HomeMy WebLinkAboutCOM 0082.037 2004-2006 OJNYY~aF F,,~
~ Lawrence K. Mahuna
Harry Kim
11nvor Police Chief
i•
. Harry S. Kubojiri
J're oi'M~"• Depan~ Police Chief
County of Hawaii
March 15, 2006 POLICE DEPARTMENT
349 Kapiolani Stree[ • Hilo, Hawaii 96720-3998
(808)935-3311 • Fax (808)961-8869 -
TO STACY K. RIGA, COUNCIL CHAIR\ ^A/ND COUNCIL MEMBERS
VIA TKO, CONTROLLER tN'
FROM LAWRENCE K. MAHUNA, POLICE CHIEF
SUBJECT NOTIFICATION OF GRANT AWARD
Compliance with Ordinance No. n5-86, Section 7(1)
Name of Grant Program: Community Oriented Policing Services
Federal or State Grantor: Hawaii Community Foundation
County Grantee DepartmenUAgency: County Police Department
Grant No.: 20051088
Amount of Grant: $487,473.63
Amount of County Match: $0.00
County Revenue & Expenditures Acct 010.201.5216.16, 3303.44
Grant Period: July 1, 2005 -July 1, 2006
Purpose of Grant: To hire officers to address the crystal
methamphetamine "ICE" problem in the
County of Hawaii.
Is final report required by grantor? yes
Notification Attached: yes
Comm. No. 6 2. 3
Ref. To; -~-•7-y~~~tt~~
Ref. iJata~ L 4 Luyu
RETURN TO EPA, PMD-7
BF-96957001-0 Pa et
ASSISTANCE ID NO.
J~~g~Ee, U.S. ENVIRONMENTAL PRG DOC ID AM ENDM DATE OF AWARD
~ PROTECTION AGENCY BF - 96957001 - 0 DEC 2 1 2005
` TYPE OF ACTION MAILING DATE
New
Cooperative Agreement PAYMENT METHOD: ACHM
ACH 90204
RECIPIENT TYPE: Send Payment Request to:
County Las Vegas Finance Center, Fax (702) 798-2423
RECIPIENT: PAYEE:
County of Hawaii County of Hawaii
25 Aupuni Street 25 Aupuni Street
Hilo, HI 96720 Hilo, HI 96720
EIN: 99-6000567
PROJECT MANAGER EPA PROJECT OFFICER EPA GRANT SPECIALIST
Barbara Bell Susanne Perkins Martha Villarceal
25 Aupuni Street 75 Hawthorne Street, SFD-1 Grants Management Office, PMD-7
Hilo, HI 96720 San Francisco, CA 94105 E•Mail: Villarreal.Martha~epamail.epa.gov
E-Mail: E-Mail: Perkins.Susanne®epamail.epa.gov Phone: 415-972-3666
Phone: 808-961-8083 Phone: 415-972-3208
PROJECT TITLE AND DESCRIPTION
Brownfields Assessment Cooperative Agreement
This assistance agreement provides $200,000 in federal funds to develop an inventory of sites and to conduct community-wide Phase 1 and Phase II
assessments at sites contaminated by hazardous substances. The site assessments will be located in various target communities within the County of
Hawaii.
BUDGET PERIOD ~ PROJECT PERIOD TOTAL BUDGET PERIOD COST TOTAL PROJECT PERIOD COST
01/01/2006 - 09/30/2007 01/01/2006 - 09/30/2007 $200,000.00 $200,000.00
NOTE: The Agreement must be completed in duplicate and the Original returned to the appropriate Grants Management Office listed below,
within 3 calendar weeks aker receipt or within any extension of time as may be granted by EPA. Receipt of a written refusal or failure
to return the properly executed document within the prescribed time, may result in the withdrawal of the offer by the Agency. Any
change to the Agreement by the Reclplent subsequent to the document being signed by the EPA Award Official, which the Award
Official determines to materially alter the Agreement, shall void the Agreement.
OFFER AND ACCEPTANCE
The United States, acting by and through the U.S. Environmental Protection Agency (EPA), hereby offers Assistance/Amendment to
the County of Hawaii for 100.00 % of all approved costs incurred up to end not exceeding
5200.000 for the support of approved budget period effort described in application (including all application modiTicetions)
cited in the Project Title end Description above, sigried 06/20/2005 included herein by reference.
ISSUING OFFICE (GRANTS MANAGEMENT OFFICE) AWARD APPROVAL OFFICE
ORGANIZATION /ADDRESS ORGANIZATION /ADDRESS
U.S. EPA, Region 9 U.S. EPA, Region 9
Grants Management Office, PMD-7 Superfund
75 Hawthome Street 75 Hawthorne Street
San Francisco, CA 94105 San Francisco, CA 94105
THE UNITED STATES OF AMERICA BY THE U.S. ENVIRONMENTAL PROTECTION AGENCY
SIGN TUBE OF AWARD OFFICIAL TYPED NAME AND TITLE DATE
Keith Takata,
(/i Director-Superfund Division
~L DEC 12005
This agreement is subject to applicable U.S. Environmental Protection Agency statutory provisions and assistance regulations. In
accepting this award or amendment and any payments made pursuant thereto, (f) the undersigned represents that he is duly .
authorized to act on behalf of the recipient organization, and (2) the recipient agrees (a) that the award is subject to the applicable
provisions of 40 CFR Chapter 1, Subchapter B and of the provisions of this agreement (and all attachments), end (b) that acceptance of
any payments constitutes an agreement by the payee that the amounts, if any found by EPA to have been overpaid will be refunded or
credited in full to EPA.
BY AND ON BEHALF OF THE DESIGNATED RECIPIENT ORGANIZATION
SS
ATU~ TYPED NAME AND TITLE DATE
Dixie Kaetsu, ~ A ~ ~ C 2001
Managing Director F1 U
EPA Funding Information BF-sss6~oo,-o Paget
FUNDS FORMER AWARD THIS ACTION AMENDED TOTAL
EPA Amount This Action $ $ 200,000 $ 200,000
EPA In-Kind Amount $ $ $ p
Unexpended Prior Year Balance $ $ $ 0
Other Federal Funds $ $ $ 0
Recipient Contribution $ $ $ p
State Contribution $ $ $ 0
Local Contribution $ $ $ 0
Other Contribution - ~ $ $ ~ $ 0
Allowable Project Cost $ 0 - $ 200,000 $ 200,000
Assistance Program (CFDA) StaWtory Authority Regulatory Authority
66.818 - Brownfields Assessment and Cleanup CERCLA: Sec. 104(k)(2) 40 CFR PART 31
Cooperative Agreements
Fiscal
Site Name DCN FY Approp. Budget PRC Object Site/Project Cost Obligation /
Code Organization Class Organization Deobligation
- KSBOS 200 E 09KOAG 402D79E 411 G900NY0 200,00
200,00
BF-96957001-0 Page 3
Bud et Summa Pa e
Table A -Object Class Category Total Approved Allowable
(Non-construction) Budget Period Cost
1. Personnel $14,000
2. Fringe Benefits $0
3. Travel $3,000
4. Equipment $0
5. Supplies $3,000
6. Contractual $180,000
7. Construction $0
8. Other $0
9. Total Direct Charges $200,000
10. Indirect Costs: °k Base $0
11. Total (Share: iiecipient 0.00 % Federal 100.00 $200,000
12. Total Approved Assistance ount $200,000
13. Program Income $0
l
BF - 96957001 - 0 Page 4
Administrative Conditions
t. An interim Financial Status Report (FSR), Standard Form 269A (Rev. 7/97), covering
the period from "project/budget period start date" to September 30 of each calendar
year shall be submitted to the Grants Management Office, PMD-7, no later than
December 31 of the same calendar year. The initial FSR is due December 31, 2006.
The final FSR covering the entire project period shall be submitted to the U.S. EPA Las
Vegas Finance Center PO Box 98515 Las Vegas, NV 89193-8515 within 90 days after
the end of the project period according to the recipients respective Code of Federal
Regulations Part 31.23(b).
2. The recipient shall comply with the Single Audit Act and the reporting requirements
set forth in OMB Circular A-133.
3. The recipient agrees to complete and submit to the Grants Management Office,
PMD-7, a MBE/WBE Utilization Report (EPA Form 5700-52A), within 30 days after the
end of the Federal fiscal year, i.e., by October 30 of each calendar year. Negative
reports are required.
a. In accordance with EPA's Program for Utilization of Small, Minority and Women's
Business Enterprises in procurement under Federal assistance programs, the recipient
agrees to:
a) Accept the applicable "fair share" goals negotiated with EPA by the HI
Department of Health, as follows:
MBE WBE `
Construction 50% 4%
Supplies 29% 7%
Services 21 % 2%
Equipment . 27% 2%
If the recipient does not want to rely on the applicable State's. MBE/WBE "fair share"
goals, the recipient agrees to submit proposed MBE/W BE "fair share" goals based
on availability of qualified minority and women-owned businesses to do work in the
relevant market for construction, services, supplies, and equipment.
"Fair share" objectives must be submitted to Joe Ochab, PMD-1, within 30 days of
award and approved by EPA no later than 30 days thereafter.
b) Ensure to the fullest extent possible that at least the applicable "fair share"
objective {see a) above} of Federal funds for prime contracts for supplies,
construction, equipment or services are made available to organizations owned or
controlled by socially and economically disadvantaged individuals, women and
historically black colleges and universities.
c) Include in its bid documents applicable "fair share" objectives {see a) above} and
require all of its prime contractors to include in their bid documents for subcontracts
the negotiated fair share percentages.
Page 5
d) Follow the six affirmative steps stated in 40 CFR Section 30.44(b), Section
31.36(e), Section 35.3145(d), or Section 35.6580(a), as appropriate.
e) In the event race and/or gender neutral efforts prove to be inadequate to achieve
a fair share objective for MBENVBEs, the recipient agrees to notify EPA in advance
of any race and/or gender conscious action it plans to take to more closely achieve
the fair share objective.
f) Until the recipient has completed its fair share negotiations with EPA, it agrees
to apply the main State agency's fair share objectives. Once the recipient has
completed its fair share negotiations with EPA, it will apply those objectives. The
recipient also agrees to include in its bid documents the applicable "fair share"
objectives and require all of its prime contractors to include in their bid documents
for subcontracts the applicable "fair share" percentages and to comply with
paragraphs (c) through (e) above.
5. The cost principles of OMB Circular A-87 are applicable to this award. Since there
are no indirect costs included in the assistance budget, they are not allowable under
this Assistance Agreement.
s. When procuring services, equipment, and/or supplies under this assistance
agreement, the recipient will follow the same policies and procedures it uses for
procurements from its non-Federal funds. The recipient will follow their own
procurement policies and procedures provided that the policies and procedures
conform wilh EPA regulations 40 CFR Part 3i .36 or 30.44 (as applicable) which state
that all procurement transactions will be conducted in a manner providing full and open
competition.
7. The recipient agrees to comply with Title 40 CFR Part 34, New Restrictions on
Lobbying . The recipient shall include the language of this provision in award
documents for all subawards exceeding $100,000, and require that subrecipients
submit certification and disclosure forms accordingly.
In accordance with the Byrd Anti-Lobbying Amendment, any recipient who makes a
prohibited expenditure under Title 40 CFR Part 34 or fails to file the required
certification or lobbying forms shall be subject to a civil penalty of not less than $10,000
and not more than $100,000 for each such expenditure.
B. Pursuant to EPA's annual Appropriations Act, the chief executive officer of this
recipient agency shall require that no grant funds have been used to engage in lobbying
of the Federal Government or in litigation against the United States unless authorized
under existing law. As mandated by this Act, the recipient agrees to provide
certification to the award official via EPA Form 5700-53, Lobbying and Litigation
Certificate, or in a written statement. The Lobbying and Litigation certification and final
Financial Status Report shall be submitted within 90 days after the end of project
period.
Page 6
Recipient shall abide by its respective OMB Circular (A-21, A-87, or A-122), which
prohibits the use of federal grant funds for litigation against the United States. Any Part
30 recipient shall abide by its respective OMB Circular (A-21 or A-122), which prohibits
the use of Federal grant funds to participate in various forms of lobbying or other
political activities.
s. Pursuant to EPA Order 1000.25 and Executive Order 13101, the recipient agrees to
use recycled paper for all reports which are prepared as a part of this agreement and
delivered to EPA. This requirement does not apply to Standard Forms. These forms
are printed on recycled paper as available through the General Services Administration.
Recipient shall comply with the requirements set forth in Section 6002 of the Resource
Conservation and Recovery Act (RCRA) (42 U.S.C. 6962). Regulations issued under
RCRA Section 6002 apply to any acquisition of an item where the purchase price
exceeds $10,000 or where the quantity of such items acquired in the course of the
preceding fiscal year was $10,000 or more. RCRA Section 6002 requires that
preference be given in procurement programs to the purchase of specific products
containing recycled materials identified iri guidelines developed by EPA. These
guidelines are listed in 40 CFR 247.
to. Effective October 1, 1994, the recipient agrees to ensure that all conference,
meeting, convention, or training space funded in whole or in part with Federal funds
complies with the Hotel and Motel Fire Safety Act of 1990.
tt. Payment to consultants. Per 40 CFR Part 31.36(j), EPA's participation in the
salary rate (excluding overhead and travel) paid to individual consultants retained by
recipients or by a recipient's contractors or subcontractors shall be limited to the
maximum daily rate for a Level IV of the Executive Schedule, to be adjusted annua{ly.
This limit applies to consultation services of designated individuals with specialized
skills and if the terms of the contract provide the recipient with responsibility for the
selection, direction, and control of the individuals who will be providing services under
the contract at an hourly or daily rate of compensation. As of January 1, 2005, the rate
is $537.76 per day and $67.22 per hour. This rate does not include overhead or travel
costs and the recipient may pay these in accordance with its normal travel practices.
Subagreements with firms or individuals for services which are awarded using the
procurement requirements in 40 CFR Parts 30 or 31, as applicable, are not affected by
this limitation unless the terms of the contract provide the recipient with responsibility for
the selection, direction, and control of the individuals who will be providing services
under the contract at an hourly or daily rate of compensation. See 40 CFR Part
31.36(j)(2) or Part 30.27(b).
12. The recipient shall fully comply with Subpart C of 40 CFR Part 32, entitled
"Responsibilities of Participants Regarding Transactions." The recipient is responsible
for ensuring that any lower tier covered transaction, as described in Subpart B of 40
CFR Part 32, entitled "Covered Transactions," includes a term or condition requiring
compliance with Subpart C. The recipient is responsible for further requiring the
inclusion of a similar term or condition in any subsequent lower tier covered
transactions. The recipient acknowledges that failing to disclose the information
required under 40 CFR 32.335 may result in the delay or negation of this assistance
agreement, or pursuance of {egal remedies, including suspension and debarment.
Page 7
The recipient may access the Excluded Parties List System at http:!/egls.arnet.pov.
This term and condition supersedes EPA Form 5700-49, "Certification Regarding
Debarment, Suspension, and Other Responsibility Matters."
Programmatic Conditions
P1. This budget and work plan are conditionally approved. The grantee must submit
the final work plan to EPA no facer than 30 days from the date of this award.
See Attached Brownfields Assessment Grant Terms and Conditions.
---END OF DOCUMENT---
e
BF-96957001-0
County of Hawaii, HI
Brownfields Assessment Grant Terms and Conditions
Please note that these Terms and Conditions (T&Cs) apply to.brownfields grants
under CERCLA 104(k) and do not apply to pre-FY 2003 grants subject to 104(d).
I. GENERAL FEDERAL REQUIREMENTS
NOTE: For the purposes of these Terms and Conditions the term "assessment" includes,
eligible activities under the Comprehensive Environmental Response, Compensation, and
Liability Act (CERCLA) 104(k)(2)(A)(i) such as activities involving the inventory,
characterization, assessment, and planning relating to brownfield sites as described in the
EPA approved scope of work.
A. Federal Policy and Guidance
1. a. Cooperative Agreement Recipients: In implementing this agreement, the
cooperative agreement recipient (CAR) shall insure that work done with
cooperative agreement funds complies with the requirements of the
Comprehensive Environmental Response, Compensation, and Liability Act
(CERCLA) 104(k). The CAR will also ensure that assessment activities
supported with cooperative agreement funding comply with all applicable Federal
and State laws and regulations.
b. CERCLA 104(g) requires that recipients comply with the prevailing wage rate
requirements under the Davis-Bacon Act of 1931 for construction, repair or
alteration contracts "funded in whole or in part" with funds provided under this
agreement. If the CAR uses funds awarded under this agreement to contract for
construction, repair or alteration work, it must obtain recent and applicable wage
rates from the U.S. Department of Labor and incorporate them into the
construction, alteration or repair contract..
c. The recipient agrees to comply with Executive Order 13202 (Feh. 22, 2001, 66
Fed. Reg. 11225) of February 17, 2001, entitled "Preservation of Open
Competition and Government Neutrality Towards Government Contractors' Labor
Relations on Federal and Federally Funded Construction Projects," as amended by
Executive Order 13208 (April 11, 2001, 66 Fed. Reg. 18717) of Apri16, 2001,
entitled "Amendment to Executive Order 13202, Preservation of Open
Competition and Govemment Neutrality Towards Government Contractors' Labor
Relations on Federal and Federally Funded Construction Projects.
d. The recipient must comply with Federal cross-cutting requirements. These
requirements include but are not limited to, MBE/WBE requirements found at 40
Final FY05 Assessment T&C 8 Sept OS
CFR 31.36(e) or 40 CFR 30.44(b); OSHA Worker Health & Safety Standard 29
CFR 1910.120; the Uniform Relocation Act; National Historic Preservation Act;
Endangered Species Act; and Permits required by Section 404 of the Clean Water
Act; Executive Order 11246, Equal Employment Opportunity, and implementing
regulations at 41 CFR 60-4; Contract Work Hours and Safety Standards Act, as
amended (40 USC 327-333) the Anti Kickback Act (40 USC 276c) and Section
504 of the Rehabilitation Act of 1973 as implemented by Executive Orders 11914
and 11250.
B. Eligible Brownfields Site Determinations
1. a. The CAR must provide information to EPA about site-specific work prior to
incurring any costs under this cooperative agreement for sites that have not
already been pre-approved in the CAR's work plan by the EPA. The information
that must be provided includes whether or not [he site meets the definition of a
brownfield site as defined in § 101(39) of CERCLA, the identity of the owner, and
the date of acquisition. ,
b. If the site is excluded from the general definition of a brownfield, but is
eligible for aproperty-specific funding determination, then the CAR must
provide information sufficient for EPA to make aproperty-specific
funding determination. The CAR must provide sufficient information on
how financial assistance will protect human health and [he environment,
and either promote economic development or enable the creation of,
preservation of, or addition to parks, greenways, undeveloped property;
other recreational property, or other property used for nonprofit purposes.
The CAR must not incur costs for assessing sites requiring a property-
specific funding determination by EPA until the EPA Project Officer has
advised the CAR that the Agency has determined that the property is
eligible.
2 a. PETROLEUM FUNDING ONLY: For any petroleum contaminated brownfield
site that is not included in the CAR's EPA approved work plan, [he CAR shall
provide sufficient documentation to the EPA prior to incurring costs under this ,
cooperative agreement which includes (see the latest version of EPA's Proposal
Guidelines for Brownfields Assessment, Revolving Loan Fund and Cleanup
Grants for discussion of this element):
(1) that a State has determined that the petroleum site is of relatively low
risk, as compared to other petroleum-only sites in the State,
(2) that the State determines there is "no viable responsible party" for the
site;
(3) that the State determines that the person assessing or investigating the
site is a person who is not potentially liable for cleaning up the site; and
(4) that the site is not subject to'any order issued under section 9003(h} of the
Solid Waste Disposal Act.
This documentation must be prepared by the CAR or the State following contact
Final FY05 Assessment T&C 8 Sept OS
and discussion with the appropriate petroleum program official.
b. Documentation must include the identity of the State program official
contacted, the State official's telephone number, the date of the contact,
and a summary of the discussion relating to the state's determination that
the site is of relatively low risk, that there is no viable responsible party
and that the person assessing or investigating the site is a person who is
not potentially liable for cleaning up the site. Other documentation
provided by a State to the recipient relevant to any of the determinations
by the State must also be provided to the EPA Project Officer.
c. If the State chooses not to make the determinations described in 2.a.
above, the CAR must contact the EPA Project Officer and provide the
information necessary for EPA to make the requisite determinations.
d. EPA must also make all determinations on the eligibility of petroleum
contaminated brownfield sites located on Indian tribal lands. Prior to
incurring costs for these sites, the CAR must,coritact the EPA Project
Officer and provide the information necessary for EPA to make the
determinations described in 2.a. above.
II. GENERAL COOPERATIVE AGREEMENT
ADMINISTRATIVE REQUIREMENTS
A. Term of the Agreement
1. The term of this agreement is two years from the date of award, unless otherwise
extended by EPA at the CAR's request. ~
2. If after 1~/z years from the date of award, EPA determines that the CAR has not made
sufficient progress in implementing its cooperative agreement, the Agency may terminate
this agreement.
3. Assessment funding for any eligible brownfields site may not exceed $200,000 unless a
waiver has been granted by EPA and then funding is not to exceed $350,000 at the site
subject to the waiver.
B. Substantial Involvement
I . The U.S. EPA may be substantially involved in overseeing and monitoring this
cooperative agreement.
a. Substantial involvement by the U.S. EPA generally includes
administrative activities such as: monitoring; review of project phases; and
approval of substantive terms included in professional services contracts.
Final FY05 Assessment T&C 8 Sept OS
b. Substantial EPA involvement also includes brownfields property-specific
funding determinations described in I.B. under Eligible Brownfields Site
neterminations above. If the CAR awards a subgrant for site assessment,
the CAR must obtain technical assistance from EPA on which sites qualify
as a brownfields site and determining whether the statutory prohibition
found in section 104(k)(4)(B)(i)(N) of CERCLA applies. This prohibition
precludes the subgrantee from using EPA funds to assess a site for which
the subgrantee is potentially liable under § 107 of CERCLA.
c. Substantial EPA involvement may include reviewing financial and
environmental status reports; and monitoring all reporting, record-keeping,
and other program requirements.
d. EPA may waive any of the provisions in term and condition II.B.1., with
,the exception of property-specific funding determinations. EPA will
provide waivers in writing.
2. Effect of EPA's substantial involvement includes:
a. EPA's review of any project phase, document, or cost incurred under this
cooperative agreement, will not have any effect upon CERCLA § 128
Eligible Response Site determinations or for rights, authorities, and actions
under CERCLA or any Federal statute.
b. The CAR remains responsible for ensuring that all assessments are
protective of human health and the environment and comply with all
applicable Federal and State laws.
c. The CAR and its subgrantees+remain responsible for incurring costs that
are allowable under the applicable OMB Circulars.
C. Cooperative Agreement Recipient Roles and Responsibilities
1. The CAR must acquire the services of a qualified environmental professional(s) to
coordinate, direct, and oversee the brownfields assessment activities at a particular site, if
they do not have such a professional on staff.
2. The CAR is responsible for ensuring that contractors and subgrant recipients comply with
the terms of their agreements with the CAR, and that agreements between the CAR and
subgrant recipients and contractors are consistent with the terms and conditions of this
agreement.
3. Subgrants are defined at 40 CFR 31.3. The CAR may not sub grant to for-profit
organizations. The CAR must obtain commercial services and products necessary to
carry out this agreement under competitive procurement procedures as described in 40
CFR 31.36. In addition, EPA policy encourages awarding sub-grants competitively and
Final FY05 Assessment T&C 8 Sept OS
the CAR must consider awarding subgrants through competition.
4. The CAR is responsible for assuring that EPA's Brownfields Assessment Grant funding
received under this grant, or in combination with any other previously awarded
Brownfields Assessment grant does not exceed the $200,000 assessment grant funding
limitation for an individual brownfield site. Waiver of this funding limit for a
brownfields site must be approved by EPA prior to the expenditure of funding exceeding
$200,000. In no case may EPA funding exceed $350,000 on a site receiving a waiver.
(Note: Cooperative Agreement Recipients expending funding from acommunity-wide
assessment grant on a particular site must include such funding amount in any total
funding expended on the site.)
D. Quarterly Progress Reports
1. The CAR must submit progress reports'on a quarterly basis (30 days after the end of each
Federal fiscal quarter) to the EPA Project Officer. The progress reports must document
,-incremental progress at achieving the project goals and milestones. Quarterly progress
reports must include:
a. Documentation of progress at meeting performance outcomes/outputs, project
narrative, project time line and an explanation for any slippage in meeting
established output/outcomes.
b. An update on project milestones.
c. A budget recap summary page with the following headings: Curren[ Approved
Budget; Costs Incurred this Quazter; Costs Incurred to Date; and Total Remaining
Funds.
d. If applicable, quazterly reports must specify costs incurred at petroleum
contaminated brownfields sites.
e. Recipient quarterly reports must clearly identify which activities performed during
the reporting period were undertake$with EPA funds, and must relate EPA-
funded activities to the objectives and milestones agreed upon in the work plan
including a list of sites where assessment activities were completed.
2. The CAR must maintain records that will enable it to report to EPA on the amount of
funds expended on specific sites under this grant.
3. The CAR must maintain records that will enable it to report to EPA on the amount of
funds expended by the CAR at petroleum sites identified in the EPA approved scope of
work.
4. The CA'R must complete and submit relevant portions of the Property Profile Form
(available at http://www.epa.aov/brownfields/pubs/rptforms.htm or from [he EPA Project
Officer) reporting the commencement of a Phase I assessment, the expenditure of $1,000
or more of grant funds at a property or the completion of a property assessment. The
CAR must submit the updated Property Profile Form reflecting such events within 30
days after the end of the Federal fiscal quarter in which the event occurred. The CAR
will electronically submit Quarterly Reports and Property Profile Forms to the EPA
Final FY05 Assessment T&C H Sept OS
Project Officer with a copy directed to EPA Headquarters at bf~orms@epa.gov.
5. In accordance with 40 C.F.R. § 31.40 (d), the recipient agrees to inform EPA as soon as
problems, delays or adverse conditions become known which will materially impair the
ability to meet the outputs/outcomes specified in the assistance agreement work plan.
E. Closeout Reporting
1. At the conclusion of this project and/or as directed by the project officer, the CAR will
implement closeout procedures and prepare all documents and reports required for the
closeout of this cooperative agreement.
III. FINANCIAL ADMINISTRATION REQUIREMENTS
A. Eligible Uses of the Funds for [he Cooperative Agreement Recipient
1. To the extent allowable under the scope of work, cooperative agreement funds may be `
used for eligible programmatic expenses to inventory, characterize, assess, and conduct
panning and outreach. Eligible programmatic expenses include activities described in
Section N of these Terms and Conditions. In addition, such eligible programmatic
expenses may include:
a. Determining whether assessment activities at a pazticular site are authorized by
CERCLA 104(k);
b. Ensuring that an assessment complies with applicable requirements under Federal
and State laws, as required by CERCLA 104(k);
c. Using a portion of the grant to purchase environmental insurance for the
characterization or assessment of the site. Funds may not be used to purchase
insurance intended to provide coverage for any of the Ineligible Uses under
Section B.
d. Any other eligible programmatic costs including direct costs incurred by the recipient
in reporting to EPA; procuring and managing contracts; awarding and managing
subgrants to the extent allowable under III. B. 2.; and carrying out community
involvement pertaining to the assessment activities.
2. Local Governments only. No more than 10% of the funds awarded by this agreement
may be used for brownfield program development and implementation (including
monitoring of health and institutional controls) as described in the specific Task of the
EPA approved scope of work. The CAR must maintain records on funds that will be
used to carry out this Task).
B. Ineligible Uses of the Funds for the Cooperative Agreement Recipient
Final FY05 Assessment T&C 8 Sept OS
1. Cooperative agreement funds shall not be used by the CAR for any of [he following
activities:
a. Cleanup activities;
b. Development activities that are not brownfields assessment activities (e.g.,
construction of anew-facility);
c. Job training unrelated to performing a specific assessment at a site covered by the
grant;
d. To pay for a penalty or fine;
e. To pay a federal cost shaze requirement (for example, acost-share required by
another Federal grant) unless there is specific statutory authority;
f. To pay for a response cost at a brownfields site for which the recipient of the grant
or subgrant is potentially liable under CERCLA § 107;
g. To pay a cost of compliance with any.federal law, excluding the cost of
compliance with laws applicable to the assessment; and
h. Unallowable costs (e.g., lobbying and fund raising) under applicable OMB
Circulars.
2. Under CERCLA 104(k)(4)(B), administrative costs are prohibited costs under this
agreement. Prohibited administrative costs include all indirect costs under applicable
OMB Circulars.
a. Ineligible administrative costs include costs incurred in the form of ~
salaries, benefits, contractual costs, supplies, and data processing chazges,
incurred to comply with most provisions of the ,Uniform Administrative
Requirements for Grants contained in 40 CFR Part 31. Direct costs for
grant administration, with the exception of costs specifically identified as
eligible programmatic costs, are ineligible even if the grant recipient is
required to carry out the activity under the grant agreement.
b. Ineligible grant administration costs include direct costs for:
(1) Preparation of applications for Brownfields grants;
(2) Record retention required under 40 CFR 31.42;
(3) Record-keeping associated with supplies and equipment purchases required
under 40 CFR 31.32 and 31.33;
(4) Preparing revisions and changes in the btadgets, scopes of work, program
Final FY05 Assessment T&C 8 Sept OS
plans and other activities required under 40 CFR 31.30;
(5) Maintaining and operating financial management systems required under 40
CFR 31;
(6) Preparing payment requests and handling payments under 40 CFR 31.21;
(7) Non-federal audits required under 40 CFR 31.26 and OMB Circular A-133.
3. Cooperative agreement funds may not be used for any of the following properties:
a. Facilities listed, or proposed for listing, on [he National Priorities List (NFL);
b. Facilities subject to unilateral administrative orders, court orders, administrative
orders on consent or judicial consent decree issued to or entered by parties under
CERCLA;
c. Facilities that,aze subject to [he jurisdiction, custody or control of the United
States government except for land held in trust by the United States government
for an Indian tribe; or
d. A site excluded from the definition of a brownfields site for which EPA has not made a
property-specific funding determination.
C. Interest -Bearing Accounts and Program Income
1. In accordance with 40 CFR 31.25(8)(2), the CAR is authorized to add program income to
the funds awazded by the EPA and use the program iACOme under the same terms and
conditions of this agreement. Program income for the assessment CAR shall be defined
as the gross income received by the recipient, directly generated by the cooperative
agreement award or earned during the period of the awazd. Program income includes, but
is not limited to, fees charged for conducting assessment, site characterizations, clean up
planning or other activities when the costs for the activity is charged to this agreement.
2. The CAR must deposit advances of grant funds and program income (e.g., fees) in an
interest bearing account.
a. Interest earned on advances, CARS are subject to the provisions of 40 CFR
§31.21(1) to remitting interest on advances to EPA on a quarterly basis.
b. Interest earned on program income is considered additional program
income.
Final FY05 Assessment T&C 8 Sept OS
IV. ASSESSMENT ENVIRONMENTAL REQUIREMENTS
A. Quality Assurance (QA) Requirements
1. This grant includes the performance of environmental measurements, therefore, a QA
Plan, a Sampling and Analysis Plan, or other comparable document covering QA
activities, must be prepared before any sampling or cleanup activities at the site may
begin. An example of a comparable document is a Sampling Plan approved by the state
oversight authority. If the document submitted does not meet EPA's basic information
requirements, an addendum or supplemental Sampling and Analysis Plan maybe required
before sampling work may begin. The recipient should consult with the Region 9 Quality
Assurance Office at 415-972-3798 to determine if a QA document is required. The
Quality Assurance Manager will determine what type of QA documentation would be
most appropriate and what QA guidance should be followed if a document is required.
The QA Plan must be approved by the EPA Project Officer, the Region 9 Quality
Assurance Manager, and the recipient's Quality Assurance Officer before measurement
activities are undertaken. Typically, measurement activities must be described by the type
of media (soil, water, air), by [he phase of the project (i.e.: sampling backfill material, air
monitoring during removal work, confirmation sampling), and by location.
2. Emergency measurements may be taken without a QA Plan being prepazed if the Region
9 Quality Assurance Manager agrees that the nature of the data collection activity
required due to the emergency wasants an exemption and the recipient contacts the
Quality Assurance Manager to obtain approval prior to beginning the sampling work.
Contact the QA Office at 415-972-3798. Irt the event an unforseen site condition arises
during the cleanup work, changes or deviations [o the type of contaminant sampled,
methodology, or sample spacing, [he recipient must contact the Quality Assurance
Manager to determine if the Sampling and Analysis Plan must be amended before new
• work is initiated. If the change is such that a site hazard is created by a delay in the work,
the recipient shall contact the Quality Assurance Manager to obtain approval prior to
formally revising the document. Minor field deviations (i.e: slight location changes)
should be noted in the final cleanup report, but do not require EPA approval.
3. Under the Assessment program, area-wide projects or multi-site projects will require the
prepaza[ion of a Quality Assurance Project Plan (QAPP) in addition to site specific
Sampling and Analysis Plans.
4. Under the Assessment, Cleanup, and Revolving Loan Fund programs, aone-site project
may use the one-site Region 9 Sampling and Analysis Plan which incorporates the QAPP.
5. Under the Revolving Loan Fund program, [he CAR is responsible for prepazing the
QAPP for the program. In turn, the individual borrowers or sub-grantees are responsible
for preparing the site specific Sampling and Analysis Plan in accordance with Region 9's
current QA guidance. The borrowers or sub-grantees must contact the Quality Assurance
Manager to obtain the current QA guidance for each site.
6. If the review and approval of the QAPP was completed five years ago, it must be
Final FY05 Assessment T&C 8 Sept OS
resubmitted to EPA for review and approval to ensure it remains a useful and valid
document for the site.
7. In general, a QAPP or Sampling and Analysis Plan will require approximately two to four
weeks for the EPA Quality Assurance Manager to review and return comments.
Documents generally require one revision and re-submittal. The re-submittal review time
is typically two weeks.
B. Implementation and Completion of Assessment Activities
1. For those assessment projects where acommunity-wide inventory precedes any site
assessments, if proposed sites have not been previously identified in the approved work
plan for an ASTM Phase I or Phase II environmental assessment, the EPA project officer
must be consulted to approve further selected sites before assessment work is
implemented.
2. The CAR shall properly document the completion of all activities described in the EPA
approved scope of work. This must be done through a final report or letter from a
qualified environmental professional, or other documentation provided by a State or Tribe
that shows assessments are complete.
C. All Appropriate Inquiry
1. As required by CERCLA § 104(k)(2)(B)(ii) and CERCLA § 101(35)(B), the CAR shall
ensure that a "Phase I" site characterization and assessment carried out under this
agreement will be performed in accordance with ASTM standard E1527-2000 "Standard
Practices for Environmental Site Assessment: Phase I Environmental Site Assessment
Process," until EPA promulgates final federal standards governing the conduct of "all
appropriate inquiry." After EPA promulgates final regulations governing the conduct of
all appropriate inquiry, Phase I site chazacterizations and assessments will have to be
conducted in compliance with the final regulations. This does not preclude the use of
grant funds for additional site characterization and assessment activities that may be
necessary to characterize the environmental impacts at the site or to comp]y with
applicable State standards.
D. Community Relations and Public Involvement in Assessment Activities
1. Some assessment activities may require asite-specific community relations plan. Those
activities include assessment work performed beginning with the Phase II environmental
assessment through [o the development of a remediation/cleanup plan. It should address
providing reasonable notice of site work, opportunity for public involvement, response to
comments, decisions for site work, and an administrative record being made available to
the public. The CAR should consult with the EPA Project Officer on the project's
community relations plan. The plan should be made available upon request.
Final IY05 Assessment T&C 8 Sept OS
V. OTHER ASSESSMENT REQUIREMENTS
A. Conflict of Interest
1. The CAR shall establish and enforce conflict of interest provisions that prevent the award
of subgrants that create real or apparent personal conflicts of interest, or the CAR's
appearance of lack of impartiality. Such situations include, but are no[ limited to,
situations in which an employee, official, consultant, contractor, or other individual
associated with the CAR (affected party) approves or administers a grant or subgrant to a
subgrant recipient in which the affected party has a financial or other interest. Such a
conflict of interest or appearance of lack of impartiality may arise when:
(i) The affected party,
(ii) Any member of his immediate family,
(iii) His or her partner, or '
(iv) An organization which employs, or is about to employ, any of the above,
has a financial or other interest in the subgrant recipient.
Affected employees will neither solicit nor accept gratuities, favors, or anything of
monetary value from subgrant recipients. Recipients may set minimum rules where the
financial interest is not substantial or the gift is an unsolicited item of nominal intrinsic
value. To the extent permitted by State or local law or regulations, such standazds of
conduct will provide for penalties, sanctions, or other disciplinary actions for violations
of such standards by affected parties.
m
VI. PAYMENT AND CLOSEOUT
A. Payment Schedule
1. The CAR may request payment from EPA pursuant [0 40 CFR §31.21(c).
B. Schedule for Closeout
1. Closeout will be conducted in accordance with 40 CFR 31.50.
Final FY05 Assessment T&C 8 Sept OS
~Y~
HAWAII COMMUNITY FOUNDATION ~ ,a
,,I_
c~U~1~~
August 4, 2005
Lawrence Mahuna
Police Chief
County of Hawaii Police Department
349 Kapiolani Street
Hilo. Hawaii 96720
Deaz Chief Mahuna:
On behalf of the volunteers and staff of the Hawaii Community Foundation, I am pleased to inform you that a
grant has been awarded to yow organization in connection with the Tri County Crystal Methamphetamine
Initiative, a partnership of the Counties of Hawaii, Kauai and Maui, and the Hawaii Community Foundation
(HCF). The project is funded by the U.S. Department of Justice, Community Oriented Policing Services
(COPS), (the "Federal Grant"), Public Safety Partnership and Community Policing Grants, CFDA#l16.710, and
is subject to the conditions of that program. We are excited about yow project and believe it is the kind of work
that can help to make a difference in Hawaii.
Proposal 1D#: 20051088 Grant Award: $487,473.63
Grant Period: 7/1/2005 to 7/1/2006
Grant Purpose: Hawaii Police Department Ice Task Force and Airport Interdiction Detail to combat
crystal methamphetamine
Final Report: Due 30 days aRer the grant end date
Please read the following Brant conditions carefully:
This grant is to be used only for the purposes set forth in the proposal and work plan you submitted to
HCF, as mutually amended from time tc time (the "Proposal"). If there is any change in any of the
activities described in the Proposal, please contact us before expending the funds.
• As grantee, you acknowledge that the grant is being made in connection with the Federal Grant. You
further acknowledge and agree that you aze fazniliaz with the requirements and conditions of the Federal
Grant and agree to comply with all requirements that may be applicable to yow organization as a sub- _
recipient of the Federal Grant as further set forth in Exhibit "A", which is attached hereto and
incorporated by reference.
• The grant will be paid in increments upon satisfactory achievement of milestones as set forth in Exhibit
"B". All deliverables funded by prior increments must be completed before additional grant increments
will be paid. Any exceptions must be requested and approved by HCF in writing in advance of the
deadline.
A grant activities report and financial report are required to be submitted to HCF quarterly in order to
administer the grant and maintain necessary expenditure records. Deadlines for the quarterly reports aze
set forth in Exhibit "B".
• HCF reserves the right to require site visits while the project is in progress and/or once the project has
been completed.
2~n!~e
• You must notify HCF of any unexpended funds at the end of the grant period, or if (i) your organization
has not performed in accordance with the Proposal or this agreement, (ii) your organization loses its
exemption from federal income taxes under Section 501(c)(3) of the Internal Revenue Code, or (iii) your
organization materially changes its programs, activities or mission.
• You acknowledge that the services provided in connection with the Proposal aze provided solely as a
grantee and there is no principal/agent or employee/employer relationship between your organization
and HCF.
• Should you publicize the receipt of this grant, please send a copy of any articles, video taped television
coverage, annual reports, or similar publications to the HCF Communications Officer. Please see the
attached "Publicity Tips for your HCF Grant" for more information. In addition, any publication
material developed and /or purchased with federal grant funds must contain the following designation:
"This document prepared by (name of your aeencyl, was supported by Grant #2004CKWX0370,
awarded by the U.S. Department of Justice, Office of Community Oriented Policing Services. The
opinions, findings and conclusions or recommendations expressed in this document aze those of the
author(s) and do not necessarily represent the official position or policies of the U.S. Department of
Justice or the COPS Office."
• Subject to the legally required appropriations, and subject to all federal, state, and county laws, as
grantee, you agree to defend, to save harmless, and to indemnify HCF against all claims, losses, liability,
damages, and expenses in connection with the services provided by your organization pursuant to the
Proposal, including, but not limited to, any failure to comply with the requirements applicable to grantee
pursuant to the Federal Grant requirements.
Should you have any questions call me at 961-9216. I wish you great success and look forward to heazing
about the success of your project.
Snnincppe~~rely,
l~ ~G~R
Clarysse Kami Nunokawa
Program Officer
Enclosures
I hereby agree to comply with the above grant terms
6r~ . ~v- ?r.l5
Authorized Agent of Grantee Organization Date
Lawrence K. Mahuna
Print Name
IN WITNESS WHEREOFF, the parties hereto have executed this agreement on the day and year
first above written.
COUNTY OF HAWAII: HAWAII COMMUNITY FOUNDATION:
gy~~a'~^,~v7~ By ~ I~Cf,~
~IIv4 Rixrp R~G"'s.j CHRISTINE van BERG IJK
Its A4eyet~ )1,cnartra DIr~f19M ~ Vice President -Programs
APPROVED AS TO FORM AND LEGALITY:
ii£PV Corpor ~ n Counsel
STATE OF HAWAII )
SS.
COUNTY OF HAWAII )
k~ 11
On this lb day of ~HY"St" , 2005, before me
personally appeared DIXIE K,4ETSU, to me personally known, who, being by me duly
sworn, did say that she is the Managing Director of the County of Hawaii, a municipal
corporation of the State of Hawaii; that the seal affixed to the foregoing instrument is
the corporate seal of said County of Hawaii; that the foregoing instrument was signed
and sealed in behalf of the County of Hawaii by authority given to said Mayor of the
County of Hawaii by Section 5-1.3(g) of the County Charter, County of Hawaii (2000),
as amended, and assigned by the Mayor to the Managing Director pursuant to
Section 6-1.3(h) of the County Charter; and said DIXIE ItAETSU acknowledged said
instrument to be the free act and deed of said County of Hawaii.
JEAN IERNES
Notary Public, State of Hawaii
My commission expires: 11/1/2005
iL, ( _
i,
^t
J t - ^~\V
4
i
N.
STATE OF HAWAII )
SS.
COUNTY OF HAWAII )
On this a ~~h day of ~LIO'F ~m'b L'~ , 2005, before me
personally appeared CHRISTINE van BERGEIJK, to me personally known, who, being
by me duly sworn, did say that she is the Vice President of Programs for the HAWAII
COMMUNITY FOUNDATION, a non profit organization incorporated in the State of
Hawaii, that she is the Vice President of Programs for the HAWAII COMMUNITY
FOUNDATION, anon-profit organization incorporated in the State of Hawaii, that said
instrument was signed and sealed in behalf of said organization by authority of its Board
of Directors; and that said officer acknowledged said instrument to be the free act and
deed of said organization.
Notary Pu lic, State of Hawaii
My commission expires: 0!0 • x (0• x009
PAS
Exhibit "A"
By accepting this grant, you are obtaining federal funds from the U.S. Department of Justice, Office of
Community Oriented Policing Services (COPS Office). In addition to the Grant Conditions and the attached
Certification and Assurances, your agency agrees to the following grant contingencies:
1. Use of funds for this grant will adhere to what is "Allowable Costs" under the COPS grants. In addition,
please note the following:
a. Prior approval by the COPS Office will be requested and received for consulting costs over $450 per
day before expenditure.
b. Approval by the COPS federal officer will be requested and received for equipment purchase $5,000
or more prior to purchase.
2. The Hawaii Community Foundation has contracted with the University of Hawaii -Center on the
Family to conduct an evaluation of the Crystal Meth Initiative. Your agency agrees to work with the
Center on the Family as it conducts its evaluation.
3. Your agency agrees to keep all financial records, including payroll, time and attendance records,
purchase orders, canceled checks, or similar documents associated with your grant for at least three
years from the date of award.
4. Participate in training to use web-based reporting system and use the web based reporting system to
submit required quarterly financial reports.
5. Attend all grantee gathering sponsored by the Foundation for the Crystal Meth Initiative.
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Organization: County of Hawaii, Police Department
Grant ID#: 20051088
PROJECT BUDGET
Other APPROVED
CATEGORY Meth Re uest Resources Bud et
1 EQUIPMENT $0.00 $0.00 $0.00
2 OTHER $0.00 $0.00 $0.00
3 SUPPLIES $0.00 $0.00 $0.00
4 TRAVEL $0.00 $0.00 $0.00
5 CONSULTANTS/CONTRACTORS $0.00 $0.00 $0.00
6 PERSONNEL (Wages/Salaries) $343,464.00 $0.00 $343,464.00
1.0 FTE Police Officer III (6 positions) $285,048.00 $285,048.00
1.0 FTE Police Detective $58,416.00 $58,416.00
7 FRINGE BENEFITS $144,009.63 $0.00 $144,009.63
Health Insurance (Medical, Dental, Vision) $40,152.00 $40,152.00
Life Insurance $336.00 $336.00
Retirement 7% 24042.48 $24,042.48
Worker's Comp 4.28% $14,700.26 $14,700.26
Unemployment Insurance 0.25% $858.66 $858.66
Medicare 1.45% $4,980.23 $4,980.23
Other (SOCD) $7,140.00 $7,140.00
Car allowance $37,800.00 $37,800.00
Car insurance $14,000.00 $14,000.00
Total Budget $487,473.63 $0.00 $487,473.63
v
US. Departmeat olJuatke
Office of Community Oriented Policing Services
Certifications
Regarding Lobbying; Debarment, Suspension and Other Responsibility Mariers; Drug-Free
Workplace Requirements Coordination with Affected Agencies.
Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; Drug-Free \Gorkplace Requiremrnts Coord'uration with
Affencd Agrnoes.
Although the Departrnmt of Justice has made every effort [o simplify [he application praea; other provisions of federal Iavr require us ro
xek your agrnty's certi6caton regarding certain marten. Applicants should and the regulations tired below artd the iustruetiom Eor
certification included in the regulations to understand the rcquvements and whechu thry apply m a particular app6eane Signing this form
complies with certification rcgttircmrnts undec 28 CFR Put 69, "New Resaictiom on Lobbying," 28 CFR Put 67, "Govemmrnt-Wide
Debument and Suspension (Nonprocuremrnt)", 28 CFR Pan 83 Govrrnmrno-Wide Requiremmn for Ding-Fret Workphee (Grants),"
and the coordination requiremmn of the Public Safety Pumership and Conunutdry Policing Act of 1994. The eerti6ntions shwa be -
treated as a material rcprcsenration of fatt upon which rebance will be plated whin the Deparvnent of Justice daamines ro award the
covered grant
1. Lobbying n Arc not prcarncly debarred, suspended, proposed fo:
debarment, declared ineligibk, smtenttd ro a denial of federal
Aa requred by Section 1352, Tide 31 of the U.S. Code, and benefits by a start or federal coon, or wlunhdly excluded from
impkmrnted rat 28 CFR Part 69, for persons entering into a gran[ or covered rrmmctions by any kderal departmmt or agency;
cooperative agreemem over 5700,000. as defined at 28 CFA Pan 69,
the applcant certifies that (u) Have not within a three-Saar parod preeedurg this appGation
been comic[ed of or had a civil judgmmt rendered against them
A. No federal appropriated funds have been paid or will be paid, by for commission of fraud or a criminal offense in connection with
or on behalf of the smdersigned, ro any person for influrnang a obtausing, artempting ro obroiq or pcrformiog • public (federal,
anempting to influma an of6cu or employee of crag agrnry, a state or ~ or priwte agmmmt or transaction; violation of
member of Congress, m office oc employee of Congress, or an federal a crate antitrust sneutes a commistion of
employee of a member of Congress in connection with the making <mbezzlemrne, theft, forgery; bribery; falsi6ntion or destruttioo
of any federal gnat the entering into of any cooperative agmmrnt; of records, making false sutemmts, tax evasion, or receiving
and the extension, contintrotion, renewal, nmrndmmt or modification stolrn propary, making falx daiass, or obseucdon of justice, or
of any federal grant or cooperative ngrcemrnC commission of any offrnx indkating a belt of business integrity
or business horresry that xriously affects your ptacm
B. IE any funds other than federal appropriated Eunda have been paid responsibility.
or will be paid w arty person for influenclng or anempturg to
influence an officer or empbyee of any agency, a member of (rb) Ax na preaendy indicted for or orherwix criminally a
Congress, an of6cu or employee of Congress, or m employee of a civi0y charged by a governmcntd entity ((erlval, :rate or lonl)
member of Congress in comection with this fedml grant or with commission of any of the offrnxs enumerated in paragraph
cooperative agrcemmS nc~ undersigned sha8 complete and submit (A)(u) of this eenification; and
Srandard Form - LLL, "Disclosure of Lobbying Activities," N
accordmce with its insauctions; (rv) Have not within a [hree-peu period preceding this
application had one or more public transactions (federal, ante or
G The undersigned shall require that the language of dos local) rcrmina[ed for eaux or defaulC and
cvtification be included m the award drrevmenn for all subawards at
all tiers (including subgrants, contracts under gents and cooperative B. Where the applicant is unable ro cectifp to my of the
agreements, and subconrracn) and that all sub-rmipienu shall ttrtify sra[emrnts N thu certification, he or she shall attach an
and disdox accordirrgly, explanation to this application.
2. Dbbazment, Suspension and Other Responsibility Manors (Duect 3. Drug-Free Workplace (Granttts Other Thm Individuals)
Rcclpicnt)
As required by the Drug-Free Workplace Att of 1988, and
As required by Executive Order 12549, Debarment and Suspension, unplemcnted ac 28 CFR Put 83, for grantees, u defined at 28
and implemented at 28 CFR Pratt G7, for prospective partidpann in CFR Part 83, Sections 83 and 83.5]0 -
primary ctrvercd transactions, as defined at 28 CFR Pan 67, Section
67 440 - A. The applicant cerd6es chat it wJl, or will continue to, provide
a drug-fret wodtplace by.
A. The applicant certifies chat it and its printipals:
T
O PubBshing a statement notifying employees that the urilawfd (vt) Taking one of [he following actions, within 30 twkndar
manufacture, distribution, dispensing, possession or use of a days of receiving notice undo subparagraph (rv)(b), with
controlled substance is prohibited in the grantee i workplace and respect to any employee who is so tonvieted -
specifying the actions that will be taken against employees for
violation of such prohibition; (a) Taking appropriam pcrsomd action agains[ such an
(n) Establishing an on-going drug-(tee awareness program to employeq up to and including termination, etmsiatrnt with
inform employees about - the rcquucments of the Rehabilirotion Act of 1973, as
amended; or
(a) The dangers of drug abuse in the workplace; ,
(b) Requiring such employee to panidpa[e satisfactorily in
(b) The grantee s pobcy of maintaining adrug-&ec workplacr, drug abuse assisance or rehabilitation program approved for
such purposes by a (ederil, state or local health, law
(c) Any available drug counseling, rchabJitauon and employee enforcemen[ or other appropriate agency;
assistance programs; and (vu) Making a good faith cffon to eondmu to maintain a
drvg-fret workplace through implementation of paragraphs
(d) The penalties that may be imposed upon employees (or drug- n, (u), (w), (rv), (v) and (vr).
abuse violations occurring in the workplace;
B. The grantee may insert N the space provided below the
(ru) Making it a requirement tlut each employee ro be engaged in site(s) for the performance of work done in eonntttion with
the performance of the grant be given a copy of the srotemrnt the specific grann
requned by paragraph n; Place of performance (soett address, dry, eotmry, state, ap
code)
(v} Notifying :hc tmployee in the statement rnquued by' paragraph
n char, as a condition of employment under the grant, the
employee will -
Check O if there am workplaces on file that arc oa
(a) Abidc~by the terms of the sta¢mcnr, and idrntified here.
(b) Notify the employer in welting of his or her convittion fora 4. Coordination -
violation of a mtrrinil drug srotute occurring in [he workplace tro
late: than five caendar days afty such conviction; The Public Sn(ery Partnership and Commudry Policing An
of 1994 requires applicants to ccrtifj• that there has been
(v) Notifying the agency, in writing, within 10 calendar days after appropriate coordination with all agencies clot mry be
receiving notice under subparagraph (v)(b) from m employee or affected by the applicant's grant proposal if approved,
otherwise receiving actual notice of such conviction. Employers of Affected agencies may include, among others, the OR~ee of
conviacd cmplq•ccs must provide notice, including position tide, the United States Attomry, smte or hxal prosecutors, OI
to: COPS Office, 1100 Vumont Ava, NW, Washingtoq D.C. correctional agendea The applicant certifies that there has
20530. Notice shall include the identilcation numbtt(s) of each been appropriate coordination with oU aEfeaed agences
affcc¢d grant
Grantee Agency Name and Address:
Grantee ]RS/ Vendor Number.
Filse sm[ements or claims made in connection with COPS grants (including coopendve agreements) may result in fares,
imprisonment, disbument from participating in (ede:il grans or contracts, and/or any other remedy available by lava
I arofy [hat the assurances provided arc we and accuram to the best of my knowledge.
Elections or other selections of new officials will not relieve the grantee entity of its obligations under this grant
Tyycd Nam< and Tide aw Enforcement Executive (oz Official with Programmatic Authority, as applicable):
Lawr ce K. Dlahun Police Chief
AUC 0 2005
Signature: Date:
Typed Name and Tide of Government Executive (or Official with Financial Authority, as applicable):
Dixie Ra u 0 q {
S~ m r Datt; AUG ~ 6 1005
updored: January 16, 1004 e01041197
US. Depanment of Justin
Office of Community Oriented Policing Smices
Assurances
Several provisions of federal law and policy apply ro all gent programs. We (the OfFic< of Community Oriented Pohang Services) rxed ro
secure your assurance that rh< applicant will comply with thex provisions ]f you world like further infortmtion about anq of eheu
assurances, please conuct your smtla COPS Gram Program Spcad'ut at (800) 421.6770.
By the app8cant's authorized apresrnmvve's signatutt, the appGnnt assures that it will comply with all legal and adminiswirve
requucmena that govern the applicant for accepunee and use of federal grant funds In partitvlar, the npphant sssures us that
1. It has been 1cga0y acrd of0aa8y authorized by the appmpdatc 19G8, as artscndcd (42 U.S.C. § 3789(d)); Tide Vf of the Civil
governing body (foe example, tuaya or city council) ro apply fw this Rights Act of 1964, as atnrnded (42 USG S ZOOOd); the Intlnn
grant and chat the persona signing the application and these Civil Righa Aa (25 USC. $S 1301-1303): Seedon SO{ oC the
assurances on its behalf are authorized to do so and ro att on its Rehabilintioo Aa of 1973, as arnendtd (29 USG S 794): Title 17,
behalf with respect to arty issues that may adu during processing of Subtitle A of the Ameriam with Diasbflitio Act (RDA) (42
this spplirltioa U.S.C § 12]01, n uq.); dtc Age Disaimioarion Att of 1975 (42
U.S.C. $ 6101, n seq.); and Depanmem of Justice Noo-
2. It will comply with the provisions of (edml law which limi[ certain Discrimination Regulations contained in Title 28, Patti 35 and 42
political activities of grantee empbyces whose pdnapal employmrnt (subparts C, D, E and G) of the Code of Federal Reguhtiom.
u in connection with an activity financed in whole a in part with this
grant. Thcsc res¢ictions arc xt forth in 5 U.S.C. § 1501, et seq. A. In th< event that any court or adminiatndre agmry trrakes a .
fmding of dismmination on grounds of race, clot, rtligioq
3. ]twill comply with the minimum wage and maximum hours national origin, gender, disability or age agaitrrt the applicant afar
provisions of the Federal Fair Labor Standards An, if applicable, a due process heacirag, it agrees m frrcwatd ¦ copy of the finding
to the Office of Civil Rights, Offitx of Justice Programs, 810 7th
4. ]t will ntab8sh sa(cguards, if it has nor done so atrndy, ro pmlibit Street, NW, Washington, AG 20531.
employees fran using thou positions for a pucpox that is, o< gives
the appearance of being, motivated by a desire for pirvate gain for B. Grantees that have 50 of more empltyees and grants Duff
rhemsehzs m other, pamculady those with whom they have family, 5500,000 (tic over 51,000,000 N grants wet rneighteen-month
business or other tics. period), must submit an acccprable Etpral Empkrpmrnt
Opportuttiry Plan ("EEOP'~ tic ESOP ahon form pf grantee is
5. It will give th< Deputmrnt of Justice or the Comptro0u Gcnrnl required ro submit an EEOP utdet ZB CF'A 41.302), that is
access to and the right ro examine records and docum<nts related ro approved by the Office of )ustitt Program; OlEtee Eor Civil
~ grant. Rights within GO days of the award start date. For grants undo
5500,000, but Duct 525,000, or for granted with fewer than 50
6. It will comply with all requirements imposed by the Dcpartmrnc of employee0. the grantee must submit an ESOP Certifxatioa
Justice as a condition or admutiswtive ttquiremem of the grmy (Gnnmea oC less than 525,000 arc not atibjett ro the EEOP
inaurf'usg bu[ not bmitcd to; the ttgtitcmcnts of 28 CFR Putt 6G and ttquircmrnt.)
28 CFR Pan 70, m the Federal Acquisition Regulation0. as applicable
(governing cost pdncipka}; OMB Ciceular A-133 (groaning audits) 9. Pursuant to Department of )ustke guidelines Qune ]8, 2002
and other applicable OMB cktvlan; ch< applicable provisions of the Federal Register (Volume 67, Ntrmbts 117, pages 4]455-41472)),
Omnibus Crime Control and Safe Svects Act of 1968, ss amended; under Tide VI of the Civil Rights Aa of 1964, it will ensure
28 CFR Pan 3&]; the resent edition of the COPS Grant Monitoring mcaringEul access to its prognnrs and activities by persons with
Snnduda and Guidelines; and with oU other applicable peognm kmited English proficicnry.
ttquirements, laws, orders, ttgulations, or cirtvlacs.
10. It will ensure that any fadlitlea under its ownership, lease or
7. If appGrabk, it will, to the extrnt pncdcabk and consistent with supervision which shall be uriliud ie the accomplishmrnt of the
applicable law, seek, recruit and hire qualified members of racial and project art not listed on the Ertvironmrnml Protection Agency's
ethnic minority groups and qualified women in order to Fur[ha (EPA) list of Violating Facilities and that it will notify us if
effective law enforc<rnent by increasing their ranks within the sworn advised by the EPA that a Facility to be used in this gent is under
positions in the agency. considtxation for such listing by the EPA,
8. It a01 not, on the ground of racer, cobr, religion, national origin, ]7. If the applicant's staff has established a mica and eommrnt
gender, disability or age, unlawfully exclude any person from procedure under Executive Order 12372 and has selected this
puticipation in, drny the benefits of or employment to any penoq progrun Eor review, it has made this applinritm available for
or subject any person to disaimination in connection with any review by the sate Single Point of Conraee
programs of activities funded in whole or in pan with federal funds.
These civil tights requirements arc found in the non-discrimination
provisions of the Omnibus Crime Control and Safe Streets Act of
a
11. Pursuant to Executive Order 13043, it will cn(ome on-the-job 75. ]t will not ux any fedrnl funding directly or indircdy
scat bolt politics and programs for emp)oy¢s when operating to influence in any roamer a Member of Congress, a
agency-owned, ren[ed or persona8yowned vehicles. jurisdicoon, or an official of any government, ro favor,
adopt, or oppose, by vtnc or otherwise, any Icgjsladon, law
13. It will not use COPS funds to supplant (replace) state, Ioca1, or ratification, policy or appropriation whether before or after
Ilureau of ]radian Affair funds that otherwise would M made the inttoduction of any bill, measure, or rcsoluuon
available for the purposes of this grant, as applicable. proposing such legislation, law, ratiEicndon, policy or
appropriation as set forth in the Mti-Lobby Act, 18 U.S.C
14. ]f the awarded grant contains a retention requirement, it will 1913.
retain [F¢ incensed officer sraffusg level rand/or the inneased
o(Bcer redeploynnent Irvd, as applicable, with start or local funds False matements or claims made N cormection with COPS
for a minimum of one full local budget cycle following expiration grants (including cooperative agreements) may insult in
of the grant period. fines, imptisotunrnt, disbarment from pardcipadng in
federal grants or contracts, and/or any othv remedy
available by law.
I certify that the assurances provided arc true and accurate to the best of my knowledge
Ele ns or other adaa ~ of new officials wiU not relieve the grantee entity of its obligations under this grant.
AUG 0 5.105
Signature a Law Enforcement Executive (or Offidal with Datc
Prog atic Aud mty, as ¦ licablc)
t fi 2005
Signamre of Government Executive (or Of0ua1 with Date
Fittartdal Authority, as npplicablc)
updated: January 16, 1004 e01041197
5
U.S. Department of Justice
Office of Community Oriented Policing Services
Disclosure of lobbying Activities
Instructitxts for Completion o(SFW, D'isdosure of lobbying Acti]irties
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal reapi-
ent, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant
to title 31 U.S.C. section ]352. The filing of a form is required for each payment or agreement to make pay-
ment to any lobbying entity for influendng 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 con-
nection with a covered Federal action. Complete all items that apply for both the initial filing and material
change report. Refer to the implementing guidance published by the Office of Management and Budget for
additional information.
1. Identify the type of covered Federal action for which lob- erect Federal action (item 1). If known, enter the full Catalog
bying activity is and/or has been secured to influence the out- of Federal Domestic Assistance (CFDA) number for grants,
come of a covered Federal action. cooperative agreements, loans and loan commitments.
8. Enter the most appropriate Federal identifying number
2 Identify the status of the covered Federal action. available for the Federal action identified in item i (e.g.,
Request for Proposal (RFP) number Invitation for Bid (IFB)
3. Identify the appropriate dassification of this report. If this number grant announcement number; the contract, grant, or
is a follow-up report reused by a material change to the infor- loan award numberthe appliption/proposal control number
mation previously reported, enter the year and quarter in assigned by the Federal agency): Indude prefixes, e.g., "RFP-
which the change occurred. Enter the date of the lazt previ- DE-90-001"
ously submitted report by this reporting entity forthis cov-
ered Federal action 9. For a covered Federal action where there has been an
award or loan commitment by the Federal agency, enter the
9. Enter the full name, address, dty, state and zip code of the Federal amount of the award /loan commitment for the prime
reporting entity. Indude Congressional District number, if entity identified in item 4 or 5.
known. Check the appropriate dassification of the reporting
entity that designates if it is, or expects to be, a prime or sub- 10. (a) Enter the full name, address, dty; state and zip code of
award redpient Identify the tier of the subawardee, e.g., the the lobbying entity engaged by the reporting regishant identi-
first subawardee of the prime is the ] st tier. Subawards fled in item 4 to influence the covered Federal action
indude but are not limited to subcontracts, subgnnts and
contract awards under grants. (b) Enter the full name(s) of the individual(s) performing ser-
vices, and indude full address if different from 10 (a). Enter
5. If the organization filing the report in item 4 checks Last Name; First Name, and Middle Initial (Mn.
"Subawardee;' then enter the full name, address, dty, state
and zip code of the prime Federal redpient indude 11. The certifying offidal shall sign and date the form, print
Congressional District, if known. his/her name, title and telephone number.
6. Enter the name of the Federal agency making the award or Public reporting burdrn for this aollertion of information is estimattd to
Loan commitment. Indude at least one organizational level average 30 minutes per response, including time for reviewing instructions,
below a en name, if known For exam le, De artment of searching existing data sources, gathering and maintaining the data Herded,
g cY P P and rompleting and reviewing the collection of infonwtion. Send mm -
Transportation, United States Coast Guard. mrnts regarding the burden estimak or any othn aspect of thrs rollection of
infonnativn, including suggestions for reducing this burden, ro the OJficeof
7. Enter the Federal program name or desa-iption for the cov- Managemrnt and Budget, Paperuiork Reduction Project (0398.0046),
Washington, D.C. 20530.
Disclosure Of Lobbying Activities APProveabyOMB
0348-0046
(asamended)
Complete this form to disclose lobbying activities pttrsuant to 31 U.S.C. 1352
(See reverse for instructions and public burden disclosure}
1. Type of Federal Action: _ 2 Status of Federal Action: _ 3. Report Type: _
a. contract a. bid/offer/application a, initial filing
b. grant b. initial award b. material change
c. cooperative agreement c. post-award
d. loan For Material Clwnge Only:
e. loan guarantee Year:
f. loan insurance Quarter:
Date of last report
9. Name and Address of Reporting Entity: 5. If Repotting Entity in No. 4 is Subawardee, Enter
? Prime O Subawardee Name and Address of Prime:
Tier_~ iflrnown:
I
Congressional District (number), if ]crown: _ Congressional District (number), if known: ,
6. Federal Department/Agency: 7. Federal Program Name/Destription:
CFDANumber, if applicable:
8. Federal Action Number, if known: 9. Award Amount, if known:
10. a. Name and Address of Lobbying Registrant ]0. b. ]ndividuals Performing Services
(if individual, last name, first name, MI): (including address if different from No.lOa)
(last name, first name, MI):
ll.lnfonnation requested through this form is authorized by Signa e:
TiOe 31 U.S.C. Section 1352 This disclosure of lobbying
activities is a material representation of fad upon which Print Name: Lawrence K. Nlahuna
reliance was placed by the tier above when this transaction
was made or entered into. This disclosure is required pur- PO11C2 C}llef
suant to 31 U.S.C. 1352 This information will be reported to Title:
the Congers semi-annually and will be available forpublic
inspection Any person who tails to file the requireddisclo- Tele hone No.: 508-961-2283 DateAl)~ Q ~ 2d~5
sure shall be subject to a evil penalty of not less than $30p00 p
and not mare than $100,000 for each such failure.
Federal Use Only: Authorized for Local Reproduction, Standard Form - LLL