R18-157 1 RESOLUTION NO. R18-157
2
3 A RESOLUTION OF THE CITY OF BOYNTON BEACH,
4 FLORIDA, APPROVING AND AUTHORIZING THE CITY TO
5 APPLY FOR THE 2018 ASSISTANCE TO FIREFIGHTERS
6 GRANT (AFG) FROM THE DEPARTMENT OF HOMELAND
7 SECURITY IN THE AMOUNT OF $481,166.00 PLUS A CITY
8 MATCH OF $48,116.00 FOR A TOTAL COST OF $529,282.00;
9 AND PROVIDING AN EFFECTIVE DATE.
10
11
12 WHEREAS, the purpose of this program is to support local fire departments by
13 helping with the acquisition of needed equipment, vehicles and services; and
14 WHEREAS, the Fire Department has applied for a grant to be used to replace the
15 department's advanced life support cardiac monitors/defibrillators; and
p pp
16 WHEREAS, the estimated total project cost is $529,282.00 and the grant is in the
17 amount of$481,166.00, therefore the City will match the remaining amount of$48,116.00
18 from the Fire Department's grant match account; and
19 WHEREAS, the grant, if awarded, will be used for replacement of our advanced
20 life support equipment.
21 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION
22 OF THE CITY OF BOYNTON BEACH, FLORIDA, THAT:
23
24 Section 1. The foregoing "Whereas" clauses are hereby ratified and confirmed as
25 being true and correct and are hereby made a specific part of this Resolution upon adoption
26 hereof.
27 Section 2. The City Commission approves and authorizes the City to apply for
28 the Assistance to Firefighters Grant (AFG) from the Department of Homeland Security in
29 the amount of $481,166.00 for the replacement of the Fire Department's advanced life
30 support equipment, a copy of which is attached hereto as Exhibit "A".
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31 Section 3. This Resolution shall become effective immediately upon passage.
32
33 PASSED AND ADOPTED this 7th day of November, 2018.
34 CITY OF BOYNTON BEACH, FLORIDA
35 YES NO
36
37 Mayor— Steven B. Grant Abse u/-
38
39 Vice Mayor—Christina L. Romelus -/
40
41 Commissioner—Mack McCray /
42
43 Commissioner—Justin Katz /
44
45 Commissioner—Vacant
46 .��
47 VOTE
48 ATTEST:
49
50
51 L`4l 6 '
/e
52 Judith . yle, CMC
53 City Clerk
54
55
56 (Corporate Seal)
57
O
s
' htir. __- -
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Application Number: EMW-2018-FO-00546 Page 1 of 27
Entire Application
DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
AFG Application (General Questions and Narrative)
OMB No.: 1660-0054
Expiration Date:August, 312019
PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this data collection is estimated to average 9 hours per response for FEMA Form
080-0-2 "AFG Application (General Questions and Narrative)".The burden estimate includes the time for
reviewing instructions,searching existing data sources, gathering and maintaining the data needed, and
completing and submitting this form. This collection of information is required to obtain or retain benefits.
You are not required to respond to this collection of information unless a valid OMB control number is
displayed on this form.Send comments regarding the accuracy of the burden estimate and any suggestions
for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal
Emergency Management Agency, 500 C Street,SW.,Washington, DC 20472-3100, Paperwork Reduction
Project (1660-0054) NOTE: Do not send your completed form to this address.
Applicant's Acknowledgements
• I certify the DUNS number in this application is our only DUNS number and we have confirmed it is active in
SAM.gov as the correct number.
•As required per 2 CFR 6 25, I certify that prior to submission of this application I have checked the DUNS
number listed in this application against the SAM.gov website and it is valid and active at time of submission.
I certify that the applicant organization has consulted the appropriate Notice of Funding Opportunity and that
all requested activities are programmatically allowable, technically feasible and can be completed within the
award's one (1)year Period of Performance (POP).
* I certify that the applicant organization is aware that this application period is open from 09/24 to 10/26/2018
and will close at 5 PM EST; further that the applicant organization is aware that once an application is
submitted, even if the application period is still open, a submitted application cannot be changed or released
back to the applicant for modification.
I certify that the applicant organization is aware that it is solely the applicant organization's responsibility to
ensure that all activities funded by this award(s) comply with Federal Environmental planning and Historic
Preservation (EHP) regulations, laws, and Executive Orders as applicable. The EHP Screening Form designed
to initiate and facilitate the EHP Review is available at: http://www.fema.gov/media-librarv-
data/1431970163011-80ce3cd907072a91295b1627c56d8fd2/qpd ehp screening form 51815.pdf
• I certify that the applicant organization is aware that the applicant organization is ultimately responsible for the
accuracy of all application information submitted. Regardless of the applicant's intent, the submission of
information that is false or misleading may result in actions by FEMA that include, but are not limited to: the
submitted application not being considered for award, an existing award being locked pending investigation, or
referral to the Office of the Inspector General.
Signed by JEFFREY B DAVIDSON on 2018-10-09 17:26:32.0
Overview
Application Number: EMW-2018-FO-00546 Page 2 of 27
•Did you attend one of the workshops conducted by an AFG regional fire program
specialist?
Yes, I have attended workshop
* Did you participate in a webinar that was conducted by AFG?
Yes
•Are you a member,or are you currently involved in the management,of the fire
department or nonaffiliated EMS organization or a State Fire Training Academy applying
for this grant with this application?
Yes, I am a member/officer of this applicant
If you answered "No", please complete the information below. If you answered "Yes", please skip the Preparer
Information section.
Fields marked with an*are required.
Preparer Information
Preparers Name
Address 1
Address 2
City
State
Zip Neeo help for ZIP+4?
In the space below please list the person your organization has selected to be the primary point of contact for
this grant. This should be a department officer or member of the organization who will see this grant through
completion, including closeout. Reminder: if this person changes at any time during the period of performance
please update this information. Please list only phone numbers where we can get in direct contact with the
POC.
Primary Point of Contact
•Title DEPUTY FIRE CHIEF
Prefix(select one) N/A
• First Name JEFFREY
Middle Initial B
•Last Name DAVIDSON
*Primary Phone 5617426326 Ext. Type work
•Secondary Phone 9547709847 Ext. Type cell
Optional Phone Type
Fax
•Email davidsonJ@bbfl.us
FEMA Form 080-0-2
Contact Information
Application Number: EMW-2018-FO-00546 Page 3 of 27
Alternate Contact Information Number 1
* Title FIRE CHIEF
Prefix (select one) N/A
•First Name GLENN
Middle Initial
•Last Name JOSEPH
*Primary Phone 5617426339 Ext. Type work
*Secondary Phone 5617426300 Ext. Type cell
Optional Phone Type
Fax
*Email JosephG@bbfl.us
Alternate Contact Information Number 2
•Title DEPUTY FIRE CHIEF
Prefix(select one) N/A
Name*FirstLATOSHA
Middle Initial
•Last Name CLEMONS
•Primary Phone 5617426342 Ext. Type work
Secondary Phone 5617426300 Ext. Type cell
Optional Phone Type
Fax
Email ClemonsL@bbfl.us
FEMA Form 080-0-2
Application Number: EMW-2018-FO-00546 Page 4 of 27
Applicant Information
EM W-2018-FO-00546
Originally submitted on 10/16/2018 by Jeffrey Davidson (Userid: schuldtkl)
Contact Information:
Address: 2080 High Ridge Rd.
City: Boynton Beach
State: Florida
Zip: 33426
Day Phone: 5617426326
Evening Phone:
Cell Phone:
Email: davidsonj@bbfl.us
Application number is EMW-2018-FO-00546
•Organization Name Boynton Beach Fire Rescue
•Type of Applicant Fire Department/Fire District
• Fire Department/District, Non-Affiliated EMS,
and Regional applicants, select type of Jurisdiction City
Served
If"Other', please enter the type of Jurisdiction
SAM.gov (System For Award Management)
•What is the legal name of your Entity as it appears
in SAM.gov?
Note: This information must match your SAM.gov City of Boynton Beach
profile if your organization is using the DUNS
number of your Jurisdiction.
•What is the legal business address of your Entity as it appears in SAM.gov?
Note: This information must match your SAM,gov profile if your organization is using the DUNS number of
your Jurisdiction.
•Mailing Address 1 100 E Boynton Beach Blvd
Mailing Address 2
•City Boynton Beach
•State Florida
33435- 38
•Zip Need help38 Z P+4?
•Employer Identification Number(e.g. 12-3456789)
Note: This information must match your SAM.gov 59-6000282
profile.
• Is your organization using the DUNS number of Yes
your Jurisdiction?
I certify that my organization is authorized to use the .t
DUNS number of my Jurisdiction provided in this
application (Required if you selected Yes above)
072247133
Application Number: EMW-2018-F0-00546 Page 5 of 27
What is your 9 digit DUNS number?
(call 1-866-705-5711 to get a DUNS number)
If you were issued a 4 digit number(DUNS plus 4)
by your Jurisdiction in addition to your 9 digit number
please enter it here.
Note: This is only required if you are using your
Jurisdiction's DUNS number and have a separate
bank account from your Jurisdiction. Leave the field
blank if you are using your Jurisdiction's bank
account or have your own DUNS number and bank
account separate from your Jurisdiction.
• Is your DUNS Number registered in SAM.gov
(System for Award Management previously Yes
CCR.gov)?
• I certify that my organization/entity is registered 4
and active at SAM.gov and registration will be
renewed annually in compliance with Federal
regulations. I acknowledge that the information
submitted in this application is accurate, current and
consistent with my organization's/entity's SAM.g_ov
record.
Headquarters or Main Station Physical Address
Physical Address 1 2080 High Ridge Rd.
Physical Address 2
•City Boynton Beach
-State Florida
Zip 33426 -8714
Need help for ZIP+4?
Mailing Address
•Mailing Address 1 2080 High Ridge Rd.
Mailing Address 2
•City Boynton Beach
•State Florida
33426 - 8714
•Zip Need help for ZIP+4?
Bank Account Information
•The bank account being used is: (Please select one
from the right)
Maintained by my Jurisdiction
Note: The following banking information must match your SAM.gov profile.
•Type of bank account Checking
•Bank routing number-9 digit number on the bottom 063000047
left hand corner of your check
•Your account number 001611435311
Additional Information
Application Number: EMW-2018-FO-00546 Page 6 of 27
*For this fiscal year(Federal) is your organization No
receiving Federal funding from any other grant
program that may duplicate the purpose and/or
scope of this grant request?
Is the applicant delinquent on any Federal debt? No
If you answered yes to any of the additional questions above, please provide an explanation in the space
provided below:
FEMA Form 080-0-2
Fire Department/Fire District Department Characteristics (Part I)
* Is this application being submitted or. behalf of a Federal Fire
Department or organization contracted by the Federal government No
which is solely responsible for the suppression of fires on Federal
property?
*What kind of organization do you represent? All Paid/Career
If you answered"Combination", above, how many career
members in your organization? (whole numbers only) •
If you answered "Volunteer" or"Combination" or"Paid on-call",
how many of your volunteer Firefighters are pad members from
another career department? (whole numbers only)
What type of community does your organization serve? Urban
*Is your Organization considered a Metro Department? (Over 350 No
paid career Firefighters)
What is the square mileage of your frst-due response area? 20
(whole number only)
What percentage of your response area is protected by 98%
hydrants?(whole number only)
*In what county/parish is your organization phys'.cally located? If
you have more than one station, in what county/parish is your Palm Beach County
main station located?
•Does your organization protect critical infrastructure? Yes
If"Yes", please describe the critical infrastructure protected below:
Boynton Beach Fire Rescue protects approximately five miles of coastline, ten miles of intra-coastal shoreline,
.5 miles of inland water, ten miles of railroad line, and five miles of a 12-lane Interstate Highway System.
Additionally, the Fire Department protects Natural Gas Pipelines, the potable water treatment plant, South
Florida Water Management Drainage Canals and control devices, and a 400-bed community hospital.
Potential hazards include Atlantic Hurricanes, tropical storms, tornadoes, flooding, plume exposure from the
St. Lucie and Turkey Point Nuclear Power Plants, hazardous materials release from transportation or
industry, surface and deep water rescue, and incidents that require tactical rescue.
•What percentage of your primary response area is for 12
agriculture, wi;dland, open space, or undeveloped properties? 6
What percentage of your primary response area is for 23
0/0
commercial and industrial purposes?
Application Number: EMW-2018-FO-00546 Page 7 of 27
•What percentage of your primary response area is used for 65 %
residential purposes?
* What is the permanent resident population of your Primary/First- 77720
Due Response Area or jurisdiction served? (whole numbers only)
• Do you have a seasonal increase in population? Yes
If"Yes"what is your seasonal increase in population? 8000
• How many active firefighters does your department have who 140
perform firefighting duties? (whole numbers only)
* How many members in your department/organization are trained
to the level of EMR or EMT, Advanced EMT or Paramedic? 140
(whole numbers only)
Does your department have a Community Paramedic program? Yes
How many personnel are trained to the Community Paramedic 5
level? (whole numbers only)
• How many stations are operated by your organization? (whole 5
numbers only)
•Is your department compliant to your local Emergency
Management standard for the National Incident Management Yes
System (NIMS)?
• Do you currently report to the National Fire Incident Reporting
System (NFIRS)?
Note: You will be required to report to NFIRS for the entire period Yes
of the grant. AFG does not require NFIRS reporting for
nonaffiliated EMS Organizations and State Fire Training
Academy.
If you answered "Yes" above, please enter your FDIN/FDID 06032
•How many of your active firefighters are trained to the level of 140
Firefighter I (or equivalent)? (whole numbers only)
* How many of your active firefighters are trained to the level of
Firefighter II (or equivalent)? (whole numbers only, include all 140
personnel who have attained Firefighter I)
Are you requesting training funds in this application to bring 100% No
of your firefighters into compliance with NFPA 1001?
If you indicated that less than 100%of your firefighters are trained to the Firefighter II level and you are not
asking for training funds to bring everyone to the Firefighter II level in this application, please describe in the
box below your training program and your plans to bring your membership up to Firefighter Il.
* What services does your organization provide?
Advanced Life Support Emergency Medical Responder
Haz-Mat Operational Level Rescue Technical Level
Basic Life Support Structural Fire Suppression
Community Paramedic Wiidland Fire Suppression
•Please describe your organization and/or community that you serve.
Boynton Beach is located in southeastern Florida on the Atlantic coast, halfway between West Palm Beach
and Boca Raton. Dubbed "Americats Gateway to the Gulfstream", Boynton Beach offers a prime coastal
retreat on Florida's Atlantic Shore, and attracts some of the finest fishing, boating and diving in the region.
The City was incorporated in 1920 and was originally known for its production of tomatoes and pineapples.
Boynton Beach Fire Rescue Department(BBFRD), established in 1924, is a municipal service provider with
Application Number: EMW-2018-FO-00546 Page 8 of 27
an Insurance Service Organization (ISO) rating of Class 2. This career department of 162 total personnel,
provides fire suppression, advanced life support, emergency medical services (EMS), special operations and
a Community Standards Division that conducts fire inspections, plans review and code enforcement services.
The 2016 census report indicates that there are 77,720 residents in the city and over 2,900 businesses within
the 16 square miles of incorporated Boynton Beach. The department provides the same services to four
neighboring cities through inter-local agreements adding 5,227 residents and 3.51 square miles to our service
area. The department also participates in municipal, county-wide and statewide mutual aid agreements.
Boynton Beach has longstanding mutual aid agreements with Delray Beach, Boca Raton, and Palm Beach
County Fire Rescue to protect the 1,397,710 residents of Palm Beach County located in 2,386 square miles.
Our technical rescue team, Florida Urban Search and Rescue team#74, is a recognized asset of the Florida
State Urban Search and Rescue response effort. Palm Beach County is the second largest county in the
State of Florida and ranks third in population. As the third largest city in Palm Beach County, Boynton Beach
has more than 36,289 housing units and 15,673 families contributing to the population density of 4,369.6 per
square mile. Senior citizens are 21.4% of the population compared to the 17.3% average in the state.
Residents living below poverty level is slightly higher(15.1%) than the state average of 14.7%. The rate of
home ownership (67.2%) in this city is lower than the rest of the state (69%); the multi-housing market is
significantly higher (45.3%)than the state average of 29.9%. Due to the high population of elders, the
percentage of households living in poverty and a significantly higher ratio of multi-unit residences to single
family units, contribute to a lower tax base and increase the number of requests for emergency services.
FEMA Form 080-0-2
Fire Department Characteristics (Part II)
2017 2016 2015
-What is the total number of fire-related civilian
fatalities in your jurisdiction over the last three 0 0 0
calendar years?
•What is the total number of fire-related civilian
injuries in your jurisdiction over the last three 3 6 2
calendar years?
•What is the total number of line of duty member
fatalities in your jurisdiction over the last three 0 0 L 0
calendar years?
'What is the total number of line of duty member
injuries in your jurisdiction over the last three 6 7 4
calendar years?
*Over the last three years, what was your 23524949
organization's operating budget?
• How much of your TOTAL budget is dedicated to
personnel costs(salary, overtime and fringe 20779778
benefits)?
Does your department have any rainy day reserves, No
emergency funds, or capital outlay?
If Yes,what is the total amount currently set aside?
If Yes, describe the planned purpose of this fund
•What percentage of your annual operating budget
is derived from: 2017 2016 2015
Enter numbers only, percentages must sum up to
100%
Application Number: EMW-2018-FO-00546 Page 9 of 27
I Taxes? •
II 91 % II 91 % I 91
Bond Issues? 0 % 0 % 0 %
EMS Billing? 6 % 6 % 6 %
Grants? 2 % 2 % 2 %
Donations? 0 % 0 % 0 %
Fund drives? 0 % 0% 0 %
Fee for Service? 1 % 1 % 1
Applicants should describe their financial need and how consistent it is with the intent of the AFG Program.
This statement should include details describing the applicant's financial distress, including summarizing
budget constraints, unsuccessful attempts to obtain vehicle and outside funding, and proving the trouble is out
of their control.
Boynton Beach Fire Rescue has a tremendous need for this grant funding request. As a municipal fire rescue
department, Boynton Beach Fire Rescue's operating budget is funded primarily from ad valorem taxes which
are based on local property values. Recent initiatives by the Florida State Legislature to cap ad valorem taxes
for all taxing authorities within the State of Florida have created a budget deficit for the City of Boynton Beach.
Under the Florida Constitution, every Florida homeowner can receive a homestead exemption up to$50,000.
With the City of Boynton Beach having a median home value of$206,100, this exemption tremendously limits
our ad valorem tax base. In addition to the homestead exemption, the Save-Our-Homes Amendment caps the
amount of appreciation the City can tax. The change in tax cannot exceed the lesser value of either 3%of the
prior year's evaluation or the percentage change of the Consumer Price Index. The devaluation of the real
estate market has further reduced revenue. Given these significant limitations, the funding of vital equipment
will not be possible at any time within the next several years. To compound our financial restraints, during the
2016 Fiscal Year, Boynton Beach Fire Rescue had a mandatory need to upgrade our entire fleet of self-
contained breathing apparatus (SCBA), as our inventory was not compliant to the new NFPA standards. This
mandatory upgrade was at a cost of$744,600. Funding was impossible for the City, and because it was a
requirement, we had to enter into a 5-year lease agreement, in order for our firefighters to safely operate in
environments that are Immediately Dangerous to Life and Health (IDLH). Each year, through 2022, our lease
payment is $146,000, which is taken out of any budgeted safety equipment we may have. Mission critical
equipment is purchased out of the remaining funding, such as dive packs for our dive team, a thermal imaging
camera for our rapid intervention teams, and tactical equipment for our special operations team. The fire
department budget in fiscal year 2016/2017 was $21,789,868; personnel costs accounted for 86.6%
($18,874,025) of the budget. In this fiscal year we merged the Fire and Life Safety Division with Code
Compliance Division to form the Community Standards Division, which is under the Fire Department. The
impact to the Fire Department budget was that the remaining balance of$2,915,843 from the Fire Rescue
budget was partially reallocated in the amount of$849,724 ($737,460 in personnel costs and the balance of
$112,264 to operational costs to fund Community Standards). The residual balance was allocated toward Fire
Rescue operating costs, such as vehicle maintenance, equipment maintenance, fuel,water and electric,
contractual services, fees and permits, and uniforms; this allowed only$360,705 to be allocated to safety
equipment, with $146,000 being earmarked for our SCBA lease payment. The fire department budget in fiscal
year 2017/2018 was$23,514,949; personnel costs accounted for 88% ($20,779,778) of the budget. The
remaining balance of$2,745,171 was allocated toward operating costs, such as vehicle maintenance,
equipment maintenance, fuel, water and electric, contractual services, fees and permits, and uniforms; this
allowed only $210,000 to be allocated to safety equipment, with $146,000 earmarked for our SCBA lease
payment. Additionally, in each of the budget years cited above, the city was required to increase spending on
health insurance, pension shortfalls, and vehicle replacement costs; as a result, there were significant
reductions in funding for other operational costs and the much needed purchases to replace of upgrade
mission critical equipment. Based on the financial status of Boynton Beach Fire Rescue, the funding for
replacement of our non-compliant Cardiac Monitors/Defibrillators to the current standard,will be unattainable
without the award of this grant request.
In cases of demonstrated economic hardship, and
upon the request of the grant recipient, the FEMA
Administrator may waive or reduce an AFG grant No
recipient's cost share requirement. Is it your
department's intent to apply for cost share waiver?
Application Number: EMW-2018-FO-00546 Page 10 of 27
How many vehicles does your organization have in each type or class of vehicle listed below? You must
include vehicles that are leased or on long-term loan as well as any vehicles that have been ordered or
otherwise currently under contract for purchase or lease by your organization but not yet in your
possession. ( Enter numbers only and enter 0 if you do not have any of the vehicles below. )
Number
Number of Number of of Seated
Type or Class of Vehicle Front Line Reserve Riding
Apparatus Apparatus Positions
Engines or Pumpers (pumping capacity of 750 gpm
or greater and water capacity of 300 gallons or
more): 1 1 12
Pumper, Pumper/Tanker, Rescue/Pumper, Foam
Pumper, CAFS Pumper, Type 1 or Type II Engine
Urban Interface
Ambi lances for transport and/or emergency 5 2 28
response:
Tankers or Tenders (pumping capacity of less than ,
750 gallons per minute (gpm) and water capacity of 0 0 0
1,000 gallons or more):
Aerial Apparatus:
Aerial Ladder Truck, Telescoping, Articulating, 5 2 42
Ladder Towers, Platform, Tiller Ladder Truck, Quint
Brush/Quick attack(pumping capacity of less than
750 gpm and water carrying capacity of at least
300 gaiions):
Brush Truck, Patrol Unit(Pickup w/Skid Unit), 0 0 0
Quick Attack Unit, Mini-Pumper, Type III Engine,
Type IV Engine, Type V Engine, Type VI Engine,
Type VII Engine
Rescue Vehicles:
Rescue Squad, Rescue (Light, Medium, Heavy), 1 0 6
Technical Rescue Vehicle, Hazardous Materials
Unit
'Additional Vehicles:
EMS Chase Vehicle, Air/Light Unit, Rehab Units,
Bomb Unit, Technical Support(Command, 1 1 I 8
Operational Support/Supply), Hose Tender,
Salvage Truck, ARFF (Aircraft Rescue Firefighting),
Command/Mobile Communications Vehicle
FEMA Form 080-0-2
Fire Department Call Volume
2017 2016 2015
Summary of responses per year by category (Enter
whole number only.If you have no calls for any of The categories,
Enter 0)
Fire NFIRS Series 100 187 68 148
17 15 15
Application Number: EMW-2018-F0-00546 Page l 1 of 27
Overpressure Rupture, Explosion, Overheat (No
Fire) - NFIRS Series 200
Rescue& Emergency Medical Service Incident- 11737 10951 10561
NFIRS Series 300
Hazardous Condition (No Fire) - NFIRS Series 400 347 195 168
Service Call- NFIRS Series 500 1008 974 994
Good Intent Call - NFIRS Series 600 944 999 971
False Alarm& False Call -NFIRS Series 700 1143 496 985
Severe Weather& Natural Disaster- NFIRS Series 14 5 4
800
Special Incident Type- NFIRS Series 900 8 12 13
FIRES
How many responses per year by category? (Enter whole number only.If you have no calls for any of the categories,Enter
0)
Of the NFIRS Series 100 calls, how many are 34 31 30
Structure Fire" (NFIRS Codes 111-120)
Of the NFIRS Series 100 calls, how many are 42 20 34
'Vehicle Fire" (NFIRS Codes 130-138) _
Of the NFIRS Series 100 calls, how many are 35 29 23
`'Vegetation Fire" (NFIRS Codes 140-143)
What is the total acreage of all vegetation fires? 15 11 12
RESCUE AND EMERGENCY MEDICAL SERVICE INCIDENTS
* How many responses per year by category? (Enter whole number only. If you have no calls for any of the categories,Enter
0)
Of the NFIRS Series 300 calls, how many are "Motor 1159 1139 1055
Vehicle Accidents" (NFIRS Codes 322-324)
Of the NFIRS Series 300 calls, how many are 2 0 0
"Extrications from Vehicles" (NFIRS Code 352)
Of the NFIRS Series 300 calls, how many are 27 7 18
Rescues" (NFIRS Codes 300, 351, 353-381)
How many EMS-BLS Response Calls 2873 3189 1934
How many EMS-ALS Response Calls 8864 6579 6467
How many EMS-BLS Scheduled Transports 0 0 0
How many EMS-ALS Scheduled Transports 0 0 0
How many Community Paramedic Response Calls 0 0 0
MUTUAL AND AUTOMATIC AID
* How many responses per year by category?(Enter whole number only.If you have no calls for any of the categories,Enter
0)
How many times did your organization receive 21 19 15
Mutual Aid?
How many times did your organization receive 0 0 0
Automatic Aid?
How many times did your organization provide 8 9 14
Mutual Aid?
How many times did your organization provide 0 0 0
Automatic Aid?
Of the Mutual and Automatic Aid responses, how 0 0 1
many were structure fires?
FEMA Form 080-0-2
Application Number: EMW-2018-FO-00546 Page 12 of 27
Application Number: EMW-2018-FO-00546 Page 13 of 27
Request Information
1. Select a program for which you are applying. If you are interested in applying under both Vehicle
Acquisition and Operations and Safety, and/or regional application you will need to submit separate
applications..
Program Name
Operations and Safety
2. Will this grant benefit more than one organization?
Yes
If you answered "Yes" to Question 2, please explain how this request benefits other organizations below:
Boynton Beach Fire Rescue also provides Fire and EMS Services to four contracted service areas, which
include: The Town of Hypoluxo, Ocean Ridge, Briney Breezes and The Village of Golf. In addition,Boynton
Beach Fire Rescue has mutual aid agreements with Palm Beach County Fire Rescue, Delray Beach Fire
Rescue and Boca Raton Fire Rescue. Our mutual aid partners carry new and upgraded ECG monitor
diagnostic devices. A receiving function of these systems is to provide mutual aid patient care and transport
support. By utilizing the upgraded cardiac monitors, we can assure a smooth transition in patient transfer.
Additionally, we will adhere to approved Firefighter Regional Rehab protocols by following NFPA 1584
recommended safety guidelines for screening of firefighters during mutual aid fire ground operations and
rehab by identifying carbon monoxide poisoning and life threatening methemoglobinemia.
* 3. Is your department facing a new risk, expanding service to Yes
new area, or experiencing an increased call volume?
If you answered "Yes"to Question 3., please explain how your department is facing a new risk, expanding
service to new area, or experiencing an increased call volume
Boynton Beach Fire Rescue is experiencing an increase in call volume each and every year, without an
increase in response apparatus or personnel. In 2015, the department handled 13,341 emergency responses
to 911 calls received. In 2016, emergency responses increased to 14,348 and in 2017 the number of
emergency responses handled increased to 15,468.As statistics show, from 2015 to 2017, Boynton Beach
has had an increase of 16% in call volume, without an increase in response personnel or apparatus.
4. Enter grant-writing fee associated with the preparation of this request. Enter 0 if there is no fee.
$0
* 5. Are you requesting a Micro Grant?
A Micro Grant is limited to$50,000 Federal share. Modification No
to Facilities activity is ineligible for Micro Grants.
FEMA Form 080-0-2
Request Details
DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
Activity Specific Questions for AFG Operations and Safety Applications
OMB No.: 1660-0054
Expiration Date:August,31 2019
PAPERWORK BURDEN DISCLOSURE NOTICE
Application Number: EMW-2018-FO-00546 Page 14 of 27
Public reporting burden for this data collection is estimated to average 4.6 hours per response for FEMA Form
080-0-2b"Activity Specific Questions for AFG Operations and Safety Applications".The burden estimate
includes the time for reviewing instructions, searching existing data sources,gathering and maintaining the
data needed, and completing and submitting this form.This collection of information is required to obtain or
retain benefits.You are not required to respond to this collection of information unless a valid OMB control
number is displayed on this form.Send comments regarding the accuracy of the burden estimate and any
suggestions for reducing the burden to: Information Collections Management, Department of Homeland
Security, Federal Emergency Management Agency, 500 C Street,SW., Washington, DC 20472-3100,
Paperwork Reduction Project(1660-0054) NOTE: Do not send your completed form to this address.
The activities for program Operations and Safety are listed in the table below.
Activity Number of Entries Total Cost Additional Funding
Equipment 1 $ 529,282 $ 0
Modify Facilities 0 $ 0 $ 0
Personal Protective Equipment 0 $ 0 $ 0
Training 0 $ 0 $ 0
Wellness and Fitness Programs 0 $ 0 $0
Grant-writing fee associated with the preparation of this request. $0
Equipment
Equipment Details
1. What equipment will your organization purchase with this grant? Monitor/Defibrillator- 15 leads
' Please provide a detailed description of the item selected above. Boynton Beach Fire Rescue will
purchase thirteen (13)Cardiac
Monitor/Defibrillators for pre-hospital
Advanced Cardiac Life Support to be
placed on each of our ALS emergency
units. Our current inventory of cardiac
monitors has exceeded its lifespan and
has caused excessive costly
maintenance and out of service time.
With 11,737 call to emergency medical
services in 2017, the newest technology
in modern Cardiac Monitor/Defibrillators
will increase the survival rates in cardiac
patients.
2. Number of units: (whole number only) 13
3. Cost per unit: (whole dollar amounts only;this amount should reflect any $40714
volume discounts,rebates,etc.)
4. Generally the equipment purchased under this grant program will:
Replace non-compliant equipment to current standard
If you selected"Replace unusable/unrepairable equipment to 9
meet current standard"or"Replace non-compliant equipment to
Application Number: EMW-2018-F0-00546 Page 15 of 27
current standard" (from 04)above, please specify the age of
equipment in years.
5. Will the equipment being requested bring the organization into Yes
voluntary compliance with a national standard, e.g. compliance with
NFPA, OSHA, etc?
In your Narrative Statement, please explain how this equipment will
bring the organization into voluntary compliance.
6. Is your department trained in the proper use of the equipment Yes
being requested?
7. Are you requesting funding to be trained for these item(s)? No
(Funding for requested training should be requested in the
Equipment Additional Funding section).(Under the Action column
select Update Additional Funding)
8. If you are not requesting training funds through this application, Yes
will you obtain training for this equipment through other sources?
FEMA Form 080-0-2b
Firefighting Equipment-Narrative
* Section# 1 Project Description: In the space provided below, include clear and concise details regarding
your organization's project's description and budget. This includes providing local statistics to justify the needs
of your department and a detailed plan for how your department will implement the proposed project. Further,
please describe what you are requesting funding for, including budget descriptions of the major budget items,
i.e., personnel, equipment, contracts, etc. *4000 characters
First, we would like to thank you for your time in reviewing our grant proposal and taking an interest in further
enhancing the Operations and Safety of Boynton Beach Fire Rescue.
After careful consideration and prioritization, Boynton Beach Fire Rescue has determined the equipment being
requested in this grant, which is most vital to our daily EMS operations, is the procurement of thirteen (13)
Cardiac Monitor/Defibrillators.
Our current cardiac equipment has limited capabilities and lack the technological advances of the past several
years that can very much enhance patient monitoring and care. They are obsolete and cannot be upgraded
with any new technology or capabilities. This includes the inability to transmit 12 lead analyses without
additional hardware, to the receiving hospital or to monitor patient Carbon Monoxide levels. Current monitors
on the market have a vast number of improvements over the units we currently have in service that can
dramatically affect patient and responder care.
A vital concern is the monitoring of Carbon Monoxide levels for both responders and patients. Each year,
carbon monoxide claims the lives of nearly 3,800 Americans and is the most commonly reported form of
poisoning in the United States. NFPA 1854 also recommends the monitoring of CO in firefighters during rehab
operations.
Boynton Beach Fire Rescue would like to improve ALS patient care through replacement of these outdated
units that are the cornerstone of EMS response service. We respectfully request$529,283 in aid from the
Assistance to Firefighters Grant for purchase of thirteen (13) replacement 12 lead biphasic cardiac
monitor/defibrillators, capable of 360 Joules, transmittable 12 lead analyses, pulse oximetry, CO2 detector,
and Carbon Monoxide monitoring, which have become the standard in our county.
The requested equipment will be placed in service on all of our ALS Transport Rescues, ALS Engines, Truck
and Heavy Rescue, and Paramedic Battalion Chief. Boynton Beach Fire Rescue commits to the 10% match,
in the amount of approximately$48,116, required of the grant should the grant be received, and also commits
to all maintenance and training needs to keep the units in a constant state of readiness. The cost was taken
Application Number: EMW-2018-FO-00546 Page 16 of 27
from an approximation from different manufacturer prices of the units with the same capabilities.
This equipment will allow us to meet our State and County Medical Direction and protocols to have full 12 lead
capabilities. This equipment will also bring us into compliance with current training, patient care, and
equipment standards including, but not limited to: NFPA Standards 450, 473, and 1584 and FDA Standards
(21CFR870.5300: Performance Standard for DC-Defibrillator Including Paddles, 21CFR870.1025:
Performance Standard for Arrhythmia Detector and Alarm).
Upon receipt of the units, hands-on training will be held for all Boynton Beach Fire Rescue personnel, along
with continued annual training.
* Section#2 Cost/Benefit: In the space provided below please explain, as clearly as possible, what will be the
benefits your department or your community will realize if the project described is funded (i.e. anticipated
savings and/or efficiencies)? Is there a high benefit for the cost incurred? Are the costs reasonable? Provide
justification for the budget items relating to the cost of the requested items. *4000 characters
Protecting lives and property is the core mission of Boynton Beach Fire Rescue. The benefits of receiving
funding would be exponential to the 77,720 residents of Boynton Beach,the four contracted service areas,
and the three mutual aid cities we provide service to. The following is a list of issues existing with our current
inventory of cardiac monitors:
NFPA standards for CO monitoring were not met until 2013.
Firefighter and patient health are at risk due to potential CO exposure during smoke and fire related incidents.
11,737 patients were treated without the technology that is available to easily identify ST elevation.
Electrocardiograms are not easily sent to the receiving cardiac hospital without the use of external devices
and modems.
Monitor displays are hard to read in bright conditions.
Unit components have continuously failed or break, causing a maintenance agreement of almost$20,000 per
year.
A lack of monophasic/biphasic technology in the deliverance of defibrillation, which causes increased damage
to the cardiac muscle.
Lack of the ability for continuous body temperature monitoring which is imperative in the return of
spontaneous circulation in cardiac arrest patients, and is necessary to meet NFPA 1584 standards on
firefighter rehabilitation.
One hundred percent of Boynton Beach Fire Rescue response areas will benefit from this life-saving cardiac
equipment, enabling the receiving Cardiac Care Hospitals in our city to diagnose what type of cardiac patient
is enroute to their facility, which increases the survivability of these patients. Firefighter/Paramedics will be
able to identify and treat cardiac issues quicker and more efficiently due to having the most current technology
available. This will reduce morbidity and increase the quality of care as a result of rapid intervention during
cardiac emergencies.
The total cost for new cardiac monitor/defibrillators is$529,283. Boynton Beach has 77,720 residents and the
new monitors have a usable life of 8 years, which equates to$1.17 (one dollar and seventeen cents), per
resident, per year, to provide the most technologically advanced Cardiac Monitor/Defibrillators available to the
residents of Boynton Beach.
In the effort to control costs, equipment has only been requested for our primary response units, all of which
are ALS Transport Rescues, ALS Pumpers, an ALS Heavy Rescue and Tower Ladder, and a Paramedic
Battalion Chief.
In the event Boynton Beach Fire Rescue would not receive funding towards the purchase of Cardiac
Monitors/Defibrillators, the Paramedics and their patients would remain limited to older, less precise
electrocardiogram monitoring, defibrillating, pacing and monitoring. The city is unable to keep pace with the
cost of the technology of modern medicine, and Boynton Beach is a growing city with critical infrastructure,
and needs to be able to treat all of our patients with the highest standard of pre-hospital care and
management.
Application Number: EM W-2018-FO-00546 Page 17 of 27
* Section# 3 Statement of Effect: How would this award impact the daily operations of your department? How
would this award impact your department's ability to protect lives and property in your community?*4000
characters
In 2017, Boynton Beach Fire Rescue responded to 11,737 calls for Emergency Medical Services; an increase
of 11%from 2016, and an increase of 11%from 2015. AFG funding will allow us to provide better patient care
for our response area and fire department personnel. The cardiac monitor/defibrillator will be utilized on every
medical response for vital sign monitoring.Additionally, the patient's odds of survival will be vastly improved
when Paramedics acquire 12 lead ECGs in response to chest pain or other cardiac emergencies. Rapid
identification and treatment has been shown to preserve cardiac function, limit infarct size, and reduce
morbidity and mortality. In short, minimal time to treatment yields maximum patient benefit. As stated, many
technological improvements have been made to the newest generation cardiac monitor/defibrillators. A
sampling of these improvements include the latest algorithm for confirming cardiac activity; the ability to
confirm/verify tube placement(ETCO2); the ability to view ST trending; a CPR metronome which effectively
guides compression rates; carboxyhemoglobin (CO detection in the blood) monitoring, which also meets
NFPA 1584 standards.
The 12-lead ECG performed and transmitted from the field is vital in the early detection and prompt treatment
of patients with acute myocardial infarction. The procedure takes five minutes or less to perform and, when
transmitted or interpreted on scene or en route, has been shown to shorten time to in-hospital treatment by
roughly 30 to 60 minutes. The receiving Emergency Department can prepare for immediate patient
assessment and rapid treatment with thrombolytic therapy or percutaneous transluminal coronary angioplasty
(PTCA). Patients may also benefit from triage and transport to the most appropriate facility. Documentation of
transient or intermittent arrhythmias (irregular heart beat) and other electrophysiologic events that occur in the
prehospital setting can assist in diagnosis and treatment decisions in the Emergency Department. The
prehospital 12-lead ECG not only provides a diagnostic quality ECG for use in the detection of AMI but also
allows the knowledgeable paramedic to determine the area of myocardial injury, anticipate associated
potential complications, and implement treatment strategies accordingly.
The additional capability of CO detection to our existing response capabilities would greatly enhance our
ability to expeditiously make the proper field diagnosis and render the appropriate care and transport
decisions,thus reducing morbidity and mortality from CO intoxication for both the public and firefighters.
The procurement of this equipment will allow the Department to meet 4 target capabilities. These capabilities
include Emergency Triage and Pre-Hospital Treatment, Medical Surge, 12 lead telemetry and increased
Responder Safety and Health.
This request meets the priorities of the Assistance to Firefighters Grant, in that the greatest benefits of funding
will be achieved by supporting department's existing mission and to replace used or obsolete equipment.
We sincerely thank you for your consideration of our request, and hope for a favorable reply to replace our
obsolete equipment for ALS service.
FEMA Form 080-0-2b
Budget
Budget Object Class
a. Personnel $ 0
b. Fringe Benefits $0
c. Travel $0
Application Number: EMW-2018-F0-00546 Page 18 of 27
d. Equipment $ 529,282
e. Supplies $ 0
f. Contractual $ 0
g. Construction $0
h. Other $0
i. Indirect Charges $0
j. State Taxes $0
Federal and Applicant Share
Federal Share $481,166
Applicant Share $48,116
Applicant Share of Award (%) 10
'Non-Federal Resources (The combined Non-Federal Resources most equal the Applicant Share of $48,116)
-11
a. Applicant $48,116
b. State $0
c. Local $0
d. Other Sources
$0
if you entered a value in Other Sources other than zero (0), include your explanation below. You can use this
space to provide information on the project, cost share match, or if you have an indirect cost agreement with a
federal agency.
Total Budget $529,282
FEMA Form 080-0-2b
Application Number: EMW-2018-FO-00546 Page 19 of 27
Narrative Statement
For 2011 and on, the Narrative section of the AFG application has been modified. You will enter
individual narratives for the Project Description, Cost-Benefit, Statement of Effect, and Additional
Information in the Request Details section for each Activity for which you are requesting funds. Please
return to the Request Details section for further instructions.You will address the Financial Need in
Applicant Characteristics II section of the application. We recommend that you type each response in a
Word Document outside of the grant application and then copy and paste it into the spaces provided
within the application.
Application Number: EMW-20 I 8-FO-00546 Page 20 of 27
Assurances and Certifications
FEMA Form SF 424E
You must read and sign these assurances.These documents contain the Federal requirements
attached to all Federal grants including the right of the Federal government to review the grant activity.
You should read over the documents to become aware of the requirements. The Assurances and
Certifications must be read, signed,and submitted as a part of the application.
Note: Fields marked with an * are required.
O.M.B Control Number 4040-0007
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 or organizational conflict of
interest, or 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; (f)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)§§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
Application Number: EMW-2018-F0-00546 Page 21 of 27
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 all interest in real property acquired for project purposes regardless of Federal
participation in purchases.
8. Will comply, as applicable,with provisions of the Hatch Act(5 U.S.C. §§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. §§276a
to 276a-7), the Copeland Act (40 U.S.C. §276c and 18 U.S.C. §874), and the Contract
Work Hours and Safety Standards Act(40 U.S.C. §§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.
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. §§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. §§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 Amendments of 1996 and OMB Circular No. A-133, "Audits of
States, Local Governments, and Non-Profit Organizations."
18. Will comply with all applicable requirements of all other Federal laws, executive orders,
regulations and policies governing this program.
Application Number: EMW-2018-FO-00546 Page 22 of 27
Signed by JEFFREY DAVIDSON on 10/08/2018
Application Number: EMW-2018-FO-00546 Page 23 of 27
Form 20-16C
You must read and sign these assurances.
Certifications Regarding Lobbying, Debarment, Suspension and Other Responsibility Matters and
Drug-Free Workplace Requirements.
Note: Fields marked with an * are required.
O.M.8 Control Number 1660-0025
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 44 CFR Part 17, "Government-wide Debarment and
Suspension (Non-procurement)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
Department of Homeland Security (DHS)determines to award the covered transaction, grant, or cooperative
agreement.
1. Lobbying
A. As required by the section 1352, Title 31 of the US Code, and implemented at 44 CFR Part 18 for persons
(entering) into a grant or cooperative agreement over$100,000, as defined at 44CFR 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 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 employee of congress, or an 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 the sub awards at all tiers (including sub grants, contracts under grants and
cooperative agreements and sub contract(s)) and that all sub recipients shall certify and
disclose accordingly.
2. Debarment, Suspension and Other Responsibility Matters(Direct Recipient)
A. As required by Executive Order 12549, Debarment and Suspension, and implemented at 44CFR 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.
(b) Have not within a three-year period preceding this application been convicted of or 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.
Application Number: EMW-2018-FO-00546 Page 24 of 27
(c)Are not presently indicted for or otherwise criminally or civilly charged by a government 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
transactions (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 she shall attach
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 44CFR 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 provide 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 that will be taken against
employees for violation of such prohibition;
(b) Establishing an on-going drug free awareness program to inform employees
about:
(1)The dangers of drug abuse in the workplace;
(2)The grantees 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 DHS awarding office, i.e. regional office or
DHS office.
(f)Taking one of the following actions, against such an employee,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).
Application Number: EMW-2018-FO-00546 Page 25 of 27
(B)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 City State Zip Action
If your place of performance is different from the physical address provided by you in the Applicant
Information, press Add Place of Performance button above to ensure that the correct place of
performance has been specified.You can add multiple addresses by repeating this process multiple
times.
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
DHS funding. States and State agencies may elect to use a Statewide certification.
Signed by JEFFREY DAVIDSON on 10/08/2018
Application Number: EMW-2018-FO-00546 Page 26 of 27
FEMA Standard Form LLL
Only complete if applying for a grant for more than $100,000 and have lobbying activities. See Form 20-
16C for lobbying activities definition.
Application Number: EMW-20)8-F0-00546 Page 27 of 27
Submit Application
Application 100% complete, Submitted
Please click on any of the following links to visit a particular section of your application. Once all areas
of your application are complete, you may submit your application.
Application Area Status
Applicants Acknowledgements Complete
Overview Complete
Contact Information Complete
Applicant Information Complete
Applicant Characteristics (I) Complete
Applicant Characteristics(II) Complete
Department Call Volume Complete
Request Information Complete
Request Details Complete
Budget Complete
Assurances and Certifications Complete
PLEASE READ THE FOLLOWING STATEMENTS BEFORE YOU SUBMIT.
YOU WILL NOT BE ALLOWED TO EDIT THIS APPLICATION ONCE IT HAS BEEN
SUBMITTED. If you are not yet ready to submit this application, save it, and log out until
you feel that you have no more changes.
When you submit this application, you, as an authorized representative of the organization
applying for this grant, are certifying that the following statements are true:
To the best of my knowledge and belief, all data submitted in this application are true and
correct.
This application has been duly authorized by the governing body of the applicant and the
applicant will comply to the Assurances and Certifications if assistance is awarded.
To sign your application, check the box below and enter your password in the space provided.
To submit your application, click the Submit Application button below to officially submit your
application to FEMA.
Note: The primary contact will be responsible for signing and submitting the application. Fields
marked with an asterisk (•) are required.
I, JEFFREY B DAVIDSON, am hereby providing my signature for this application as of 16-Oct-
2018.