergency $32,231.00 E2U-0 ' CTS
Services
351 NW North Street
Chehalis,WA 98532-1926
4. Subrecipient Contact,phone/email: 5. Grant Agreement Start Date: 6. Grant Agreement End Date:
Steve Mansfield,360-740-3310 September 1,2019 August 31,2021
steve.mansfield@lewiscountywa.gov
7. Department Contact,phone!email: 8. Data Universal Numbering System(DUNS): 9. UBI#(state revenue):
John Hollingsworth,253-512-7044 079272555 212-002-978
john.hollingsworth@mil.wa.gov
10. Funding Authority:
Washington State Military Department(the"Department")and the U.S.Department of Homeland Security(DHS)
11. Federal Funding Identificat'on#: 12. Federal Award Date: 13. Assistance Listings#(formerly CFDA)#&Title:
EMW-2019SS-00044-S01 08/8/2019 97.067-19HSGP(SHSP)
14. Total Federal Award Amount: 15. Program Index#&OBJISUB-OBJ:
$15,581,281 Local: 793SL,793S13,793SQ,793SC,793SH,793SZ/NZ
State: 793SG, 793SS,793SA, 793SS,793ST,793SE/NZ
16. Service Districts: 17. Service Area by County(ies): 18. Women/Minority-Owned,State
BY LEGISLATIVE DISTRICTS: 19,20 Lewis County Certified: ® N/A NO
BY CONGRESSIONAL DISTRICTS: 3 U YES, OMWBE#
19. Agreement Classification 20. Contract Type(check all that apply):
❑ Personal Services C Client Services ® Public/Local Gov't ❑ Contract El Grant Z Agreement
❑ Research/Development LI AlE _7 Other _ ❑ Intergovernmental(RCW 39.34) ❑ Interagency
21. Subrecipient Selection Process: 22. Subrecipient Type(check all that apply)
® "To all who apply&qualify" ❑ Competitive Bidding ❑ Private Organization/Individual ❑ For-Profit
❑ Sole Source ❑ NE RCW C N/A Z Public Organization/Jurisdiction 0 Non-Profit
❑ Filed w/OFM? = Advertised? ❑ YES ❑ NO D CONTRACTOR ® SUBRECIPIENT 0 OTHER
23. PURPOSE&DESCRIPTION:
The purpose of the Federal Fiscal Year(FFY)2019 Homeland Security Grant Program(19HSGP)is to support state,local,tribal,and territorial efforts
to prevent terrorism and other catastrophic events and to prepare the Nation for threats and hazards that pose the greatest risk to the security of the
United States.19HSGP provides funding to Implement investments that build,sustain,and deliver the core capabilities essential to achieving the National
Preparedness Goal of a secure and resilient Nation. 19HSGP supports core capabilities across the five mission areas of Prevention, Protection,
Mitigation,Response,and Recovery based on allowable costs.HSGP is comprised of three interconnected grant programs'State Homeland Security
Program (SHSP), Urban Areas Security Initiative (UASI), and Operation Stonegarden (OPSG). Together, these grant programs fund a range of
preparedness activities,including planning,organization,equipment purchase,training.exercises,and management and administration.
The Department is the Recipient and Pass-through Entity of the 19HSGP DHS Award Letter for Grant No. EMW-2019-SS-00044-S01, which is
incorporated in and attached hereto as Attachment 1,and has made a subaward of funcs to the Subrecipient pursuant to this Agreement. The
Subrecipient is accountable to the Department for use of Federal award funds provided under this Agreement.The Subrecipient's Work Plan,Timeline,
and Budget for the subaward are detailed in Attachment 2.
IN WITNESS WHEREOF, the Department and Subrecipient acknowledge and accept the terms of this Agreement, including all referenced Exhibits and
Attachments which are hereoy incorporated in and made a part hereof,and have executed this Agreement as of the date below.This Agreement Face Sheet;
Special Terms&Conditions(Exhibit A);General Terms and Conditions(Exhibit B);Attachments 1 and 2;and all other documents,exhibits and attachments
expressly referenced and incorporated herein contain all the terms and condi:ions agreed upon by the parties and govern the rights and obligations of the
parties to this Agreement.No other understandings,oral or otherwise,regarding the subject matter of this Agreement shall be deemed to exist or to bind any
of the parties hereto.
In the event of an inconsistency in this Agreement, unless otherwise provided herein, the inconsistency shall be resolved by giving
precedence in the following order:
1. Applicable Federal and State Statutes and Regulations 4.Specie1 terms nd Conditions
2. DHS/FEMA Award and program documents 5 General Te s and Conditions,and,
3. Work Plan,Timeline,and Budget '6.Other pr tsions of the Ag"eem incorporated by reference.
WHEREAS,the parties hereto have executed this AgreementOn the day year last s cjfjed ow.
F9R HE DEPA5TMENT: f/ ` // z /9
Sig
t�e Date Signatur Dat
Regan Anne Hesse, Chief Financial Officer Robe C.Jackson, Board Chair
Washington State Military Department '_ewis County
BOILERPLATE APPROVED TO FORM: APPROVED AS TO FORM (if applicable):
Brian E. Buchholz,Sr.Assistant Attorney General 9/16/2019
Applicant's Legal Review Date
DHS-FEMA-HSGP-SHSP-FFY19 Page 1 of 36 Lewis County, E20-070
Exhibit A
SPECIAL TERMS AND CONDITIONS
ARTICLE I. KEY PERSONNEL
The individuals listed below shall be considered key personnel for point of contact under this Agreement Any
substitution of key personnel by either party shall be made by written notification to the current key personnel.
SUBRECIPIENT DEPARTMENT
Name Steve Mansfield Name John Hollingsworth
Title Emergency Services Director Title Program Coordinator
E-Mail steve.mansfield @lewiscountywa.gov E-Mail john.hollingsworth @mil.wa.gov
Phone 360-740-3310 Phone 253-512-7044
Name Cheryl Millman Name Kathryn Zetzer
Title Emergency Services/911 Title Program Manager
E-Mail cheryl.millman @lewiscountywa.gov E-Mail kathryn.zetzer @mil.wa.gov
Phone 360-740-1464 Phone 253-512-7140
Name Scott Mattoon Name
Title Radio Services Administrator Title
E-Mail scott.mattoon • lewiscount a.•ov E-Mail
Phone 360-740-1292 Phone
ARTICLE II. ADMINISTRATIVE AND/OR FINANCIAL REQUIREMENTS
The Subrecipient shall comply with all applicable state and federal laws, rules, regulations, requirements and
program guidance identified or referenced in this Agreement and the informational documents published by
DHS/FEMA applicable to the 19HSGP Program, including, but not limited to, all criteria, restrictions, and
requirements of "The Department of Homeland Security (DHS) Notice of Funding Opportunity (NOFO) Fiscal
Year 2019 Homeland Security Grant Program (HSGP)" document, the FEMA Preparedness Grants Manual
document, the DHS Award Letter for Grant No EMW-2019-SS-00044-S01, and the federal regulations
commonly applicable to DHS/FEMA grants, all of which are incorporated herein by reference The DHS Award
Letter is incorporated in this Agreement as Attachment 1.
The Subrecipient acknowledges that since this Agreement involves federal award funding, the period of
performance described herein may begin prior to the availability of appropriated federal funds The Subrecipient
agrees that it will not hold the Department, the state of Washington, or the United States liable for any damages,
claim for reimbursement, or any type of payment whatsoever for services performed under this Agreement prior
to distribution of appropriated federal funds, or if federal funds are not appropriated or in a particular amount.
A STATE AND FEDERAL REQUIREMENTS FOR DHS/FEMA PREPAREDNESS GRANTS:
The following requirements apply to all DHS/FEMA Preparedness Grants administered by the Department
1. SUBAWARDS & CONTRACTS BY SUBRECIPIENTS
a The Subrecipient must make a case-by-case determination whether each agreement it makes for
the disbursement of 19HSGP funds received under this Agreement casts the party receiving the
funds in the role of a subrecipient or contractor in accordance with 2 CFR 200 330
b If the Subrecipient becomes a pass-through entity by making a subaward to a non-federal entity
as its subrecipient.
i. The Subrecipient must comply with all federal laws and regulations applicable to pass-
through entities of 19HSGP funds, including, but not limited to, those contained in 2 CFR
200
ii The Subrecipient shall require its subrecipient(s) to comply with all applicable state and
federal laws, rules, regulations, requirements and program guidance identified or referenced
in this Agreement and the informational documents published by DHS/FEMA applicable to
the 19HSGP Program, including, but not limited to, all criteria, restrictions, and requirements
of the"The Department of Homeland Security(DHS) Notice of Funding Opportunity(NOFO)
Fiscal Year 2019 Homeland Security Grant Program (HSGP)" document, the FEMA
DHS-FEMA-HSGP-SHSP-FFY19 Page 2 of 36 Lewis County, E20-070
Preparedness Grants Manual document, the DHS Award Letter for Grant No EMW-2019-
SS-00044-S01 2019-SS-00044-S01 in Attachment 1, and the federal regulations commonly
applicable to DHS/FEMA grants.
iii The Subrecipient shall be responsible to the Department for ensuring that all 19HSGP
federal award funds provided to its subrecipients are used in accordance with applicable
federal and state statutes and regulations, and the terms and conditions of the federal award
set forth in Attachment 1 of this Agreement.
2. BUDGET, REIMBURSEMENT, AND TIMELINE
a Within the total Grant Agreement Amount, travel, subcontracts, salaries, benefits, printing,
equipment, and other goods and services or other budget categories will be reimbursed on an
actual cost basis upon completion unless otherwise provided in this Agreement
b The maximum amount of all reimbursement requests permitted to be submitted under this
Agreement, including the final reimbursement request, is limited to and shall not exceed the total
Grant Agreement Amount
c If the Subrecipient chooses to include indirect costs within the Budget (Attachment 2), an indirect
cost rate agreement negotiated between the federal cognizant agency for indirect costs and the
Subrecipient establishing approved indirect cost rate(s) as described in 2 CFR 200.414 and
Appendix VII to 2 CFR 200 must be submitted to the Department Key Personnel However, under
2 CFR 200 414(f), if the Subrecipient has never received a negotiated indirect cost rate agreement
establishing federally negotiated rate(s), the Subrecipient may negotiate a rate with the
Department or charge a de minimis rate of 10% of modified total direct costs. The Subrecipient's
actual indirect cost rate may vary from the approved rate but must not exceed the approved
negotiated indirect cost rate percentage for the time period of the expenditures. If a Subrecipient
chooses to charge the 10% de minimis rate, but did not charge indirect costs to previous
subawards, a request for approval to charge indirect costs must be submitted to the Department's
Key Personnel for approval with an explanation for the change
d For travel costs, the Subrecipient shall comply with 2 CFR 200.474 and should consult their
internal policies, state rates set pursuant to RCW 43 03 050 and RCW 43 03 060 as now existing
or amended, and federal maximum rates set forth at htt p g sa//www cloy, and follow the most
q
restrictive If travel costs exceed set state or federal limits, travel costs shall not be reimbursed
without prior written approval by Department Key Personnel
e Reimbursement requests will include a properly completed State A-19 Invoice Form and
Reimbursement Spreadsheet (in the format provided by the Department) detailing the
expenditures for which reimbursement is sought Reimbursement requests must be submitted to
Reimbursements(c�mil.wa.gov no later than the due dates listed within the Timeline (Attachment
2)
Reimbursement request totals should be commensurate to the time spent processing by the
Subrecipient and the Department
f. Receipts and/or backup documentation for any approved items that are authorized under this
Agreement must be maintained by the Subrecipient consistent with record retention requirements
of this Agreement and be made available upon request by the Department, and federal, state,
and local auditors
g The Subrecipient must request prior written approval from Department Key Personnel to waive
or extend a due date in the Timeline (Attachment 2) and, once approved, submit those costs on
the next scheduled reimbursement due date contained in the Timeline Waiving or missing
deadlines serves as an indicator for assessing an agency's level of risk of noncompliance with
the regulations, requirements, and the terms and conditions of the Agreement and may increase
required monitoring activities Any request for a waiver or extension of a due date in the Timeline
will be treated as a request for Amendment of the Agreement This request must be submitted to
the Department Key Personnel sufficiently in advance of the due date to provide adequate time
for Department review and consideration and may be granted or denied within the Department's
sole discretion
DHS-FEMA-HSGP-SHSP-FFY19 Page 3 of 36 Lewis County, E20-070
h. All work under this Agreement must end on or before the Grant Agreement End Date, and the
final reimbursement request must be submitted to the Department within 45 days after the Grant
Agreement End Date, except as otherwise authorized by written amendment of this Agreement
and issued by the Department
i. No costs for purchases of equipment/supplies will be reimbursed until the related
equipment/supplies have been received by the Subrecipient, its contractor, or any non-federal
entity to which the Subrecipient makes a subaward and is invoiced by the vendor.
j. Failure to submit timely, accurate, and complete reports and reimbursement requests as required
by this Agreement (including, but not limited to, those reports in the Timeline [Attachment 2]) will
prohibit the Subrecipient from being reimbursed until such reports are submitted and the
Department has had reasonable time to conduct its review.
k Final reimbursement requests will not be approved for payment until the Subrecipient is current
with all reporting requirements contained in this Agreement.
I A written amendment will be required if the Subrecipient expects cumulative transfers among
project totals, as identified in the Work Plan and Budget (Attachment 2), to exceed 10% of the
Grant Agreement Amount For SHSP and UASI, if a Subrecipient has only one subproject,
cumulative transfers among solution areas within the subproject that exceed 10% of the Grant
Agreement Amount shall require an amendment to this Agreement For OPSG agreements,
budget category totals shall be used to calculate the cumulative transfer. Any adjustments to
totals not in compliance with the above will not be reimbursed.
m. Subrecipients shall only use federal award funds under this Agreement to supplement existing
funds and will not use them to replace (supplant) non-federal funds that have been budgeted for
the same purpose The Subrecipient may be required to demonstrate and document that the
reduction in non-federal resources occurred for reasons other than the receipt or expected receipt
of federal funds
3. REPORTING
a. With each reimbursement request, the Subrecipient shall report how the expenditures, for which
reimbursement is sought, relate to the Work Plan (Attachment 2) activities in the format provided
by the Department
b. With the final reimbursement request, the Subrecipient shall submit to the Department Key
Personnel a final report describing all completed activities under this Agreement
c The Subrecipient shall comply with the Federal Funding Accountability and Transparency Act
(FFATA) and related OMB Guidance consistent with Public Law 109-282 as amended by section
6202(a) of Public Law 110-252 (see 31 U.S.0 6101 note) and complete and return to the
Department the FFATA Form located at http.//mil wa qov/emergency-management-
division/qrants/requiredgrantforms, which is incorporated by reference and made a part of this
Agreement.
d. SHSP and UASI Subrecipients shall participate in the State's Stakeholder Preparedness Review
(SPR), the State's Threat and Hazard Identification and Risk Assessment (THIRA), core
capabilities assessments, and data calls UASI Subrecipients must also participate in the UASI
SPR and THIRA.
4. EQUIPMENT AND SUPPLY MANAGEMENT
a. The Subrecipient and any non-federal entity to which the Subrecipient makes a subaward shall
comply with 2 CFR 200.318 — 200.326 when procuring any equipment or supplies under this
Agreement, 2 CFR 200.313 for management of equipment, and 2 CFR 200 314 for management
of supplies, to include, but not limited to
i. Upon successful completion of the terms of this Agreement, all equipment and supplies
purchased through this Agreement will be owned by the Subrecipient, or a recognized non-
federal entity to which the Subrecipient has made a subaward, for which a contract,
subrecipient grant agreement, or other means of legal transfer of ownership is in place
DHS-FEMA-HSGP-SHSP-FFY19 Page 4 of 36 Lewis County, E20-070
All equipment, and supplies as applicable, purchased under this Agreement will be recorded
and maintained in the Subrecipient's inventory system
iii. Inventory system records shall include
A. Description of the property;
B Manufacturer's serial number, model number, or other identification number,
C Funding source for the equipment, including the Federal Award Identification Number
(FAIN),
D Assistance Listings Number (formerly CFDA number);
E Who holds the title,
F Acquisition date,
G Cost of the equipment and the percentage of federal participation in the cost,
H. Location, use and condition of the equipment at the date the information was reported,
I. Disposition data including the date of disposal and sale price of the property
iv. The Subrecipient shall take a physical inventory of the equipment, and supplies as
applicable, and reconcile the results with the property records at least once every two years
Any differences between quantities determined by the physical inspection and those shown
in the records shall be investigated by the Subrecipient to determine the cause of the
difference. The Subrecipient shall, in connection with the inventory, verify the existence,
current utilization, and continued need for the equipment.
v The Subrecipient shall be responsible for any and all operational and maintenance
expenses and for the safe operation of their equipment and supplies including all questions
of liability The Subrecipient shall develop appropriate maintenance schedules and
procedures to ensure the equipment, and supplies as applicable, are well-maintained and
kept in good operating condition.
vi. The Subrecipient shall develop a control system to ensure adequate safeguards to prevent
loss, damage, and theft of the property. Any loss, damage, or theft shall be investigated,
and a report generated and sent to the Department
vii The Subrecipient must obtain and maintain all necessary certifications and licenses for the
equipment
viii. If the Subrecipient is authorized or required to sell the property, proper sales procedures
must be established and followed to ensure the highest possible return For disposition, if
upon termination or at the Grant Agreement End Date, when original or replacement
supplies or equipment acquired under a federal award are no longer needed for the original
project or program or for other activities currently or previously supported by a federal
awarding agency, the Subrecipient must comply with the following procedures.
A For Supplies. If there is a residual inventory of unused supplies exceeding $5,000 in
total aggregate value upon termination or completion of the project or program and the
supplies are not needed for any other federal award, the Subrecipient must retain the
supplies for use on other activities or sell them, but must, in either case, compensate
the federal government for its share. The amount of compensation must be computed
in the same manner as for equipment.
B For Equipment
DHS-FEMA-HSGP-SHSP-FFY19 Page 5 of 36 Lewis County, E20-070
1) Items with a current per-unit fair-market value of$5,000 or less may be retained,
sold, or otherwise disposed of with no further obligation to the federal awarding
agency
2) Items with a current per-unit fair-market value in excess of$5,000 may be retained
or sold The Subrecipient shall compensate the federal awarding agency in
accordance with the requirements of 2 CFR 200 313 (e) (2).
ix. Records for equipment shall be retained by the Subrecipient for a period of six years from
the date of the disposition, replacement, or transfer If any litigation, claim, or audit is started
before the expiration of the six-year period, the records shall be retained by the Subrecipient
until all litigation, claims, or audit findings involving the records have been resolved
b The Subrecipient shall comply with the Department's Purchase Review Process, which is
incorporated by reference and made part of this Agreement. No reimbursement will be provided
unless the appropriate approval has been received
c Allowable categories for 19HSGP are listed on the Authorized Equipment List (AEL) located on
the FEMA website at http//www fema.qov/authorized-equipment-list It is important that the
Subrecipient and any non-federal entity to which the Subrecipient makes a subaward regard the
AEL as an authorized purchasing list identifying items allowed under the specific grant program
and includes items that may not be categorized as equipment according to the federal, state,
local, and tribal definitions of equipment. The Subrecipient is solely responsible for ensuring and
documenting purchased items under this Agreement are authorized as allowed items by the AEL
at time of purchase
If the item is not identified on the AEL as allowable under HSGP, the Subrecipient must contact
the Department Key Personnel for assistance in seeking FEMA approval prior to acquisition
d. Unless expressly provided otherwise, all equipment must meet all mandatory regulatory and/or
DHS/FEMA adopted standards to be eligible for purchase using federal award funds.
e. For OPSG Subrecipients, equipment purchased with DHS federal award funds is to be marked
prominently with "Purchased with DHS funds for Operation Stonegarden Use" when practicable
f Procurement of medical countermeasures must be conducted in collaboration with state, city, or
local health departments that administer federal funds from Health and Human Services (HHS)
for this purpose and with existing Metropolitan Medical Response System (MMRS) committees
where available, to sustain their long-term planning for appropriate, rapid, and local medical
countermeasures, including antibiotics and antidotes for nerve agents, cyanide, and other toxins.
Procurement must have a sound threat-based justification with an aim to reduce the
consequences of mass casualty incidents during the first crucial hours of a response Prior to
procuring pharmaceuticals, Subrecipients must have in place an inventory management plan to
avoid large periodic variations in supplies due to coinciding purchase and expiration dates
Subrecipients are encouraged to enter into rotational procurement agreements with vendors and
distributors Purchases of pharmaceuticals must include a budget for the disposal of expired drugs
within each fiscal year's period of performance for 19HSGP The cost of disposal cannot be
carried over to another DHS/FEMA grant or grant period
g. The Subrecipient must pass on equipment and supply management requirements that meet or
exceed the requirements outlined above to any non-federal entity to which the Subrecipient
makes a subaward of federal award funds under this Agreement
5 ENVIRONMENTAL AND HISTORICAL PRESERVATION
a The Subrecipient shall ensure full compliance with the DHS/FEMA Environmental Planning and
Historic Preservation (EHP) Program. EHP program information can be found at
https //www fema goy/media-library/assets/documents/85376 all of which are incorporated in and
made a part of this Agreement.
b. Projects that have historical impacts or the potential to impact the environment, including, but not
limited to, construction of communication towers; modification or renovation of existing buildings,
structures and facilities, or new construction, including replacement of facilities, must participate
DHS-FEMA-HSGP-SHSP-FFY19 Page 6 of 36 Lewis County, E20-070
in the DHS/FEMA EHP review process prior to project initiation. Modification of existing buildings,
including minimally invasive improvements such as attaching monitors to interior walls, and
training or exercises occurring outside in areas not considered previously disturbed also require
a DHS/FEMA EHP review before project initiation.
c The EHP review process involves the submission of a detailed project description that includes
the entire scope of work, including any alternatives that may be under consideration, along with
supporting documentation so FEMA may determine whether the proposed project has the
potential to impact environmental resources and/or historic properties.
d The Subrecipient agrees that, to receive any federal preparedness funding, all EHP compliance
requirements outlined in applicable guidance must be met. The EHP review process must be
completed and approval received by the Subrecipient before any work is started for which
reimbursement will be later requested Expenditures for projects started before completion of the
EHP review process and receipt of approval by the Subrecipient may not be reimbursed
6. PROCUREMENT
a The Subrecipient shall comply with all procurement requirements of 2 CFR Part 200 318 through
200 326 and as specified in the General Terms and Conditions, Exhibit B, A.10.
b For all sole source contracts expected to exceed $250,000, the Subrecipient must submit to the
Department for pre-procurement review and approval the procurement documents, such as
requests for proposals, invitations for bids and independent cost estimates This requirement must
be passed on to any non-federal entity to which the Subrecipient makes a subaward, at which
point the Subrecipient will be responsible for reviewing and approving sole source justifications of
any non-federal entity to which the Subrecipient makes a subaward
7. SUBRECIPIENT MONITORING
a The Department will monitor the activities of the Subrecipient from award to closeout. The goal of
the Department's monitoring activities will be to ensure that agencies receiving federal pass-
through funds are in compliance with this Agreement, federal and state audit requirements,
federal grant guidance, and applicable federal and state financial regulations, as well as 2 CFR
Part 200 Subpart F.
b To document compliance with 2 CFR Part 200 Subpart F requirements, the Subrecipient shall
complete and return to the Department the "2 CFR Part 200 Subpart F Audit Certification Form"
located at http.//mil.wa.gov/emergency-management-division/grants/requiredgrantforms with the
signed Agreement and each fiscal year thereafter until the Agreement is closed, which is
incorporated by reference and made a part of this Agreement.
c Monitoring activities may include, but are not limited to
i. Review of financial and performance reports,
ii Monitoring and documenting the completion of Agreement deliverables;
iii Documentation of phone calls, meetings (e.g. agendas, sign-in sheets, meeting minutes), e-
mails, and correspondence,
iv Review of reimbursement requests and supporting documentation to ensure allowability and
consistency with Agreement Work Plan and Budget(Attachment 2), and federal requirements;
v. Observation and documentation of Agreement-related activities, such as exercises, training,
funded events, and equipment demonstrations; and
vi On-site visits to review equipment records and inventories, to verify source documentation for
reimbursement requests and performance reports, and to verify completion of deliverables.
d The Subrecipient is required to meet or exceed the monitoring activities, as outlined above, for
any non-federal entity to which the Subrecipient makes a subaward as a pass-through entity
under this Agreement
e. Compliance will be monitored throughout the performance period to assess risk Concerns will be
addressed through a Corrective Action Plan.
DHS-FEMA-HSGP-SHSP-FFY19 Page 7 of 36 Lewis County, E20-070
8. LIMITED ENGLISH PROFICIENCY (CIVIL RIGHTS ACT OF 1964 TITLE VI)
The Subrecipient must comply with the Title VI of the Civil Rights Act of 1964 (Title VI) prohibition
against discrimination on the basis of national origin, which requires that Subrecipients of federal
financial assistance take reasonable steps to provide meaningful access to persons with limited
English proficiency (LEP) to their programs and services. Providing meaningful access for persons
with LEP may entail providing language assistance services, including oral interpretation and written
translation Executive Order 13166, Improving Access to Services for Persons with Limited English
Proficiency (August 11, 2000), requires federal agencies to issue guidance to recipients, assisting
such organizations and entities in understanding their language access obligations DHS published
the required recipient guidance in April 2011, DHS Guidance to Federal Financial Assistance
Recipients Regarding Title VI Prohibition against National Origin Discrimination Affecting Limited
English Proficient Persons, 76 Fed Reg 21755-21768, (April 18, 2011) The Guidance provides
helpful information such as how a recipient can determine the extent of its obligation to provide
language services, selecting language services, and elements of an effective plan on language
assistance for LEP persons For additional assistance and information regarding language access
obligations, please refer to the OHS Recipient Guidance at https//www dhs qov/quidance-published-
help-department-supported-organizations-provide-meaningful-access-people-limited and additional
resources on http //www lep qov
9. NIMS COMPLIANCE
a The National Incident Management System (NIMS) identifies concepts and principles that answer
how to manage emergencies from preparedness to recovery regardless of their cause, size,
location, or complexity NIMS provides a consistent, nationwide approach and vocabulary for
multiple agencies or jurisdictions to work together to build, sustain, and deliver the core
capabilities needed to achieve a secure and resilient nation.
b Consistent implementation of NIMS provides a solid foundation across jurisdictions and
disciplines to ensure effective and integrated preparedness, planning, and response NIMS
empowers the components of the National Preparedness System, a requirement of Presidential
Policy Directive 8, to guide activities within the public and private sector and describes the
planning, organizational activities, equipping, training and exercising needed to build and sustain
the core capabilities in support of the National Preparedness Goal
c. In order to receive FY 2019 federal preparedness funding, to include 19HSGP, the Subrecipient
will ensure all NIMS objectives have been initiated and/or are in progress toward completion
NIMS Implementation Objectives are located at https//www fema qov/media-
library/assets/documetns/130743.
B. HSGP SPECIFIC REQUIREMENTS
1. The Subrecipient must use HSGP funds only to perform tasks as described in the Work Plan
(Attachment 2), as approved by the Department, and in compliance with this Agreement.
a SHSP-funded projects must address high-priority preparedness gaps across all core capabilities
that support terrorism preparedness
b. UASI-funded projects must build, sustain, and deliver the capabilities necessary for high-threat,
high-density Urban Areas to prevent, protect against, mitigate, respond to, and recover from acts
of terrorism
c OPSG-funded projects must enhance cooperation and coordination among Customs and Border
Protection, United States Border Patrol, and federal, state, local, tribal, and territorial law
enforcement agencies to support joint efforts to secure the United States' borders along routes of
ingress from international borders to include travel corridors in states bordering Mexico and
Canada, as well as states and territories with international water borders.
2. The Budget (Attachment 2) may include the following caps and thresholds
a If funds are allotted for Management and Administration (M&A), such expenditures must be
related to administration of the grant The maximum percentage of the Grant Agreement Amount
that may be used for M&A costs when allocated under this Agreement shall not exceed 5% but
may be less.
DHS-FEMA-HSGP-SHSP-FFY19 Page 8 of 36 Lewis County, E20-070
b. At least 25% of the combined HSGP award allocated under SHSP and UASI must be dedicated
to law enforcement terrorism prevention activities (LETPA). To meet this requirement, the
Subrecipient has agreed, at a minimum, to meet the LETPA percentage indicated in the Budget
If the Subrecipient anticipates spending less than the indicated amount, a budget amendment is
required
c The maximum percentage of the Grant Agreement Amount that may be used for personnel
expenses under this Agreement is identified in the Budget If the Subrecipient anticipates
spending more on personnel costs, an amendment is required. Additional approval steps may
also be required before the personnel percentage can be increased
3 If funding is allocated to emergency communications, the Subrecipient must ensure that all projects
comply with SAFECOM Guidance on Emergency Communications Grants ensuring the investments
are compatible, interoperable, resilient, and support national goals and objectives for improving
emergency communications.
4. If funding is allocated to a Fusion Center investment, the Subrecipient must ensure all Fusion Center
analytical personnel demonstrate qualifications that meet or exceed competencies identified in the
Common Competencies for state, local, and tribal Intelligence Analysts, which outlines the minimum
categories of training needed for intelligence analysts. A certificate of completion of such training
must be submitted to the Department Key Personnel as applicable.
5 If funding is allocated to non-DHS FEMA training, the Subrecipient must request prior approval from
the Department Key Personnel before attending the training. The Department will coordinate
approval with the State Training Point of Contact Pursuant to DHS/FEMA Grant Programs
Directorate Policy FP 207-008-064-1 (https //www fema goy/media-
library/assets/documents/34856), the training must fall within the FEMA mission scope and be
included in the Subrecipient's Emergency Operations Plan This requirement only applies to training
courses and does not include attendance at conferences. Furthermore, additional federal approvals
are required for courses that relate to Countering Violent Extremism prior to attendance
6 Subrecipients are required to complete the 2019 Nationwide Cybersecurity Review (NCSR)
https //www cisecurity orq/ms-isac/services/ncsr to benchmark and measure progress of improving
their cybersecurity posture before December 31, 2019. In support of efforts to enhance capabilities
for detecting, deterring, disrupting, and preventing acts of terrorism and other catastrophic events,
operational overtime costs are allowable for increased protective security measures at critical
infrastructure sites or other high-risk locations and to enhance public safety during mass gatherings
and high-profile events. However, except for an elevated National Terrorism Advisory System alert,
prior written approval is required before SHSP and UASI funds may be used for operational overtime.
Requests must be submitted to the Department Key Personnel in advance of the expenditure to
ensure all additional approval steps can be met
7 Subrecipients are encouraged to participate in the State's annual Training and Exercise Planning
Workshop (TEPW) or may conduct their own local/regional TEPW.
C. DHS TERMS AND CONDITIONS
As a subrecipient of 19HSGP program funding, the Subrecipient shall comply with all applicable DHS
terms and conditions of the 19HSGP Award Letter and its incorporated documents for DHS Grant No.
EMW-2019-SS-00044-S01, which are incorporated in and made a part of this Agreement as Attachment
1.
DHS-FEMA-HSGP-SHSP-FFY19 Page 9 of 36 Lewis County, E20-070
Exhibit B
Washington State Military Department
GENERAL TERMS AND CONDITIONS
Department of Homeland Security (DHS)/
Federal Emergency Management Agency (FEMA)
Grants
A 1 DEFINITIONS
As used throughout this Agreement, the terms will have the same meaning as defined in 2 CFR 200
Subpart A (which is incorporated herein by reference), except as otherwise set forth below
a "Agreement" means this Grant Agreement
b
"Department" means the Washington State Military Department, as a state agency, any division,
section, office, unit or other entity of the Department, or any of the officers or other officials lawfully
representing that Department The Department is a recipient of a federal award directly from a
federal awarding agency and is the pass-through entity making a subaward to a Subrecipient
under this Agreement
c
"Subrecipient" when capitalized is primarily used throughout this Agreement in reference to the
non-federal entity identified on the Face Sheet of this Agreement that has received a subaward
from the Department However, the definition of"Subrecipient" is the same as in 2 CFR 200 93
for all other purposes.
d. "Monitoring Activities" means all administrative, financial, or other review activities that are
conducted to ensure compliance with all state and federal laws, rules, regulations, authorities and
policies.
e. "Investment" means the grant application submitted by the Subrecipient describing the project(s)
for which federal funding is sought and provided under this this Agreement Such grant
application is hereby incorporated into this Agreement by reference
A.2 ADVANCE PAYMENTS PROHIBITED
The Department shall make no payments in advance or in anticipation of goods or services to be provided
under this Agreement. Subrecipient shall not invoice the Department in advance of delivery and invoicing
of such goods or services
A 3 AMENDMENTS AND MODIFICATIONS
The Subrecipient or the Department may request, in writing, an amendment or modification of this
Agreement However, such amendment or modification shall not be binding, take effect or be
incorporated herein until made in writing and signed by the authorized representatives of the Department
and the Subrecipient. No other understandings or agreements, written or oral, shall be binding on the
parties.
A 4 AMERICANS WITH DISABILITIES ACT (ADA) OF 1990, PUBLIC LAW 101-336, 42 U S C 12101 ET
SEQ AND ITS IMPLEMENTING REGULATIONS ALSO REFERRED TO AS THE "ADA" 28 CFR Part
35
The Subrecipient must comply with the ADA, which provides comprehensive civil rights protection to
individuals with disabilities in the areas of employment, public accommodations, state and local
government services, and telecommunication.
A5 ASSURANCES
The Department and Subrecipient agree that all activity pursuant to this Agreement will be in accordance
with all the applicable current federal, state and local laws, rules and regulations.
A.6 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, OR INELIGIBILITY
As federal funds are a basis for this Agreement, the Subrecipient certifies that the Subrecipient is not
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participating in this Agreement by any federal department or agency
The Subrecipient shall complete, sign, and return a Certification Regarding Debarment, Suspension,
Ineligibility, and Voluntary Exclusion form located at http.//mil.wa qov/emergency-management-
division/grants/requiredgrantforms. Any such form completed by the Subrecipient for this Agreement
shall be incorporated into this Agreement by reference
DHS-FEMA-HSGP-SHSP-FFY19 Page 10 of 36 Lewis County, E20-070
Further, the Subrecipient agrees to comply with all applicable federal regulations concerning the federal
debarment and suspension system, including 2 CFR Part 180 The Subrecipient certifies that it will
ensure that potential contractors or Subrecipients or any of their principals are not debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from participation in "covered
transactions" by any federal department or agency. "Covered transactions" include procurement
contracts for goods or services awarded under a non-procurement transaction (e.g. grant or cooperative
agreement) that are expected to equal or exceed $25,000, and subawards to Subrecipients for any
amount. With respect to covered transactions, the Subrecipient may comply with this provision by
obtaining a certification statement from the potential contractor or Subrecipient or by checking the System
for Award Management(https://sam.gov/SAM/) maintained by the federal government The Subrecipient
also agrees not to enter into any arrangements or contracts with any party on the Washington State
Department of Labor and Industries' "Debarred Contractor List"
(https//secure.lni.wa.qov/debarandstrike/ContractorDebarList aspx) The Subrecipient also agrees not
to enter into any agreements or contracts for the purchase of goods and services with any party on the
Department of Enterprise Services' Debarred Vendor List
(http//www.des.wa.qov/services/ContractingPurchasing/Business/Pages/Vendor-Debarment aspx)
A.7 CERTIFICATION REGARDING RESTRICTIONS ON LOBBYING
As required by 44 CFR Part 18, the Subrecipient hereby certifies that to the best of its knowledge and
belief (1) no federally appropriated funds have been paid or will be paid by or on behalf of the
Subrecipient 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)
that 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
Agreement, grant, loan, or cooperative agreement, the Subrecipient will complete and submit Standard
Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions; (3) and that, as
applicable, the Subrecipient will 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. This
certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into and is a prerequisite for making or entering into this transaction imposed by section
1352, title 31, U.S. Code.
A.8 COMPLIANCE WITH APPLICABLE STATUTES, RULES AND DEPARTMENT POLICIES
The Subrecipient and all its contractors and subrecipients shall comply with, and the Department is not
responsible for determining compliance with, any and all applicable federal, state, and local laws,
regulations, executive orders, OMB Circulars, and/or policies. This obligation includes, but is not limited
to nondiscrimination laws and/or policies, Energy Policy and Conservation Act(PL 94-163, as amended),
the Americans with Disabilities Act (ADA), Age Discrimination Act of 1975, Title VI of the Civil Rights Act
of 1964, Civil Rights Act of 1968, the Robert T. Stafford Disaster Relief and Emergency Assistance Act,
(PL 93-288, as amended), Ethics in Public Service (RCW 42.52), Covenant Against Contingent Fees (48
CFR Section 52 203-5), Public Records Act (RCW 42.56), Prevailing Wages on Public Works (RCW
39.12), State Environmental Policy Act(RCW 43 21C), Shoreline Management Act of 1971 (RCW 90 58),
State Building Code (RCW 19 27), Energy Related Building Standards (RCW 19 27A), Provisions in
Buildings for Aged and Handicapped Persons (RCW 70 92), and safety and health regulations
In the event of noncompliance or refusal to comply with any applicable law, regulation, executive order,
OMB Circular or policy by the Subrecipient, its contractors or subrecipients, the Department may rescind,
cancel, or terminate the Agreement in whole or in part in its sole discretion The Subrecipient is
responsible for all costs or liability arising from its failure, and that of its contractors and subrecipients, to
comply with applicable laws, regulations, executive orders, OMB Circulars or policies.
A.9 CONFLICT OF INTEREST
No officer or employee of the Department, no member, officer, or employee of the Subrecipient or its
designees or agents; no member of the governing body of the jurisdiction in which the project is
DHS-FEMA-HSGP-SHSP-FFY19 Page 11 of 36 Lewis County, E20-070
undertaken or located; and no other official of the Subrecipient who exercises any functions or
responsibilities with respect to the project during his or her tenure, shall have any personal or pecuniary
gain or interest, direct or indirect, in any contract, subcontract, or the proceeds thereof, for work to be
performed in connection with the project assisted under this Agreement
The Subrecipient shall incorporate, or cause to incorporate, in all such contracts or subawards, a
provision prohibiting such interest pursuant to this provision
A 10 CONTRACTING & PROCUREMENT
a. The Subrecipient shall use a competitive procurement process in the procurement and award of
any contracts with contractors or subcontractors that are entered into under the original
agreement award. The procurement process followed shall be in accordance with 2 CFR Part
200.318 General procurement standards through 200 326 Contract provisions
As required by Appendix I I to 2 CFR Part 200, all contracts entered into by the Subrecipient under
this Agreement must include the following provisions, as applicable'
1) Contracts for more than the simplified acquisition threshold currently set at $250,000, which
is the inflation adjusted amount determined by the Civilian Agency Acquisition Council and
the Defense Acquisition Regulations Council (Councils) as authorized by 41 U.S.0 1908,
must address administrative, contractual, or legal remedies in instances where contractors
violate or breach contract terms, and provide for such sanctions and penalties as appropriate.
2) All contracts in excess of$10,000 must address termination for cause and for convenience
by the non-federal entity including the manner by which it will be affected and the basis for
settlement
3) Equal Employment Opportunity Except as otherwise provided under 41 CFR Part 60, all
contracts that meet the definition of"federally assisted construction contract" in 41 CFR Part
60-1 3 must include the equal opportunity clause provided under 41 CFR 60-1.4(b), in
accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319,
12935, 3 CFR Part, 1964-1965 Comp , p 339), as amended by Executive Order 11375,
"Amending Executive Order 11246 Relating to Equal Employment Opportunity," and
implementing regulations at 41 CFR part 60, "Office of Federal Contract Compliance
Programs, Equal Employment Opportunity, Department of Labor."
4) Davis-Bacon Act, as amended (40 U S C. 3141-3148). When required by Federal program
legislation, all prime construction contracts in excess of $2,000 awarded by non-federal
entities must include a provision for compliance with the Davis-Bacon Act (40 U S C 3141-
3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Part
5, "Labor Standards Provisions Applicable to Contracts Covering Federally Financed and
Assisted Construction"). In accordance with the statute, contractors must be required to pay
wages to laborers and mechanics at a rate not less than the prevailing wages specified in a
wage determination made by the Secretary of Labor In addition, contractors must be
required to pay wages not less than once a week. The non-federal entity must place a copy
of the current prevailing wage determination issued by the Department of Labor in each
solicitation The decision to award a contract or subcontract must be conditioned upon the
acceptance of the wage determination. The non-federal entity must report all suspected or
reported violations to the federal awarding agency The contracts must also include a
provision for compliance with the Copeland "Anti-Kickback" Act (40 U S C 3145), as
supplemented by Department of Labor regulations (29 CFR Part 3, "Contractors and
Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or
Grants from the United States"). The Act provides that each contractor or Subrecipient must
be prohibited from inducing, by any means, any person employed in the construction,
completion, or repair of public work, to give up any part of the compensation to which he or
she is otherwise entitled The non-federal entity must report all suspected or reported
violations to the federal awarding agency.
5) Contract Work Hours and Safety Standards Act (40 U S C 3701-3708) Where applicable,
all contracts awarded by the non-federal entity in excess of $100,000 that involve the
employment of mechanics or laborers must include a provision for compliance with 40 U.S.C.
3702 and 3704, as supplemented by Department of Labor regulations(29 CFR Part 5) Under
DHS-FEMA-HSGP-SHSP-FFY19 Page 12 of 36 Lewis County, E20-070
40 U.S.C. 3702 of the Act, each contractor must be required to compute the wages of every
mechanic and laborer on the basis of a standard work week of 40 hours Work in excess of
the standard work week is permissible provided that the worker is compensated at a rate of
not less than one and a half times the basic rate of pay for all hours worked in excess of 40
hours in the work week The requirements of 40 U.S.C. 3704 are applicable to construction
I work and provide that no laborer or mechanic must be required to work in surroundings or
under working conditions which are unsanitary, hazardous or dangerous. These
requirements do not apply to the purchases of supplies or materials or articles ordinarily
available on the open market, or contracts for transportation or transmission of intelligence
6) Rights to Inventions Made Under a Contract or Agreement If the federal award meets the
definition of"funding agreement" under 37 CFR §401.2 (a) and the recipient or Subrecipient
wishes to enter into a contract with a small business firm or nonprofit organization regarding
the substitution of parties, assignment or performance of experimental, developmental, or
research work under that "funding agreement," the recipient or Subrecipient must comply
with the requirements of 37 CFR Part 401, "Rights to Inventions Made by Nonprofit
Organizations and Small Business Firms Under Government Grants, Contracts and
Cooperative Agreements,"and any implementing regulations issued by the awarding agency.
7) Clean Air Act (42 U S C 7401-7671q ) and the Federal Water Pollution Control Act (33
U S C 1251-1387), as amended—Contracts and subgrants of amounts in excess of
$150,000 must contain a provision that requires the non-federal award to agree to comply
with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42
U S C 7401-7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C.
1251-1387) Violations must be reported to the federal awarding agency and the Regional
Office of the Environmental Protection Agency (EPA)
8) Debarment and Suspension (Executive Orders 12549 and 12689)—A contract award (see 2
CFR 180 220) must not be made to parties listed on the government-wide exclusions in the
System for Award Management(SAM), in accordance with the OMB guidelines at 2 CFR 180
that implement Executive Orders 12549 (3 CFR part 1986 Comp , p 189) and 12689 (3 CFR
part 1989 Comp., p. 235), "Debarment and Suspension " SAM Exclusions contains the
names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties
declared ineligible under statutory or regulatory authority other than Executive Order 12549
9) Byrd Anti-Lobbying Amendment(31 U.S.C. 1352)—Contractors that apply or bid for an award
exceeding $100,000 must file the required certification. Each tier certifies to the tier above
that it will not and has not used federal appropriated funds to pay any person or organization
for influencing or attempting to influence an officer or employee of any agency, a member of
Congress, officer or employee of Congress, or an employee of a member of Congress in
connection with obtaining any federal contract, grant or any other award covered by 31
U S C 1352 Each tier must also disclose any lobbying with non-federal funds that takes
place in connection with obtaining any federal award. Such disclosures are forwarded from
tier to tier up to the non-federal award
10) Procurement of recovered materials -- As required by 2 CFR 200 322, a non-federal entity
that is a state agency or agency of a political subdivision of a state and its contractors must
comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource
Conservation and Recovery Act The requirements of Section 6002 include procuring only
items designated in guidelines of the Environmental Protection Agency (EPA)at 40 CFR part
247 that contain the highest percentage of recovered materials practicable, consistent with
maintaining a satisfactory level of competition, where the purchase price of the item exceeds
$10,000 or the value of the quantity acquired during the preceding fiscal year exceeded
$10,000, procuring solid waste management services in a manner that maximizes energy
and resource recovery, and establishing an affirmative procurement program for
procurement of recovered materials identified in the EPA guidelines
11) Notice of awarding agency requirements and regulations pertaining to reporting
12) Federal awarding agency requirements and regulations pertaining to copyrights and rights in
data
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13) Access by the Department, the Subrecipient, the federal awarding agency, the Comptroller
General of the United States, or any of their duly authorized representatives to any books,
documents, papers, and records of the contractor which are directly pertinent to that specific
contract for the purpose of making audit, examination, excerpts, and transcriptions
14) Retention of all required records for six years after the Subrecipient has made final payments
and all other pending matters are closed
15) Mandatory standards and policies relating to energy efficiency which are contained in the
state energy conservation plan issued in compliance with the Energy Policy and
Conservation Act (Pub L 94-163, 89 Stat 871).
b The Department reserves the right to review the Subrecipient's procurement plans and
documents and require the Subrecipient to make changes to bring its plans and documents into
compliance with the requirements of 2 CFR Part 200.318 through 200.326 The Subrecipient
must ensure that its procurement process requires contractors and subcontractors to provide
adequate documentation with sufficient detail to support the costs of the project and to allow both
the Subrecipient and Department to make a determination on eligibility of project costs
c All contracting agreements entered into pursuant to this Agreement shall incorporate this
Agreement by reference
A 11 DISCLOSURE
The use or disclosure by any party of any information concerning the Department for any purpose not
directly connected with the administration of the Department's or the Subrecipient's responsibilities with
respect to services provided under this Agreement is prohibited except by prior written consent of the
Department or as required to comply with the state Public Records Act, other law or court order.
A.12 DISPUTES
Except as otherwise provided in this Agreement, when a bona fide dispute arises between the parties
and it cannot be resolved through discussion and negotiation, either party may request a dispute
resolution panel to resolve the dispute A request for a dispute resolution board shall be in writing, state
the disputed issues, state the relative positions of the parties, and be sent to all parties The panel shall
consist of a representative appointed by the Department, a representative appointed by the Subrecipient
and a third party mutually agreed upon by both parties The panel shall, by majority vote, resolve the
dispute. Each party shall bear the cost for its panel member and its attorney fees and costs and share
equally the cost of the third panel member.
A.13 LEGAL RELATIONS
It is understood and agreed that this Agreement is solely for the benefit of the parties to the Agreement
and gives no right to any other party. No joint venture or partnership is formed as a result of this
Agreement.
To the extent allowed by law, the Subrecipient, its successors or assigns, will protect, save and hold
harmless the Department, the state of Washington, and the United States Government and their
authorized agents and employees, from all claims, actions, costs, damages or expenses of any nature
whatsoever by reason of the acts or omissions of the Subrecipient, its subcontractors, subrecipients,
assigns, agents, contractors, consultants, licensees, invitees, employees or any person whomsoever
arising out of or in connection with any acts or activities authorized by this Agreement.
To the extent allowed by law, the Subrecipient further agrees to defend the Department and the state of
Washington and their authorized agents and employees in any litigation, including payment of any costs
or attorneys' fees for any claims or action commenced thereon arising out of or in connection with acts
or activities authorized by this Agreement.
This obligation shall not include such claims, costs, damages or expenses which may be caused by the
sole negligence of the Department, provided, that if the claims or damages are caused by or result from
the concurrent negligence of(1)the Department, and (2)the Subrecipient, its agents, or employees, this
indemnity provision shall be valid and enforceable only to the extent of the negligence of the Subrecipient,
or the Subrecipient's agents or employees
Insofar as the funding source, the Department of Homeland Security (DHS)/Federal Emergency
Management Agency (FEMA), is an agency of the Federal government, the following shall apply
DHS-FEMA-HSGP-SHSP-FFY19 Page 14 of 36 Lewis County, E20-070
44 CFR 206 9 Non-liability. The Federal government shall not be liable for any claim based upon the
exercise or performance of, or the failure to exercise or perform a discretionary function or duty on the
part of a federal agency or an employee of the Federal government in carrying out the provisions of the
Stafford Act
A 14 LIMITATION OF AUTHORITY—AUTHORIZED SIGNATURE
The signatories to this Agreement represent that they have the authority to bind their respective
organizations to this Agreement Only the Department's Authorized Signature representative and the
Authorized Signature representative of the Subrecipient or Alternate for the Subrecipient, formally
designated in writing, shall have the express, implied, or apparent authority to alter, amend, modify, or
waive any clause or condition of this Agreement Any alteration, amendment, modification, or waiver of
any clause or condition of this Agreement is not effective or binding unless made in writing and signed
by both parties' Authorized Signature representatives
Further, only the Authorized Signature representative or Alternate for the Subrecipient shall have
signature authority to sign reimbursement requests, time extension requests, amendment and
modification requests, requests for changes to projects or work plans, and other requests, certifications
and documents authorized by or required under this Agreement.
A 15 LOSS OR REDUCTION OF FUNDING
In the event funding from state, federal, or other sources is withdrawn, reduced, or limited in any way
after the effective date of this Agreement and prior to normal completion or end date, the Department
may unilaterally reduce the work plan and budget or unilaterally terminate all or part of the Agreement as
a "Termination for Cause" without providing the Subrecipient an opportunity to cure Alternatively, the
parties may renegotiate the terms of this Agreement under "Amendments and Modifications" to comply
with new funding limitations and conditions, although the Department has no obligation to do so
A.16 NONASSIGNABILITY
Neither this Agreement, nor any claim arising under this Agreement, shall be transferred or assigned by
the Subrecipient
A 17 NONDISCRIMINATION
The Subrecipient shall comply with all applicable federal and state non-discrimination laws, regulations,
and policies No person shall, on the grounds of age, race, creed, color, sex, sexual orientation, religion,
national origin, marital status, honorably discharged veteran or military status, or disability (physical,
mental, or sensory) be denied the benefits of, or otherwise be subjected to discrimination under any
project, program, or activity, funded, in whole or in part, under this Agreement
A 18 NOTICES
The Subrecipient shall comply with all public notices or notices to individuals required by applicable local,
state and federal laws and regulations and shall maintain a record of this compliance
A 19 OCCUPATIONAL SAFETY/HEALTH ACT and WASHINGTON INDUSTRIAL SAFETY/HEALTH ACT
(OSHA/WISHA)
The Subrecipient represents and warrants that its workplace does now or will meet all applicable federal
and state safety and health regulations that are in effect during the Subrecipient's performance under this
Agreement To the extent allowed by law, the Subrecipient further agrees to indemnify and hold harmless
the Department and its employees and agents from all liability, damages and costs of any nature,
including, but not limited to, costs of suits and attorneys' fees assessed against the Department, as a
result of the failure of the Subrecipient to so comply.
A 20 OWNERSHIP OF PROJECT/CAPITAL FACILITIES
The Department makes no claim to any capital facilities or real property improved or constructed with
funds under this Agreement, and by this subaward of funds does not and will not acquire any ownership
interest or title to such property of the Subrecipient. The Subrecipient shall assume all liabilities and
responsibilities arising from the ownership and operation of the project and agrees to indemnify and hold
the Department, the state of Washington, and the United States government harmless from any and all
causes of action arising from the ownership and operation of the project.
DHS-FEMA-HSGP-SHSP-FFY19 Page 15 of 36 Lewis County, E20-070
A.21 POLITICAL ACTIVITY
No portion of the funds provided herein shall be used for any partisan political activity or to further the
election or defeat of any candidate for public office or influence the approval or defeat of any ballot issue
A 22 PROHIBITION AGAINST PAYMENT OF BONUS OR COMMISSION
The assistance provided under this Agreement shall not be used in payment of any bonus or commission
for the purpose of obtaining approval of the application for such assistance or any other approval or
concurrence under this Agreement provided, however, that reasonable fees or bona fide technical
consultant, managerial, or other such services, other than actual solicitation, are not hereby prohibited if
otherwise eligible as project costs
A 23 PUBLICITY
The Subrecipient agrees to submit to the Department prior to issuance all advertising and publicity
matters relating to this Agreement wherein the Department's name is mentioned, or language used from
which the connection of the Department's name may, in the Department's judgment, be inferred or
implied. The Subrecipient agrees not to publish or use such advertising and publicity matters without the
prior written consent of the Department. The Subrecipient may copyright original work it develops in the
course of or under this Agreement, however, pursuant to 2 CFR Part 200 315, FEMA reserves a royalty-
free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize
others to use the work for government purposes
Publication resulting from work performed under this Agreement shall include an acknowledgement of
FEMA's financial support, by the Assistance Listings Number(formerly CFDA Number), and a statement
that the publication does not constitute an endorsement by FEMA or reflect FEMA's views
A 24 RECAPTURE PROVISION
In the event the Subrecipient fails to expend funds under this Agreement in accordance with applicable
federal, state, and local laws, regulations, and/or the provisions of the Agreement, the Department
reserves the right to recapture funds in an amount equivalent to the extent of noncompliance. Such right
of recapture shall exist for the life of the project following Agreement termination. Repayment by the
Subrecipient of funds under this recapture provision shall occur within 30 days of demand In the event
the Department is required to institute legal proceedings to enforce the recapture provision, the
Department shall be entitled to its costs and expenses thereof, including attorney fees from the
Subrecipient
A.25 RECORDS
a The Subrecipient agrees to maintain all books, records, documents, receipts, invoices and all
other electronic or written records necessary to sufficiently and properly reflect the Subrecipient's
contracts, subawards, grant administration, and payments, including all direct and indirect
charges, and expenditures in the performance of this Agreement (the "records").
b. The Subrecipient's records related to this Agreement and the projects funded may be inspected
and audited by the Department or its designee, by the Office of the State Auditor, DHS, FEMA or
their designees, by the Comptroller General of the United States or its designees, or by other
state or federal officials authorized by law, for the purposes of determining compliance by the
Subrecipient with the terms of this Agreement and to determine the appropriate level of funding
to be paid under the Agreement.
c The records shall be made available by the Subrecipient for such inspection and audit, together
with suitable space for such purpose, at any and all times during the Subrecipient's normal
working day
d The Subrecipient shall retain and allow access to all records related to this Agreement and the
funded project(s) for a period of at least six (6) years following final payment and closure of the
grant under this Agreement Despite the minimum federal retention requirement of three (3)
years, the more stringent State requirement of six (6) years must be followed.
A.26 RESPONSIBILITY FOR PROJECT/STATEMENT OF WORK/WORK PLAN
While the Department undertakes to assist the Subrecipient with the project/statement of work/work plan
(project) by providing federal award funds pursuant to this Agreement, the project itself remains the sole
responsibility of the Subrecipient The Department undertakes no responsibility to the Subrecipient, or
to any third party, other than as is expressly set out in this Agreement.
DHS-FEMA-HSGP-SHSP-FFY19 Page 16 of 36 Lewis County, E20-070
The responsibility for the design, development, construction, implementation, operation and maintenance
of the project, as these phrases are applicable to this project, is solely that of the Subrecipient, as is
responsibility for any claim or suit of any nature by any third party related in any way to the project
Prior to the start of any construction activity, the Subrecipient shall ensure that all applicable federal,
n local permits and clearances are obtained, including, not limited to, FEMA compliance with
state, and p g, p
the National Environmental Policy Act, the National Historic Preservation Act, the Endangered Species
Act, and all other environmental laws, regulations, and executive orders
The Subrecipient shall defend, at its own cost, any and all claims or suits at law or in equity, which may
be brought against the Subrecipient in connection with the project The Subrecipient shall not look to the
Department, or to any state or federal agency, or to any of their employees or agents, for any
performance, assistance, or any payment or indemnity, including, but not limited to, cost of defense
and/or attorneys' fees, in connection with any claim or lawsuit brought by any third party related to any
design, development, construction, implementation, operation and/or maintenance of a project
A 27 SEVERABILITY
If any court of rightful jurisdiction holds any provision or condition under this Agreement or its application
to any person or circumstances invalid, this invalidity does not affect other provisions, terms or conditions
of the Agreement, which can be given effect without the invalid provision To this end, the terms and
conditions of this Agreement are declared severable
A.28 SINGLE AUDIT ACT REQUIREMENTS (including all AMENDMENTS)
The Subrecipient shall comply with and include the following audit requirements in any subawards.
Non-federal entities, as Subrecipients of a federal award, that expend $750,000 or more in one fiscal
year of federal funds from all sources, direct and indirect, are required to have a single or a program-
specific audit conducted in accordance with 2 CFR Part 200 Subpart F Non-federal entities that spend
less than $750,000 a year in federal awards are exempt from federal audit requirements for that year,
except as noted in 2 CFR Part 200 Subpart F As defined in 2 CFR Part 200, the term "non-federal entity"
means a state, local government, Indian tribe, institution of higher education, or nonprofit organization
that carries out a federal award as a recipient or subrecipient.
Subrecipients that are required to have an audit must ensure the audit is performed in accordance with
Generally Accepted Government Auditing Standards (GAGAS) as found in the Government Auditing
Standards (the Revised Yellow Book) developed by the United States Comptroller General and the OMB
Compliance Supplement The Subrecipient has the responsibility of notifying its auditor and requesting
an audit in compliance with 2 CFR Part 200 Subpart F, to include the Washington State Auditor's Office,
a federal auditor, or a public accountant performing work using GAGAS, as appropriate Costs of the
audit may be an allowable grant expenditure as authorized by 2 CFR Part 200.425.
The Subrecipient shall maintain auditable records and accounts so as to facilitate the audit requirement
and shall ensure that any subcontractors also maintain auditable records The Subrecipient is
responsible for any audit exceptions incurred by its own organization or that of its
subcontractors Responses to any unresolved management findings and disallowed or questioned costs
shall be included with the audit report The Subrecipient must respond to Department requests for
information or corrective action concerning audit issues or findings within 30 days of the date of
request The Department reserves the right to recover from the Subrecipient all disallowed costs
resulting from the audit
After the single audit has been completed, and if it includes any audit findings, the Subrecipient must
send a full copy of the audit and its Corrective Action Plan to the Department at the following address no
later than nine (9) months after the end of the Subrecipient's fiscal year(s)
Washington Military Department
ATTN. Contract's Office
1 Militia Drive; TA-20
Camp Murray, WA 98430-5032
The Subrecipient must send a completed "2 CFR Part 200 Subpart F Audit Certification Form"
(https•//www mil wa qov/emergency-management-division/grants/requiredgrantforms)to the Department
at the address listed above before this Agreement is executed and timely submit annual updates to the
DHS-FEMA-HSGP-SHSP-FFY19 Page 17 of 36 Lewis County, E20-070
Department every year thereafter, and if the Subrecipient is claiming it is exempt from the audit
requirements of 2 CFR Part 200 Subpart F include an explanation of the criteria for exemption.
The Department retains the sole discretion to determine whether a valid claim for an exemption from the
audit requirements of this provision has been established.
Conducting a single or program-specific audit in compliance with 2 CFR Part 200 Subpart F is a material
requirement of this Agreement. In the absence of a valid claim of exemption from the audit requirements
of 2 CFR Part 200 Subpart F, the Subrecipient's failure to comply with said audit requirements may result
in one or more of the following actions in the Department's sole discretion a percentage of federal awards
being withheld until the audit is completed in accordance with 2 CFR Part 200 Subpart F, the withholding
or disallowing of overhead costs, the suspension of federal awards until the audit is conducted and
submitted, or termination of the federal award.
A 29 SUBRECIPIENT NOT EMPLOYEE
The parties intend that an independent contractor relationship will be created by this Agreement The
Subrecipient, and/or employees or agents performing under this Agreement are not employees or agents
of the Department in any manner whatsoever The Subrecipient will not be presented as, nor claim to
be, an officer or employee of the Department by reason of this Agreement, nor will the Subrecipient make
any claim, demand, or application to or for any right or privilege applicable to an officer or employee of
the Department or of the state of Washington by reason of this Agreement, including, but not limited to,
Workmen's Compensation coverage, unemployment insurance benefits, social security benefits,
retirement membership or credit, or privilege or benefit which would accrue to a civil service employee
under Chapter 41 06 RCW
It is understood that if the Subrecipient is another state department, state agency, state university, state
college, state community college, state board, or state commission, that the officers and employees are
employed by the state of Washington in their own right and not by reason of this Agreement
A 30 TAXES, FEES AND LICENSES
Unless otherwise provided in this Agreement, the Subrecipient shall be responsible for, pay and maintain
in current status all taxes, unemployment contributions, fees, licenses, assessments, permit charges and
expenses of any other kind for the Subrecipient or its staff required by statute or regulation that are
applicable to Agreement performance
A 31 TERMINATION FOR CONVENIENCE
Notwithstanding any provisions of this Agreement, the Subrecipient may terminate this Agreement by
providing written notice of such termination to the Department Key Personnel identified in the Agreement,
specifying the effective date thereof, at least thirty (30) days prior to such date
Except as otherwise provided in this Agreement, the Department, in its sole discretion and in the best
interests of the state of Washington, may terminate this Agreement in whole or in part by providing ten
(10) calendar days written notice, beginning on the second day after mailing to the Subrecipient. Upon
notice of termination for convenience, the Department reserves the right to suspend all or part of the
Agreement, withhold further payments, or prohibit the Subrecipient from incurring additional obligations
of funds In the event of termination, the Subrecipient shall be liable for all damages as authorized by
law The rights and remedies of the Department provided for in this section shall not be exclusive and
are in addition to any other rights and remedies provided by law.
A.32 TERMINATION OR SUSPENSION FOR CAUSE
In the event the Department, in its sole discretion, determines the Subrecipient has failed to fulfill in a
timely and proper manner its obligations under this Agreement, is in an unsound financial condition so
as to endanger performance hereunder, is in violation of any laws or regulations that render the
Subrecipient unable to perform any aspect of the Agreement, or has violated any of the covenants,
agreements or stipulations of this Agreement, the Department has the right to immediately suspend or
terminate this Agreement in whole or in part.
The Department may notify the Subrecipient in writing of the need to take corrective action and provide
a period of time in which to cure The Department is not required to allow the Subrecipient an opportunity
to cure if it is not feasible as determined solely within the Department's discretion Any time allowed for
cure shall not diminish or eliminate the Subrecipient's liability for damages or otherwise affect any other
remedies available to the Department. If the Department allows the Subrecipient an opportunity to cure,
DHS-FEMA-HSGP-SHSP-FFY19 Page 18 of 36 Lewis County, E20-070
the Department shall notify the Subrecipient in writing of the need to take corrective action If the
corrective action is not taken within ten (10) calendar days or as otherwise specified by the Department,
or if such corrective action is deemed by the Department to be insufficient, the Agreement may be
terminated in whole or in part.
The Department reserves the right to suspend all or part of the Agreement, withhold further payments,
or prohibit the Subrecipient from incurring additional obligations of funds during investigation of the
alleged compliance breach, pending corrective action by the Subrecipient, if allowed, or pending a
decision by the Department to terminate the Agreement in whole or in part.
In the event of termination,the Subrecipient shall be liable for all damages as authorized by law, including,
but not limited to, any cost difference between the original Agreement and the replacement or cover
Agreement and all administrative costs directly related to the replacement Agreement, e g , cost of
administering the competitive solicitation process, mailing, advertising and other associated staff time
The rights and remedies of the Department provided for in this section shall not be exclusive and are in
addition to any other rights and remedies provided by law.
If it is determined that the Subrecipient: (1) was not in default or material breach, or (2) failure to perform
was outside of the Subrecipient's control, fault or negligence, the termination shall be deemed to be a
"Termination for Convenience".
A 33 TERMINATION PROCEDURES
In addition to the procedures set forth below, if the Department terminates this Agreement, the
Subrecipient shall follow any procedures specified in the termination notice Upon termination of this
Agreement and in addition to any other rights provided in this Agreement, the Department may require
the Subrecipient to deliver to the Department any property specifically produced or acquired for the
performance of such part of this Agreement as has been terminated
If the termination is for convenience, the Department shall pay to the Subrecipient as an agreed upon
price, if separately stated, for properly authorized and completed work and services rendered or goods
delivered to and accepted by the Department prior to the effective date of Agreement termination, the
amount agreed upon by the Subrecipient and the Department for (i) completed work and services and/or
equipment or supplies provided for which no separate price is stated, (ii) partially completed work and
services and/or equipment or supplies provided which are accepted by the Department, (iii) other work,
services and/or equipment or supplies which are accepted by the Department, and (iv)the protection and
preservation of property
Failure to agree with such amounts shall be a dispute within the meaning of the "Disputes" clause of this
Agreement If the termination is for cause, the Department shall determine the extent of the liability of
the Department The Department shall have no other obligation to the Subrecipient for termination The
Department may withhold from any amounts due the Subrecipient such sum as the Department
determines to be necessary to protect the Department against potential loss or liability
The rights and remedies of the Department provided in this Agreement shall not be exclusive and are in
addition to any other rights and remedies provided by law
After receipt of a notice of termination, and except as otherwise directed by the Department in writing,
the Subrecipient shall:
a. Stop work under the Agreement on the date, and to the extent specified, in the notice,
b Place no further orders or contracts for materials, services, supplies, equipment and/or facilities
in relation to this Agreement except as may be necessary for completion of such portion of the
work under the Agreement as is not terminated,
c. Assign to the Department, in the manner, at the times, and to the extent directed by the
Department, all of the rights, title, and interest of the Subrecipient under the orders and contracts
so terminated, in which case the Department has the right, at its discretion, to settle or pay any
or all claims arising out of the termination of such orders and contracts,
d. Settle all outstanding liabilities and all claims arising out of such termination of orders and
contracts, with the approval or ratification of the Department to the extent the Department may
require, which approval or ratification shall be final for all the purposes of this clause;
DHS-FEMA-HSGP-SHSP-FFY19 Page 19 of 36 Lewis County, E20-070
e Transfer title to the Department and deliver in the manner, at the times, and to the extent directed
by the Department any property which, if the Agreement had been completed, would have been
required to be furnished to the Department;
f. Complete performance of such part of the work as shall not have been terminated by the
Department in compliance with all contractual requirements; and
g Take such action as may be necessary, or as the Department may require, for the protection and
preservation of the property related to this Agreement which is in the possession of the
Subrecipient and in which the Department has or may acquire an interest.
A 34 UTILIZATION OF MINORITY AND WOMEN BUSINESS ENTERPRISES (MWBE)
The Subrecipient is encouraged to utilize business firms that are certified as minority-owned and/or
women-owned in carrying out the purposes of this Agreement The Subrecipient may set utilization
standards, based upon local conditions or may utilize the state of Washington MWBE goals, as identified
in WAC 326-30-041
A 35 VENUE
This Agreement shall be construed and enforced in accordance with, and the validity and performance
shall be governed by, the laws of the state of Washington Venue of any suit between the parties arising
out of this Agreement shall be the Superior Court of Thurston County, Washington The Subrecipient,
by execution of this Agreement, acknowledges the jurisdiction of the courts of the state of Washington
A 36 WAIVERS
No conditions or provisions of this Agreement can be waived unless approved in advance by the
Department in writing The Department's failure to insist upon strict performance of any provision of the
Agreement or to exercise any right based upon a breach thereof, or the acceptance of any performance
during such breach, shall not constitute a waiver of any right under this Agreement
DHS-FEMA-HSGP-SHSP-FFY19 Page 20 of 36 Lewis County, E20-070
ATTACHMENT 1
FFY19 HSGP Award Documents
EMW-2019-SS-00044-S01
Award Letter
U S Department of Homeland Security
iymt7•,yf Washington,D C 20472
ls
`' o
i'I
c........_
ND S'-
Bret Daugherty
Washington Military Department
Building 20
Camp Murray,WA98430-5122
Re Grant No EMW-2019-SS-00044
Dear Bret Daugherty
Congratulations, on behalf of the Department of Homeland Security, your application for financial assistance submitted under
the Fiscal Year (FY)2019 Homeland Security Grant Program has been approved in the amount of$15,581,281 00 You are
not required to match this award with any amount of non-Federal funds
Before you request and receive any of the Federal funds awarded to you,you must establish acceptance of the award By
accepting this award,you acknowledge that the terms of the following documents are incorporated into the terms of your
award
• Agreement Articles(attached to this Award Letter)
• Obligating Document(attached to this Award Letter)
• FY 2019 Homeland Security Grant Program Notice of Funding Opportunity
• FEMA Preparedness Grants Manual
Please make sure you read, understand, and maintain a copy of these documents in your official file for this award
In order to establish acceptance of the award and its terms, please follow these instructions
Step 1 Please log in to the ND Grants system at https.f/portal fema gov
Step 2 After logging in,you will see the Home page with a Pending Tasks menu Click on the Pending Tasks menu,select the
Application sub-menu, and then click the link for"Award Offer Review"tasks This link will navigate you to Award Packages
that are pending review
Step 3 Click the Review Award Package icon (wrench)to review the Award Package and accept or decline the award Please
save or print the Award Package for your records
System for Award Management(SAM) Grant recipients are to keep all of their information up to date in SAM,in particular,
your organization's name,address, DUNS number, EIN and banking information Please ensure that the DUNS number used
in SAM is the same one used to apply for all FEMA awards Future payments will be contingent on the information provided
in the SAM, therefore,it is imperative that the information is correct The System for Award Management is located at http.//
www.sa m.g av_
If you have any questions or have updated your information in SAM, please let your Grants Management Specialist(GMS)
know as soon as possible This will help us to make the necessary updates and avoid any interruptions in the payment
process
a//vaid.444,44,..,,,
BRIDGET ELLEN BEAN GPD Assistant Administrator
DHS-FEMA-HSGP-SHSP-FFY19 Page 21 of 36 Lewis County, E20-070
Agreement Articles
Sun Sep 01 00 00:00 GMT 2019
U S Department of Homeland Security
4,-ei‘Rtif, Washington,D C 20472
v.........„..„...„
Agaire .0 J
1,N-D S"C
AGREEMENT ARTICLE S
Homeland Security Grant Program
GRANTEE. Washington Military Department
PROGRAM. Homeland Security Grant Program
AGREEMENT NUMBER: EMW-2019-SS-00 04 4-50 1
TABLE OF CONTENTS
Article I Summary Description of Award
Article II Acceptance of Post Award Changes
Article III Prior Approval for Modification of Approved Budget
Article IV Disposition of Equipment Ac q uired Under the Federal Award
p
Article V Assurances,Administrative Requirements,Cost Principles,
Representation and Certifications
Article VI DHS Specific Acknowledgements and Assurances
Article VII Acknowledgement of Federal Funding from DHS
Article VIII Activities Conducted Abroad
Article IX Age Discrimination Act of 1975
Article X Americans with Disabilities Act of 1990
Article XI Best Practices for Collection and Use of Personally
Identifiable Information (PII)
Article XII Civil Rights Act of 1964-Title VI
Article XIII Civil Rights Act of 1968
DHS-FEMA-HSGP-SHSP-FFY19 Page 22 of 36 Lewis County, E20-070
Article XIV Copyright
Article XV Debarment and Suspension
Article XVI Drug-Free Workplace Regulations
Article XVII Duplication of Benefits
Article XVIII Education Amendments of 1972(Equal Opportunity in
Education Act)-Title IX
Article XIX Energy Policy and Conservation Act
Article XX False Claims Act and Program Fraud Civil Remedies
Article XXI Federal Debt Status
Article XXII Federal Leadership on Reducing Text Messaging while
Driving
1 Article XXIII Fly America Act of 1974
Article XXIV Hotel and Motel Fire Safety Act of 1990
Article XXV Limited English Proficiency(Civil Rights Act of 1964,Title VI)
Article XXVI Lobbying Prohibitions 1
Article XXVII National Environmental Policy Act
Article XXVIII Nondiscrimination in Matters Pertaining to Faith-Based
Organizations
Article XXIX Non-Supplanting Requirement
Article XXX Notice of Funding Opportunity Requirements
Article XXXI Patents and Intellectual Property Rights
Article XXXII Procurement of Recovered Materials
Article XXXIII Rehabilitation Act of 1973
Article XXXIV Reporting of Matters Related to Recipient Integrity and
Performance
Article XXXV Reporting Subawards and Executive Compensation
Article XXXVI SAFECOM
DHS-FEMA-HSGP-SHSP-FFY19 Page 23 of 36 Lewis County, E20-070
Article XXXVII Terrorist Financing
Article)(XXVIII Trafficking Victims Protection Act of 2000
Article XXXIX Universal Identifier and System for Award Management
Article XL USA Patriot Act of 2001
Article XLI Use of DHS Seal, Logo and Flags
Article XLII Whistleblower Protection Act
Article XLIII Environmental Planning and Historic Preservation
Article XLIV Operation Stonegarden Program Hold
Article I -Summary Description of Award
The purpose of the FY 2019 HSGP is to support state and local efforts to prevent terrorism and other catastrophic events and
to prepare the Nation for the threats and hazards that pose the greatest risk to the security of the United States The HSGP
provides funding to implement investments that build, sustain, and deliver the 32 core capabilities essential to achieving the
National Preparedness Goal of a secure and resilient Nation Among the five basic homeland security missions noted in the
DHS Quadrennial Homeland Security Review, HSGP supports the goal to Strengthen National Preparedness and Resilience
The building, sustainment, and delivery of these core capabilities are not exclusive to any single level of government,
organization, or community, but rather, require the combined effort of the whole community This HSGP award consists
of State Homeland Security Program(SHSP)funding in the amount of$7,000,000, Urban Area Security Initiative(UASI)
funding in the amount of$6,000,000, and Operation Stonegarden (OPSG)funding in the amount of$2,581,281 The following
counties shall receive Operation Stonegarden subawards for the following amounts Clallam, $450,000, Colville, $55,393,
Ferry, $125,000, Island, $203,386, Jamestown S'Klallam, $75,000, Makah, $72,018, Nooksack, $105,262,Okanogan,
$245,000, Pend Oreille, $150,232,Quileute, $75,000, San Juan, $160,750,Skagit, $42,240,Spokane, $150,250, Stevens,
$170,000, Swinomish, $90,750,Whatcom, $411,000 These grant programs fund a range of activities, including planning,
organization, equipment purchase, training, exercises, and management and administration across all core capabilities and
mission areas
Article II -Acceptance of Post Award Changes
In the event FEMA determines that changes are necessary to the award document after an award has been made, including
changes to period of performance or terms and conditions, recipients will be notified of the changes in writing Once
notification has been made, any subsequent request for funds will indicate recipient acceptance of the changes to the award
Please call the FEMA/GMD Call Center at(866)927-5646 or via e-mail to ASK-GMDedhs.gov if you have any questions
Article III-Prior Approval for Modification of Approved Budget
Before making a ny change to the DHS/FEMA a pp roved budget for this award, y ou must request prior written approval from
DHS/FEMA where required by 2 C F R Section 200 308 DHS/FEMA is also utilizing its discretion to impose an additional
restriction under 2 C F R Section 200 308(e) regarding the transfer of funds among direct cost categories, programs,
functions, or activities Therefore,for awards with an approved budget where the Federal share is greater than the simplified
acquisition threshold(currently$250,000),you may not transfer funds among direct cost categories, programs,functions,
or activities without prior written approval from DHS/FEMA where the cumulative amount of such transfers exceeds or is
expected to exceed ten percent(10%)of the total budget DHS/FEMA last approved You must report any deviations from
your DHS/FEMA approved budget in the first Federal Financial Report(SF-425)you submit following any budget deviation,
regardless of whether the budget deviation requires prior written approval
Article IV-Disposition of Equipment Acquired Under the Federal Award
DHS-FEMA-HSGP-SHSP-FFY19 Page 24 of 36 Lewis County, E20-070
When original or replacement equipment acquired under this award by the recipient or its sub-recipients is no longer needed
for the original project or program or for other activities currently or previously supported by DHS/FEMA,you must request
instructions from DHS/FEMA to make proper disposition of the equipment pursuant to 2 C F R Section 200 313
Article V-Assurances,Administrative Requirements,Cost Principles, Representation and Certifications
DHS financial assistance recipients must complete either the Office of Management and Budget(OMB)Standard Form 424B
Assurances-Non-Construction Programs, or OMB Standard Form 424D Assurances-Construction Programs, as applicable
Certain assurances in these documents may not be applicable to your program, and the DHS financial assistance office(DHS
FAO) may require applicants to certify additional assurances Applicants are required to fill out the assurances applicable to
their program as instructed by the awarding agency Please contact the DHS FAO if you have any questions
OHS financial assistance recipients are required to follow the applicable provisions of the Uniform Administrative
Requirements, Cost Principles, and Audit Requirements for Federal Awards located at Title 2, Code of Federal Regulations
(C F R) Part 200, and adopted by DHS at 2 C F R Part 3002
Article VI-DHS Specific Acknowledgements and Assurances
All recipients, subrecipients, successors, transferees, and assignees must acknowledge and agree to comply with applicable
provisions governing DHS access to records, accounts, documents, information,facilities, and staff
1 Recipients must cooperate with any compliance reviews or compliance investigations conducted by OHS
2 Recipients must give DHS access to, and the right to examine and copy, records, accounts, and other documents and
sources of information related to the federal financial assistance award and permit access to facilities, personnel, and other
individuals and information as may be necessary, as required by DHS regulations and other applicable laws or program
guidance
3 Recipients must submit timely, complete, and accurate reports to the appropriate OHS officials and maintain appropriate
backup documentation to support the reports
4 Recipients must comply with all other special reporting, data collection, and evaluation requirements, as prescribed by law
or detailed in program guidance
5 Recipients of federal financial assistance from OHS must complete the DHS Crvrl Rights Evaluation Too/within thirty(30)
days of receipt of the Notice of Award or, for State Administering Agencies,thirty(30)days from receipt of the DHS Civil
Rights Evaluation Tool from OHS or its awarding component agency. Recipients are required to provide this information once
every two(2)years, not every time an award is made After the initial submission for the first award under which this term
applies, recipients are only required to submit updates every two years, not every time a grant is awarded Recipients should
submit the completed tool, including supporting materials,to CivilRightsEvaluation @hq dhs gov This tool clarifies the civil
rights obligations and related reporting requirements contained in the OHS Standard Terms and Conditions Subrecipients are
not required to complete and submit this tool to DHS The evaluation tool can be found at https.//www dhs gov/publication/dhs-
civil-rights-evaluation-tool
Article VII-Acknowledgement of Federal Funding from DHS
Recipients must acknowledge their use of federal funding when issuing statements, press releases, requests for proposal, bid
invitations, and other documents describing projects or programs funded in whole or in part with federal funds
Article VIII -Activities Conducted Abroad
Recipients must ensure that project activities carried on outside the United States are coordinated as necessary with
appropriate government authorities and that appropriate licenses, permits, or approvals are obtained
Article IX-Age Discrimination Act of 1975
Recipients must comply with the requirements of the Age Discnmination Act of 1975, Pub. L. No 94-135(1975) (codified as
amended at Title 42, U S Code, section 6101 et seq),which prohibits discrimination on the basis of age in any program or
activity receiving federal financial assistance
Article X-Americans with Disabilities Act of 1990
DHS-FEMA-HSGP-SHSP-FFY19 Page 25 of 36 Lewis County, E20-070
Recipients must comply with the requirements of Titles I, II, and III of the Americans with Disabilities Act, Pub. L No 101-336
(1990) (codified as amended at 42 U S C sections 12101-12213), which prohibits recipients from discriminating on the basis
of disability in the operation of public entities, public and private transportation systems, places of public accommodation, and
certain testing entities
Article XI-Best Practices for Collection and Use of Personally Identifiable Information(PII)
Recipients who collect PII are required to have a publicly available privacy policy that describes standards on the usage and
maintenance of the PII they collect DHS defines personally identifiable information(PII)as any information that permits the
identity of an individual to be directly or indirectly inferred, including any information that is linked or linkable to that individual
Recipients may also find the DHS Privacy Impact Assessments Privacy Guidance and Privacy Template as useful resources
respectively
Article XII-Civil Rights Act of 1964-Title VI
Recipients must comply with the requirements of Title VI of the Civil Rights Act of 1964(codified as amended at 42 U S C
section 2000d et seq), which provides that no person in the United States will, on the grounds of race, color, or national origin,
be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity
receiving federal financial assistance DHS implementing regulations for the Act are found at 6 C F R Part 21 and 44 C F R
Part 7
Article XIII-Civil Rights Act of 1968
Recipients must comply with Title VIII of the Civil Rights Act of 1968, Pub L No 90-284, as amended through Pub L. 113-4,
which prohibits recipients from discriminating in the sale, rental,financing, and advertising of dwellings, or in the provision of
services in connection therewith, on the basis of race, color, national origin, religion, disability,familial status, and sex(see
42 U S C section 3601 et seq), as implemented by the U S Department of Housing and Urban Development at 24 C F R
Part 100 The prohibition on disability discrimination includes the requirement that new multifamily housing with four or more
dwelling units-i e, the public and common use areas and individual apartment units(all units in buildings with elevators and
ground-floor units in buildings without elevators)-be designed and constructed with certain accessible features (See 24
C F R Part 100, Subpart D)
Article XIV-Copyright
Recipients must affix the applicable copyright notices of 17 U S C sections 401 or 402 and an acknowledgement of U S
Government sponsorship(including the award number)to any work first produced under federal financial assistance awards
Article XV-Debarment and Suspension
Recipients are subject to the non-procurement debarment and suspension regulations implementing Executive Orders(E O)
12549 and 12689, which are at 2 C F R Part 180 as adopted by DHS at 2 C F R Part 3000 These regulations restrict
federal financial assistance awards, subawards, and contracts with certain parties that are debarred, suspended, or otherwise
excluded from or ineligible for participation in federal assistance programs or activities
Article XVI-Drug-Free Workplace Regulations
Recipients must comply with drug-free workplace requirements in Subpart B(or Subpart C, if the recipient is an individual)of 2
C F R Part 3001,which adopts the Government-wide implementation(2 C F R Part 182)of sec 5152-5158 of the Drug-Free
Workplace Act of 1988(41 U S C sections 8101-8106)
Article XVII-Duplication of Benefits
Any cost allocable to a particular federal financial assistance award provided for in 2 C F R Part 200, Subpart E may not
be charged to other federal financial assistance awards to overcome fund deficiencies,to avoid restrictions imposed by
federal statutes, regulations, or federal financial assistance award terms and conditions, or for other reasons However, these
prohibitions would not preclude recipients from shifting costs that are allowable under two or more awards in accordance with
existing federal statutes, regulations, or the federal financial assistance award terms and conditions
Article XVIII-Education Amendments of 1972(Equal Opportunity in Education Act)-Title IX
DHS-FEMA-HSGP-SHSP-FFY19 Page 26 of 36 Lewis County, E20-070
Recipients must comply with the requirements of Title IX of the Education Amendments of 1972, Pub L No 92-318 (1972)
(codified as amended at 20 U.S C section 1681 et seq), which provide that no person in the United States will, on the basis
of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any educational
program or activity receiving federal financial assistance DHS implementing regulations are codified at 6 C F R Part 17 and
44CFR Part 19
Article XIX-Energy Policy and Conservation Act
Recipients must comply with the requirements of the Energy Policy and Conservation Act, Pub L No 94-163(1975) (codified
as amended at 42 U S C section 6201 et seq),which contain policies relating to energy efficiency that are defined in the state
energy conservation plan issued in compliance with this Act
Article XX-False Claims Act and Program Fraud Civil Remedies
Recipients must comply with the requirements of the False Claims Act, 31 U S C sections 3729-3733, which prohibits the
submission of false or fraudulent claims for payment to the federal government. (See 31 U S C sections 3801-3812,which
details the administrative remedies for false claims and statements made)
Article XXI-Federal Debt Status
All recipients are required to be non-delinquent in their repayment of any federal debt Examples of relevant debt include
delinquent payroll and other taxes, audit disallowances, and benefit overpayments. (See OMB Circular A-129)
Article XXII-Federal Leadership on Reducing Text Messaging while Driving
Recipients are encouraged to adopt and enforce policies that ban text messaging while driving as described in E 0 13513,
including conducting initiatives described in Section 3(a)of the Order when on official government business or when
performing any work for or on behalf of the federal government
Article XXIII-Fly America Act of 1974
Recipients must comply with Preference for U S Flag Air Carriers(air carriers holding certificates under 49 U S C
section 41102)for international air transportation of people and property to the extent that such service is available, in
accordance with the International Air Transportation Fair Competitive Practices Act of 1974, 49 U S C section 40118, and
the interpretative guidelines issued by the Comptroller General of the United States in the March 31, 1981, amendment to
Comptroller General Decision B-138942
Article XXIV-Hotel and Motel Fire Safety Act of 1990
In accordance with Section 6 of the Hotel and Motel Fire Safety Act of 1990, 15 U S C section 2225a, recipients must ensure
that all conference, meeting, convention, or training space funded in whole or in part with federal funds complies with the fire
prevention and control guidelines of the Federal Fire Prevention and Control Act of 1974, codified as amended at 15 U S C
section 2225
Article XXV-Limited English Proficiency(Civil Rights Act of 1964,Title VI)
Recipients must comply with the Title VI of the Civil Rights Act of 1964(42 U S C section 2000d et seq) prohibition against
discrimination on the basis of national origin, which requires that recipients of federal financial assistance take reasonable
steps to provide meaningful access to persons with limited English proficiency(LEP)to their programs and services For
additional assistance and information regarding language access obligations, please refer to the DHS Recipient Guidance
https.//www dhs gov/guidance-published-help-department-supported-organizations-provide-meaningful-access-people-limited
and additional resources on http.//www lep gov
Article XXVI-Lobbying Prohibitions
Recipients must comply with 31 U S C section 1352, which provides that none of the funds provided under a federal financial
assistance award may be expended by the recipient to pay any person to influence, or attempt to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with any federal action related to a federal award or contract, including any extension, continuation,
renewal, amendment, or modification
DHS-FEMA-HSGP-SHSP-FFY19 Page 27 of 36 Lewis County, E20-070
Article XXVII-National Environmental Policy Act
Recipients must comply with the requirements of the National Environmental Policy Act of 1969, Pub L No 91-190(1970)
(codified as amended at 42 U S C section 4321 et seq)(NEPA)and the Council on Environmental Quality(CEO) Regulations
for Implementing the Procedural Provisions of NEPA,which requires recipients to use all practicable means within their
authority, and consistent with other essential considerations of national policy, to create and maintain conditions under which
people and nature can exist in productive harmony and fulfill the social, economic, and other needs of present and future
generations of Americans
Article XXVIII-Nondiscrimination in Matters Pertaining to Faith-Based Organizations
It is DHS policy to ensure the equal treatment of faith-based organizations in social service programs administered or
supported by DHS or its component agencies, enabling those organizations to participate in providing important social
services to beneficiaries Recipients must comply with the equal treatment policies and requirements contained in 6 C F R
Part 19 and other applicable statues, regulations, and guidance governing the participations of faith-based organizations in
individual DHS programs
Article XXIX-Non-Supplanting Requirement
Recipients receiving federal financial assistance awards made under programs that prohibit supplanting by law must ensure
that federal funds do not replace(supplant)funds that have been budgeted for the same purpose through non-federal
sources
Article XXX-Notice of Funding Opportunity Requirements
All of the instructions, guidance, limitations, and other conditions set forth in the Notice of Funding Opportunity(NOFO)for
this program are incorporated here by reference in the award terms and conditions All recipients must comply with any such
requirements set forth in the program NOFO
Article XXXI -Patents and Intellectual Property Rights
Unless otherwise provided by law, recipients are subject to the Bayh-Dole Act, 35 U S C section 200 et seq Recipients are
subject to the specific requirements governing the development, reporting, and disposition of rights to inventions and patents
resulting from federal financial assistance awards located at 37 C F R Part 401 and the standard patent rights clause located
at 37 C F R section 401 14
Article XXXII-Procurement of Recovered Materials
States, political subdivisions of states,and their contractors must comply with Section 6002 of the Solid Waste Disposal Act,
Pub L No 89-272(1965) (codified as amended by the Resource Conservation and Recovery Act,42 U S C section 6962
The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection
Agency(EPA)at 40 C F R Part 247 that contain the highest percentage of recovered materials practicable, consistent with
maintaining a satisfactory level of competition
Article XXXII!-Rehabilitation Act of 1973
Recipients must comply with the requirements of Section 504 of the Rehabilitation Act of 1973, Pub L. No 93-112(1973)
(codified as amended at 29 U S C section 794),which provides that no otherwise qualified handicapped individuals in
the United States will, solely by reason of the handicap, be excluded from participation in, be denied the benefits of, or be
subjected to discrimination under any program or activity receiving federal financial assistance
Article XXXIV-Reporting of Matters Related to Recipient Integrity and Performance
If the total value of any currently active grants, cooperative agreements, and procurement contracts from all Federal awarding
agencies exceeds$10,000,000 for any period of time during the period of performance of this Federal award, then the
recipients must comply with the requirements set forth in the government-wide Award Term and Condition for Recipient
Integrity and Performance Matters located at 2 C F R Part 200, Appendix XII, the full text of which is incorporated h ere by
reference in the award terms and conditions
Article XXXV-Reporting Subawards and Executive Compensation
DHS-FEMA-HSGP-SHSP-FFY19 Page 28 of 36 Lewis County, E20-070
Recipients are required to comply with the requirements set forth in the government-wide award term on Reporting Subawards
and Executive Compensation located at 2 C F R Part 170, Appendix A, the full text of which is incorporated here by reference
in the award terms and conditions
Article XXXVI-SAFECOM
Recipients receiving federal financial assistance awards made under programs that provide emergency communication
equipment and its related activities must comply with the SAFECOM Guidance for Emergency Communication Grants,
including provisions on technical standards that ensure and enhance interoperable communications
Article XXXVII -Terrorist Financing
Recipients must comply with E 0 13224 and U S laws that prohibit transactions with, and the provisions of resources and
support to, individuals and organizations associated with terrorism Recipients are legally responsible to ensure compliance
with the Order and laws
Article XXXVIII-Trafficking Victims Protection Act of 2000
Recipients must comply with the requirements of the government-wide financial assistance award term which implements
Section 106(g)of the Trafficking Victims Protection Act of 2000(TVPA), codified as amended at 22 U S C Section 7104 The
award term is located at 2 C F R Section 175 15, the full text of which is incorporated here by reference
Article XXXIX-Universal Identifier and System for Award Management
Recipients are required to comply with the requirements set forth in the government-wide financial assistance award term
regarding the System for Award Management and Universal Identifier Requirements located at 2 C F R Part 25, Appendix A,
the full text of which is incorporated here by reference
Article XL-USA Patriot Act of 2001
Recipients must comply with requirements of Section 817 of the Uniting and Strengthening America by Providing Appropriate
Tools Required to Intercept and Obstruct Terrorism Act of 2001 (USA PATRIOT Act), which amends 18 U S C sections
175-175c
Article XLI-Use of DHS Seal,Logo and Flags
Recipients must obtain permission from their DHS FAO pnor to using the DHS seal(s), logos, crests or reproductions of flags
or likenesses of DHS agency officials, including use of the United States Coast Guard seal, logo, crests or reproductions of
flags or likenesses of Coast Guard officials
Article XLII-Whistleblower Protection Act
Recipients must comply with the statutory requirements for whistleblower protections(if applicable)at 10 U S C section 2409,
41 U S C section 4712, and 10 U S C section 2324, 41 U S C sections 4304 and 4310
Article XLIII -Environmental Planning and Historic Preservation
DHS/FEMA funded activities that may require an EHP review are subject to FEMA's Environmental Planning and Historic
Preservation(EHP) review process This review does not address all federal, state, and local requirements Acceptance of
federal funding requires recipient to comply with all federal, state, and local laws Failure to obtain all appropriate federal,
state, and local environmental permits and clearances may jeopardize federal funding
DHS/FEMA is required to consider the potential impacts to natural and cultural resources of all projects funded by DHS/
FEMA grant funds, through its EHP Review process, as mandated by the National Environmental Policy Act, National Historic
Preservation Act of 1966, as amended, National Flood Insurance Program regulations,and, any other applicable laws and
Executive Orders To access the FEMA's EHP screening form and instructions, go to the DHS/FEMA website at https.//
www.fema.gov/media-library/assets/documents/90195. In order to initiate EHP review of your project(s), you must complete
all relevant sections of this form and submit it to the Grant Programs Directorate(GPD)along with all other pertinent project
information Failure to provide requisite information could result in delays in the release of grant funds
If ground disturbing activities occur during construction, applicant will monitor ground disturbance, and if any potential
archeological resources are discovered, applicant will immediately cease work in that area and notify the pass-through entity,
if applicable, and DHS/FEMA
DHS-FEMA-HSGP-SHSP-FFY19 Page 29 of 36 Lewis County, E20-070
Article XLIV-Operation Stonegarden Program Hold
The recipient is prohibited from drawing down OPSG funding under this award or reimbursing OPSG subrecipients of this
award until each unique, specific, or modified county level,tribal, or equivalent Operations Order or Fragmentary Order
(Frago) has been reviewed by FEMA/GPD and Customs and Border Protection/United States Border Patrol (CBP/USBP) The
recipient will receive the official notification of approval from FEMA/GPD
BUDGET COST CATEGORIES
Personnel $844,918 46
Fringe Benefits $253,475 54
Travel $17,879 00
Equipment $0 00
Supplies $8,599 00
Contractual $14,267,430 00
Construction $0 00
Indirect Charges $188,979 00
Other $0 00
DHS-FEMA-HSGP-SHSP-FFY19 Page 30 of 36 Lewis County, E20-070
Obligating Document for Award/Amendment
la.A GREEMENT NO. 2 AMENDMENT NO 3 4 TYPE OF ACTION 5.CONTROL NO.
EMW-2019-SS-00044-S01 *** RECIPIENT AWARD WX04625N2019T,
NO WX04626N2019T,
916001095 G WX04629N2019T
6.RECIPIENT NAME AND 7 ISSUING FEMA OFFICE AND 8 PAYMENT OFFICE AND ADDRESS
ADDRESS ADDRESS FEMA Finance Center
Washington Military FEMA-GPD 430 Market Street
Department 400 C Street,SW,3rd floor Winchester,VA 22603
Building 20 Washington,DC 20472-3645
Camp Murray,WA,98430- POC 866-927-5646
5122
9 NAME OF RECIPIENT PHONE NO 10 NAME OF FEMA PROJECT COORDINATOR
PROJECT OFFICER 253-512-7472 Central Scheduling and Information Desk
Gail Cram Phone:800-368-6498
Email Askcsid @dhs gov
11.EI ECTIVE DATE OF 12. 13 ASSISTANCE ARRANGEMENT 14 PERFORMANCE PERIOD
THIS ACTION METHOD Cost Reimbursement From: To:
09/01/2019 OF 09/01/2019 08/31/2022
PAYMENT
PARS Budget Period
09/01/2019 08/31/2022
1 5 DESCRIPTION OF ACTION
a.(Indicate funding data for awards or financial changes)
PROGRAM CFDA NO. ACCOUNTING DATA PRIOR AMOUNT CURRENT CUMULATIVE NON-
NAME (ACCS CODE) TOTAL AWARDED TOTAL FEDERAL COMMITMENT
ACRONYM XXXX-XXX-XXXXXX- AWARD THIS AWARD
XXXXX-XXXX-XXXX-X ACTION
+OR(-)
Homeland 97067 2019 FA 0001 P410 -4101 D $0 00 $7,000,000 00 $7,000,000 00 See Totals
Security Grant
Program
Homeland 97067 2019 FA GH01 P410 -4101 D 10 00 $6,000,000 00 $6,000,000 00 See Totals
Security Grant
Program
Homeland 97067 2019 FA 0002 P410 -4101 D $0 00 $2,581,281 00 $2,581,281 00 See Totals
Security Grant
Program
$0.00 $15,581,281.00 85,581,281.00 $0.00
b.To describe changes other than funding data or financial changes,attach schedule and check here
N/A
16 a.FOR NON-DISASTER PROGRAMS RECIPIENT IS REQUIRED TO SIGN AND RETURN THREE(3)COPIES OF THIS
DOCUMENT TO FEMA(See Block 7 for address)
Homeland Security Grant Program recipients are not required to sign and return copies of this document.However,recipients should
pnnt and keep a copy of this document for their records
16b FOR DISASTER PROGRAMS.RECIPIENT IS NOT REQUIRED TO SIGN
This assistance is subject to terms and conditions attached to this award notice or by incorporated reference in program legislation cited
above
17.RECIPIENT SIGNATORY OFFICIAL(Name and Title) DATE
Gail Cram, Fri Aug 23 20 52 17 GMT
2019
18.FEMA SIGNATORY OFFICIAL(Name and Title) DATE
Thu Aug 08 15 42 17 GMT
2019
cY4400,
SHENAUZ SUBRINA WONG,Assistance Officer
DHS-FEMA-HSGP-SHSP-FFY19 Page 31 of 36 Lewis County, E20-070
ATTACHMENT 2
19SHSP Investment and Regional Project
Investment Justification
Washington is comprised of 39 counties with geography including forests,mountains,islands,rainforests,rivers,lakes,
and plains.The U S Bureau of Economic Analysis ranked Washington 13 of 50 states for gross domestic product in
2017;several world-class organizations headquarter their operations within the state.Washington has marine,
aviation,rail,and road transportation infrastructure to support its position as a bustling trade center Approximately
half of Washington's 7 5 million population lives in the Seattle metropolitan area located along the Puget Sound This
area is the center of transportation,business,and industry and is the fastest growing region in the state Over three-
fourths of the state's population lives in densely settled urbanized areas Understanding Washington's population is
critical in order to mitigate vulnerabilities,respond to incidents,and effectively concentrate recovery efforts
Washington is subject to ten natural hazards and seven human-caused hazards The THIRA focuses on eight of those
risks earthquake,tsunami,flood,biological [communicable disease],wildfire,radiological,cyber incident,and
terrorism Planning,training,and exercise efforts are being restructured to encompass the entire spectrum of
catastrophic incidents within this context Washington saw few significant changes in the 2018 Capabilities
Assessment The lowest rated capabilities were Situational Assessment, Mass Care Services, Economic Recovery,
Health and Social Services,and Housing—all essential during a catastrophic incident -The strongest capabilities lie in
Pubic Information and Warning and the most opportunity lie in Situational Assessment The 2018 SPR results
confirmed the findings from prior years.Stakeholders at every level struggle to sustain emergency response
capabilities with dwindling resources and are significantly challenged preparing for catastrophic disasters Since the
early 2000s,cumulative emergency management funding at the state and local levels has reduced significantly causing
an increased dependence on federal grants to meet necessary emergency management requirements As a result,
many areas are in a sustainment mode when it comes to emergency management capability and capacity
Investment#3-Regional Homeland Security Projects
The State is divided into 9 Homeland Security Regions,made up of 39 counties,which differ in many respects including
geography(from marine to desert),major industry(from large business to agricultural),and population (from dense
urban settings to rural areas) Each Region develops projects to address their specific risks and hazards which sustain
previously built capabilities or close identified gaps While the communities may differ,emergency management
priorities are similar across the state and most initiatives can be tied back to building regional capability to respond and
recover,and be in "a state of readiness"through planning,training,equipping,or exercising,should a natural or human-
caused catastrophic incident occur As communicated in the 2017 and confirmed in the 2018 THIRA,Capabilities
Estimation,&SPR,gaps have been identified in the following core capabilities.All jurisdictions have targeted efforts
related to Operational Coordination The foremost gaps are 1) PLANNING Plans lack horizontal and vertical
integration and need adjusting to be scalable for use during a catastrophic incident.Recovery needs to be
incorporated 2)ORGANIZATION• Response and recovery to catastrophic incidents will require additional trained
personnel to support either large-scale or long-term activations 3) EQUIPMENT There is a lack of integration and
mteroperability of tools to form a Common Operating Picture for all stakeholders Additionally,equipment continues
to age,with subsequent degradation occurring with routine usage,and there is a lack of funding to sustain and/or
replace Resiliency is still an evolving concept without a formalized statewide,whole community approach to focus
efforts While the State is introducing initiatives to combat that reality,local jurisdictions still struggle with gaps related
to Community Resilience 1)TRAINING. Individuals and businesses need to move from awareness to action 2)
EXERCISE Communities are dependent on volunteers to exercise this capability and do not have the tools or expertise
to engage stakeholders Related to Resilience,jurisdictions recognize the need to communicate with all stakeholders
and continue to expand the reach of their messaging. Initiatives are ongoing to address the identified Public
Information and Warning gap related to 1) PLANNING. Plans do not fully address communicating with non-English
speaking populations,immigrant groups,and individuals with disabilities
DHS-FEMA-HSGP-SHSP-FFY19 Page 32 of 36 Lewis County, E20-070
Regional Hazards and Risks- Reasons for the Work
Terrorist targets include:
•Government facilities
•Transportation corridors
•Power generation and distribution systems
•Events where large numbers of citizens congregate
•Communications systems
•Terrorist acts which contaminate crops
Primary all-hazard risks include:
•Food-borne illness outbreak
•Plant,pest,or animal disease outbreak
•Wildland fires
•Flooding
•Radiological releases
•Earthquake
•Tsunami
•Winter storm
•Wind storm
•Landslide
•Health epidemic
•Hazmat incident
•Terrorist activity
•Dam failure
•Volcanic activity
DHS-FEMA-HSGP-SHSP-FFY19 Page 33 of 36 Lewis County, E20-070
19SHSP Work Plan and Budget
Lewis County,Department of Emergency Services
Region-3 Homeland Security Project
Region 3 will sustain capabilities to include special response teams through equipping,training,and AGREEMENT AMOUNT $32,231
exercising.Activities will include 1)Further develop the planning,training,and exercise programs of Region AMOUNT
3.2)Provide equipment and training for specialized technical response teams,regional Incident LETPA $8,057.75
Management Team,and local response agencies.3)Support public education programs.4)Purchase and 25%of the agreement total
install communications and dispatching systems and upgrade specialized equipment and secondary power PERSONNEL $0 00
for command posts,communications vehicles and critical facilities.Equipment will be replaced as identified
0%of the agreement rotal
and all communications investments will align with the Statewide Communication Interoperable Plan(SCIP)
and will be coordinated with the Statewide lnteroperability Coordinator(SWIC) 5)Provide equipment and
training to protect election systems from cyber-attacks or threats BUDGET
AMOUNT
SUBPROJECT#1 $32,231.00
M&A $0.00
SUBTOTAL $32,231 00
INDIRECT $0.00
TOTAL $32,231.00
SUBPROJECT#1 Operational Communications
PRIMARY CORE CAPABILITIES BEING ADDRESSED SOLUTION AREA
Operational Communications PLANNING ORGANIZATION EQUIPMENT TRAINING EXERCISE TOTAL
Intelligence and Information Sharing $0.00 $32,231.00 $0 00 $0 00 $32,231.00
WHY IS THE WORK NEEDED?
GAP identified
The primary communications channels are too congested when more than one incident is being communicated First
responders cannot communicate effectively and safely because frequencies overlap which delays and prevents paging
and critical information from reaching first responders.
CAPABILITY sustained or enhanced
Enhancing Operational Communications and Information sharing by improving the shared first responder radio
system
DHS-FEMA-HSGP-SHSP-FFY19 Page 34 of 36 Lewis County, E20-070
ACTIVITIES TO BE PERFORMED
This project completes the subproject outlined in the 18SHSP work plan to improve the remotely controlled radio
system This will take some of the additional load to provide better coordination of effort and safety to personnel in
the field
-Purchase,install and maintain a remotely controlled radio system capable of providing our Fire Services and Law
Enforcement personnel with a paging and ground tactical channel to ease congestion and improve safety while caring
out the fire fighting, medical aid and law enforcement details.
ASSOCIATED DELIVERABLES/OUTPUTS
-Improves efficiency,effectiveness and reliability of communications with first responders,and volunteers
-More immediate Information sharing.
DESIRED OUTCOMES
The Fire Service and Law Enforcement departments and field teams can communicate more effectively among
themselves,the 911 center,and the Community District Commands.
The equipment will assist with the recognition,understanding,communication of,and planning for risk and empower
individuals and communities to make informed risk management decisions necessary to adapt to,withstand,and
auicklv recover from future incidents.
DHS-FEMA-HSGP-SHSP-FFY19 Page 35 of 36 Lewis County, E20-070
19SHSP TIMELINE
Lewis County,Department of Emergency Services
DATE TASK v
September 1,2019 Grant Agreement start date
NLT December 31,2019 Complete National Cybersecurity Review(NCSR)
March 1,2020 Estimated date work scheduled for one or more Subprojects
Submit Reimbursement Request, Progress Report,and proof of NCSR
NLT April 30,2020 completion
NLT October 31,2020 Submit Reimbursement Request and Progress Report
NLT April 30,2021 Submit Reimburesment Request and Progress Report
August 31,2021 Grant Agreement end date
October 15,2021 Submit Final Reimbursement Request and Closeout Report
HSGP Performance Period.September 1,2019 to August 31,2022
DHS-FEMA-HSGP-SHSP-FFY19 Page 36 of 36 Lewis County, E20-070
FFATA FORM
Subrecipient Agency Lewis County Department of Emeraencv Services
Grant and Year 19HSGP (SHSP) Agreement Number 20-070
Completed Steve Mansfield Director 360.740.3310
by
Name Title Telephone
Date Completed
STEP 1
YES STOP, no further NO
Is your grant agreement less than $25,000? analysis needed, v GO to Step 2
GO to Step 6
STEP 2
In your preceding fiscal year, did your YES NO STOP, no further
organization receive 80% or more of its annual GO to STEP 3 v analysis needed, GO to
gross revenues from federal funding? Step 6
STEP 3
In your preceding fiscal year, did your YES NO STOP, no further
organization receive$25,000,000 or more in GO to STEP 4 analysis needed, GO to
federal funding'? Step 6
STEP 4
Does the public have access to information about YES STOP, no further NO
the total compensation* of senior executives in analysis needed, GO to STEP 5
your organization'? GO to step 6
STEP 5
Executive#1 Name
Total Compensation amount $
Executive#2 Name
Total Compensation amount $
Name.
Executive#3
Total Compensation amount $
Name.
Executive#4 Total Compensation amount $
Executive#5 Name
Total Compensation amount $
STEP 6
If your organization does not meet these criteria, specifically identify below each criteria that is not met for your
organization For Example "Our organization received less than $25,000 "
Our organization receives less than 80% of our annual gross revenue from federal funding.
Signature Date
*Total compensation refers to
• Salary and bonuses
• Awards of stock, stock options, and stock appreciation rights
• Other compensation including, but not limited to, severance and termination payments
• Life insurance value paid on behalf of the employee
Additional Resources
http//www whitehouse qov/omb/open
http.//www.hrsa.gov/grants/ffata.html
http//www qpo qov/fdsys/pkq/FR-2010-09-14/pdf/2010-22705 pdf
http.//www.grants.gov/
Page 1 of 3
FFATA PROVISIONS AND INSTRUCTIONS
For Compliance With The
Federal Funding Accountability and Transparency Act of 2006(P.L. 109-282)(FFATA)
The Federal Funding Accountability and Transparency Act (FFATA) was signed on September
26, 2006 The FFATA requires legislation uires information on federal awards (federal financial
g q
assistance and expenditures) be made available to the public via a single, searchable website
Federal awards include grants, subgrants, loans, awards, cooperative agreements and other forms
of financial assistance as well as contracts, subcontracts, purchase orders, task orders, and
delivery orders. The legislation does not require inclusion of individual transactions below
$25,000 or credit card transactions before October 1, 2008 However, if an award is initially
below this amount yet later increased, the act is triggered Due to this variability in compliance
Subrecipients are required by the Military Department to be familiar with the FFATA
requirements and complete this Worksheet for each contract for the State's submission in to the
FFATA portal
ADDITIONAL PROVISIONS
A This contract (subaward) is supported by federal funds, requiring compliance with the
Federal Funding Accountability and Transparency Act (FFATA or the Transparency Act)
and Office of Management and Budget Guidance (OMB) Public Law 109-282 as amended
by section 6202(a) of Public Law 110-252 (see 31 U S C 6101 note) By entering into this
contract, contractor agrees to provide all applicable reporting information to the Washington
Military Department(WMD)required by FFATA and OMB Guidance
B. The FFATA requires the OMB to establish a publicly available online database
(USASpending.gov) containing information about entities that are awarded Federal grants,
loans, and contracts As required by FFATA and OMB Guidance, certain information on the
first-tier subawards related to Federal contracts and grants, and the executive compensation
of awardees,must be made publicly available
C For new Federal grants beginning October 1, 2010, if the initial subaward is equal to or
greater than $25,000, reporting of the subaward and executive compensation information is
required If the initial subaward is below $25,000 but subsequent grant modifications result
in a total subaward equal to or over $25,000, the subaward will be subject to the reporting
requirements as of the date the subaward exceeds $25,000. If the initial subaward equals or
exceeds $25,000 but funding is subsequently de-obligated such that the total award amount
falls below $25,000, the subaward continues to be subject to the reporting requirements of
the Transparency Act and OMB Guidance.
D As a Federal grant subawardee under this contract, your organization is required by FFATA,
OMB Guidance and this contract to provide the WMD, as the prime grant awardee, all
information required for FFATA compliant reporting by WMD. This includes all applicable
subawardee entity information required by FFATA and OMB Guidance, subawardee DUNS
number, and relevant executive compensation data, as applicable
1 Data about your organization will be provided to USASpending gov by the WMD
System for Award Management (SAM) is a government wide registration system for
organizations that do business with the Federal Government. SAM stores information
about awardees including financial account information for payment purposes and a link
to D&B for maintaining current DUNS information,www.sam gov WMD requires SAM
registration and annual renewal by your organization to minimize unnecessary data entry
Page 1 of 2
and re-entry required by both WMD and your organization It will also reduce the
potential of inconsistent or inaccurate data entry.
2 Your organization must have a Data Universal Numbering System (DUNS) number
obtained from the firm Dun and Bradstreet (D&B) (www dnb coin) A DUNS number
provides a method to verify data about your organization D&B is responsible for
maintaining umque identifiers and organizational linkages on behalf of the Federal
Government for organizations receiving Federal assistance
E The WMD, as the prime awardee, is required by FFATA to report names and total
compensation of the five (5) most highly compensated officers of your organization (as the
subawardee) if
1 Your organization (the subawardee), m the preceding fiscal year, received 80 percent or
more of its annual gross revenues from Federal awards and $25,000,000 or more in
annual gross revenues from Federal awards, and
2 The public does not have access to this information about the compensation of the senior
executives of your organization through periodic reports filed under section 13(a) or
15(d) of the Securities and Exchange Act of 1934 (15 U S C §§ 78m(a), 78o(d) or
section 6104 of the Internal Revenue Code of 1986
"Total compensation" for purposes of this requirement generally means the cash and non-
cash value earned by the executive during the past fiscal year and includes salary and bonus,
awards of stock, stock options and stock appreciation rights; and other compensation such as
severance and termination payments, and value of life insurance paid on behalf of the
employee, and as otherwise provided by FFATA and applicable OMB guidance.
F. If(1) m the preceding fiscal year your organization received 80 percent or more of its annual
gross revenues from Federal awards and $25,000,000 or more in annual gross revenues from
Federal awards, and (2) the public does not have access to this information about the
compensation of the senior executives of your organization through periodic reports filed
under section 13(a) or 15(d) of the Securities and Exchange Act of 1934 (15 U S C §§
78m(a), 78o(d) or section 6104 of the Internal Revenue Code of 1986, insert the names and
total compensation for the five most highly compensated officers of your organization as
identified in Step 5 of the FFATA Form
Page 2 of 2
Request for Taxpayer Give Form to the
Form
(Rev October2018) Identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Revenue Service ■Go to www.irs.gov/FormW9 for instructions and the latest information.
1 Name(as shown on your income tax return) Name is required on this line do not leave this line blank.
Lewis,County of
2 Business name/disregarded entity name,if different from above
Lewis County Department of Emergency Services
m 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1 Check only one of the 4 Exemptions(codes apply only to
mfollowing seven boxes certain entities,not individuals,see
o_ instructions on page 3)
O ❑ IndividuaVsole proprietor or ❑ C Corporation ❑S Corporation ❑ Partnership ❑Trust/estate
in single-member LLC Exempt payee code(if any)
o. o
4,j ❑ Limited liability company Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)I. '
8 2 Note:Check the appropriate box in the line above for the tax classification of the single-member owner Do not check Exemption from FATCA reporting
w LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is code if an
another L1C that is not disregarded from the owner for U.S federal tax purposes Otherwise a single-member LLC that ( y
a o is disregarded from the owner should check the appropriate box for the tax classification of its owner
w
y fl Other(see instructions)► (Applies to accounts maolteined outsioe the U.S.) '
' 5 Address(number,street,and apt.or suite no.)See instructions Requester's name and address(optional)
a 351 NW North Street
6 City,state,and ZIP code
Chehalis,WA 98532
7 List account number(s)here(optional)
Part I Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid I Social security number
backup withholding For individuals,this is generally your social security number(SSN) However,for a
resident alien,sole propnetor,or disregarded entity,see the instructions for Part I,later For other — —
entities,it is your employer identification number(EIN).If you do not have a number,see How to get a - -
TIN,later or
Note:If the account is in more than one name,see the instructions for line 1 Also see What Name and I Employer identification number I
Number To Give the Requester for guidelines on whose number to enter. - i
9 1 - 6 0 0 1 3 5 1
Part II Certification
Under penalties of perjury,I certify that.
1 The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me),and
2 I am not subject to backup withholding because.(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding,and
3 I am a U S citizen or other U S.person(defined below),and
4 The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return • .r real estate transactions,item 2 does not apply For mortgage interest paid,
acquisition or abandonment of secured prop,. y,cance tion of deg ontributicns to an individual retirement arrangement(IRA),and generally,payments
other than interest and dividends,you area It require• • • • the ' ation,but you must provide your correct TIN See the instructions for Part II,later I
Sign signature of
Here U.S,person• V // Date• /1/f Cl/I&
General Instructions •Form 1099-DIV(dividends,including those from stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of income,prizes,awards,or gross
noted proceeds)
Future developments For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its instructions,such as legislation enacted transactions by brokers) '
after they were published,go to www irs.gov/FormW9 •Form 1099-S(proceeds from real estate transactions)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest),1098-E(student loan interest)
information return with the IRS must obtain your correct taxpayer 1098-T(tuition)
identification number(TIN)which may be your social security number •Form 1099-C(canceled debt)
(SSN),individual taxpayer identification number(ITIN) adoption •Form 1099-A(acquisition or abandonment of secured property)
taxpayer identification number(ATIN),or employer identification number
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S person(including a resident
amount reportable on an information return Examples of information alien),to provide your correct TIN
returns include,but are not limited to,the following If you do not return Form W-9 to the requester with a TIN,you might
•Form 1099-INT(interest earned or paid) be subject to backup withholding See What is backup withholding
later
Cat No 10231X Form W-9(Rev 10-2018)
Form W-9(Rev 10-2018) Page 2
By signing the filled-out form,you Example.Article 20 of the U S.-China income tax treaty allows an
1 Certify that the TIN you are giving is correct(or you are waiting for a exemption from tax for scholarship income received by a Chinese
number to be issued), student temporarily present in the United States Under U.S.law this
student will become a resident alien for tax purposes if his or her stay in
2 Certify that you are not subject to backup withholding,or the United States exceeds 5 calendar years.However,paragraph 2 of
3 Claim exemption from backup withholding if you are a U S.exempt the first Protocol to the U.S.-China treaty(dated April 30,1984)allows
payee If applicable,you are also certifying that as a U.S person,your the provisions of Article 20 to continue to apply even after the Chinese
allocable share of any partnership income from a U S trade or business student becomes a resident alien of the United States.A Chinese
is not subject to the withholding tax on foreign partners'share of student who qualifies for this exception(under paragraph 2 of the first
effectively connected income,and protocol)and is relying on this exception to claim an exemption from tax
4 Certify that FATCA code(s)entered on this form(if any)indicating on his or her scholarship or fellowship income would attach to Form
that you are exempt from the FATCA reporting,is correct See What is W-9 a statement that includes the information described above to
FATCA reporting,later,for further information support that exemption
Note.If you are a U S person and a requester gives you a form other If you are a nonresident alien or a foreign entity,give the requester the
than Form W-9 to request your TIN,you must use the requester's form if appropriate completed Form W-8 or Form 8233
it is substantially similar to this Form W-9 Backup Withholding
Definition of a U.S.person.For federal tax purposes,you are
considered a U S person if you are What is backup withholding?Persons making certain payments to you
•An individual who is a U S citizen or U S resident alien, must under certain conditions withhold and pay to the IRS 24%of such
payments.This is called"backup withholding." Payments that may be i
•A partnership,corporation,company,or association created or subject to backup withholding include interest,tax-exempt interest,
organized in the United States or under the laws of the United States, dividends,broker and barter exchange transactions,rents,royalties,
•An estate(other than a foreign estate),or nonemployee pay,payments made in settlement of payment card and
•A domestic trust(as defined in Regulations section 301 7701 7). third party network transactions,and certain payments from fishing boat
operators.Real estate transactions are not subject to backup
Special rules for partnerships.Partnerships that conduct a trade or withholding
business in the United States are generally required to pay a withholding 'You will not be subject to backup withholding on payments you
tax under section 1446 on any foreign partners'share of effectively receive if you give the requester your correct TIN,make the proper
connected taxable income from such business.Further,in certain cases certifications,and report all your taxable interest and dividends on your
where a Form W-9 has not been received,the rules under section 1446 tax return.
require a partnership to presume that a partner is a foreign person,and
pay the section 1446 withholding tax.Therefore,if you are a U.S.person Payments you receive will be subject to backup withholding if
that is a partner in a partnership conducting a trade or business in the 1 You do not furnish your TIN to the requester,
United States,provide Form W-9 to the partnership to establish your 2.You do not certify your TIN when required(see the instructions for
U.S status and avoid section 1446 withholding on your share of Part II for details),
partnership income
In the cases below,the following person must give Form W-9 to the 3 The IRS tells the requester that you furnished an incorrect TIN,
partnership for purposes of establishing its U S status and avoiding 4.The IRS tells you that you are subject to backup withholding
withholding on its allocable share of net income from the partnership because you did not report all your interest and dividends on your tax
conducting a trade or business in the United States return(for reportable interest and dividends only),or
•In the case of a disregarded entity with a U S owner,the U S owner 5.You do not certify to the requester that you are not subject to
of the disregarded entity and not the entity; backup withholding under 4 above(for reportable interest and dividend
•In the case of a grantor trust with a U.S.grantor or other U S owner, accounts opened after 1983 only).
generally,the U S grantor or other U S owner of the grantor trust and Certain payees and payments are exempt from backup withholding.
not the trust,and See Exempt payee code,later,and the separate Instructions for the
•In the case of a U S trust(other than a grantor trust),the U.S.trust Requester of Form W-9 for more information.
(other than a grantor trust)and not the beneficiaries of the trust Also see Special rules for partnerships,earlier
Foreign person.If you are a foreign person or the U S branch of a What is FATCA Reporting?
foreign bank that has elected to be treated as a U S.person,do not use
Form W-9 Instead,use the appropriate Form W-8 or Form 8233(see The Foreign Account Tax Compliance Act(FATCA)requires a
Pub.515,Withholding of Tax on Nonresident Aliens and Foreign participating foreign financial institution to report all United States
Entities). account holders that are specified United States persons Certain
Nonresident alien who becomes a resident alien.Generally,only a payees are exempt from FATCA reporting See Exemption from FATCA
nonresident alien individual may use the terms of a tax treaty to reduce reporting code, later,and the Instructions for the Requester of Form
or eliminate U S tax on certain types of income However,most tax W-9 for more information
treaties contain a provision known as a"saving clause"Exceptions Updating Your Information
specified in the saving clause may permit an exemption from tax to
continue for certain types of income even after the payee has otherwise You must provide updated information to any person to whom you
become a U S resident alien for tax purposes claimed to be an exempt payee if you are no longer an exempt payee
If you are a U S resident alien who is relying on an exception and anticipate receiving reportable payments in the future from this
contained in the saving clause of a tax treaty to claim an exemption person.For example,you may need to provide updated information if
from U S tax on certain types of income,you must attach a statement you are a C corporation that elects to be an S corporation,or if you no
to Form W-alha eeecifiee the tenew ng_five item _Langer are tax exe_mIA,In_addition,you must furnish a new Form W-9 if
1.The treaty country Generally,this must be the same treaty under the name or TIN changes for the account,for example,if the grantor of a
which you claimed exemption from tax as a nonresident alien grantor trust dies
2.The treaty article addressing the income Penalties
3 The article number(or location)in the tax treaty that contains the
saving clause and its exceptions Failure to furnish TIN If you fail to furnish your correct TIN to a
4 The type and amount of income that qualifies for the exemption requester,you are subject to a penalty of$50 for each such failure
from tax unless your failure is due to reasonable cause and not to willful neglect
5.Sufficient facts to justify the exemption from tax under the terms of Civil penalty for false information with respect to withholding If you
the treaty article make a false statement with no reasonable basis that results in no
backup withholding you are subject to a$500 penalty
Form W-9(Rev 10-2018) Page 3
Criminal penalty for falsifying information.Willfully falsifying IF the entity/person on line 1 is THEN check the box for...
certifications or affirmations may subject you to criminal penalties a(n)...
including fines and/or imprisonment
Misuse of TINs.If the requester discloses or uses TINs in violation of • Corporation Corporation
federal law,the requester may be subject to civil and criminal penalties • Individual Individual/sole proprietor or single-
• Sole proprietorship,or member LLC
Specific Instructions • Single-member limited liability
company(LLC)owned by an
Line 1 individual and disregarded for U S
You must enter one of the following on this line,do not leave this line federal tax purposes.
blank The name should match the name on your tax return • LLC treated as a partnership for Limited liability company and enter
If this Form W-9 is for a joint account(other than an account U S federal tax purposes, the appropriate tax classification.
maintained by a foreign financial institution(FFI)),list first,and then • LLC that has filed Form 8832 or (P=Partnership;C=C corporation,
circle,the name of the person or entity whose number you entered in 2553 to be taxed as a corporation, or S.S corporation)
Part I of Form W-9.If you are providing Form W-9 to an FFI to document or
a joint account,each holder of the account that is a U S person must
• LLC that is disregarded as an
provide a Form W-9
entity separate from its owner but
a. Individual.Generally,enter the name shown on your tax return If the owner is another LLC that is
you have changed your last name without informing the Social Security not disregarded for U S federal tax
Administration(SSA)of the name change,enter your first name,the last purposes
name as shown on your social security card,and your new last name
Note.ITIN applicant Enter your individual name as it was entered on • Partnership Partnership
your Form W-7 application,line 1 a This should also be the same as the • Trust/estate Trust/estate
name you entered on the Form 1040/1040A/1040EZ you filed with your Line 4, Exemptions
application
b Sole proprietor or single-member LLC.Enter your individual If you are exempt from backup withholding and/or FATCA reporting,
name as shown on your 1040/1040N1040EZ on line 1.You may enter enter in the appropriate space on line 4 any code(s)that may apply to
your business,trade,or"doing business as"(DBA)name on line 2 you
c Partnership,LLC that is not a single-member LLC,C Exempt payee code
corporation,or S corporation.Enter the entity's name as shown on the • Generally,individuals(including sole proprietors)are not exempt from
entity's tax return on line 1 and any business,trade,or DBA name on backup withholding.
line 2 • Except as provided below,corporations are exempt from backup
d. Other entities Enter your name as shown on required U.S.federal withholding for certain payments,including interest and dividends
tax documents on line 1 This name should match the name shown on the • Corporations are not exempt from backup withholding for payments
charter or other legal document creating the entity You may enter any made in settlement of payment card or third party network transactions.
business,trade,or DBA name on line 2 • Corporations are not exempt from backup withholding with respect to
e Disregarded entity.For U S federal tax purposes,an entity that is attorneys'fees or gross proceeds paid to attorneys,and corporations
disregarded as an entity separate from its owner is treated as a that provide medical or health care services are not exempt with respect
"disregarded entity" See Regulations section 301 7701-2(c)(2)(iii) Enter to payments reportable on Form 1099-MISC
the owner's name on line 1 The name of the entity entered on line 1
should never be a disregarded entity.The name on line 1 should be the The following codes identify payees that are exempt from backup
name shown on the income tax return on which the income should be withholding.Enter the appropriate code in the space in line 4
reported.For example,if a foreign LLC that is treated as a disregarded 1—An organization exempt from tax under section 501(a),any IRA,or
entity for U S federal tax purposes has a single owner that is a U.S. a custodial account under section 403(b)(7)if the account satisfies the
person,the U S owner's name is required to be provided on line 1 If requirements of section 401(0(2)
the direct owner of the entity is also a disregarded entity,enter the first 2—The United States or any of its agencies or instrumentalities
owner that is not disregarded for federal tax purposes Enter the
disregarded entity's name on line 2,"Business name/disregarded entity 3—A state,the District of Columbia,a U S commonwealth or
name"If the owner of the disregarded entity is a foreign person,the possession,or any of their political subdivisions or instrumentalities
owner must complete an appropriate Form W-8 instead of a Form W-9 4—A foreign government or any of its political subdivisions,agencies,
This is the case even if the foreign person has a U S TIN or instrumentalities
Line 2 5—A corporation
If you have a business name,trade name,DBA name,or disregarded 6—A dealer in securities or commodities required to register in the
entity name,you may enter it on line 2 United States,the District of Columbia,or a U.S.commonwealth or
possession
Line 3 7—A futures commission merchant registered with the Commodity
Check the appropriate box on line 3 for the U S.federal tax Futures Trading Commission
classification of the person whose name is entered on line 1 Check only 8—A real estate investment trust
one box on line 3 9—An entity registered at all times during the tax year under the
Investment Company Act of 1940
TO-A commorT tru—g-tur-Td-OperIt4d by a bank under section 584(a) _ t
11—A financial institution
12—A middleman known in the investment community as a nominee or
custodian
13—A trust exempt from tax under section 664 or described in section
4947
' Form W-9(Rev.10-2018) Page 4
The following chart shows types of payments that may be exempt M—A tax exempt trust under a section 403(b)plan or section 457(g)
from backup withholding.The chart applies to the exempt payees listed plan
above,1 through 13. Note You may wish to consult with the financial institution requesting
IF the payment is for... THEN the payment is exempt this form to determine whether the FATCA code and/or exempt payee
for... code should be completed
Interest and dividend payments All exempt payees except Line 5
for 7 Enter your address(number,street,and apartment or suite number).
Broker transactions Exempt payees 1 through 4 and 6 This is where the requester of this Form W-9 will mail your information
through 11 and all C corporations returns If this address differs from the one the requester already has on
S corporations must not enter an file,write NEW at the top If a new address is provided,there is still a
exempt payee code because they chance the old address will be used until the payor changes your
are exempt only for sales of address in their records
noncovered securities acquired Line 6
prior to 2012
Enter your city,state,and ZIP code
Barter exchange transactions and Exempt payees 1 through 4
patronage dividends Part I. Taxpayer Identification Number (TIN)
Payments over$600 required to be Generally,exempt payees Enter your TIN in the appropriate box.If you are a resident alien and
reported and direct sales over 1 through 52 you do not have and are not eligible to get an SSN,your TIN is your IRS
$5,000' individual taxpayer identification number(ITIN).Enter it in the social
security number box If you do not have an ITIN,see How to get a TIN
Payments made in settlement of Exempt payees 1 through 4 below
payment card or third party network If you are a sole proprietor and you have an EIN you may enter either
transactions your SSN or EIN
1 See Form 1099-MISC,Miscellaneous Income,and its instructions If you are a single-member LLC that is disregarded as an entity
separate from its owner,enter the owner's SSN(or EIN,if the owner has
2 However,the following payments made to a corporation and one).Do not enter the disregarded entity's EIN If the LLC is classified as
reportable on Form 1099-MISC are not exempt from backup a corporation or partnership,enter the entity's EIN
withholding medical and health care payments,attorneys'fees,gross Note See What Name and Number To Give the Requester,later,for
proceeds paid to an attorney reportable under section 6045(0,and
payments for services paid by a federal executive agency further clarification of name and TIN combinations.
Exemption from FATCA reporting code.The following codes identify How to get a TIN.If you do not have a TIN,apply for one immediately
payees that are exempt from reporting under FATCA.These codes To apply for an SSN,get Form SS 5,Application for a Social Security
apply to persons submitting this form for accounts maintained outside Card,from your local SSA office or get this form online at
of the United States by certain foreign financial institutions.Therefore,if w ww SSA.gov You may also get this form by calling 1-800-772-1213
you are only submitting this form for an account you hold in the United Use Form W-7,Application for IRS Individual Taxpayer Identification
States,you may leave this field blank.Consult with the person Number,to apply for an ITIN,or Form SS-4,Application for Employer
requesting this form if you are uncertain if the financial institution is Identification Number,to apply for an EIN.You can apply for an EIN
subject to these requirements.A requester may indicate that a code is online by accessing the IRS website at www irs.gov/Businesses and
not required by providing you with a Form W-9 with"Not Applicable"(or clicking on Employer Identification Number(EIN)under Starting a
any similar indication)written or printed on the line for a FATCA Business.Go to www.irs.gov/Forms to view,download,or print Form
exemption code W-7 and/or Form SS-4 Or,you can go to www irs gov/OrderForms to
place an order and have Form W-7 and/or SS-4 mailed to you within 10
A—An organization exempt from tax under section 501(a)or any business days
individual retirement plan as defined in section 7701(a)(37) If you are asked to complete Form W-9 but do not have a TIN,apply
B—The United States or any of its agencies or instrumentalities for a TIN and write"Applied For"in the space for the TIN,sign and date
C—A state,the District of Columbia,a U S commonwealth or the form,and give it to the requester.For interest and dividend
possession,or any of their political subdivisions or instrumentalities payments,and certain payments made with respect to readily tradable
D—A corporation the stock of which is regularly traded on one or instruments,generally you will have 60 days to get a TIN and give it to
more established securities markets,as described in Regulations the requester before you are subject to backup withholding on
section 1 1472-1(c)(1)(i) payments The 60-day rule does not apply to other types of payments.
You will be subject to backup withholding on all such payments until
E—A corporation that is a member of the same expanded affiliated you provide your TIN to the requester
group as a corporation described in Regulations section 1 1472-1(c)(1)(i) Note Entering"Applied For"means that you have already applied for a
F—A dealer in securities,commodities,or derivative financial TIN or that you intend to apply for one soon
instruments(including notional principal contracts,futures,forwards,
and options)that is registered as such under the laws of the United Caution:A disregarded U S entity that has a foreign owner must use
States or any state the appropriate Form W-8
G—A real estate investment trust Part II. Certification
H—A regulated investment company as defined in section 851 or an To establish to the withholding agent that you are a U S person,or
entity registered at all times during the tax year under the Investment resident alien,sign Form W-9 You may be requested to sign by the
Company Act of 1940 withholding agent even if item 1.A.4r 5 below indiieetes.Otherwise.
I—A common trust fund as defined in section 584(a) For a joint account,only the person whose TIN is shown in Part I
J—A bank as defined in section 581 should sign(when required) In the case of a disregarded entity,the
K—A broker person identified on line 1 must sign Exempt payees,see Exempt payee
L—A trust exempt from tax under section 664 or described in section code,earlier
4947(a)(1) Signature requirements.Complete the certification as indicated in
items 1 through 5 below
Form W-9(Rev 10-2018) Page 5
1 Interest,dividend,and barter exchange accounts opened For this type of account: Give name and EIN of'
before 1984 and broker accounts considered active during 1983 14 Account with the Department of The public entity
You must give your correct TIN,but you do not have to sign the
Agriculture in the name of a public
certification.
entity(such as a state or local
2.Interest,dividend,broker,and barter exchange accounts government,school district or
opened after 1983 and broker accounts considered inactive during prison)that receives agricultural
1983.You must sign the certification or backup withholding will apply If program payments
you are subject to backup withholding and you are merely providing
your correct TIN to the requester,you must cross out item 2 in the 15 Grantor trust filing under the Form The trust
certification before signing the form 1041 Filing Method or the Optional
3.Real estate transactions You must sign the certification You may Form 1099 Filing Method 2(see
cross out item 2 of the certification
Regulations section 1.671-4(b)(2)(i)(B))
4.Other payments.You must give your correct TIN,but you do not 1 List first and circle the name of the person whose number you furnish
have to sign the certification unless you have been notified that you If only one person on a joint account has an SSN,that person's number
have previously given an incorrect TIN "Other payments"include must be furnished
payments made in the course of the requester's trade or business for 2 Circle the minor's name and furnish the minor's SSN
rents,royalties,goods(other than bills for merchandise),medical and
health care services(including payments to corporations),payments to 3 You must show your individual name and you may also enter your
a nonemployee for services,payments made in settlement of payment business or DBA name on the"Business name/disregarded entity"
card and third party network transactions,payments to certain fishing name line You may use either your SSN or EIN(if you have one),but the
boat crew members and fishermen,and gross proceeds paid to IRS encourages you to use your SSN
attorneys(including payments to corporations) 4 List first and circle the name of the trust,estate,or pension trust (Do
5.Mortgage interest paid by you,acquisition or abandonment of not furnish the TIN of the personal representative or trustee unless the
secured property,cancellation of debt,qualified tuition program legal entity itself is not designated in the account title)Also see Special
payments(under section 529),ABLE accounts(under section 529A), rules for partnerships,earlier
IRA,Coverdell ESA,Archer MSA or HSA contributions or *Note The grantor also must provide a Form W-9 to trustee of trust
distributions,and pension distributions.You must give your correct Note:If no name is circled when more than one name is listed,the
TIN,but you do not have to sign the certification number will be considered to be that of the first name listed.
What Name and Number To Give the Requester Secure Your Tax Records From Identity Theft
For this type of account: Give name and SSN of Identity theft occurs when someone uses your personal information
1 Individual The individual such as your name,SSN,or other identifying information,without your
2 Two or more individuals(joint The actual owner of the account or,if permission,to commit fraud or other crimes An identity thief may use
account)other than an account combined funds the first individual on your SSN to get a job or may file a tax return using your SSN to receive
maintained by an FFI the account' a refund
3 Two or more U.S persons Each holder of the account To reduce your risk.
(joint account maintained by an FFI) •Protect your SSN,
4 Custodial account of a minor The minor •Ensure your employer is protecting your SSN,and
(Uniform Gift to Minors Act) •Be careful when choosing a tax preparer
5 a.The usual revocable savings trust The grantor-trustee' If your tax records are affected by identity theft and you receive a
(grantor is also trustee) notice from the IRS,respond right away to the name and phone number
b So-called trust account that is not The actual owner' printed on the IRS notice or letter.
a legal or valid trust under state law
If your tax records are not currently affected by identity theft but you
6 Sole proprietorship or disregarded The owner3 think you are at risk due to a lost or stolen purse or wallet,questionable
entity owned by an individual credit card activity or credit report,contact the IRS Identity Theft Hotline
7 Grantor trust filing under Optional The grantor' at 1-800-908-4490 or submit Form 14039
Form 1099 Filing Method 1(see For more information,see Pub 5027,Identity Theft Information for
Regulations section 1.671-4(b)(2)(i) Taxpayers
(A)) Victims of identity theft who are experiencing economic harm or a
For this type of account: Give name and EIN of: systemic problem,or are seeking help in resolving tax problems that
8 Disregarded entity not owned by an The owner have not been resolved through normal channels,may be eligible for
individual Taxpayer Advocate Service(TAS)assistance.You can reach TAS by
a calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD
9 A valid trust,estate,or pension trust Legal entity 1-800-829-4059
10 Corporation or LLC electing The corporation Protect yourself from suspicious emails or phishing schemes.
corporate status on Form 8832 or Phishing is the creation and use of email and websites designed to
Form 2553 mimic legitimate business emails and websites The most common act
11 Association club religious, The organization is sending an email to a user falsely claiming to be an established
charitable,educational,or other tax- legitimate enterprise in an attempt to scam the user into surrendering
exempt organization _ private information that will be used for identity theft
12 Partnership or multi-member LLC The partnership
13 A broker or registered nominee The broker or nominee
Form W-9(Rev 10-2018) Page 6
The IRS does not initiate contacts with taxpayers via emails Also,the Privacy Act Notice
IRS does not request personal detailed information through email or ask
taxpayers for the PIN numbers,passwords,or similar secret access Section 6109 of the Internal Revenue Code requires you to provide your
information for their credit card,bank,or other financial accounts correct TIN to persons(including federal agencies)who are required to
If you receive an unsolicited email claiming to be from the IRS, file information returns with the IRS to report interest,dividends,or
Y g certain other income paid to you,mortgage interest you paid,the
forward this message to phishing @irs gov You may also report misuse acquisition or abandonment of secured property,the cancellation of
of the IRS name,logo,or other IRS property to the Treasury Inspector debt,or contributions you made to an IRA,Archer MSA,or HSA.The
General for Tax Administration(TIGTA)at 1-800-366-4484 You can person collecting this form uses the information on the form to file
forward suspicious emails to the Federal Trade Commission at information returns with the IRS,reporting the above information
spam@uce.gov or report them at www.ftc.gov/complaint You can Routine uses of this information include giving it to the Department of
contact the FTC at www.ftc.govlidtheft or 877-IDTHEFT(877-438-4338) Justice for civil and criminal litigation and to cities,states,the District of
If you have been the victim of identity theft,see www IdentityTheft.gov Columbia,and U.S.commonwealths and possessions for use in
and Pub.5027 administering their laws The information also may be disclosed to other
Visit www irs.gov/ldentityTheft to learn more about identity theft and countries under a treaty,to federal and state agencies to enforce civil
how to reduce your risk. and criminal laws,or to federal law enforcement and intelligence
agencies to combat terrorism You must provide your TIN whether or
not you are required to file a tax return Under section 3406,payers
must generally withhold a percentage of taxable interest,dividend,and
certain other payments to a payee who does not give a TIN to the payer
Certain penalties may also apply for providing false or fraudulent
information
2 CFR Part 200 Subpart F Audit Certification Form
Audits of States, Local Governments, Indian Tribes, and Non-Profit Organizations
Contact Information
Subrecipient Name(Agency,Local Government,or Organization) Lewis County Department of Emergency Services
Authorized Chief Financial Officer(central accounting office) Suzette Smith
Address 351 NW North, Chehalis, WA 98532
Email Suzettte Smith @Iewiscountywa gov Phone# 360.740.1339
Purpose' As a pass-through entity of federal grant funds,the Washington Military Department/Emergency Management Division(Department)
is required by 2 CFR Part 200 Subpart F to monitor activities of subrecipients to ensure federal awards are used for authorized purposes and
verify that subrecipients expending $750,000 or more in federal awards during their fiscal year have met the 2 CFR Part 200 Subpart F Audit
Requirements Your entity is a subrecipient subject to such monitoring by MIL/EMD because it is a non-federal entity that expends federal grant
funds received from the Department as a pass-through entity to carry out a federal program 2 CFR Part 200 Subpart F should be consulted
when completing this form
Directions' As required by 2 CFR Part 200 Subpart F, non-federal entities that expend$750,000 in federal awards in a fiscal year shall have
a single or program-specific audit conducted for that year. If your entity is not subject to these requirements, you must complete Section A of
this Form If your entity is subject to these requirements, you must complete Section B of this form When completed, you must sign, date,
and return this form with your grant agreement and every fiscal year thereafter until the grant agreement is closed Failure to return this
completed Audit Certification Form may result in delay of grant agreement processing,withholding of federal awards or disallowance of costs,
and suspension or termination of federal awards
SECTION A Entities NOT subject to the audit requirements of 2 CFR Part 200 Subpart F
Our entity is not subject to the requirements of 2 CFR Part 200 Subpart F because(check all that apply)
❑ We did not expend$750,000 or more of total federal awards during the fiscal year
❑ We are a for-profit agency.
❑ We are exempt for other reasons(describe)
However, by signing below, I agree that we are still subject to the audit requirements, laws and regulations governing the program(s)in
which we participate,that we are required to maintain records of federal funding and to provide access to such records by federal and state
agencies and their designees,and that WMD/EMD may request and be provided access to additional information and/or documentation to
ensure proper stewardship of federal funds
SECTION B• Entities that ARE subject to the audit requirements of 2 CFR Part 200 Subpart F
(Complete the information below and check the appropriate box)
❑ We completed our last 2 CFR Part 200 Subpart F Audit on[enter date] for Fiscal Year ending[enter date] There
were no findings related to federal awards from WMD/EMD No follow-up action is required by WMD/EMD as the pass-through entity
A complete copy of the audit report,which includes exceptions,corrective action plan and management response, is
either provided electronically to contracts office @mil wa gov or provide the state auditor report number
❑ We completed our last 2 CFR Part 200 Subpart F Audit on[enter date] for Fiscal Year ending[enter date] There
were findings related to federal awards
A complete copy of the audit report,which includes exceptions,corrective action plan and management response,is either
provided electronically to contracts office @mil wa gov or provide the state auditor report number
❑ Our completed 2 CFR Part 200 Subpart F Audit will be available on [enter date]for Fiscal Year ending
[enter date] We will provide electronic copy of the audit report to contracts.office @mil.wa.gov at that time or
provide the state auditor report number
I hereby certify that I am an individual authorized by the above identified entity to complete this form. Further, I certify that the
above information is true and correct and all relevant material findings contained in audit report/statement have been disclosed
Additionally, I understand this Form is to be submitted every fiscal year for which this entity is a subrecipient of federal award
funds from the Department until the grant agreement is closed
Signature of Authorized Chief Financial Officer Date.
Print Name & Title
WMD Form 1009-13,8/19/2013,Updated 9/9/2015
SIGNATURE AUTHORIZATION FORM
WASHINGTON STATE MILITARY DEPARTMENT
Camp Murray, Washington 98430-5122
Please read instructions on reverse side before completing this form
NAME OF ORGANIZATION DATE SUBMITTED
Lewis County Department of Emergency Services
PROJECT DESCRIPTION CONTRACT NUMBER
19HSGP (SHSP) E20-016
1. AUTHORIZING AUTHORITY
SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE
, 1d /, ow Robert C. Jackson BOCC Chair 01.01.17-12 31 20
2. • • HORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS
SIGNATURE PRINT OR TYPE NAME TITLE
/dr �1 Robert C Jackson BOCC Chair
01 Steve Mansfield Director
"7,4 C U Scott Mattoon Radio Administrator
3 AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT
SIGNATURE PRINT OR TYPE NAME TITLE
P /01 Steve Mansfield Director
�../ Scott Mattoon Radio Administrator
\\NAc-1\voL1\HOME\KARENB\ . \WP\SIGNAUTH Revised 3/03
INSTRUCTIONS FOR SIGNATURE AUTHORIZATION FORM
This form identifies the persons who have the authority to sign contracts, amendments,
and requests for reimbursement It is required for the management of your contract with
the Military Department (MD). Please complete all sections One copy with original
signatures is to be sent to MD with the signed contract, and the other should be kept with
your copy of the contract
When a request for reimbursement is received, the signature is checked to verify that it
matches the signature on file The payment can be delayed if the request is
presented without the proper signature. It is important that the signatures in MD's files
are current Changes in staffing or responsibilities will require a new signature
authorization form.
1 Authorizing Authority. Generally, the person(s) signing in this box heads
the governing body of the organization, such as the board chair or mayor. In
some cases, the chief executive officer may have been delegated this
authority
2 Authorized to Sign Contracts/Contract Amendments. The person(s) with
this authority should sign in this space. Usually, it is the county
commissioner, mayor, executive director, city clerk, etc.
3. Authorized to Sign Requests for Reimbursement. Often the executive
director, city clerk, treasurer, or administrative assistant have this authority
It is advisable to have more than one person authorized to sign
reimbursement requests This will help prevent delays in processing a
request if one person is temporarily unavailable.
If you have any questions regarding this form or to request new forms, please call your
MD Program Manager
Washington Military Department Contract Number ZU-U/U
Debarment, Suspension, Ineligibility or Voluntary Exclusion Certification Form
NAME Doing business as(DBA)
Lewis County
ADDRESS Applicable Procurement WA Uniform Business Federal Employer Tax
351 NW North St , Chehalis, WA 98532 or Solicitation#,if any. Identifier(UBI) Identification#
NA 212002978 91-6001351
This certification is submitted as part of a request to contract.
Instructions For Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower
Tier Covered Transactions
READ CAREFULLY BEFORE SIGNING THE CERTIFICATION. Federal regulations require contractors and bidders to sign and
abide by the terms of this certification, without modification, in order to participate in certain transactions directly or
indirectly involving federal funds.
1 By signing and submitting this proposal, the prospective lower tier participant is providing the certification 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 lower tier participant 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 lower tier participant shall provide immediate written notice to the department, institution or office to
which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was
erroneous when submitted or had 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 meaning
set out in the Definitions and Coverage sections of rules implementing Executive Order 12549 You may contact the
person to which this proposal is submitted for assistance in obtaining a copy of those regulations
5 The prospective lower tier participant 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
proposed for debarment under the applicable CFR, 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 lower tier participant further agrees by submitting this proposal that it will include this clause titled
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered
Transaction," 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 proposed for debarment under applicable CFR, debarred, suspended, ineligible, or voluntarily
excluded from covered transactions, 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 Federal Procurement and 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 activity
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 proposed for debarment under applicable
CFR, suspended, debarred, ineligible, or voluntarily 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
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier
Covered Transactions
The prospective lower tier participant certifies, by submission of this proposal or contract, that neither it nor its
principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded
from participation in this transaction by any Federal department or agency. Where the prospective lower tier
participant is unable to certify to any f the s tements ' this certification, such prospective participant shall
attach an explanation to this form.
Bidder or Contractor Signature ' Date I 677/c7
Print Name and Title Steve Mansfield, Emergenc Services Director
Washington Military Department Contract Number.`u-uru
FEDERAL DEBARMENT, SUSPENSION
INELIGIBILITY and VOLUNTARY EXCLUSION
(FREQUENTLY ASKED QUESTIONS)
What is "Debarment, Suspension, Ineligibility, and Voluntary Exclusion"?
These terms refer to the status of a person or company that cannot contract with or receive grants from a federal agency
In order to be debarred, suspended, ineligible, or voluntarily excluded, you must have
• had a contract or grant with a federal agency, and
• gone through some process where the federal agency notified or attempted to notify you that you could not contract
with the federal agency
• Generally, this process occurs where you, the contractor, are not qualified or are not adequately performing under a
contract, or have violated a regulation or law pertaining to the contract.
Why am I required to sign this certification?
You are requesting a contract or grant with the Washington Military Department Federal law (Executive Order 12549)
requires Washington Military Department ensure that persons or companies that contract with Washington Military
Department are not prohibited from having federal contracts
What is Executive Order 12549?
Executive Order 12549 refers to Federal Executive Order Number 12549 The executive order was signed by the
President and directed federal agencies to ensure that federal agencies, and any state or other agency receiving federal
funds were not contracting or awarding grants to persons, organizations, or companies who have been excluded from
participating in federal contracts or grants Federal agencies have codified this requirement in their individual agency
Code of Federal Regulations (CFRs)
What is the purpose of this certification?
The purpose of the certification is for you to tell Washington Military Department in writing that you have not been
prohibited by federal agencies from entering into a federal contract
What does the word "proposal" mean when referred to in this certification?
Proposal means a solicited or unsolicited bid, application, request, invitation to consider or similar communication from
you to Washington Military Department
What or who is a "lower tier participant"?
Lower tier participants means a person or organization that submits a proposal, enters into contracts with, or receives a
grant from Washington Military Department, OR any subcontractor of a contract with Washington Military Department. If
you hire subcontractors, you should require them to sign a certification and keep it with your subcontract.
What is a covered transaction when referred to in this certification?
Covered Transaction means a contract, oral or written agreement, grant, or any other arrangement where you contract
with or receive money from Washington Military Department. Covered Transaction does not include mandatory
entitlements and individual benefits
Sample Debarment, Suspension, Ineligibility, Voluntary Exclusion Contract Provision
Debarment Certification. The Contractor certifies that the Contractor is not presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from participating in this Contract by any
Federal department or agency. If requested by Washington Military Department, the Contractor shall complete
a Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion form Any such form
completed by the Contractor for this Contract shall be incorporated into this Contract by reference
BOCC AGENDA ITEM SUMMARY
Resolution: BOCC Meeting Date: Oct. 21, 2019
Suggested Wording for Agenda Item: Agenda Type: Deliberation
Approving an agreement between the Washington State Military Department and Lewis County
Department of Emergency Services, Radio Services Division, for FFY 2019 State Homeland Security
Grant Program (19HSGP) Funding Assistance
Contact: Cheryl Millman Phone: 3607401464
Department: DES - Emergency Management (Dept. of Emergency Services)
Description:
Approving agreement between the Washington State Military Department and Lewis County for the
19SHSP Homeland Security Program Grant
Approvals: Publication Requirements:
Publications:
User Status
Cheryl Millman Pending
Kevin McDowell Approved
PA's Office Approved
Additional Copies
Cheryl Millman, Scott Mattoon, Steve Mansfield