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CM-14-01-291/111111"."'- ND ROCK, TEXAS City of Round Rock Agenda Item Summary Agenda Number: Title: Consider executing the Fiscal Year 2014 Emergency Management Performance Grant Application. This program supports budgeted salaries for two staff positions and is administered by the Texas Division of Emergency Management. City Manager Item City Manager Approval 1/17/2014 David Coatney, Fire Chief Type: Governing Body: Agenda Date: Dept Director: Cost: Indexes: Attachments: Department: EMPG FY14 Applicationn Package 01 10 14 Fire Department Text of Legislative File CM -14-01-291 Consider executing the Fiscal Year 2014 Emergency Management Performance Grant Application. This program supports budgeted salaries for two staff positions and is administered by the Texas Division of Emergency Management. The Emergency Management Performance Grant (EMPG) supports local comprehensive emergency management programs by off -setting the salaries of EMPG staff. The program is administered by the Texas Division of Emergency Management and requests for funding must be submitted annually. Participation will partially fund salaries for the Emergency Management Coordinator and the Assistant Emergency Management Coordinator. The expected grant funding is $43,182.00. The remaining salaries for the two positions is budgeted in the FY 13-14 General Fund. Approval City of Round Rock Page 1 Printed on 1/13/2014 CONTRACT APPROVAL FORM FOR CITY MANAGER ACTION Required for Submission of Specific City Manager Items Department Name: Fire Department Project Mgr/Resource: Brad Bradford City Manager Approval CMA Wording Project Name: Grant Application ContractorNendor: Texas Division of Emergency Management Consider executing the Fiscal Year 2014 Emergency Management Performance Grant Application. This program supports budgeted salaries for two staff positions and is administered by the Texas Division of Emergency Management. Approval ElEmployee EE Bowden Date January 10, 2014 Notes/Comments FISCAL YEAR 2014 EMERGENCY MANAGEMENT PERFORMANCE GRANT APPLICATION 1. APPLICANT NAME (Jurisdiction): City of Round Rock 2. COUNTY: Williamson 3. DISASTER DISTRICT: 6B Program applicant 4. EMPG STATUS: 1i1 Current EMPG Program participant ❑ New EMPG 5. PROGRAM PARTICIPANTS: (List all jurisdictions that are participants in your emergency management program. Identify any jurisdictions that have joined or withdrawn from your program in the last year.) n/a 6. CHECKLIST OF APPLICATION ATTACHMENTS: (See the FY 2014 Grant (EMPG) Guide for information on completing these forms.) Emergency Management Performance form shall be signed by the EMC this form shall sign this form required for each staff member listed in the be signed by an Authorized Official Suspension, & Other Responsibility Authorized Official required only if the Number (form AP -152) - The Grant sign this form 0 Designation of Grant Officials (TDEM-17B) I Statement of Work & Cumulative Progress Report (TDEM-17A) - This /1 EMPG Staffing Pattern (TDEM-66) - The Authorized Official shall sign // Application for Federal Assistance (TDEM-67) -The Authorized Official 0 EMPG Staff Job Description (TDEM-68) - A current job description is FY 2014 EMPG Staffing Pattern (TDEM-66) I FEMA Form 20-16 Summary Sheet for Assurances & Certifications - Shall Attached: // FEMA Form 20-16A, Assurances — Non -Construction Programs 0 FEMA Form 20-16C, Certifications Regarding Lobbying, Debarment, Matters; and Drug -Free Workplace Requirements ❑ FEMA Form SF LLL, Disclosure of Lobbying Activities - Signed by the applicant performs lobbying to influence federal actions // Direct Deposit Authorization (form 74-146) or Application for Payee ID Financial Officer shall sign this form I Travel Policy Certification (TDEM-69) - The Grant Financial Officer shall 7. CERTIFICATION: This Application, together with the approved EMPG Statement (TDEM-17A), constitutes the annual work plan for the emergency management program undersigned agree to exert their best efforts to accomplish all activities listed in the Report '• ved by the xas Divisio' of Emergency Management. of Work & Cumulative Progress Report whose participants are listed above. The Statement of Work & Cumulative Progress lir /? , 140 41 Authorized Official Date Emergency Management Coordinator Date (Original Signature) (Original Signature) Printed Name: Printed Name: Steve Norwood Thomas L. Bradford TDEM-17 10/13 Mail completed fomes and application materials to: CM -14-0 -aq Grant Coordinator Office of Management and Budget Texas Division of Emergency Management Texas Department of Public Safety PO Box 4087 Austin, TX 78773-0223 Page 1 of 1 FISCAL YEAR 2014 DESIGNATION OF EMPG GRANT OFFICIALS APPLICANT NAME (Jurisd ction): City of Round Rock EI ERSENCY MANAGEMENT COORDINATOR* NAME L Mr. ❑ Ms. Thomas L. Bradford, III Official Mailing Address Please include mail stop code 2701 N. Mays Round Rock, TX 78665-2412 Daytime Phone Number (512) 341-3106 Fax Number (512) 218-6681 E-mail Address bbradfordroundrocktexas.gov ct POINT OF CONTACT (RESPONSIBLE FOR APPLICATION) NAME ❑ Mr. /.1 Ms. Thomas L. Bradford, III Title EMC Official Mailing Address Please include mail stop code. 2701 N. Mays Round Rock, TX 78665-2412 Daytime Phone Number (512) 341-3106 Fax Number (512) 218-5442 E-mail Address bbradford(aroundrocktexas.gov GRANT FINANCIAL OFFICER °{CANNOT BE EMC) NAME ❑ Mr. .1 Ms. Olivia Riley Title Accounting Supervisor Official Mailing Address Please include mail stop code. 221 East Main St. Round Rock, TX 78664-5271 Daytime Phone Number 512-341-3300 Fax Number 512-218-5442 E-mail Address oriley(a)roundrocktexas.gov AUTHORIZED OFFICIAL {MAYOR, COUNTY JUDGE, CITY MANAGER) NAME ►Z1 Mr. ❑ Ms. Steve Norwood Title City Manager Official Mailing Address Please include mail stop code. 221 East Main St. Round Rock, TX 78664-5271 Daytime Phone Number (512) 218-5443 Fax Number (512) 218-7097 E-mail Address snorwood(a�roundrocktexas.gov TDEM-17B 10/2013 age 1 0 FISCAL YEAR 2014 EMPG STATEMENT OF WORK & CUMULATIVE PROGRESS REPORT APPLICANT NAME (Jurisdiction): City of Round rock Document Number Active Date TDEM Review By Date Jurisdiction DUN/SAM # 10-274-0792 01.10.14 Jurisdiction Congressional District TX -31 01.10.14 Document Submitter Date TDEM Review By Date Statement of Work Thomas L. Bradford 01.10.14 Progress Report #1 Progress Report #2 TASK 1 -WORK PLAN & SEMIANNUAL PROGRESS REPORT Our jurisdiction will submit an EMPG Application, two Progress Reports, four Quarterly FEMA Training matrices, and four Quarterly Financial Reports ►5 Work Plan • This Progress Report # 1 is being submitted to TDEM OMB Financial Report has been submitted to TDEM OMB ■ Progress Report #1 ■ First ■ This Progress Report # 2 is being submitted to the TDEM OMB & Third Quarter Financial Reports have been submitted to TDEM OMB Quarter Financial Report has been submitted to TDEM OMB • Progress Report #2 ■ Second • Fourth TASK 2 -LEGAL AUTHORITIES FOR EMERGENCY MANAGEMENT PROGRAM Our jurisdiction management will maintain current program TRRN registration completed legal documents are current jurisdiction will prepare legal documents establishing our emergency and resources entered & on file with TDEM; no additional action is required or update & submit to TDEM: Court Order # for: dated: ►/ Our I Our Work Plan ■ Our • Commissioner's ■ City Ordinance(s) ■ Updated Joint Resolution IN NIMS Adoption dated: • Our TRRN registration completed legal documents are current jurisdiction completed and resources entered & on file with TDEM, no additional action is required & submitted to TDEM: Order # for: dated: • Our ■ Progress Report #1 ■ Our October 1 — Oct Marchob r II Commissioner's Court • City Ordinance(s) • Updated Joint Resolution ■ NIMS Adoption dated: TRRN registration completed legal documents are current jurisdiction completed and resources entered & on file with TDEM, no additional action is required & submitted to TDEM: Order# for: dated: • Our ■ Progress Report #2 • Our April 1- September 30 • Our • Commissioner's Court IN City Ordinance(s) • Updated Joint Resolution • NIMS Adoption dated: TDEM-17A 10/2013 Mail completed form to: Page 1 of 6 Grant Coordinator Office of Management and Budget Texas Division of Emergency Management Texas Department of Public Safety P O Box 4087 Austin, TX 78773-0223 TASK 3-PUBLIC EDUCATION/INFORMATION Option 1: Our jurisdiction will conduct 30 hours of hazard awareness activities for local citizens i1 Option 2: Our jurisdiction will prepare & distribute public education/information materials to a substantial portion of the community. In the space below, describe the materials to be distributed: We will continue to encourage citizen registration of cell phones in the Emergency Notification System databases. We will distribute materials for National Night Out and during open houses. Other public education opportunities will include NWS Skywarn/Storm Spotter program. We will participate in local and regional CTCCC efforts. We will continue publication of our emergency management website and effort to provide a web-based special needs assistance program. "You may provide a combination of both options. Work Plan • Our jurisdiction completed the following hazard awareness and/or public education/information activities: • Progress Report #1 October 1 — March 31 ■ No Task 3 progress was made this report period. IN Our jurisdiction completed the following hazard awareness and/or public education/information activities: ■ Progress Report #2 April 1 — September 30 • No Task 3 progress was made this report period. TASK 4-EMERGENCY MANAGEMENT PLANNING DOCUMENTS ►/ Our jurisdiction reviewed our emergency management plan & annexes for currency and NIMS compliance ►.1 Our emergency management plan and all annexes are current and NIMS compliant ►� We will develop, update, revise, or change planning documents as needed. ■ Basic Plan ►1 Work Plan Annexes: ■A ■B ■C •D •E ■F •G ■H ■I ■J •K •L •M ■N■O■P■Q■R■S■T■U■V ■ Other documents: NOTE: Plans & annexes dated prior to September 30, 2009 must be revised or updated this year. All Plans and Annexes must be NIMS compliant. • Our jurisdiction reviewed our emergency management plan & annexes for currency and NIMS compliance 1 Our emergency management plan and all annexes are current and NIMS compliant ■ Progress Report #1 ■ We updated by revision or change these planning documents: October 1 — O Oc31 ■ Basic Plan Annexes: ■A •B ■C ID •E •F ■G •H ■I IJ ■K ■L IMM ■N 10 IP ■Q ■R ■S ■T ■U ■V • Other documents: • No Task 4 progress was made this report period. • Our jurisdiction reviewed our emergency management plan & annexes for currency and NIMS compliance 1 Our emergency management plan and all annexes are current and NIMS compliant II Progress Report #2 1 We updated by revision or change these planning documents: April 1 — September 30 • Basic Plan Annexes: ■ A ■ B ■ C ■ D ■ E ■ F ■ G ■ H ■ I ■ J ■ K ■ L ■ M ■N ■O ■P •Q •R IS IT ■U •V ■ Other documents: • No Task 4 progress was made this report period. TDEM-17A 10/2013 TASK 5— TEP, NOTIFICATION AND INDIVIDUAL EXERCISE PARTICIPATION ►� 0 Date Work Plan TEP Submitted: Training and Exercise Plan Each jurisdiction must develop and submit a multi-year Training and Exercise Plan (TEP), not less than three years, to the TDEM Exercise Unit 0 TDEM. EXERCISESC)dgs.texas.aov. Each jurisdiction must submit the Pre -Exercise Notification Form to the TDEM Exercise Unit not less than 45 days prior to a planned exercise event. Each jurisdiction must submit an After Action Report (AAR) and Improvement Plan (IP) for a minimum of two (2) discussion -based exercises and one (1) operations -based exercise. All AARs/lPs all exercise activities to the TDEM Exercise unit not more than 45 days after the conclusion of the exercise. One real world event is currently allowed per fiscal year. NOTE: A Full -Scale exercise must be conducted every three (3) years. **Each EMPG-funded person must complete and submit Individual Exercise Participation forms. All EMPG funded personnel must participate in at least three exercises per year. REQUIRED EXERCISE SCHEDULE Performance Period Exercise Type Exercise Name & Exercise Date Quarter of Year Fiscal (October September Year 2014 1, 2013 - 30, 2014) ►.1 Discussion Based T&EPW 12.18.13 0 1 • 2 • 3 ■ 4 ►� Discussion Based RR EOC TTX 04.14 ■ 1 02 • 3 • 4 ►:I Operational Based RR EOC FE 05.14 • 1 • 2 3 • 4 • Real World Event • 1 • 2 ■ 3 ■ 4 i1 Full Scale CAPCOG Regional CBRNE FS • 1 ■ 2 ■ 3 ►-_ 4 Our last Full -Scale exercise was conducted on (date): 12/1-2/12 • October March ■ Date Progress Report #1 1 - 31 TEP Submitted: We conducted the following exercises and provided documentation to TDEM: Exercise Type Exercise Name 1 Exercise Date 1 EMPG Funded YIN ►1 • • • • Discussion Discussion Operation Real World Event Full Scale Annual T&EPW 12.18.13 N ■ event ■ Our jurisdiction completed NO exercise and did not request credit for a real world Exercise approved documentation attached ■ Progress Report #2 April 1 - September 30 We conducted the following exercises and provided documentation to TDEM: Exercise Type Exercise Name 1 Exercise Date 1 EMPG Funded YIN • • ■ ■ • Discussion Discussion Operation Real World Event Full Scale • event • Our jurisdiction completed NO exercise and did not request credit for a real world Exercise approved documentation attached TDEM-17A 10/2013 Page 3 of 6 TASK 6 -TRAINING FOR EMERGENCY MANAGEMENT PERSONNEL ALL EMPG-funded emergency management personnel will participate in the following training during FY 2014: Position & Name Course Name or Number Bradford, Thomas L, EMC MGT -404 Sports & Special Events Incident Mgt. G-197 Emrg Ping & Special Needs G-358 Evacuation & Re -Entry Miller, Dorothy L, AEMC MGT -404 Sports & Special Events Incident Mgt. IS -241 Decision Making/Problem Solving HSEEP K-146 01.14 IS -242 Effective Communications IS -244 Developing & Managing Volunteers PDS and APS Courses ►:� Work Plan Emergency management personnel completed the following training and documentation is attached: Position & Name Course Name or Number Date Completed Bradford, Thomas L, EMC MGT -404 10/16/13 Miller, Dorothy L, AEMC MGT -404 10/16/13 IS -241 11/27/13 • Progress Report #1 October 1 — March 31 • No training took place this report period. Emergency management personnel completed the following training and documentation is attached: Position & Name Course Name or Number Date Completed • Progress Report #2 April 1 — September 30 ■ No training took place this progress report period. TDEM-17A 10/2013 Page 4 of 6 TASK 7 -EMERGENCY MANAGEMENT TRAINING FOR OTHER PERSONNEL Our jurisdiction will conduct or arrange emergency management related training for elected officials, other local officials, & support agencies. Work Plan ■ Progress Report #1 October 1 — March 31 The following formal training courses were taught or contracted: Date Course Title I Class Description I # Trained 10.15-16.13 MGT -404 Sports & Special 48 Events Incident Mgt took place this progress report period. training courses were taught or contracted: • No training The followingformal • Progress Report #2 April 1 — September 30 Date Course Title 1 Class Description I # Trained took place this progress report period. • No training TASK 8 -EMERGENCY MANAGEMENT ORGANIZATIONAL DEVELOPMENT Our jurisdiction will participate in the following emergency management organizational development activities: CAPCOG Regional Horneland Security Task Force; CAPCOG HSTF Regional Preparedness Committee; CAPCOG HSTF Exercise SubCommittee; Texas Homeland Security Conference; WCEPG/LEPC; CTPG; CTCTTF; CTSSC; FBI InfraGard; FBI InfraGard Board; CASHP; CAIMT/CTIMT; Austin -Round Rock UA; BioWatch BAC/PSS; WCLTRC; CTCCC; T&EPW Workshop; NWS Storm Ready Program; WILDCATS; UA CIP Program Core Working Group. I Work Plan Our jurisdiction completed the following staff development activities: • Progress Report #1 October 1 — March 31 Our jurisdiction completed the following staff development activities: ■ Progress Report #2 April 1 — September 30 TDEM-17A 10/2013 Page 5 of 6 JURISIDICTION NAME: City of Round Rock REMARKS (Use an Additional Sheet if Necessary) TDEM-17A 10/2013 Page 6 of 6 FISCAL YEAR 2014 EMPG STAFFING PATTERN 1. APPLICANT NAME (as is appears on EMPG application) City of Round Rock 2. COUNTY Williamson 3. FULL-TIME EMPLOYEES (including those who work all or only a portion of their time in emergency management duties) 4. Gross Annual Salary 5. Gross Annual Benefits 6. Gross Salary & Benefits (4+5) 7. % Work in EM Duties 8. Salary & Benefits for EM (6x7) 9. Est EM Travel Costs Name: Thomas L. Braford, III 84,053.00 28,995.00 113,048.00 100% 113,048.00 3,000.00 Position: Emergency Management Coordinator Name: Dorothy L. Miller 68,203.00 25,242.00 93,445.00 100% 93,445.00 3,000.00 Position: Assistant Emergency Management Coordinator Name: Name: 0.00 0.00 Position: Name: Position: Name: 0.00 0.00 0.00 Position: Name: Position: 0.00 0.00 Position: Name: 0.00 0.00 Name: 0.00 Position: Name: 0.00 0.00 Position: 0.00 Position: A. SUBTOTAL:� � � �_ _.� ; ,�� � ..,.:,� � .� 206,493.00 6,000.00 10. PART-TIME EMPLOYEES 11. % of Full Time 12. Gross Annual Salary 13. Gross Annual Benefits 14. Gross Salary & Benefits (12+13) 15. % Work in EM Duties 16. Salary & Benefits for EM (14x15) 17. Est EM Travel Costs Name: 0.00 0.00 Position: Name: 0.00 0.00 Position: Name: 0.00 0.00 Position: Name: 0.00 0.00 Position: Name: 0.00 0.00 Position: Name: 0.00 0.00 Position: Name: 0.00 0.00 Position: B. SUBTOTAL s, ': TOTAL: 0.00 18. 206,493.00 0.00 19. 6,000.00 CERTIFICATION: 1 certify that no individual listed above holds an elected office. ilii Signature of Authorized Official: i ii�/ Printed name of Authorized Official: Ejc e V C"'- I \\ Date Signed: e777?/, TDEM-66 10/13 age i o FISCAL YEAR 2014 APPLICATION FOR FEDERAL ASSISTANCE (Instructions on Reverse) NAME OF PROGRAM/ ASSISTANCE: EMERGENCY MANAGEMENT PERFORMANCE GRANT (EMPG) 1. CFDA NUMBER: 97.042 2. APPLICANT New Applicant Renewal STATUS: ❑ ►1 3. FEDERAL FISCAL YEAR: FY 2014 4. START DATE: OCTOBER 1, 2013 5. END DATE: SEPTEMBER 30, 2014 6. APPLICANT INFORMATION a. Legal Name of Applicant Organization (as it appears on the EMPG Application (TDEM-17): City of Round Rock b. Name & Telephone Number of Emergency Management Coordinator: Thomas L. Bradford, III 512-341-3106 c. Mailing Address: City Hall 221 East Main St. Round Rock, TX 78664 Employer Identification Number/Tax ID# 76-6017485 d. Physical Address (if different from Mailing Address): 2701 Mays Round Rock, TX 78665 7. EMPG PERSONNEL SUMMARY (include only those staff that will be paid with EMPG funds): a. Number of EMPG Staff & Percentage of Time Worked in Emergency Management Duties: # Staff Percent # Staff Percent # Staff Percent 1) Full Time: 2 100 2) Part Time b. Total Number of EMPG-Funded Personnel: 2 8. ESTIMATED EXPENSES: a. Salary & Benefits (from line 18, form TDEM-66) 206,493.00 b. Travel Expenses (from line 19 form TDEM-66) 6,000.00 c. Other Expenses (from section 11 on reverse) d. Total Expenses (A + B + C) 212,493.00 e. Federal Share (D x .50) 106,246.50 Note: If you cannot meet the cash match requirement, check the box below and attach a match proposal as specified in Section 2 of the Local Emergency Management Performance Grant Guide. TDEM must review and approve any exceptions made to the cash match requirement at the time of application. ■ Cash Match Exception Requested 9. CERTIFICATION: I certify that to the best of my knowledge and belief this application and its attachments are true and correct. a. Typed Name of Authorized Official: Steve Norwood b. Title of Authorized Official: City Maria. -r c. Original Signature of Authorized Official: �ij��,.� i .. -, ''0." d. Date Signed: 0/ /Z / T TDEM-67 10/13 Page 1 of 2 INSTRUCTIONS 1. Except as indicated below, entries are self-explanatory. 2. Item 7A: Enter the legal name of your jurisdiction. Your entry should match the Applicant Name used on the EMPG Program Application (TDEM-17). 3. Item 8A: Indicate the number of full-time employees who work specific percentages of time in emergency management duties. Example: 1 staff @ 100 percent, 2 staff @ 50 percent. Also indicate the number of part- time employees. Include only staff members whose salary and benefits will be supported by EMPG funding. The data in this section should agree with the information included on the EMPG Staffing Pattern (TDEM-66). 4. Item 10 A, B, & C. This form must be signed by an Authorized Official, who is a person authorized by the governing body of the jurisdiction to apply for grants and accept grants and execute agreement and contracts on behalf of the jurisdiction. Authorized Officials are County Judges, Mayors, and many City Managers — not Emergency Management Coordinators. 11. OTHER ALLOWABLE EXPENSES: Describe the other allowable expenses of your emergency management program that you are requesting be supported by EMPG funding and provide an estimate of the amount of those expenses. These costs must comply with 2 CFR, Part 225, Cost Principles for State. Local, and Indian Tribe Govemments (OMB Circular A-87). Salaries and expenses for elected officials are not allowed. Continue on a separate sheet if necessary. Transfer the Total calculated below to line 9c on the front of this form. To determine if an expense is allowable under the EMPG program, refer to the DHS Authorized Equipment List (AEL) available on the Responder Knowledge Base at Lessons Learned Information Sharing at https://www.11ls.dhs.gov/knowledgebase Please reference the appropriate Authorized Equipment List (AEL) for expenses listed below. AEL Code Specific Description of Expense (Descriptions must be specific — do not use broad or general categories, such as operating or administrative expenses) Estimated Amount n/a Total TDEM-67 10/13 Page 2 of 2 EMPG STAFF JOB DESCRIPTION Jurisdiction Name City of Round Rock Staff Member Name Thomas L. (Brad) Bradford, III Position Title EMC Description Prepared By Thomas L. (Brad) Bradford, III Date Prepared 12.16.13 ❑ Current Job JOB DESCRIPTION Description Attached See Below A. Provide a general description of the duties performed by this staff member. SUMMARY OF POSITION The City of Round Rock Emergency Management Coordinator (EMC) is responsible for planning, organizing and directing activities for the City's Emergency Management Plan, including: Develop, review and update emergency operation plan to prepare for potential emergency or disaster situations. Coordinate staffing for the EOC with designated department personnel, and coordinates EOC activities. Prepare and submit program funding documents and coordinate grant proposal activities related to emergency preparedness. Develop, coordinate and lead emergency management training, coordinate and evaluate emergency operations drills and actual disasters; make recommendations to improve operations and/or response. Advise departments on their emergency plans and coordinate interdepartmental activities. Communicate emergency operations plans to appropriate local groups to coordinate response planning with City operations. Evaluate EOC operations during and after emergency operations exercises and/or emergencies and actual disasters; make recommendations to City Manager and appropriate departments. ORGANIZATIONAL RELATIONSHIPS 1. Reports to Fire Chief on emergency responsibilities. 2. Advises Mayor, City Council and City Manager on emergency management matters. B. If this staff member performs both emergency management duties and other duties, identify the specific emergency management duties performed. TDEM-68 10/13 etain a copy of this description for future use. EMPG STAFF JOB DESCRIPTION Jurisdiction Name City of Round Rock Staff Member Name Dorothy L. Miller Position Title AEMC Description Prepared By Thomas L. Bradford Date Prepared 12.16.13 ❑ Current Job JOB DESCRIPTION Description Attached See Below A. Provide a general description of the duties performed by this staff member. SUMMARY OF POSITION The Assistant Emergency Management Coordinator (AEMC) assists the EMC and participates in regional committees such as Homeland Security Task Force, Regional Preparedness, Regional Exercise, WILCO Emergency Planning Group and Capital Area IMT (Logs Chief). Duties performed by the AEMC include: Assist with internal emergency management planning process, including ongoing revisions and coordination of City Emergency Management Plan and Annexes, maintaining Jurisdiction Preparedness Profile of "Advanced" as requirement of funding sources to include EMPG. Assist with training and maintenance of City's NIMS compliance. Assist with emergency management planning and response relationships between City and its partners, including schools, hospitals, county, region, state, and federal departments and agencies. Assist with development of special needs assistance program. Assist with development and maintenance of Critical Infrastructure Protection Program. Enhances the promotion of emergency preparedness throughout City and its broader community. Maintains MEP certification and assist in emergency preparedness training and management of Homeland Security Exercise and Evaluation Program (HSEEP) within City and its wider community. Assist with disaster response and recovery efforts. Maintains Emergency Management Webpage; and assist with social media efforts as required. ORGANIZATIONAL RELATIONSHIPS Reports to and advises the City EMC on Emergency Management matters. B. If this staff member performs both emergency management duties and other duties, identify the specific emergency management duties performed. TDEM-68 10/13 etain a copy of this description for future use. U.S. Department of Homeland Security SUMMARY SHEET FOR ASSURANCES AND CERTIFICATIONS O.M.B. No. 3067-0206 Expires February 28, 2007 FOR FY 2014 CA FOR (Name of Applicant) City of Round Rock This summary sheet includes Assurances and Certifications that must be read, signed, and submitted as a part of the Application for Federal Assistance. An applicant must check each item that they are certifying to: Part I © FEMA Form 20-16A, Assurances-Nonconstruction Programs Part II El FEMA Form 20-16B, Assurances -Construction Programs Part III ® FEMA Form 20-16C, Certifications Regarding Lobbying; Debarment, Suspension, and Other Responsibility Matters; and Drug -Free Workplace Requirements Part IV SF LLL, Disclosure of Lobbying Activities (If applicable) As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the identified attached assurances and certifications. Steve Norwood City Manager Typed Name of Authorized Representative Title Signature of Authorized Representative Date Signed NOTE: By signing the certification regarding debarment, suspension, and other responsibility matters for primary covered transaction, the applicant agrees that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by FEMA entering into this transaction. The applicant further agrees by submitting this application that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," provided by the FEMA Regional Office entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. (Refer to 44 CFR Part 17.) Paperwork Burden Disclosure Notice "Public reporting burden for this form is estimated to average 1.7 hours per response. Burden means the time, effort and financial resources expended by persons to generate, maintain, retain, disclose, or to provide information to us. You may send comments regarding the burden estimate or any aspect of the form, including suggestions for reducing the burden to: Information Collections Management, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472, Paperwork Reduction Project (3067-0206). You are not required to respond to this collection of information unless a valid OMB control number appears in the upper right corner of this form. Please do not send your completed form to the above address. Form 20-16, FEB 01 U.S. DEPARTMENT OF HOMELAND SECURITY ASSURANCES -NON -CONSTRUCTION PROGRAMS Note: Certain of these assurances may not be applicable to your project or program. If you have any questions, please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. As the duly authorized representative of the applicant, I certify that the applicant: 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non -Federal share of project costs) to ensure proper planning, management and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. Section 4728-4763) relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration) 5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. Sections 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. Section 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. Sections 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (1) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Sections 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290-dd-3 and 290-ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Acts of 1968 (42 U.S.C. Section 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and (j) the requirements of any other nondiscrimination statute(s) which may apply to the application. 7. Will comply, or has already complied, with the requirements of Title II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or Federally assisted programs. These requirements apply to alt interest in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply with provisions of the Hatch Act (5 U.S.C. Sections 1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. Sections 276a to 276a- 7), the Copeland Act (40 U.S.C. Section 276c and 18 U.S.C. Sections 874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. Sections 327-333), regarding labor standards for federally assisted construction subagreements. 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more. Form 20-16A, JUN 94 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. Section 1451 et seq.); (f) conformity of Federal actions to State (Clean Air) Implementation Plans under Section 176(c) of the Clean Air Act of 1955, as amended (42 U.S.C. Section 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205). 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. Section 1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.). 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. Section 4801 et seq.) which prohibits the use of lead based paint in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act of 1984. 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. 19. It will comply with the minimum wage and maximum hours provisions of the Federal Fair Labor Standards Act (29 U.S.C. 201), as they apply to employees of institutions of higher education, hospitals, and other non-profit organizations. Form 20-16A (BACK) U.S. DEPARTMENT OF HOMELAND SECURITY CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS Applicants should refer to the regulations cited below to determine the certification to which they are required to attest. Applicants should also review the instructions for certification included in the regulations before completing this form. Signature on this form provides for compliance with certification requirements under 44 CFR Part 18, "New Restrictions on Lobbying; and 28 CFR Part 17, "Government -wide Debarment and suspension (Nonprocurement) and Government -wide Requirements for Drug -Free Workplace (Grants)." The certifications shall be treated as a material representation of fact upon which reliance will be placed when the Federal Emergency Management Agency (FEMA) determines to award the covered transaction, grant, or cooperative agreement. 1. LOBBYING A. As required by section 1352, Title 31 of the U.S. Code, and implemented at 44 CFR Part 18, for persons entering into a grant or cooperative agreement over $100,000, as defined at 44 CFR Part 18, the applicant certifies that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of congress, or an employee of a Member of Congress in connection with the making of any Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement; (b) If any other funds 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 an employee of Congress, or employee of a member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form LLL, "Disclosure of Lobbying Activities," in accordance with its instructions; (c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants, contracts under grants and cooperative agreements, and subcontract(s) and that all subrecipients shall certify and disclose accordingly. Standard Form LLL, "Disclosure of Lobbying Activities" attached. (This form must be attached to certification if nonappropriated funds are to be used to influence activities.) 2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS (DIRECT RECIPIENT) As required by Executive Order 12549, Debarment and Suspension, and implemented at 44 CFR Part 67, for prospective participants in primary covered transactions, as defined at 44 CFR Part 17, Section 17.510-A. The applicant certifies that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, sentenced to a denial of Federal benefits by a State or Federal court, or voluntarily excluded from covered transactions by any Federal department or agency; Form 20-16C, JUN 94 (b) Have not within a three-year period preceding this application been convicted of ar had a civilian judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or perform a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly charged by a govemmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and (d) Have not within a three-year period preceding this application had one or more public t ransactions (Federal, State, or local) terminated for cause or default; and B. Where the applicant is unable to certify to any of the statements in this certification, he or shall shall attached an explanation to this application. 3. DRUG-FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS) As required by the Drug -Free Workplace Act of 1988, and implemented at 44 CFR Part 17, Subpart F, for grantees, as defined at 44 CFR Part 17, Sections 17.615 and 17.620: A. The applicant certifies that it will continue to privide a drug- free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions tht will be taken against employees for violation of such prohibition; (b) Establishing an on-going drug free awareness program to inform empoyees about: (1) The dangers of drug abuse in the workplace; (2) The grantee's policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and (4) the penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee to be engaged in the performance of the grant to be given a copy of the statement required by paragraph (a); (d) Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant, the employee will: (1) Abide by the terms of the statement; and (2) Notify the employee in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction. (e) Notifying the agency, in writing, within 10 calendar days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to the applicable FEMA awarding office, i.e., regional office or FEMA office. (t) Taking one of the following actions, within 30 calendar days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted: (1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency. (g) Making a good faith effort to continue to maintain a drug free workplace through implementation of paragraphs (a), (b), (c), (d), (e), and (f). 8. the grantee may insert in the space provided below the site(s) for the performance of work done in connection with the specific grant: Place of Performance (Street address, City, County, State, Zip code) 221 East Main Street Round Rock, TX 78664 Check nif there are workplaces on file that are not identified here. Section 17.630 of the regulations provide that a grantee that is a State may elect to make one certification in each Federal fiscal year. A copy of which should be included with each application for FEMA funding. States and State agencies may elect to use a Statewide certification. Form 20-16C (BACK) 74.176 (Ret 1412/15) For ComptroLer'S Use Onty 1 1 Direct Deposit Authorization This form may be used by vendors, individual recipients or state employees to receive payments from the state of Texas by direct deposit or to change/cancel existing direct deposit information. Tran T SECTION 1 ype sac ion iNew setup (Sections 2, 3, 4 and 5 - Section 6 is optional) 0 Change account type (Sections 2, 3, 4 and 5 - Section 6 is optional) ❑ Change financial institution (Sections 2, 3, 4 and 5 - Section 6 is optional) 0 Cancellation (Sections 2 and 5 - Sections 7 and 8 for state agency use) ❑ Change account number (Sections 2, 3, 4 and 5 - Section 6 is optional) CV Payee I!° 0 State employee/crave 1...) Vendor or other recipient ■ 0 Texas identfication Number (TIN) Employer Identification Number (EIN) Social Security Number (SSN)' 1 7 , 4 , 6 , 0 , 1 , 7 , 4 , 8 , 5 , , , Mail code (!f not known. leave blank) 1 0 , 0 , 1, z transit number (9 digits) Customer accourd number maximum 17 characters) ,4,5,6,8,9,1,3,8,6, , , , , , , , 1 0 N Payee ate City of Round Rock Krone number ext. Mailing address 221 East Main Street City Round Rock st�512-218-54700 TX 78664 ommended. r,lla,I inRouting 0 UF N .tae 1114.09.11.....v.. (................... —,-...—.._.—..---------- --- - - - Financial instindan name JP Morgan Chase, N.A. City Austin Date State TX transit number (9 digits) Customer accourd number maximum 17 characters) ,4,5,6,8,9,1,3,8,6, , , , , , , , 1 Typo of account Rechecking ■Savings 11,1,1,01-,0,0,6,11-,4, repr *entativa name (optional) Larnell Camus Tide (°P +el) Senior Vice President Financial representative signature (optiona6 Phone number (optional) ext. Date (optional) international Payments Verification (required) Will these payments be forwarded to a financial institution outside the United States? ❑ YES WINO If' TES," also complete the ACM (Direct Deposit) Payment Destination Confirmation (Form 74-227). Authorization for Setup, Changes or Cancellation (required) z O U W tn. I authorize the Texas Comptroller of. Public Accounts to deposit my payments from the state of Texas to my financial institution electronically. I understand that the Texas Comptroller of Public Accounts will reverse any payments made to my account in error. I further understand that the Texas Comptroller of Public Accounts will comply at all times with the National Automated Clearing House Association's rules. (For further information on these rules, please contact your financial institution.) sign 0 / here t Cancellation by Agency (for state ager use) Printed name Che i Delaney Date Ltiti)/ 01/09/14 m 0 rn Ranson Date orstate agency use I SECTION 7 Signature sign here Date Phone number ext. Agency number AQbncy name Comments Please return your completed form to: TRAVEL POLICY CERTIFICATION Jurisdiction Name: City of Round Rock Check one of the two blocks below This jurisdiction has no qualifying travel regulations. EMPG participants requesting reimbursement for travel expenditures will do so in accordance with State of Texas travel regulations and reimbursement rates as published by the Texas Comptroller of Public Accounts. State travel regulations are available at haps://fmx. cpa. state. tx. us/fmx/travet/textraveI/index. php OR nThis jurisdiction has its own qualifying travel policy, a copy of which is attached. EMPG participants requesting reimbursement for travel expenditures will do so in accordance with that policy. Name of Grant Financial Officer (Printed or Typed) Olivia Riley Original Signature of Grant Financial Officertf r irg' Date Signed // 1-1 TDEM-69 10//2013