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FEDERALLY FUNDED SUBAWARD AND GRANT AGREEMENT FOR DR-46673 - HURRICAN IANAgreement Number: FEDERALLy FUNDED SUBAWARD.AND GRANT AGREEMENT for DR -4673= Hurricane lan The following. Agreement is made and information Subrecipient's name: Subreciplent'suniqueentity identifier: Federal Award Date: Subaward Period of Performance Start and End Date .(Cat A -B); Subaward Period of Performance Start and End Date (Cat G,G): Amount of Federal: Funds Obligated by this Agreement: Total Amount of Federal Funds Obligated to the Subrecipient by the pass-through entity to include this Agreement Total Amount of the Federal Award committed to the.Subrecipient: by the pass-through entity: Federal award project description (see Federal Funding. Accountability and Transparency Act (FFATA}: is provided pursuantto2 CFR §200.332(a)(1): Clearwater, City Of SG2DQRMWJYL6 Name of Federal awarding agency: Name of pass-through entity: .Contact information for the.pass;th rough. entity; Assistance. Listing Number (Formerly CFDA Number): 9130/2022 Sep 23, 2022- Mar 29, 2023 Sep 23, 2022- Mar 29, 2024 N/A. Grant for communities to respond to and recover from major disasters or emergencies and' for limited mitigation measures. Department ofHomeland Security CDHSI Federal Emergency Management Agency CFEMA} Florida Division of Emergency Management CFDEM} 2555 Shurnard Oak Blvd. Tallahassee. FL 32399-2100 97.036 Assistance Listing Program Title (Formerly CFDA program Title): Clearwater, City Of THIS AGREEMENT is entered into by the State of. Florida, Division of Emergency Management, with headquarters. in Tallahassee, Florida. (hereinafter referred to as the "Division"), and Clearwater, City Of (hereinafter referred to as the."Subrecipient"). THIS AGREEMENT IS ENTERED INTO BASED ON TH E FOLLOWING REPRESENTATIONS: A: The Subrecipient represents that it is fully qualified and eligible to receive these grant funds to provide the services identified herein; B. The Subrecipient, by its decision to participate in thisgrant program, bears the ultimate responsibility .for ensuring compliance with all applicable State and Federal laws, regulations and policies, and bears the ultimate. consequences of any adverse decisions rendered by the Division, the Federal Awarding Agency. or any other State and Federalagencies with audit, .regulatory, or enforcement authority.;. C. This Agreement establishes the relationship between 'the Division and the Subrecipient: to. allow the Division to pay grant funds to the Subrecipierii THEREFORE, the Division arid the Subrecipient agree to the following: (1) APPLICATION OF.STATE LAW TO THIS AGREEMENT 2 C FR §200.302.provides: "Each.state.mutt expend and account for the Federal award in accordance with state laws and procedures for expending and accounting for the state's. own funds:" Therefore, section 215.971., FloridaStatutes, entitled "Agreements funded with federal orsteteassistance;"appliestothisAgreernerit. (2) LAWS. RULES. REGULATICNSAND POLICIES a. Performance under this Agreement .is subject to 2 CFR .Part 200, .entitled "Uniform. Administrative Requirements, Cog Principtes, and Audit.Requirementsfor Federal Awards:" b. In addition to the foregoing, the .Subrecipient. and the Division shall be govemed by allapplicable State and Federal laws, rules, and .regulations. Any express reference in Mit Agreement to:a particular statute, rule,. or regulation in no way implies. that no. other statute, rule, or regulation applies; The :applicable statutes, rules, or regulations arethe statutes, rules, or. regulations in effect at the time .of the declaration of the .incidentthrough.which federal funds are awarded, or as otherwise indicated. as retroactively applied. (3) CONTACT a. In accordance with section 1.5.971.(2), Florida Statutes, the Division's Grant Manager shall be responsible for enforcing performanceof this Agreement's terms and conditions and shall serve as the Division's liaison with the Subrecipient. As part of his/her duties, the Grant Manager for the Division. shall: I. Monitorand document Subrecipient performance: and IL Review and document all deliverables for which the Subrecipient requestspayment. b. The Division's Grant Managerforthis Agreement is: Name JenniferStallings Title Grant Program'Manager Bureau of Recovery Address:. Flogda Division of E[troencv Management .2§55 Shumard Oak Blvd: Tallahassee. FL 32399-2100 Telephone;, (3591 815=4408 Email: Jennifer.Stallingseem. rnyflorida,com c. The name and address of the Representative.of the Subrecipient responsible for the administration of this Agreement is: Name:. Jevon A. Graham Address: • 1140' Couit Street: Clearwater, FI, 33756 Telephone; 727-562-4334 ext 3205 Email_ ievongrahamermiclearwater.com d. In the: event that different representatives or addresses are designated by either party after execution of this Agreement; noticeofthe •name, title, and address of the new representative will .be provided to: the other party in wilting via :letter or electronic email. e, •Systems.Access: It is the Subrecipient's responsibility to maintain current active users in the DiVisiori`s grants. management system in accordance•with Attachment B to this Agreement ("Systems Access Form"). (4) TERMS AND CONDITIONS ThisAgreement contains all the terms and conditions agreed upon bythe parties.. (5) EXECUTION This Agreement May be executed in any number of counterparts, of Which may betaken as an original.. (6). MODIFICATION Either party may request modification. of the provisions of this Agreement Changes which are agreed upon. shall be valid only when in writing, signed by each ofthe parties,: and attached to theoriginal of this.Agreement (7) SCOPE OF WORK The Subrecipient shell perform the work as approved by FEMA and provide the necessary documentation to substantiate work completed. (8) PERIODOFAGREEMENT/PERI OD OF PERFORMANCE The Period.ofAgreement establishes.atimeframe for all Subrecipient contractual obligations to be completed. Upon execution by. both parties, this Agreement shall begin on the first day of the incident period for the disaster applicable to the agreement and shall end upon closeout of the Subrecipient's account for this disaster bythe Federal Awarding. Agency, unless:terminated earlier as specified elsewhere in_ this Agreement; This Agreement survives and remains in effect after termination for the herein referenced State and Federal audit ;requirements and the referenced required recordsretention periods. Work may only be performed during the timefrarnes established and approved by FEMA for each Category of Work type. (9) FUNDING a. The amount of total available funding for this subgrant is limited. to the amount obligated by the Federal Awarding Agency for all projectsapproved for this Subrecipient for DR 4673 - Hurricane Ian Payments to Subrecipients are contingent upon the granting of budgetauthoiity to the Division. b. Pursuant to section 252:37(5)(a), Florida Statutes, unless • otherwise. specified iii the General Appropriations.Act, whenever the State accepts financial assistance from the Federal -Government or is agencies •underthe Federal Public Assistance Prograrn and such financial assistance is conditioned upon a.requirement for matching funds, the.State•shall provide the entire match requirementforatateagencies and .one-half of the required .match for grants to Local governments. Affected Local governments shall be required to• provide •onehaif•of the 3 required -match. prior to receipt . of such financial astistance: Section 252.37; Florida Statutes, does not 'apply to Subreclplents that are considered Private Non -Profit entitles, therefore the entirenon-federal share shall be.the responsibility atilt Private•Non-Profit Subrecipient. c. The Executive. Office. of the Governor may approve a.walver to local governments- for the NoreFederat leatch requirement. The local.government must for the waiver in.accordancemith Section 252:37(5)(b), Florida Statutes. Local g ovem men ts.inust apply for the match waiverledependently from theirresP ective County: (To) PAYMENT a.. The payment method used by the. -Division is either a Cast :Reimbursement or an Advance Payment. Advance paymentswill be. governed by-Chajfiter216, Florida Statutes: b. The Division's Grant Manager, as required by section 215.971(2)(c), Florida Statetes,,sheltrecoricile and verify 4111u -ids received.egainst ail funds expended during, the grant agreement period and produce' a'final. reconciliation report: The trial report must identify any funds paid in excess of the expenditures incurred by the Stibrecipienl. (11). REPAYMENTS. a. Refunds .or .repayments. of obligated funds may be paid to the Division through .check or throUghea payment plan as appro.ved. bit the Department of. Financial .Services. Additionally, FEMA may permit the Division to off-eet ageinst other obligated :projects wheredeemed.apprepriate. In -aecordancewith Chapter 255, Florida Statutes the Subrecipient has 36 daysto repaytheigunds. from the issuance .ofthe invoicefrom the DivisiOn. The Division. may impose a -OA; per month interest feefor -Unpaidinveices. b. Ali refunds or repayments due to the Division under thisAgreement are to b made to the order of Division of Emergency Management,' and must include the irivoice' number and the applicable Disaster and. Project number(s) that are.the subject of -the invoice,. and be mailed: directly to. the following address: Division of Emergency Management Cashier 2555 Shumard Oak Boulev.ard Tallahassee FL 32399-2100' (12) RECORDS a. As required by 2 CFR § 200.334 and modified by Florida Department. of State's record retention requirements Fia. Admin. Code:R..13-24:003),the Subrecipient shall retain sefficient records to show its.complianca with .the terms of this Agreement and ail relevant terms and conditions of the award paid, from funds under this Agreement, for a period Of five (5) years from the dateof submission of the filial expenditure report This period may be extended for reasons including, but not limited to, litigation, fraud, br appeal. As required by 2 CFR §200.303(e), the Subrecipient shall take reasonable measures to safeguard protected personally: ideptifiabie information and other hfOniiation the Federal Awarding Agency or the Division designates as sensitive or the Subrecipient considers sensitive consistent with applicable Federal, State, lecal, and tribal laws regarding privacy and responsibley over confidentiality. b.. The Subrecipient shall maintain ali records for the Subrecipient and for all subcoptractor0 or consultants. to be paid from funds provided under this Agreement, including documentation of all progratn costs. in a form sufficient 4 to determine compliance with the requirements and objectives of the award and all other applical* laws and regulatiOns. (1 3)A U [NTS a.. The Su brecip ientsh a II ccim:plyWiththe a tid it req Wren" ents containedin 2CFRPart200, Subpart F. b. As required by 2 CFR §200.337(a), The- Federai.avverdhg agency, Inspectors -general, the Comptroller General of the United States, and the [Division], or any of their authorized representatIVes, shall .enjoy the right of access to any documents, papers, or other records Of the .[SubreCipiert] whbh.ere pertinent to the Federal award, h order to make abditS, exaMitations, excerpts, and transcripts.. The rigt.t.also. includes timely and reasonable access to .the [Subrecipienrel personnel for the: pypOse of interview. and discission related t� such documents." The right of:access.:Is not limited to the required retention Period. bit lasts as bng as the records are.'retained (2. CFR § .200.337(c)). c. As required- by.2. CFR §200332(a)(5), the Division, the Chief Inspector General of the -State Of Florida, the Florida Auditor General, Or any of their authorized represertatives, shall enjoithe:. right of access. to any documents, financlal statements, papers, orother records of the SubrecipiertWhich are pertinent tothisAgreement in.order to make: audits, examinations, excerpts, and' tranScripts. The. right Of acCessalso. induths timely and reasonabb-: access to the SubreCil:bnt'S personnel for purpose of interview and discussion related to such documents. (14) REPORTS a. Consistent with 2 CFR §200.326, the Subrecipent shall provide the: DiAsion with quarterly reports and any eppicablefinancial reporting, including reports reqtked bYthe Federal FundingAccOuritability and TranaPerendy Act (FFATA). These reports Shall include the current statUS andprogress by the Subrecipientandi ea aPtilicabb, alt subcontractors in completing the work described n the Scope of Work and the expenditure of funds under this Agreement, in addition to any other information requested by theDivisibri. b. The SUbrecipient agrees to submit quarterly reports to the DiOsiOn no later than fifteen (15) days after the end of each quarter of the program year and to submit quarterly reports each quarter until one quarter Past the closeout of each project n the Dkiitiones Grant Management System. The ending dates for each quarter of the program year are MarCh 31, June 30, September30, and December 31. c. The closeout report is due sixty (60) days after completion ofeach projectworksheet associated With the applicant executing thfsAgreement, or Sbcty (60) days after termi nation of fh is Agree Merit, whicheyerftrst occurs. 5 Reporting Time Period Subretipleut Report Submittal Deadliie Quarter 1 (Q1) ..October 1-Decetriber :31 January 15 0u.arter 2 (Q2) January 1- March.31 Apti115. Quarter 3 (03) April 1-June3O July 15 Clyarter 4 (Q4) JulyI-September 30 October 15. b. The SUbrecipient agrees to submit quarterly reports to the DiOsiOn no later than fifteen (15) days after the end of each quarter of the program year and to submit quarterly reports each quarter until one quarter Past the closeout of each project n the Dkiitiones Grant Management System. The ending dates for each quarter of the program year are MarCh 31, June 30, September30, and December 31. c. The closeout report is due sixty (60) days after completion ofeach projectworksheet associated With the applicant executing thfsAgreement, or Sbcty (60) days after termi nation of fh is Agree Merit, whicheyerftrst occurs. 5 d. The SUbrecipbrit shall provide additional program reports, updates, or information•that may be required bythe Division orthe Federal awarding agency. (15) MONITORING a The Division shall monitor the performance of the Subredipiert under this Agreemert to ensure that the Scope of Work is being accomplished Within the specified time periods, and that other perforrnance goals are being met b. The Subrecipient agrees to .cpmpy and cooperate with :ay monteringprocedures/processes deemed. 'appropriate by the Division. In the event' thatthe Division detertninesthatan audit of the Sdbredpent is appropriate, the Subrecipient agrees .comply with any additional instructions provided by.the Division to the Subreqicant regarding such audit.. c.. Small Projects, asclefined in 44. CFR § 206203, that.. are obligated above the Federal: SirripWied Acquisition Threshold (SAT).Will besubjectto.enhanCed.oversightand monitoring by the Division as atthoriked-tY2 .CFR §200:$32(a)(2). (16) UAELtTY Ur4ss the Subrecipient is a State agency -or polkicel subdivision, -as:defined h section 768.28 (2), Fbrida Statutes, the:Subrecipient iSsolely responsible to thi-d parties t deals With in carrying out the terms ofthisAg reenient As authorized by section 76828(10), Florida:Statutes, Subrecipientshall hddthe Division har Iessagaimtall claims otwhatever nature by third parties arising from the work performance.underthis Agreement. :For purposes ofthis Agreement,Suhreolpbnt agrees that Os not an. employee or aged of the-DivitiOn but is .art independent contractor. b. :As required -bY section 768.28(19), Florida Statutes, any Subreclplentwhichis a -State agency or political subdivision, as defined n section 7.68;8(2), Florida Stati.tes, agrees to be fully-responsitb for its negligent :or tortious .acts or ornissiorls which result in claims- or suits against tie :Divisionand agrees to be liable' for any damages. Proximately .caused- by the actsor Omissions le the eident.set forth insection 768-28, Florida Statute* Nothing herein is- intended to serve as a waiver of sovereign immunity by any Subrecipient to which sovereign immunity appries. Nothing herein shall be construed as consent by a State agency or Subdivision of the State of Fioridato be sued by third parties n any natter arising: out of any. contract. (17)TERIVNAIIDN This -Agreement terminates upon the completion :of all eligibb work and payment •of all el4ibb• costs b aCcordante with the PublbAssietanceProgratn requirements. The Division and Subrecipientagreethat all records will bemaintained until the conclusion otany record retention.period.. (1:8) PROCUREMENT a The Subrecipient must ensure that any procurement involving ftinds authorized by the Agreement complies with all appficabte Federal and State laws and regulations, inCluding 2 CFR §§200.318 through 200.327 as Well as Appendix lite 2 CFR Part 200 (entitled "Contract Proyisions for Non -Federal Entity Contracts Under Federal Awards): Additional requirements,: guidance; templates, .and checklists regarding procurement may be obtained through the FEMA Procurement Disaster Assatande Team. Resources found here: httos:/twww.ferna.gov/grerts/procurernent. b, The Subrecipient must inClude all applicable federal contract terms for ail contracts for which federal. 6 funds are received. If the Subrecipient contracts with any contractor or vendor for performance. of any portion of the work required under this Agreement, the Subrecipient must incorporate into its.contract with such.contractbr or vendor an indemnification clause holding the Federal Government, its employees and/or their contractors, the Division, its erriployees and/or their contractors,:and..the Subrecipient and its employees and/or their contractors harmless from Ilabiltyto third parties for claims asserted under suCh:contract. c. The •Subrecipient must monitor and document, in the quarterly report, the. contractor's progress in performing itswork. on its behalf .underthis Agreement in addition to its own progress. d.. The Subrecipient must ensure ail :contracts conform to sectiaris.287.057 and 288.703, Florida Statutes, as applicable: (119) ATTACHMENTS a. Alt attach mentotothisAgreement are.incorporatedashet outfully. b. 1n the. event of any .inconsistencies or conflict .between the language of this Agreement and the attachments; the' language. ofthe attachments shall control, bufonlyta the extent ofthe conflict or inconsistency: c, ThisAgreement hasthe:following attachments: i. AttachrhentA.-Certification' Regarding Debarment ii. AttachmentB-SystemsAccess Form. ill. AttachmentC-Certification Regarding Lobbying 7 Agreement Number: Z311 IN VVITNESS WHEREOF, the parties hereto have executed thisAgregment. susREC1P1 ENT: Clearwater, ity0f By: (Signature) .Name:. 541 ialod j. Ti le: Date: STATE OF 'FLORIDA DIVISION OF EMERGENCYMANAGEMENT By: parr -fic. povernar's Authorized Representative Date: Atts.chmentA: CERTIFICATION R EGARDINOttARMENTSUSPENSION, INELIGIBILITY andVOLUNTAay EXCLUSION The!Subrecipierasertifes, to ihe beatOf is:knowledge and 6elief, that itarkfitt• principals:. 1. Are not presently • debarred, suSpended, proposed for. debarment, declared ineligible or voluntarily: exduded from Covered transaCtiona by any Federal' departnient•ciraciencz, 2. Have, -nrit within the .five-year period preceding entefing 'IntoWs Agreetnant fad .one. or.,more pubI 'transactions fFederal. %ate or Lanai) ferminated•for cause Or default: and 3 FlaVe..not within:1M five-year period PrededIng entering:into this proposal (seen ccnvli4ed °for -hada civA judgment rendered agalfist then) for. • • .a) the can,njision .of fraud or a criminal offense In�onnUoWift, obtainir0: atteMpting obtaini'.0 performing a. puhlip.(Fecieral, State; or Local) transaction era contract .under public transaction, ..Or violation a Fectaral.er State antitrust statutes ar coMmisston of etinbezzlement, theft, forgery, bribery, faislffoatibni QgdeettciotiOn. Of record's, °making false stateMents, receivingstOlin prop.erly,c The:,$uhroCipienk:Underatands and .agrees that .tha iangu;sgg... of tbia'rAtlification mat be Iftludeci ill the *arr.] documents .for. all :AdbOarda at all tiers (including • subcontracts, subbrants,..bantracts under .gratitt, loansi and cociperattve agreements) and that all contractors -arid :14b;cotitrOcts finest s'ndtliscicse aCcordinglY, The.SuhreCipIentfurther Lihrlerstands.and agrees that Mit certifleatibn is a material representatloP.Ofact uperritiO !dance -was placed.When.this transaction Vat 'Made Or entered into. Bates Electric, Inc. . M coffi.ta- Sjgroture Craig Mattila, Project Manager •Nianiearid Title 6011 Cleveland Street, Suite 600 Street Actdreiss CioaNarater, FL, 33755 Cltsk'State; Zp 1/30/23 Date g Clediviatdri Cit Of sorecipiont's Name Z3113 D5MOontract NurOet AttachmentA ERTIFICATIQN REGARD1NaDEBARMENT,SpSPENSION; INELIGIBILITY andVOLUNTARY ELUSION TheSubrecipIenterlifint, to Hie bestof fa knowledge and beilef, ihet it aittits princlpela:: 1. Are not presentlY .debaired. sUspendeci. proposed for debarment, declared ine.figibla, or voluntarily 65(d -tided frOm CoVered trarinebtion bY atlY Federal degarblie00regpcZ, 2. Have 'not. within the, five-year period preceding enteting. Into this Agreernent had .ora or .more public •tannactions tFederal,S.take, or Weal) terminated cause or default and • 3. Have not within -111e five-year period Pretheding. entering into this proposal been .o.onvlatecl of orhad judgment rendered against them for, a) the. commiseion of fraud or a criminal offense in .connection-lkith obtainin. attemptingto obtain; 'or perfOrming a public (Federal, State, -or• LOcal):trinsaCtion bre contract under pithllo trarfsection,-Or b) •vioiaiion of Federal or State antitrust statuteszor•ocifirniselon of einbezzlementtheft fOrgptY.; briber, felslficatiOn, or deetructipn, of recordsimaking falsestatetnentei 'or receiving stain p.ropertY: T.t, ;SPOIV.Pipierit- Understand! and agrees 'that' the. language Ihis' certification must be ,indluded in the aiiverd- dgPilinet)te. far ait,subeWarda-•at all tiers (including- subcontracts, subgrants,,:ttintracks under grahts, loans; and • cooperative agrearnents) and that all conttactbrataiid:Sub;contractars 'Must certify and discloSeaccordingly:. 111eSkibreentipriher understands and agresethathie cortifitationis.a material reprir*Ontatio.n.offact upOn'Which .rellancelivaS placed When this transaction WO -Made of entered into. P9M-71"—Wrf Karyn Erickson, PM :Marne and Title 000r Cleveland -Street, Suite -:600 1;reet Addnlies Cteafwaterl FL, 33755 City; .atate, Zip Date Clearwater, City Of SubreciPlents Rama Z3t113: DM .0ontra4, N.urni?et Attachment B SYSTEMS ACCESS The System Access Form is submitted with each new disaster .or emergency declaration to'identify the Subrecipient:s contacts for the FDEM Grants ManagementSystem n order to enter notes, review notes and documents, and submitthe documentationnecessary to work the new event. The :Systems Access Forrn isoriginally submitted as Attachment "B•tothe PA Funding Agreement. The.Subrecipient is responsible for regularly reviewing It .contacts. Contacts shouts be removed within 14 days of separation, retirement, or are reassignment.by the Subrecipient. A newform will.only be needed fall listed contacts haveseparated from the Agency. fa new Systems Access fonn issubmitted. aIlAaencv Reotesentatives gurrently listed as contacts atare notiincludedonthe undated forrr{ will be deleted from FDEM Grants Manaaement System for the specified arant. All users. must log in on a mohthly basis to keep 'theirac counts from becoming bcked. Note: the. Systems Access- Fonn'is NOT a delegation of authority. A signatory must have an attached delegation of authority as appropriate. hstructions for Completion Cornpletethe form in is entirety, fisting the name. and. information for all representatives who will beworkirg `n the' FDEM: GrantManagemert System Userswill be notified via email when they. have been granted. access. The.user •must log it to the FDEM Grants Management_ System within twelve (12) hours of.being notified or'their account will iockthemi oulEach user must bg h within.a sixty (60) day period •or"ti eit account will'bck them' oil in the evert you try to bg• in and your account is ticked; users must• submit a request for 'unlocking to RPA. Help@em. mvftorida. corn . Theform is:divided intotwelve bbcks; each back mustbecompleteowhere appropriate. Biock 1: Authorized Agent—This shoiti be the highest authority in your organization who is authorized, to sign legal documents on behalf ofyourorganization. A subsequent newAuthorized. Agent must be designated through a letter on btterhead from the.Subrecipient's Authorized_ Representative, 1t is recommended to delegate t t. authorfy to an organizational staff mernberto avoid delays'' grant management(Only oneAuthorized Agent s.allowed, and this_ person will havefulbaccess/ar thority'u nless otherwise requested.). Bock 2: "Primary Contact-This.is the :person: designated biyour organization to receive all correspondence and is our main point of contact This contact will be responsible for answering.questions, upbading documents, and submitting reportslrequests in FDEM Grants Management System. The Authorized. Agent may desgnate:a new Prtnmary Corrtac.(Only' one 'Primary Contactis allowed, and.this contact will have full access). Block.3: Alternate Contact"—This is the persondesignated byyourorgarilzationto. beava1abtewhen'the Prirnary snot:EthertheAuthorizedAgentorPrimaryContactrnaydesignateanewAfternateContact. (OiijroneAitemate Contactisallowed, andthis contactwillhavefullaccess).. Block 4, 5,' and 6: "Other" (Finance/Point of Contact,: Risk Management Irsurance, and Environmental -Historic). Providing these cortacts is essential. in the coordination and communication required between State and Local 'subject matter experts. We: urrierstana that the same agent may be idertifieii ii multiple blocks, however we ask.that"you enter the name and.informatian again to ensure we are communicating with the .correct individuals. Block?—'i2: "Other (Read.OnyAccess) —There is hot mit on "Other" contacts, but we askthetthis be restricted to those that are going to actually need to bg. hand have a roe in reviewing the information: This designation t only for. situational awareness purposes as ndividuaIswith the "Other Read -Only" designation cannottakeany`action in FDEM Grants Management System. Note: The .Syttems: Access Form Bs NOT...a delegation of authority:_ A signatory must have. an attached delegation of'.authority as appropriate. IO 11 SYSTEMS ACCESS FORM (CONTACTS) FEMA/GRANTEE PUBLIC ASSISTANCE PROGRAM FLORIDA DMSION OF EMERGENCY MANAGEMENT Subrecipient: Clearwater, City Of Box 1: Authorized Agent (Full Access) Box 2: PrimaryContact(FullAccess) Name Jennifer Poirrier Name Jevon A. Graham Signature / , } s Signature a_444.--- Organization/Official Position Interim City Manager Organization07 fficial Position Emergency Manager Mailing Address 600 Cleveland Street Ste. 600 Mailing Address 1140 Court Street City, S1a1e, Zip Clearwater, Florida, 33755 City, S1a1e, Zip Clearwater, Florida, 33756 Daytime Telephone 727-562-4885 Daytime Telephone 727-562-4334, Ext. 3205 E-mailAddress Jennifer poirrier!az m vciearwater corn. E-mail Address jevon graham4myciearwater corn Box 3: Alternate Contact (FullAccess) Box 4: Other-Finance/Point of Contact (Full Access) Name Derek Smit Name Jay Ravine Signatur.e—N----c.„20.447‘./c. Signature Organization I Official Posit gency Management Specialist Organization cial ositio Finance' Director Mailing Address 1140 Court Street Mailing Address 100 S. Myrtle Ave City, Slate, Zip Clearwater, FI. 33756 City, Slate, Zip Clearwater, FI. 33756 Daytime Telephone 727-562-4334 ext. 4171 Daytime Telephone 727-562-4538 E-mail Address derek smithemyclearwater corn E-mail Address Jay ravmsmyclearwater.com Box 5: Other -Risk Mgmt-Insurance (Full Access) Box 6: Other -Environmental -Historic (Full Access) Name Todd Morrone Name Monica Mitchell Signature)1/4).4.4.4 Signature Organization 10fficial Position Risk Manager Organization 1 Official Position Finance Assistant Director Mailing Address 100 S. Myrtle Ave. Mailing Address 100 S. Myrtle Ave. City, S1e1e, Zip Clearwater, FI. 33756 ' City, S1a1e, Zip Clearwater, FI. 33756 baytime Telephone 727-562-4655 DaytimeTelephone 727-562-4533 E-mail Address Edward morronea'mvc+earwatercorr ' E-mail Address monica mitchelZmvclearwateccom The above contacts may utilize the FDEM Grants Management System to perform the Subrecipient's responsibilities regarding the Public Assistance Grant according 1 their level of access. The Subrecipient is responsibleforensuringthat all contactsarecorrect and up-to-date. a recipient Auth ized Representative Signature - (f/Ae DatY/ 11 SYSTEMS ACCESS FORM (CONTACTS). FEMA/GRANTEE P.UB.LIC ASSISTANCE PROGRAM FLORIDA DMSION OF EMERGENCY MANAGEMENT Subrecipient: Clearwater; .City Of Date; Box 7: other(ReadOnlyAccess} Box B: other (Read On,ly.Access) Nan:re .Scott Ehlers �' \ Name Daniel SiaughterA 4 Signature. , signature s - -� OrganizationlOfficial Position Fire Chief Organization /Official Positr6n .Police Chief Mailing Address. 1140 Court -Street Mailing Address • 645 -Pierce St City, State, Zip Clearwater; Fl„ 33758 City,Stete,Zip Clearwater,.F1..,:3375E DaytkreTeiepnone 727-562=4334 ext 3174 Dayti[rieTelephone 727.562.4247 E-mailAddress scottehiers@myclearwster.com E-mailAddress Daniel.slaughter@mycieerwater.com Box 9: Other (ReadOnlyAcce.s's) Box 1O: Other (ReadOnlyAccess) Name Name. Signature Signature Organization!Of ficial Position Organization !Official Position Mailing Address Mailing Address City, State, Zip .City,Stale,Zip Daytine•Teephone ' Daytime Telephone E:mailAddress E-mail Address Box 11: Other (ReadOnlyAccess) Box 12; Other (Read OnlyAccess) Nwr►e Name Signature Signature Organization !Official Position Organization !Official Position Mailing Address Mailing Address City, State, Zip City,State,Zip Daytime Telephone Daytirne Telepho ne. E-mailAddress • 'E-mail Address •Sirbrecipient's FiscalYear(FY) Start22,Month: (0/ Day: 0 (' Subrecipient's Federal Employe (s Identification Number.(EIN) 59-6000289 Subrec ipients.Grantee CognizantAgency for SingleAudit Purposes; Florida Division Of Emergency Management Subrecipients: PIPS -Number (if.known) 103-12875-00 1? Attachment:C Certification Regarding Lobbying APPENDIX A.44 CFR PART 13 -CERTIFICATION REGARDING LOBBYING Certification for Contracts, Grants, Loans, and. CooperativeAgreements The undersigned certifies;to:the bestofhis Or. herknowledgeand belief,.that: 1. No Federal 'appropriated'funds have:been paid or will be paid, by or on behalfof the undersigned, to any person for nfluencing orattempting to infuence.an officer or em ployee of en agency; a.Member of ,Congress, an ofiicer.oremployee of Congress, Oran employee of a MemberofCongress inconnection with -the awarding of any Federal contract, the making of any Federafgrant, the making of any Federal loan, the. entering into, of any cooperative agreement, and. the extension, continuation, renewal, amendment,.or modificationofany. Federal contract; grant, ban, orcooperativeagreement. 2. any -funds other than Federal appropriated funds have been paid Or will be. paid to any :person for influencingorattempting to influence ari offiiceroremployee ofanyagency,a Memberof.Congress.,-an 'Officer or employee of Congress, or an -employee. of a Merriber.of Congress in connectionwith this Federal.contract, grant, loan, orcooperative agreement, the undersigned shall corripieteand submit Standard Form -LLL, "Disclosure Form to Report Lobbying," inaccordancewith.iis.instructioris. 3. The undersigned shad requirethatthe language ofthis certification be.included'nthe award documents 'for all subawards atalitierss (1nciuding subcontracts, subgrants, andcontracts.undergrants, loans, and cooperative agreements) and theta!! Su brecipieritethall.certify and disclose accordingly. This cettification isa rnaterial.representation of fact upon which rel'rancewas placed when this transaction was made orenteredinto. Submission of thiscertiiication is a.prerequisite formaking Or -entering intothls transaction. .imposed by section 1352, title 31, U.S. Code. Any person who failsto file. the. required certification -shall be subject toa civil penalty -of not bssthan $10,000 and not more than $1 e0,000.for each such failure. The Su brecipient or contractor, certifesoraffirrnsthetruthfulnessand. accuracy of each statement of its certification and disclosure, ifany. Inaddition, the Contractor understands and agrees provisions of 31 U.S.C. Chap. 38, Administrative Remedies for False Clairns and Statements, applytothis 'fxation.and cji¢closure, ifany. Signet tfreofSubreci i Vcanted uthorizedOfficiai Name and Title of SubrecipietlVconiractor's Authorized Official (--1lac3 Date 1 . Agreement Number: Z3113 FEDERALLY FUNDEDSUBAWARD AND GRANT AGREEMENT for DR - 4673 - Hurricane lan The following Agreement is made, and information is provided pursuant to 2 CFR §200.332(a)(1): Subrecipient's name: Clearwater, City Of Subrecipient's unique entity identifier: 078307303 Federal Award Date: Subaward Period of Performance Start and End Date (CatA-B): Subaward Period of Performance Start and End Date (Cat C -G): Amount of Federal Funds Obligated by this Agreement: Total Amount of Federal Funds Obligated to the Subrecipient by the pass-through entity to include this Agreement: Total Amount of the Federal Award committed to the Subrecipient by the pass-through entity: Federal award project description (see Federal Funding Accountability and Transparency Act (FFATA}: Name of Federal awarding agency: Name of pass-through entity: Contact information for the pass-through entity: Assistance Listing Number (Formerly CFDA Number): 9/30/2022 Sep 23, 2022- Mar 29, 2023 Sep 23, 2022- Mar 29, 2024 N/A Grant for communities to respond to and recover from major disasters or emergencies and for limited mitigation measures. Department of Homeland Security CDHSI Federal Emergency Management Agency CF EMA} Florida Division of Emergency Management CFDEM} 2555 Shumard Oak Blvd. Tallahassee. FL 32399-2100 97.036 Assistance Listing Program Title (Formerly CFDA program Title): Clearwater, City Of THIS AGREEMENT i s entered into by the State of Florida, Division of Emergency Management, with headquarters in Tallahassee, Fbrida (hereinafter referred to as the "Division"), and (hereinafter referred to as the "Subrecipient"). Clearwater, City Of THIS AGREEMENT IS ENTERED INTO BASED ON THE FOLLOWING REPRESENTATIONS: A. The Subrecipient represents that it is fully qualified and eligible to receive these grant funds to provide the services identified herein. B. The Subrecipient, by its decision to participate in this grant program, bears the ultimate responsibility for ensuring compliance with all applicable State and Federal laws, regulations and policies, and bears the ultimate consequences of any adverse decisions rendered by the Division, the Federal Awarding Agency, or any other State and Federal agencies with audit, regulatory, or enforcement authority. 1 C. This Agreement establishes the relationship between the Division and the Subrecipient to allow the Division to pay grant funds to the Subrecipienl THEREFORE, the Division and the Subrecipient agree to the following: (1) APPLICATION OF STATE LAWTO THIS AGREEMENT 2 CFR §200.302 provides: "Each state must expend and account for the Federal award in accordance with state laws and procedures for expending and accounting for the state's own funds." Therefore, section 215.971, Florida Statutes, entitled "Agreements funded with federal or state assistance," applies tothisAgreement. (2) LAWS. RULES. REGULATIONS AND POLICIES a. Performance under this Agreement is subject to 2 CFR Part 200, entitled "Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards." b. In addition to the foregoing, the Subrecipient and the Division shall be governed by all applicable State and Federal laws, rules, and regulations. Any express reference in this Agreement to a particular statute, rule, or regulation in no way implies that no other statute, rule, or regulation applies. The applicable statutes, rules, or regulations are the statutes, rules, or regulations in effect at the time of the declaration of the incident through which federal funds are awarded, or as otherwise indicated as retroactively applied. (3) CONTACT a. In accordance with section 215.971(2), Florida Statutes, the Division's Grant Manager shall be responsible for enforcing performance of this Agreement's terms and conditions and shall serve as the Division's liaison with the Subrecipient. As part of his/her duties, the Grant Manager for the Division shall: Monitor and document Subrecipient performance; and ii. Review and document all deliverables for which the Subrecipient requests payment. b. The Division's Grant Manager for this Agreement is: Name Jennifer Stallings Title Grant Program Manager Bureau of Recovery Address: Florida Division of Emeraencv Manaaement 2555 Shumard Oak Blvd. Tallahassee. FL 32399-2100 Telephone: (8501 815-4408 Email: Jennifer.Stallings@em. myflorida.com c. The name and address of the Representative of the Subrecipient responsible for the administration of this Agreement is: Name: Jevon A. Graham Address: 1140 Court Street Clearwater, FI. 33756 2 Telephone: 727-562-4334 ext. 3205 Email: ievon.araham anmvclearwater.com d. In the event that different representatives or addresses are designated by either party after execution of this Agreement, notice of the name, title, and address of the new representative will be provided to the other party in writing via letter or electronic email. e. Systems Access: t is the Subrecipient's responsibility to maintain current active users in the Division's grants management system in accordance with Attachment B to this Agreement ("Systems Access Form"). (4) TERMS AND CONDITIONS This Agreement contains all the terms and conditions agreed upon by the parties. (5) EXECUTION This Agreement may be executed in any number of counterparts, of which may be taken as an original. (6) MODIFICATION Either party may request modification of the provisions of this Agreement. Changes which are agreed upon shall be valid only when in writing, signed by each of the parties, and attached to the original of this Agreement. (7) SCOPE OF WORK The Subrecipient shall perform the work as approved by FEMA and provide the necessary documentation to substantiate work completed. (8) PERIODOFAGREEMENT/PERI OD OF PERFORMANCE The Period of Agreement establishes atimeframe for all Subrecipient contractual obligations to be completed. Upon execution by both parties, this Agreement shall begin on the first day of the incident period for the disaster applicable to the agreement and shall end upon closeout of the Subrecipient's account for this disaster by the Federal Awarding Agency, unless terminated earlier as specified elsewhere in this Agreement. This Agreement survives and remains in effect after termination for the herein referenced State and Federal audit requirements and the referenced required records retention periods. Work may only be performed during the timeframes established and approved by FEMA for each Category of Work type. (9) FUNDING a. The amount of total available funding for this subgrant is limited to the amount obligated by the Federal Awarding Agency for all projects approved for this Subrecipient for DR - 4673 - Hurricane Ian Payments to Subrecipients are contingent upon the granting of budget authority to the Division. b. Pursuant to section 252.37(5)(a), Florida Statutes, unless otherwise specified in the General Appropriati ons Act, whenever the State accepts financial assistance from the Federal Government or is agencies under the Federal Public Assistance Program and such financial assistance is conditioned upon a requirement for matching funds, the State shall provide the entire match requirement for state agencies and one-half of the required match for grants to Local governments. Affected Local governments shall be required to provide one-half of the 3 required match prior to receipt of such financial assistance. Section 252.37, Florida Statutes, does not apply to Subreclplents that are considered Private Non -Profit entitles, therefore the entire non-federal share shall be the responsibility of the Private Non -Profit Subrecipient. c. The Executive Office of the Governor may approve a waiver to local governments for the Non -Federal match requirement. The local government must apply for the waiver in accordance with Section 252.37(5)(b), Florida Statutes. Local governments must apply for the match waiver independently from their respective County. (10) PAYMENT a. The payment method used by the Division is either a Cost Reimbursement or an Advance Payment. Advance payments will be governed by Chapter 216, Florida Statutes. b. The Division's Grant Manager, as required by section 215.971(2)(c), Florida Statutes, shall reconcile and verify all funds received against all funds expended during the grant agreement period and produce a final reconciliation report. The final report must identify any funds paid in excess of the expenditures incurred by the Subreci pienl. (11) REPAYMENTS a. Refunds or repayments of obligated funds may be paid to the Division through check or through a payment plan as approved by the Department of Financial Services. Additionally, FEMA may permit the Division to off -set against other obligated projects where deemed appropriate. In accordance with Chapter 255, Florida Statutes, the Subrecipient has 30 days to repay the funds from the issuance of the invoice from the Division. The Division may impose a 1% per month interest fee for unpaid invoices. b. All refunds or repayments due to the Division under this Agreement are to be made payable to the order of "Division of Emergency Management," and must include the invoice number and the applicable Disaster and Project number(s) that are the subject of the invoice, and be mailed directly to the following address: Division of Emergency Management Cashier 2555 Shumard Oak Boulevard Tallahassee FL 32399-2100 (12) RECORDS a. As required by 2 CFR § 200.334 and modified by Florida Department of State's record retention requirements (Fla. Admin. Code R. 1 B-24.003), the Subrecipient shall retain sufficient records to show its compliance with the terms of this Agreement and all relevant terms and conditions of the award paid from funds under this Agreement, for a period of five (5) years from the date of submission of the final expenditure report. This period may be extended for reasons including, but not limited to, litigation, fraud, or appeal. As required by 2 CFR § 200.303(e), the Subrecipient shall take reasonable measures to safeguard protected personally identifiable infonnation and other information the Federal Awarding Agency or the Division designates as sensitive or the Subrecipient considers sensitive consistent with applicable Federal, State, local, and tribal laws regarding privacy and responsibilty over confidential ity. b. The Subrecipient shall maintain all records for the Subrecipient and for all subcontractors or consultants. to be paid from funds provided underthisAgreement, including documentation of all program costs, in aform sufficient 4 to determine compliance with the requirements and objectives of the award and all other applicable laws and regulations. (13) AUDITS a. The Subrecipientshallcomply with the audit requirements contained in 2 CFR Part200, Subpart F. b. As required by 2 CFR §200.337(a), The Federal awardng agency, Inspectors General, the Comptroller General of the United States, and the [Division], or any of their authorized representatives, shall enjoy the right of access to any documents, papers, or other records of the [Subrecipiert] which are pertinent to the Federal award, in order to make audits, examinations, excerpts, and transcripts. The right also includes timely and reasonable access to the [Subrecipient's] personnel for the purpose of interview and discussion related to such documents." The right of access is not limited to the required retention period but Lasts as bng as the records are retained (2 CFR § 200.337(c)). c. As required by 2 CFR §200332(a)(5), the Division, the Chief hspector General of the State of Fbrida, the Fbrida Auditor General, or any of their authorized representatives, shall enjoy the right of access to any documents, financial statements, papers, or other records of the Subrecipient which are pertinent to this Agreement, in order to make audits, examinations, excerpts, and transcripts. The right of access also includes timely and reasonable access to the Subrecipent's personnel for the purpose of interview and discussion related to such documents. (14) REPORTS a. Consistent with 2 CFR §200.329, the Subrecipient shall provide the Division with quarterly reports and any applcablefinancial reporting, including reports requi'ed by the Federal Funding Accountability and Transparency Act (FFATA). These reports shall include the current status and progress by the Subrecipient and, as applicable, all subcontractors in completing the work described h the Scope of Work and the expenditure of funds under this Agreement, in addition to any other information requested by the Division. b. The Subrecipient agrees to submit quarterly reports to the Division no later than fifteen (15) days after the end of each quarter of the program year and to submit quarterly reports each quarter until one quarter past the closeout of each project in the Division's Grant Management System. The ending dates for each quarter of the program year are March 31, June 30, September 30, and December 31. c. The closeout report is due sixty (60) days after completion of each project worksheet associated with the applicant executing thisAgreement, or sixty (60) days after termination of this Ag reement, whichever first occurs. 5 Reporting Time Period Subrecipient Report Submital Deadline Quarter 1 (Q1) October 1 -December 31 January 15 Quarter 2 (Q2) January 1- March 31 April 15 Quarter (Q3) April 1 -June 30 July 15 Quarter 4 (Q4) July 1 -September 30 October 15 b. The Subrecipient agrees to submit quarterly reports to the Division no later than fifteen (15) days after the end of each quarter of the program year and to submit quarterly reports each quarter until one quarter past the closeout of each project in the Division's Grant Management System. The ending dates for each quarter of the program year are March 31, June 30, September 30, and December 31. c. The closeout report is due sixty (60) days after completion of each project worksheet associated with the applicant executing thisAgreement, or sixty (60) days after termination of this Ag reement, whichever first occurs. 5 d. The Subrecipient shall provide additional program reports, updates, or information that may be required by the Division or the Federal awarding agency. (15) MONITORING a The Division shall monitor the performance of the Subrecipiert under this Agreement to ensure that the Scope of Work is being accomplished within the specified time periods, and that other performance goals are being met. b. The Subrecipient agrees to compy and cooperate with ary monitoring procedures/processes deemed appropriate by the Division. In the event that the Division determines that an audit of the Subrecipient is appropriate, the Subrecipient agrees to comply with any additional instructions provided by the Division to the Subrecipent regarding such audit. c. Small Projects, as defined in 44 CFR § 206.203, that are obligated above the Federal Simpliied Acquisition Threshold (SAT) will be subject to enhanced oversight and monitoring by the Division as authored by 2 CFR §200.332(a)(2). (16) LIA13_ITY a Urress the Subrecipient is a State agency or political subdivision, as defined n section 768.28(2), Fbrida Statutes, the Subrecipient is solely responsible to thFd parties it deals with in carrying out the terms of thisAgreement As authorized by section 76828(19), Fbrida Statutes, Subrecipient shall Fuld the Division harmless against all daims of whatever nature by third parties arising from the work performance under this Agreement. For purposes of this Agreement, Subrecipent agrees that i is not an employee or agent of the Division but is an independent contractor. b. As required by section 768.28(19), Florida Statutes, any Subrecipient which is a State agency or political subdivision, as defined n section 768.28(2), Florida Statutes, agrees to be fully responsitie for its negligent or tortious acts or omissions which result in claims or suits against the Division and agrees to be liable for any damages proximately caused by the acts or omissions to the extent set forth in section 768.28, Florida Statutes. Nothing herein is intended to serve as a waiver of sovereign immunity by any Subrecipient to which sovereign immunity applies. Nothing herein shall be construed as consent by a State agency or subdivision of the State of Florida to be sued by third parties n any matter arising out of any contract. (17) TERMVAIDN This Agreement terminates upon the completion of all eligible work and payment of all el'gitle costs n accordance with the PublcAssistance Program requirements. The Division and Subrecipient agree that all records will be maintained until the conclusion of any record retention period. (18) PROCUREMENT a The Subrecipient must ensure that any procurement involving funds authorized by the Agreement complies with all applicable Federal and State laws and regulations, including 2 CFR §§200.318 through 200.327 as well as Appendix II to 2 CFR Part 200 (entitled "Contract Provisions for Non -Federal Entity Contracts Under Federal Awards). Additional requirements, guidance, templates, and checklists regarding procurement may be obtained through the FEMA Procurement Disaster Assistance Team. Resources found here: httos:/twww.fema. gov/grarts/procurement. b. The Subrecipient must include all applicable federal contract terms for all contracts for which federal. 6 funds are received. If the Subrecipient contracts with any contractor or vendor for performance of any portion of the work required under this Agreement, the Subrecipient must incorporate into its contract with such contractor or vendor an indemnification clause holding the Federal Government, its employees and/or their contractors, the Division, its employees and/or their contractors, and the Subrecipient and its employees and/or their contractors harmless from liabiliy to third parties for claims asserted under such contract. c. The Subrecipient must monitor and document, in the quarterly report, the contractor's progress in performing its work on its behalf under this Agreement in addition to its own progress. d. The Subrecipient must ensure all contracts conform to sections 287.057 and 288.703, Florida Statutes, as applicable. (19) ATTACHMENTS a. All attachments to this Agreement are incorporated as ifset out fully. b. In the event of any inconsistencies or conflict between the language of this Agreement and the attachments, the language of the attachments shall control, but only to the extent of the conflict or inconsistency. c. This Agreement has the following attachments: i. Attachment A - Certification Regarding Debarment ii. Attachment B -Systems Access Form iii. AttachmentC-Certification Regarding Lobbying 7 IN WITNESS WHEREOF, the parties hereto have executed this Agreement. susREC1P1ENT: Clearwater, City Of By: Name: Title: Date: (Signature) STATE OF FLORIDA DIVISION OF EMERGENCY MANAGEMENT By: Date: Governor's Authorized Representative CITY OF CLEARWATER, FLORIDA Je?fniffr Poirrier Interim City Manager Ap ; -d as o form: Owen Kohler Assistant City Attorney 8 Attest: )eba-ntabt Rosemarie Call City Clerk Agreement Number: Z3113 Attachment A CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY and VOLUNTARY EXCLUSION The Subrecipient certifies, to the best of is knowledge and belief, that it and its principals: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; 2. Have not within the five-year period preceding entering into this Agreement had one or more public transactions (Federal, State, or Local) terminated for cause or default; and 3. Have not within the five-year period preceding entering into this proposal been convicted of or had a civil judgment rendered against them for: a) the commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or Local) transaction or a contract under public transaction, or b) 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. The Subrecipient understands and agrees that the language of this certification must be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, contracts under grants, loans, and cooperative agreements) and that all contractors and sub -contractors must certify and disclose accordingly. The Subrecipient further understands and agrees that this certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. By: Clearwater, City Of Signature Subrecipient's Name Z3113 Name and Title 600 Cleveland Street, Suite 600 Street Address Clearwater, FL, 33755 City, State, Zip Date 9 DEM Contract Number Attachment B SYSTEMS ACCESS The System Access Form is submitted with each new disaster or emergency declaration to identify the Subrecipient's contacts for the FDEM Grants Management System n order to enter notes, review notes and documents, and submitthe documentation necessary to work the new event. The Systems Access Form isoriginally submitted as Attachment "13- to the PA Funding Agreement. The Subrecipient is responsible for regularly reviewing is contacts. Contacts should be removed within 14 days of separation, retirement, or are reassignment bar the Subrecipient. A newform will only be needed f all listed contacts have separated from the Agency. Fa new Systems Access fonn is submitted. al lAaencv Representatives currently listed as contacts that are not included on the updated form will be deleted from FDEM Grants Manaaement System for the specified arant. All users must log in on a monthly basis to keeptheiraccounts from becoming ticked. Note: the Systems Access Fonn b NOT a delegation of authority. A signatory must have an attached delegation of authority as appropriate. hstructions for Completion Complete the form h is entirety, listing the name and information for all representatives who will be working in the FDEM Grant Managemert System. Users will be notified via email when they have been granted access. The user must bg in to the FDEM Grants Management System within twelve (12) hours of being notified or their account will bck them oulEach user must bg h within a sixty (60) day period or their account will bck them out. h the evert you try to bg in and your account is ticked, users mist submit a request for unbcking to RPA. Help@em. mvftoride. com. The form is divided into twelve blocks; each bock must be completed where appropriate. Block 1: •Authorized Agent - This should be the highest authority in your organization who is authorized to sign legal documents on behalf of your organization. A subsequent new Authorized Agent must be designated through a letter on letterhead from the Subrecipient's Authorized Representative. t 's recommended to delegate the authorty to an organizational staff member to avoid delays n grant management (Only one Authorized Agents albwed, and this person will have full access/authority unless otherwise requested). Block 2: "Primary Contact -This 's the person designated by your organization to receive all correspondence and is our main point of contact. This contact will be responsible for answering questions, uploading documents, and submitting reports/requests h FDEM Grants Management System. The Authorized Agent may designate a new Primary Contac (Ony one Primary Contact is allowed, and this contact will have full access). Block 3: Alternate Contact" -This is the person designated by your organization to be availablewhen the Primary s not Ether the Authorized Agent or Primary Contact may designate a newAlternate Contact. (Ony oneAlternate Contact is allowed, and this contact will havefull access). Block 4, 5, and 6: "Other" (Finance/Point of Contact, Risk Management-Irsurance, and Environmental -Historic). Providing these cortacts s essential in the coordination and communication required between State and Local subject matter experts. We understand that the same agent may be identified in multiple blocks, however we ask that you enter the name and information again to ensure we are communicating with the correct individuals. Block 7-12: "Other (Read Only Access) -There is no limit on "Other" contacts, butwe ask that this be restricted to those that are going to actually need to bg n and have a rale in reviewing the infonnation. This designation is only for situational awareness purposes as ndividuals with the "Other Read -Only" designation cannot take any action in FDEM Grants Management System. Note: The Systems Access Form is NOT a delegation of authority. A signatory must have an attached delegation of authority as appropriate. 10 SYSTEMS ACCESS FORM (CONTACTS) FEMA/GRANTEE PUBLIC ASSISTANCE PROGRAM FLORIDA DMSION OF EMERGENCY MANAGEMENT Subrecipient: Clearwater, City Of Box 1: Authorized Agent(FullAccess) Box 2: Primary Contact(FullAccess) Name Jennifer Poirrier Name Jevon A. Graham Signature Signature Organization / Official Position Interim City Manager Organization I Official Position Emergency Manager Mailing Address 600 Cleveland Street. Ste. 600 Mailing Address 1140 Court Street City, Stale, Zip Clearwater, FI, 33755 City, Stale, Zip Clearwater, FI., 33756 Daytime Telephone 727-562-4885 Daytime Telephone 727-562-4334 Ext. 3205 E-mail Address jennifer.poirrier@myclearwater.com E-mail Address jevon.graham@myclearwater.com Box 3: Alternate Contact (F u I I Access) Box 4: Other-Finance/Point of Contact (Full Access) Name Derek Smith Name Jay Ravins Signature Signature Organization / Official Position Emergency Management Specialist Organization I Official Position Finance Director Mailing Address 1140 Court Street Mailing Address 100 S. Myrtle Ave City, Slate, Zip Clearwater, FI. 33756 City, Slate, Zip Clearwater, FI., 33756 Daytime Telephone 727-562-4334 ext. 4171 Daytime Telephone 727-562-+4538 E-mail Address derek.smith@myclearwater.com E-mail Address jay.ravins@myclearwater.com Box 5: Other-Risk Mgmt-I nsurance (Full Access) Box 6: Other-Environmental-Historic (Full Access) Name Todd Morrone Name Monica Mitchell Signature Signature Organization / Official Position Risk Manager Organization I Official Position Finance Assistant Director Mailing Address 100 S. Myrtle Ave Mailing Address 100 S. Myrtle Ave City, Stele, Zip Clearwater, FI., 34656 City, Stale, Zip Clearwater, FI. 34656 Daytime Telephone 727-562- 4655 Daytime Telephone 727-562-4533 E-mail Address Edward.morrone@myclearwater.com E-mail Address monica.mitchell@myclearwater.com The above contacts may utilize the FDEM Grants Management System to perform the Subrecipient's responsibilities regarding the Public Assistance G rant according 1D their level of access. The Subrecipient is responsible forensuring that all contacts are correct and up to date. Subrecipient Authorized Representative Signature Date 11 SYSTEMS ACCESS FORM (CONTACTS} FEMA/GRANTEE PUBLIC ASSISTANCE PROGRAM FLORIDA DMSION OF EMERGENCY MANAGEMENT Subrecipient: Clearwater, City Of Date: Box 7: other(ReadOnlyAccess} Box 8: uther (Read OnlyAccess) Narne Scott Ehlers Name Daniel Slaughter Signature Signature Organization /Official Position Fire Chief Organization (Official Position Police Chief Mailing Address 1140 Court Street Mailing Address 645 Pierce St City, State, Zip Clearwater, FI., 33756 City, State, Zp Clearwater, F1.., 33756 Daytime Telephone 727-562-4334 ext. 3173 Daytime Telephone 727-562-4242 E-mailAddress scott.ehlers@myclearwater.com E-mailAddress Daniel.slaughter@mydearwater.com Box 9: Other (Read OnlyAccess) Box 10: Other (Read OnlyAccess) Name Name Signature Signature Organization /Official Position Organization /Official Position Mailing Address Mailing Address City, State, Zip City, State, Zip Daytime Telephone Daytime Telephone E-mail Address E-mail Address Box 11 : Other (Read OnlyAccess) Box 12: Other (Read OnlyAccess) Name Name Signature Signature Organization /Official Position Organization /Official Position Mailing Address Mailing Address City, State, Zip City, State, Zip Daytime Telephone Daytime Telephone E-mailAddress E-mail Address Subrecipient's Fiscal Year (FY) Start: Month: Day: Subrecipient's Federal Employe (s Identification Number (EIN) 59-6000289 Subrecipients Grantee Cognizant Agency for SingleAudit Purposes: Florida Division of Emergency Management Subrecipients: FIPS Number (If known) 103-12875-00 12 Attachment C Certification Regarding Lobbying APPENDIXA.44 CFR PART 18 -CERTIFICATION REGARDING LOBBYING Certification for Contracts, Grants, Loans, and Cooperative Agreements The undersigned certifies, to the best of his or herknowledge and belief, that: 1. 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 an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress inconnection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, orcooperative agreement. 2 i any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure Formto Report Lobbying," in accordance with its instructions. a The undersigned shall requirethatthe language ofthis certification be included in the award documents for allsubawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all Subrecipients shall certify and disclose accordingly. This certification isa material representation offact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The Subrecipient or contractor, Clearwater, City of , certifies oraffirms the truthfulness and accuracy of each statement of its certification and disclosure, ifany. lnaddition, the Contractor understands and agrees that the provisions of 31 U.S.C. Chap. 38, Administrative Remedies for False Claims and Statements, apply to this certification and disclosure, if any. Signature of Subrecipient contractor's Authorized Official Name and Title of SubrecipienVcontractor's Authorized Official 3 WL3 Date Jenn e P irrier Interim City Manager 13 Agreement Number:23113 FEDERALLY FUNDED SUBAWARDAND GRANT AGREEMENT for DR-4573-.Hurricane fan The following Agreement is made,:and information is provided pursuant to 2 CFR.§200.332(a)(1): 5ubrecipient's name: Clearwater, City Of Subrecipient's unique entity identifier: 078307303 Federal Award Date: 9/30/2022 Subaward Period of Performance 5tartand End Date(Cat A-13): Sep 23, 2.022-Mar.29;.2023 Subaward.Period of Performance Start and End Date(Cat C-G): Sep 23, 2022= Mar 29, 2024 Amount of Federal Funds❑bligated by this Agreement: NIA. Totaf.Am.ount of Federal Funds:Obligated to the Subrecfpient bythe pass-through entity to include this Agreement: Total Amount of the Federal.Award committed to the.Subrecipient by#he.pass-through entity: Federal award project description (see Federal Funding Accountability and Transparency Act(FFATA): Grant for communities to respond to and recover from ma'or disasters or emergencies and for.limited mitigation measures: Name of Federal awarding agency.: Det)artment of Homeland�Security CDHSI. Federal Emergency Management Apen . CFEMA} Name of pass-through entity: Florida Division of Emergency Management CFDEM} Contactinformat!onforthe.pass-through entity: 2555 Shumaed Oak Blvd: Tallahassee:FL 32399-2100 Assistance Listing.Number(Formerly CFDA Number): 97.03E Assistance Listing Program Title(Formerly CFDA program Title): Clearwater, City Of THIS AGREEMENT is entered into by the State of Florida, Division of Emergency Management, with headquarters.in Tallahassee,. Florida (hereinafter referred to as the"Division"), and Clearwater,City.Of (hereinafter referred to as the"Subrecipient"). THISAGREEMENT IS ENTERED INTO BASED0N THE FOLLOWING REPRESENTATIONS: A. The.Subrecipient represents that it is fully qualified and eligible..to.receive these grant funds.to provide the services identified herein. S. The Subre.cipient,:by its:decision to participate in this grant program.; bears the ultimate responsibility for ensuring compliance with all applicable State.and Federal laws, regulations and policies, and bears the .ultimate consequences of anyadverse decisions rendered by the.Division,.the Federal Awarding Agency, or any other State and Fe.deraf agencies with audit, regulatory,or enforcement authority. C.. This Agreement establishes the relationship between the Division and the. 5ubrecipient to allow the Division to. pay grant funds to the Subrecipienl THEREFORE;.the.Division acid the Subrecipient agree to the following: (1). APPLICATION OF STATE LAW TO THIS AGREEMENT 2 CFR§200,302 provides:"Each state rnustexpend and account:forthe Federal award in accordance with statelaws and procedures for expending and accounting ferthe.state's own funds." Therefore, section 215:971; Florida Statutes;entitled."Ag reements fundedwith fed eralorstate assistance,"appliestathisAgreement, (2) LAWS.RULgS.R a. Performance under this Agreement is subject to 2 CFR Part. 200, entitled "Uniform Administrative Requirements, Cost Principles, andAudit Requirements for Federal Awards." b. In addition to the foregoing, the Subrecipient and the Division shall.be governed.by all.applicable State and Federal laws, rules, and. regulations. Any .express reference in this Agreement to a particularstatute, rule, or regulation in no way implies that n.o other statute, rule; :or regulation applies. The applicable statutes., rules, or regulations are the.statutes, rules; or regulations in effect at the.time of the declaration of the incident through which federal funds are awarded, or as otherwise indicatedas retroactively applied. (3.) CONTACT a: In accordance with. section 21 ;971.(2), Florida Statutes, the Division's Grant Manager shall be responsible for enforcing performance .of this. Agreement's terms :and .conditions and shall serve as the Division's liaison with.the 5ubrecipient. As part of his/her duties,the.Grant Manager for the.Division shall: is Monitor:and document Subreci.pient performance;and ii.. Review and document all:deliverables for which the 5ubrecipient requests payment. b� The Division's Grant Manager for this Agreement.is: Name Jennifer Stallings Title Grant Program Manager Bureau of Recovery Address: Elodda Divisionr n 25§5 Shuman!„Qak Blvd. Tallahassee FL 32399-2100 Telephone: (8501 8454408 Email: Jennifer,Stallings@em. myflonda.com c. The name and address:of the Representative of the Subrecipient responsiible for the administration of this Agreement.is: Name: Jevon A,:Graham 1140 court street Address: Clearwater, Fl. 33756 2 727-582-4334.ext. 3205 Telephoner Email: iey_oa-amLg=_rnycIe@rwater-com .d. In the event that different representatives or addresses are designated by either party after execution of this Agreement, notice of the name,title, and address of the new representative will be provided to.the other party in writing via letter or electronic email. e. Systems Access: lis.the Subrecipient's responsibility to maintain current:active users in.the Division's grants managementsystem in accordance with Attachment 6 to this Agreement ("Systems:Access Form"). (4) TERMS AND.CONDITIONS This Agreement contains all the terms and conditions agreed upon by the parties. (5) EXECUTION This Agreement may.be executed in any number of counterparts, of whichmay betaken as an original. (6) MODIFICATION Either party may request modification of the provisions of this.Agreement. Changes which are agreed upon shall be valid only when in:Writing,signed by each of the parties, and attached to the original of this Agreement. (7) scOPE OF WORK The Sbrecipient shall perform.the work as approved by FEMA and provide the necessary documentation to substantiate work completed. (8) PERIOD OFAGR.EEMENT/PERI OD OF PERFORMANCE The Period of:Agreement.establishes atimeframe for a#I.Subrecipient contractual obligations to be completed. Upon execution by both:parties, this Agreement shall begin on the first day of the incident. period for.the disaster applicable to the agreement and shall end upon closeout.of the Subrecipient's accountfor this disaster by the Federal Awarding.Agency, unless termi nated earlier as specified elsewhere in this.Agreement. This Agreement survives and remains in effect:after termination for the herein referenced.State and Federal audit.requirements and the referenced required records retention periods. Work may only be performed during the timeframes established and approved by FEMA for each.Category of Work type. (9) FUNDING .a. The amount of total available.funding for'this subgrant:is limited:to the amount obligated by the Federal Awarding Agency for all projects approved for this Subrecipient for DR.- 4.673:= Hurricane Ian Payments to Subrecipients are contingent upon the granting of budget authority to the Division. b. Pursuant to. section .252.37(5)(a), Florida Statutes, :unless otherwise specified in the General Appropriations Act; whenever the State accepts financial assistance from the Federal Government or its agencies under the. Federal. Public Assistance program:and.such financial assistance is conditioned upon a requirement for ma#thing funds,.the.State shall provide the entire match requirement for state agencies and one-half of the required match for.grants to Local governments. Affected Local governments shall be required to provideone-half of.the 3 required match prior to receipt of such financial assistance. Section. 252.37, Florida Statutes., does not apply to Subreclplents that are considered Private Non-Profit entities, therefore the entire non-federal share shall be the responsibility of the Private.Non-Profit5ubrecipient.. c. The Executive. Office of the Governor may approve a waiver to local governments for the Nora-Federal match requirement. The local government:must apply for the waiver in accordance with Section 252.37(5)(b), Florida Statutes. Local governments must apply for the match waiver:independently from their respective County.. (10) PAYMENT a. Thepayment method used by the Division is%either a Cost Reimbursement or an.Advance.Payment. Advance payments will be governed by Chapter 216, Florida Statutes. b. The Division's Grant Manager, as required by section 21.5.971(2}(c} .Florida Statutes,.shall reconcile and verify all funds received against:all funds expended during the grant agreement period and produce:a final reconciliation report.. The final.report must:identify any funds.paid inexcess of the expenditures incurred by the S:ubrecipienl. (11) REPAYMENTS a. Refunds or repayments of obligated funds may be paid.to. the Division .through check or through a payment plan as approved by the Department.of Financial Services.Additionally, FEMA may permit the Division to off-set against other obligated projects.where deemed appropriate.. In accordance with Chapter 255, Florida Statutes, the Subrecipient has 30 days to repay.the funds.from the issuance of the:invoice from the Division,The Division may impose a 1%o. per.rnonth interest fee for unpaid Invoices. b.. All. refunds or repayments due10 the Division under this Agreement orb to be made payable to theorder of "Division of Emergency Management," and must include the invoice number and the applicable Disaster and Project number(s) that are the subject of the invoice, and be mailed directly to the following address: Division.af Emergency Management Cashier 2555 Shumard Oak Boulevard Tallahassee FL 32399-2100 (12) RECORDS a. As required. by 2 CFR § 200.334 and. modified by Florida Department .of State's record retention requirements (Fla.Admin. Code R. 11B-24.00},the Subrecipientshall retain sufficient recordsto show"its compliance with the terms of this.Agreement :and all relevant terms and. conditions of the. award paid from funds under this. Agreement, far.a period of five (5)years from the date of subrnission of the final expenditure report.This period may be extended for reasons including, out not limited to, litigation,fraud, or appeal.As required.by 2 CFR §.200,303(e), the.Subrecipient shall take reasonable measures to safeguard.protected personally identifiable.infonnation and other information the Federal Awarding Agency or the Division designates as sensitive or the Subrecipient considers sensitive consistent with applicable .Federal,.State, local., and tribal laws regarding privacy and responsibility over confidential ity. b. The 5ubrecipient,shall maintain all records for the Subrecipient and for all subcontractors or.consultants. to.be paid from funds provided underthisAgreement, includ'ing.documentation of all program costs,in aform sufficient. 4 to determine compliance with the requirements and objectives of the award and. all other applicable laws.arid regulations. (13)AUDITS a. The Subrecipientshailcomply with the audit requirements contained in 2 CFR.Part200,Subpart F. b. As required by 2 CFR §200.33.7(a), The Federalawarding agency; Inspectors General,.the.Comptroller General of the United .States, and the [Division]; or'.any of their authorized representatives, shall. enjoy the right of access to.any documents, papers; or other records of the (Su.brecipirt]which are pertinent to the. Federal.award, in order to make audits,.examinations, excerpts, and transcripts. The right also includes:timely and reasonable access to the [Subrecipient's].personnel for the.purpose of interview and discussion related to such documents." The right of access is. not limited to the required retention period but lasts as bng..as the records are retained (2 CFR .§ 200.337(c)}. c. As required by 2 CFIR §200332(a)(5), the Division;the Chief Inspector General of the State of Florida, the Florida Auditor General,or any of their authorized representatives, shall enjoy.theright of access to any documents,financial statements,papers,nrofher records of the Subrec'ipiertwhicb are pertinent to this Agreement, h.order to.: make audits, examinations, excerpts, arid transcripts. Theright of access also includes timely and reasonable access to the Subrecipant's personnel for the purpose of interview and discussion related to such documents. (14) REPORTS a. Consistent:with 2 CFR §2170,329, the.Subrecipient shall provide the Division withquarterly reports and any apoRcablefinancial reporting;including reports req u ed:bythe.Federal Fu riding Accountability'and Transparency Act(FFATA).T..hese.reports shall include the current status and progress by the Subrecipient and, as applicable, all subcontractors in completing the work described in the Scope of Work and:the expenditureof funds under this Agreement, in addition to arty other information requested.by the Division. Reporting Time Period Subrecipient Report Submittal Deadibe Quarter 1 (Q1). October 1-December 31 January 15 Quarter 2(Q2) January 1-March 31. April 15 Quarter 3:(Q3) April 1=June 30 July 15 Quarter.4 (Q4) 1 July 1-September 30 October 15 7 7 b. The Subrecipient agrees to submit quarterly reports to the Division no later than fifteen (15) days after the end of each quarter of the program year and to submit.qua.rterly reports each quarter until one quarter past the closeout of each project in the Division's Granit Management System. The ending dates for each quarter of the program year are March 31,June 30, September 3.0, and December 31. c. The closeout reportis due sixty(50)days after completion ofeach projectworksheet associated with the applicant executing thisAg reeme.nt,or sixty(60)days after termination of this Ag reeme nt,wh ichever first occurs:. 5 d. The Subrecipient shall provide additional program reports, updates,or information that maybe required by the Division or the Federal awarding agency. (15)MONTORING a The Division shall monitor the performance of the Subrecipient under this Agreement to ensure that the Scope of Work is being accomplished within the specified time periods, and that other performance goals are being met. b. The Subrecipient agrees to comp* and cooperate with any monitoring procedures/processes deemed appropriate by the Division. In the event that the Division determines that an audit of the Subrecipient is appropriate, the Subrecipient agrees to comply with any additional instructions provided by the Division to the Subrecildent regarding such audit. c. Small Projects, as defined in 44 CFR §206,203, that are obligated above the Federal Simplifled Acquisition Threshold(SAT)will be subject to enhanced oversight and monitoring bythe Division as authored by 2 CFR §200.332(a)(2). (16)LIA13LITY a. Unless the Subrecipient is a State agency or political subdivision,as defined in section 768-28(2),Fbrida Statutes,the Subrecipient is so*responsible to third parties t deals within carrying out the terms of thisAgreement As authorized by section 76828(19),Florida Statutes, Subrecipient shall Wd the Division harmless against all d `ms of whatever nature by third parties arising from the work performance under this Agreement. For purposes of this Agreement,Subrecipient agrees that it is not an employee or agent of the Division but is an independent contractor. b. As required by section 768.28(19), Florida Statutes, any Subrecipient which is a State agency or political subdivision, as defined in section 768.28(2), Florida Statutes, agrees to be fully responside for its neglent or tortious acts or omissions which result in claims or suits against the Division and agrees to be liable for any damages proximately caused by the acts or omissions to the extent set forth in section 768.28, Florida Statutes. Nothing herein is intended to serve as a waiver of sovereign immunity by any Subrecipient to which sovereign immunity applies. Nothing herein shall be construed as consent by a State agency or subdivision of the State of Rokb to be sued by third parties in any matter arising out of any contract. (17)TERIVNAIDN This Agreement terminates upon the completion of all eligible work and payment of all elbible costs in accordance with the PubIbAssistance Program requirements. The Division and Subrecipient agreethat all records will be maintained until the conclusion of any record retention period. (18)PROCUREMENT a. The Subrecipient must ensure that any procurement involving funds authorized by the Agreement compiles with all applicable Federal and State laws and regulations, including 2 CFR §§200.318 through 200.327 as well as Appendix I I to 2 CFR Part 200 (entitled "Contract Provisions for Non-Federal Entity Contracts Under Federal Awards). Additional requirements, guidance, templates, and checklists regarding procurement may be obtained through the FEMA Procurement Disaster Assistance Team, Resources found here: httos:/tw%vw.feiiia.gov/grarts/procurement, lb� The Subrecipient must include all applicable federal contract terms for all contracts for which federal. 6 funds are received, If the Subrecipien.t contracts.with any contractor or vendor for performance of any portlom of the workrequired under this Agreement; the.Subrecipient must incorporate into its contract with such contractor or vendor an 'indemnification clause holding`the Federal Government, its employees and/or their contractors,. the Division,. itsemployees and/or their contractors, and the Subrecipient and its:employees and/or their contractors harmless from liability to third parties for.claims asserted under such contract. c. The Subrecipient must monitor and document, in the quarterly report, the contractor's progress in performing its work on.its behalf under this Agreement in addition to its ownprogress. d. The.Subrecipientmust ensure all contracts conform to sections 287.057 and 288.703; Florida Statutes, as applicable. 19)ATTACHMENTS. a. All attachments tothisAgreernent.areincorporated asifsetout.fully. b. Inthe event of any inconsistencies or conflict between the language of this Agreement and the attachments, the language of the attachments shall control, but only to the extentof the conflict or Inconsistency. c.. This Agreement has.the following attachments; i. Attachment.A.-Certification Regarding Debarment ii. AttachmentB-SystemsAccess rorm iii. AttachmentC-Certification Regarding Loboying 7 Agreement Number: 23113 IN WITNESS WHEREOF,the parties hereto have executed this Agreement. sus EClPlENT: lea Ater, t°Q By: ignature) Name: Title: QjajjA C "C Or & r f rIg Cate: V-1 _ STATE OF FLORIDA DIVISION DF EMERGENCY MANAGEMENT By: Governor's Authorized Representative Date: CITY OF CLEARWATER, FLORIDA Je niftr Poirrier Interim City Manager Ap d as o form: Attest. eV; r . Gwen Kohler Rosemarie Call Assistant City Attorney City Clerk US 8 Attachment,* CERTIFIdATI N REGx'ARDING.DEB 4RMENT,-SUSPENSION,.INELIGIRILITY andVOLUNT4RY EXPWSION The Subrecipientcertifips,:to the best of 4 knowledge:and belfef;.that.A ai fd"its prindpa€s, 1. Are not presenf[y-debarred, suspended, proposed for' debarment., declared €neligible; or voluntarily, excluders from covered transactlons by ahy Federal departrfient,or agency;. 2. Have-'not..withlb the five-year period prerading entering 'Into this Agreement,.,had.ane.or:more public transactions�F.ederal,State, or Local}terminatedJor camse ar default,and 3 Haile not`withim-the,€ive-year period preceding entering into this pro' sial been convicted of.or.-iiad'a:.civil judomerit rendered against them far a)the commlWon of fraud or a criminal offense in.connection with obtaining;. atteripti'ng"to.obtains`or performing a public (Federal, State;.or�focal)transaction or a`contract under public transaction, or tc} violation -of Fedoral or State antitrust statutos.or commission. of.eriml;ezzlement, Met, forgery,.bribery', falsftgtian, Or.destruction-of records, malting false statements,'or receiving stolen property. The..Subrecipient'understands and agrees`that the language.of.thiis-certification must be €hcluded it)the award docuriments for all-subawards.°at all tiers (Including subcontracts, subgrants,, contracts under grants, loans, and cooperative agreements)and that all contractors-arid sub-=Mractdrs must certify and disclose accordingly.. The Subrecipiant-further understands and agrees that this certification is a material rep res6ritation.of-fact upan4wh€cit reliancewas placed when this trantaction..Was made or entered into. Bates. Electric, Inc. py: CinN{ � Clearwatbr-, CYY Of Sighatum $zliarecipent's Name Craig. Mattila, Project Manager 211113 Mania and Title DEIVI Contract.Nuniber 600,C,leveliAnd Street;.Suite 600 Street Address Clearwater, FL, 33755 City;,$tats;Zip 1130123 Date Attachment:A CERTIFICATION REGARDING-DEBARMENT,-SUSPENSION,INELIGIBILITY ancfVOLUNTARY>=XcLUSION The,Sub..reclpientceOps,to the best-of ks:knowledge and.belief,that.itand-andprincipals,' t. Are not presently'tlebarred,. suspended, proposed,for debarment, declared ineligible; or voiuntarlly eXcludjM from covered transabdons by any Federal.departrrient,or agency: 2. Have'not.withl.n the fve-year period Preceding.entering 'Into this Agreetne'it.'had.vne. or.more public transactions(Federal.,$tate,or.Local)iermtnated fair cause ar default; and a Have notwit}in the five-year period preceding entering into this proposal been convicted of or.had a.civil .judgment rendered against f hem.:fpr: A the carnrniss n of fraud or a criminal offense in:connedf[on 4iih obtaining;, attempting to obtaini-or performing a public (Federal, S.fate,.or Loca1)#alnsaction or a contract under public trari'sactlon, .br b) violation of Federal or State antitrust stafutes or commission of embezzlement, theft, forgery, bribery, faisi1•ic206n, at destructi(yn,of retards; retaking faise staterriants,'or receiving stolen property: The..:Subrecipient'understands and agrees'that the language of-this:cestificatiari must. be ;nctuded. In the award documents for all sufaawards at all tiers (including.subcontracts, sub'grants, contracts under grants, loans, and cooperative.agresments).and tltat.all contractors Arid sub contractors must certifyand disclose accordingly,. The Subrecipientfurther understands and agrees that this certification is a material representation_of fact upon tivhich ,reliance,-was placed Wti 6n this transaction wa8,rnade.or entered into- 13 Clearwrater,. aOf Sign re, Subreciplent's Martie KarErickson; PM.n. Z3-113 Norrie and Title DENrl Contract Number 600 GI.eYeland Streefi; SuRe 600 Street Address Clearwater; FL, 33755 City.;State;zip Date P Attachment B SYSTEMS ACCESS The System: Access Form is .submitted with each new disaster or ernergency declaration to. identify the Subrecipient's contacts for the FDEM Grants Management. System in order to enter notes, review notes and documents,and submit the documentation necessary.to-work the new,event. The SystenisAccess Farre is originally submitted as Attachment"l-to the PA Fu nding Agreement. The Sub recipient is re.sponsib.le for regularly reviewing its contacts: Contacts.shoutl be removed within '14 days of separation, retirement, or.a.re reassignment ty the Subrecipient: A newform will only be needed ir all listed contacts have separated from.the Agency. I.fa new Systems Access fonn issUbmitted.allAgeno Representatives-curruntlyi d as conteiMludedon form ill elptqd from FIDEM Ora nts Man m he specified g rant All users must log in on a monthly basis.to keep theiraccounts.from becoming locked.. Note:the Systems Access Fonrn is NOT a delegation of authority.. A signatory must have an attached delegation of authority as appropriate. hstructions for Completion Complete the form in is entirety, listing the name and information for all representatives who will be working in the FID EM.Grant Management System. Users will be notified.via email When they have been granted access. The user must log in.to the FDEM Grants Management System within twelve (12.) hours of.beingnotified-or their account wilt lock them oul Each user must log in within a.sixty (60)day period or their account.will lock them out, In.the evert you try to bg in :and: your account is locked, users must submit a request for .unbckirg to RPA.H.e1p@em.mv­fto6da.com. Theform is divided into twelve blocks;each tbckmust becompleted where appropriate. Block 1::-Authorized Agent—This shoud be the highest authority in your organisation who is. authorized to sign legal documents on behalf of you r organizatio n.A subsequent new Authorized Agent must be designated through a Letter on letterhead from the Subrecipient's Authorized Representative. t is recommended to delegate this authority to an.organizational staff member to avoid delays V1 grant management(Only one Authorized.Agent.i;allowed,and this personwill have full accesslacthority unless otherwise requested.). Block 2:."Primary Contact-This is the person designated.by.your organization to receive.all correspondence and is our main point of contact, This..contact.will be responsible for answering questions, uploading documents, and submitting reports/requests.in FIaEM Grants Management System.. The Authorized Agent may designate a new Primary Contac(Only one:Primary Contact is allowed,and this contactwill have full access}, Block 3:Alternate Contact"—Th is."sthe person designated by your organizationto be availablewhen the Primary is not EithertheAuthorized Agent or Primary Contact may designate a newAlternate Contact.(Only oneAlternate Contact isallowed,andthis.contact:wi11 havefulIaccess).. Block 4, .5, and 6: "Other" (Finance/Point of Contact, Risk Management Insurance, and Environmen taWistoric). Providing these contacts is essential in the coordination and communication required between State and Local subject matter experts. We understand that the.same agent.may be identified.in mufti pie.blocks, however we ask that.you enter the naive and information again to ensure we are cornmunicatingmith the correct individuals. Block 7:-12:".Other(Read OniyAccess)—There is,no limit on"Other"contacts,butwe askthatthis be restricted to those that-are goingto actually need to log n and have a rcle in reviewing the infon nation,This designation is only for situational awareness purposes.as ndWduals with the"Other Read-Only"designation cannot take any.action.in FDEM.Grants Management System. Note: The Systems Access Form is NOT a delegation of authority. A..signatory must have an attached delegation of authority as appropriate. 10 SYSTEMS ACCESS FORM(CONTACTS) FEMA/GRANTEE PUBLIC ASSISTANCE PROGRAM FLORIDA DIVISION OF EMERGENCY MANAGEMENT Subrecipient: Clearwater, City Of Box 1: Authorized Aent Full Access Box 2 Prima Contact FullAccess Name Jennifer Poirrier Name Jevon A.Graham Signature Signature Crgarfz-Aon I Official Position Interim City Manager Organization 7 Official Position Emergency Manager Mailing Address 600 Cleveland Street.Ste.600 Mailing Address 1140 Court Street City,Slale,Zip Clearwater,A,33755 City,Slade,Zip Clearwater,A.,33756 Daytime Telephone 727.562.4865 Daytime Telephone 727.562-4334 Ext,3205 E-mail Address Jennifer.poirrier@myclearwater.com E-mailAddress jevon,grahama@myclearwater.com Box S: Alternate Contact(FullAccess) Box 4: Other-Finance/Point of Contact (Full Access) Name Derek Smith Name Jay Ravins Signatu Signature I V_:b (::4� Orgaril I Official Position Emergency Management Specialist Organizatio tion Finance Director Mailing Address 1140 Court Street Mailing Address 100 S.Myrtle Ave City,Slate,Zip Clearwater, A.33756 City,Slate,Zip Clearwater,Fl.,33756 Daytime Telephone 727-562-4334 ext.4171 Daytime Telephone 727-562-+4538 E-mailAddress derek.smith@mydearwater.com E-mallAddress jay.ravins@myclearwater.com Box S: Other-Risk Mgmt-Insurance(Full Access) Box l6; Other-Environmental-Historic (Full Access)i��i�Name o d morrone - Name Monica Mitchel =LL. t Signature Signature Organizatiorf t Official Position Risk Manager Organization I Official Position Finance Assistant Director Mailing Address 100 S.Myrtle Ave Mailing Address 100 S.Myrfle Ave City,Slele,Zip Clearwater,Fl.,34656 City,5lale,Zip Clearwater,Fl.34656 Daytime Telephone 727-562-4655 Daytime Telephone 727-562-4533 E-mail Address Edward.morrone@myclearwater.com E-mail Address monica.rnitchell@myclearwater.com The above contacts may utilize the FD EM Grants Management System to perform the Subrecipient's responsibilities regarding the Public Ass istarice Grantaccording 1 D th a I r I ev el of access,Th e Su breci pient is respo nsib le fo re n s u 6 n g that all conta cts a re correct a n d up to date. recipient Authonzed Representative Signature Date i1 12 Attachment C Certification Regarding Lobbying APPENDIX A.44 CFR PART 18-CERTIFICATION REGARDING LOBBYING Certification for Contracts,Grants,Loans,and Cooperative Agreements The undersigned certifies,tothe bestof his orherknowledge and belief,that: 1. No Federal appropriated funds have been paid orwill be paid,by or on behalf of the undersigned, to any personfor influencing or attemptingto influence an officer oremployee of an agency,a Member of Congress,an officer or employee of Congress,oran employee of a Member ofCongress inconnection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,ormodification ofany Federal contract,grant,loan,orcooperative agreement, * ff any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing orattempting to influence an officer oremployee of any agency,a Memberof Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this Federal contract,grant, loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL,"Disclosure Formto Report Lobbying,"in accordance with its instructions. * The undersigned shall requirethatthe language ofthis,certification be included intheaward documents forall subawards atalltiers(including subcontracts,subgrants,and contracts undergrants,loans,and cooperative agreements)andthatall Subrecipients shall certify and disclose accordingly. This certification isa material representation of fact upon which reliancewas placed when this transaction was made orentered into.Submission ofthis certification is a prerequisitefor making orentering into this transaction imposed by section 1352,title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a cMl penalty of not less than$10,000 and not more than$100,000 for each such failure. The Subrecipient or contractor, Clearwater, City of ,certifies oraffirmsthetruthfulness and accuracy of each statement of its certification and disclosure,ifany.Inaddition,the Contractor understands and agrees that the provisions of 31 U.S.C.Chap.38,Administrative Remedies for False Claims and Statements, apply to t h is certification and disclosure, if a n y. Qlo� a AdL__ gnatu re of S ub rec i pie nt contra cto r's Autho rized Official Name and Title of Subr;cipienVcontrdctor`s Autllorized Official Date Jenn1-f-'ekJ PcYirr ier Interim City Manager 13 c �,gtGENt`y r RECOVERY BUREAU RI IAS ESSM NT QUESTIONNAIRE s �• ^r. � r - •- i s a r r r M r # # * t 4M- MortrIMMA �, ■ FDE Declaration Number: DR4673 Subrecipient Name(Entity): Clearwater,City o Fiscal Year End Date: October 2023 Risk Assessment Completed by:levon A.Graham Date: 1. Has this entity ever been suspended or debarred? 19 A. No,this entity has not been suspended or debarred within the last 10 years. B.Yes,this entity has been suspended or debarred in the last 4-10 years. C.Yes,this entity is currently or has been suspended or debarred within the last 3 years. Comments: 2. i-1as t j &; tity been ever been ayy,Ardp.d Federal funding? A.Yes,the entity has been awarded Federal funding for at least 5 out of the last 10 years. B.Yes,the entity has been awarded Federal funding for 2-4 out of the last 10 years, C. No,the entity does not have any experience with a Federal Grants program or has only been awarded Federal funding for 1 year or less out of the last 10 years. Comments: Clearwater,City of has received federal funding for Tropical Storm Debbie,2013,Hurricane Hermine,2016 and Hurricane Irina in 2017 3, Has this entity been awarded Public Assistance funding within the last 10 ears? A.Yes,this entity has been awarded Public Assistance funding for 2 or more events. B.Yes,this entity has been awarded Public Assistance funding;for 1 event, C. No,this entity has not been awarded Public Assistance funding. Comments: Clearwater,City of has received PA Assistance funding during the last 10 years for Tropical Storm Debbie,2013 Hurricane Hermine,2016 and Hurricane Irma in 2017 Page I Of FORM 5MP120-0.m w ■ L 'i 1 i 4. Cues this entitv have experience with proiects in the Public Assistance Pro ram within the last 10 years?(choose all that apply) A."Yes,obligated large projects. B.Yes,obligated small projects. C. No. Comments; . Was a Federal Single Audit re uired and performed for this entity's most recent fiscalyear? 6 A.Yes. B. No, but this entity has been audited by an independent auditor yearly for the last 3 years. C. No,this entity has not been audited yearly for the last 3 years. Comments: 6. Has there been turnover within the last year of key personnel responsible for Grants Mana ement e. .Chief Executive Officer Accounting Director Grant Manager and Personnel Officer Ii A. No. B.Yes,there has been turnover in one(1) Key Personnel position. C.Yes,there has been turnover in more than one (1) Key Personnel position. Comments: Page z Of FORM SMP120-01 FDE 7. Do key ersonnel responsible for Grants Management e. .Chief Executive Officer Accounting Director Grant Manager and Personnel Officer have experience with Federal Grants Programs? A.Yes,all key personnel have at least one(l)year of experience with Federal Grants Programs. R. One (1)key personnel does not have at least 1 year of experience with Federal Grants Programs. C.Two(2)or more key personnel do not have at least 1 year of experience with Federal Grants Programs. Comments: 8. Is this etit 's accounting system automated e. .QuickBooks,Sae AND can track the revenues a ncLexpenditures of program funds se a rately for eachproject? A.Yes. B. No.The entity's accounting system is manual, but can track the revenues and expenditures of program funds separately for each project. C. No,the entity's accounting system is unable to track the revenues and expenditures of program funds separately for each project. Comments: 9. Written Policies and Procedures This entity has written policies and/or procedures addressing(choose all that apply): Accounting d Ethics Conflict of Interest W Inventory, Property,and Internal Controls V J Equipment Records Retention Procurement Timekeeping and Payroll Comments: Page 3 Of €ORM s V, 0-01 10. Anticipated Project Amounts by CategorV of Work: if known Category A: 1,000,000.00 Category B. Category C: $ Category D: $ Category E: $ 4,000,000.00 Category F: 20,000.00 Category G: $ Category Z: $ dr EDEM Use OiV F©EM Comments- Risk omments:R sk Assessment Reviewed by: Date:_ Preliminary Result: Risk Rating: -0 Page 4 of 4 FORM SMP120-01