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Home My WebLink About2003-097 I . RESOLUTION NO. 2003-97 2 3 RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN BERNARDINO RATIFYING SUBMITTAL OF A GRANT APPLICATION TO THE FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA) IN THE AMOUNT OF $210,600 TO PURCHASE DEFIBRILLATORS. 4 5 BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN BERNARDINO AS FOLLOWS: 6 7 SECTION 1. The Mayor and Common Council hereby ratify the Fire Chiefs submittal of 8 an on-line grant application to FEMA in the amount of$210,600 for San Bernardino City Fire 9 Department's Emergency Medical Services Program. A copy of the on-line grant application is 10 attached as Attachment" A", and incorporated herein by reference. II fill 12 fill 13 fill 14 fill 15 fill 16 fill 17 fill fill fill 18 19 20 fill 21 fill 22 fill 23 fill 24 fill 25 fill 26 fill 27 fill 28 fill 1 2003-97 2 RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN BERNARDINO RATIFYING SUBMITTAL OF A GRANT APPLICATION TO THE FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA) IN THE AMOUNT OF $210,600 TO PURCHASE DEFIBRILLATORS. , ~ 4 I HEREBY CERTIFY that the foregoing resolution was duly adopted by the Mayor and 5 Common Council of the City of San Bernardino at a joint regular meeting thereot~ held on 6 the 21st day of April , 2003, by the following vote, to wit: 7 8 Council Members AYES NAYS ABSTAIN ABSENT 9 ESTRADA x 10 LONGVILLE x 11 McGINNIS x 12 DERRY x 13 SUAREZ x 14 ANDERSON x 15 McCAMMACK x 16 17 C2~/b. C~ Racltet G. Clark, City Clerk 18 19 The foregoing resolution is hereby approved this ~ day of April ,2003. 20 21 /,LeL -- Jud' alles, Mayor C' of San Bernardino 22 23 Approved as to form and legal content: 24 25 James F. Penman, City Attorney 26 27 2 28 I, Print Application 2003-97 Attachment "A" Page 1 of 12 Entire Application Applicant Information Submitted on 1 0-APR-2003 by Norma Camarena Based on Information you have provided, your department serves a Suburban community. Contact Information: Day Phone: 909-384-5388 Evening Phone: Cell Phone: Email: camerena_no@ci.san-bernardino.ca.us . Fire Department Name . Type of Fire Department If other, please enter the type of Fire Department . Emolover Identification Number Physical Address . Headquarters' Physical Address 1 Headquarters' Physical Address 2 . City . State 'Zip Mailing Address is the same as the Physical Address . Mailing Addressl Mailing Address2 . City . State 'Zip Account information . Type of bank account Checking . Bank routing number -lU!igj1 number on the bottom 121000248 left hand comer of your check . Your account number 4159283308 City of San Bernardino Fire Department City 95-6000772 200 East Third Street San Bernardino California 92410 - 4889 200 East Third Street San Bernardino California 92410 - 4889 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 from any other grant program regardless of Yes purpose? . Is the applicant delinauent on anv federal debt? No If yes, type explanation in space provided below Contact Information httos :/Ioortal.fema. !!ov/fire!!rantliso/firelorint aDD. iso ?orint=true&ann num her=nl111 0411012001 Print Application 'Title Salutation , First Name Middle Initial , Last Name , Day Phone 'Evening Phone Cell Phone Fax Email , Title Salutation . First Name Middle Initial , Last Name , Day Phone 'Evening Phone Cell Phone Fax Emall Department Characterjstics (I) 2003-97 Page 2 of 12 Alternate Contact Information Number 1 Fire Chief , How many structures In your jurisdiction are more than four stories tall? , What is the permanent resident population of your l:>Jjmarv/first-response area or iurisdiction served? Pitzer R Larry (909) 384-5286 Ex!. (909) 384-5286 Ex!. (909) 384-5281 pitzeUa@cLsan-bernardino.ca.us Alternate Contact Informalion Number 2 EMS Coordinator Mr. Henry Vasquez (909) 384-5286 Ex!. (909) 384-5286 Ex!. (909) 384-5281 vasquez_he@cLsan-bernardino.ca.us ....____..__..:.._.1::.._-':..1_.._.._ _.__ :._".__ Yes No All Paid/Career 63 93% 0% 4% 17 205942 h ttps:/ /portal. fema. gov /firegran t/j sp/fi re/pri n Capp.j sp ?pri nt=true&app _number-null 04/10/2003 , Are you a member of a Fire Department or authorized representative of a fire department? , Are you a member of Federal Fire Department or contracted by the Federal government and solely responsible for suppression of fires on Federal property? , What kind of Department do you represent? If you answered combination, above, what is the % percentage of career firefighters in your department? 'What is Ihe square mileage of your primary response area? . What percentage of your response area is protected by hydrants? . How much of your jurisdiction is zoned for agriculture? , How much of your jurisdiction is zoned for commercial or industrial? . MOW many active nrengmers are In me operalions/EMS division of your department? . How many stations are in your department? . Do you currently report to the National Fire Incident Reporting System (NFIRS)? If you answered yes, above, please enter your FDIN? 2003-97 142 Page 3 of 12 Print Application 12 Yes 36195 . What services does your department provide? Structural Fire Suppression Fighting Wildfire Suppression Basic Life Support Advanced Life Support Hazmat Technical Level Hazmat Specialist Level Rescue Technical Level Airport Rescue Fire Fighting (ARFF) Hazmat Operational Level Rescue Operational Level Department Characteristics (II) . What is the total number of fire related fatalities in 7 your jurisdiction over the last three years? . What is the total number of fire related firefighter 12 injuries in your jurisdiction over the last three years? . In an average year, how many times does your department receive mutual/automatic aid? . In an average year, how many times does your department provide mutual/automatic aid? . What was your department's estimated average operating budget over the last three years? , What percenlage of your annual operating budget is dedicated to personnel costs(salary, overtime and 85 % fringe benefits)? . What percentage of your annual operaling budget is derived from: Taxes? 100 % 95 57 19935051 Grants? Donations? 0% 0% Fund drives? 0 % 'How many vehicles does your department have in each of the categories below? Enter numbers only and enter 0 if you don't have any of the vehicles below Fjrst Line Reserve a. Engines (or pumpers): b. Aerial Apparatus: c. Tankers: d. Rescue Vehicles: e. Brush/Quick attack: f. Other: 11 2 2 3 5 27 5 1 o o o o Provide in the space below the following information only if you are applying for a firefighting vehicle: List all your vehicles by type (for example, engines/pumpers, brush, rescue, etc.). Then provide the year each was manufactured. If the department has more than two of any type, provide the total number of vehicles in that category and the years the oldest and the newest were manufactured. Department Call Volume https://portal.fema.gov/firegrant/jsp/fire/print_app.j sp ?print=true&app _number=null 04/10/2003 Print Application 2003-97 Page 4 of 12 . How many responses per year by category? Enter whole numbers only: If you have no calls tor any of the categories, enter zero. Structure Fires Vehicle Fires Vegetation Fires EMS Rescue Hazardous Condition/Materials Calls Service Calls Good Intent Cails/False Alarms Other Calls and Incidents 314 311 330 23571 15 119 557 592 1283 Request Information . 1. Select the program for which you are applying. Remember, you can apply for only one program this year. Within a program you may appiy for as many aclivities as are required. If you modify your selection, you will lose data entered under the original activity. Program Name Emergency Medical Services . 2. Will this grant benefit more than one department? No 3. If you answered Yes to Question 2 above, please specify how? (You can only enter 4000 characters) Request Details Activity Weilness and Fitness Programs Emergency Medical Services (Training and Equipment) Number of Entries o Totai Cost Additional Funding $ 0 $ 0 $ 210,600 $ 0 Emergency Medical Services-Equipment "1. What equipment will be purchased with grant funds? Defibrillalors If you answered other, above, please specify "2. Number of units 13 "3. Cost per unit $ 16200 "4. What is the reason for Ihis equipment purchase? Upgrade service "5. Will this equipment bring you into compliance with Stale or Federal standards/regulations? "6. Up to what level of patient care will this equipment bring your department? Yes First Responder https://portal.fema.gov/firegrant/jsp/fire/prinCapp.j sp ?pri nt=true&app _0 umber=n ul! 04/10/2003 Print Application 2003-97 Total Budget Budget Obiect Class a. Personnel b. Fringe Benefits c. Travel d. Equipment e. Supplies f. Contractual g. Construction h. Other L Indirect Charges Indirect Cost Details Agency Indirect Cost Agreement with Indirect Cost Rate Agreement Summary Federal and Applicant Share Federal Share Applicant Share Federal Rate Sharing (%) * Non~FederaJ Resources (The combined Non-Federal Resources must equal the Applicant Share of $ 63, 180) % a. Applicant b. State Page 5 of 12 $0 $0 $0 $ 210,600 $0 $0 $0 $0 $0 $ 147,420 $ 63,180 70/30 $ 63180 $0 $0 $0 c. Local d. Other Sources If you entered a value in Other Sources, Please identify the source of your cost share, Le., fund reserves, savings, fund-raisers, donations, etc. Total Budget Narrative Statement $ 210,600 https://portal.fema.gov/firegrantljsp/fire/princapp.j sp ?pri nt=true&app _n umber=n ul! 04/1012003 Print Application Page 6 of 12 2003-97 Project Description Please provide your narrative statement in the space provided below: THE PROJECT THAT WE ARE REQUESTING TO BE FUNDED: The San Bernardino City Fire Department (SBCFD) is requesting to replace our current defibrillators that are in desperate need of replacement. We would like to begin replacing them due to the following reasons we are facing: . Overall poor condition of current devices, . Exceed the industry norms of years in service, . Newer defibrillators have updated specifications, . Decrease probability of outdated defibrillator malfunction, and . Reduce the potential for liability on our current device. The new defibrillators would allow SBCFD to be better equipped to provide the highest quality of care and overall standardization of our department"s defibrillators. Also, we will be able to detect and treat cardiac incidents faster, resulting in better patient care outcomes. Defibrillators are not only very essential as part of the firefighterlparamedics overall assessment, but can be the difference between life and death of a patient. SBCFD provides a first responder paramedic program thai has thirteen (13) defibrillators; they have been in service for more than seven (7) years. The defibrillalors exceeded the warranty phase and six (6) of those defibrillators are Hewlett Packard (HP). HP no longer makes these units; parts and repair for Ihem is a real problem. The remaining seven (7) Phys-control Life Pak 10's are several years older and are in very poor condition. HOW WE PLAN TO USE THE GRANT FUNDS FOR EACH MAJOR BUDGET ACTIVITY AS LISTED ON THE BUDGET FORM: The following is a break down of how the funds will be allocated: Personnel: $ 0 requested. Fringe Benefits: $ 0 requested. Travel: $ 0 requested. Equipment: $ 210,600 requested. SBCFD plans to replace alllhirteen (13) defibrillators with new devices that have current technology. It is paramount that heart attack victims be identified as quickly as possible in order to receive life-saving treatment. Rapid identification by our firefighter/paramedic crews is the first logical step in this effort. These devices cost approximately $16,000 per defibrillator, and each device includes the following: EKG monitor (3-lead patient cables; 2 - preventive maintenance per year for 5 years) Biphasic waveform defibrillator (2-rechargeable batteries) Pulse Oximetry (Battery charging system) Noninvasive Blood pressure (Warranty for 5 years) Noninvasive Pacing (Carry case/cover) Supplies: $ 0 requested. Contractual: $ 0 requested Construction: $ 0 requested Other: $ 0 requested Indirect Charges: $ 0 requesled WHY THIS PROGRAM WOULD BE BENEFICIAL TO OUR COMMUNITY AND/OR TO OUR DEPARTMENT: https://portaLfema.gov/firegrant/jsp/fire/princapp.jsp ?pri nt=true&app _number-null 04/1012003 Print Application 2003-97 Page 7 of 12 SBCFD responds to approximately 24,000 EMS calls annually. Defibrillators will assist in enhancing the following areas: 1. Increase the number of lives saved of those with cardiac incidents. 2. Improve the quality of life for survivors of cardiac incidents and their families. 3. Equip the fire department"s EMS providers with state-of-the-art defibrillators to enhance their patient assessment and treatment. The new state-of-the-art defibrillators have the technology to record and store patient data. This allows our department to improve on the current Quality Assurance & Quality Improvement Program. This program allows us to look at outcome based research and with this information we can recommend changes to our current county protocols for the betterment of the palient outcome within our city. These new defibrillators have latest technology that will give our firefighter/paramedics the ability to more rapidly and accurately make assessments. This in-turn allows us to give Ihe patient(s) within our community the best treatment and improve diagnosis. WHY THIS PROJECT CANNOT BE FUNDED SOLELY THROUGH LOCAL FUNDING: Our City was home to Norton Air Force base that was closed in the early 1990s. At approximately the same time, Santa Fe Railroad moved their regional offices out of the area and a Kaiser Steel Mill closed. The direct impact of these three closures resulted in the loss of 23,000 high paying jobs in the area. Consequently, our City has been in an economic recovery mode for a decade that has created budgetary shortages. As example, SBCFD budget has not had an inflalionary increase in Maintenance and Operation for well over a decade. This has created a significant erosion of purchasing power to the point that no funds exist for purchases such as defibrillators. San Bernardino City is faced with significant budgetary shortfalls because of the catastrophic State budget crisis (estimated at $34 billion shortfall) and mandated retirement system increased contributions. Best case scenario for SBCFD"s share of cuts is $1.2 million and worst case $2.8 million for next fiscal year. Budget shortfall predictions for fiscal year 2004-2005 are considerably worse than for 2003-2004. Clearly, SBCFD will not have funding to purchase defibrillators for quite some time into the future. ADDITIONAL RELEVANT INFORMATION THAT WE WOULD LIKE YOU TO CONSIDER WHEN EVALUATING OUR APPLICATION: The San Bernardino City Fire Department serves a resident population of 205,942 and covers a diverse service area of 63 square miles. It is the largest city in the County and serves as the County seat. There are 3 major freeways and approximalely 19 miles of wildlandlurban interface areas within the city. SBCFD staffs eleven paramedic engines companies, two aerial trucks companies, and one aircraft rescue firefighting vehicle housed in twelve stations throughout the City. Also, under a unique partnership with the San Manuel Band of Mission Indians we provide fire and emergency services to their tribal lands. If you received a grant award in the 2002 process, does N your current request relate to your 2002 award? 0 If you answered yes, above, which of the following apply? This request enhances the 2002 award This request continues the 2002 award This request completes the 2002 award Assurances and Certifications FEMA Form 2D-16A You must read and sjgn these assurances by providing your password and checking the box at the bottom of this page. https://portal.fema.gov/firegrantljsp/fire/princapp.j sp ?pri nt=true&app _n umber=null 04/10/2003 Print Application 2003-97 Page 8 of 12 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. 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 Stales, 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 prohibil 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 Ihe 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 Acl 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 VIII of the Civil Rights Acts of 1968 (42 U.S.C. Section 3601 et seq.), as amended, relaling 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 U) the requirements of any other nondiscriminalion 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 Halch Act (5 U.S.C. Sections 1501-1508 and 7324- 7328), which limit the political activities of employees whose principal employment aclivities 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 https:llportal.fema.gov/firegrant/jsp/fire/princapp.j sp ?pri nt=true&app _number-null 04/10/2003 Print Application 2003-97 Page 9 of 12 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 wilh environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. Seclion 1451 et seq.); (f) conformity of Federal actions to State (Clean Air) Implemenlation 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-l 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 financiai and compliance audits in accordance with the Single Audit Act of 1984. 18. Will comply with all applicable requirements of all olher Federai laws, execulive orders, reguiations 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 Ihey apply to employees of institutions of higher education, hospitals, and other non-profit organizations. FEMA Form 2D-16C You must read and sign these assurances by providjng your password and checking the box at the bottom of thjs page. Note: Fields marked with an * are required. Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibilities Matters; and Drug-Free Workplace Requirements. https://portal.fema.gov/firegrantljsp/fire/print_app.j sp ?print=true&app _number-null 04/10/2003 [. Print Application 2003-97 Page 10 of 12 Applicanls should refer to Ihe regulations cited below 10 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 Ihis form provides lor compliance with certification requirements under 44 CFR Part 18, "New Restrictions on Lobbying; and 28 CFR Part 17, "Government-wide Debarment and suspension (Non-procurement) and Government-wide Requirements for Drug-Free Workplace (Grants)." The certifications shall be treated as a material representation of fact upon which reliance will be placed when the Federal Emergency Management Agency (FEMA) determines to award the covered transaction, grant, or cooperalive agreement 1. LOBBYING A. As required by the section 1352, Title 31 of the US Code, and implemented at 44 CFR Part 18 for persons 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, conlinuation, 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. Standard Form LLL Disclosure of Lobbying Activities Attached (This form must be attached 10 certification if non-appropriated funds are to be used to influence activities.) (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 Execulive 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. https://portaIJema.gov/firegrant/jsp/fire/princapp.j sp ?print=true&app _number=nu II 04/10/2003 Print Application 2003-97 Page 11 of 12 3. Drug-Free Workplace (Grantees other than individuals) As required by the Drug-Free Workplace Act of 1988, and implemented at 44CFR Part 17, Subpart F, for grantees, as defined at 44 CFR part 17, Sections 17.615 and 17.620: (A) The applicant certifies that it will continue to provide a drug-free workplace by: (a) Publishing a statement nolifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in Ihe 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 statemenl 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 wriling 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 nolice 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 salisfactorily 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 wilh the specific grant: Place of Performance Street City State Zip Action ...,,,,, 1::'__6 T"":~"" C'.....~. C'...... c...............:........ f'...I:f........:... n"'lA~n ,loon hllps:1 Iportal. fema. gov Ifiregran t/j sp/fi re/pri n t_app.j Sp ?pri nt=true&app _number=n ull 04/10/2003 Print Application 2003-97 Page 12 of 12 '::'uv C<1::'1 "11IU ~Ut:ttl ..:IetIIOl;:111ClIUIIIU .....OIIlVlllIC1 ::1"''''U ....00;:1 1201 West Ninth Street San Bernardino California 92411 -2213 2121 North Medical Center Drive San Bernardino California 92411 -1289 2641 North E Street San Bernardino California 92405-3425 1640 Kendall Drive San Bernardino California 92407-2800 1920 Del Rosa Avenue San Bernardino California 92404 -5641 282 W 40th Street San Bernardino California 92407-3706 3398 East Highland Avenue Highland California 92346-2106 502 South Arrowhead Avenue San Bernardino California 92346-2040 202 Meridian Avenue San Bernardino California 92410 -1330 450 Vanderbilt Way San Bernardino California 92408-3552 162 South Leland Norton Way San Bernardino California 92408-0120 If your place of performance is different from the physical address provided by you jn the Applicant Information, click on Add Place of Performance button above to ensure that the correct place of performance has been specifjed. You can add multiple addresses by repeatjng 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 Stalewide certification. Only complete if applying for a grant for more then $100,000 and have lobbying activities. See Form 20-16C for lobbying activities definition. Form SF-LLL This form is not applicable h ttps:/ /portal. fema. gov /firegrant/j sp/fire/pri ncapp.j sp ?print=true&app _n umber=null 04/ I 0/2003