HomeMy WebLinkAbout2011-265
1 RESOLUTION NO. 2011-265
2 RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF
SAN BERNARDINO RATIFYING THE SUBMITTAL OF THE 2011 ASSISTANCE TO
3 FIREFIGHTERS GRANT PROGRAM ON-LINE APPLICATION TO THE DEPARTMENT
OF HOMELAND SECURITY IN THE AMOUNT OF $173,200 AND AUTHORIZING THE
4 FIRE DEPARTMENT TO ACCEPT AND ADMINISTER THE GRANT FUNDS.
5 WHEREAS, in order to comply with a September 16,2011, on-line application deadline,
6 the City of San Bernardino Fire Department has submitted a grant application for the 2011
7 Assistance to Firefighters Grant Program;
8 BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE
CITY OF SAN BERNARDINO AS FOLLOWS:
9
10 SECTION 1. The Mayor and Common Council hereby ratifY the Fire Chief's
11 submittal of the on-line grant application to the Department of Homeland Security for the 2011
12 Assistance to Firefighters Grant Program in the amount of $173,200, a copy of which is attached
13 hereto as Attachment "A," and incorporated herein by reference.
14 SECTION 2. The Fire Chief is hereby authorized to accept and administer the grant
15 funds as set forth in the grant award package.
16 I I I
17 /I I
18 III
19 III
20 III
21 III
22 III
23 III
24 III
25 III
26 III
27 III
28 III
1.
2011-265
1 RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN
BERNARDINO RATIFYING THE SUBMITTAL OF THE 2011 ASSISTANCE TO
2 FIREFIGHTERS GRANT PROGRAM ON-LINE APPLlCA nON TO THE DEPARTMENT
OF HOMELAND SECURITY IN THE AMOUNT OF $173,200 AND AUTHORIZING THE
3 FIRE DEPARTMENT TO ACCEPT AND ADMINISTER THE GRANT FUNDS.
4
5 I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor
joint
6 and Common Council ofthe City of San Bernardino at a regular meeting thereof, held on
7 the ~,i,lY of September
,2011, by the following vote, to wit:
8 COUNCIL MEMBERS:
9 MARQUEZ
10 JENKINS
AYES
NAYS
ABSTAIN ABSENT
x
---1L
11 BRINKER
---1L
12 SHORETT
---1L
13 KELLEY
---1L
14 JOHNSON
---1L
15 MC CAMMACK
~
16
Q~h.~
Rachel Clark, City Clerk
17
18
The foregoing Resolution is hereby approved thi~Aiay of Septembe, 2011.
19
20
21
22
Fred Shorett, Mayo Pro Tern
City of San Bernardino
23
Approved as to form:
24
JAMES F. PENMAN,
City Attorney.
'J
,j U
~;;r . '-.>'-<' ./
By: /2,' { /!f~/ ,/
/./'"
25
26
27
28
2.
Preparer Information
Overview
2011-265
Page 1 of 1
'Did you attend one of the workshops conducted by DHS's regional fire program specialist?
No, I have not attended workshop
'Was a workshop within 2 hours drive?
No
'Are you a member, or are you currently involved in the management, of the fire department or non-
affiliated EMS organization applying for this grant with this application?
Yes, I am a member/officer of this applicant
If you answered No, please complete the information below. If you answered Yes, please skip
the Preparer Information section.
Fields marked with an ' are required.
Preparer Information
, Preparer's Name
, Address 1
Address 2
'City
, State
, Zip
Need help for ZJP+4?
In the space below please list the person your organization has selected to be the primary
point of contact for this grant. This should be a Chief Officer or long time member of the
organization who will see this grant through completion. Reminder: if this person changes at
anytime during the period of performance please update this information. Please list only
phone numbers where we can get in direct contact with you.
, Title
Prefix (check one)
, First Name
Middle Initial
, Last Name
'Business Phone (e.g. 123-456-7890)
, Home Phone (e.g. 123-456-7890)
Mobile Phone/Pager (e.g. 123-456-7890)
Fax (e.g. 123-456-7890)
, Email (e.g. user@xyz.org)
Primary Point of Contact
Division Chief
N/A
George
Avery
909 384 5286 Ex!.
909 384 5388 Ex!.
avery_ge@sbcity.org
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A1ternate Contact Information
Contact Information
'Title
Prefix
, First Name
Middle Initial
, Last Name
, Business Phone
'Home Phone
Mobile Phone/Pager
Fax
'Email
'Title
Prefix
, First Name
Middle Initial
, Last Name
, Business Phone
'Home Phone
Mobile Phone/Pager
Fax
'Email
2011-265
Page 1 of 1
Alternate Contact Information Number 1
Deputy Chief
N/A
Mat
Fratus
909 384-5286 Ex!.
909 384-5287 Ex!.
909-384-5281
fratus_ma@sbcity.org
Alternate Contact Information Number 2
Fire Chief
N/A
Michael
J
Conrad
909 384-5286 Ext.
909 384 5287 Ex!.
909 384-5281
conrad _ mi@sbcity.org
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Applicant Information
Applicant Information
. Organization Name
. Type of Applicant
2011-265
Page 1 of2
City of San Bernardino Fire Department
Fire DepartmenVFire District
. Type of Jurisdiction Served
If other, please enter the type of Jurisdiction
. Emolover Identification Number 95-6000772
. Wl1at is your organization's DUNS Number? 143532153 (call 1-866-705-5711 to gel a DUNS number)
Headquarters or Main Station Physical Address
. Physical Address 1 200 East Third Street
Physical Address 2
. City
-Slale
'Zip
Mailing Address
" Maihng Address 1
Mailing Address 2
. City
. State
'Zip
. Please describe all grants that you have
received from DHS including any AFG grant
received from DHS or FEMA, for example.
2002 AFG grant for vehicle or 2003 OD?
grant for exercises (Enter "N/A" if Not
Applicable)
Account Information
. Type of bank account
. Bank routing number - ~ number on the
boltom left hand corner of your check
'Youraccountnumber
Additional Information
. For this fiscal year (Federal) is your
organization receiving Federal funding from
any other grant program that may duplicate
the purpose andfor scope of this grant
request?
City
San Bernardino
California
92410-4889
Needl'lelllforZIP+4?
200 East Third Street
San Bernardino
California
92410-4889
Need helll for ZIP+4?
EMW-2002-FG-06494/Closed
Develop and implement a Wellness Fitness Program.
EMW-2003-FG-11600/Closed
Purchased defibrillators, self-contained breathing apparatus, communication equipment, clam shell batteries, and sWlftwater rescue equipment.
EMW-2005-FP-018121Closed
Funding for the juvenile fino-seller program, general prevention/awareness, a fire safety trailer, and fire safety props.
EMW-2008-FQ-07316/Closed
$484,455-100 wildland fire shelters and vehicle exhaust extraction systems for all fire stations.
EMW-2009-FHQ-00882/Awarded: 8/19/10-8/19/12
$2,769,602.00 for personnel costs and benefits of 12 firefighter positions
2003 Homeland Security Grant Program (HSGP)-Part I-Closed
$38,508 for fire equipment.
2003 HSGP-Part II-Closed
$155,342-turnout gear, SCBA units, and communication equipment.
2004 HSGP-Closed
$84,291-communication equipment and a command vehicle
2005 HSGP-Closed
$41,385- incident response vehicle and personal protective equipment
2006 HSGP-Closed
$18,246'generators and communication equipment
2007 HSGP.Closed
$13,827-refrigerator magnets, public announcement system, projector, picture screen, laptop, and ceiling mount.
2008 EOC (HSGP)-Closed
$9,602-6 computer notebooks for the EOC.
2002 Metropolitan Medical Response System (MMRS)-Phase I-Closed
$400,000-to plan, develop, purchase special pharmaceuticals, initiate the equipping and identify the training requirements for a MMRS as the principal resource in respon
2002 MMRS-Phase II-Closed
$200,OOO-modification2totheinitialcontract.
2002 MMRS-Phase 111- Status: Active, 5/24/02-11/24/03
$280,OOO-modification 3 to the initial contract.
2004 MMRS Program-EMW-2004-GR-0779-Closed
$400,OOO-funding for the Capability Focus Area and Sustainment of Enhanced Capabilities
2005 MMRS-Closed
$220,000. medical supplies, respirator fit tester, in suit communications for SCBAs, search cameras, deployable shelter systems, video conferencing, advanced life suppc
2006 MMRS-Closed
$232,330-command vehicle, communication equipment, EMS equipment, SCBA equipment, hazardous materials equipment, and computer equipment
2007 MMRS-Closed
$258,145-ventilators, defibrillators, pharmaceuticals, generators, web gear, fire shelters, headsets, communicalions, vehicle stakebody, storage containers, training, and (
2008 MMRS-Status: Active: 2/3/09-10/31/09
$321,221-deflbrillators, generators, communications, airway managemenl, rapid deployment shelters, and training exercises.
2009 MMRS-Status: Active: 5/2010-5/2011: 8/12111
$321,831-communication equipment, pharmaceuticals, and medical equipment
2001 Office of Traffic Safety (OTS)-EM0126-Closed
$81,OOO-heavy rescue tool, airbag rescue system, heavy rescue.
2005 OTS-EM0517 -Closed
$90,OOO-extricationequipment.
2006 OTS-EM0604-Closed
$78,500-thermal imaging device and extrication equipment.
2009 California Environmental Protection Agency-Closed
$20,OOO-for fire personnel assigned to the hazmat investigation unit.
2009 Fireman's Fund Heritage Rewards-Closed
$20,OOO-for the K-9 program authorized expenses.
2007/2008 Regional Catastrophic Preparedness Grant Program (RCPGP)
Awarded Date: 9/1/06-11128110; 12/2011
$100,OOO-subreceipientto participate in the development of regional evacuation, mass care and sheltering plans to be implemented in the event of a disaster
2009 RCPGP-Pending Award 9/10-9/11
$50,OOO-to participate in the development of regional evacuation, mass care and sheltering plans to be implemented in the event of a disaster.
2008 Urban Area Security Initiative Grant (USASI)-Awarded 10/08-3/10
$340,OOO-interoperable mobile command vehicle.
2009 USASI-Awarded 9/09-3/12; 10/2011
S270,000-develop community preparedness capabilities
Checking
121000248
4159283308
No
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Applicant Information
2011-265
Page2of2
. If awarded the AFG grant. will your
organization expend more than $500,000 In Yes
Federal funds dunng your orgamzallOn's fiscal
year in which this AFG grant was awarded?
. Is the applicant delinauent on an". Federal No
~?
If you answered yes to any of the additional
Questions above, please provide an
explanation in the space provided below'
Currently. the Fire Department has been awarded and is finalizing purchases for the 2009 Metropolitan Medical Response System Grant in the amount of $321,221: 2009 Urban Area Security Initiative Grant in the amc
to be completed by December 2011. Also, we have been awarded the 2009 SAFER grant in the amount of $2.7 million dollars and performance period deadline is August 2012.
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Fire Department Characteristics (Part I)
Department Characteristics (Part I)
. Are you a member of a Federal Fire Department or
contracted by the Federal government and solely responsible
for suppression of fires on Federal property?
. What kind of organization do you represent?
If you answered combination, above, what is the percentage
of career members in your organization?
If you answered volunteer or combination or paid on-call, how
many of your volunteer Firefighters are paid members from
another career department?
. What type of community does your organization serve?
. What is the square mileage of your first-due response area? 64
. What percentage of your response area is protected by
hydrants?
. In what county/parish is your organization physically located?
If you have more than one station, in what county/parish is
your main station located?
. Does your organization protect critical infrastructure of the
state?
. How much of your jurisdiction's land use is for agriculture,
wild land, open space, or undeveloped properties?
. What percentage of your jurisdiction's land use is for
commercial, industrial, or institutional purposes?
. What percentage of your jurisdiction's land is used for
residential purposes?
. How many occupied structures (commerciai, industrial,
residential, or institutional) in your jurisdiction are more than
three stories tall?
. What is the permanent resident population of your
Primarv/First-Due Resoonse Area or iurisdiction served?
. Do you have a seasonal increase in population?
. How many active firefighters does your department have who
perform firefighting duties?
. How many ALS level trained members do you have in your
department/organ ization?
. How many stations are operated by your organization?
. Is your department compliant to your local Emergency
Management standard for the National Incident Management
System (NIMS)?
. Do you currently report to the National Fire Incident
Reporting System (NFIRS)?
If you answered yes above, please enter your FDIN/FDID
. What percent of your active firefighters are trained to the
level of Firefighter I?
. What percent of your active firefighters are trained to the
level of Firefighter II?
2011-265
Page 1 of2
No
All Paid/Career
%
Urban
93 %
San Bernardino County
Yes
28 %
33 %
39 %
18
205942
No
156
45
12
Yes
Yes
36195
100 %
100%
If you answered less than 100% to either question above, are
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Fire Department Characteristics (Part I)
2011-265
Page 2 of2
you requesting for training funds in this application to bring
100% of your firefighters into compliance with NFPA 1001?
If you indicated that less than 100% of your firefighters are
trained to the Firefighter II level and you are not asking for
training funds in this application, please describe in the text
box to the right your training program and your plans to bring
your membership up to Firefighter II.
. What services does your organization provide?
Structural Fire Suppression
Wildland Fire Suppression
Airport Rescue Firefighting (ARFF)
Emergency Medical Responder
Basic Life Support
Advanced Life Support
Formal/Year-Round Fire Prevention Program
Hazmat Operational Level
Hazmat Technical Level
Rescue Operational Level
Rescue Technical Level
. Please describe your organization and/or community that you
serve. We recommend typing your response in a Word
Document outside of this application, then copying and
pasting it into the written field.
There is a 4000 character limit.
The City of San Bernardino Fire Department serves a resident
population of over 200,000 and covers a diverse service area of
64 square miles. In this service area there is approximately 19
miles of wildland/urban interface area, a major rail yard, an
international airport, a jail, two major mall complexes and three
major interstate freeways.
The San Bernardino City Fire Department has a well developed
department training program and has specialty programs such
as Hazmat, USAR, AARF and Wildland. The department also
has a professional Fire Prevention Bureau that offers a
comprehensive inspection program; Arson Investigation
program; Hazmat Investigation program; and a Juvenile Fire
Setter program.
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Fire Department Characteristics (Part II)
Fire Department Characteristics (Part II)
2011-265
. What is the total number of fire-related civilian fatalities in your jurisdiction
over the last three years?
. What is the total number of fire-related civilian injuries in your jurisdiction
over the last three years?
. What is the total number of line of duty member fatalities in your jurisdiction
over the last three years?
. What is the total number of line of duty member injuries in your jurisdiction
over the last three years?
. Over the last three years, what was your organization's average operating
budget?
. What percentage of your TOTAL budget is dedicated to personnel costs
(salary, overtime and fringe benefits)?
. What percentage of your annual operating budget is derived from:
Enter numbers only, percentages must sum up to 100%
Taxes?
EMS Billinq?
Grants?
Donations?
Fund drives?
Fee for Service?
Other?
If you entered a value into Other field (other than 0), please explain
* Please describe your organization's need for Federal financial assistance.
We recommend typing your response in a Word Document outside of this
application, then copying and pasting it into the written field. There is a 4000
character limit.
Page 1 of2
2010
2
2009
2
2008
2
4
5
7
o
o
o
41
48
56
32252266
89 %
87 %
0%
5%
0%
0%
8%
0%
In addition to the economic downturn,which
caused a high foreclosure rate and the closure of
businesses, the State has reduced funding to our
City. The net result is a $7 million shortfall with
more cuts on the horizon.
. How many vehicles does your organization have in each of the types or class of vehicle listed below? You must include
vehicles that are leased or on long-term loan as well as any vehicles that have been ordered or otherwise currently
under contract for purchase or lease by your organization but not yet in your possession. (Enter numbers only and enter
o if you do not have any of the vehicles below.)
Type or Class of Vehicle
Engines or Pumpers (pumping capacity of 750 gpm or greater and water
capacity of 300 gallons or more):
Pumper, PumperfTanker, Rescue/Pumper, Foam Pumper, CAFS Pumper, Quint (Aerial device
of less than 76 feet), Type I or Type II Engine Urban Interface
Ambulances for transport and/or emergency response
Tankers or Tenders (pumping capacity of less than 750 gallons per minute
(gpm) and water capacity of 1,000 gallons or more):
Aerial Apparatus:
Aerial Ladder Truck, Telescoping, Articulating, Ladder Towers, Platform, Tiller Ladder Truck,
Quint (Aerial device of 76 feet or greater)
Brush/Quick attack (pumping capacity of less than 750 gpm and water
Total Number Total Number Total
of of Number
Front line Reserve of Seated
Apparatus Apparatus Riding
Positions
19 5 96
0 0 0
0 0 0
2 15
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Fire Department Characteristics (Part II)
2011-265
Page2of2
carrying capacity of at least 300 gallons):
Brush Truck, Patrol Unit (Pick up wi Skid Unit), Quick Attack Unit, Mini.Pumper, Type III
Engine, Type IV Engine, Type V Engine, Type VI Engine, Type VII Engine
Rescue Vehicles:
Rescue Squad, Rescue (Light, Medium, Heavy), Technical Rescue Vehicle, HazardOUS
Materials Unit
5
o
20
4
20
Other:
EMS Chase Vehicle, Air/light Unit, Rehab Units, Bomb Unit, Technical Support (Command,
Operational SupporUSupply), Salvage Truck, ARFF (Aircraft Rescue Firefighting),
Command/Mobile Communications Vehicle, Other Vehicle
12
o
48
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Fire Department Call Volume
Department Call Volume
2011-265
Page 1 of 1
2010
2009
2008
* How many responses per year by category? (Enter whole numbers only. If you have no calls for any of the categories, enter 0)
Working Structural Fires 267 321 322
False Alarms/Good Intent Calls 1154 1194 1481
Vehicle Fires 189 223 213
Vegetation Fires 228 276 281
EMS-BLS Response Calls 1 1 1089
EMS-ALS Response Calls 21221 20474 20394
EMS-BLS Scheduled Transports 0 0 0
EMS-ALS Scheduled Transports 0 0 0
Vehicle Accidents w/o Extrication 102 38 1768
Vehicle Extrications 2 2 334
Other Rescue 84 76 90
Hazardous Condition/Materials Calls 216 210 246
Service Calls 440 312 325
Other Calls and Incidents 0 0 0
Total 23904 23127 26543
. How many responses per year by category? (Enter whole numbers only. If you have no calls for any of the categories, enter 0)
What is the total acreage of all
vegetation fires?
. How many responses per year by category? (Enter whole numbers only. If you have no calls for any of the categories, enter 0)
In a particular year, how many times
does your organization receive
mutual/automatic aid?
265
245
284
119
157
184
In a particular year, how many times
does your organization provide
mutual/automatic aid? (Please
indicate the number of times your
department provides or receives
mutual aid. Do not include first-due
responses claimed above.)
Out of the mutual/automatic aid
responses, how many were structure
fires?
102
160
216
47
80
99
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Request Information
Request Information
2011-265
Page 1 of 1
1. Select a program for which you are applying. If you are interested in applying under both Vehicle Acquisition and Operations
and Safety, and/or regional application you will need to submit separate applications.
Program Name
Operations and Safety
2. Will this grant benefit more than one organization?
Yes
If you answered Yes to Question 2 above, please explain.
We respond and receive mutual aid/automatic aid from surrounding agencies. These agencies are assigned to various divisions
and groups on incidents that occur. We are applying for grant funding that will allow us to purchase in-mask radio equipment that
will allow personnel on scene to receive and transmit radio transmissions. Our present radio system is extremely poor in
incidents that require personnel to wear their SCBA masks. They have a very difficult time hearing due the radio being in their
pockets and working at the same time, or their ability to work is hampered if they are carrying their radio with one hand. They
also have difficulty in transmitting with our present portable radio system with the SCBA mask due to the inability to clearly
communicate through their mask. With the radio communication system we are hoping to purchase, it allows all users to hear all
transmissions because the listening device is attached to the mask adjacent to their ear and radio speaking device is built into
the cone of their mask. When other agencies respond into our jurisdiction or when they respond into ours, our personnel will now
be able to hear and transmit important messages from their scene supervisors to dissiminate to other the other agencies
assigned to the incidents.
In addition, we are requesting to replace 122 of our SCBA cylinders that are nearing their service expiration dates. As a City that
relies on the mutual aid system to mitigate incidents, other agencies will be abie to use our cylinders during incidents when theirs
have been expended.
3. Enter Grant-writing fee associated with the preparation of this request. Enter 0 if there is no fee.
$0
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Fire Operations and Firefighter Safety Request Details
Request Details 2011-265
Page 1 of 1
The activities for program Operations and Safety are listed in the table below.
Activity
Number of Entries Total Cost Additional Funding
Action
Modify Facilities
o
$0
View Details
$ 0 View Additional Fundina
Narratives
$ 0 View Details
View Details
$ 0 View Additional Fundina
Narratives
$ 0 View Details
$ 0 View Details
Equipment
1
$ 100,000
Personal Protective Equipment
$ 73,200
Training
Wellness and Fitness Programs
o
o
$0
$0
. Total Funding for all EMS requested in this application
$0 View Details
Grant-writing fee associated with the preparation of this request.
$0
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Fire Operations and Firefighter Safety Proj Details
Request Details
Page 1 of 1
2011-165
Equipment
Item
Other Communications (explain) - We are requesting In-Mask radio
communication devices for our SCBAs. Our present portable radio
system is completely inadequate when it is used on the emergency
scenes because personnel are wearing SCBA masks. Personnel
have to remove the portable radio from their pocket and listen to
the radio with one hand, then attempt to transmit radio messages
by placing the radio next to their mask which sounds distant,
muffled and distorted.
Number of units Cost per unit Total Cost Action
100
$ 1,000 $ 100,000 View Details
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View Operations and Firefighter Safety - Equipment
View Operations and Firefighter Safety - Equipment
Equipment Details
1. What equipment will your organization purchase with this grant?
Please provide further description of the item selected above or if you selected
Other above, please specify.
2. Number of units:
3. Cost per unit:
4. Generaliy the equipment purchased under this grant program is:
Page 1 of 1
2011-265
Other Communications (explain)
We are requesting In-Mask radio communication
devices for our SCBAs. Our present portable radio
system is completely inadequate when it is used on
the emergency scenes because personnel are
wearing SCBA masks. Personnel have to remove
the portable radio from their pocket and listen to
the radio with one hand, then attempt to transmit
radio messages by placing the radio next to their
mask which sounds distant, muffled and distorted.
100 (whole number only)
$ 1000 (whole dollar amounts only)
The equipment wili increase your organization's availabie supply of this equipment to meet basic mission
If you seiected "replacing equipment" (from Q4) above, please specify the age of
equipment in years.
5. Generaily the equipment purchased under this grant program is:
Will bring the organization into statutory compliance.
Please explain how this equipment will bring the organization into statutory
compliance in the space provided to the right.
6. Does this equipment provide a health and safety benefit to the members of your
organization? If yes, please fuily explain in the narrative section.
7. Will the item requested benefit other organizations or otherwise be available for
use by other organizations?
If you answered Yes in the question above, please explain:
8. Will this equipment be used for wildiand firefighting purposes?
9. Is your department trained in the proper use of the equipment being purchased
with grant funds?
If not, will you be asking for training funds for this purpose with this application or
will you obtain the appropriate training through other sources?
Close Window
We presently have very limited units of the radio
communication system that allows emergency
personel to communicate effectively. NFPA 1561,
"Standard for Fire Department Incident
Management System," 1990 Edition, addressed
communications in Chapter 3-6. Chapter 3-6.4
required that communication systems foliow a
standardized method of transmitting emergency
messages and notifications of imminent hazards to
ali levels of the command structure at emergency
scenes.
Yes
Yes
Other organizations wili benefit from our grant
funded equipment through our mutual aid and
auto-aid agreements. Responding personnel will
be able to communicate with the other agency's
command and general staff on the emergency
scene.
No
Yes
No
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Firefighting Equipment - Narrative
Firefighting Equipment - Narrative
Page 1 of 4
2011-265
* Section # 1 Project Description: In the space
provided below include clear and concise details
regarding your organization's project's description
and budget. This includes providing local
statistics to justify the needs of your department
and a detailed plan for how your department will
implement the proposed project. Further, please
describe what you are requesting funding for
including budget descriptions of the major budget
items, i.e., personnel, equipment, contracts, etc.?
*3000 characters
The Sperian Respiratory Protection Radio
Communication Systems we are requesting grant
funding for is approximately $1000 per unit. In
order to outfit our Chief Officers and Captains
who will be charged with communicating on the
emergency scene, we will need 100 of these
units. Because this system is an integral part of
the SCBA mask, the price point is set by Sperian
Respiratory Systems and will be sought as a sole
source vendor. This was the oniy device we
researched that met the intrinsically safe
characteristics we need for our all risk response
department. In addition, this was the only product
we found that allowed emergency personnel to
communicate with surrounding personnel using
the amplification device attached to the SCBA
mask. The final feature the Sperian Radio
Communication System offered was the users
were able to quickly connect the radio to the
SCBA mask without delay or difficulty. The other
devices we researched, such as bone mics and
throat mics, had limitations due to its functional
characteristics. The bone mics were able to
transmit and receive through the ear piece, but
were not abie to amplify the user's voice to the
nearby personnel. The personnel who tried these
types of products also reported that the wires
caused a delay in response and easily caught on
common construction debris found in most
structure fires or rescue scenes.
* Section # 2 Cost/Benefit: In the space provided
below please explain, as clearly as possible, what
will be the benefits your department or your
community will realize if the project described is
funded (i.e. anticipated savings and/or
efficiencies)? Is there a high benefit for the cost
incurred? Are the costs reasonable? Provide
justification for the budget items relating to the
cost of the requested items. *3000 characters
The Assistance to Firefighters Grant will help our
department tremendously since we do not have
the financial resources to purchase the SCBA
radio communication systems we are requesting.
We have lost 30 positions on the fire department
in the last 3 years. Our City leadership divulged
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Firefighting Equipment - Narrative
there is a strong likelihood our City will have to
cut 4 million dollars from our general fund which
will have a great impact on the Fire Department
budget.
This impact is an addition to the City eliminating
30 positions on the fire department in the last 3
years. We have realized fewer personnel on our
fire engines and truck companies which equates
to delays in attacking structure fires, resulting in
increased dollar loss rates and mortality rates
due to fire, and increased risks to firefighter
health and safety. The impact of not having
adequate staffing places a premium on fireground
communications. There are less firefighters
available to adequately provide a constant risk
assessment on the fireground. The
communication devices we are requesting will
greatly assist in broadcasting ever changing fire
conditions to all levels of ICS on the fire.
2011-265
Page 2 of 4
* Section # 3 Statement of Effect: How would this
award affect the daily operations of your
department (i.e., describe how frequently the
equipment will be used or what the benefits will
provide the personnel in your department)? How
would this award affect your department's ability
to protect lives and property in your community?
*3000 characters
San Bernardino City has a population of over
200,000 people that is diverse and has many
target hazards. The target hazards include a
major railway hub and commuter train facility;
three major highway arteries (1-10, 1-215, and 1-
210 freeways); County Seat buildings including
Caltrans and Courthouses; and numerous large
industrial buildings. Due to these target hazards
and frequency of which our personnel use the
SCBA, the San Bernardino City Fire Department
is requesting funding for NIOSH approved In-
Mask Communications devices. These devices
designed and sold by Sperian Respiratory
Protection USA amplify voice transmissions
through the cone of the SCBA facepiece; and at
the same time allows the user to effectively hear
radio transmissions with their strategically
designed amplifying earpiece that attaches to the
SCBA facepiece.
Our present system is does not meet the
standard set forth by NFPA 1561, "Standard for
Fire Department Incident Management System,"
1990 Edition, addressed communications in
Chapter 3-6. Chapter 3-6.4 required that
communication systems follow a standardized
method of transmitting emergency messages and
notifications of imminent hazards to all levels of
the command structure at emergency scenes.
Our system does not allow emergency personnel
to realize effective two-way communicate
because personnel are required to either remove
the radio from their pockets to transmit
messages; or if they have a remote microphone
they cannot hear transmissions because they are
not able to attach the microphone near their ear.
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Firefighting Equipment - Narrative
The San Bernardino City Fire Department
conducted a department wide survey in
accordance to the development of our Stratgic
Plan. The survey revealed that the number one
issue at our department was in-mask
communications on the fireground. Personnel
found the present system to be so hampering, it
creates an unsafe working condition.
The San Bernardino City Fire Department has
suffered some near misses due to our inability to
effectively communicate. We put together a
Incident Review Team to examine our near miss
events. The common conclusion derived from the
analysis was our personnel were not able to
commun icate safety issues effectively due to the
configuration of our present portable radio system
and its inability to allow personnel to hear and
transmit messages effectively. The most notable
incidents we have incurred was one of our
firefighters was severely electricuted wh ile
attempting to suppress a fire inside a commercial
radiator repair shop. He did not hear, nor did his
captain hear that the power to the building was
not shut off and a result came in contact with an
energized metal bar. Another high profile incident
we had was a well involved residential structure
fire where a firefighter was inside the structure
and his captain was not able to communicate to
the IC that structure was on the verge of
collapsing. The firefighter had to be physically
removed before the structure collapsed.
2011-265
Page 3 of 4
, Section # 4 In the space provided below include
details regarding your organization's request not
covered in any other section. '3000 characters
The City of San Bernardino Fire Department has
concentrated on being NIMS compliant and was
awarded a UASI Grant to purchase a mobile
command post. One of the primary purposes of
this vehicle to offer radio interoperability through
its 12 channel V.I.P.E.R. INTEROPERABILlTY
SYSTEM. The system also offers FOUR (4) SAN
BERNARDINO 800 MHz TRUNKED SYSTEM
RADIOS, ONE (1) 450-520 MHz RADIO, ONE (1)
136-174 MHz RADIO, ONE (1) 39-50 MHz
RADIO, ONE (1) VHF AM AIRCRAFT RADIO.
This system will be used in conjunction with
Sperian Respiratory Protection radio
communication system. Any agency that uses
any other radio frequency will be able to
effectively realize two-way communication with
our incident supervisors. As noted in the other
sections, we routinely request and provide mutual
aid to our neighboring agencies. These are
comprised of Federal, State, County and Local
agencies, which rely on our ability to effectively
coordinate and communicate with their
resources. The critical piece that would help us
meet the common goal of effective
communication would be to awarded the
Assistance to Firefighter's Grant necessary to
purchase the in-mask communication devices.
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Firefighting Equipment - Narrative
2011-265
Page 4 of 4
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Fire Operations and Firefighter Safety Proj Details
Request Details
Personal Protective Equipment
Item
Spare Cylinders-45 minutes
Number of units
122
2011-265
Cost per unit
$ 600
Page 1 of 1
Total Cost Action
$ 73,200 View Details
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Operations and Firefighter Safety - Personal Protective Equipment Page 1 of 2
View Operations and Firefighter Safety - Personal Protective Equipment
2011-265
Personal Protective Equipment Details
1. Select the PPE that you propose to acquire Spare Cylinders-45 minutes
Please provide further description of the item selected above or if you Sperian/Survivair replacement cylinders.
selected Other above, please specify.
2. Number of units: 122 (whole number only)
3. Cost per unit: $600 (whole doliar amounts only)
4. 100%
. For turnout requests, what percentage of your on-duty active members
will have PPE that meets applicable NFPA and OSHA standards if this
grant is awarded?
. If you are requesting new SCBA, what percentage of your seated riding
positions will have complaint SCBA assigned to it if this grant is awarded?
. If you are asking for specialized PPE (e.g., Haz-Mat), what percentage of
applicable members will have specialized PPE that meets established
standards if this grant is awarded?
5. What is the purpose of this request? to replace old/obsolete equipment
If you have indicated you are requesting PPE (any PPE other than SCBA) N/A
in the Question 1 above, what are the specific ages of your equipment in
years? If requesting SCBA, click on "N/A", do not provide PPE ages here but
continue on to the next question. Please assure that you've accounted for
ALL gear for ALL members declared in Department Characteristics -
not just the gear you wish to replace.
Age (in Years)
#of
Items
Less than 1
1
2
3
4
5
6
7
8
9
10
11
12 or more
Number of members without
gear
If you have indicated you are requesting SCBA in the Question above, to
which edition(s) of NFPA are your SCBA compliant? If not requesting SCBA,
please click on "N/A" and continue on to the next question. Please account
for ALL SCBA currently in your department's inventory - not just the
equipment you wish to replace.
Year
# of NFPA compliant
SCBA
71
70
2007 Standard
2002 Standard
Older
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Operations and Firefighter Safety - Personal Protective Equipment
Page 2 of2
2011-265
Standards
6. Is this PPE:
For protection use against fire
If you selected For some other use above, please specify
7. Will this equipment be used for wildland firefighting purposes? No
8. Is your department trained in the proper use of the equipment being Yes
purchased with grant funds?
If not, will you be asking for training funds for this purpose with this No
application or will you obtain the appropriate training through other sources?
Close Window
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Firefighting PPE - Narrative
Firefighting PPE . Narrative
Page 1 of2
20~~-265
, Section # 1 Project Description: In the space
provided below include clear and concise details
regarding your organization's project's description
and budget. This includes providing local
statistics to justify the needs of your department
and a detailed plan for how your department will
implement the proposed project. Further, please
describe what you are requesting funding for
including budget descriptions of the major budget
items, i.e., personnel, equipment, contracts, etc.?
'3000 characters
Funding is being requested for the purchase of
new cylinders for our Self Contained Breathing
Apparatus. The cylinders we are replacing must
be retired because they have reached the end of
their 15 year life cycle. The number of cylinders
purchased will represent 27% of our total number
of cylinders. Those purchased will have a 15 year
life cycle, and won't have to be replaced until
2026. This purchase will be sole-source to be
able to match the brand of the cylinder with the
Self Contained Breathing Apparatus we use. The
brand used by the San Bernardino City Fire
Department is Sperian/Survivair.
, Section # 2 CosUBenefit: In the space provided
below please explain, as clearly as possible, what
will be the benefits your department or your
community will realize if the project described is
funded (i.e. anticipated savings and/or
efficiencies)? Is there a high benefit for the cost
incurred? Are the costs reasonable? Provide
justification for the budget items relating to the
cost of the requested items. '3000 characters
By purchasing the Sperian/Survivair brand
cylinder, it will allow us to maintain our SCBA
repair program "in house". We have personnel
trained and certified as Self Contained Breathing
Apparatus Technicians, which allows us to
service and repair our Sperian/Survivair
equipment. By not shipping the work out for
service and repairs, this is a significant savings to
the City of San Bernardino. The cylinder vendor
(LN Curtis & Sons) has offered a price which is
significantly lower than list price.
, Section # 3 Statement of Effect: How would this
award affect the daily operations of your
department (i.e., describe how frequently the
equipment will be used or what the benefits will
provide the personnel in your department)? How
would this award affect your department's ability
to protect lives and property in your community?
'3000 characters
By purchasing new SCBA cylinders, it will allow
us to maintain the minimum number of air
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Firefighting PPE - Narrative
cylinders set by our department based on our
high call volume. The carbon wrapped cylinders
will be light weight in comparison to the hoop
wrapped cylinders being retired. This will ease
the physical demands of our firefighters. The
cylinders will be used on a daily basis throughout
the department on our Firefighting, Wildland,
Confined Space, HAZMAT, ARFF, Breathing
Support and Command units. The City of San
Bernardino has several LCO (Large Commercial
Occupancies) and Hi-Rise buildings, which in the
event of a fire will require a large number of Self
Contained Breathing Apparatus cylinders.
2011-265
Page 2 of2
, Section # 4 In the space provided below include
details regarding your organization's request not
covered in any other section. '3000 characters
Sperian/Survivair SCBA cylinders will be
purchased, because after market cylinders would
not give us both NFPA and NIOSH certification.
The use of Self Contained Breathing Apparatus
(cylinders) in the Fire Service maintains our
compliance with the Federal Standard for
Breathing Air (42CFR84.141), the OSHA
Standard for Respiratory Protection
(29CFR1910.134), and the OSHA Standard for
Confined Space (29CFR1910.146).
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Budget
Budget
2011-265
Page 1 of 1
Budaet Obiect Class
a. Personnel
$0
b. Fringe Benefits
c. Travel
d. Equipment
e. Supplies
f. Contractual
g. Construction
h. Other
i. Indirect Charges
j. State Taxes
$0
$0
$ 173,200
$0
$0
$0
$0
$0
$0
Federal and Applicant Share
Federal Share
Applicant Share
Federal Rate Sharing (%)
* Non-Federal Resources (The combined Non-Federal Resources must equal the Applicant Share of $ 34,640)
$ 138,560
$ 34,640
80/20
a. Applicant
b. State
c. Local
d. Other Sources
$ 34640
$0
$0
$0
If you entered a value in Other Sources other than zero (0), include your explanation below. You can use this space to provide
information on the project, cost share match, or if you have an indirect cost agreement with a federal agency.
Total Budget $ 173,200
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Narrative Statement
2011-265
Page 1 of 1
For 2011, the Narrative section of the AFG application has been modified. You will enter
individual narratives for the Project Description, Cost-Benefit, Statement of Effect, and
Additional Information in the Request Details section for each Activity for which you are
requesting funds. Please return to the Request Details section for further instructions. You
will address the Financial Need in Applicant Characteristics II section of the application. We
recommend that you type each response in a Word Document outside of the grant
application and then copy and paste it into the spaces provided within the application.
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Assurances and Certifications
Assurances and Certifications
2011-265
Page 1 of6
Form 20-16A
You must read and sign these assurances. These documents contain the Federal requirements attached to all Federal grants
including the right of the Federal government to review the grant activity. You should read over the documents to become aware
of the requirements. The Assurances and Certifications must be read, signed, and submitted as a part of the application.
Note: Fields marked with an * are required.
O.M.B Control Number 4040-0007
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 or organizational conflict of interest, or 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) SS523 and 527 of the Public Health Service
Act of 1912 (42 U.S.C. SS290 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, 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 G) the requirements of any other nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements otTitle 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, as applicable, with provisions of the Hatch Act (5 U.S.C. SS1501-1508 and 7324-7328) which
limit the political activities of employees whose principal employment activities are funded in whole or in part
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Assurances and Certifications
2011-265
Page 2 of6
with Federal funds.
9. Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. 99276a to 276a-7), the
Copeland Act (40 U.S.C. 9276c and 18 U.S.C. 9874), and the Contract Work Hours and Safety Standards Act
(40 U.S.C. 99327-333), 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
$10,000 or more.
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 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. 991451 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.
997401 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 Amendments of 1996 and OMB Circular No. A-133, "Audits of States, Local Governments, and Non-Profit
Organizations."
18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and
policies governing this program.
Signed by George Avery on 08/23/2011
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Assurances and Certifications
Form 20-16C
2011-265
Page 3 of6
You must read and sign these assurances.
Certifications Regarding Lobbying, Debarment, Suspension and Other Responsibility Matters
and Drug-Free Workplace Requirements.
Note: Fields marked with an .. are required.
O.M.B Control Number 1660-0025
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
44 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 Department of Homeland Security (DHS) determines to award the covered transaction, grant, or cooperative
agreement.
1. Lobbying
A. As required by the section 1352, Tille 31 of the US Code, and implemented at 44 CFR Part 18 for persons (entering) 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)
A. 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.
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Assurances and Certifications
Page4of6
3. Drug-Free Workplace (Grantees other than individuals) 2011-265
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 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 DHS awarding
office, Le. regional office or DHS 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).
(B) 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, press Add Place
of Performance button above to ensure that the correct place of 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
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Assurances and Certifications 2011-265 Page 5 of 6
application for DHS funding. States and State agencies may elect to use a Statewide
certification.
Signed by George Avery on 08/23/2011
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Assurances and Certifications
FEMA Standard Form LLL
2011-265
Page6of6
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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