12-115 County of Santa Clara Agreement for Granting Program Funds for FY 2011 Emergency Management Performance Grant FIRST AMENDMENT
TO AGREEMENT BETWEEN THE COUNTY OF SANTA CLARA AND
THE CITY OF'CUPERTINO
GRANTING PROGRAM FUNDS FOR THE
FISCAL YEAR 2011 EMERGENCY MANAGEMENT PERFORMANCE GRANT
RECITALS
WHEREAS the County of Santa Clara ("County") entered into an Agreement with the City of
Cupertino ("City") for the distribution of FY2011 Emergency Management Performance Grant
("EMPG") Funds on July 1, 2011.
Now,therefore,THIS FIRST AMENDMENT to the Agreement is made as of July 10,2012,in Santa
Clara County, California, by and between the County and the City. The language in the First
Amendment supersedes any contrary language in the Agreement with respect to Article 1, Section 1.
All other requirements,terms and conditions of the Agreement remain in full force and effect without
amendment or change.
AMENDMENT
1. Modification to the Agreement. The Agreement is hereby modified as follows:
Article 1,Section 1,"Amount of Payment"will have the following language replace
the existing language in its entirety:
Fiscal Year 2011 Emergency Management Performance Grant funds will be disbursed by the
County pursuant to funding allocations made by the EPC. The maximum amount of 2011
EMPG funds payable by the County to the City shall not exceed the total amount of
$17,975.94.
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Amended Agreement between the County of Santa Clara
and the City of Cupertino for the distribution of FY2011 Emergency
Management Performance Grant Funds
The parties hereto have executed this First Amendment to the Agreement as of the last date
shown below.
Signed:
COUNTY OF SANTA CLARA CITY OF CUPERTINO
BY AMT / L By 417(2 Emily arrison e David Brandt Date
Deputy County Executive City Manager
Approved to Form and Legality: Approved as to Form and Legality:
M Gonzalez City Attorney
Deputy County Counsel
t.(00
2'q4 7/ff/is-
Date Date
Amended Agreement between the County of Santa Clara
and the City of Cupertino for the distribution of FY2011 Emergency
Management Performance Grant Funds
AGREEMENT BETWEEN THE COUNTY OF SANTA CLARA AND
THE CITY OF CUPERTINO GRANTING PROGRAM FUNDS FOR THE
2011 EMERGENCY MANAGEMENT PERFORMANCE GRANT
THIS AGREEMENT is made effective July 1, 2011, by and between the County of Santa Clara
("County") and the City of Cupertino ("City") for the allocation and distribution of 2011
Emergency Management Performance Grant("EMPG") funds.
RECITALS
WHEREAS, the Cities of Campbell, Cupertino, Gilroy, Los Altos, Milpitas, Monte Sereno,
Morgan Hill, Mountain View, Palo Alto, San Jose, Santa Clara, Saratoga, Sunnyvale, the Towns of
Los Gatos, Los Altos Hills, and the County of Santa Clara, are parties to the 1994 Operational
Area Interim Agreement; and
WHEREAS,the Emergency Preparedness Council ("EPC") is the advisory body of the Santa Clara
Operational Area in matters affecting disaster preparedness throughout the Operational Area. EPC
membership includes an elected city council member from each city in the Operational Area, one
member of the Water District and one member of the Santa Clara County Board of Supervisors;
and
WHEREAS, the County Emergency Services/Civil Defense Ordinance empowers the EPC to serve
as the Santa Clara County Operational Area Council ("OAC") with governing body authority to
carry out the responsibilities of the OAC and to make funding allocation decisions for the
Emergency Management Performance Grants; and
WHEREAS, on January 9, 2012 the California Emergency Management Agency awarded the
County a 2011 Emergency Management Performance Grant of $458,807 for the purpose of
managing emergency planning;
NOW, THEREFORE, this AGREEMENT is to allocate the sum of$14, 164.05 (a portion of the
grant funds, allocated on a per capita basis, Exhibit B), from the County to the City , so that the
City may implement programs as provided under this Agreement and specified in the Emergency
Management Performance Grant guidelines for subgrant recipients, Exhibit C. The performance
period for the County for this grant expires on June 30, 2012. The performance period for the City
for the subgrant expires on June 15, 2012.
The County and City agree as follows:
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Agreement between the County of Santa Clara and City of Cupertino
granting funds for 2011 Emergency Management Performance Grant Page 1
THE AGREEMENT
Article I. Allocation and Spend Plans
1. Allocation.
The 2011 Emergency Management Performance Grant funds will be disbursed pursuant to the
State of California formula for each city. The County will reimburse to the City funds that the City
expends under 2011 Emergency Management Performance Grant. The amount for the City of
Cupertino will not exceed $14,164.05, unless additional funds become available under the 2011
Emergency Management Performance Grant following the execution of this Agreement. If
additional funds are allocated, an amendment to this MOU will follow.
2. Spend Plans
Upon execution of this agreement, City will provide County with Spend Plans for review by the
County's Director of the Office of Emergency Services or designee. A "Spend Plan" is a written
document that explains the Project on which City intends to spend 2011 EMPG funding, including
Project deliverables and milestone dates when any funds allocated will be spent. All Spend Plans
must be approved through the Office of Emergency Services. The Director of the Office of
Emergency Services or designee will approve Spend Plans based upon projects submitted to the
State for the 2011 EMPG Program. If a Spend Plan is not approved, the Office of Emergency
Services will notify City and City will have 10 days from the date of the notice to submit a revised
Spend Plan for approval or risk reallocation of funds. The City's Spend Plans are a required part
of this MOU and City's Spend Plans are attached and incorporated herein as Exhibit A.
If it is determined that a milestone date when funds are to be spent according to City's Spend Plans
cannot be met, City will be required to complete and submit a "Spend Plan Request for
Extension", (Exhibit F), for review and approval by the Director of the Office of Emergency
Services or designee. The "Request for Extension" must include an updated Spend Plan and
explain the reason for the extension, why the deliverables/milestone dates were not met, and how
City will meet the new date(s)requested for spending any allocated funds.
Article II. Requests for Reimbursement and Reimbursements
1. Required Documentation for Reimbursement
The EMPG is a matching funds grant. All requests for reimbursement should be
accompanied by a spreadsheet, Exhibit H, indicating the 50% City match and the EMPG
allowable amount up to the allocated amount of each city.
All equipment must be indicated in the City's Spend Plan submitted to the County and
authorized per the web-based Authorized Equipment List (AEL) on the Responder
Knowledge Base (RKB) which is sponsored by Grants & Training and the National
Agreement between the County of Santa Clara and City of Cupertino
granting funds for 2011 Emergency Management Performance Grant Page 2
Memorial Institute for the Prevention of Terrorism (MIPT) at https://www.rkb.us/.
Sole sources of $100,000 or more are not allowable under the grant program unless first
approved through the State. Sole Source request documentation must be obtained and
submitted through the Grants Manager, Office of Emergency Services. Upon City's
completion and submission of the required sole source documentation, the Grants Manager
will forward all sole source documents to the appropriate State contact for review and
approval. Only after State approval is granted can a sole source procurement be completed
and expenditures reimbursed using EMPG allocated funds. Sole Source request below the
$100,000 threshold, must follow your local Agency Procurement Policy.
City who award contracts in the amount of,$25,000 or more are required to report within 30
days of award on sub-awards, as well as on highly compensated individuals, on the
Financial Disclosure Form, Exhibit I, attached as to form and legality. Classified
information is exempt from the prime and sub-award reporting requirement as are
contracts with individuals. The following information must be included in your report on
Sub-awards greater than $25,000:
a) Name of entity receiving award;
b) Amount of award;
c) Funding agency;
d) The Catalog of Federal Domestic Assistance program number;
e) Award title(descriptive of the purpose of the fundi ng action);
f) Location of the entity and primary location of performance including city, state,
and Congressional district;
g) Dun & Bradstreet (D&B) DUNS Number of the entity, and its parent if
applicable; and,
h) Total compensation and names of top five executives (same thresholds as for
prime recipients).
The following documentation is required for all reimbursement requests for equipment:
• Quote or Solicitation Documents
• Summary of pricing and chosen vendor
• Documentation that vendor is not on the excluded parties list
(https://www.epls.gov/)
• Purchase order and/or Contract
• Receiving documentation/Packing slip
• Invoice
• Proof of Payment
The following documentation is required for all reimbursement requests for contractors:
• Quote or Solicitation Documents
• Executive summary on how contractor was chosen
• Documentation that contractor is not on the excluded parties list
Agreement between the County of Santa Clara and City of Cupertino
granting funds for 2011 Emergency Management Performance Grant Page 3
(https://www.epls.govl)
• Purchase order and/or Contract
• Invoice showing deliverables and milestones completed
• Proof of Payment
• Financial Disclosure Form, (Exhibit I); If award a contract is in excess of$25,000
or more
For reimbursement of Salaries:
• Functional Timesheet(Exhibit G)
• Description of scope of job which includes Emergency Management functions
• Hourly Rate
• Payroll reports showing amount paid for each pay period being claimed
For reimbursement for Training activities:
• Class Syllabus
• Class sign-in sheet
• Instructor/Consultant contract documents
• Instructor's invoice
• Proof of Payment
2. Submission of Requests for Reimbursement
(a) Cities will be expected, if it coincides with their approved Spend Plans, to submit
reimbursement requests to the Office of Emergency Services (see Article V.1 below) on a
quarterly basis as detailed in the chart below. All reimbursement requests will be due fifteen
calendar days after the end of the quarter, with the exception of the final expenditure and/or
invoice, as indicated below unless otherwise pre-approved by the Director of the Office of
Emergency Services or designee. Any expenditure during the final period identified in the
chart below must be made by June 16, 2012 and any related invoice must be submitted by June
16, 2012, unless otherwise pre-approved by the Director of the Office of Emergency Services
or designee, in order to meet 2011 EMPG deadlines. Reimbursement requests will be due for
expenditures during specified periods as follows:
For Expenditures During the Period: Due Dates for Reimbursement Requests:
July 1, 2011 through September 30, 2011 October 15, 2011
October 1, 2011 through December 31, 2011 January 15, 2012
Januaryl, 2012 through March 31, 2012 April 16, 2012
April 1, 2012 through June 16, 2012 June 16, 2012
(b) During the term of this Agreement, the County is not obligated to honor any request for
reimbursement that is submitted after the due dates for reimbursement requests for expenditures
within a given quarter as specified above in Article II, Section 2(a).
Agreement between the County of Santa Clara and City of Cupertino
granting funds for 2011 Emergency Management Performance Grant Page 4
Article III. Use of Funds
1. Scope of Services
(a) The City will use the funds granted under this Agreement only for the purpose of
implementing applicable programs under the 2011 Emergency Management Performance Grant, as
indicated in Exhibit D, Program Narrative.
(b) The City will use the funds granted under this Agreement in a manner consistent with:
(1) the applications submitted by the County to the State for the grants under this Agreement;
(2) the grant guidance issued by the State for the grants under this Agreement; and
(3) the notifications issued by the State for the approval of the grants under this Agreement.
(c) The documents described in Article III.1(b)(1-3) of this Agreement are on file with the County and
the granting agencies of the State, and are hereby incorporated into this Agreement.
(d) All EMPG grant funded personnel shall participate in no less than three exercises in a 12-month
period. EMPG grant funded personnel are any personnel paid at any percentage with EMPG
funding. This includes contracted personnel, as well as M&A staff funded by EMPG grant funds.
There is no specific requirement for level of"participation" in the exercises, so, observation and
attendance satisfies the objective. The exercises can be of any type (e.g., Drills,Tabletop
Exercises, or Functional) within the performance period(see https://hseep.dhs.gov).
(e) To ensure the development of a professional emergency management workforce all EMPG grant
funded personnel shall complete 11 training requirements and record proof of completion:
> National Incident Management System (NIMS) Training:
• IS 100 Introduction to Incident Command System
• IS 200 ICS for Single Resources and Initial Action Incident
• IS 700 National Incident Management System, An Introduction
• IS 800 National Response Framework, An Introduction
> FEMA Professional Development Series:
• IS 139 Exercise Design
• IS 230.b Fundamentals of Emergency Management
• IS 235.a Emergency Planning
• IS 240.a Leadership and Influence
• IS 241.a Decision Making and Problem Solving
• IS 242.a Effective Communication
• IS 244.a Developing and Managing Volunteers
EMPG grant funded personnel are any personnel paid at any percentage with EMPG funding. This
includes M&A staff funded by EMPG grant funds.
Agreement between the County of Santa Clara and City of Cupertino
granting funds for 2011 Emergency Management Performance Grant Page 5
2. Master Grant Obligations
(a) The City agrees to comply with all applicable requirements and assurances contained in the
State Grant Requirements. The City may designate vendors or sub-grantees to fulfill these
obligations.
(b) If any provisions of this Agreement conflict with the State Grant Requirements, the provisions
of the State Grant Requirements will control.
3. Reporting
(a) The City will prepare progress reports for the duration of the term of this Agreement. The
reports must include the status of all activities, including equipment purchases (if applicable).
(b) The reports are due to the County representative identified in Article VI.1 as follows:
Quarterly Performance Reporting Period Report Due Date
July 1, 2011 —September 30, 2011 October 15, 2011
October 1, 2011 —December 31, 2011 January 16, 2012
January 1, 2012—March 31, 2012 April 16, 2012
April 1, 2012—June 30, 2012 July 16,2012
Any final reporting documentation July 16, 2012
(c) The County will provide the City with a report template, (Exhibit E) and the City will utilize
the template.
(d) The City will notify the County representative identified in Article VI.1, within 15 days, when
the City has completed all performance obligations for these grants. The City shall provide such
notice no later than July 15, 2012.
(e) The reporting requirements under this section shall survive termination of this Agreement.
Article IV. Term and Termination
1. Term of Agreement
This Agreement is effective from July 1, 2011 through June 30, 2012.
2. Availability of Funds
(a) The parties acknowledge and agree that this Agreement is dependent upon the
availability of County, regional, State and/or federal funding.
Agreement between the County of Santa Clara and City of Cupertino
granting funds for 2011 Emergency Management Performance Grant Page 6
(b) Budgetary Contingency: This Agreement is contingent upon the appropriation of
sufficient funding by the County for the products and services covered by this
Agreement. If funding is reduced or deleted by the County for the products or
services covered by this Agreement, the County has the option to either terminate this
Agreement with no liability occurring to the County or to offer an amendment to this
Agreement indicating the reduced amount.
(c) The obligations of the County to make payments in accordance with the provisions of
this Agreement may be delayed, reduced or terminated pursuant to any delay,
reduction, or change in allocation or allotment in funding to County from federal,
State or other regional funding sources.
3. Termination
(a) Either party may terminate this Agreement for cause or no cause upon written notice
to the other. Termination for cause includes, but is not limited to a material breach of
this Agreement, a violation of any applicable laws, or failure to comply with
applicable EMPG grant guidelines.
(b) Opportunity to cure. The non-breaching party shall give written notice of the breach
to the breaching party, specifying the breach/cause. The breaching party shall not be
deemed in default hereunder and the non-breaching party shall not institute
proceedings or exercise any remedies against the breaching party unless the breach
has not been cured, corrected or remedied within thirty (30) days after the giving of
such notice of breach or within such longer period as may be reasonably required to
cure, correct or remedy the breach, provided the breaching party has commenced
such cure, correction or remedy within such thirty(30) day period and diligently and
continuously pursues such cure, correction or remedy.
(c) If this Agreement is terminated, the City shall return funding in accordance with grant
guidelines.
Article V. Liabilities
1. Mutual Indemnification
In lieu of and notwithstanding the pro rata risk allocation which might otherwise be
imposed between the parties pursuant to Government Code Section 895.6, the parties
agree that all losses or liabilities incurred by a party shall not be shared pro rata but
instead the County and the City agree that pursuant to Government Code Section 895.4,
each of the parties hereto shall fully indemnify and hold each of the other parties, their
officers, board members, employees and agents, harmless from any claim, expense or
cost, damage or liability imposed for injury (as defined by Government Code Section
810.8) occurring by reason of the negligent acts or omissions or willful misconduct of the
indemnifying party, its officers, board members, employees or agents, under or in
connection with or arising out of any work, authority or jurisdiction delegated to such
Agreement between the County of SC and City of Cupertino
Granting Funds for 2010 Homeland Security Grant Programs
party under this Agreement. No party, nor any officer, board member, employee or agent
thereof shall be responsible for any damage or liability occurring by reason of the
negligent acts or omissions or willful misconduct of other parties hereto, their officers,
board members, employees or agents, under or in connection with or arising out of any
work, authority or jurisdiction delegated to such other parties under this Agreement.
Article VI. Miscellaneous
1. Notice
All notices required by this Agreement will be deemed given when in writing and
delivered personally or deposited in the United States mail, postage prepaid, return
receipt requested, addressed to the other party at the address set forth below or at such
other address as the party may designate in writing:
To the City:
Emergency Preparedness Coordinator
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3232
To the County:
Roslyn Fuller
Administrative Services &Grants Manager
County of Santa Clara Office of Emergency Services
55 W. Younger Ave., Suite 450
San Jose, CA 95110
2. Compliance and Nondiscrimination
The parties will comply with all applicable Federal, State, and local laws and regulations. Such
laws include but are not limited to the following: Title VII of the Civil Rights Act of 1964 as
amended, the Americans with Disabilities Act of 1990, the Rehabilitation Act of 1973 (Sections
503 and 504), the California Fair Employment and Housing Act (Government Code sections
12900 et seq.), and California Labor Code sections 1101 and 1102. The parties will not
discriminate against any subcontractor, employee, or applicant for employment because of age,
race, color, national origin, ancestry, religion, sex/gender, sexual orientation, mental disability,
physical disability, medical condition, political beliefs, organizational affiliations, or marital status
in the recruitment, selection for training including apprenticeship, hiring, employment, utilization,
promotion, layoff, rates of pay or other forms of compensation. Nor will the parties discriminate in
the provision of services provided under this Agreement because of age, race, color, national
origin, ancestry, religion, sex/gender, sexual orientation, mental disability, physical disability,
medical condition, political beliefs, organizational affiliations, or marital status.
3. County No-Smoking Policy
Agreement between the County of SC and City of Cupertino
Granting Funds for 2010 Homeland Security Grant Programs
Contractor and its employees, agents and subcontractors, shall comply with the County's No Smoking
Policy, as set forth in the Board of Supervisors Policy Manual section 3.47 (as amended from time to
time), which prohibits smoking: (1) at the Santa Clara Valley Medical Center Campus and all County-
owned and.operated health facilities, (2)within 30 feet surrounding County-owned buildings and
leased buildings where the County is the sole occupant, and (3) in all County vehicles.
4. Governing Law
This Agreement has been executed and delivered in, and will be construed and enforced in
accordance with, the laws of the State of California.
5. Assignment
The parties may not assign this Agreement or the rights and obligations hereunder without the
specific written consent of the other.
6. Entire Agreement
This document represents the entire Agreement between the parties with respect to the subject
matter hereof. All prior negotiations and written and/or oral agreements between the parties with
respect to the subject matter of this Agreement are merged into this Agreement.
7. Amendments
This Agreement may only be amended by an instrument signed by the parties.
8. Counterparts
This Agreement may be executed in one or more counterparts, each of which shall be deemed to
be an original, but all of which together shall constitute one and the same instrument.
9. Severability
If any provision of this Agreement is found by a court of competent jurisdiction to be void, invalid
or unenforceable, the same will either be reformed to comply with applicable law or stricken if not
so conformable, so as not to affect the validity or enforceability of this Agreement.
10. Waiver
No delay or failure to require performance of any provision of this Agreement shall constitute a
waiver of that provision as to that or any other instance. Any waiver granted by a party must be in
writing, and shall apply to the specific instance expressly stated.
Agreement between the County of Santa Clara and City of Cupertino
granting funds for 2011 Emergency Management Performance Grant
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11. Conflict of Interest
In accepting this Agreement, City covenants that is presently has no interest and will not acquire
any interest, direct or indirect, financial or otherwise, which would conflict in any manner or
degree with the performance of services under this Agreement. City is responsible for assuring
compliance of its subcontractors, if any, with the requirements of this provision.
12. Certified Resolution of Signature Authority
Upon request of Santa Clara County, City will deliver to Santa Clara County a copy of the
resolution(s) authorizing execution, delivery and performance of this Agreement, certified as true,
accurate and complete by the appropriate authorized representative of City.
Signed:
COUNTY OF SANTA CLARA CITY OF CUPERTINO
By 3! `51, 1 Z - B i l �,30 r Z
Emily H.rrtson Da e avid Knapp se.% Date
Deputy County Executive City Manager
Approved as to Form and Legality: Approved as to Form and Legality:
Mark Gonzalez ate City Attorney Da e
Deputy County Counsel
Exhibit A City Spend Plan
Exhibit B FY08 Per Capita Distribution Worksheet
Exhibit C Grant Guidance
Exhibit D Program Narrative
Exhibit E FY11 EMPG Performance Report—Cumulative
Exhibit F Spend Plan Request for Extension
Exhibit G Functional Timesheet Template
Exhibit H City Reimbursement Worksheet
Exhibit I Financial Disclosure Form
Exhibit J FY11 Exercise Data Table Template
Agreement between the County of Santa Clara and City of Cupertino
granting funds for 2011 Emergency Management Performance Grant
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Exhibit C
FY11 Emergency Management Performance Grant
Assurances, Certifications, Terms, and Conditions
ASSURANCES
The applicant hereby assures and certifies compliance with all applicable Federal statutes,regulations, policies,
guidelines, and requirements, including OMB Circulars A-87, A-102, A-133; Executive Order 12372
(intergovernmental review of federal programs); and 44 C.F.R. pt.13 (administrative requirements for grants
and cooperative agreements). The applicant also specifically assures and certifies that:
1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial
capability(including funds sufficient to pay the non-Federal share of project costs)to ensure proper
planning, management and completion of the project described in this application.
2. Will give the awarding agency,the Controller General of the United States, and if appropriate,the State,
through any authorized representative, access to and the right to examine all records, books, papers, or
documents related to the award;and will establish a proper accounting system in accordance with
generally accepted accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or
presents the appearance of personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the
awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§ 4728-4763) relating to
prescribed standards for merit systems for programs funded under one of the nineteen statutes or
regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration
(5 C.F.R.900, Subpart F).
6. Will comply with all Federal statutes relating to nondiscrimination.These include but are not limited to:
(a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of
race, color or national origin; (b)Title IX of the Education Amendments of 1972, as amended (20 U.S.C.
§§ 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the
Rehabilitation Act of 1973, as amended (29 U.S.C. § 794), which prohibits discrimination on the basis of
handicaps; (d)the Age Discrimination Act of 1975, as amended (42 U.S.C. §§ 6101-6107), which
prohibits discrimination on the basis of age; (e)the Drug Abuse Office and Treatment Act of 1972 (P.L.
92-2S5), as amended, relating to nondiscrimination on the basis of drug abuse; (f)the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as
amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§ 523 and 527 of
the Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as amended, relating to
confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42
U.S.C. § 3601 et seq.), as amended, relating to non-discrimination in the sale, rental or financing of
housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for
Federal assistance is being made; and(j)the requirements of any other nondiscrimination statute(s)which
may apply to the application.
Exhibit C
7. Will comply, or has already complied,with the requirements of Titles II and 111 of the Uniform
Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide
for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or
federally assisted programs. These requirements apply to all interests in real property acquired for project
purposes regardless of Federal participation in purchases.
8. Will comply with the provisions of the Hatch Act(5 U.S.C. §§ 1501-1508 and 7324-7328) which limit the
political activities of employees whose principal employment activities are funded in whole or in part with
Federal funds.
9. Will comply, as applicable, with the provisions of the Davis-Bacon Act(40 U.S.C. §§ 276a to 276a7), the
Copeland Act(40 U.S.C. § 276c and 18 U.S.C. §§ 874), and the Contract Work Hours and Safety
Standards Act(40 U.S.C. §§ 327-33.3), regarding labor standards for federally assisted construction
subagreements.
10. Will comply, if applicable,with flood insurance purchase requirements of Section 102(a) of the Flood
Disaster Protection Act of 1973 (P.L. 93234)which requires recipients in a special flood hazard area to
participate in the program and to purchase flood insurance if the total cost of insurable construction and
acquisition is $10,000 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a)
institution of environmental quality control measures under the National Environmental Policy Act of
1969 (P.L. 91-190) and Executive Order(EO) 11514; (b)notification of violating facilities pursuant to EO
11738; (c)protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in
accordance with EO 11988; (e)assurance of project consistency with the approved State management
program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §§ 1451 et seq.); (0
conformity of Federal actions to State(Clear Air) Implementation Plans under Section 176(c) of the Clear
Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.); (g) protection of underground sources of drinking
water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of
endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205).
All proposed construction and renovation activities must undergo an Environmental Planning and Historic
Preservation (EHP)review, including approval of the review from FEMA, prior to undertaking any action
related to the project.Any applicant that is proposing a construction project should pay special attention to
the EHP requirements contained in Part VI (B, 5.7) of the Guidance..
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§ 1271 et seq.) related to protecting
components or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic
Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and protection of historic
properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research,
development, and related activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. 2131 et
seq.)pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching,
or other activities supported by this award of assistance.
Exhibit C
16. Will comply with the Lead-Based Paint Poisoning Prevention Act(42 U.S.C. §§ 4801 et seq.)which
prohibits the use of lead based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single
Audit Act of 1984 or OMB Circular No. A-133, Audits of Institutions of Higher Learning and other Non-
profit Institutions.
18. Will comply with Homeland Security Presidential Directive (HSPD)-5,Management of Domestic
Incidents. The adoption of the NIMS is a requirement to receive Federal preparedness assistance,through
grants, contracts, and other activities. The NIMS provides a consistent nationwide template to enable all
levels of government,tribal nations, nongovernmental organizations, and private sector partners to work
together to prevent, protect against,respond to, recover from, and mitigate the effects of incidents,
regardless of cause, size, location, or complexity.
19. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and
policies governing this program. This includes all requirements, restrictions and regulations identified in
the California Emergency Management Agency(Cal EMA)Fiscal Year 2011 Emergency Management
Performance Grant(EMPG) Recipient Subgrant Guide for Local Governments.
20. Will not dispose of, modify the use of, or change the terms of the real property title, or other interest in the
site and facilities without permission and instructions from the awarding agency. Will record the Federal
interest in the title of real property in accordance with awarding agency directives and will include a
covenant in the title of real property acquired in whole or in part with Federal assistance funds to assure
non-discrimination during the useful life of the project.
21. Will comply with the requirements of the assistance awarding agency with regard to the drafting, review
and approval of construction plans and specifications.
22. Will provide and maintain competent and adequate,engineering supervision at the construction site to
ensure that the complete work conforms with the approved plans and specifications and will furnish
progress reports and such other information as may be required by the assistance awarding agency or
State.
CERTIFICATIONS
Certification for Contracts. Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her know`edge and belief,that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of an agency, a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection
with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal
loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,
or modification of any Federal contract, grant, loan., or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an
officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal
Exhibit C
contract, grant, loan, or cooperative agreement,the undersigned shall complete and submit Standard Form-
LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for
all subawards at all tiers(including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification
is a material representation of fact upon which reliance was placed when this transaction was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction
imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be
subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure.
Statement for Loan Guarantees and Loan Insurance
The undersigned states, to the best of his or her knowledge and belief,that:
If any 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 commitment providing for the United States to insure or guarantee
a loan,the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying,"
in accordance with its instructions. Submission of this statement is a prerequisite for making or entering into
this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required
statement shall be subject to a civil penalty of not less than$10,000 and not more than $100,000 for each such
failure.
2.DEBARMENT, SUSPENSION,AND OTHER RESPONSIBILITY MATTERS (DIRECT RECIPIENT):
As required by Executive Order 12549, Debarment and Suspension, and implemented at 44 CFR, Part 17:
A.The applicant certifies that it and its principals:
(1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, sentenced to a
denial of Federal benefits by a State or Federal court, or voluntarily excluded from covered
transactions by any Federal department or agency;
(2) Have not within a three-year period preceding this application been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public(Federal, State, or local) transaction or
contract under a public transaction; violation of Federal or State antitrust statutes or commission of
embezzlement,theft, forgery, bribery, falsification or destruction of records, making false statements,
or receiving stolen property;
(3)Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity
(Federal, State, or local) with commission of any of the offenses enumerated in paragraph (A)(2) of
this certification; and
(4) Have not within a three-year period preceding this application had one or more public transactions
(Federal, State, or local) terminated for cause or default; and
Exhibit C
B. Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach
an explanation to this application.
3.CERTIFICATIONS REGARDING DRUG-FREE WORKPLACE REQUIREMENTS: This certification
commits the applicant to compliance with the certification requirements under 44 CFR, Part 17 Government-
wide Requirements for Drug-Free Workplace (Grants).
A.The grantee certifies that it will or will continue to provide a drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing,
possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the
actions that will be taken against employees for violation of such prohibition;
(b) Establishing an ongoing drug-free awareness program to inform employees about—
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations occurring in the
workplace;
(c) Making it a requirement that each employee to be engaged in the performance of the grant be given a
copy of the statement required by paragraph (a);
(d)Notifying the employee in the statement required by paragraph(a)that, as a condition of employment
under the grant,the employee will—
(1) Abide by the terms of the statement; and
(2) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute
occurring in the workplace no later than five calendar days after such conviction;
(e) Notifying the agency in writing,within ten calendar days after receiving notice under subparagraph
(d)(2) from an employee or otherwise receiving actual notice of such conviction. Employers of
convicted employees must provide notice, including position title,to every grant officer or other
designee on whose grant activity the convicted employee was working, unless the Federal agency has
designated a central point for the receipt of such notices.Notice shall include the identification
number(s) of each affected grant;
(f) Taking one of the following actions, within 30 calendar days of receiving notice under subparagraph
(d)(2),with respect to any employee who is so convicted—
(1)Taking appropriate personnel action against such an employee, up to and including termination,
consistent with the requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation
program approved for such purposes by a Federal, State, or local health, law enforcement, or other
appropriate agency;
(g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of
paragraphs (a), (b), (c), (d), (e) and (f).
Exhibit C
4. SWEATFREE CODE OF CONDUCT:
a.All applicants contracting for the procurement or laundering of apparel, garments or corresponding
accessories, or the procurement of equipment, materials, or supplies, other than procurement related to a
public works contract, declare under penalty of perjury that no apparel, garments or corresponding
accessories, equipment, materials, or supplies furnished to the state pursuant to the subgrant have been
laundered or produced in whole or in part by sweatshop labor, forced labor, convict labor, indentured
labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor, or
with the benefit of sweatshop labor, forced labor, convict labor, indentured labor under penal sanction,
abusive forms of child labor or exploitation of children in sweatshop labor. The applicant further declares
under penalty of perjury that they adhere to the Sweatfree Code of Conduct as set forth on the California
Department of Industrial Relations website located at www.dir.ca.gov, and Public Contract Code Section
6108.
b.The applicant agrees to cooperate fully in providing reasonable access to the applicant's records,
documents, agents or employees, or premises if reasonably required by authorized officials of the
contracting agency,the Department of Industrial Relations, or the Department of Justice to determine the
contractor's compliance with the requirements under paragraph (a).
5.DOMESTIC PARTNERS: For subgrants executed or amended after July 1, 2004, the applicant may elect to
offer domestic partner benefits to the applicant's employees in accordance with Public Contract Code section
10295.3. However, the applicant cannot require an employee to cover the costs of providing any benefits
which have otherwise been provided to all employees regardless of marital or domestic partner status.
TERMS AND CONDITIONS
The following laws apply to persons or entities doing business with the State of California.
1. CONFLICT OF INTEREST: Applicant needs to be aware of the following provisions regarding current or
former state employees. If subgrantee has any questions on the status of any person rendering services or
involved with the Agreement,the awarding agency must be contacted immediately for clarification.
Current State Employees (Public Contract Code§10410):
1)No officer or employee shall engage in any employment, activity or enterprise from which the officer or
employee receives compensation or has a financial interest and which is sponsored or funded by any state
agency, unless the employment, activity or enterprise is required as a condition of regular state
employment.
2)No officer or employee shall contract on his or her own behalf as an independent contractor with any state
agency to provide goods or services.
Former State Employees (Public Contract Code§10411):
1) For the two-year period from the date he or she left state employment, no former state officer or employee
may enter into a contract in which he or she engaged in any of the negotiations, transactions, planning,
arrangements or any part of the decision-making process relevant to the contract while employed in any
capacity by any state agency.
Exhibit C
2)For the twelve-month period from the date he or she left state employment,no former state officer or
employee may enter into a contract with any state agency if he or she was employed by that state agency
in a policy-making position in the same general subject area as the proposed contract within the 12-month
period prior to his or her leaving state service.
If applicant violates any provisions of above paragraphs, such action by applicant shall render this
Agreement void. (Pub. Contract Code §10420)
Members of boards and commissions are exempt from this section if they do not receive payment other
than payment of each meeting of the board or commission, payment for preparatory time and payment for
per diem. (Pub. Contract Code §10430 (e))
2. LABOR CODE/WORKERS' COMPENSATION: Applicant needs to be aware of the provisions which
require every employer to be insured against liability for Worker's Compensation or to undertake self-
insurance in accordance with the provisions, and applicant affirms to comply with such provisions before
commencing the performance of the work of this Agreement. (Labor Code Section 3700)
3.AMERICANS WITH DISABILITIES ACT: Applicant assures the State that it complies with the Americans
with Disabilities Act(ADA) of 1990,which prohibits,discrimination on the basis of disability, as well as all
applicable regulations and guidelines issued pursuant to the ADA. (42 U.S.C. 12101 et seq.)
4.APPLICANT NAME CHANGE: An amendment is required to change the applicant's name as listed on this
Agreement. Upon receipt of legal documentation of the name change the State will process the amendment.
Payment of invoices presented with a new name cannot be paid prior to approval of said amendment.
5.RESOLUTION: A county, city, district, or other local public body must provide the State with a copy of a
resolution, order, motion, or ordinance of the local governing body which by law has authority to enter into
an agreement, authorizing execution of the agreement.
6.AIR OR WATER POLLUTION VIOLATION: Under the State laws, the applicant shall not be:
(1) in violation of any order or resolution not subject to review promulgated by the State Air Resources
Board or an air pollution control district;
(2) subject to cease and desist order not subject to review issued pursuant to Section 13301 of the Water
Code for violation of waste discharge requirements or discharge prohibitions; or
(3) finally determined to be in violation of provisions of federal law relating to air or water pollution.
Failure to comply with these requirements may result in suspension of payments under the Agreement or
termination of the Agreement or both and applicant may be ineligible for award of any future State agreements
if the department determines that any of the following has occurred: the applicant has made false certification,
or violated the certification by failing to carry out the requirements as noted above. (Gov. Code §8350 et seq.)
I,the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally
bind the prospective jurisdiction to the assurances and certifications listed above.
Jurisdiction (Printed)
Exhibit C
By(Authorized Sig ature)
Printed Name and Title of Person Signing
do A irmi pA, D,4-v46 44.47,p
Date Executed I /
4,„„) \ e
CV �Q2 r�'► ►,.,
Exhibit D
FY11 EMERGENCY MANAGEMENT PERFORMANCE GRANT
PROGRAM NARRATIVE
Overview: Part of The County of Santa Clara's mission is to support comprehensive emergency
management and to encourage the improvement of mitigation,preparedness, response, and recovery
capabilities for all hazards. Funds provided under the EMPG will be used to support activities that
contribute to Santa Clara's capability to prevent,prepare for,mitigate against, respond to, and recover
from emergencies and disasters, whether natural or man-made.
The Santa Clara County Operational Area's 2011 EMPG funding will cover emergency management
activities that directly coincide with the State Secretary's Emphasis and are in compliance with the goals
and objectives.
GOAL/ ACTIVITY TASK(S)TO BE COMPLETED
OBJECTIVE
Goal 1, Information Management Emergency Operations Centers need to be
Objective -1.1, Technology and Process enhanced with the latest technology. Some of the
Goal 2, Increase regional readiness by equipment being purchased includes radios,
Objective-2.1, enhancing primary and video/display units, surveillance cameras,
Goal 3, alternate EOCs. tracking systems to hold large maps, a power
Objective -3.3 Enhance operable and supply and other enhancements. Emergency
interoperable communication 3. managers will use work in their EOCs to install,
Backup Power Supply (1), test and implement procedures for the new
10PE-00-UPS, Supply, equipment.
Uninterruptible Power(UPS) -
Proj ector& Egan Track (1),
21 GN-00-OCEQ, Equipment
and Supplies,
Information/Operations Center
- Radio (22), 06CP-01-PORT,
Radio, Portable - Radio (30),
06CP-01-PORT, Radio,
Portable - Speaker system (2),
21 GN-00-OCEQ, Equipment
and Supplies,
Information/Operations Center
- Surveillance Camera (1),
14SW-01-VIDA, Systems,
Video Assessment, Security -
Video Display with Smart
Board (1), 04MD-03-DISP,
Display, Video
Goal 2, -Emergency Responder With many retirements in emergency
Objective-2.1, Credentialing management in Santa Clara County, several of
2.6, Goal 3, Participate in EMMAA the city emergency managers are or will be new
Objective-3.2, Increase professional to emergency management this year. There is a
Goal 5, development and training need to attend some of the preliminary trainings
Exhibit D
Objective -5.1, opportunities. like "Introduction to Emergency Management,
5.2 Provide training to staff and Earthquake" which is delivered by CSTI. Also,
volunteers. there are ten active CERT programs in SCC. A
portion of the funds from this Project will be used
to pay the salaries of Emergency Managers to
plan, prepare, deliver, and report on the progress
of increasing the number of residents trained in
CERT 317 by an additional 300 participants.
Goal 3, - Alert&Warning AIertSCC, the Santa Clara County's notification
Objective-3.5, Continue to grow the system, is undergoing some upgrades and
3.7 knowledge base for AIertSCC protocol changes. These funds will have
(notification system) Emergency Managers focus on adapting to the
changes and updating the database information
used by the new system.
Goal 2, - Functional Needs Santa Clara County has a FAST team that was
Objective-2.1 • Further the Access and trained in 2010. This Project's funding will allow
2.3 Functional Needs site surveys Emergency Managers to work with the FAST
of shelters throughout the team members and incorporate this program into
county. the locate Mass Care and Shelter planning being
done.
Goal 1, -Mass Evacuation Santa Clara County has a population of 1.7
Objective-1.5, • Continue to advance the million people with over 650 thousand cats &
Goal 2, planning for Mass Evacuation. dogs, as well as over 3,000 horses. If there was a
Objective-2.4, catastrophic fire in any area of the County,
2.5, Goal 3, evacuations would be local but large scale. These
Objective-3.6 funds will be used by Emergency Mangers to
help them understand the extent of this issue and
the procedures for evacuating within the County,
including the pets and equine.
Goal 2, - Care & Shelter Recent UASI funding was used to write a Mass
Objectives-2.1, Continue Care and Shelter Care and Shelter plan that is extensive and
2.3, 2.4, 2.5 planning for the Operational intricate. Operationalizing this plan what
Area. Emergency Managers will use this Project's
ABD Pads (300), 21GN-00- funding to do.
CCEQ, Equipment, Citizen
Corps -Backboards (18),
21 GN-00-CCEQ, Equipment,
Citizen Corps - Bandages &
Dressings (30 boxes), 21GN-
00-CCEQ, Equipment, Citizen
Corps -Blood Pressure Cuffs
(40), 21 GN-00-CCEQ,
Equipment, Citizen Corps -
Canopies (15), 21GN-00-
CCEQ, Equipment, Citizen
Corps - Containers for Care&
Shelter equipment(3), 19MH-
Exhibit D
00-CONT, Containers, Storage
- Cots (30), 09ME-01-COTS.
Cots -Face Shields (40),
21 GN-00-CCEQ, Equipment,
Citizen Corps -Fluid Resistant
Coveralls (40), 21GN-00-
CCEQ, Equipment, Citizen
Corps - Gas Shut Off/Multi
Purpose Tool (30), 21GN-00--
CCEQ, Equipment, Citizen
Corps -Litters (1), 21GN-00••
CCEQ, Equipment, Citizen
Corps -Medical Gloves (40
boxes), 21 GN-00-CCEQ,
Equipment, Citizen Corps -
Mylar Sleeping Bags (200),
21 GN-00-CCEQ, Equipment,
Citizen Corps -N95 Respirator
Masks (50 cases), 21 GN-00-
CCEQ, Equipment, Citizen
Corps - Stethoscopes (40),
21 GN-00-CCEQ, Equipment,
Citizen Corps - Storage
Containers (1), 19MH-00-
CONT, Containers, Storage --
Thermometers (40), 21 GN-00-
CCEQ, Equipment, Citizen
Corps
Goal 1, - Staffing Several of the cities are updating their Emergency
Objectives-1.3, • Review and revise Operations Plan. Creating the Whole Community
Goal 2, Emergency Operations Plans. by expanding citizen's preparedness capabilities
Objectives-2.2, • Expand citizen planning and through workshops and outreach opportunities.
2.4, Goal 4, preparedness capabilities
Objectives-4.1,
4.2, 4.3
Goal 2, - Staff Participation in Many of the city Emergency Managers will be
Objectives-2.1, Trainings & Exercises participating in exercises to test emergency plans.
Goal 5, • Participate in exercises to Only one city is actually planning an exercise and
Objectives-5.1, test emergency plans, facilities the date of that exercise will happen after this
5.2 and equipment grant performance period ends, therefore, the
planning process of the exercise is listed under
"Organization" and not "Exercise."
Goal 5, -Regional Catastrophic Using RCPGP funds, the Bay Area UASI group
Objectives-5.3, Planning hired a contractor to write several regional and
5.4 • Review and implement operational area plans. Funds from this project
regional catastrophic plans will be used to review the plans and work to
incorporate them into the Operational Area
Exhibit D
planning process.
Goal 2, - COOP & COG One of the cities will begin the process of writing
Objectives-2.2, • Review, implement and a COOP plan for the city. Others will are
Goal 3, revise local government COOP gthering.information to begin the process in the
Objectives-3.1, plans. future.
3.3
Goal 2, - Coordination of school This project will hire a contractor to train and
Objectives-2.1, disaster preparation ($66,843) implement the draft School's Communication
2.3, 2.4, Goal 3, Plan that was started in 2010. The
Objectives-3.1 School's implementation includes working with 37 public
Create and implement a school districts and over 600 public, private and
County-wide School's pre-schools.
Communications Plan
including specific procedures,
not part of pass-through.
($95,000)
Goal 2, Evac Mapping This project is the beginning of Evacuation
Objectives-2.1, • Pilot an evacuation mapping mapping of the entire county. The maps will
2.4, Goal 3, project to create internal and come in two types for each area, one for first
Objectives-3.1, external maps with evacuation responder and the second map will be for the
3.6 routes general pubic. The maps will have response
instructions and evacuation sites, as well as
evacuation routes for the area. The planning team
for this project includes Emergency Managers,
CHI', Sheriffs Office, County/Local Fire, Cal
Fire and the Santa Clara Valley Water District.
FY11 Emergency Management Performance Grant (EMPG)
Performance Report— Cumulative Exhibit E
Part I: General Information Table
FY11 EMPG General Information Table Template
.Jurisdiction
Dale.<of Report
Quarter#
Grant#
Part II: Grant Activities Table
FY 11 EMPG Grant Activities Table Template
ACT IYTTY TASKS)<TO BE S`I ATUS ACTIVITY
COMPLI;1L SLIMMARY
Complete?Yes ❑ No ❑
Summary:
Complete?Yes No
Summary: ❑ ❑
Complete?Yes No
Summary: ❑ ❑
Complete?Yes No
Summary: ❑ ❑
Complete?Yes No
Summary: ❑ ❑
Questions regarding the completion of this performance report should be directed to
Santa Clara County Office of Emergency Services (408)808-7811, Roslyn Fuller.
Questions can also be sent via email to roslyn.fuller @oes.sccgov.org. Reports can be
foxed to (408)294-4851, with a hard copy of the report mailed to the below address.
//
Mailing Instructions: Please complete the performance report and return it by (see
Agreement with County for Performance Period dates)
To:
Santa Clara County Office of Emergency Services
Attention: Roslyn Fuller
55 West Younger Ave, Suite i450
San Jose CA, 95110
Exhibit F
Spend Plan Extension Request
2011 Emergency Management Performance Grant Program
SPEND PLAN EXTENSION REQUEST
Submitted by: Date:
Project:
Project Title:
Total Amount Allocated:
Amount Expended:
Original Milestone Deadline:
Requested Milestone Extension Deadline:
1) Describe the details of the project:
2) What is the current status of the project?
3) Please provide a timeline as to how you will meet the new requested milestone date:
4) How have you analyzed your errors in the initial timeline? What are the reasons why the
project is late?
5) How have you improved your planning and project management process to avoid future
delays if this request is granted? What plans and documentation do you have in place to
guarantee the requested deadline will be met?
Milestone Extension Request Revised 2-03-12
Exhibit F
6 )List and describe all equipment with costs and AEL#s:
Equipment& Description Cost AEL
number
7) Board Approval: Staff Report for Board, or date it will be approved by board?
Milestone Extension Request Revised 2-03-12
Exhibit G
Pay Period End Dates: [TIp1O�/ee,#: b `y
7/10/2011 . . . . . . . . . . . . .
Last Nam : ,Flrst Maine ; LA30 ,61STR[BUTIE7N`FClUIE,SIEE•1 ,
HOURS WORKED BY DAY TOTAL
F S S M J T W TH F S S HOURS WBS#
7/1 7/4 7/5 7/6 7/7 7/8
Project A
Information Management
Project B
N
+ Credentialing and Training
Project C
ti) . &Warning
O Project D
N Access&Functional Needs
Cl_
Project E
O
v Mass Evacuation
C
as Project F
E Care&Sheltering
o
Project G
Planning
Project H
C1- _ Exercises
WProject I
- Regional Catastrophic Planning
r-1
>- Project J
u. COOP and COG Planning
Project K
School's Project
Project L
Evacuation Mapping Project
- . - - TOTALS
Employee Signature Supervisors Signature
2011 EMPG City Rey Jrsement Worksheet Exhibt H
Project D Project H Project I Project L
Project A Project B Project E Project F Project) Project K
Project C Access& Project G Staffing for Regional Special Project Reimbursement
Information Credentialing& Mass Care& COOP and COG Special Project
Alert&Warning Functional Staffing Training& Catastrophic Evacuation Request Totals
ffi
Management Training Needs Evacuation Sheltering Exercise Planning Planning Schools Mapping
Total Amount _
Expended
Match Amount _$ $ $ - $ - $ _ $ _ $ _ $ _ $ - $ - $ - $
Expended
Reimbursable $ $ $ $ - $ - $ _ $ - $ - $ - $ - $ _ $ - $ _
Amount Expended
To complete worksheet,enter jurisdiction name at top and total expended for each project under"Total Amount Expended" (highlighted)cells.
The preset formula will calculate the city match and reimbursement total.
, •
CALIFORNIA EMERGENCY MANAGEMENT AGENCY
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FP1P01 v1.11;.a)-24:i
Exercise Data Table
FY11 Exercise Data Table Template
Tyi'of Eirc�se 1 uzber E Number Number Number of Name or E te�re�se
of Counting <' of EMPG EMPG Desenption Aligned to
Exercises:: Towards Program P�rog ani Eme'genc
Multi Fumed Funded Ope atLons
Year Personnel Personnel Plan?
TEP participating; (YesfNo)
,ti Exeretse
A�scussion-13�se
Seminar
• AAR Complete
• Corrective
Actions Identified
Progress made towards addressing Corrective Actions. Please indicate at least the percentage progress made
towards the addressing of the findings and recommendations of the AAR. Provide more details if satisfactory
progress has not been made(use additional pages,if necessary).
Workshop
• AAR Complete
• Corrective
Actions Identified
Progress made towards addressing Corrective Actions. Please indicate at least the percentage progress made
towards the addressing of the findings and recommendations of the AAR. Provide more details if satisfactory
progress has not been made(use additional pages,if necessary).
Tabletop Exercise(TTX)
• AAR Complete
• Corrective
Actions Identified
. rogress made towards addressing Corrective Actions. Please indicate at least the percentage progress made
towards the addressing of the findings and recommendations of the AAR. Provide more details if satisfactory
progress has not been made(use additional pages,if necessary). _
Game
• AAR Complete
• Corrective
Actions Identified
Progress made towards addressing Corrective Actions. Please indicate at least the percentage progress made
towards the addressing the findings and recommendations of the AAR. Provide more details if satisfactory progress
has not been made(use additional pages,if necessary).
Operations-Based
Drill
• AAR Complete
• Corrective
Actions Identified
Progress made towards addressing Corrective Actions. Please indicate at least the percentage progress made
towards the addressing of the findings and recommendations of the AAR. Provide more details if satisfactory
progress has not been made(use additional pages,if necessary).
Functional Exercise
• AAR Complete
• Corrective
Actions Identified
Progress made towards addressing Corrective Actions. Please indicate at least the percentage progress made
towards the addressing of the findings and recommendations of the AAR. Provide more details if satisfactory
progress has not been made(use additional pages,if necessary).
Full-Scale Exercise
• AAR Complete
• Corrective
Actions Identified
Exhibit J
Progress made towards addressing Corrective Actions. Please indicate at least the
percentage progress made towards the addressing of the findings and recommendations
of the AAR. Provide more details if satisfactory progress has not been made(use
additional pages,if necessary).Progress made towards completing Multi-Year TEP