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HomeMy WebLinkAboutCity of Tamarac Resolution R-2014-024Temp Reso. # 12467 Page 1 March 6, 2014 CITY OF TAMARAC, FLORIDA RESOLUTION NO. R-2014 -O?y - A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF TAMARAC, FLORIDA AUTHORIZING THE APPROPRIATE CITY OFFICIALS TO SUBMIT AN APPLICATION TO THE FLORIDA DIVISION OF EMERGENCY MANAGEMENT FOR HAZARD MITIGATION GRANT PROGRAM FUNDS FOR THE TAMARAC WATER TREATMENT PLANT RETROFIT PROJECT IN AN AMOUNT UP TO $1,100,000; PROVIDING FOR UP TO A 25 PERCENT MATCH OF $275,000 IN LOCAL FUNDS IN THE EVENT OF APPROVAL OF THE APPLICATION; PROVIDING FOR ACCEPTANCE OF THE AWARD AND EXECUTION OF DOCUMENTS UPON APPROVAL; PROVIDING FOR CONFLICTS; PROVIDING FOR SEVERABILITY;. AND PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, the City Commission of the City of Tamarac desires to improve emergency management capabilities within the City in the fundamental areas of response, recovery, and continuing operations; and WHEREAS, the Florida Division of Emergency Management provides grants to local governments for pre -disaster mitigation projects under Tier 3 of the Hazard Mitigation Grant Program, and WHEREAS, the City of Tamarac desires to protect its residents, businesses, employees and critical facilities during times of disaster; and WHEREAS, providing for the retrofit of the Tamarac Water Treatment Plant will help ensure continuity of government services during times of disaster; and Te m p Reso. # 12467 Page 2 March 6, 2014 WHEREAS, the granting agency requires and the City is willing to provide a 25 percent match in local funds in an amount up to $275,000 in the event of approval of the grant application; and WHEREAS, it is a requirement of the grant program and the City agrees to provide a Resolution authorizing the grant proposal become an official part of the application; and WHEREAS, the Directors of both Financial Services and Public Services Departments recommend submission of the grant application and acceptance of the award in the event of approval; and WHEREAS, the City Commission of the City of Tamarac deems it to be in the best interest of the citizens and residents of the City of Tamarac to submit an application to the Florida Division of Emergency Management for Hazard Mitigation Grant Program funds for the Tamarac Water Treatment Plant Retrofit Project and accept the award and execute the necessary documents following legal review. NOW THEREFORE BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF TAMARAC, FLORIDA: Section 1: The foregoing "WHEREAS" clauses are HEREBY ratified and confirmed as being true and correct and are HEREBY made a specific part of this Resolution. All exhibits Temp Reso. #12467 Page 3 March 6, 2014 attached hereto and referenced herein are expressly incorporated and made a specific part of this Resolution. Section 2: The appropriate City Officials are HEREBY authorized to submit a Hazard Mitigation Grant Program application to the Florida Division of Emergency Management in an amount up to $1,100,000, providing for a 25% match in local funds of up to $275,000 in the event of approval of the application. A copy of said application form is attached hereto as Exhibit A. Section 3: Upon approval of the application, the appropriate City officials are HEREBY authorized to accept the award and execute the necessary documents following legal review. Section 4: An appropriation for the receipt and expenditure for this grant will be included in a budget amendment prior to November 30, 2014 pursuant to F.S. 166241(2). Section 5: All Resolutions or parts of Resolutions in conflict herewith are HEREBY repealed to the extent of such conflict. Section 6: If any clause, section, other part or application of this Resolution is held by any court of competent jurisdiction to be unconstitutional or invalid, in part or in application, it shall not affect the validity of the remaining portion or applications of this Resolution. Temp Reso. #12467 Page 4 March 6, 2014 Section 7: This Resolution shall become effective immediately upon its passage and adoption. PASSED, ADOPTED AND APPROVED this day of %, 2014. ATTEST: PATRICIA TEUFI CMC CITY C L E RK\T A M J 000 � Vim; � ••• G woo W .? • ^. �• 0 U �r�11111��� I HEREBY CERTIFY THAT I HAVE APPROVED THIS RESOLUTION AS TO FORM WSA14UE S. 0 N CIA O NrTY HA DRESSLER MAYOR RECORD OF COMMISSION VOTE: MAYOR DRESSLER W4.ol DIST 1: COMM. BUSHNE L U6i...* DIST 2: VICE MAYOR GOM DIST 3: COMM. GLASSER DIST 4: COMM. PLACKO DRAFT EXHIBIT A STATE OF FLORIDA - HAZARD MITIGATION GRANT PROGRAM APPLICATION THIS SECTION FOR STATE USE ONLY FEMA- 4138-DR-FL ❑ Standard HMGP ❑ 5% Initiative Application ❑ Application Complete ❑ Standard FMA ❑ Initial Submission or ❑ Re- Submission Support Documents Eligible Applicant Project Type(s) ❑ Conforms w/ State 409 Plan ❑ State or Local Government ❑ Wind ❑ In Declared Area ❑ Private Non -Profit (Tax ID Received) ❑ Flood ❑ Statewide ❑ Recognized Indian Tribe or Tribal Organization ❑ Other: Community NFIP Status: (Check all that apply) ❑ Participating Community ID#: ❑ In Good Standing ❑ Non -Participating ❑ CRS State Application ID: State Reviewer: Signature: Reviewer Phone#: Reviewer Fax#: Reviewer E-Mail: Date Application Received: Date: This application is for all Federal Emergency Management Agency (FEMA Region IV) Hazard Mitigation Grant Program (HMGP) proposals. Please complete ALL sections and provide the documents requested. If you require technical assistance with this application, please contact your State Emergency Management Division at (850) 922-5944. KI To Fill Out This Application: Complete all sections that correspond with the type of proposed project General Application Sections: All applicants must complete these sections Environmental Review: All applicants must complete these sections Maintenance Agreement: Any applications involving public property, public ownership, or management of property Damage Frequency Assessment Worksheet: Acquisition, Elevation, Floodproofing (if FIS and H&H are unavailable) -- one worksheet per Flood -Drainage Improvement Worksheet: Tornado Worksheet.- Wind Retrofit Worksheet: Request for Public Assistance Form: Acquisition Forms: Application Completeness Checklist: Applicant Information FEMA- -DR-FL structure Acquisition, Elevation, Floodproofing (if FIS and H&H are available) -- one worksheet per structure Safe Room Projects only Wind retrofit projects only -- one worksheet per structure FEMA Form 90-49 (Request for Public Assistance): All applicants must complete, if applicable. If project type is Acquisition, these forms must be completed. (Only one of the two Notice of voluntary Interest forms is necessary.) Model Statement of Assurances for Property Acquisition Projects Declaration and Release Notice of Voluntary Interest (Town Hall Version) Notice of Voluntary Interest (Single Site Version) Statement of Voluntary Participation FEMA Model Deed Restriction Language All applicants are recommended to complete this checklist DISASTER NAME: Title / Brief Descriptive Project Summary: _ 1. Applicant (Organization): 2. Applicant Type: ❑State or Local Government Ex., FEMA-1609-DR-FL; Hurricane Wilma []Recognized Native American Tribe OPrivate Non -Profit Form No. HMGP 001, Eff. 06/2012 DRAFT 3. County: 4. State Legislative House District(s): State Legislative Senate District(s): Congressional House District(s): 5. Federal Tax I.D. Number: 6. Data Universal Numbering System (DUNS): 7. FIPS Code*: (*if your FIPS code is not known, please fill out FEMA Form 90-49 (Request for Public Assistance) so that the Department may obtain a FIPS code for you) 8. National Flood Insurance Program (NFIP) Community Identification Number (this number can be obtained from the FIRM map for your area) : 9. NFIP Community Rating System Class Number (if available): 10. NFIP Last Community Assistance Visit Date (FMA ONLY): 11. Attach proof of current Flood Insurance Policy (FMA ONLY): 12. Point of Contact E]Ms. ❑Mr. ❑Mrs. First Name: Last Name: Title: Street Address: City: State: Zip Code: Telephone: Fax: Email Address: 13. Application Prepared by ❑Ms. ❑Mr. ❑Mrs. First Name: Last Name: Title: Telephone: Fax: Email Address: 14. Authorized Applicant Agent (proof of authorization authority required) E]Ms. ❑Mr. ❑Mrs. First Name: Last Name: Title: Telephone: Fax: Street Address: City: State: Zip Code: _ Email Address: Signature: Date: 15. All proposed projects should be included in the county's Local Mitigation Strategy (LMS). Attached is a letter of endorsement for the project from the county's Local Mitigation Strategy Chairperson. []Yes []No 16. Has this project been submitted and/or funded under a previous disaster event? If so please provide the disaster number and project number if available. Section I. Project Description A. Hazards to be Mitigated / Level of Protection 1. Select the type of hazards the proposed project will mitigate: El Flood ❑Wind ❑Storm surge ❑Other (list): 2. Identify the type of proposed project: ❑ Elevation and retrofitting of residential or non-residential structure ❑ Acquisition and relocation ❑ Acquisition and demolition ❑ Wind retrofit ❑ Minor drainage project that reduces localized flooding ❑ Other (please explain) Attach any continuations or additional items to this page Form No. HMGP 001, Eff. 06/2012 3. List the total number of persons that will be protected by the proposed project: 4. Fill in the level of protection and the magnitude of event the proposed project will mitigate. (e.g. 23 structures protected against the 100-year [ 1 %] flood) structure(s) protected against the structure(s) protected against -year Flood (10, 25, 50, 100, or 500 year) mile per hour (mph) winds 5. Engineered projects only (e.g. Drainage Improvements, Erosion Control or other special project types. [Other special project types include drainage and other engineered projects. These projects are unlike acquisition, elevation or wind retrofits/shutters.]) Attach to this page ALL engineering calculations and design plans used to determine the above level of protection. 6. Project will provide protection against the hazard(s) above for years. (i.e., what is the useful life of the project?) B. Project Description, Scope of Work, and Protection Provided (Must be Completed in Detail) 1. Describe, in detail, the existing problem, the proposed project, and the scope of work. Explain how the proposed project will solve the problem(s) and provide the level(s) of protection described in Part A. Also, if available, attach a vendor's estimate and/or a contractor's bid for the scope of work. Please ensure that each proposed project is mitigation and not maintenance. 2. Description of the existing problems: 3. Describe the type(s) of protection that the proposed project will provide: 4. Scope of Work (describe in detail what you are planning to do): 5. Describe any other on -going or proposed projects in the area that may impact, positively or negatively, the proposed HMGP or FMA project: Section II. Project Location (Fully describe the location of the proposed project.) A. Site 1. Describe the physical location of this project, including street numbers (or neighborhoods) and zip codes. If available, please provide precise longitude and latitude coordinates for the site utilizing a hand-held global positioning system (GPS) unit or the equivalent: 2. Title Holder: 3. Is the project site seaward of the Coastal Construction Control Line (CCCL)? ❑YES ❑NO 4. Provide the number of each structure type (listed below) in the project area that will be affected by the project. That is, all structures in project area. ❑ Residential property: El Public buildings: D Other: ❑ Businesses/commercial property: ❑ Schools/hospitals/houses of worship: Attach any continuations or additional items to this page Form No. HMGP 001, Eff. 06/2012 DRAFT C. Flood Insurance Rate Map (FIRM) showing Project Site [:] Attach two (2) copies of the FIRM map, a copy of the panel information from the FIRM, and, if available, the Floodway Map. FIRM maps are required for this application (if published for your area). Also, all attached maps must have the project site and structures clearly marked on the map. FIRMs are typically available from your local floodplain administrator who may be located in a planning, zoning, or engineering office. Maps can also be ordered from the Map Service Center at 1-800-358-9616. For more information about FIRMs, contact your local agencies or visit the FIRM site on the FEMA Web -page at l,itt s:;'/msc.tenia. g av,.""weba / -res/stores/servl.et/FensaWelcon.ieVi.ew'storeld=10001. &catalo .ld=i 0001 &Ian Id=-1 Using the FIRM, determine the flood zone(s) of the project site (Check all zones in the project area). (See FIRM legend for flood zone explanations) (A Zone must be identified) El VE or V 1-30 El AE or A 1-30 El AO or AH ❑ A (no base flood elevation given) ❑ B or X (shaded) ❑ C or X (unshaded) ❑ Floodway ❑ Coastal Barrier Resource Act (CBRA) Zone (Federal regulations strictly limit Federal funding for projects in this zone. Please coordinate with your state agency before submitting an application for a CBRA Zone project). ❑ If the FIRM Map for your area is not published, please attach a copy of the Flood Hazard Boundary Map (FHB for your area, with the project site and structures clearly marked on the map. [:]Attach a copy of a Special Flood Hazard Area Flood Insurance Assurance(s). City or County Map with Project Site and Photographs []Attach a copy of a city or county scale map (large enough to show the entire project area) with the project site and structures marked on the map. ❑Attach a USGS TOPO map with project site clearly marked on the map. ❑For acquisition or elevation projects, include copy of Parcel Map (Tax Map, Property Identification Map, etc.) showing each property to be acquired. The map should include the Tax ID numbers for each parcel, if possible. E]Attach photographs (a minimum of 2 photographs) for each project site per application. The photographs should be representative of the project area, including any relevant streams, creeks, rivers, etc., and drainage areas, which affect the project site or will be affected by the project. For each structure, please include the following angles: front, back and both sides. ,W) Attach any continuations or additional items to this page Form No. HMGP 001, Eff. 06/2012 DRAFT Section III. Budget/Costs In this section, provide details of all the estimated costs of the project. As this information is used for the Benefit -Cost Analysis, reasonable cost estimates are essential. Do not include contingency costs in the budget. Avoid the use of lump sum costs. Note: To be eligible for HMA funding, pre -award costs must be identified as separate line items in the cost estimate of the application. This must be done in addition to filling out the HMGP Pre -Award Cost Request Form. Please mark each pre -award cost with an asterisk A. Materials B. Labor (Include equipment costs. Please indicate all "soft" or in -kind matches. All in -kind match must be identified in the Section III. Budget/Costs of this application.) T\ • • TT n _A - r- � 4 Description n aurs nine C. Fees Paid (Include any other costs associated with the project.) Total Estimated Project Cost $ Attach any continuations or additional items to this page Form No. HMGP 001, Eff. 06/2012 DRAFT D. Funding Sources (Round figures to the nearest dollar.) The maximum FEMA share for HMGP projects is 75%. The other 25% can be made up of State and Local funds as well as in -kind services. The FMA program requires that the maximum in -kind match be no more than 12.5% of the total project costs. HMGP/FMA funds may be packaged with other Federal funds, but other Federal funds (except for Federal funds that lose their Federal identity at the State level such as CDBG and certain tribal funds) may not be used for the non -Federal share of the costs. Estimated FEMA Share Non -Federal Share Estimated Local Share Global Match Project Title: Other Agency Share (Identify Other Non -Federal Agency and availability date: Total Funding sources from above $ % of Total (maximum of 75%) % of Total (Cash) % of Total (In -kind*) % of Total (Project Global Match* * ) % of Total Total % (should equal 100%) *Identify proposed eligible activities directly related to project to be considered for In -kind services. (Note on Section B) "Separate Separate project application must be submitted for each project (Global) Match project. E. Project Milestones/Schedule of Work List the major milestones in this project by providing an estimated time -line for the critical activities not to exceed a period of 3 years for performance, e.g. Designing, Engineering, Permitting, etc. These milestones should correspond with the scope of work and budget. Milestone Number o Da s to Complete [Example: Demolition of 6 structures and removal of debris 14 days] Attach any continuations or additional items to this page Form No. HMGP 001, Eff. 06/2012 1 �Alk Section IV. Environmental Review and Historic Preservation Compliance (NOTE: This application cannot be processed if this section is not completed.) Because HMGP/FMA are federally funded programs, all projects are required to undergo an environmental and historic preservation review as part of the grant application process. Moreover, all projects must comply with the National Environmental Policy Act (NEPA) and associated Federal, State, Tribal, and Local statutes to obtain funding. NO WORK can be done prior to the NEPA review process. If work is done on your proposed project before the NEPA review is completed, it will NOT be eligible for Federal funding. A. The following information is required for the Environmental and Historic Preservation review: All projects must have adequate documentation to determine if the proposed project complies with NEPA and associated statutes. The State Environmental Staff provide comprehensive NEPA technical assistance for applicants, with their consent, to complete the NEPA review. The type and quantity of NEPA documents required to make this determination varies depending upon the project Ys size, location, and complexity. However, at a minimum, please provide the applicable documentation from this section to facilitate the NEPA compliance process. [:] Detailed project description, scope of work, and budget/costs (Section I and Section III of this application). ❑ Project area maps with project site and staging area marked (Section II, part B & C of this application). ❑ Project area/structure photographs (Section II, part C of this application). ❑ Preliminary project plans. ❑ Project alternatives description and impacts (Section IV of this application). ❑ Please complete the applicable project worksheets. Dates of construction are required for all structures. ❑ Environmental Justice — Attach documents regarding evaluation (required) and satisfactory resolution (if necessary) of Environmental Justice issues (Highly Disproportionate, Adverse Impacts [effects] on Minority or Low Income Populations.) Documents can include public meeting records, media reports, letters from interested persons and groups, studies on population, ethnic groups, quality of life, housing, economics, transportation, public services, schools, public health, recreation, voting, etc. ❑ Provide any applicable information or documentation referenced on the Information and Documentation Requirements by Project Type (p. 10 of this application). B. Executive Order 12898, Environmental Justice for Low Income and Minority Population Are there low income or minority populations in the project area or adjacent to the project area? If yes, please describe any disproportionate and adverse effects to these populations. To help evaluate the impact of the project, please indicate below any other information you are providing: ❑ Description of the population affected and the portion of the population that would be disproportionately and adversely affected. Please include specific efforts to address the adverse impacts in your proposal narrative and budget. El Attached materials or additional comments. Attach any continuations or additional items to this page Form No. HMGP 001, Eff. 06/2012 DRAFT C. Information required for Tribal Consultations Section 106 of the National Historic Preservation Act (NHPA) requires federal agencies to take into account the effect of their undertakings on historic properties. The NHPA requires that agencies must complete this process prior to the expenditure of any Federal funds on the undertaking. A Tribal Consultation is required for any project disturbing ground or moving soil, including but not limited to: drainage projects; demolition; construction; elevation; communication towers; tree removal; utility improvements. 1. Describe the current and future use of the project location. A land use map may be provided in lieu of a written description. 2. Provide information on any known site work or historic uses for project location. ❑ Attach a copy of a city or county scale map (large enough to show the entire project area) with the horizontal limits (ft) and vertical depths (sq ft) of all anticipated ground disturbance. D. Alternative Actions The NEPA process requires that at least two alternative actions be considered that address the same problem/issue as the proposed project. In this section, list two feasible alternative projects to mitigate the hazards faced in the project area. One alternative is the "No Action Alternative." 1. No Action Alternative Discuss the impacts on the project area if no action is taken. 2. Other Feasible Alternative Discuss a feasible alternative to the proposed project. This could be an entirely different mitigation method or a significant modification to the design of the current proposed project. Complete all of parts a-e (below) and include engineering details (if applicable). a. Project Description for the Alternative Describe, in detail, the alternative project. Also, explain how the alternative project will solve the problem(s) and/or provide protection from the hazard(s). b. Project Location of the Alternative (describe briefly) E]Attach a map or diagram showing the alternative site in relation to the proposed project site [:]Photographs (2 copies) of alternative site Attach any continuations or additional items to this page Form No. HMGP 001, Eff. 06/2012 DRAFT C. Scope of Work for Alternative Project d. Impacts of Alternative Project Below, discuss the impact of this alternative on the project area. Include comments on these issues as appropriate: Environmental Justice, Endangered Species, Wetlands, Hydrology (upstream and downstream surface water impacts), Floodplain/Floodway, Historic Preservation and Hazardous Materials. e. Estimated Budget/Costs for Alternative Project In this section, provide details of all the estimated costs of the alternative project (round figures to the nearest dollar). A lump sum budget is acceptable. 1. Materials Item Dimension Quantity Cost per Unit Cost 2. Labor (Include equipment costs. Please indicate all "soft" or in -kind matches.) Description of Task Hours Rate Cost Attach any continuations or additional items to this page Form No. HMGP 001, Eff. 06/2012 DRAFT 3. Fees Paid (Include any other costs associated with the project.) Description qf Task Hours Rate Cost Total Estimated Project Cost $� Attach any continuations or additional items to this page Form No. HMGP 001, Eff. 06/2012 FITITTAIffim HMGP ENVIRONMENTAL REVIEW Information and Documentation Requirements by Project Type Retrofits to Existing Facilities/Structures Elevations Acquisitions with Demolition ✓ Dates of Construction ✓ Concurrence from State Historic Preservation Officer if structure is 50 years or older, if work to be done is outside the existing footprint or if there is six (6) inches or more of ground disturbance. Drainage Improvements ✓ Engineering plans/drawings ✓ Permit or Exemption letter to address any modifications to water bodies and wetlands o Department of Environmental Protection o Water Management District o U.S. Army Corps of Engineers ✓ Concurrence letter from State Historic Preservation Office addressing archeological impacts. Required if there is six (6) inches or more of ground disturbance. ✓ Concurrence from U.S. Fish and Wildlife addressing any impacts to wildlife, particularly endangered and threatened species and their habitats. ✓ If the project is in coastal area, attach a letter from the National Marine Fisheries Service addressing impacts to marine resources. ✓ Concurrence from Natural Resource Conservation Service if project is located outside city limits and may impact prime or unique farmland. Note: This is a general guideline for most projects. However, there will be exceptions. Consult with environmental staff on project types not listed Attach any continuations or additional items to this page Form No. HMGP 001, Eff. 06/2012 DRAFT Section V. Maintenance Agreement All applicants whose proposed project involves the retrofit or modification of existing ,public property or whose proposed project would result in the public ownership or management of property, structures, or facilities, must first sign the following agreementprior to submitting the application to FEMA. (NOTE: Those applicants whose project only involves the retrofitting, elevation, or other modi ication to private property where the ownership will remain private after project completion DO NOT have to complete this form.) The of , State of Florida, hereby agrees that if it receives an Federal aid as a result of the attached ppro* ect application, it will acce t res onsibili at its own expense if necessary,for the routine pl? � p p tY� .. � maintenance of an real roe structures or facilities acquired r d o constructed as a y . p p �'� q . result of such Federal aid. Routine maintenance ... shall include, but not be limited to, such responsibilities as keeping vacant land clear of debris, garbage, and vermin; keeping stream channels, culverts, and storm drains clear of obstructions and debris; and kee in detention ponds free f debris, p g p o d b s, trees, and woody growth. The purpose of this agreement is to make clear the Su grantee's maintenance responsibilities followin r ' g project ect award and to show the Subgrantee s acceptance of these respponsibilities. It does not re lace, supercede, or add to any other maintenance res onsibilities imposedF p b ederal law or regulation pyand which are in force on the date of project award. Signed by the duly authorized representative (printed or typed name of signing official) (title) this Signature* (day) of (month), (year). *Please note: The above signature must be by an individual with legal signing authority for the respective local government or county (e.g., the Chairperson, Board of County Commissioners or the County Manager, etc.) DRAFT HMGP Application Completeness Checklist This checklist contains an explanation, example and/or reference for information requested in the application. Please use this checklist to assure your application is complete and includes the required information for HMGP projects. The appropriate documentation must also be attached. It is important to note that this checklist is similar to the form that will be used during the application sufficiency review by the HMGP staff. Project Title: _ Applicant: _ Application Explanation of Information Required � Requirements Title/Brief The project title should include: 1) Name of Applicant, 2) Name of Project, 3) Descriptive Project Type of Project. (Example: City of Tallahassee City Hall Wind Retrofit) Summary 1. Applicant Name of organization applying. Must be an eligible applicant. 2. Applicant Type State or local government, recognized Native American tribe, or private non- profit organization. If private non-profit, please attach documentation showing legal status as a 501(C). (Example: IRS letter, Tax Exempt Certificate) 3. County Indicate county in which the project is located. 4. State Legislative Specify the appropriate State Senate, House and Congressional District code & Congressional for the project site. For multiple sites, please list codes for each site. District(s) htt ://www.m floridahouse. ov/sections/re resentatives/m re resentative.as x 5. Federal Tax I.D. List the FEIN number. May be obtained from your finance/accounting Number department. 6. DUNS Number Include DUNS number in appropriate location on application. If none, please refer to HMGP FAA's in Application Reference Material for instructions on obtaining a DUNS number. 7. FIPS Code List the FIPS Code. May be obtained from your finance/accounting/grants department. If none, please submit FEMA Form 90-49. 8. NFIP ID Number List the NFIP number. You must be a participating NFIP member to be eligible for HMGP funding. Please make sure that the number is the same as the panel number on the FIRM provided with the application. 9. Point of Contact Please provide all pertinent information for the point of contact. If this information changes once the application is submitted, please contact the HMGP staff immediately. 10. Application Please provide the preparer information. May be different from the point of Prepared By DRAFT contact (line 8) and/or the applicants agent (line 10). 11. Authorized An authorized agent must sign the application. "An authorized agent is the Applicant chief elected official of a local government who has signature authority, so for Agent a county it would be the Chairman of the Board of County Commissioners and for a municipality it would be the Mayor (the exact title sometimes varies). Any local government may delegate this authority to a subordinate official (like a City or county Manager) by resolution of the governing body (the Board of County Commissioners or Board of City Commissioners). If a local government delegates signature authority, a copy of the resolution by the governing body authorizing the signature authority for the individual signing must beprovided.."* 12. LMS Letter A letter of endorsement for the project and its priority number from the Local Mitigation Strategy must be included. Refer to Sample LMS Letter. Applications without a letter of endorsement will not be processed. Section I - Project Description A. Hazards to be Mitigated/Level of Protection 1. Type of Hazards Identify the hazard(s) that the proposed project will mitigate. More than one the Proposed hazard may be selected. Project will Mitigate 2. Identify the Type Describe the mitigation project being proposed. (Example: drainage, wind of Proposed retrofit, etc.) Project 3. Number of Explain how many people will be protected by or benefit from the proposed Persons project. Protected 4. Level of Specify the level of protection and magnitude of the event the proposed Protection project will mitigate. Attach support documentation that verifies the stated level of protection. (Example: In a wind retrofit project, the product specifications should include product test results or a signed and sealed letter from a professional engineer assuring the wind standard, missile impact, etc.) 5. Engineered Include available engineering calculations, studies, and designs for the Projects Only (e.g. proposed project (for engineered projects only). Drainage) S. Life of the project Determine the useful life of this project. If FEMA's standard values are not used, please attach support documentation as a justification of the value entered. (Example: in a wind retrofit project, the product specifications should include product life.) FEMA's standard values are: infrastructure and major drainage, 50; elevations and minor drainage, 30; wind, 15; acquisition, 100. DRAFT B. Project Description, Scope of Work, and Protection Provided (Must be Completed in Detail) 1. Existing Problem Describe the existing problem, location, source of the hazard, and the history and extent of the damage. Include newspaper articles, insurance documentation, photographs, etc. If this project is eligible for PA (406) mitigation activities, please describe the 406 activities. 2. Type of Determine how the funding will solve the existing problem and provide Protection protection. 3. Scope of Work: Determine the work to be done. The scope of work must meet eligibility What the Project based on HMGP regulations and guidance. Explain how the proposed Proposes to Do problem will be solved. (NOTE: The proposed project must be a mitigation action, not maintenance.) Does the proposed project solve a problem independently or constitute a functional part of a solution where there is assurance that the project as a whole will be completed (44 CFR 206.434[b][4])? Does the proposed project address a problem that has been repetitive or that poses a significant risk to public health and safety if left unresolved (44 CFR 206.434[b](5](i])? See Sample Scope of Work Language in HMGP Application Reference Material. Generators should not be included in the scope of work unless said generator only powers the mitigation elements. 4.On-Going or Determine if other projects, zoning changes, etc. are planned (particularly in Proposed the same watershed if flooding is being addressed) that may negatively or Projects in the positively impact the proposed project. If there is a drainage project or Area downstream issue elsewhere, it may eliminate the current flooding issue, erasing the need for the proposed project. Answer Yes/No or unknown with an explanation required if yes. Response applies to drainage and acquisition projects. N/A is appropriate in wind retrofit shutter projects only. If this project is also being considered under the Public Assistance Program (406), please describe in detail the 406 mitigation activities and/or services. Do not include project costs associated with the above referenced HMGP application. Section II A. Site - Project Location 1. Physical List the physical location of the project site(s) including the street number(s), Location zip code(s) and GPS coordinates (latitude/longitude). The physical address must correspond with the address locations specified on maps submitted with the application. 2. Title Holder Provide the titleholder's name. 3. Project Seaward Determine if the project site is located seaward of the Coastal Construction of the CCCL? T!. Control Line. 4. Number and Specify the number and type of properties affected by the project. Types of (Example: Drainage project that affects 100 homes, 15 businesses and 2 Structures Affected schools.) What does the project protect? Should have a number next to the box that is checked. (See Section II, Item 4.) B. Flood Insurance Rate Map (FIRM) Showing Project Site 1. Copies of FIRM Attach a copy (or copies) of the FIRM and clearly identify the project site. The FIRM Panel number must be included. To obtain a FIRM map, go to http://www.store.msc.fema.gov/. See instructions on How to make a FIRMette. 2. Flood Zone Specify the flood zone(s) of the project site(s). If project is located in a Determination Special Flood Hazard Area, proof of flood insurance will need to be provided. Amount of coverage must be equal to or greater than the amount of Federal mitigation funding obligated to the project. 3. Flood Hazard Not required if a copy of the FIRM is attached. Boundary Map (FHBM) Note: All maps must be linked to the application. C. City or County Map with Project Site and Photographs 1. City/County Map The project site and staging location (if applicable) should be clearly marked with Project Site on a legible City/County map. The map should be large enough to show the project site. More than one map may be required. 2. USGS TOPO with The project site should be clearly marked on a legible USGS 1:24,000 TOPO Project Site map. To obtain a TOPO map, go to ht p_//www Diital-Togo=al2s .c m 3. Parcel/Tax Map A Parcel, Tax or Property Identification map is required o for acquisition and elevation projects. The location of the structure must be clearly identified. 4. Site Photograph At least two sets of photographs are required that clearly identify the project site. The photos must be representative of the project area, including any relevant streams, creeks, rivers, etc., and drainage areas, which affect the project site or will be affected by the project. The front, back and both side angles are required for each structure. For acquisition and elevation projects, a photo taken away from the structure (in front toward the street, and in back toward backyard) to show the area along with photographs of specific elements of the structure affected by the project (windows for shutters or window replacements) should also be provided. Please label photographs appropriately. In addition, CDs may be submitted. Note: All maps must be linked to the application. DRAFT Section III - Budget/Costs Please make sure all calculations are correct. Provide a breakdown of materials, labor and fees paid for the proposed project. Support documentation must be attached, i.e. vendor's quote, professional estimate (from engineer, architect, local building official, etc.). The proposed budget line items should represent allowable costs associated with the scope of work. Please make sure contingency costs are not included. It is important to complete this section; it will be used for the Benefit -Cost Analysis (BCA). Costs should be accurate, complete and reasonable compared to industry standards. Make sure the total cost is correct on the entire application. A. Materials Describe the cost of materials. B. Labor Provide a breakdown of description, hours, rate, and cost or lump sum labor cost. Can use "in -kind" contribution as part of the 25% match. (Attach support documentation for in -kind match to detail wages and salaries charged for any in -kind contribution. No overtime wages can be used to satisfy "in -kind" match contributions). C. Fees Paid Provide a breakdown of associated fees i.e., consultants, studies, engineering, permits. Maintenance is not an allowable cost under HMGP. Pre -award costs may be requested (See Pre -award Costs guidance). Total Estimated Please make sure all calculations are correct. This figure should be the Project Cost same as the figure for total funding. D. Funding Sources (round figures to the nearest dollar) The proposed sources of non-federal matching funds must meet eligibility requirements. (Except as provided by Federal statute, acost-sharing or matching requirement may not be met by costs borne by another Federal grant.) 44 CFR 13.24 (b)(1). 1. Estimated FEMA The estimated FEMA share is generally 75%. If the FEMA share is not 75%, Share assure actual amount is entered. It could be 50% or 35%, etc. of the total dollar amount of project depending on county allocation and LMS priority. This figure cannot exceed 75%. 2. Estimated Local May include all 3 sources, i.e. cash, "in kind" and global match, as long as Share the total is a minimum of 25%. Match cannot be derived from a federal agency except Federal funds that lose their federal identity (e.g., CDBG funding and certain tribal funding). 3. Total In -Kind May use materials, personnel, equipment, and supplies owned, controlled and operated from within governing jurisdiction as an in -kind match. Third party in -kind contributions would be volunteer services, employee services from other organizations furnished free of charge, donated supplies, and loaned equipment or space. The value placed on these resources must be at a fair market value and must be documented. if in -kind is claimed from outside the applicant jurisdiction, it must be cash only. 4. Total Project Project (global) match must 1) meet all the eligibility requirements of HMGP; (Global) Match and 2) begin after FEMA's approval of the match project. A separate HMGP application must be submitted for global match projects. Indicate which 0 912TArANW1 project(s) will be matched. The global match is not required to be an identical project. Projects submitted as global match for another project must meet the same period of performance time constraints as the HMGP. 5. Total Funding Total must represent (1100%) of the total estimated project cost. E. Project Milestones/Schedule of Work 1. Milestones Identify the major milestones in the proposed project and provide an (Schedule) estimated time -line (e.g. Designing, Engineering - 3 months, Permitting — 6 months, Procurement — 30 days, Installation — 6 months, Contracting — 1 month, Delays, Project Implementation, Inspections, Closeout, etc. See Typical Project Milestones for estimated time -frames) for the critical activities not to exceed a period of 3 years for performance. Milestones should not be grouped together but listed individually. Please allot for the appropriate amount of time. Section IV - Environmental Review & Historic Preservation Compliance A. No work can begin prior to the completion of the environmental (NEPA) review. In order for the Environmental staff to conduct the NEPA review, all sections listed below must be completed. 1. Detailed Project Complete Sections I & III of the application. Description, Scope of Work & Budget/Costs 2. Project Area Maps Complete Section II, part B & C of the application. 3. Project Complete Section II. Area/Structure Photographs 4. Preliminary For shutters see the scope of work and for drainage & elevation see Project engineering drawings. Plans 5. Project Dates of construction are required for all structures. See worksheets. Worksheets - Dates of Construction Required on All Projects 6. Documentation Provide any of the required documentation as listed on page 9 in the Requirements by Information and Documentation Requirements by Project Type that may Project Type have already been obtained. DRAFT B. Executive Order 12898, Environmental Justice for Low Income and Minority Population 1. Documentation of Determine the proportion of the population, in either the project zip code or Environmental city, characterized as having a minority background, and proportion of the .Justice population living below poverty level. Go to htt p://www.census.qov/. If yes, complete Section IV, part B. C. Information required for Tribal Consultation 1. Documentation for For all projects with any ground disturbing activities, complete Section IV part Tribal C. Consultation D. Alternative Actions 1. No Action Alternative Please discuss the impacts on the project area if no action is taken. 2.Other Feasible Has the proposed project been determined to be the most Alternative Action practical, effective and environmentally sound alternative after consideration of a range of options? (44 CFR 206.434[b][51[iii]) a. Project NEPA requires that at least three alternatives must be presented to Description for mitigate the problem. In addition to the proposed action and no the Alternative action, one other feasible alternative must be provided. Describe how the alternative project will solve the problem and provide b. Project Location of the Alternative protection from the hazard. (describe briefly) c. Scope of Work for Alternative Project d. Impacts of the Alternative Project E. Estimated Budget/Costs for Alternative Project 1. Materials Optional 2. Labor Optional 3. Fee Paid Optional Total Estimated Project Costs Total cost is required. Vendor quote is not required. A lump sum budget may be submitted as justification to why this alternative was not chosen. Section V - Other Required Documentation 1. Maintenance Please complete, sign and date the maintenance agreement. The Agreement maintenance agreement must be signed by an individual with signature authority, preferably the authorized agent. 2. FFATA Form Please complete, sign and date the FFATA Project File Form. Instructions are provided for your convenience. 3. SFHA Required for all projects in the Special Flood Hazard Area. Read and sign the Acknowledgement SFHA Acknowledgement of Conditions document. This form must be of Conditions notarized, signed by the local jurisdiction and the property owner. 4. Pre -award Cost If pre -award costs are being requested with your project, please be sure to Form identify all pre -award costs in the application budget per instructions. The pre -award cost form must be completed and submitted with your application. 5. Request for Applicable if no FIPS number is assigned to applicant/recipient. Public Assistance Form 6. Model Statement For Acquisition projects only. of Assurances for Property Acquisition Projects 7. Declaration and For Acquisition projects only. Must be signed by all persons whose names Release are on the property deed. 8. Notice of For Acquisition projects only. Two forms are included for your convenience. Voluntary Interest Please use the form that is most appropriate to your situation. Must be signed by all persons whose names are on the property deed. 9. Statement of For Acquisition projects only. Must be signed by all persons whose names Voluntary are on the property deed. Participation for Acquisition of Property for Purpose of Open Space