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State-Local Disaster AgreementSTATE-LOCAL DISASTER ASSISTANCE AGREEMENT 404 HAZARD MITIGATION GRANT PROGRAM This agreement between the State of New York and ~Ct ~ ~ n rQ ~ ~ u ~- z /,~~ (Applicant's Full Name) shall be effective on the date signed by the applicant. It shall apply to all assistance funds provided by or through the State to the applicant as a result of the declaration of the major disaster by the President of the United States. The Applicant's designated representative certifies that He/She has legal authority to apply for assistance on behalf of the applicant, and that the Applicant will: 1. Provide all necessary financial and managerial resources to meet the terms and conditions of receiving federal and/or state disaster assistance. 2. Use disaster assistance funds solely for the purpose for which these funds are provided and as approved by the Governor's Authorized Representative (GAR). 3. Agree to assume costs of the non-federal (at least 25% of the projects total cost). 4. Designate an Applicant's local Agency to act on the jurisdiction's behalf and will establish and maintain a proper accounting system to record expenditures of disaster assistance funds in accordance with generally accepted accounting standards or as directed by the GAR. 5. Return to the State, within 15 days of a result for payment by the GAR, any advance funds received which are not supported by audit or other federal or state review of the applicant's compliance with program requirements. 6. Give federal and state agencies, designated by the GAR, access to and the right to examine all records and documents related to the use of disaster assistance funds. 7. Comply with all applicable codes and standards as pertain to this project and agree to provide all appropriate project maintenance. 8. Comply with all applicable provisions of federal and state law and regulations with regard to the procurement of goods and services. 9. Begin project work within 90 days of the approval of the grant and follows apre-approved timetable for project completion. 10. Comply with all federal and state statutes and regulations relating to non-discrimination. 11. Comply with provisions of the Hatch Act limiting political activities of public employees. 12. Comply with the National Flood Insurance Program (NFIP) purchase requirements. 13. Not enter into cost-plus-percentage-of-cost contracts for the completion of HMGP project work. 14. Not enter into contracts for which payment is contingent upon receipt of federal or state funding. 15. Not enter into contracts with any party debarred or suspended from participating in federal assistance programs. Signed for the Applicant: Typed Name ~ Ll r~Q rGc_ ~ ~ ~,t t / Ps- Signature Title t--~f;~ i S v~~ / r .~w p ~~~ (,(~ ~. rl G f'-l Date _ ~~~ / ,~ ~~ / ~ Signed for the State: Typed Name Title Signature Date REQUIRED CERTIFICATIONS GENERAL CONDITIONS The undersigned submits this application under the Federal Emergency Management Agency's Hazard Mitigation Grant Program (HMGP) and certifies it will fulfill all program requirements. The undersigned acknowledges that actions initiated and/or completed without fulfilling the specific documentation and procedural requirements of the National Environmental Policy Act (NEPA) may not be considered for FEMA funding. Only in rare situations, where actions were initiated in an emergency situation to prevent or reduce an immediate threat to life, health, property or severe economic losses can exceptions be considered, if otherwise eligible. However, no project application can be considered for FEMA funding that was initiated prior to the receipt of this application from the NYS Division of Homeland Security and Emergency Services (DHSES). The undersigned acknowledges that to retain eligibility for funding, the applicant may not initiate work on this project prior to FEMA approval. Furthermore, that as a condition of any project approval; the applicant acknowledges that they are responsible for obtaining all required permits prior to project initiation. Copies of all permits are to be forwarded to DHSES. Any modifications to the approved scope of work must be submitted to FEMA (through DHSES) for approval. All site inspections and maintenance should be documented and maintained by the applicant, since this would be essential in determining the eligibility of federal funding for future damages arising at the sites. The undersigned acknowledges that other types of federal assistance that have been received for this project has been identified within this application. In addition all requests or anticipated requests for funding made to other federal agencies or sources are also identified within this application. MAINTENANCE AGREEMENT The City/Town/Village/County of ~Q,~ p ~ ,~ a 2 f ,State of _' r ec-~) J ~ r,L ,hereby agrees that if it receives any Federal aid as a result of the attached project application, it will accept responsibility, at its own expense if necessary, for the routine maintenance of any real property, structures, or facilities acquired or constructed as a result of such Federal aid. Routine maintenance shall include, but not be limited to, such responsibilities as keeping vacant land clear of debris, garbage, and vermin; keeping stream channels, culverts, and storm drains clear of obstructions and debris; and keeping detention ponds free of debris, trees, and woody growth. The purpose of this agreement is to make clear the Subgrantee's maintenance responsibilities following project award and to show the Subgrantee's acceptance of these responsibilities. It does not replace, supersede, or add to any other maintenance responsibilities imposed by any Federal law or regulation and which are in force on the date of project award. Annual inspections should be documented and maintained by the Applicant, since this would be essential in determining the eligibility of Federal funding for future damages arising at the project site. To the best of my knowledge and belief, all data/information that is submitted within this application is true and correct. I represent this Applicant and am authorized by the governing body of this jurisdiction to commit the local matching share. Signature: ti~ Date: ~'~~~-v~e->,-L.e-e,~ /~, ~ i3 /~ ' Title: ,.`~~ FEDERAL EMERGENCY MANAGEMENT AGENCY CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS (GRANTEES OTHER THAN INDIVIDUALS) This certification is required by the regulations implementing the Drug-Free Workplace Act of 1988, 44 CFR Part 17, Subpart F. The regulations, published in the 1989 Federal Register, require certification by grantees prior to award, that they will maintain adrug-free workplace. The certification set out below is a material representation of fact upon which reliance will be placed, when the agency determines to award the grant. False certification or violation of the certification shall be grounds for suspension of payments, suspension or termination of grants, or government-wide suspension or debarment (See 44 CFR Part 13, Subpart C 13.300 and Subpart D13.400) The grantee certifies that it will provide adrug-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 that will be taken against employees for violation of such prohibition (b) Establishing adrug-free awareness program to inform employees 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 be given a copy of the statement required by paragraph (a) (d) Notifying the employee in the statement (required by Paragraph 9a) that, as a condition of employment under the grant the employee will: (1) Abide by the terms of The statement and (2) Notify the employer of an criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction (e) Notifying the agency within ten days after receiving notice under subparagraph (d)(2), from an employee otherwise receiving actual notice of such conviction (f) Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is convicted (1) Taking appropriate personnel action against such an employee, up to and including termination; (2) Requiring such employee to participate satisfactorily in a drug abuse assistance of 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) and (g). Places of Performance: The grantee shall insert in the space provided below the site(s) for the performance of work done in connection with the specific grant (street address, city, county, state, zip code) T ©cJu ~ o ~' NN /a ~ Organizatidh Name`(As appropriate) Application Number i ou~n off' i,~~; ~~ e~- Printed Name