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Contract Number: 16 -CP -11-10-40-01-174
STATE -FUNDED SUBGRANT AGREEMENT
THIS AGREEMENT is entered into by the State of Florida, Division of Emergency Management,
with headquarters in Tallahassee, Florida (hereinafter referred to as the "Division"), and Indian River
County, (hereinafter referred to as the "Recipient").
THIS AGREEMENT IS ENTERED INTO BASED ON THE FOLLOWING REPRESENTATIONS:
A. The Recipient represents that it is fully qualified and eligible to receive these funds to provide
the services identified herein; and
B. The Division has received these funds from the State of Florida, and has the authority to
subgrant these funds to the Recipient upon the terms and conditions below; and
C. The Division has statutory authority to disburse the funds under this Agreement.
THEREFORE, the Division and the Recipient agree to the following:
(1) SCOPE OF WORK.
The Recipient shall perform the work in accordance with the Deliverables and Scope of
Work, Attachment A of this Agreement.
(2) INCORPORATION OF LAWS, RULES, REGULATIONS AND POLICIES
The Recipient and the Division shall be governed by applicable State and Federal laws,
rules and regulations, including those identified in Attachment B.
(3) PERIOD OF AGREEMENT
This Agreement shall begin July 1, 2015, and shall end June 30, 2016, unless terminated
earlier in accordance with the provisions of Paragraph (12) of this Agreement.
(4) MODIFICATION OF CONTRACT
Either party may request modification of the provisions of this Agreement. Changes
which are agreed upon shall be valid only when in writing, signed by each of the parties, and attached to
the original of this Agreement.
(5) RECORDKEEPING
(a) As applicable, Recipient's performance under this Agreement shall be subject to the
federal OMB Circular No. A-102, "Common Rule: Uniform Administrative Requirements for Grants and
Cooperative Agreements to State and Local Governments" (53 Federal Register 8034) or OMB Circular
No. A-110, "Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher
Education, Hospitals, and Other Nonprofit Organizations," and either OMB Circular No. A-87, "Cost
Principles for State, Local and Indian Tribal Governments," OMB Circular No. A-21, "Cost Principles for
Educational Institutions," or OMB Circular No. A-122, "Cost Principles for Non-profit Organizations."
(b) The Recipient shall retain sufficient records to show its compliance with the terms of
this Agreement, and the compliance of all subcontractors or consultants paid from funds under this
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Agreement, for a period of five years from the date the audit report is issued, and shall allow the Division
or its designee, the State Chief Financial Officer or the State Auditor General access to the records upon
request. The Recipient shall ensure that audit working papers are available to them upon request for a
period of five years from the date the audit report is issued, unless extended in writing by the Division.
The five year period may be extended for the following exceptions:
1. If any litigation, claim or audit is started before the five year period expires,
and extends beyond the five year period, the records shall be retained until all litigation, claims or audit
findings involving the records have been resolved.
2. Records for the disposition of non -expendable personal property valued at
$5,000 or more at the time it is acquired shall be retained for five years after final disposition.
3. Records relating to real property acquired shall be retained for five years after
the closing on the transfer of title.
(c) The Recipient shall maintain all records for the Recipient and for all subcontractors or
consultants to be paid from funds provided under this Agreement, including documentation of all program
costs, in a form sufficient to determine compliance with the requirements and objectives of the
Deliverables and Scope of Work - Attachment A - and all other applicable laws and regulations.
(d) The Recipient, its employees or agents, including all subcontractors or consultants to
be paid from funds provided under this Agreement, shall allow access to its records at reasonable times
to the Division, its employees, and agents. "Reasonable" shall ordinarily mean during normal business
hours of 8:00 a.m. to 5:00 p.m., local time, on Monday through Friday. "Agents" shall include, but not be
limited to, auditors retained by the Division.
(6) AUDIT REQUIREMENTS
(a) The Recipient agrees to maintain financial procedures and support documents, in
accordance with generally accepted accounting principles, to account for the receipt and expenditure of
funds under this Agreement.
(b) These records shall be available at reasonable times for inspection, review, or audit
by state personnel and other personnel authorized by the Division. "Reasonable" shall ordinarily mean
normal business hours of 8:00 a.m. to 5:00 p.m., local time, Monday through Friday.
(c) The Recipient shall provide the Division with the records, reports or financial
statements upon request for the purposes of auditing and monitoring the funds awarded under this
Agreement.
(d) If the Recipient is a nonstate entity as defined by Section 215.97, Fla. Stat., it shall
comply with the following:
If the Recipient expends a total amount of State financial assistance equal to or more than
$500,000 in any fiscal year of such Recipient, the Recipient must have a State single or project -specific
audit for such fiscal year in accordance with Section 215.97, Fla. Stat.; applicable rules of the Executive
Office of the Governor and the Chief Financial Officer; and Chapters 10.550 (local government entities) or
10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. EXHIBIT 1 to this
Agreement shows the State financial assistance awarded by this Agreement. In determining the State
financial assistance expended in its fiscal year, the Recipient shall include all sources of State financial
assistance, including State funds received from the Division, other state agencies, and other nonstate
entities. State financial assistance does not include Federal direct or pass-through awards and resources
received by a nonstate entity for Federal program matching requirements.
In connection with the audit requirements addressed in this Paragraph 6(d) above, the Recipient
shall ensure that the audit complies with the requirements of Section 215.97(8), Fla. Stat. This includes
submission of a reporting package as defined by Section 215.97(2)(e), Fla. Stat. and Chapters 10.550
(local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General.
If the Recipient expends less than $500,000 in State financial assistance in its fiscal year, an
audit conducted in accordance with the provisions of Section 215.97, Fla. Stat, is not required. In the
event that the Recipient expends less than $500,000 in state financial assistance in its fiscal year and
elects to have an audit conducted in accordance with the provisions of Section 215.97, Fla. Stat, the cost
of the audit must be paid from the nonstate entity's resources (i.e., the cost of such an audit must be paid
from the Recipient's resources obtained from other than State entities). Additional information on the
Florida Single Audit Act may be found at the following website:
https://apps.fldfs.com/fsaa/singleauditact.aspx.
(e) Report Submission
1. The annual financial audit report shall include all management letters and the
Recipient's response to all findings, including corrective actions to be taken.
2. The annual financial audit report shall include a schedule of financial
assistance specifically identifying all Agreement and other revenue by sponsoring agency and Agreement
number.
3. Copies of financial reporting packages required under this Paragraph 6 shall
be submitted by or on behalf of the Recipient directly to each of the following:
The Division of Emergency Management at the following addresses:
Division of Emergency Management
Office of Inspector General
2555 Shumard Oak Boulevard
Tallahassee, Florida 32399-2100
The Auditor General's Office at the following address:
Auditor General's Office
Room 401, Claude Pepper Building
111 West Madison Street
Tallahassee, Florida 32399-1450
4. Any reports, management letter, or other information required to be submitted
to the Division of Emergency Management pursuant to this Agreement shall be submitted on time as
required under OMB Circular A-133, Florida Statutes, and Chapters 10.550 (local governmental entities)
or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable.
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5. Recipients, when submitting financial reporting packages to the Division of
Emergency Management for audits done in accordance with OMB Circular A-133 or Chapters 10.550
(local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General, should indicate the date that the reporting package was delivered to the Recipient in
correspondence accompanying the reporting package.
(f) If the audit shows that all or any portion of the funds disbursed hereunder were not
spent in accordance with the conditions of this Agreement, the Recipient shall be held liable for payment
to the Division of all funds not spent in accordance with these applicable regulations and Agreement
provisions within thirty days after the Division has notified the Recipient of such non-compliance.
(g) The Recipient shall have all audits completed in accordance with Section 215.97, Fla.
Stat. by an independent certified public accountant (IPA) who shall either be a certified public accountant
or a public accountant licensed under Chapter 473, Fla. Stat. The IPA shall state that the audit complied
with the applicable provisions noted above. The audit must be submitted to the Division no later than
nine (9) months from the end of the Recipient's fiscal year.
(7) PROGRESS REPORTS
(a) The Recipient shall provide the Division with quarterly reports and a close-out report.
These reports shall include the current status and progress by the Recipient and all subrecipients and
subcontractors in completing the work described in the Scope of Work and the expenditure of funds under
this Agreement, in addition to any other information requested by the Division.
(b) Quarterly reports are due to the Division no later than 30 days after the end of each
quarter of the program year and shall be sent each quarter until submission of the administrative close-
out report. The ending dates for each quarter of the program year are March 31, June 30, September 30
and December 31.
(c) The close-out report is due 60 days after termination of this Agreement or 60 days
after completion of the activities contained in this Agreement, whichever first occurs.
(d) If all required reports and copies are not sent to the Division or are not completed in a
manner acceptable to the Division, the Division may withhold further payments until they are completed or
may take other action as stated in Paragraph (11) REMEDIES. "Acceptable to the Division" means that
the work product was completed in accordance with the Budget and Scope of Work.
(e) The Recipient shall provide additional program updates or information that may be
required by the Division.
(f) The Recipient shall provide additional reports and information identified in Attachment
D.
(8) MONITORING
The Recipient shall monitor its performance under this Agreement, as well as that of its
subcontractors and/or consultants who are paid from funds provided under this Agreement, to ensure that
time schedules are being met, the Schedule of Deliverables and Scope of Work are being accomplished
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within the specified time periods, and other performance goals are being achieved. A review shall be
done for each function or activity in Attachment A to this Agreement, and reported.
In addition to reviews of audits conducted in accordance with paragraph (6) above, monitoring
procedures may include, but not be limited to, on-site visits by Division staff, limited scope audits, and/or
other procedures. The Recipient agrees to comply and cooperate with any monitoring
procedures/processes deemed appropriate by the Division. In the event that the Division determines that
a limited scope audit of the Recipient is appropriate, the Recipient agrees to comply with any additional
instructions provided by the Division to the Recipient regarding such audit. The Recipient further agrees
to comply and cooperate with any inspections, reviews, investigations or audits deemed necessary by the
Florida Chief Financial Officer or Auditor General. In addition, the Division will monitor the performance
and financial management by the Recipient throughout the contract term to ensure timely completion of
all tasks.
(9) LIABILITY
(a) Unless Recipient is a State agency or subdivision, as defined in Section 768.28 Fla.
Stat., the Recipient is solely responsible to parties it deals with in carrying out the terms of this
Agreement, and shall hold the Division harmless against all claims of whatever nature by third parties
arising from the work performance under this Agreement. For purposes of this Agreement, Recipient
agrees that it is not an employee or agent of the Division, but is an independent contractor.
(b) Any Recipient which is a state agency or subdivision, as defined in Section 768.28,
Fla. Stat., agrees to be fully responsible for its negligent or tortious acts or omissions which result in
claims or suits against the Division, and agrees to be liable for any damages proximately caused by the
acts or omissions to the extent set forth in Section 768.28, Fla. Stat. Nothing herein is intended to serve
as a waiver of sovereign immunity by any Recipient to which sovereign immunity applies. Nothing herein
shall be construed as consent by a state agency or subdivision of the State of Florida to be sued by third
parties in any matter arising out of any contract.
(10) DEFAULT
If any of the following events occur ("Events of Default"), all obligations on the part of the
Division to make further payment of funds shall, if the Division elects, terminate and the Division has the
option to exercise any of its remedies set forth in Paragraph (11). However, the Division may make
payments or partial payments after any Events of Default without waiving the right to exercise such
remedies, and without becoming liable to make any further payment:
(a) If any warranty or representation made by the Recipient in this Agreement or any
previous agreement with the Division is or becomes false or misleading in any respect, or if the Recipient
fails to keep or perform any of the obligations, terms or covenants in this Agreement or any previous
agreement with the Division and has not cured them in timely fashion, or is unable or unwilling to meet its
obligations under this Agreement;
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(b) If material adverse changes occur in the financial condition of the Recipient at any
time during the term of this Agreement, and the Recipient fails to cure this adverse change within thirty
days from the date written notice is sent by the Division.
(c) If any reports required by this Agreement have not been submitted to the Division or
have been submitted with incorrect, incomplete or insufficient information;
(d) If the Recipient has failed to perform and complete on time any of its obligations
under this Agreement.
(11) REMEDIES
If an Event of Default occurs, then the Division shall, after thirty calendar days written
notice to the Recipient and upon the Recipients failure to cure within those thirty days, exercise any one
or more of the following remedies, either concurrently or consecutively:
(a) Terminate this Agreement, provided that the Recipient is given at least thirty days
prior written notice of the termination. The notice shall be effective when placed in the United States, first
class mail, postage prepaid, by registered or certified mail -return receipt requested, to the address in
paragraph (13) herein;
(b) Begin an appropriate legal or equitable action to enforce performance of this
Agreement;
(c) Withhold or suspend payment of all or any part of a request for payment;
(d) Require that the Recipient refund to the Division any monies used for ineligible
purposes under the laws, rules and regulations governing the use of these funds.
(e) Exercise any corrective or remedial actions, to include but not be limited to:
1. request additional information from the Recipient to determine the reasons for
or the extent of non-compliance or lack of performance,
2. issue a written warning to advise that more serious measures may be taken if
the situation is not corrected,
3. advise the Recipient to suspend, discontinue or refrain from incurring costs for
any activities in question or
4. require the Recipient to reimburse the Division for the amount of costs incurred
for any items determined to be ineligible;
(f) Exercise any other rights or remedies which may be available under law.
(g) Pursuing any of the above remedies will not stop the Division from pursuing any other
remedies in this Agreement or provided at law or in equity. If the Division waives any right or remedy in
this Agreement or fails to insist on strict performance by the Recipient, it will not affect, extend or waive
any other right or remedy of the Division, or affect the later exercise of the same right or remedy by the
Division for any other default by the Recipient.
(12) TERMINATION
(a) The Division may terminate this Agreement for cause after thirty days written notice.
Cause can include misuse of funds, fraud, lack of compliance with applicable rules, laws and regulations,
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failure to perform on time, and refusal by the Recipient to permit public access to any document, paper,
letter, or other material subject to disclosure under Chapter 119, Fla. Stat., as amended.
(b)The Division may terminate this Agreement for convenience or when it determines, in
its sole discretion, that continuing the Agreement would not produce beneficial results in line with the
further expenditure of funds, by providing the Recipient with thirty calendar days prior written notice.
(c) The parties may agree to terminate this Agreement for their mutual convenience
through a written amendment of this Agreement. The amendment will state the effective date of the
termination and the procedures for proper closeout of the Agreement.
(d) In the event that this Agreement is terminated, the Recipient will not incur new
obligations for the terminated portion of the Agreement after the Recipient has received the notification of
termination. The Recipient will cancel as many outstanding obligations as possible. Costs incurred after
receipt of the termination notice will be disallowed. The Recipient shall not be relieved of liability to the
Division because of any breach of Agreement by the Recipient. The Division may, to the extent
authorized by law,withhold payments to the Recipient for the purpose of set-off until the exact amount of
damages due the Division from the Recipient is determined.
(13) NOTICE AND CONTACT
(a) All notices provided under or pursuant to this Agreement shall be in writing, either by
hand delivery, or first class, certified mail, return receipt requested, to the representative named below, at
the address below, and this notification attached to the original of this Agreement.
(b) The name and address of the Division contract manager for this Agreement is:
Paul Wotherspoon
2555 Shumard Oak Boulevard
Tallahassee, Florida 32399-2100
Telephone: 850-413-9913, Cell 850-528-8975
Fax: 850-488-6250
Email:paul.wotherspoon@em.myflorida.com
(c) The name and address of the Representative of the Recipient responsible for the
administration of this Agreement is: John King, Director
Indian River County Dept. of Emergency Services
4225 43rd Avenue, Vero Beach, FL 32967
Telephone: 772-226-3859.
Fax: 772-567-9323
Email:jking@ircgov.com
(d) In the event that different representatives or addresses are designated by either party
after execution of this Agreement, notice of the name, title and address of the new representative will be
provided as outlined in (13)(a)above.
(14) SUBCONTRACTS
If the Recipient subcontracts any of the work required under this Agreement, a copy of the
unsigned subcontract must be forwarded to the Division for review and approval before it is executed by
the Recipient. The Recipient agrees to include in the subcontract that(i)the subcontractor is bound by
the terms of this Agreement, (ii)the subcontractor is bound by all applicable state and federal laws and
regulations, and (iii)the subcontractor shall hold the Division and Recipient harmless against all claims of
whatever nature arising out of the subcontractor's performance of work under this Agreement, to the
extent allowed and required by law. The Recipient shall document in the quarterly report the
subcontractor's progress in performing its work under,this Agreement.
For each subcontract, the Recipient shall provide a written statement to the Division as to
whether that subcontractor is a minority business enterprise, as defined in Section 288.703, Fla. Stat.
(15) TERMS AND CONDITIONS
This Agreement contains all the terms and conditions agreed upon by the parties.
(16) ATTACHMENTS
(a) All attachments to this Agreement are incorporated as if set out fully.
(b) In the event of any inconsistencies or conflict between the language of this
Agreement and the attachments, the language of the attachments shall control, but only to the extent of
the conflict or inconsistency.
(c) This Agreement has the following attachments:
Exhibit 1 -Funding Sources
Attachment A—Scope of Work and Deliverables
Attachment B—Program Statutes and Regulations
Attachment C—302 Facility List
Attachment D—Invoice
Attachment E—Justification of Advance Payment
Attachment F—Warranties and Representations
Attachment G—Certification Regarding Debarment
Attachment H --Statement of Assurances
Attachment I—Facility Checklist and CAMEO Guide
Attachment J—Site Visit Certification Form
Attachment K—Statement of Determination
Attachment L—Hazards Analysis review Criteria
(17) FUNDING/CONSIDERATION
(a) This is a fixed fee Agreement, in an amount not to exceed:$3,944.00 subject to the
availability of funds.
(b) Any advance payment under this Agreement is subject to Section 216.181(16),
Fla.Stat., and is contingent upon the Recipient's acceptance of the rights of the Division under Paragraph
(12)(b)of this Agreement. The amount which may be advanced may not exceed the expected cash
needs of the Recipient within the first three(3) months of the contract term. For a federally funded
contract, any advance payment is also subject to federal OMB Circulars A-87, A-110,A-122 and the Cash
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Management Improvement Act of 1990. All advances are required to be held in an interest-bearing
account. If an advance payment is requested, the budget data on which the request is based and a
justification statement shall be included in this Agreement as Attachment E. Attachment E will specify the
amount of advance payment needed and provide an explanation of the necessity for and proposed use of
these funds. No advance shall be accepted for processing if a payment has been paid prior to the
submittal of a request for advanced payment.
(c) After the initial advance, if any, payment shall be made on a cost reimbursement
basis as needed. The Recipient agrees to expend funds in accordance with the Budget and Scope of
Work,Attachment A of this Agreement.
(d) Invoices shall be submitted and shall include the supporting documentation for all
costs of the project or services. Invoices shall be accompanied by a statement signed and dated by an
authorized representative of the Recipient certifying that"all disbursements made in accordance with
conditions of the Division agreement and payment is due and has not been previously requested for
these amounts." The supporting documentation must comply with the documentation requirements of
applicable OMB Circular Cost Principles. The final invoice shall be submitted within sixty(60) days after
the expiration date of the agreement.
If the necessary funds are not available to fund this Agreement as a result of action by the United
States Congress, the federal Office of Management and Budgeting, the State Chief Financial Officer or
under subparagraph (19)(h) of this Agreement, all obligations on the part of the Division to make any
further payment of funds shall terminate, and the Recipient shall submit its closeout report within thirty
days of receiving notice from the Division.
(18) REPAYMENTS
All refunds or repayments due to the Division under this Agreement are to be made payable to
the order of"Division of Emergency Management" and mailed directly to the following address:
Division of Emergency Management
Cashier
2555 Shumard Oak Boulevard
Tallahassee FL 32399-2100
In accordance with Section 215.34(2), Fla. Stat., if a check or other draft is returned to the Division for
collection, Recipient shall pay the Division a service fee of$15.00 or 5%of the face amount of the
returned check or draft, whichever is greater.
(19) MANDATED CONDITIONS
(a) The validity of this Agreement is subject to the truth and accuracy of all the
information, representations, and materials submitted or provided by the Recipient in this Agreement, in
any later submission or response to a Division request, or in any submission or response to fulfill the
requirements of this Agreement. All of said information, representations, and materials is incorporated by
reference. The inaccuracy of the submissions or any material changes shall, at the option of the Division
and with thirty days written notice to the Recipient, cause the termination of this Agreement and the
release of the Division from all its obligations`to the Recipient.
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(b) This Agreement shall be construed under the laws of the State of Florida, and venue
for any actions arising out of this Agreement shall be in the Circuit Court of Leon County. If any provision
of this Agreement is in conflict with any applicable statute or rule, or is unenforceable, then the provision
shall be null and void to the extent of the conflict, and shall be severable, but shall not invalidate any other
provision of this Agreement.
(c) Any power of approval or disapproval granted to the Division under the terms of this
Agreement shall survive the term of this Agreement.
(d) This Agreement may be executed in any number of counterparts, any one of which
may be taken as an original.
(e) The Recipient agrees to comply with the Americans With Disabilities Act(Public Law
101-336, 42 U.S.C. Section 12101 et seq.), which prohibits discrimination by public and private entities on
the basis of disability in employment, public accommodations, transportation, State and local government
services, and telecommunications.
(f) Those who have been placed on the convicted vendor list following a conviction for a
public entity crime or on the discriminatory vendor list may not submit a bid on a contract to provide any
goods or services to a public entity, may not submit a bid on a contract with a public entity for the
construction or repair of a public building or public work, may not submit bids on leases of real property to
a public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or,
consultant under a contract with a public entity, and may not transact business with any public entity in
excess of$25,000.00 for a period of 36 months from the date of being placed on the convicted vendor list
or on the discriminatory vendor list.
(g) Any Recipient which is not a local government or state agency, and which receives.
funds under this Agreement from the federal government, certifies, to the best of its knowledge and belief,
that it and its principals:
1. are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from covered transactions by a federal department or agency;
2. have not, within a five-year period preceding this proposal been convicted of
- or had a civil judgment rendered against them for fraud or a criminal offense in connection with obtaining,
attempting to obtain, or performing a public(federal, state or local)transaction or contract under public
transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery,
bribery, falsification or destruction of records, making false statements, or receiving stolen property;
3. are not presently indicted or otherwise criminally or civilly charged by a
governmental entity(federal, state or local)with commission of any offenses enumerated in paragraph
19(g)2. of this certification; and
4. have not within a five-year period preceding this Agreement had one or more
public transactions(federal, state or local)terminated for cause or default.
If the Recipient is unable to certify to any of the statements in this certification, then the Recipient
shall attach an explanation to this Agreement.
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In addition, the Recipient shall send to the Division (by email or by facsimile transmission)
the completed "Certification Regarding Debarment, Suspension, Ineligibility And Voluntary
Exclusion" (Attachment G) for each intended subcontractor which Recipient plans to fund under
this Agreement. The form must be received by the Division before the Recipient enters into a
contract with any subcontractor.
(h) The State of Florida's performance and obligation to pay under this Agreement is
contingent upon an annual appropriation by the Legislature, and subject to any modification in
accordance with Chapter 216, Fla. Stat. or the Florida Constitution.
(i) All bills for fees or other compensation for services or expenses shall be submitted in
detail sufficient for a proper preaudit and postaudit thereof.
(j) Any bills for travel expenses shall be submitted in accordance with Section 112.061,
Fla. Stat.
(k) The Division reserves the right to unilaterally cancel this Agreement if the Recipient
refuses to allow public access to all documents, papers, letters or other material subject to the provisions
of Chapter 119, Fla. Stat., which the Recipient created or received under this Agreement.
(I) If the Recipient is allowed to temporarily invest any advances of funds under this
Agreement, any interest income shall either be returned to the Division or be applied against the
Division's obligation to pay the contract amount.
(m) The State of Florida will not intentionally award publicly -funded contracts to any
contractor who knowingly employs unauthorized alien workers, constituting a violation of the employment
provisions contained in 8 U.S.C. Section 1324a(e) [Section 274A(e) of the Immigration and Nationality Act
("INA")]. The Division shall consider the employment by any contractor of unauthorized aliens a violation
of Section 274A(e) of the INA. Such violation by the Recipient of the employment provisions contained in
Section 274A(e) of the INA shall be grounds for unilateral cancellation of this Agreement by the Division.
(n) The Recipient is subject to Florida's Government in the Sunshine Law (Section
286.011, Fla. Stat.) with respect to the meetings of the Recipient's governing board or the meetings of
any subcommittee making recommendations to the governing board. All of these meetings shall be
publicly noticed, open to the public, and the minutes of all the meetings shall be public records, available
to the public in accordance with Chapter 119, Fla. Stat.
(o) All expenditures of state financial assistance shall be in compliance with the laws,
rules and regulations applicable to expenditures of State funds, including but not limited to, the Reference
Guide for State Expenditures.
(p) The Agreement may be charged only with allowable costs resulting from obligations
incurred during the term of the Agreement.
(q) Any balances of unobligated cash that have been advanced or paid that are not
authorized to be retained for direct program costs in a subsequent period must be refunded to the State.
(20) LOBBYING PROHIBITION
(a) No funds or other resources received from the Division under this Agreement may be
used directly or indirectly to influence legislation or any other official action by the Florida Legislature or
any state agency.
(b) The Recipient certifies, by its signature to this Agreement, that to the best of his or
her knowledge and belief:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf
of the Recipient, 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 the awarding of any Federal contract, the making of any Federal grant, the
making of any Federal loan, the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment or modification of any Federal contract, grant, loan or cooperative
agreement.
2. If any funds other than Federal appropriated funds have been paid or will be
paid to any person for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with this Federal contract, grant, loan or cooperative agreement, the Recipient shall complete
and submit Standard Form -LLL, "Disclosure of Lobbying Activities."
3. The Recipient shall require that this certification be included in the award
documents for all subawards (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose.
This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a prerequisite for
making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who
fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not
more than $100,000 for each such failure.
(21) COPYRIGHT, PATENT AND TRADEMARK
ANY AND ALL PATENT RIGHTS ACCRUING UNDER OR IN CONNECTION WITH THE
PERFORMANCE OF THIS AGREEMENT ARE HEREBY RESERVED TO THE STATE OF FLORIDA.
ANY AND ALL COPYRIGHTS ACCRUING UNDER OR IN CONNECTION WITH THE PERFORMANCE
OF THIS AGREEMENT ARE HEREBY TRANSFERRED BY THE RECIPIENT TO THE STATE OF
FLORIDA.
(a) If the Recipient has a pre-existing patent or copyright, the Recipient shall retain all
rights and entitlements to that pre-existing patent or copyright unless the Agreement provides otherwise.
(b) If any discovery or invention is developed in the course of or as a result of work or
services performed under this Agreement, or in any way connected with it, the Recipient shall refer the
discovery or invention to the Division for a determination whether the State of Florida will seek patent
protection in its name. Any patent rights accruing under or in connection with the performance of this
Agreement are reserved to the State of Florida. If any books, manuals, films, or other copyrightable
12
material are produced, the Recipient shall notify the Division. Any copyrights accruing under or in
connection with the performance under this Agreement are transferred by the Recipient to the State of
Florida.
(c) Within thirty days of execution of this Agreement, the Recipient shall disclose all
intellectual properties relating to the performance of this Agreement which he or she knows or should
know could give rise to a patent or copyright. The Recipient shall retain all rights and entitlements to any
pre-existing intellectual property which is disclosed. Failure to disclose will indicate that no such property
exists. The Division shall then, under Paragraph (b), have the right to all patents and copyrights which
accrue during performance of the Agreement.
(22) LEGAL AUTHORIZATION
The Recipient certifies that it has the legal authority to receive the funds under this
Agreement and that its governing body has authorized the execution and acceptance of this Agreement.
The Recipient also certifies that the undersigned person has the authority to legally execute and bind
Recipient to the terms of this Agreement.
(23) ASSURANCES
The Recipient shall comply with any Statement of Assurances incorporated as
Attachment H.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement.
RECIPIENT:
Indian River County
By:
Name and title: Wesley S. Davis, Chairrdnco,vr;;,--
. zj` 6! s/0`
*'
Date: July 7, 2015
FID#j 59-6000674
STATE OF FLORIDA
DIVISION OF EMERGENCY MANGEMENT
1`--
w
APPROVED
unty Ad
inistratar
\Attest: Jeffrey R. Smith, Clerk of
Court and Comptroller
L
By: /S By:
Name and Title: Brya W. Koon, Director, Florida Division of Emergency Management
1 to is
Date:
13
Deputy Clerk
APPROVED AS TO FOR;`
AND " FFICIENC
BY
WILLIAM K. DEBRAAL
DEPUTY COUNTY ATTORNEY
EXHIBIT -1
STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST
OF THE FOLLOWING:
SUBJECT TO SECTION 215.97, FLORIDA STATUTES:
Division of Emergency Management, Florida Hazardous Materials Planning and Prevention Program,
Catalog of State Financial Assistance Number 31.067 in the amount of $ 3,944.00 .
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO
THIS AGREEMENT ARE AS FOLLOWS:
1. Emergency Planning and Community Right -to -Know Act (EPCRA), Title III of the Superfund
Amendments and Reauthorization Act of 1986, 42 U.S.C. s. 11001, et seq. (SARA).
2. Florida Emergency Planning and Community Right -to -Know Act, Chapter 252, Part II, Florida Statutes
14
Attachment A
DELIVERABLES AND
PERFORMANCE
Deliverable
#
Deliverables
Minimum Performance
Price
Financial
Consequences
1
Within 30 days of receipt of the
executed contract submit
electronically, 3 sample CAMEO
hazard analyses chosen from
facilities identified in Attachment C.
Must be in compliance with Section
C of the Scope of Work. DEM will
review the sample and provide
constructive feedback within 10
business days.
1. Each CAMEO facility file must
contain complete, correct and
accurate information required in
Section C of the Scope of Work.
No payment
2
Not later than November 2, 2015
provide complete CAMEO files in
compliance with Section C, Scope of
Work, on 50% of facilities identified
in Attachment C. Include a list of
facilities visited. DEM staff will
review the deliverables within 21
business days of receipt and
provide general feedback on any
errors. DEM staff WILL NOT make
corrections to the files. Recipient
will have 10 business days from
time of receipt to return corrected
files.
1. Each CAMEO facility file must
contain complete, correct and
accurate information required in
Section C of the Scope of Work.
2. A signed Site Visit Certification
Form and Site Plan in accordance with
SOW Section D for each facility. For
sulfuric acid (batteries) facilities, the
site visit form must contain the date
facility was called and the person that
responded to the EPCRA inquiries.
45 % of Contract
Amount
Payment will be reduced
by $110.00 per Facility
with incorrect or
incomplete CAMEO files
after initial review.
3
Not later than March 1, 2016
provide complete CAMEO files in
compliance with Section C, Scope of
Work, on 50% of facilities identified
in Attachment C. Include a list of
facilities visited. DEM staff will
review the deliverables within 21
business days of receipt and
provide general feedback on anySOW
errors. DEM staff WILL NOT make
corrections to the files. Recipient
will have 10 business days from
time of receipt to return corrected
files.
1. Each CAMEO facility file must
contain complete, correct and
accurate information required in
Section C of the Scope of Work.
2. A signed Site Visit Certification
Form and Site Plan in accordance with
Section D for each facility. For
sulfuric acid (batteries) facilities, the
site visit form must contain the date
facility was called and the person that
responded to the EPCRA inquiries.
45 % of Contract
Amount
Payment will be reduced
by $110.00 per Facility
with incorrect or
incomplete CAMEO files
4
1. Not later than May 16, 2016
provide completed Hazards Analysis
(CAMEO File) to the Local
Emergency Planning Committee
and provide DEM with transmittal.
Notify first responders and
Attachment C facilities of the
availability of the file. Provide DEM
with transmittal.
1. Provide a complete correct copy of
the approved hazards analysis file
(Completed CAMEO file in compliance
with Section C, Scope of Work) to the
Local Emergency Planning Committee
(LEPC) and provide the Division with a
copy of the transmittal letter.
2. Notify all Attachment C facilities
and first responders of the availability
of the hazards analysis information,
and make that information available
upon request. Submit a copy of the
notification to thg Division.
10% of the
contract amount
Payment will not be
made without required
transmittal and
notification letters/E-
mails.
Attachment A
SCOPE OF WORK
Purpose
On October 17, 1986, Congress enacted the Emergency Planning and Community Right to Know Act
(EPCRA), also known as Title III of the Superfund Amendments and Reauthorization Act (SARA). EPCRA
requires hazardous chemical emergency planning by Federal, State and local governments, Indian
Tribes, and industry. Additionally, EPCRA required industry to report on the storage, use and releases of
certain hazardous materials.
At the Federal level, the U.S. Department of Environmental Protection Agency (EPA) administers EPCRA.
At the state level, the Florida Division of Emergency Management (DEM) serves as the lead agency
responsible for oversight and coordination of the local planning efforts required by EPCRA. Chaired by
the Director of DEM, the State Emergency Response Commission on Hazardous Materials (SERC)
serves as a technical advisor and information clearinghouse for state and federal hazardous materials
programs. Additionally, the SERC conducts quarterly public meetings in varying locations throughout the
state. Currently, SERC membership consists of 28 Governor -appointed individuals who represent the
interests of state and local government, emergency services, industry and the environment.
At the district level, Regional Planning Councils (RPCs) each oversee a Local Planning Committee
(LEPC) that: (1) performs outreach functions to increase hazardous materials awareness; (2) collects
data on hazardous materials stored within the geographical boundaries of the RPC; (3) develops
hazardous materials emergency plans for use in responding to and recovering from a release or spill of
hazardous or toxic substances; (4) submits hazardous materials emergency plans to the SERC for
review; (5) provides the public with hazardous materials information upon request. LEPC membership
consists of local professionals representing occupational categories such as firefighting, law enforcement,
emergency management, health, environment, and/or transportation.
At the local level, each of Florida's 67 counties performs a hazards analysis (county may elect to contract
to the RPC or qualified vendor). The county hazards analysis is used as input to the LEPC Emergency
Response Plan for Hazardous Substances required under EPCRA and encompasses; identification of
facilities and transportation routes of extremely hazards substances (EHS); description of emergency
response procedures; designation of a community coordinator and facility emergency coordinator(s) to
implement the plan; outline of emergency notification procedures; description of how to determine the
probable affected area and population by releases; description of local emergency equipment and
facilities and the persons responsible for them; outline of evacuation plans; a training program for
emergency responders; and, methods and schedules for exercising emergency response plans. This
Agreement provides funding so that the Recipient, can assist in maintaining the capability necessary to
perform the duties and responsibilities required by EPCRA. The recipient shall update the hazards
analysis for all facilities listed in Attachment C, which have reported to the State Emergency Response
Commission the presence of those specific Extremely Hazardous Substances designated by the U.S.
Environmental Protection Agency in quantities above the Threshold Planning Quantity. The data collected
under this Agreement will be used to comply with the planning requirements of the Superfund
Amendments and Reauthorization Act of 1986, Title III, "Emergency Planning and Community Right -To -
Know Act of 1986" and the Florida Emergency Planning and Community Right -To -Know Act, Florida
Statutes, Chapter 252, Part 11.
Requirements
A. The Recipient shall submit a list of facilities within the geographical boundaries of the County
listed on Attachment C that are suspected of not reporting to the State Emergency Response
Commission the presence of Extremely Hazardous Substances in quantities above the Threshold
Planning Quantity, as designated by the U. S. Environmental Protection Agency.
16
B. The completed hazards analysis shall comply with the site-specific hazards analysis criteria
outlined below for each facility listed in Attachment C. The primary guidance documents are
Attachment I (Hazards Analysis Contract Checklist and CAMEOfm Guide) to this Agreement and
the U.S. Environmental Protection Agency's "Technical Guidance for Hazards Analysis" at;
http:l/www.epa.gov/emergencies/docs/chem/tech.pdf. All hazards analyses shall be
consistent with the provisions of these documents. Any variation from the procedures outlined in
these documents must be requested in writing, submitted in advance and approved by the
Division.
C. Conduct an on-site visit at each Attachment C facility to ensure accuracy of the hazards analysis.
Each applicable facility's hazards analysis information shall be entered into the U.S.
Environmental Protection Agency's latest CAMEOfm version 3.0.1 (download from):
http://www.epa.gov/emergencies/content/cameo/index.htm. Each facility hazards analysis
shall include, but is not limited to, the following items:
1. Facility Information (CAMEOfm Facility Page)
(a) Enter the facility name (per Attachment C) in the Facility Name field.
(b) Enter the facility physical address (no Post Office Box) in the Street Address fields of
the Address tab.
(c) Enter the geographic coordinates (in decimal degrees) in the latitude/longitude fields
of the Map Data tab.
(d) Enter the maximum number of employees present at the facility at any given time in
the Number of Employees on Site field of the ID Codes tab. (a minimum of one is
required for unmanned facilities)
(e) Enter the Facility phone number in the Facility Phones tab field.
(f) Enter the name, title and 24-hour phone number of the designated facility emergency
coordinator in the Contacts tab field.
(g)
Enter the main route(s) used to transport chemicals to the facility (from the County
line to the facility) in the notes tab of the Facility Page.
(h) Enter the route(s) used to exit the Vulnerable Zone(s) in the notes tab of the Facility
Page.
(i)
Enter any past releases that have occurred in the last five years at the facility in the
notes tab of the Facility Page. Include date, time, chemical name/quantity and
number of persons injured or deaths (this information is available from the facility). If
it is determined that a facility does not have a historical accident record, that shall be
noted.
2. Hazard Identification (CAMEOfm Chemical in Inventory Page)
(a) For each Extremely Hazardous Substance present over the Threshold Planning
Quantity (TPQ), create a Chemical in Inventory page (if a Chemical in Inventory page
hasn't been created already) and enter the proper chemical name and Chemical
Abstract Service (CAS) number.
(b) On each Chemical in Inventory page created for each Extremely Hazardous
Substance present over the TPQ, enter in pounds (not range codes) the maximum
quantity of each Extremely Hazardous Substance in the Max Daily Amount field of
the Physical State and Quantity tab.
17
(c) Enter the amount (in pounds) of each Extremely Hazardous Substance stored in the
largest container or interconnected containers in the Max amount in largest container
field of the Physical State and Quantity tab (this is the release amount used to
determine the Vulnerable Zone).
(d) Choose the appropriate code from the drop down list for the Type of storage
container (drum, cylinder, tank etc.), storage pressure (ambient, greater than ambient
etc.) and storage temperature (ambient, greater than ambient etc.) of each Extremely
Hazardous Substance in those fields on the Location tab.
(e) For each Extremely Hazardous Substance over TPQ, On the Physical State &
Quantity tab check the appropriate boxes in the Physical State, Hazards and Health
Effects fields (information on the above may be found by clicking on the Datasheet
button which opens the CAMEOfm Chemicals database.)
3. Vulnerability Analysis (CAMEOfm Scenario Page)
(a) For each Extremely Hazardous Substance present over the Threshold Planning
Quantity (TPQ), create a New Scenario page (if a Scenario page hasn't been created
already) and enter the maximum amount in the largest container or interconnected
containers in the Amount Released field of the Scenario Description tab.
(b) On the Scenario page(s) Scenario Description tab, enter the concentration
percentage in the Concentration field.
(c) On the Scenario page(s) Scenario Description tab, enter the release duration in the
Release Duration field as follows:
(1) Gases —10 minutes
(2) Powders or solids in solution —10 minutes
(3) Liquids — No value shall be entered
(d) Enter the proper natural physical state of the chemical at room temperature in the
physical state field. (as specified in CAMEOfm Chemicals)
(e) On the Scenario page(s) Scenario Description tab, use the weather default settings
or, enter average wind speed (don't enter a value in the Wind From field) and
Urban or Forest is recommended in the Ground Roughness field.
(f) On the Scenario page(s) Scenario Description tab, rate the Risk, Consequences and
Overall Risk of a release occurring at the facility on the bottom of the Scenario Page
(the Risk Assessment should be based upon the Extremely Hazardous Substance,
previous release history, maintenance conditions etc.).
(g) After entering the information noted above on the Scenario Description tab and
clicking on the Estimate Threat Zone Radius button, CAMEOfm will automatically
estimate the extent of the vulnerable zone that may cause injury or death to human
populations following an accidental release.
(h) On the Scenario page(s) notes tab, enter an estimate of the total exposed population
within the vulnerable zone(s).
(i) On the Scenario page(s) notes tab, identify each critical facility by name and
maximum expected occupancy within the vulnerable zone(s) (schools, day cares,
public safety facilities, hospitals, etc.). If there are no critical facilities within the
vulnerable zone(s), that shall be noted.
18
D. Supporting documentation in the form of Site Visit Certification Form, Statement of Determination
or dated letter from the facility identifying the reason the EHS is no longer present shall be
submitted to the Division which lists the facilities for which a hazards analysis was not completed.
E. On -Site Visits
1. Conduct a detailed on-site visit, within the period of this Agreement, of all the facilities
listed in Attachment C, to confirm the accuracy and completeness of information in the
hazards analysis.
2. Submit a completed Hazards Analysis Site Visit Certification Form (Attachment J) for
each facility to the Division (file name must contain at minimum the SERC number if
applicable and SV — if SERC number is not available facility name and SV — additional
info allowed but not required). Add the site visit certification form to the Site Plan
Tab of the CAMEOfm Facilities Page for each facility visited or contacted.
(a) On -Site visit exception for sulfuric acid (batteries), this exception does NOT
apply to bulk storage of sulfuric acid.
(1) For facilities listed on Attachment C that report the presence of only sulfuric
acid in batteries, an initial on-site visit is required and an on-site visit form
(Attachment J) signed and dated by the facility representative and the
Recipient shall be submitted to the Division.
(2) In Agreements subsequent to the initial on-site visit, the Recipient shall
contact the facility representative by email or telephone to verify the
presence of all extremely hazardous substances. The on-site visit form shall
be signed by the Recipient and identify the date and facility contact
information. Another on-site visit is not required in subsequent Agreements,
unless, the facility reports the presence of another extremely hazardous
substance above TPQ.
(3)
If a facility representative reports the presence of an extremely hazardous
substance other than sulfuric acid in batteries, subsequent to the period of
Agreement in which the initial site visit was conducted, the Recipient shall
conduct an on-site visit and submit a completed on-site visit form
(Attachment J) to the Division.
3. For each facility for which a hazard analysis is conducted, a site plan must be
added to the site plan tab of the CAMEOfm Facilities Page. (file name must contain at
minimum the SERC number if applicable and SP — if SERC number is not available
facility name and SP — additional info allowed but not required) The site plan shall contain
sufficient information to provide situational awareness and at a minimum include:
(a) Location of major building(s)
(b) Name and location of extremely hazardous substance(s). If multiple extremely
hazardous substances are co -located, noting EHS is acceptable.
(c) Name and location of street(s)
(d) Identify pertinent access and egress point(s)
(e) Note any additional features pertinent to hazmat and medical response
F. Ensure that the Hazards Analysis information is reflected in the County Local Mitigation Strategy.
19
Attachment B
Program Statutes and Regulations
1. Emergency Planning and Community Right to Know Act (EPCRA), Title III of the Superfund
Amendments Reauthorization Act of 1986, 42 U.S.C. s. 1101, et seq. (SARA).
2. Florida Emergency Planning and Community Right to Know Act, Chapter 252, Part II, Florida
Statutes.
20
ATTACHMENT C - INDIAN RIVER COUNTY SECTION 302 FACILITY LIST
2015-2016
SERC #
Facility Name / Address
County
EHS Chemical
Contact Number
30425
AT & T-FLO900
1825 Old Dixie Hwy
Vero Beach, 32960
Indian River
Sulfuric Acid
Donald Carroll
800-566-9347
16451
AT & T-FLE620
402 Southeast Becker
Port St Lucie, 32963
Indian River
Sulfuric Acid
Donald Carroll
800-566-9347
5233
Bellsouth-E8612
766 Beachland Boulevard
Beachland, 32960
Indian River
Sulfuric Acid
Donald Carroll
800-566-9347
5234
Bellsouth-E8636
197616 Avenue
Vero Beach, 32960
Indian River
Sulfuric Acid
Donald Carroll
800-566-9347
29563
Bellsouth-E8640
1137 US Highway 1
Sebatian, 32958
Indian River
Sulfuric Acid
Donald Carroll
800-566-9347
36806
Orchid Island Golf & Beach Club
One Indies Drive
Orchid, 32963
Indian River
Sulfuric Acid
Mike Rose
772-388-0330
1320
Piper Aircraft
2926 Piper Drive
Vero Beach, 32960
Indian River
Sulfuric Acid
Ted Dyer
772-299-2476
30651
Sam's Club -6520
5565 20 Street
Vero Beach, 32966
Indian River
Sulfuric Acid
Julie Angle
772-978-9385
1386
Sun Ag-Fellsmere Farms Division
7735 County Road 512
Fellsmere, 32948
Indian River
Chlorine
Michael Monroe
772-571-1933
1095
Syngenta Crop Protection
7145 58 Avenue
Vero Beach, 32967
Indian River
Paraquat Dichloride
Matt Thornton
772.336-3458
21
4/7/15
ATTACHMENT C - INDIAN RIVER COUNTY SECTION 302 FACILITY LIST
2015-2016
33962
The Home Depot Store -8545
13361 US Highway 1
Sebatian, 32958
Indian River
Sulfuric Acid
Jennifer Caton
772-589-1383
24057
Verizon-MCI-VOBEFL
South 1-95, Vero Beach State Road 60 exit
Vero Beach, 32960
Indian River
Sulfuric Acid
Jason Weller
800-386-9639
29521
Verizon-MCI-VROBFL
142019 Place
Vero Beach, 32962
Indian River
Sulfuric Acid
Jason Weller
800-386-9639
6540
Vero Chemical Distributors
755 20 Place
Vero Beach, 32960
Indian River
Chlorine
Mark Thurn
772-562-4463
10539
White Face Acres
12600 State Road 60
Vero Beach, 32966
Indian River
Paraquat Dichloride
Alexander Kromhout
772-473-2758
22
4/7/15
Attachment D
FINANCIAL INVOICE FORM
FOR
HAZARDOUS MATERIALS HAZARDS ANALYSIS UPDATE
RECIPIENT: Indian River County AGREEMENT#16-CP-11-10-40-01-174
AMOUNT AMOUNT APPROVED
REQUESTED BY THE
BY THE RECIPIENT DIVISION
1. First Payment (45% of contract amount) $ $
(50% Hazards Analyses submitted and approved)
2. Second Payment (45% of contract amount) $ $
(50% Hazards Analyses submitted and approved)
3. Final Payment(10% of contract amount) $ $
(approval, distribution & notification)
TOTAL AMOUNT $ $
(To be completed by
the Division)
I certify that to the best of my knowledge and belief the billed costs are in accordance with the
terms of the Agreement.
Signature of Authorized Official/Title
Date
TOTAL AMOUNT TO BE PAID AS OF
THIS INVOICE $
(To be completed by the Division)
23
Attachment E
JUSTIFICATION OF ADVANCE PAYMENT
RECIPIENT:
If you are requesting an advance, indicate same by checking the box below.
[ ] ADVANCE REQUESTED
Advance payment of $ is requested. Balance of
payments will be made on a reimbursement basis. These funds are
needed to pay staff, award benefits to clients, duplicate forms and
purchase start-up supplies and equipment. We would not be able to
operate the program without this advance.
If you are requesting an advance, complete the following chart and line item justification below.
ESTIMATED EXPENSES
BUDGET CATEGORY/LINE ITEMS
(list applicable line items)
20-20
Anticipated Expenditures for First Three Months of
Contract
For example
ADMINISTRATIVE COSTS
(Include Secondary Administration.)
For example
PROGRAM EXPENSES
TOTAL EXPENSES
LINE ITEM JUSTIFICATION (For each line item, provide a detailed justification explaining the need for
the cash advance. The justification must include supporting documentation that clearly shows the advance
will be expended within the first ninety (90) days of the contract term. Support documentation should
include quotes for purchases, delivery timelines, salary and expense projections, etc. to provide the Division
reasonable and necessary support that the advance will be expended within the first ninety (90) days of the
contract term. Any advance funds not expended within the first ninety (90) days of the contract term shall be
returned to the Division Cashier, 2555 Shumard Oak Boulevard, Tallahassee, Florida 32399, within thirty
(30) days of receipt, along with any interest earned on the advance)
24
Attachment F
Warranties and Representations
Financial Management
Recipient's financial management system must include the following:
(1) Accurate, current and complete disclosure of the financial results of this project or program
(2) Records that identify the source and use of funds for all activities. These records shall
contain information pertaining to grant awards, authorizations, obligations, unobligated
balances, assets, outlays, income and interest.
(3) Effective control over and accountability for all funds, property and other assets. Recipient
shall safeguard all assets and assure that they are used solely for authorized purposes.
(4) Comparison of expenditures with budget amounts for each Request For Payment. Whenever
appropriate, financial information should be related to performance and unit cost data.
(5) Written procedures to determine whether costs are allowed and reasonable under the
provisions of the applicable OMB cost principles and the terms and conditions of this
Agreement.
(6) Cost accounting records that are supported by backup documentation.
Competition
All procurement transactions shall be done in a manner to provide open and free competition. The
Recipient shall be alert to conflicts of interest as well as noncompetitive practices among contractors that
may restrict or eliminate competition or otherwise restrain trade. In order to ensure excellent contractor
performance and eliminate unfair competitive advantage, contractors that develop or draft specifications,
requirements, statements of work, invitations for bids and/or requests for proposals shall be excluded
from competing for such procurements. Awards shall be made to the bidder or offeror or whose bid or
offer is responsive to the solicitation and is most
25
advantageous to the Recipient, considering the price, quality and other factors. Solicitations shall clearly
set forth all requirements that the bidder or offeror must fulfill in order for the bid or offer to be evaluated
by the Recipient. Any and all bids or offers may be rejected when it is in the Recipient's interest to do so.
Codes of Conduct
The Recipient shall maintain written standards of conduct governing the performance of its employees
engaged in the award and administration of contracts. No employee, officer, or agent shall participate in
the selection, award, or administration of a contract supported by public grant funds if a real or apparent
conflict of interest would be involved. Such a conflict would arise when the employee, officer, or agent,
any member of his or her immediate family, his or her partner, or an organization which employs or is
about to employ any of the parties indicated, has a financial or other interest in the firm selected for an
award. The officers, employees, and agents of the Recipient shall neither solicit nor accept gratuities,
favors, or anything of monetary value from contractors or parties to subcontracts. The standards of
conduct shall provide for disciplinary actions to be applied for violations of the standards by officers,
employees, or agents of the Recipient.
Business Hours
The Recipient shall have its offices open for business, with the entrance door open to the public, and at
least one employee on site, from Monday to Friday 8:00 AM - 5:00 PM.
Licensing and Permitting
All subcontractors or employees hired by the Recipient shall have all current licenses and permits
required for all of the particular work for which they are hired by the Recipient.
26
Attachment G
Certification Regarding
Debarment, Suspension, Ineligibility
And Voluntary Exclusion
Subcontractor Covered Transactions
(1) The prospective subcontractor of the Recipient, , certifies, by
submission of this document, 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 Recipient's subcontractor is unable to certify to the above statement, the prospective
subcontractor shall attach an explanation to this form.
SUBCONTRACTOR:
By:
Signature Recipient's Name
Name and Title DCA Contract Number
Street Address
City, State, Zip
Date
27
Attachment H
Statement of Assurances
The Recipient hereby assures and certifies compliance with all Federal statutes, regulations, policies,
guidelines and requirements, including OMB Circulars No. A-21, A-110, A-122, A-128, A-87; E.O. 12372
and Uniform Administrative Requirements for Grants and Cooperative Agreements 28 CFR, Part 66,
Common rule, that govern the application, acceptance and use of Federal funds for this federally -assisted
project. Also the Applicant assures and certifies that:
1. It will comply with provisions of Federal law which limit certain political activities of employees of a
State or local unit of government whose principal employment is in connection with an activity financed in
whole or in part by Federal grants. (5 USC 1501,et. seq.)
2. It will comply with the minimum wage and maximum hour's provisions of the Federal Fair Labor
Standards Act.
3. It will establish safeguards to prohibit employees from using their positions for a purpose that is or
gives the appearance of being motivated by a desire for private gain for themselves or others, particularly
those with whom they have family, business, or other ties.
4. It will give the sponsoring agency or the Comptroller General, through any authorized representative,
access to and the right to examine all records, books, papers, or documents related to the grant.
5. It will ensure that the facilities under its ownership, lease or supervision which shall be utilized in the
accomplishment of the project are not listed on the Environmental Protection Agency's (EPA) list of
Violating Facilities and that it will notify the Federal grantor agency of the receipt of any communication
from the Director of the EPA Office of Federal Activities indicating that a facility to be used in the project is
under consideration for listing by the EPA.
6. In the event a Federal or State court or Federal or State administrative agency makes a finding of
discrimination after a due process hearing on the Grounds of race, color, religion, national origin, sex, or
disability against a recipient of funds, the recipient will forward a copy of the finding to the Office for Civil
Rights, Office of Justice Programs.
7. It will provide an Equal Employment Opportunity Program if required to maintain one, where the
application is for $500,000 or more.
8. DRUG-FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS) As required by the Drug -Free
Workplace Act of 1988, and implemented at 28 CFR Part 67, Subpart F, for grantees, as defined at 28
CFR Part 67 Sections 67.615 and 67.620.
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Attachment I
Hazard Analysis Contract Checklist and CAMEOfm Guide
Facility Information (CAMEOfm Facility Page)
Facility Name {per Attachment C} ( Facility Page)
Facility Physical Address (Facility Page)
Latitude and Longitude in Decimal Degrees {ex. 30.197, -84.3621} (Map Data Tab on Facility Page)
Facility Phone Number (Facility Phones Tab on Facility Page)
Facility Emergency Coordinator Name, Title and 24-hour Emergency Phone Number (Contact Tab on Facility Page)
Transportation Route(s) {From County Line to the Facility} (Notes Tab on Facility Page)
Evacuation Route(s) to exit the Vulnerable Zone (Notes Tab on Facility Page)
Historical Accident Record {If none, please note} (Notes Tab on Facility Page)
Facility Maximum Occupancy {a minimum of one is required for unmanned facilities} (ID Codes Tab on facility Page)
Hazard Identification (CAMEOfm Chemical in Inventory Page) (for each Extremely Hazardous Substance on site)
Proper Chemical Name(s) (Chemical in Inventory Page{s})
Chemical Abstract Service (CAS) Number (Chemical in Inventory Page{s})
Physical State in Storage {ex. mixture, pure, liquid, gas} (Chemical in Inventory Page{s}, Physical State and Quantity Tab)
Maximum Quantity On-site in Pounds (Chemical in Inventory Page{s}, Physical State and Quantity Tab)
Amount in Largest Container or Interconnected Containers (Chemical in Inventory Page{s}, Physical State and Quantity Tab)
Type/Design, Pressure and Temperature of Container(s) {cylinder, battery, ambient etc.} (Chemical in Inventory Page{s}, Location Tab)
Nature of the Hazard {ex. acute, chronic, fire, pressure, etc.} Chemical in Inventory Page{s}, Physical State and Quantity Tab)
Vulnerability Analysis (CAMEOfm Scenario Page) (for each Extremely Hazardous Substance on site)
Enter maximum amount in largest container or interconnected containers in the Amount Released field (Scenario Description tab)
Enter the concentration percentage in the Concentration field (Scenario Description tab)
Enter Release Duration (10 minutes for gases, solids in solution or powders; no entry for liquids is required) (Scenario Description tab)
Determine the natural Physical State (specified in CAMEO Chemicals) and enter into the Physical State field (Scenario Description tab)
Weather Information - Use the weather default settings or enter average wind speed (don't enter a value in the Wind From field) and
Urban or Forest is recommended in the Ground Roughness field. (Scenario Description tab)
Risk Assessment - Rate the Risk, Consequences and Overall Risk of a release occurring {based upon release history & maintenance etc.}
(Scenario Description tab)
Extent of Vulnerable Zone {CAMEO automatically calculates Threat Zone Radius when Edit button and Estimate Threat Zone Radius
buttons are used} (Scenario Description tab)
Enter estimate of Total Exposed Population (Notes Tab on Scenario Page{s})
Enter Critical Facilities {name of critical facility(s) and max occupancy for each; if none, state No Critical Facilities} (Notes Tab on Scenario Page{s})
On -Site Visits (for each Facility and within the Contract Period)
Site Visit Certification Form (Attached to Site Plan Tab on Facility Page) (file name must contain at minimum the SERC number if
applicable and SV — if SERC number is not available facility name and SV. If it's a telephone call for the sulfuric acid exception the name
of the facility rep spoken to and date of call must be noted on the form. Additional info allowed but not required.)
Site Plan (Attached to Site Plan Tab on Facility Page) {file name must contain at minimum the SERC number if applicable and SP — if
SERC number is not available the facility name and SP — additional info allowed but not required.}
Sufficient Detail to Identify:
Location of Major Building(s)
Name and Location of Extremely Hazardous Substance(s) (if extremely hazardous materials are co -located, noting EHS is acceptable)
Name and Location of Street(s)
Identify Pertinent Access and Egress Points
Note Additional Features Pertinent to Hazardous Materials and Medical Response
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Attachment J
FLORIDA STATE EMERGENCY RESPONSE COMMISSION FOR HAZARDOUS
MATERIALS
HAZARDS ANALYSIS SITE VISIT CERTIFICATION FORM
Facility Name (Please print)
Street Address, City & Zip Code (Please print)
County (Please print)
Name of Facility Representative (Please print)
Facility Representative Signature Site Visit Date
Site Visit Performed by (Please print)
Signature Site Visit Date
The individuals signing above certify that a hazards analysis site visit was conducted on the
above date.
Notes:
❑ Check if facility representative was informed about using E-Plan(https://erplan.net/eplan/login.htm) for EPCRA
on-line filing
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Attachment K
STATEMENT OF DETERMINATION
Facility Name
Physical Address (Street only)
City
County
LEPC District
I have determined that this facility is / is not subject to the following section(s) of EPCRA, Title III, for the
reporting year(s) indicated (circle all applicable):
SECTION
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
302/303
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
311/312
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
313
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
"No" was indicated on any of the above, please check appropriate box(s) why:
Sections
302/303
Extremely Hazardous Substances (EHSs) are / were present only in amounts less than established Threshold
Planning Quantities (TPQs).
Name of owner / operator's authorized representative (printed):
No EHSs are Present.
Official Title (printed):
No EHSs were present on-site during the year.
Sections
311/ 312
Hazardous chemicals/EHSs are/were present only in amounts below established reporting thresholds.
No hazardous chemicals/EHSs are/were present.
No hazardous chemicals were present on-site during the year.
Section
313
Not within covered SIC Codes.
Within covered SIC Codes, but Tess than ten (10) employees.
Within covered SIC Codes, but no Section 313 chemicals were present or were below Section 313 reporting
thresholds.
Other
Closed facility
YES / NO
Chemicals removed
YES / NO
Chemicals reduced below
threshold/TPQ YES / NO
Date Effective:
New Facility. Date chemicals brought on site meeting / exceeding TPQ:
Further explanation if necessary:
31
CERTIFICATION:
I understand the requirements of the law(s) circled above. I also understand that ultimate
compliance responsibility lies with me and failure to comply, if required, can result in civil and
criminal penalties under federal and state laws.
Name of owner / operator's authorized representative (printed):
Official Title (printed):
Signature:
Date signed:
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ATTACHMENT L
HAZARD ANALYSIS REVIEW CRITERIA
Facility Page
1. Facility Name
2. Facility Address
3. Facility Phone#
4. Name and phone number for 24-hour contact
5. Evacuation route(s)
6. Legible/Detailed Site Plan (SERC#SP) with location of EHS(s)
7. Site Visit Certification Form (SERC#SV)
8. Latitude & Longitude in Decimal/Degrees
9. Maximum No. of Occupants (minimum of one for unmanned facility)
Chemical In Inventory
1. Proper Chemical Name and Chemical Abstract Number
2. Max Daily Amount
3. Max Amount in Largest Container
Scenario Page
1. Amount Released (Must be the same as Max Amount in Largest Container)
2. Release Duration for Gases and Solids in Solution must be 10 Minutes
3. Natural Physical State
4. Risk Assessment
5. Estimate Threat Zone Radius
6. Name of Critical Facilities if None Indicate So
7. Estimate Total Exposed Population
8. SOD or Supporting Documentation
32