HomeMy WebLinkAboutCity of Tamarac Resolution (260)Temp Reso. #9894
Page 1
September 25, 2002
CITY OF TAMARAC, FLORIDA
RESOLUTION NO, R-2002-260
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 $90,000 WITH A TOTAL
ESTIMATED PROJECT COST OF $153, 253 FOR THE
PURCHASE OF A MOBILE FIRE SAFETY HOUSE AND
ENHANCEMENT OF THE EDUCATION GENERATIONS
FIRE SAFETY EDUCATION AND OUTREACH PROGRAM;
AUTHORIZING A CITY MATCH IN THE AMOUNT OF
$63,253 TO BE ALLOCATED AS $54,730 IN -KIND AND
$8,523 CASH; 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 to promote 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
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
Temp. Reso. # 9536
Page 2
September 25, 2002
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 $90,000
providing for a match of $63,523, with $8,523 in cash and $54,730 in -kind for a total project
cost of $153,253; and
WHEREAS, the City Manager and the Fire Chief recommend filing of the application
(attached hereto as "Exhibit A"); 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.
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.
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Temp. Reso. # 9536
Page 3
September 25, 2002
I ]
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 A") and made a part hereof requesting $90,000 providing for a match of
$63,523, with $8,523 in cash and $54,730 in -kind, for a total project cost of $153, 253.
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.
Section 5: This Resolution shall become effective immediately upon its adoption.
PASSED, ADOPTED AND APPROVED this Rath day of September, 2002.
ATTEST:
MARION SWENSON, CMC
CITY CLERK
I HEREBY CERTIFY that
I have approved this
RESOLUTION as to form.
MITCHELL S. KRAF
CITY ATTORNEY
C b
"JOE SCHREIBER
MAYOR
RECORD OF COMMISSION VOTE:
MAYOR SCHREIBER AYE
DIST 1: V/M. PORTNER AYE
DIST 2: COMM. MISHKIN AYE
DIST 3: COMM. SULTANOF AYE
DIST 4: COMM. ROBERTS AYE
City of Tamarac
im
/ RESCUE \
Federal Emergency Management Agency
Assistance to Firefighters Fire
Prevention and Safety Program
2002 Fire Prevention Grant Proposal
Educating Generations
Table of Contents
Project Summary
Introduction
Financial Support
Qualifications
Project Overview
Problem Statement
Project Goal
Objectives
Implementation Methods
Evaluation
Schedule
Budget
Future Plans
City of Tamarac — Educating Generations
Fire Prevention Grant Proposal
September 20, 2002
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Attachments
Attachment 1: Letters of Support
Attachment 2: Resume for Project Manager
Attachment 3: Mobile Fire Safety House Information
Attachment 3: Budget Information — Non -construction Program, FEMA Form 20-20
Attachment 4: Application for Federal Assistance, Standard Form 424
Attachment 5: Direct Deposit Signup Form, Standard Form 1199A
Attachment 6: Summary Sheet for Assurances and Certification, FEMA Forms 20-16,
20-16A and 20-16C.
Attachment 7: Disclosure of Lobbying Activities, Standard Farm LLL
City of Tamarac — Educating Generations
Fire Prevention Grant Proposal
September 20, 2002
Project Summary
The City of Tamarac's Fire Rescue Department proposes to enhance our fire
Prevention and safety outreach and education program, called Educating Generations,
through the purchase of a mobile fire safety house. The total cost of this project is
estimated to be $153,253. The total grant request is for $90,000 with a $63,253 cash
and in -kind match. This project will significantly increase the department's ability to
reach and educate multiple constituencies through realistic fire situation simulations.
The goal of the program is to educate children, families, and the elderly on fire safety
and eliminate preventable fire -related injuries and deaths within our community.
Introduction
The City of Tamarac was incorporated in 1963 and has been providing fire
rescue and emergency medical services since that time. The City of Tamarac has a
combination of urban, suburban and commercial features and has grown to a population
of 56,000. Once considered a retirement destination, Tamarac has a rapidly changing
demographic. During the 1990 census, the median age in Tamarac was 63. By the
time the 2000 census was taken, the median age had dropped to 53 and is continuing
to fall. Many young families are moving to Tamarac lured by affordable starter homes,
and the reputation as a safe, low crime area. Two new schools have opened in
Tamarac within the past two years to accommodate the growing student population in
our area.
The mission of the Fire Rescue Department is to protect life, health, property,
and natural resources of the citizens and visitors of Tamarac by providing the highest
quality emergency service, fire suppression, education, and inspection services. The
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City of Tamarac — Educating Generations
Fire Prevention Grant Proposal
September 20, 2002
Fire Rescue Department's commitment to and involvement in the community is very
strong. It has been providing fire prevention education for over eleven years. The
department has an extensive smoke detector give -a -way program and has provided
thousands of free smoke detectors to area residents. Thanks to the burgeoning youth
population, in 2001 a new fire cadet program was started for young people interested in
becoming fire fighters. The older generation participates in volunteer activities, such as
the Citizens Emergency Response Team (CERT), to assist the department in reaching
as many residents as possible. The Department works with Broward County Public
Schools to give demonstrations and lectures about fire safety and currently serves
several hundred children annually. Including the schools, the Departments outreach
programs reached over 20,000 community members in fiscal year 2002. The
Department's goal is to reach 30,000 people in 2003.
Tamarac Fire Rescue is dedicated to continuous improvement of all of its
programs. A team of Tamarac Fire Rescue personnel recently placed third in an
international Advanced Lifesaving Skills competition held at ClinCon 2002 in Orlando,
Florida. In 2000, the City won the State Fire Rescue competition held at the University
of Miami, in Coral Gables, Florida. This dedication to excellence extends to its outreach
programs as well. Attachment 1, which includes several letters of support from our
constituents, provides testament to Departments efforts in the area of fire prevention
and safety and the community's appreciation of those efforts.
Financial Support
The Department's projected budget for the 2003 fiscal year, which runs from
October 1 St to September 30t", is $9.6 million. The Department is supported through
City of Tamarac — Educating Generations
Fire Prevention Grant Proposal
September 20, 2002
allocations of collected City taxes, fees for services, and various grant programs. The
purchase of a mobile fire safety house has been on the wish list of the Department for
several years, however other more pressing fire suppression and EMS issues have
taken precedence.
Qualifications
The Fire & Safety Education Specialist, Van Schoen, will act as the project
manager for the mobile fire safety house. Mr. Schoen's resume is included in
Attachment 2. Mr. Schoen is extremely active in the community. He is a member of the
Broward County Safe Kids Coalition, the Child Safety Seat Checkpoint Coordinator for
the City, he participates in the Walk This Way Children's Programs and he coordinates
a variety of special events for the Department.
The Fire Chief, James Budzinski, has been with the Department since 1979 and
is actively involved in the community outreach program. Chief Budzinski's resume is
also included in Attachment 2. Chief Budzinski has served as the President of the
Broward County Chiefs Association for the last four years, is a member of the Florida
Chiefs Association, the International Association of Fire Chiefs, the Florida Emergency
Preparedness Association and the National Fire Protection Association. The Chief will
be able to utilize his considerable influence to encourage participation and feedback
from other departments as well as community groups and associations.
Project Overview
This project involves the purchase of a mobile fire safety house, and truck for
towing, to enhance the Educating Generations fire safety outreach and education
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City of Tamarac — Educating Generations
Fire Prevention Grant Proposal
September 20, 2002
program. The project will involve several volunteer organizations and it is hoped that
this program will become a model for other municipalities' fire rescue departments.
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. The
number of structural fires is on the rise in Tamarac and in 2001 there were 39 structural
fires in Tamarac with one civilian injury. Many of these deaths and injuries 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.
City of Tamarac — Educating Generations
Fire Prevention Grant Proposal
September 20, 2002
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. A sample floor plan and detailed information is
included in Attachment 3. 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 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
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City of Tamarac -- Educating Generations
Fire Prevention Grant Proposal
September 20, 2002
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.
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City of Tamarac — Educating Generations
Fire Prevention Grant Proposal
September 20, 2002
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.
Schedule
Activity
Develop specifications for trailer & truck
Send Requests for Bids
Evaluate and Select Successful Bid
Take delivery on new equipment
Complete training volunteers on new equipment
Begin community education with new trailer
Target Completion
15 days from Notice of Award
45 days from Notice of Award
90 days from Notice of Award
210 days from Notice of Award
240 days from Notice of Award
240 days from Notice of Award
City of Tamarac — Educating Generations
Fire Prevention Grant Proposal
September 20, 2002
Budget
Grant
Item
Item Cost Quantit
Total Cost
Request
Cash Match
In -Kind Match
Mobile Fire Safety House
$
60,000.00 1
$
60,000.00 $
60,000.00
Pick -Up Truck
$
30,000.00 1
$
30,000.00 $
30,000.00
Smoke Detectors
$
3.50 1,000
$
3,500.00
$
3,500.00
Radios
$
30.00 4
$
120.00
$
120-00
Strobe lights
$
560.00 1
$
560.00
$
560.00
Whelen Directional Advisor
$
295.00 1
$
295.00
$
295.00
Computer
$
3,000.00 1
$
3,000.00
$
3,000.00
Megaphone
$
80.00 1
$
80.00
$
80.00
Digital Camera
$
700.00 1
$
700.00
$
700.00
Clipboards
$
5.00 10
$
50.00
$
50.00
Golight
$
109.00 2
$
218.00
$
218.00
Personnel Hours
Fire Chief
$
60.00 100 hours
$
6,000.00
$ 6,000.00
Project Manager
$
25.55 600 hours
$
15,330.00
$ 15,330.00
Other Fire Rescue Personnel $
33.50 400 hours
$
13,400.00
$ 13,400.00
Volunteers
$
10.00 2000 hours $
20,000.00
$ 20,000.00
TOTAL GRANT REQUEST $ 90,000.00
Total Cash Match $ 8,523.00
Total In -Kind Match $ 54,730.00
TOTAL MATCH $ 63,253.00
TOTAL PROJECT COSTS $153,253.00
The costs for the mobile safety trailer were estimated by contacting other
departments that utilize such equipment and by contacting vendors who build the
trailers. The pick-up truck will be a heavy-duty model with a large towing capacity and
an extended cab. The price of the pick-up was estimated using previous bids for other
City departments. The Department purchases smoke detectors each year to distribute
in a free give-away program. The Department will continue this program and
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City of Tamarac — Educating Generations
Fire Prevention Grant Proposal
September 20, 2002
incorporate it into the mobile safety house programs. The computer and digital camera
will be used in the mobile fire safety house to demonstrate particular scenarios, show
videos and interface with some of the electronics built into the house. The remaining
equipment will be used for various simulations and communication purposes.
The personnel who will participate in the program include the Fire Chief, who is
actively involved in community outreach programs, the project manager who is the Fire
Safety and Education Specialist, and several other Department employees including the
Battalion Chiefs, and the Fire Inspector, as well as several firefighters. The project will
train volunteers to eventually fill many of the positions that will initially utilize paid
firefighters.
Future Plans
The City of Tamarac and the Fire Rescue Department are committed to
continuing the Educating Generations program long after the initial purchase of the new
mobile fire safety house. The mobile fire safety house has an expected useful life of 15
years, while the truck has an expected useful life of 7 years. The necessary
maintenance and personnel will be committed to program as required. As volunteers
become more proficient, the number of paid staff who participate in the programs will
decrease, thus decreasing overall costs of the program. This program is and will
continue to be an integral part of the Department's mission.
10
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WRITE ALUMINUM,
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THE BLEACHER DESIGN ALLOWS
FOR HIGHER VOLUME TRAINING,
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THIS UNIT WILL MAKE TRAINING
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NEW OPTIONAL FEATURES
THIS UNIT CAN BE UP GRADED
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ESCAPE LADDER
911 OR ANY NUMBER PHONE SYSTEM
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36B LTD1 Page 2 of 2
LARGE OUTSIDE STORAGE COMPARTMENT OUTSIDE PHONE JACK
SMOKE SYSTEM WITH SMOKE MACHINE FURNACE AND GAS SYSTEM
MICROWAVE OVEN I ELECTRICALLY HEATED DOOR
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SURREY FIRE.SAFETY HOUSE
36BSTDI
SPECIFICATION SHEET
LENGTH: 36' 6" WIDTH: 8'0" GVW: 6,400# GVWR: 10,400#
HEIGHT: 11' 6" Interior Ht.: 96" HITCH WT.: 800# AXLE WT.: 5,600#
ADA Compliant: All units handicap accessible.
FRAME, & SIDEWALL CONSTRUCTION
FRAME 2X8 high strength Bullmoose double tube steel rails. Welded battery rack on
tongue with a steel tube 4x4 rear bumper with aluminum cover and standard safety chains.
Rear skid bars for additional protection.
SIDEWALL CONSTRUCTION
2x2 members 16" on center. Studs are bonded to 5/32 plywood paneling for high strength
and light weight. ABS fenders with galvanized wheel pans. Handcut fiberglass insulation in
sidewalls with a R 9 rating.
EXTERIOR: The exterior of the house is available in white aluminum RV siding.
AXLES AND BRAKES
ROOF
Unit shall have tandem 4" drop axles 5,200# each with equalized suspension. The axles are
spring leaf. 4 wheel 10 " electric brakes will be utilized mfg by Hayes or equal. A brake
away switch will be attached to the frame as an emergency stop, in the unlikely event of
unit separation.
TIRES AND WHEEL,S_P225/75/R15 ST trailer tires on heavy duty styled white 6 lug
wheels and center caps.
A 1 piece aluminum roof is provided. Tapered 2x6 roof truss system provides a crown to
the roof eliminating puddling. 3 roof vents are in place.
FLOOR_ The floor is constructed of 5/8" exterior grade tongue & groove plywood on 2x4
support
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36b1_spec
Page 2 of 4
members 12" on center. Living room, bedroom and stairs are fully carpeted with a 112" foam
pad. Kitchen and control room as well as the storage compartments have a fully insulated
Door with heavy duty vinyl underbelly for maximum weather shielding at a minimal
weight.
LIGHTS -INTERIOR: 12 volt lights shall be as follows with a total of 22 lights. (some have
2 lights in one fixture): Bedroom-6, Generator compartment-1, Control room-2 , Kitchen &
Living room-6, bleacher area-4, basement storage-1.
LIGHTS -EXTERIOR:
WINDOWS
2 porch lights. 1 on door side and one on rear. The LED lights are 110 volt fixture with the
ability to flash a distress signal to responding assistance. A light fixture is provided in the
top of the generator storage compartment. Standard ICC lights are in place as required. 2
hook up lights are on the power tongue jack. A 12 volt power source with an on/off switch
IS prewired to the roof for a strobe or rotator. The wall switch will be located in the control
room. (4) lights are at steps.
All windows are heat treated safety glass A single hung 36"x 36" control room picture
window with screen and mini blind is provided. Living room and bedroom windows are
aluminum RV slider windows. Curtains, with tie backs, valances and mini blinds with the
exception of the 40"x 45" sliding window leading onto the escape ladder and control room
window.
FIREPLACE
An electric fireplace with crackling sounds will be located in the living room. It will have a
screen and simulated brick face. An on/off switch will be wall mounted next to the
fireplace.
REAR LADDER:
KITCHEN
A commercially available chain escape ladder shall be bolted securely at upper and lower
deck for escape simulation. The ladder will be mounted in a manner that allows shoe
clearance between siding and chain ladder.
The kitchen shall be equipped with a functional 3 burner stove with oven. The stove will be
equipped with a shut off valve in the gas supply line. A city water hook up is provided to
allow use of stainless steel sink. A functional microwave oven will be provided as well as a
place for a refrigerator with 4 power outlets. An exhaust fan and hood with light will also be
provided. Upper and lower cabinets are in place. There are two carpeted benches provided.
FRONT ROOM -carpeted bleacher seats shall be provided.
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SMOKE MACHINE AND FLUID
Smoke machine and 1 case of water base smoke fluid is standard MSDS sheet provided.
CONTROL ROOM
A control room will be provided allowing control of many educational functions. A hands
free 911 phone system for 911 training. On/off switch for 110 volt smoke alarms. An on/off
switch for bedroom electrically heated door shall be in the control room. ABS smoke
ducting system (schedule 40) with control valves allowing room selection as well as an
operating location and outlet for water base smoke machine. A smoke ready light in the
control room will be controlled by the training officer in the bedroom. The control room
will have a 48" counter with storage cabinets and a 48" x 15.5"x 23" cushion on a bench for
the control room operator. A YxY single hung window with screen and mini blind.
Observation ports in bedroom & living room. A power vent is also provided.
GENERATOR STORAGE A generator compartment is provided to store and transport a
generator. It is located so that the wheel chair ramp can be used to load and unload
generator.
TV_CABINET: A TV cabinet is provided on the awning side of the trailer.
DOORS -OUTSIDE:
A 36"x 75" out swinging RV door is provided on the curbside. A 7"x55" door with key lock
will be on left side for handicap ramp storage compartment as well as a 40"xI 1" door with
key lock for under stairwell storage access.
COOLING, HEATING AND VENTILATION
BEDROOM
13,500 BTU air conditioning is standard, with ducting to bedroom , living room, control
room and kitchen. Heat will be provided by a 35,000 BTU Atwood #8500 forced air furnace
ducted throughout. 3 power roof vents, 1 in kitchen and 2 in bedroom shall be installed to
aid in removing non toxic smoke as well as help hold the smoke to the ceiling during
training.
The bedroom shall be on the main floor. It will be fully carpeted with foam pad, curtains
with tie backs valances and mini blinds on the single hung windows. A bed with vinyl
covered mattress, bedspread and pillow sham. A carpeted bench is included. An exhaust fan
shall be roof mounted with an on/off switch control, allowing instructor to monitor smoke
removal. A smoke on signal in the control room can be activated by the instructor in the
bedroom A sliding window in the rear of the unit will allow access to rear escape ladder. An
electrically heated door is used to simulate fire on the opposite side.
ELECTRICAL- 110 VOLT:
A 30 amp power supply cord shall be provided for 110 volt AC power needs. All wall
receptacles are functional. Ground fault receptacles are in the kitchen as well as both
http://firesafetyhouse.com/36bl spec.htm 9/11/02
36bl_spec Page 4 of 4
outside outlets. Power is supplied through circuit breakers built into a 55 amp DC solid state
power converter.
ELECTRICAL-12 VOLT:
12 volt power for the unit is provided by a 55 amp magnetek solid state power converter.
The converter will supply all 12 volt needs of the unit when plugged in. The unit will have a
deep cycle battery and box to supply 12 volt power on short term when not plugged in.
911 PRONE With Call back feature:_
A wall phone will be located in the living room allowing a child to experience dialing 911
or any number and reaching (control room) a fire fighter or dispatcher. The system is hands
free for the control room operator. An external phone jack will be located on the door side
of the unit, allowing 911 training from outside the unit or to demonstrate the need to exit the
home in a fire situation and call from a neighbor.
HITCH. -JACK
A high torque 12 volt power tongue jack manufactured by H&H Engineering will be in
place. The unit will have manual back up capability as well as 2 hookup lights.
STABILIZER_JACK
4 BAL crank down stabilizer jacks shall be frame mounted. These jacks will stabilize the
unit and eliminate suspension travel while occupied.
OUTLETS
Control room-5, Kitchen-4, Living roam-3, Bedroom-4, Outside-2.
LIVING_ ROOM
Windows have curtains with tie backs, valances and mini blinds. Electric fireplace with
on/off switch. Carpeted benches. Lights above mantel. Wall mounted telephone.
S36BSTDI 4/9/01
http://firesafetyhouse.corr /36b] spec.htm
9/11 /02
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APPLICATION FOR
OMB Approval No. 0348-0043
FEDERAL A5515TANCE
2. DATE SUBMITTED
Applicant Identifier
September 20, 2002
1, TYPE OF SUBMISSION;
3. DATE RECEIVED BY STATE
State Application Identifier
Application
Preapplication
4, DATE RECEIVED BY FEDERAL AGENCY
Federal Identifier
Construction
BConstruction
Non-Construction
Non -Construction
5. APPLICANT INFORMATION
Legal Name:
Organizational Unit:
City of Tamarac
Fire Rescue Department
Address (give city, county, State, and zip code):
Name and telephone number of person to be contacted on matters involving
7525 NW 88th Avenue
this application (give area code)
Tamarac, FL 33321
Kimberly Perron
(954) 718-3051
6. EMPLOYER IDENTIFICATION NUMBER (EIN):
5 9- 11 1013 15 19 9 2
7. TYPE OF APPLICANT: (enter appropriate letter in box)
A. State H. Independent School Dist.
B. County 1. Stale Controlled Institution of Higher Learning
8. TYPE OF APPLICATION:
New ElContinuation
FiRevision
C. Municipal J. Private University
D. Township K. Indian Tribe
If Revision, enter appropriate letter(s) in box(es)
❑ M
E. Interstate L. Individual
F. Intermunicipal M. Profit Organization
A. Increase Award B. Decrease Award
C. Increase Duration
G. Special District N. Other (Specify)
D. Decrease Duration Other (specify):
9. NAME OF FEDERAL AGENCY:
Federal Emergency Management Agency
10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER:
11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT:
8 5 - 5 5 4
TITLE:
Educating Generations on Fire Safety
12. AREAS AFFECTED BY PROJECT (Cities, Counties, States, etc.):
Tamarac, Broward County, Florida
13. PROPOSED PROJECT:
14. CONGRESSIONAL DISTRICTS OF:
Start Date
Ending Date
a. Applicant
b. Project
01/01/2003
12/31/2003
FL-19
FL-19
15. ESTIMATED FUNDING:
16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE
ORDER 12372 PROCESS?
a. Federal
$ 90,000.00
.00
a. YES. THIS PREAP PLICATION/APPLICATION WAS MADE AVAILABLE
TO THE STATE EXECUTIVE ORDER 12372 PROCESS FOR
b. Applicant
$ 63,253.00
.00
REVIEW ON:
c. State
$
.00
DATE-
d. Local
$
.00
b. No. PROGRAM IS NOT COVERED BY E.O. 12372
X OR PROGRAM HAS NOT BEEN SELECTED BY STATE
e. Other
$
00
FOR REVIEW
f. Program Income
$
.00
17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT?
Yes If "Yes," attach an explanation. 0No
g. TOTAL
$ 153,253.00
.00
18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION/PREAPPLICATION ARE TRUE AND CORRECT, THE
DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE
ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED.
a. Type Name of Authorized Representative
b. Title
c. Telephone Number
Jeffrey L. Miller
City Manager
(954) 724-1230
d. Signature of Authorized Representative
e. Date Signed
September 20, 2002
Previous dition Usable
Standard Form 424(Rev. -9 )
Authorized for Local Reproduction Prescribed by OMB Circular A-102
Standard Form 1199A OMB No. 1510.0007
(Rev. June 1987)
Prescribed by Treasury
Department • SIGN-UP FORM
Treasu Dept. Cir. 1076
DIRECTIONS
• To sign up for direct deposit, the payee is to read the back of this « The claim number and type of payment are printed on Government
form and fill in the information requested in Sections 1 and 2. Then checks. (See the sample check on the back of this form.) This informa-
take or mail this form to the financial institution. The financial in- tion is also stated on beneficiary/annuitant award letters and other
stitution will verify the information in Sections 1 and 2, and will com- documents from the Government agency.
plete Section 3. The completed for will be returned to the Govern-
ment agency identified below. Payees must keep the Government agency informed of any address
changes in order to receive important information about benefits and
• A separate form must be completed for each type of payment to be to remain qualified for payments.
sent by Direct Deposit.
SECTION 1 (TO BE COMPLETED BY PAYEE)
A NAME OF PAYEE (last,. first, middle initial)
Q TYPE OF DEPOSITOR ACCOUNT ❑ CHECKING SAVINGS
E DEPOSITOR ACCOUNT NUMBER
ADDRESS (sheet, route, P.D. Box, APO/FPU)
CITY STATE ZIP CODE
F TYPE OF PAYMENT (Check only one)
❑ Social Security ❑ Fed Salary/Mil. Civilian Pay
❑ Supplemental Security Income ❑ Mil. Active
TELEPHONE NUMBER
AREA CODE
--
❑ Railroad Retirement ❑ Mil. Retire.
❑ Civil Service Retirement (OPM) ❑ Mil. Survivor
❑VA Compensation or Pension ❑Other
B NAME OF PERSON($) ENTITLED TO PAYMENT
(s vecify)
C CLAIM OR PAYROLL ID NUMBER
G THIS BOX FOR ALLOTMENT OF PAYMENT ONLY (�fapplicable)
TYPE
AMOUNT
Prefix Sufffix
PAYEE/JOINT PAYEE CERTIFICATION
_
JOINT ACCOUNT HOLDERS' CERTIFICATION (optional)
I certify that I am entitled to the payment identified above, and that I
I certify that I have read and understood the back of this form, including
have read and understood the back of this form. In signing this form I
the SPECIAL NOTICE TO JOINT ACCOUNT HOLDERS.
authorize my payment to be sent to the financial institution named
below to be deposited to the designated account.
SIGNATURE
DATE
SIGNATURE
DATE
SIGNATURE
DATE
SIGNATURE
DATE
SECTION 2 (TO BE COMPLETED BY PAYEE OR FINANCIAL INSTITUTION)
GOVERNMENT AGENCY NAME GOVERNMENT AGENCY ADDRESS
SECTION 3 (TO BE COMPLETED BY FINANCIAL INSTITUTION)
NAME AND ADDRESS OF FINANCIAL INSTITUTION
ROUTING NUMBER
D[I]MI111P
DEPOSITOR ACCOUNT TITLE
FINANCIAL INSTITUTION CERTIFICATION
CHECK
DIGIT
I confirm the identity of the above -named payee(s) and the account number and title. As representative of the above -named financial institution, I cer-
tify that the financial institution agrees to receive and deposit the payment identified above in accordance with 31 CFR Parts 240, 209, and 210.
PRINT OR TYPE REPRESENRATIVE'S NAME I SIGNATURE OF REPRESENTATIVE I TELEPHONE NUMBER I DATE
Financial institutions should refer to the GREEN BOOK for further instructions.
THE FINANCIAL INSTITUTION SHOULD MAIL THE COMPLETED FORM TO THE GOVERNMENT AGENCY IDENTIFIED ABOVE.
NSN 7540-01-058-0224 1199-207
FEDERAL EMERGENCY MANAGEMENT AGENCY
SUMMARY SHEET FOR ASSURANCES AND CERTIFICATIONS
R I CA FOR (Name of Applicant)
O.M.B. No. 3067-0206
Expires February 29, 2004
his summary sheet includes Assurances and Certifications that must be read, signed, and submitted as a part of the
pplication for Federal Assistance.
n applicant must check each item that they are certifying to:
Part I El FEMA Form 20-16A, Assurances-Nonconstruction Programs
Part II
❑
FEMA Form 20-16B, Assurances -Construction Programs
Part III El
FEMA Form 20-16C, Certifications Regarding Lobbying;
Debarment, Suspension, and Other Responsibility
Matters; and Drug -Free Workplace Requirements
Part IV nX
SF LLL, Disclosure of Lobbying Activities (If applicable)
the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the identified
ached assurances and certifications.
Jeffrev L. Miller City Manager
Typed Name of Authorized Representative Title
September 20, 2002
Signature of Authorized Representative Date Signed
1OTE: By signing the certification regarding debarment, suspension, and other responsibility matters for primary covered
ransaction, the applicant agrees that, should the proposed covered transaction be entered into, it shall not knowingly enter
nto any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded
'rom participation in this covered transaction, unless authorized by FEMA entering into this transaction.
The applicant further agrees by submitting this application that it will include the clause titled "Certification
�garding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," provided by
e FEMA Regional Office entering into this covered transaction, without modification, in all lower tier covered transactions
A in all solicitations for lower tier covered transactions. (Refer to 44 CFR Part 17.)
Paperwork Burden Disclosure Notice
Public reporting burden for this form is estimated to average 1.7 hours per response. Burden means the time, effort and
nancial resources expended by persons to generate, maintain, retain, disclose, or to provide information to us. You may
end comments regarding the burden estimate or any aspect of the form, including suggestions for reducing the burden
a: Information Collections Management, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472,
aperwork Reduction Project (3067-0206). You are not required to respond to this collection of information unless a valid
FMB control number appears in the upper right corner of this form. Please do not send your completed form to the above
FEMA Form 20-16, FEB 01
FEDERAL EMERGENCY MANAGEMENT AGENCY
ASSURANCES -NON -CONSTRUCTION PROGRAMS
Note: Certain of these assurances may not be applicable to your project or program. If you have any questions, please
contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to
additional assurances. If such is the case, you will be notified.
As the duly authorized representative of the applicant, I certify that the applicant:
1. Has the legal authority to apply for Federal assistance,
and the institutional, managerial and financial capability
(including funds sufficient to pay the non -Federal share of
project costs) to ensure proper planning, management and
completion of the project described in this application.
2. Will give the awarding agency, the Comptroller
General of the United States, and if appropriate, the State,
through any authorized representative, access to and the
right to examine all records, books, papers, or documents
related to the award; and will establish a proper accounting
system in accordance with generally accepted accounting
standards or agency directives.
3. Will establish safeguards to prohibit employees from
using their positions for a purpose that constitutes or
presents the appearance of personal 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 1X 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 o1' 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; (1) 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 ct 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 0) the requirements of any other
nondiscrimination statutc(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.
S. 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 I8
U.S.C. Sections 874), and the Contract Work flours
and Safety Standards Act (40 U.S.C. Sections 327-333),
regarding labor standards for federally assisted
construction subagreements.
10. Will comply, if applicable, with flood insurance
purchase requirements of Section 102(a) of the Flood
Disaster Protection Act of 1973 (P.L. 93-234) which
requires recipients in a special flood hazard area to
participate in the program and to purchase flood
insurance if the total cost of insurable construction and
acquisition is S10,000 or more.
FEMA Form 20-16A, JUN 94
11. Will comply with environmental standards which may
be prescribed pursuant to the following: (a) institution
of environmental quality control measures under the
National Environmental Policy Act of 1.969 (P.L. 91-190)
and Executive Order (EO) 1.1514; (b) notification of violating
facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11991); (d) evaluation of flood hazards in
tloodplains in accordance with EO 1.1988; (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.); (1) 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 (1.6 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-I 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.) ivltieb
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.
FEMA Form 20-16A (BACK)
FEDERAL. EMERGENCY MANAGEMENT AGENCY
CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND
OTHER RESPONSIBILITY 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
forni provides for compliance with certification requirements under 44 CFR Part 18, "New Restrictions on Lobbying; and 28 CFR
Part 17, "Government -wide Debarment and suspension (Nonprocurement) 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.
1. LOBBYING
A. As required by section 1352, Title 31 of the U.S. Code, and
implemented at 44 CFR Part 18, for persons entering into a grant
or cooperative agreement over $100,000, as defined at 44 CFR
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 the 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 an employee of Congress, or 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 subawards at all tiers
(including subgrants, contracts under grants and cooperative
agreements, and subcontract(s) and that all subrecipients shall
certify and disclose accordingly.
(b) Have not within a three-year period preceding this application been
convicted of ar 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 governmental 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 t ransactions (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 shall shall attached 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 44 CFR Part 17, Subpart F, for grantees, as defined
at 44 CFR Part 17, Sections 17.615 and 17.620:
A. The applicant certifies that it will continue to privide a drug -
free workplace by:
Standard Form LLL, "Disclosure of Lobbying Activities" attached.
(This form must be attached to certification if nonappropriated funds (a) Publishing a statement notifying employees that the unlawful
are to be used to influence activities.) manufacture, distribution, dispensing, possession, or use of a
controlled substance is prohibited in the grantee's workplace and
2. DEBARMENT, SUSPENSION, AND OTHER specifying the actions tht will be taken against employees for
RESPONSIBILITY MATTERS violation of such prohibition;
(DIRECT RECIPIENT)
As required by Executive Order 12549, Debarment and Suspension
and implemented at 44 CFR 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) Establishing an on -going drug free awareness program to
inform empoyees about.
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug -free workplace;
(3) Any available drug counseling, rehabilitation, and
employee assistance programs; and
(4) the penalties that may be imposed upon employees for
drug abuse violations occurring in the workplace;
FEMA Form 20-16C, JUN 94
(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, 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).
S. 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 address, City, County, State, Zip code)
Check ❑ if there are workplaces on file that are not identified here.
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.
FEMA Form 20-16C (BACK)
DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046
(See reverse for public burden disclosure)
Type of Federal Action:
2. Status of Federal Action:
3. Report Type:
11.
a. contract
FKa. bid/offer/application
�a. initial filing
Ella. grant
b. initial award
b. material change
C. cooperative agreement
c. post -award
For Material Change Only:
d. loan
year quarter
e. loan guarantee
date of last report
f, loan insurance
Name and Address of Reporting Entity:
5. If Reporting Entity in No. 4 is Subawardee, Enter Name
EX Prime Subawardee
and Address of Prime:
City of Tamarac Tier if known:
7525 NW 88th Avenue
Tamarac, FL 33321
Congressional District, if known: FL 19th
Congressional District, ifknown:
6. Federal Department/Agency:
7. Federal Program Name/Description:
Assistance to firefighters - Fire prevention and
Safety Program - Special Grant for Fire Prevention
Federal Emergency Management Agency
CFDA Number, if applicable: 85.554
8. Federal Action Number, if known:
9. Award Amount, if known
10. a. Name and Address of Lobbying Registrant
b. Individuals Performing Services (including address if
(if individual, last name, first name, Ml):
different from No. f pa)
(last name, first name, Ml):
None
11. Information requested through this form is authorized by title 31
U.S.C. section 1352. This disclosure of lobbying activities is a material
Signature:
representation of fact upon which reliance was placed by the tier
above when this transaction was made or entered into. This
Print Name; Jeffrey L. Miller
disclosure is required pursuant to 31 U.S.G. 1352. This information
will be reported to the Congress semi-annually and will be
Title: City Manager
available for public inspection. Any person who fails to file the
required disclosure shall be subject to a civil penalty of not less
Telephone No.: 954-724-1230 Date: 9120/02
than $10,000 and not more than $100,000 for each such failure.
Federal Use Only;
Authorized for Local Reproduction
Standard Form LLL (Rev. 7-97)