CM-12-02-029LVED
RECE
FEB 0 9 2012
ROUND ROCK, City Manager Approval Form
PURPOSE R1 SION. PROWERMt
Consider authorizing submission of grant application by the City Manager to the Texas Forest Service for
funding for purchase of brush truck.
Item Caption:
Approval Date: 2/10/2012
Department Name: Fire Department
Project Manager: Charles Meserole
Assigned Attorney: J. Kay Gayle
Item Summary:
Consideration and approval of a Resolution authorizing the City Manager to submit a Texas Intrastate Fire Mutual Aid System
(TIFMAS) Grant application to the Texas Forest Service, approving the Supplemental Terms and Conditions Agreement with the
Texas Intrastate Fire Mutual Aid System (TIFMAS) Grant Assistance Program and authorizing the City Manager to execute the
Supplemental Terms and Conditions Agreement with the Texas Forest Service upon notice of award of the TIFMAS Grant.
The City proposes to apply for a TIFMAS Apparatus Grant to purchase a Type III Apparatus (Brush Truck) for use during local and
regional mutual aid incidents, local and regional multiple alarm incidents, local community events, training of firefighters and the
temporary standby for regular apparatus while out of service for repairs.
If the City is awarded a TIFMAS Apparatus Grant, the purchase of the Brush Truck would be fully funded through the TIFMAS
Grant Assistance Program. The estimated value of the Brush Truck is $231,600.
The City will incur an estimated $48,836 in general operating expenses to outfit the Brush Truck. These expenses are not
currently budgeted. The expenses are expected to occur in Fiscal Year 2013. Operations and Maintenance costs for the Brush
Thiele aro octimatori at cQnn nor uaar haainnina in Ficral Vaar 7n1A
No. of Originals Submitted: 2
Project Name: Grant Application for funding for brush truck
Cost: $48,836.00
Source of Funds: General Fund
Source of Funds (if applicable): Select Source Fund
Account Number: N/A, Funding will be identify if the City of Round Rock is awarded the Grant.
Finance Director Approval: Chery Delane Date: 2/7/12
Department Director Approval: Date: 2' S 1 kZ
**Electronic signature by t or is acceptable. Please only subm E approval form per item. **
CIP 111 LI Budget
N/A OK
El El
N/A OK
Purchasing
111
N/A OK
Accounting
El El
N/A OK
ITEMS WILL NOT BE PLACED ON THE COUNCIL OR CM AGENDA W/OUT PRIOR FINANCE AND/OR LEGAL APPROVAL
REV. 6/20/11
Pape 1of5
GRANT APPLICATION/PROPOSAL REVIEW FORM
2012
Grants Coordinator
Laurie Bom
671-2876
Submit completed form for all City Manager and City Council approvals.
Required to: a) submit a grant appNcalion b) accept a grant c) renew a grant d) change the budgeted amount of a grant
Department Name:
Dept. Contact Person:
Dept. Director's Signature:
Departmental Goal #:
Strategic Plan - Priority Goal #:
Fire
Top Priority: Provide a safe environment....th
contk►ued ...fire safety...
Requested City Council or City Manager Approval Date:
For Finance Use ONLY
Deadline for GAPR Review:
21612012
Tag #:
Origami Documents Received: 1 12/1212011
Grant Title & CFDA #: TIFMAS Apparatus Request
Funding Agency/Department: Texas Forest Service (TAMU)
Texas Intrastate Fire Mutual MI System Grant Assistance
Program Name:
Program
Grant Term Dates: 09101/12 Through life of vehicle
Est. Award Amount $100,000
The CORR is a: Recipient f1Sub.Recipient
02/23/12
Grant Application Deadline:
Rolling
Brief project description
A resolution authorizing submission of a grant application to the Texas Forest Service, providing 100 percent of
the cost of a standardized National Wildfire Coordination Group (NWCG) Type 111 wildland fire engine (Brush
Truck). Apparatus to be used during local and regional mutual aid Incidents, local and regional multiple alarm
Incidents, local community events, training of firefighters and the temporary standby for regular apparatus while
out of service for repairs.
Finance Information
Is this a new program?
Yes
Fiscal Year
FY11.12
FY12.13
FY13.14
Total
Grant Amount
$ 231,600
$ -
$ -
$ 231,600
Required Match*
$ -
$ -
$ -
$ -
StaffTante
$ -
$ -
$ -
$ -
Operatlonal Expenses
$ 48,836
$ 1,000
$ 1,000
$ 50,836
TOTAL Costs
$ 280,436
$ 1,000
$ 1,000
$ 282,436
Senn of Required Machin 8:
No gm
N/A
If yes, complete a New Program
Worksheet (see Tab 2)
Proposed Grant -Funded
FTEs: 161 NIA
L7
TITLE
COST/YEAR
TOTAL:
GRANT -FUNDED MULTI-YEAR TOTAL:
RECURRING COSTS:.st. $1 IC/year
Advanced Funds
DJ Reimbursable Funds
i!1
Performance Measures: (1st three)
1 Maintain, operate and repair the vehicle in order to ensure a high state of readiness at a1 times
2 Train and qualify personnel to be mobilized with the apparatus
3 Carry Debility insurance
Yes, this is an "in-kind* service agreement.
If yes, have the departments providing services been contacted?
This is an ILA or MOU with: (names of collaborators)
This is a: (choose application type)
Comptditive Funding
CITY MANAGER/CITY COUNCIL
N/A APPROVED
❑ \ 1 CITY MANAGER:
ED
CI Y COUNCIL:
AltiaMcGraw
DATE:
n*TF•
REVISED 21112012
CM''(v '2 "�Z°�
• •
TEXAS
FOREST SERVICE
The Texas A&M University System
CASE#
SUPPLEMENTAL TERMS AND CONDITIONS AGREEMENT
TEXAS INTRASTATE FIRE MUTUAL AID SYSTEM
(TIFMAS) GRANT ASSISTANCE PROGRAM
Mobilization of local resources to respond to statewide emergencies is of great concern.
The 81st Texas State Legislature passed Senate Bill 1011 in 2009. The law amended
portions of the statute goveming the Texas Commission on Fire Protection ("TCFP").
One of the amendments changed the TCFP Fire Department Emergency Program
(FDEP). By statute, the Fire Department Emergency Program was abolished effective
January 1, 2010 and all funds and loan obligations of the former FDEP were transferred
to the Texas Forest Service ("TFS"), a member of The Texas A&M University System
and an agency of the State of Texas, herein referred to as "Service." The Service will
use a portion of these funds to administer a pilot project to acquire fire and rescue
apparatus to support the Texas Intrastate Fire Mutual Aid System ("TIFMAS").
Through the TIFMAS Grant Assistance Program (the "TIFMAS Grant Program"), the
Service considers applications for participation in the TIFMAS Grant Program and will
provide certain response apparatus ("TIFMAS Vehicle(s)") to cooperators in the
TIFMAS Grant Program.
In consideration for the provision of TIFMAS Vehicle(s), of
County, Texas, ("Cooperator"), agrees to the terms and conditions set
forth herein.
This document describes the Service's statutorily required administration and the terms
and responsibilities of Cooperator related to TIFMAS Vehicle grants under the TIFMAS
Grant Pr ram
grant
award, the following shall apply:
Service Authority and Responsibilities:
1. Service will provide a standardized TIFMAS Vehicle titled in the name of
Cooperator under the following guidelines:
b.
c
2. Service will perform an inspection after the TIFMAS Vehicle has been purchased
and delivered and will document the vehicle on a TIFMAS Vehicle Equipment
List, signed by both parties.
i
TIFMAS GRANT ASSISTANCE PROGRAM
TIFMAS VEHICLE GRANTS
Page 2 of 4
3. Service will perform occasional inspections of the TIFMAS Vehicle to insure the
Cooperator is fulfilling its obligations in accordance with this agreement.
Cooperator Responsibilities:
1. Cooperator will take possession of TIFMAS Vehicle at a time and location
mutually decided on by Service and Cooperator.
2. Cooperator will facilitate an initial inspection of the TIFMAS Vehicle by the
Service and sign the TIFMAS Equipment Vehicle List provided by Service.
3. Cooperator may add additional loose equipment to the TIFMAS Vehicle, but
cannot alter or change the original specification of the TIFMAS Vehicle. All
additional loose equipment added by Cooperator shall remain the property and
responsibility of the Cooperator.
4. Cooperator will use the TIFMAS Vehicle only for the following:
a. Local and Regional Mutual Aid Incidents.
b. Local/Regional Multiple Alarm Incidents.
c. Emergency events threatening properties vital to National Defense,
Critical Infrastructure or Important Military Installations.
d. Local community events (parades, displays).
e. Training of firefighters.
f. Temporary standby for Cooperator's regular apparatus while out of service
for repairs. Cooperator agrees to notify the Service if the standby period
will exceed 90 days.
6.
7.
a. TIFMAS Vehicle shall be housed on the property of the Cooperator and
Cooperator will provide reasonable protection against weather, vandalism,
theft, or damage.
TIFMAS GRANT ASSISTANCE PROGRAM
TIFMAS VEHICLE GRANTS
Page 3 of 4
8. Cooperator will operate and maintain each TIFMAS Vehicle in a roadworthy and
legal condition, with a current state inspection decal, and within the posted Gross
Vehicle Weight Rating (GVWR) of the chassis as stated by the manufacturer.
9. Cooperator shall notify the Service if the apparatus is damaged and cannot
respond for a TIFMAS authorized deployment.
General Provisions:
1. The TIFMAS Vehicle will be titled in the name of the Cooperator.
2. If the Cooperator does not fulfill its obligations under the TIFMAS Grant Program,
the TIFMAS Vehicle and title must be transferred to another fire department of the
Service's choice.
3. The Service shall have the right to inspect the TIFMAS Vehicle at any time.
4.
5. If the Cooperator chooses to end its participation in the TIFMAS Grant Program,
Cooperator shall give Service 14 -days prior written notice. Upon termination of its
participation, all TIFMAS Vehicles, equipment, and titles will be transferred to
another fire department of the Service's choice. Cooperator shall not alter the
TIFMAS Vehicle in any way prior to transferring the TIFMAS Vehicle. Damage
shall be limited to normal wear and tear.
6. The primary points of contact for each party shall be as follows:
Cooperator Service
Texas Forest Service
P.O. Box 310
Lufkin, TX 75901
Attn: Emergency Services Grants Unit
Tel: (936) 639-8130
Fax: (936) 639-8138
Contracting parties agree to notify the other of any changes in the above. Any
notices regarding violations or termination shall be made in writing to the point of
contact.
7. Performance by the Texas Forest Service under this agreement may be
dependent upon the appropriation and allotment of funds by the Texas State
Legislature (the "Legislature"). If the Legislature fails to appropriate or allot the
necessary funds, the Texas Forest Service will issue written notice to Cooperator
and the Texas Forest Service may terminate this Agreement without further duty
or obligation hereunder. Cooperator acknowledges that appropriation of funds is
beyond the control of the Texas Forest Service.
•
TIFMAS GRANT ASSISTANCE PROGRAM
TIFMAS VEHICLE GRANTS
Page 4 of 4
8. Cooperator understands that pursuant to Section 51.9335(c) of the Texas
Education Code, the state auditor may audit purchases of goods or services by
an institution of higher education or by a component thereof that purchases
goods and services. Cooperator agrees to cooperate with the state auditor in the
conduct of the audit or investigation, including without limitation, providing all
records requested.
9. Cooperator expressly acknowledges that the Texas Forest Service is an agency
of the State of Texas and nothing in this Agreement will be construed as a waiver
or relinquishment by the Texas Forest Service of its right to claim such
exemptions, privileges, and immunities as may be provided by law.
10. The dispute resolution process provided in Chapter 2260, Texas Govemment
Code, and the related rules adopted by the Texas Attorney General pursuant to
Chapter 2260, shall be used by the Texas Forest Service and Cooperator to
attempt to resolve any claim for breach of contract made by Cooperator that
cannot be resolved in the ordinary course of business. Cooperator shall submit
written notice of a claim of breach of contract under this Chapter to the Associate
Director for Finance and Administration of the Texas Forest Service, who shall
examine Cooperator's claim and any counterclaim and negotiate with Cooperator
in an effort to resolve the claim.
11. The Cooperator agrees to abide by the terms and responsibilities described
herein and the terms outlined in the grant.
Acceptance of Terms and Responsibilities
Signature
ON WiAfkaitY
Title (1 se Print)0 AO*
Date
Form w'9
(Rev. October 2004)
Department et me treasury
vernal Revenue Stowe
Request for Taxpayer
Identification Number and Certification
Give form to the
requester. Do not
send to the IRS.
Print or type
See Specific Instructions on page 2.
Name (as reported on your income tax return)
i.
City of Round Rock
Business name, f different from above
Individual/ ❑ Municipality
Check appropnate box: ❑ Sole proprietor Corporation Partnership Other ►
Exempt from
baceup
ma withholding
Address (number. street, and apt. or suite no.)
221 East Main St
Requester's name and address (opiionai)
C+ty, state. and ZIP code
Round Rock, TX 78664
List account numberls) here (optional)
Part I Taxpayer Identification Number (11N)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid
backup withholding. For individuals, this is your social security number (SSN). However, for a resident
alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is
your employer identification number (EIN). If you do not have a number. see How to get a TIN on page 3.
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number
to enter.
Social security number
ifl+(fl]
or
Employer identification number
7144.610111714(8
5
Part II
Certification
Under penalties of perjury, 1 certify that:
1. The number shown on this form is my correct taxpayer identification number (or I ant waiting tor a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) l have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result o1 a failure to report all interest or dividends, or (c) the IRS has
notified me that 1 am no longer subject to backup withholding, and
3. 1 am a U.S. person (including a U.S. resident alien).
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.
For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must
provide your correct TIN. (See the instructions on page 4.)
Sign signature of
Here U.S. person ►
Purpose of For
A person who is required to file an information return with the
IRS, must obtain your correct taxpayer identification number
(TIN) to report, for example, income paid to you, real estate
transactions, mortgage interest you paid. acquisition or
abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
U.S. person. Use Form W-9 only if you are a U.S. person
(including a resident alien), to provide your correct TIN to the
person requesting it (the requester) and, when applicable, to:
1, Certify that the TIN you are giving is correct (or you are
waiting for a number to be issued),
2. Certify that you are not subject to backup withholding,
or
3. Claim exemption from backup withholding if you are a
U.S. exempt payee.
Note. If a requester gives you a form other than Form W-9
request your TIN, you must use the requester's form if it is
substantially similar to this Form W-9.
Date P.
3-d a -/o
• any estate (other than a foreign estate) or trust. See
Regulation section 301.7701-6(a) for additional information.
Foreign person. If you are a foreign person, use the
appropriate Form W-8 (see Publication 515, Withholding of
Tax on Nonresident Aliens and Foreign Entities).
Nonresident alien who becomes a resident alien.
Generally, only a nonresident alien individual may use the
terms of a tax treaty to reduce or eliminate U.S. tax on
certain types of income. However, most tax treaties contain a
provision known as a 'saving clause." Exceptions specified
in the saving clause may permit an exemption from tax to
continue for certain types of income even after the recipient
has otherwise become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an
exception contained in the saving clause of a tax treaty to
to claim an exemption from U.S. tax on certain types of income,
you must attach a statement that specifies the following five
items:
1. The treaty country. Generally, this must be the same
treaty under which you claimed exemption from tax as a
nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that
contains the saving clause and its exceptions.
For federal tax purposes you are considered a person if you
are:
• an individual who is a citizen or resident of the United
States.
• a partnership, corporation, company, or association
created or organized in the United States or under the laws
of the United States, or
Cat No. 10231x
Form W-9 (Rev. 10-20041