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FY 2022 - 2023 EMPG AGREEMENT <br />ATTACHMENT H <br />REPORTING FORMS <br />FLORIDA DIVISION OF EMERGENCY MANAGEMENT <br />2022-2023 EMERGENCY MANAGEMENT PERFORMANCE GRANT- EMPG BASE GRANT <br />DIVISION FORM 1 B - QUARTERLY TASKS <br />SUB -RECIPIENT: <br />QUARTER: <br />EMPG Emergency Management Personnel <br />EM Funded Stag Name & Position Trtle <br />DELIVERABLES/TASK REQUIREMENTS <br />T1 (A): Quarterly Match: Submit Division Form 3A - Qua <br />Match to identify the non-federal match amount. For thot <br />recipients using local funds, supporting documentation it <br />required with the form to support match amount reported <br />Q1-04) <br />TI (B): Ensuring the Protection of Civil Rights: Complete <br />submit the Civil Rights Evaluation tool <br />Ci�ilRightsEwluation@hq.dhs.gov Form (Attachment H) <br />include supporting materials within thirty (30) days of rec <br />the Notice of Award (November 1, 2022) for the first aw <br />under which this term applies. (Due 01) <br />T2 (A): National Incident Management System: NIMS Da <br />Collection Worksheet Local, provided by the Pmparedn, <br />Bureau in the month of September, must be submitted It <br />Salesforce by December 1, 2022 to the Bureau Chief of <br />Preparedness (Due 01) <br />T2 (B): Operational Coordination: Must engage with who <br />community stakeholders on a quarterly basis either bu <br />participating in regional meeetings of existing muhiagen <br />organizations (i.e. Regional Domestic security Task bre <br />Local Emergency Planning Committes, Regional Health <br />Coalitions, Local Voluntary/Community Organizations A, <br />Disaster) or by hosting/conducting meetings with whole <br />communty stakeholders. Must submit proof of participatl <br />representative ofthe Sub -Recipient in quarterly meetings <br />Meeting minutes, agendas and signAn sheets. <br />(Due 01-04) <br />T2 (C): Public Inbrmalion and Warning: The Sub-recipiei <br />upload their updated FEMA IPAWS County executed Mi <br />signed IPAWS Rules of Behavior forms for each author¢ <br />given access to send IPAWS messages for the county. <br />Salesforce no later than August 30, 2023. (Due 04) <br />T3 (A): Integrated Preparedness Program: Upload the G <br />2024-2026 IPP in Salesforce by January 10, 2023. Prov <br />of participation by a representative ofthe Sub -Recipient <br />appropriate Regional IPP Workshop (IPPW). EMPG fun, <br />personnel are encourage to attend. Dates and places an <br />in the scope of work (SOW). (Due 02) <br />T3 (B): Training: Protide Division Form 4 - Staffing Detail <br />funded EMPG personnel. Provide training transcripts for <br />funded personnel listed on Division Form 4 - Staffing Det <br />certificates are uploaded into SERT TRAC, the Division's <br />Manager will request a copy them the T&E Unit. (Due Q' <br />updates if necessary Q2-04) <br />T3 (C): Validating Capabilities Through Exercise: Provide <br />sheet or certificate of participation in a minimum ofthme <br />exercises for funded EMPG personnel during the period <br />petbnnance. (Due 01, Deliverable accepted) (Due Q <br />Not her <br />if completed in 01) <br />"By signing this report 1 certify to the bear ofmy knowledge and beliefMat the report is We, complete, and accurefe, and the expenditures, disbursements and <br />cash reoeipFa ere Far the purposes end objectives set ford, in Me bnna and conditions ofthe Federal amid. l am aware that any Was, fictitious, or fraudulent <br />information, or the omission ofeny matenal Fact, may subject me to criminal, civil oradminisfntive penalties for baud, false statements, false claims or otherwise. <br />(U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812).' <br />SIGNATURE: <br />AUTHORIZED REPRESENTATIVE <br />PRINTED NAME: <br />62 <br />194 <br />