HomeMy WebLinkAboutCity of Tamarac Resolution R-2003-257Temporary Resolution 10283
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November 3, 2003
CITY OF TAMARAC, FLORIDA
RESOLUTION NO. R-2003 - .A,S 7
A RESOLUTION OF THE CITY COMMISSION OF THE
CITY OF TAMARAC, FLORIDA AUTHORIZING THE
APPROPRIATE CITY OFFICIALS TO SEEK GRANT
FUNDING FROM THE FEDERAL EMERGENCY
MANAGEMENT AGENCY'S ASSISTANCE TO
FIREFIGHTERS - FIRE PREVENTION AND SAFETY
PROGRAM IN THE AMOUNT OF $75,327 WITH AN IN -
KIND MATCH OF $32,283 FOR A TOTAL PROJECT COST
OF $107,610 TO PURCHASE A MOBILE FIRE SAFETY
HOUSE AND ENHANCEMENT OF THE EDUCATING
GENERATIONS FIRE SAFETY EDUCATION AND
OUTREACH PROGRAM; PROVIDING FOR CONFLICTS;
PROVIDING FOR SEVERABILITY; AND PROVIDING FOR
AN EFFECTIVE DATE.
WHEREAS, the City Commission of the City of Tamarac realizes that
fire prevention and safety outreach programs are necessary in order to educate
the public and to prevent injuries and deaths related to fire; and
WHEREAS, the City of Tamarac's Fire Rescue Department has
developed a fire prevention and safety outreach program called Educating
Generations to promote fire safety with programs for children, families and senior
citizens; and
WHEREAS, the City of Tamarac is committed to enhancing the Fire
Rescue Department's Educating Generations safety outreach programs; and
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Temporary Resolution 10283
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November 3, 2003
WHEREAS, The City of Tamarac wishes to purchase a mobile fire
safety house and associated equipment to maximize the flexibility and
effectiveness of the Fire Rescue Department's Educating Generations safety
outreach programs; and
WHEREAS, the Federal Emergency Management Agency through
the Assistance to Firefighters — Fire Prevention and Safety Grant Program
provides funds to municipalities for fire prevention and safety programs; and
WHEREAS, should the application be approved and grant awarded,
the City agrees to maintain the mobile fire safety house and associated equipment
which are the subject of this application on an ongoing basis; and
WHEREAS, the City of Tamarac is willing to match the grant request
of $75,327 providing for an in -kind match of $32,283 for a total project cost of
$107,610; and
WHEREAS, the City Manager and the Fire Chief recommend filing of the
application (attached hereto as "Exhibit 1 "); 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 a
grant application to the Federal Emergency Management Agency through the
Assistance to Firefighters -- Fire Prevention and Safety Program for the
enhancement of the Fire Rescue Department's Educating Generations safety
outreach program by purchasing a mobile fire safety house and associated
equipment.
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Temporary Resolution 10283
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November 3, 2003
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.
Section 2: The appropriate City officials are hereby authorized to submit
the Assistance to Firefighters — Fire Prevention and Safety Program Grant
Application (attached hereto as "Exhibit 1 ") and made a part hereof requesting
$75,327 with an in -kind match of $32,283 for a total project cost of $107,610.
Section 3: All resolutions in conflict herewith are hereby repealed to the
extent of such conflict.
Section 4: 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.
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Temporary Resolution 10283
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November 3, 2003
Section 5: This Resolution shall become effective immediately upon its
adoption.
PASSED, ADOPTED AND APPROVED this 121" day of November, 2003,
JOE SCHREIBER
MAYOR
ATTEST:
��� '' >�.•c 'IL'�_.•' RECORD OF COMMISSION VOTE:
MARION SWENSON, CMC MAYOR SCHREIBER
CITY CLERK DIST 1: COMM. PORTNER
DIST 2: COMM. FLANSBAUM-TALABISCO
DIST 3: COMM. SULTANOF
DIST 4: V/M ROBERTS
I HEREBY CERTIFY that
I have approved this
RESOLUTION as to form.
MITCHELL S.4
CITY ATTOR
Print Application
Exhibit 1
Page 1 of 10
Preparer Information
Prefix
First Name
Middle Initial
Last Name
Organization Name
Address 1
City
State
Zip
Business Phone
Home Phone
Mobile Phone/Pager
Email
Entire Application
Preparer Information
Ms.
Kimberly
Perron
7525 NW 88 Ave
Tamarac
Florida
33321 -
954-718-1803 Ext.
954-724-1230
dianep@tamarac.org
Are you the person to be contacted on matters involving this application? No
If yes, please specify: Alternate Contact
Contact Information
Primary. Contact_ Information
Title
Chief
Prefix
N/A
• First Name
Jim
Middle Initial
R Last Name
Budzinski
• Business Phone
954-724-2436 Ext.
Home Phone
954-724-1230 Ext.
Mobile Phone/Pager
Fax
954-724-2438
*Email
jimb@tamarac.org
Alternate Contact Information
Title Assistant Chief
Prefix N/A
• First Name Kingman
Middle Initial
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• Last Name Schuldt
• Business Phone 954-724-2436 Ext.
*Home Phone 954-724-1230 Ext.
Mobile Phone/Pager
Fax 954-724-2438
*Email kingmans@tamarac.org
Applicant Information
• Applicant Name
Tamarac Fire Rescue
• Type of Applicant
Fire Department
If other, please enter the type of Applicant
• Employer. Identification Number
59-1039552
• What is your DUNS Number?
077270940
Headquarters Physical Address
• Physical Address 1
7515 NW 88 Ave
Physical Address 2
• City
Tamarac
• State
Florida
• Zip
33321 - 2401
Mailing Address
• Mailing Addressl
7525 NW 88 Ave
Mailing Addressl
City
Tamarac
• State
Florida
Zip
33321 - 2401
Account information
• Type of bank account
Checking
• Bank routing number - 9 digit number on the bottom
067006432
left hand corner of your check
• Your account number
2090001028714
Additional Information
• This fiscal year, are you receiving Federal funding
from any other grant program for the same purpose
No
for which you are applying for this grant?
. This fiscal year, are you receiving Federal funding
No
from any other grant program regardless of purpose?
• Is the applicant delinquent on any federal debt?
No
If you answered yes to any of the additional questions
above, please provide an explanation in the space
provided below:
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Request Information
• Are you an international or national organization? No
If No, what is the population/constituency served by your organization? 56440
Project Title Target Audience Target Partnerships Action
Audience Size
Mobile Fire Safety House 65 Children under 14, Adults over 30000 No View Details
Request Details
Project Title
Mobile Fire Safety House
Budget
Budget.Object Class
Number of Programs Total Cost Action
1 $ 107610 View Details
a. Personnel
$ 33,000
b. Fringe Benefits
$ 0
c. Travel
$ 0
d. Equipment
$ 70,535
e. Supplies
$ 4,075
f. Contractual
$ 0
g. Construction
$ 0
h. Other
$ 0
i. Indirect Charges
$ 0
Indirect Cost Details
Agency Indirect Cost Agreement with
Indirect Cost Rate %
Agreement Summary
Federal and Applicant Share
Federal Share
$ 75,327
Applicant Share
$ 32,283
Federal Rate Sharing (%)
70/30
" -N...o..n_-F..e. d2ra.l...REs.o.urces (The combined Non -Federal Resources must equal the Applicant Share of $ 32.283)
a. Applicant
$ 32283
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b. State $ 0
c. Local $ 0
d. Other Sources $ 0
If you entered a value in Other Sources, include your explanation below. You can use this space to provide
information on the project, cost share match.
Total Budget
Narrative Statement
Project Description
Please provide your narrative statement in the space provided below:
$ 107,610
Project Overview
This project involves the purchase of a mobile fire safety house, training equipment and fire prevention materials
to enhance the Educating Generations fire safety outreach and education program. The City will provide a
vehicle to tow the mobile fire safety house. Teaching fire safety can be greatly enhanced through the use of
realistic scenarios and simulations. People of all ages learn better by actively participating in demonstrations,
which increases retention, and may ultimately save more lives.
The City of Tamarac currently does not have adequate fire safety scenario equipment or access to such
equipment. A mobile safety demonstration unit would best serve the needs of the community as it would
eliminate the need to transport large groups to the fire stations and it would provide the greatest amount of
flexibility for the program.
Problem Statement
Broward County has the highest number of structural fires in the state of Florida. Per the Florida State Fire
Marshall's 2000 Annual Report, there were 1,703 structural fires in the County in 2000. The County also has the
second highest fire -related fatality and injury rate with 97 civilian injuries and 5 civilian deaths caused by fires. In
Tamarac, there were 28 structural fires in 2002 and 27 structural fires so far in 2003. Many of these incidents
could have been prevented with training and education on how to respond to a fire situation.
Project Goal
The goal of Educating Generations is to educate children, families and the elderly on fire safety and to eliminate
preventable fire -related injuries and deaths.
Objectives
1. Train 30,000 people within one year of receipt of the new mobile fire safety house on how to respond to a fire
in order to save lives and prevent injuries.
2. Coordinate and partner the enhanced Educating Generations program with area civic organizations, schools,
neighborhood associations and other agencies.
3. Develop a high -quality program to be used as a model in other communities.
Implementation Methods
Educating Generations will be enhanced through the purchase of a mobile fire safety house that is capable of
simulating a fire and severe weather. The mobile fire safety house is a 36' long enclosed trailer that is set up like
a typical home with a kitchen area, living room and bedroom. The trailer is equipped with bleacher seating to
accommodate several participants at a time. Many different scenarios can be run and can include such
simulations as heated doors to demonstrate checking door temperatures while attempting to exit in a fire
situation, smoke from a kitchen fire, the sounds of an approaching tornado, using fire safety ladders to escape
from windows and many more.
Educating Generations targets all age groups and is open to the public. The department has specific programs
for each age group including pre-school age children, elementary school children, middle and high school
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students, families, and a special program for the elderly. Each group has their own level of experience,
challenges, and concerns. The mobile fire safety house and program focus will be able to adjust to these varying
needs to ensure everyone receives the necessary information to prevent a tragedy.
The Department's programs extend far beyond the City of Tamarac. Many of the people who participate in
programs at the local schools, community centers, fire stations, shopping centers, and other public locations are
from surrounding communities all over Broward County. Tamarac has built a reputation for providing excellent
fire education and safety programs with some organizations traveling from neighboring communities to
participate in Tamarac's programs.
The City of Tamarac and the Fire Rescue Department are fortunate to have many active partnerships
throughout the community. They enjoy an excellent relationship with the citizens, businesses, schools and the
community at large. To this end, the Department will coordinate its education and outreach efforts with these
various groups. In particular, the Florida Guard, a group of retired military personnel, will play an active role as
volunteers with the mobile safety house. The CERT members and Cadets will also participate in outreach and
education programs throughout the City. Using volunteers to assist with the outreaches will also reduce the cost
of the program.
The Department intends to invite other area fire rescue departments to participate in the outreach programs to
exchange ideas and receive feedback. When available, the Department will also bring the mobile fire safety
house to neighboring community's schools, large gatherings such as fairs and expositions, and other special
events. While the Department already enjoys an excellent reputation for its quality education programs, we
intend to publicize our programs to encourage other municipalities to upgrade their own programs. The
information collected from our program evaluations will be made available to other departments as well to
provide insight for bolstering their own programs.
Evaluation
This program will be evaluated in a number of ways including:
1. The number of individuals who participate in the program and their ages will be tracked. The goal of the
program is to educate at least 30,000 people from all ages groups within the first year.
2. All of the older student and adult participants will be given the opportunity to complete a survey providing
feedback to the department on what they liked about the program, what they think they learned, and suggestions
for improvement.
3. The number of volunteers who are trained and participate in public safety education programs will be tracked.
The goal is to have at least 50 people from the community trained to assist in fire safety education programs
within the first year. This will alleviate some of the cost burden for operating the program.
4. Feedback and recommendations for improvement will also be solicited from other fire rescue departments
and safety education specialists who will be invited to participate in events, especially those targeting children
and the elderly.
Assurances and Certifications
FEMA Form 20-16A
You must read and sign these assurances by providing your password and checking the box at the
bottom of this page.
Note: Fields marked with an " are required.
Assurances Non -Construction Programs
Note: Certain of these assurances may not be applicable to your project or program. If you have any questions,
please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to
certify to additional assurances. If such is the case, you will be notified.
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As the duly authorized representative of the applicant I certify that the applicant:
1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and
financial capability (including funds sufficient to pay the non -Federal share of project costs) to
ensure proper planning, management and completion of the project described in this
application.
2. Will give the awarding agency, the Comptroller General of the United States, and if
appropriate, the State, through any authorized representative, access to and the right to
examine all records, books, papers, or documents related to the award; and will establish a
proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that
constitutes or presents the appearance of personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval
of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. Section 4728-4763)
relating to prescribed standards for merit systems for programs funded under one of the
nineteen statutes or regulations specified in Appendix A of OPM's Standards for a Merit
System of Personnel Administration) 5 C.F.R. 900, Subpart F).
6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not
limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits
discrimination on the basis of race, color or national origin; (b) Title IX of the Education
Amendments of 1972, as amended (20 U.S.C. Sections 1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973,
as amended (29 U.S.C. Section 794), which prohibits discrimination on the basis of
handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. Sections 6101-
6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis
of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment
and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on
the basis of alcohol abuse or alcoholism; (g) Sections 523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. 290-dd-3 and 290-ee-3), as amended, relating to
confidentiality of alcohol and drug abuse patient records; (h) Title Vill of the Civil Rights Acts
of 1968 (42 U.S.C. Section 3601 et seq.), as amended, relating to nondiscrimination in the
sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific
statute(s) under which application for Federal assistance is being made; and (j) the
requirements of any other nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Title II and III of the Uniform
Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646)
which provide for fair and equitable treatment of persons displaced or whose property is
acquired as a result of Federal or Federally assisted programs. These requirements apply to
all interest in real property acquired for project purposes regardless of Federal participation in
purchases.
8. Will comply with provisions of the Hatch Act (5 U.S.C. Sections 1501-1508 and 7324-7328),
which limit the political activities of employees whose principal employment activities are
funded in whole or in part with Federal funds.
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. Sections
276a to 276a- 7), the Copeland Act (40 U.S.C. Section 276c and 18 U.S.C. Sections 874),
and the Contract Work Hours and Safety Standards Act (40 U.S.C. Sections 327-333),
regarding labor standards for federally assisted construction sub agreements.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of
the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special
flood hazard area to participate in the program and to purchase flood insurance if the total
cost of insurable construction and acquisition is $10,000 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the following:
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(a) institution of environmental quality control measures under the National Environmental
Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating
facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d)
evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the
Coastal Zone Management Act of 1972 (16 U.S.C. Section 1451 et seq.); (f) conformity of
Federal actions to State (Clean Air) Implementation Plans under Section 176(c) of the Clean
Air Act of 1955, as amended (42 U.S.C. Section 7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-
523); and (h) protection of endangered species under the Endangered Species Act of 1973,
as amended, (P.L. 93-205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. Section 1271 et seq.)
related to protecting components or potential components of the national wild and scenic
rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National
Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and
protection of historic properties), and the Archaeological and Historic Preservation Act of
1974 (16 U.S.C. 469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research,
development, and related activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7
U.S.C. 2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals
held for research, teaching, or other activities supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. Section 4801 et
seq.) which prohibits the use of lead based paint in construction or rehabilitation of residence
structures.
17. Will cause to be performed the required financial and compliance audits in accordance with
the Single Audit Act of 1984.
18. Will comply with all applicable requirements of all other Federal laws, executive orders,
regulations and policies governing this program.
19. It will comply with the minimum wage and maximum hours provisions of the Federal Fair
Labor Standards Act (29 U.S.C. 201), as they apply to employees of institutions of higher
education, hospitals, and other non-profit organizations.
Signed by Kimberly Perron on 11/03/2003
FEMA Form 20-16C
You must read and sign these assurances by providing your password and checking the box at the
bottom of this page.
Note: Fields marked with an * are required.
Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibilities Matters; and Drug -Free
Workplace Requirements.
Applicants should refer to the regulations cited below to determine the certification to which they are required to
attest. Applicants should also review the instructions for certification included in the regulations before
completing this form. Signature on this form provides for compliance with certification requirements under 44
CFR Part 18, "New Restrictions on Lobbying; and 28 CFR Part 17, "Government -wide Debarment and
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suspension (Non -procurement) and Government -wide Requirements for Drug -Free Workplace (Grants)." The
certifications shall be treated as a material representation of fact upon which reliance will be placed when the
Federal Emergency Management Agency (FEMA) determines to award the covered transaction, grant, or
cooperative agreement.
UW61113110110
A, As required by the section 1352, Title 31 of the US Code, and implemented at 44 CFR Part 18 for persons
into a grant or cooperative agreement over $100,000, as defined at 44CFR Part 18, the applicant certifies that:
(a) No federal appropriated funds have been paid or will be paid by or on behalf of the undersigned
to any person for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of congress, or an employee of a Member of
Congress in connection with the making of any federal grant, the entering into of any cooperative
agreement and extension, continuation, renewal amendment or modification of any Federal Grant
or cooperative agreement.
(b) If any other funds than Federal appropriated funds have been paid or will be paid to any person
for influencing or attempting to influence an officer or employee of any agency, a Member of
Congress, an officer or employee of congress, or an employee of a Member of Congress in
connection with this Federal grant or cooperative agreement, the undersigned shall complete and
submit Standard Form LLL, "Disclosure of Lobbying Activities", in accordance with its instructions.
(c) The undersigned shall require that the language of this certification be included in the award
documents for all the sub awards at all tiers (including sub grants, contracts under grants and
cooperative agreements and sub contract(s)) and that all sub recipients shall certify and disclose
accordingly.
2. Debarment, Suspension and Other Responsibility Matters (Direct Recipient)
As required by Executive Order 12549, Debarment and Suspension, and implemented at 44CFR Part 67, for
prospective participants in primary covered transactions, as defined at 44 CFR Part 17, Section 17.510-A, the
applicant certifies that it and its principals:
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, sentenced
to a denial of Federal benefits by a State or Federal court, or voluntarily excluded from covered
transactions by any Federal department or agency.
(b) Have not within a three-year period preceding this application been convicted of or had a
civilian judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain or perform a public (Federal, State, or local)
transaction or contract under a public transaction; violation of Federal or State antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making
false statements, or receiving stolen property.
(c) Are not presently indicted for or otherwise criminally or civilly charged by a government entity
(Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of
this certification: and
(d) have not within a three-year period preceding this application had one or more public
transactions (Federal, State, or local) terminated for cause or default; and
B. Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach an
explanation to this application.
3. Drug -Free Workplace (Grantees other than individuals)
As required by the Drug -Free Workplace Act of 1988, and implemented at 44CFR Part 17, Subpart F, for
grantees, as defined at 44 CFR part 17, Sections 17.615 and 17.620:
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(A) The applicant certifies that it will continue to provide a drug -free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture,
distribution, dispensing, possession, or use of a controlled substance is prohibited in
the grantee's workplace and specifying the actions that will be taken against
employees for violation of such prohibition;
(b) Establishing an on -going drug free awareness program to inform employees
about:
(1) The dangers of drug abuse in the workplace;
(2) The grantees policy of maintaining a drug -free workplace;
(3) Any available drug counseling, rehabilitation and employee
assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace;
(c) Making it a requirement that each employee to be engaged in the performance of
the grant to be given a copy of the statement required by paragraph (a);
(d) Notifying the employee in the statement required by paragraph (a) that, as a
condition of employment under the grant, the employee will:
(1) Abide by the terms of the statement and
(2) Notify the employee in writing of his or her conviction for a violation
of a criminal drug statute occurring in the workplace no later than five
calendar days after such conviction.
(e) Notifying the agency, in writing within 10 calendar days after receiving notice
under subparagraph (d)(2) from an employee or otherwise receiving actual notice of
such conviction. Employers of convicted employees must provide notice, including
position title, to the applicable FEMA awarding office, i.e. regional office or FEMA
office.
(f) Taking one of the following actions, against such an employee, within 30 calendar
days of receiving notice under subparagraph (d)(2), with respect to any employee
who is so convicted:
(1) Taking appropriate personnel action against such an employee, up
to and including termination, consistent with the requirements of the
Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a drug abuse
assistance or rehabilitation program approved for such purposes by a
Federal, State, or local health, law enforcement or other appropriate
agency.
(g) Making a good faith effort to continue to maintain a drug free workplace through
implementation of paragraphs (a), (b), (c), (d), (e), and (f).
(8) The grantee may insert in the space provided below the site(s) for the performance of work
done in connection with the specific grant:
Place of Performance
Street City
State Zip
Action
If your place of performance is different from the physical address provided by you in the Applicant
Information, click on Add Place of Performance button above to ensure that the correct place of
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performance has been specified. You can add multiple addresses by repeating this process multiple
times.
Section 17.630 of the regulations provide that a grantee that is a State may elect to make one certification in each
Federal fiscal year. A copy of which should be included with each application for FEMA funding. States and State
agencies may elect to use a Statewide certification.
Signed by Kimberly Perron on 11/03/2003
FEMA Standard Form LLL
Only complete if applying for a grant for more than $100,000 and have lobbying activities. See Form 20-16C for
lobbying activities definition.
This form is not applicable
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