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HomeMy WebLinkAboutCOM 0813.000 2000-2002 Harry Kim ;c William Takaba Mayor' ' Director f Nancy E. Crawford ~i.~`•'•,ia'M a Deputy Director TP OVA County of Hawaii Finance Department 25 Aupuni Street, Room 118 • Hilo, Hawaii 96720 (808) 961-8234 • Fax (808) 961-8248 November 4, 2002 c i_ Honorable James Arakaki, Chairperson and Members of the County Council y, Hawaii County Council 25 Aupuni Street Hilo, Hawaii 96720 Re: Operating Budget - The U.S. Department of the Interior, U.S. Fish and Wildlife Service is providing a $5,000 Rural Fire Assistance Grant to the Hawaii County Fire Department for wildland fire training and equipment purchase. This should benefit the public by having reduced fire loss, increased firefighter safety and training, and the reduction of occurrence and intensity of wildland fires with the urban interface. Enclosed is a resolution to authorize the Mayor to enter into an agreement with the U.S. Department of the Interior, U.S. Fish and Wildlife Service. Also enclosed is a bill for an ordinance amending the Operating Budget by appropriating this $5,000 Rural Fire Assistance Grant. If there are any questions, please do not hesitate to call the Fire Department. William Taka Director of Finance Jarry OVED: Kim Mayor Enc. kes . 16 S -0--9, Cozn:rr ~f 13,'11 _3 File No cc: Fire T . r . OV 0 7 2002 Form B-52 7/18/91 DEPARTMENT OF FINANCE REQUEST FOR COUNCIL ACTION DEPARTMENT: FIRE DATE: October 24, 2002 STAFF CONTACT: Gerald Makino PHONE: 969-7912 A. REQUEST: Prepare a resolution to accept grant of $5,000 from the Department of Interior, U. S. Fish and Wildlife Service (FWS) to be used by Hawaii County Fire Department for wildland fire equipment purchases. Prepare ordinance to appropriate funds: 3302 Federal Grants $5,000 010-221-5226.02-231 Volunteer Fire $5,000 B. BACKGROUND AND JUSTIFICATION (USE ADDITIONAL SHEETS AS NEEDED): The Department of Interior is authorized by P.L. 107-103, Making Appropriations for the Department of Interior and Related Agencies for the Fiscal Year ending September 30, 2002, and for Other Purposes, which states, in part, the Department of Interior will provide rural fire assistance. The public will benefit by having reduced fire loss, increased firefighter safety and training, and the reduction of occurrence and intensity of wildland fires with the urban interface. FWS is providing $5,000 in funding. County match required is $500 to come from appropriated funds. Term of agreement is from date of approval to September 30, 2003. SIGNED: a-- DATE: Department Head GRANT SUMMARY Su lement to B-52, Request for Council Action) Type of Grant Appropriation being re uested: (New or an additional appropriation) X New (for this fiscal year period). OR ? Additional appropriation (to an existing grant); Is a draft agreement attached? Has the original grant notification been transmitted to X Yes ? No Council? ? Yes ? No Name of Grant Program: Rural Fire Assistance Grantor: U.S. Fish and Wildlife Service, Dept of Interior County Grantee Department or Agency: Hawaii County Fire Department County Grantee Contact Person: Gerald Makino Phone Number: 969-7912 Amount of Grant: $5,000 Grant Period (Commencement & Completion): 9/15/02 - 9/30/03 Purpose of Grant: Provide funding for wildland fire training and equipment purchase. County Match required?: X Yes ? No If yes, Matching Amount? $500 Budgeted in account# : 010-221-5226.02-231 In-kind? Explain: Explanation: County's personnel requirements: Amount of new position(s)? Qty: Permanent: ? Temporary: Duration: Full-time: ? Part-time: Time Element: Qty: Contractual: ? Explain: Explanation: Additional Comments about Grant: B-52 Grant Summary Form PAGE 1 OF 8 PAGES Form IS11-I---- - - (February 1989) United States Department of the Interior 1. AGREEMENT NO. U.S. Fish & Wildlife Service 10131-2-6120 ASSISTANCE AGREEMENT 2. TASK ORDER NO. NOTE: By signing this document, the recipient accepts this agreement and agrees to perform in accordance with all the enclosed terms, conditions, and documents attached hereto. 3. TYPE OF AGREEMENT (Check one) X GRANT COOPERATIVE AGREEMENT 4. NAME, ADDRESS AND PHONE NO. OF ASSISTANCE OFFICER 5. NAME, ADDRESS AND PHONE NO. OF RECIPIENT U.S. Fish and Wildlife Service Hawaii County Fire Department 911 NE 11 `h Ave 25 Aupuni St. Rm 103 Portland, OR 97232 Hilo, 11196720 808-961-8297 Carol Bohan, Re ional Chief, Nat'l Wildlife Refuge S ems 6. NAME, ADDRESS AND PHONE NO. OF ASSISTANCE REPRESENTATIVE 7. NAME, ADDRESS AND PHONE NO. OF RECIPIENTS PROJECT MANAGER Same as Item 4 Hawaii County Fire Department 25 Aupuni St. Rm 103 Hilo, HI 96720 Darryl Oliveira 808-961-8297 &PROGRAM STATUTORY AUTHORITY P.L. 107-103 9. STARTING DATE Sept. 15, 2002 10. EFFECTIVE DATE Se t. 15, 2002 11. COMPLETION DATE Se t.30, 2003 12. TYPE OF RECIPIENT (Check one) 13. FUNDING INFORMATION ? STATE Recipient Agency X Local- GOVERNMENT This obligation s500.00 S 5,000.00 ? INDIAN TRIBAL GOVERNMENT Previouobligtion $ O S O ? EDUCATIONAL INSTITUTION ? INDIVIDUAL Total obligation s 500.00 s5,000.00 ? FOR-PROFIT ORGANIZATION ? NON-PROFIT ORGANIZATION Sbare Ratio 10% 90% ? OTHER (SPECIFY) 14. ACCOUNTING AND APPROPRIATION DATA 10131-9265-0000 15. PROJECT TITLE AND BRIEF SUMMARY OF THE PURPOSE AND OR.JECTI VES Rural Fire Assistance - FWS will provide funding to Hawaii County Fire Department to to be used for wildland fire training and equipment purchases as outlined in the National Fire Plan - Rural Fire Assistance. 16a. NAME AND TITLE OF SIGNER (Type or print) 17a. NAME AND TITTLE OF ASSISTANCE ORDERING OFFICER (type or print) Daryl Oliveira Chief Carolyn Bohan, Regional Chief, Nat'l Wildlife Refuge Systems 1615. IPMNT 16c. DATE SIGNED 17b. TED STATES O RI ^ 17c. DATE SIGNED EP 16 2002 BY j ; " / , (Authorised Si re e O rear) O. CGS Sufficiency Review Jcn/lid ~ ~ 0 koa oa I fl s cod , Iii 10131-2-G I20 Page 2 of 8 1. Statement of Joint Objectives A. Pu se. This agreement is made and entered into by the Department of the Interior, U. S. Fish and Wildlife Service (FWS) and the Hawaii County Fire Department to provide funding to be used by Hawaii County Fire Department for wildland fire training and equipment purchases. B. Objective. To provide assistance in training, equipment purchase, and prevention activities on a cost share basis. To increase firefighter safety, enhance the fire protection capabilities of Hawaii County Fire Department, and to enhance protection in the wildland urban interface. C. Authority. P.L. 107-103, Making Appropriations for the Department of Interior and Related Agencies for the Fiscal Year ending September 30, 2002, and for Other Purposes, which states, in part, the Department of Interior will provide rural fire assistance. D. Benefits. The public will benefit by having reduced fire loss, increased firefighter safety and training, and the reduction of occurrence and intensity of wildland fires with the urban interface. II. Definitions. A. Agreement: This is a grant agreement. B. Assistance Officer (AO): The FWS Assistance Officer. The AO is the only individual authorized to obligate funds, award, modify or terminate the agreement. C. Assistance Representative (AR): The FWS Assistance Representative. The AR will be designated for the purpose of administering the technical aspect of the agreement. The AR is responsible for monitoring the agreement, enforcing the agreement provisions, issuing timely performance and payment approvals, terminating the agreement, and closing out the agreement. The AR is authorized to clarify technical requirements, and to review and approve work which is clearly within the scope of the work specified in this agreement., The AR is not authorized to issue changes or in any other way modify this agreement. D. FWS may also be referred to as Service. E. The Code of Federal Regulations (CFR). F. Fiscal Year (FY): The Federal fiscal year which extends from October I of one year through September 30 of the following year. G. The Hawaii County Fire Department. May also be referred to as recipient. H. NTE: Not-to-Exceed 1. The Office of Management and Budget (OMB). 10131-2-G 120 Page 3 of 8 J. Project Inspector (PI): The FWS project inspector. At the time of award, a FWS employee(s) may be appointed as the PI. If appointed, the PI will be responsible for providing on-site inspection of the work and for giving the Hawaii County Fire Department representative any special instructions, guidance, or training necessary to complete or perform the work. The PI will not be authorized to issue changes or in any way modify the agreement. K. Project Manager: The recipient's Project Manager. L. Responsible Official: The recipient's Responsible Official. The responsible official is the individual who is authorized to act for the recipients organization and commit the recipient to .compliance with the terms and conditions of this agreement. III. Project Management Plan. A. The Hawaii County Fire Department agrees to: 1. Purchase wildland personal protective equipment for firefighters. Purchase supplies and materials associated with wildland firefighting activities, i.e., fusees, hose, adapters, nozzles, drip torches, etc. Purchase of wildland fire tools, radios, engines, trucks, pumps and pump packages to be identified by types and quantities. Provide wildland fire training to employees as needed. B. The Service agrees to: 1. Provide funding and guidance as needed towards the purchase of equipment and to assist as needed in wildland fire training. 2. Provide payments to the Hawaii County Fire Department in accordance with Section V, Financial Support, and Section VI, Payments, of this agreement and applicable OMB and Treasury Regulations. IV. Term of Agreement. This agreement shall become effective on the date of signature of the FWS Contracting/Assistance Officer and shall remain in effect until September 30, 2003, unless terminated in accordance with the provisions of 43 CFR, Subpart C, Section 12.84. This agreement may be renewed for subsequent FYs (NTE a total of five), subject to the availability of Federal funding, by mutual written modification signed by both parties to this agreement. Agreement may be terminated by either party, with 30 days written notice, or at any time, by written, mutual consent of both parties. V. Financial Su~rt. A. This agreement may be funded each FY based on the availability of FWS funding. The recipient hereby releases the FWS from all liability due to failure of Congress to appropriate funds. B. Funds obligated but not expended in one FY can be carried forward and expended in the subsequent FY. 10131-2-G 120 Page 4 of 8 C. $5,000 represents the annual NTE amount for which the FWS will be responsible under the terms of this agreement. Each modification issued will specify the NTE amount for that modification. The FWS shall not be obligated to pay for nor shall the Fire Protection Districts be obligated to perform any effort that will require the expenditure of Federal funds above the NTE amount specified in that modification. D. Cost sharing for this agreement shall be in accordance with 43 CFR, Subpart C, Section 12.64. Other Federal funds may not be used for cost sharing. The required cost share is 90% FWS/10% Hawaii County Fire Department. Cooperator's contribution may be in the form of in-kind services. VI. Pates. A. Electronic Funds Transfer Payments 1. Payment under this agreement will be made by the Government by electronic funds transfer (through the Treasury Fedline Payment System (FEDLINE) or the Automated Clearing House (ACH)), or National Institute of Health (NIH) payment system. 2. After award, but no later than 14 days before an invoice or agreement financing request is submitted, the Recipient shall designate a financial institution for receipt of electronic funds transfer payments (SF-3881), and shall submit this designation to the following address: US Fish & Wildlife Service 911 NE 11 d Ave. Portland, OR 97232 3. If a designation has been submitted to the FWS under a previous agreement it is not necessary to complete another SF-3881 unless you are changing your designation of financial institution. B. The Hawaii County Fire Department shall be entitled to advance payment at least quarterly upon submission of an original Request for Advance or Reimbursement, Standard Form (SF) 270. Payments shall be governed by the provisions of 43 CFR Subpart C, Section 12.61 and 12.81. C. If advance payments are made the Hawaii County Fire Department must submit a Federal Cash Transaction Report, SF 272 to the FWS Contracting/Assistance Officer 15 working days following the end of each quarter. D. Advance payments shall be made only in amounts necessary to meet current disbursement needs and shall be scheduled so that the funds are available only immediately prior to their disbursement. VII. Propejjy Management and Disposition. 10131-2-G 120 Page 5 of 8 Any FWS property used or other property acquired under this agreement, including intangible property such as copyrights and patents shall be governed by the provisions of 43 CFR, Subpart C, Section 12.71 through 12.74. Each party agrees that it will be responsible for its own acts and the results thereof and shall not be responsible for the acts of the other party and the results thereof. Each party, therefore, agrees, to the extent authorized by applicable laws will assume all risks and liability to itself, its agents or employees, for any injury to persons or property resulting from any operations of its agents or employees under this agreement, and for any loss, cost, damage, or expense resulting at any time from any and all clauses due to any acts, or negligence, or the failure to exercise proper precautions of or by itself or its own agents to this agreement. The FWS assumes no liability for any actions or activities conducted under this agreement except to the extent that recourse or remedies are provided by Congress under the Federal Tort Claims Act [28 U.S.C. 1346(b), 2401(b), 2671 - 2680, as amended by P.L. 89-506, 80 Stat. 306. VIII. Deliverables and Reports. Submit one copy of an annual performance report to the FWS within 90 days after the end of the FY. The performance report must be prepared in accordance with 43 CFR, Subpart C, Section 12.80 and address items such as a comparison of actual accomplishments with established goals, reasons why goals may not have been met, cost overruns and any other pertinent information. IX. Key Officials. A. Carolyn Bohan / Assistance Officer (AO) U.S. Fish and Wildlife Service 911 NE 11th Ave Portland, OR 97232 B. Bruce Babb / Assistance Representative (AR) U.S. Fish and Wildlife Service 911 NE 11th Ave Portland, OR 97232 503-231-6234 C. Bruce Babb / Project Inspector (PI) U.S. Fish and Wildlife Service 911 NE I Vh-Ave Portland, OR 97232 503-231-6234 D. Darryl Oliveira / Responsible Official (RO) Hawaii County Fire Department 25 Aupuni St. Rm 103 Hilo, HI 96720 808-961-8297 10131-2-G 120 Page 6 of 8 E. Darryl Oliveira / Project Manager (PM) Hawaii County Fire Department 25 Aupuni St. Rm 103 Hilo, HI 96720 808-961-8297 X. Special Terms and Conditions. A. Order of Precedence Any inconsistency in this agreement shall be resolved by giving precedence in the following order: (a) Any national policy requirements and administrative management standards, (b) requirements of the applicable OMB Circulars and Treasury regulations; (c) 43 CFR Part 12; (d) special terms and conditions; and (e) all Agreement sections, documents, exhibits, and attachments. B. Modifications This agreement may be modified by written agreement signed by both the Hawaii County Fire Department and the CO/AO. Administrative changes (i.e. name change) which do not change the project management plan, NTE amount, etc. or otherwise affect the recipient may be signed unilaterally by the CO/AO. C. Procurement Procedures It is a national policy to place a fair share of purchases with minority business firms. The Department of the Interior is strongly committed to the objectives of this policy and encourages all recipients of its grants and cooperative agreements to take affirmative steps to ensure such fairness. Positive efforts shall be made by recipients to utilize small businesses, minority-owned firms, and women's business enterprises, whenever possible. Recipients of Federal awards shall take all of the following steps to further this goal: 1. Ensure that small businesses, minority-owned firms, and women's business enterprises are used to the fullest extent practicable. 2. Make information on forthcoming opportunities available and arrange time frames for purchases and contracts to encourage and facilitate participation by small businesses, minority-owned firms, and women's business enterprises. 3. Consider in the contract process whether firms competing for larger contracts intend to subcontract with small businesses, minority-owned firms, and women's business enterprises. 4. Encourage contracting with consortiums of small businesses, minority-owned firms and women's business enterprises when a contract is too large for one of these firms to handle individually. 10131-2-G120 Page 7 of 8 5. Use the services and assistance, as appropriate, of such organizations as the Small Business Development Agency in the solicitation and utilization of small business, minority-owned firms and women's business enterprises. XI. General Provisions. A. National Policy Requirements and Administrative Management Standards. All applicable national policy requirements and administrative management standards as set forth in the Office of Management and Budget, Financial Management Division, Directory of Policy Requirements and Administrative Standards for Federal Aid Programs are incorporated by reference. B. 43 CFR Part 12, Administrative and Audit Requirements and Cost Principles for Assistance Programs is incorporated by reference. C. OMB Circular A-87, Cost Principles for State and Local Governments is incorporated by reference. D. Single Audit Act Amendments of 1996, Public Law 104-156, 110 Stat. 1396, 31 U.S.C. 750 1-7 and 43 CFR, Part 12, is incorporated by reference. E. 43 Code of Federal Regulations (CFR) Part 12, Appendix A to Subpart D, Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transaction and completed Form DI-2010 are incorporated by reference. F. 43 CFR Part 12, Appendix C to Subpart D, Certification Regarding Drug-Free Workplace Requirements, Alternate I (Grantees other than individuals) and completed Form DI- 2010 are incorporated by reference. G. 31 U.S.C. 1352, Certification Regarding Lobbying and completed Form DI-2010 are incorporated by reference. H. - Compliance With Buy American Act. Pursuant to Sec. 307 of the Department of the Interior and Related Agencies Appropriations Act of 2000, Public Law 106-113, be advised of the following: 1. None of the funds made available in this agreement may be expended by a recipient unless the recipient agrees that in expending the funds the recipient will comply with sections 2 through 4 of the Act of March 3, 1933 (41 U.S.C. I Oa-10c; popularly known as the "Buy American Act"). 2. Purchase of American-made equipment and products. In the case of any equipment or product that may be authorized to be purchased with financial assistance provided using funds made available in this Act, it is the sense of the Congress that entities receiving the assistance should, in expending the assistance, purchase only American-made equipment and products. 3. Recipient also agrees to follow the procedures in 43 CFR Part 12, Subpart E, 10131-2-G 120 Page 8 of 8 Section 12.700 - Buy American Requirements for Assistance Programs. 1. Opposition to Any Legislation. Recipient shall not use any part of the Government's funds for any activity or the publication or distribution of literature that in any way tends to promote public support or opposition to any legislative proposal on which Congressional action is not complete. J. Increasing Seat Belt Use in the United States. Recipients of grants/cooperative agreements and/or sub-awards are encouraged to adopt and enforce on-the-job seat belt use policies and programs for their employees when operating company-owned, rented, or personally owned vehicles. These measures include, but are not limited to, conducting education, awareness, and other appropriate programs for their employees about the importance of wearing seat belts and the consequences of not wearing them. U.S. Department of the Interior Certifications Regarding Debarment, Suspension and Other Responsibility Matters, Drug-Free Workplace Requirements and Lobbying Persons signing this form should refer to the regulations referenced Certification Regarding Debarment, Suspension, ineligibility and below for complete instructions: Voluntary Exclusion - Lower Tier Covered Transactions - (See Certification Regarding Debarment, Suspension, and Other Appendix B of Subpart D of 43 CFR Part 12.) Responsibility Matters - Primary Covered Transactions - The Certification Regarding Drug-Free Workplace Requirements - prospective primary participant further agrees by submitting this Alternate 1. (Grantees Other Than Individuals) and Alternate II. proposal that it will include the clause titled, "Certification (Grantees Who are Individuals) - (See Appendix C of Subpart D of 43 Regarding Debarment, Suspension:, Ineligibility and Voluntary CFR Part 12) Exclusion - Lower Tier Covered Transaction," provided by the department or agency entering into this covered transaction, Signature on this form provides for compliance with certification without modification, in all lower tier covered transactions and in requirements under 43 CFR Parts 12 and 18. The certifications shall all solicitations for lower tier covered transactions. See below for be treated as a material representation of fact upon which reliance will language to be used or use this form for certification and sign. (See be placed when the Department ofthe Interior determines to award the Appendix A of Subpart D of 43 CFR Part 12.) covered transaction, grant, cooperative agreement or loan. PART A: Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions CHECK IF THIS CERTIFICATION IS FOR A PRIMARY COVERED TRANSACTION AND IS APPLICABLE. (1) The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency; (b) Have not within a three-year period preceding this proposal 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; (c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and (d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. (2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. PART B: Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions CHECK IF THIS CERTIFICATION IS FOR A LOWER TIER COVERED TRANSACTION AND IS APPLICABLE. (1) The prospective lower tier participant certifies, by submission of this proposal, 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. (2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. DI-2010 June 1995 (This form replaces DI-1953, DI-1954, DI-1955, DI-1956 and DI-1963) PART C: Certification Regarding Drug-Free Workplace Requirements CHECK IF THIS CERTIFICATION IS FOR AN APPLICANT WHO IS NOT AN INDIVIDUAL. Alternate I. (Grantees Other Than Individuals) A. The grantee certifies that it will or 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 underthe 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 (dx2) 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 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 numbers(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). B. The grantee may insert in the space provided below the sites for the performance of work done in connection with the specific grant: Place of Performance (Street address, city, county, state, zip code) Check if there are workplaces on file that are not identified here. PART D: Certification Regarding Drug-Free Workplace Requirements CHECK IF THIS CERTIFICA TION IS FOR AN APPLICANT WHO IS AN INDIVIDUAL. Alternate 11. (Grantees Who Are Individuals) (a) The grantee certifies that, as a condition of the grant, he or she will not engage in the unlawful manufacture, distribution, dispensing; possession, or use of a controlled substance in conducting; any activity with the grant; (b) If convicted of a criminal drug offense resulting from a violation occurring during the conduct of any grant activity, he or she will report the conviction, in writing, within 10 calendar days of the conviction, to the grant officer or other designee, unless the Federal agency designates a central point for the receipt of such notices. When notice is made to such a central point, it shall include the identification number(s) of each affected grant. DY-2®10 June 1995 (Thus form replaces DI-1953, DI-1954, Fat-1955, DI-1956 and DI-1963) PART E: Certification Regarding Lobbying Certification for Contracts, Grants, Loans, and Cooperative Agreements CHECK IF CERTIFICATION IS FOR THE AWARD OFANY OF THE FOLLOWING AND THE AMOUNT EXCEEDS $100,000. A FEDERAL GRANT OR COOPERATIVE AGREEMENT, SUBCONTRACT, OR SUBGRANT UNDER THE GRANTOR COOPERATIVE AGREEMENT. CHECK IF CERTIFICATION IS FOR THE AWARD OF A FEDERAL LOAN EXCEEDING THE AMOUNT OF $130,000, OR A SUBGRANT OR SUBCONTRACT EXCEEDING 5100,000, UNDER THE LOAN. The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, and 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 Feder-,;I 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 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 $1 Q000 and not more than S 100,000 for each such failure. As the authorized certifying official, I hereby certify that the above specified certifications are true. AATURt OF ACERTIFYING OFFICIAL Darryl Oliveira, Fire Chief TYPED NAME AND TITLE September 10, 2002 DATE DI-2010 June 1995 (This fern replaces Dt-1953, DI-1954, DI-1955, DI-1956 and DI-1%3) APPLICATION FOR OMB Approval No. 0348-0043 FEDERAL- ASSISTANCE 2. DATE SUBMITTED Applicant Identifier 1. TYPE OF SUBMISSION. 3. DATE RECEIVED BY STATE State Application Identifier Application Preapplication O Construction O Construction 4, DATE RECEIVED BY FEDERAL AGENCY Federal Identifier ef Non-Construction 0 Non-Construction 5. APPLICANT INFORMAMON Legal Name: Hawaii County Fire Department Organizad-31 Unit Hawaii County Fire Department Address (give city, county, state, and zip code): Name and telephone number of the person to be contacted on matters Involving this Hawaii County Fire Department application (give area code) 25 Aupuni St. Rm 102 Darryl Oliveira 808-961-8297 Hilo, HI 96720 6. EMPLOYER IDENTIFICATION NUMBER (EIM: 7. TYPE OF APPLICANT: (enter appropriate fetter in box) 99 6000567 J A. State H. Independent School Dist 8. TYPE OF APPLBCATION B. County 1. State Controlled Institution of Higher Leaming C. Municipal J. Private University ild Now O Continuation O Revislcn D. Towtwhip K Indian Tn'ba E. Interstate L. Indivlduzt F. Inten usnicipal M. Profit Organization G. Special District N. Other (Specify) if Revision, enter appropriate fitter(s) in box(es) F1 A. Increase Award B. Decrease Award C. Increase Duration D. Decrease Duration Other (specify): 9. NAME OF FEDERAL AGENCY: U.S. Department of Interior, Fish and Wildlife Service 14. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT: Rural Fire Assistance Agreement TITLE: 12. AREAS AFFECTED BY PROJECT (Cities, Countie3, States, eta): Hawaii County - Hawaii 13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF: Start Date Ending DatT a. Applicant lil -1 b Project HI -1 09(15102 09/30103 15. ESTIMATED FUNDING: 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER a. Federal $ 5,000.00 12372 PROCESS? a. YES. THIS PREAPPLICATIONIAPPLICATION WAS MADE AVAILABLE b. Applicant $ 0.00 TO THE STATE EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON: c. State $ 0.00 DATE d. Local $ 0.00 b. NO. 19 PROGRAM IS NOT COVERED BY E.O.12372 e. Other $ 0.00 O OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR f. Program Income $ 0.00 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? g. TOTAL $ 5.000.00 ? Yes If "Yes; attach an explanation. Ild No 18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATIONIPREAPPLICATION ARE TRUE AND CORRECT, THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED. a. Type Name of Authorized Representative b. Title c. Telephone Number Darryl Oliveira Chief 808-961-8297 d. Signature of ed epres t e. Dgfpn~ 2002 Previous Edit Usable Standard Form 424 (Rev_ 4-92) Authorized to Local 1'e r action Prescribed by OMB Circular A-102 OMB Approval No. 0348-0040 ASSURANCES - NON-CONSTRUCTION PROGRAMS Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503. PLEASE CO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING .AGENCY. NOTE: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. As the duly authorized representative of the applicant, I certify that the applicant: 1. Has the legal authority to apply for Federal assistance Act of 1973, as amended (29 U.S.C. §794); which and the institutional, managerial and financial capability prohibits discrimination on the basis of handicaps; (d) (including funds sufficient to pay the non-Federal share the Age Discrimination Act of 1975, as amended (42 of project cost) to ensure proper planning, management U.S.C. §§6101-6107), which prohibits discrimination and completion of the project described in this on the basis of age; (e) the Drug Abuse Office and application, Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug 2. Will give the awarding agency, the Comptroller General abuse; (f) the Comprehensive Alcohol Abuse and of the United States and, if appropriate, the State, Alcoholism Prevention, Treatment and Rehabilitation through any authorized representative, access to and Act of 1970 (P.L, 91-616), as amended, relating to the right to examine all records., books, papers, or nondiscrimination on the basis of alcohol abuse or documents related to the award; and will establish a alcoholism; (g) §§523 and 527 of the Public Health proper accounting system in accordance with generally Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee- accepted accounting standards or agency directives. 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title Vill of the 3. Will establish safeguards to prohibit employees from Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as using their positions for a purpose that constitutes or amended, relating to nondiscrimination in the sale, presents the appearance of personal or organizational rental or financing of housing; (i) any other conflict of interest, or personal gain. nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being 4. Will initiate and complete the work within the applicable made; and, 0) the requirements of any other time frame after receipt of approval of the awarding nondiscrimination statute(s) which may apply to the agency. application. 5. Will comply with the Intergovernmental Personnel Act of 7. Will comply, or has already complied, with the 1970 (42 U.S.C. §§4728-4763) relating to prescribed requirements of Titles II and III of the Uniform standards for merit systems for programs funded under Relocation Assistance and Real Property Acquisition one of the 19 statutes or regulations specified in Policies Act of 1970 (P.L. 91-646) which provide for Appendix A of OPM`s Standards for a Merit System of fair and equitable treatment of persons displaced or Personnel Administration (5 C.F.R. 900, Subpart F). whose property is acquired as a result of Federal or federally-assisted programs. These requirements apply 6. Will comply with all Federal statutes relating to to all interests in real property acquired for project nondiscrimination. These include but are not limited to: purposes regardless of Federal participation in (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) purchases. which prohibits discrimination on t,e basis of race, color or national origin; (b) Title IX of the Education 8. Will comply, as applicable, with provisions of the Amendments of 1972, as amended (20 U.S.C. §§1681- Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328) 1683, and 1685-1686), which prohibits discrimination on which limit the political activities of employees whose the basis of sex; (c) Section 504 of the Rehabilitation principal employment activities are funded in whole or in part with Federal funds. Previous Edition Usable Standard Form 4248 (Rev. 7-97) Authorized for Local Reproduction Prescribed by OMB Circular A-102 9. Will comply, as applicable, with the provisions of the Davis- 12. Will comply with the Wild and Scenic Rivers Act of Bacon Act (40 U.S.C. §§276a to 276a-a, the Copeland Act 1968 (16 U.S.C. §§1271 et seq.) related to protecting (40 U.S.C. §276c and 18 U.S.C. §874), and the Contract components or potential components of the national Work Hours and Safety Standards Act (40 U.S.C. §§327- wild and scenic rivers system. 333), regarding labor standards for federally-assisted construction subagreements. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation 10. Will comply, if applicable, with flood insurance purchase Act of 1966, as amended (16 U.S.C. §4701, EO 11593 requirements of Section 102(a) of the Flood Disaster (identification and protection of historic properties), and Protection Act of 1973 (P.L. 93-234) which requires the Archaeological and Historic Preservation Act of recipients in a special flood hazard area to participate in the 1974 (16 U.S.C. §§469a-1 et seq.). program and to purchase flood insurance if the total cost of insurable construction and acquisition iv $10,000 or more. 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and 11. Will comply with environmental standards which may be related activities supported by this award of assistance. prescribed pursuant to the following, (a) institution of environmental quality contr(9 measures under the National 15. Will comply with the Laboratory Animal Welfare Act of Environmental Policy Act of 1969 (P.L. 91-190) and 1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 et Executive Order (EO) 11514; (b) noffication of violating seq.) pertaining to the care, handling, and treatment of facilities pursuant to EO 11738; (c) protection of wetlands warm blooded animals held for research, teaching, or pursuant to EO 11990; (d) evaluation of flood hazards in other activities supported by this award of assistance. floodplains in accordance with EO 11918; (e) assurance of project consistency with the approved State management 16. Will comply with the Lead-Based Paint Poisoning program developed under the Coastal Zone Management Prevention Act (42 U.S.C. §§4801 et seq.) which Act of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity of prohibits the use of lead-based paint in construction or Federal actions to State (Clean Air) Implementation Plans rehabilitation of residence structures. under Section 176(c) of the Clean Air Act of 1955, as amended (42 U.S.C. §§7401 et seq.); (g) protection of 17. Will cause to be performed the required financial and underground sources of drinking waftsr under the Safe compliance audits in accordance with the Single Audit Drinking Water Act of 1974, as amended (P.L. 93-523); Act Amendments of 1996 and OMB Circular No. A-133, and, (h) protection of endangered species under the "Audits of States, Local Governments, and Non-Profit Endangered Species Act of 1973, as amended (P.L. 93- Organizations." 205). 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations, and policies governing this program. SIGN RE ORIZED CERTIFYING OFFICIAL TITLE ar 1 Oliveira Fire Chief APPLICANT ORGANIZATION DATE SUBMITTED Hawaii County Fire Department September 10, 2002 Standard Form 4248 (Rev. 7-97) Back _