09-923Council File # u / � ���
Green Sheet #3075597
RESOLUTION
T PAUL, MINNESOTA
�
Presented by
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WHEREAS, the Saint Paul Fire Depariment has applied for and received a grant from the Federal Emergency Management
A�ency's Assistance to Firefighters Grant — Fire Prevenrion and Safety Grant Pro�ram to iinplement Project Safe Haven in 100
homes in the City of Samt Paul, and
WHEREAS, Project Safe Haven is a program that brings citizens and £uefighters together to protect families and create a safe
home envuonment with home visrts by the firefighters to make sure the smoke detectors and carbon monoxide detectors aze in
working order, and
WHEREAS, the City of Saint Paul is required to pay a 20% matching fund contnbution of $4,162.OQ and
WHEREAS, upon receipt of this grant, the City is obligated to appropriate the grant amount of $16,648.00, and
NOW THEREFORE IT BE RESOLVED, that the City Council accepts the FY2008 Assistance to Fuefighteis Grant—Fue
Prevenrion and Safety Grant; a copy of said application is to be kept on file and of record in the Office of Financial Services.
Yeas Nays Absent
Bostrom
Carter
Harris �
Helgen �
Lanhy ,�
Stark ,/
Thune �
i d
Requested by Dep�s�hnent of:
�/'' ! "�' T . ' p '`
Fire
By:
Approved
By:
Approved
By: _
Adopted by Council: Date ��,al,o �/✓� Approved
Adoprion Cerhfied by Council cretary By: �'
BY= / / If1/Ji /' i �ci�e7
Approve M yor: ate � �
By:
for Submission to Council
� Green Sheet 6reen Sheet Green Sheet Green Sheet Green Sheet Green Sheet ��
_ ��'�3-3
Department/�celCouncil: � Date Initiated: M
FR - Fre 12-AUG-09 � Gl�ee� Sf Ieet NO 3075597
Contact Person & Phone: Department Sent To Person Initial/Date
Fire Chief Tim Butler �� o Fre
222-0477 ' 1 F5re DeoartmentDirector �j
Must Be on Council Agenda by (Date):
Doc. Type: RESOLUTION
', E-DOCUment Required: �'
'�, Document Contact: ���� LaCasse
�� ConWctPhone: 228-6257
Assign 2
Number 3
For
Routing '� 4
Order I 5
6
7otal # of Signature Pages _(Clip All Locations for Signature)
MavONASSistavt
Mayor/ASSistant
�
'�, Approval of the attached Council Resolution authorizing the Saint Paul Fire Department to accept the FY2008 Assistance to
I Firefighters Grant Program - Fire Prevention and Safety Crrant from the Federal Emergency Management Agency.
Recommendations: Approve (A) or Reject (R):
Pfanning Commission
CIB Committee
Civil Service Commission
Personal Service Contracts Must Answer the Following Questions:
1. Has this person/frm ever worked under a contract for this departmeni?
Yes No
2. Has this person/frm ever been a city employee?
Yes No
3. Does this person/frm possess a skiil not normally possessed by any
current ciry employee?
Yes No
F�cplain all yes answers on separete sheet and attach to green sheet.
Initiating Problem, Issues, Opportunity (Who, What, When, Where, Why):
The Saint Pau] Fire Department has applied for and received a FP2008 Assistance to Firefighter Grant - Fire Revention and Safery
Grant to implement Project Safe Haven. A requirement of this grant includes a 20% match by the City of 5aint Paul.
AtivanWges If Approved:
The Saint Paul Fire Departcnent will be able to unplement Project Safe Haven, a program that brings citizens and firefighters together
to create safe home environments.
Disadvantages If Approvetl:
None.
��������
Disadvantages If Not Approved:
Lost opportunity to receive funding to unplement Project Safe Haven.
��e � � ��a�
"�.,��, =�=,.,>-�� ,�'`=':��
,� a
7ota1 Amount of $Z0,810.00
Transaction:
Funding Source: �'fa�t
Financiai Information: Federal Shaze $16,648.00
(Euplain) City Share $ 4,162.00
Total $20,810.00
CosURevenue Budgeted:
Activiiy Number:
August 12, 2009 9:21 AM Page 1
Panel Review Page 2 of 6
09-923
iJ_S_ �e�art,m.eni of!-?cma(2nd Sacunty
N1ashlrotcn. C C 2Q472
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I A4e�Y'+tiL
Ms. Jill Lacasse
Saint Paul Department of Fire and Safety Services
100 East 11th Street
Saint Paul, Minnesota 55101-2227
Re: Grant No.EMW-2008-FP-01563
Dear Ms. Lacasse:
On behalf of the Federal Emergency Management Agency (FEMA) and the Department of Homeland Security (DHS), I
am pleased to inform you that your grant application submitted under the FY 2008 Assistance to Firefighters Grant
Program - Fire Prevention and Safety Grants has been approved. FEMA is responsible for carrying out the Federal
responsibilities of administering your grant. The approved project costs total to $20,810.00.
As part of your award package, you will find Grant Agreement Articles. Please make sure you read and understand the
Articles as they outline the terms and conditions of your Grant award. Maintain a copy of these documents for your
official file. You establish acceptance of the Grant and Grant Agreement Articles when you request and receive
any of the Federal Grant funds awarded to you. By accepting the grant, you agree not to deviate from the approved
scope of work without prior written approval from DHS.
If your SF 1199A has been reviewed and approved, you will be able to request payments online. Remember, you should
basically request found when you have an immediate cash need (i.e. you have a bill in-hand that is due within 30 days).
If you have any questions or concerns regarding the process to request your grant funds, please call the helpdesk at 1-
866-274-0960.
Sincerely,
G�J'' �i'
W. Ross Ashley, III, Assistant Administrator
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Panel Review
Agreement Articles
09-923 Page 3 of 6
�tsar?E�xr .
i. � U.S. Department of Homeland Security
� ����� Washington,D.C.20472
��' :
tja ��..
AGREEMENT ARTICLES
ASSISTANCE TO FIREFIGHTERS GRANT PROGRAM - FIRE PREVENTION AND SAFETY
GRANTEE: Saint Paul Department of Fire and Safety Services
PROGRAM: Fire Prevention
AGREEMENT NUMBER: EMW-2008-FP-01563
AMENDMENT NUMBER:
TABLE OF CONTENTS
Article I
Article II
Article III
Article IV
Article V
Article VI
Article VII
Article VIII
Article IX
Article I - Project Description
Project Description
Grantee Concurrence
Period of Performance
Amount Awarded
Finar�cial Guidelines
Prohibition on Using Federal Funds
GPD Allocations
Financial Reporting
DHS O�cials
The purpose of the Assistance to Firefighters — Fire Prevention and Safety Grants is to provide funds to national, State,
local or community organizations that are recognized for their experience and expertise with respect to fire prevention or
fire safety programs and activity. After careful consideratian, DHS has determined that the grantee's project submitted as
part of the grantee's application, and detailed in the project narrative as well as the request details section of the
application — including budget information — was consistent with the program's purpose and worthy of award. Therefore,
the grantee shall pertorm the work described in the approved grant application as itemized in the request details section
of the application and further described in the approved grant app�ication's narrative. That narrative is made a part of
these grant agreement articles by reference. These sections of the application are made a part of the approved scope of
work outlined in the above referenced sedions of the application without prior written approval from DHS.
Article 11 - Grantee Concurrence
By requesting and receiving Federal grant funds provided by this grant program, the grantee accepts and agrees to
abide by the terms and conditions of the grant as set forth in this document and the documents identified below. By
receiving funds under this grant, grantees agree that they will use the funds provided through the Fiscal Year 2008
Assistance to Firefighters Grant Program in accordance with these Articles of Agreement and the program guidelines
provided in the Fiscal Year 2008 Assistance to Firefighters program guidance. All documents submitted as part of the
application are made a part of this agreement by reference.
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Article 111 - Period of Performance
The period of perform2nce shall be from 31-JUL-09 to 30-JUL-10.
Arficle IV - Amount Awarded
The amount of the award is detailed on the Obligating Document for Award attached to these articles. Foilowing are the
budgeted estimates for object classes for this grant (including Federal share plus grantee match):
Personnel $0.00
Fringe Benefits $0.00
Travel $0.00
Equipment
Supplies
Contractual
Construction
Other
Indirect Charges
Total
$16,800.00
$2,610.00
$400.00
$0.00
$1,000.00
$0.00
$20,810.00
Article V - Financial Guidelines
The grantee and any subgrantee shall comply with the most recent version of the Administrative Requirements, Cost
Principles, and Audit Requirements. A non-exclusive list of regulations commoniy applicable to DHS grants are listed
below:
A. Administrafive Requirements
1. 44 CFR Part 13, Uniform Administrative Requirements for Grants and Cooperative Agreements to State and
Local Governments
2. 2 CFR Part 215, Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher
Education, Hospitals, and Other Non-Profit Organizations (OMB Circular A-110)
8. Cost Principles
1. 2 CFR Part 225, Cost Principles for State, Local, and Indian Tribal Governments (OMB Circular A-87)
2. 2 CFR Part 220, Cost Principles for Educational Institutions (OMB Circular A-21)
3. 2 CFR Part 230, Cost Principles for Non-Profit Organizations (OMB Circular A-122)
4. Federa� Acquisition Regulations (FAR), Part 31.2 Contract Cost Principles and Procedures, Contracts with
Commerciai Organizations
C. Audit Requirements
1. OMB Circular A-133, Audits of States, Local Govemments, and Non-Profit Organizations
Article VI - Prohibition on Using Federal Funds
Recipient understands and agrees that it cannot use any federal funds, either directly or indirectly, in support of the
enactment, repeal, modification or adoption of any law, regulation or policy, at any level of government, without the
express prior written approval of FEMA.
Article VII - GPD Allocations
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The recipient agrees that all allocations a�d use of fu�ds under this grant will be in accordance with the Assistance to
Firefighters Grant Program 2008 Fire Prevention and Safety Grants Program and App�ication Guidance and application
kit.
Article VIII - Financial Reporting
The grantee must complete an on-line, semia�nual financial status report to meet FEMA requirements. Semiannual
financial reperts are due within 30 days of the end of every six month period for the life of the grant. At the end of the
performance period, or upon completion of the grantee's final program narrative, the grantee must complete an on-line
final financial status report that is required to close out the grant. If a grantee's performance period is extended beyond
the initial 12-month period, a periodic pertormance report is due every six month increment until closeout.
Article IX - DHS Officials
Program Officer: Catherine Patterson, is the Program Officer for the Fire Prevention and Safety Grants. The Program
Officer is responsible for the technical monitoring of the stages of work and technical performance of the activities
described in the approved grant application.
Grants Assistance Officer: Nica Mathes, is the Assistance Officer for this grant program. The Assistance Officer is the
Federal o�cial responsible for negotiating, administering, and executing all grant business matters.
Grants Management Specialist: The Grants Management Specialist shall be contacted ta address all financial and
administrative grant business matters for this award. If you have any questions regarding your grant please call ASK-
GMD at 866-927-5646 to be directed to a specialist.
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1a. AGREEMENT NO.
EMW-2008-FP-0'1563
6. RECIPIcNT NAME AND
ADDRESS
Saint Paul Department of Fre and
Safety Services
�00 East 11th Street
Saint Paul
Minnesota, 55'10'I-2227
9. NAME OF RECIPIENT
PROJECT OFFICER
Jill Lacasse
09-923 Page 6 of 6
FEDERAL EMERGENCY MANAGEMENT AGENCY
OBLIGATING DOCUMENT FOR AWARD/AMENDMENT
2. AMENDMENT NO. 3. RECIPIENT NO.
0 41-600552'I
4. TYPE OF 5. CONTROL NO.
ACTION W462197N
AWARD
7. ISSUING OFFICE AND ADDRESS 8. PAYMENT OFFICE AND ADDRESS
Grants Management, Opera6ons Directorate FEMA, Financial Services &anch
245 Murray Lane - Building 410, SW 500 C SVeet, S.W., Room 723
Washington DC, 2052&7000 Washington DC, 20472
POC: Nica Mathes
PHONE NO. '10. NAME OF PROJECT COORDINATOR
65�2286257 CatherinePatterson
11. EFFECTIVE DATE OF THIS '12. METHOD OF 13. ASSISTANCE ARR4NGEMENT
ACTION PAYMENT Cost Sharing
3'I-JUL-09 SF-270
15. DESCRIPTION OF ACTION
a. Qndicate funding data for awards or financial changes)
PROGRAM NAME CFDA NO. ACCAUNTING DATA PRIOR AMOUNT
ACRONYM (AACS CODE) TOTAL AWARDED THIS
XXXX-XXX-XXXXXX-XXXXX- AWARD ACTION
XXXX-XXXX-X + OR (-)
FP 97.044 200&MS-OOOtGF-25000000-
4101-D
TOTALS
$0.00 $16,648.00
$0.00 $16.645.00
PHONE NO.
'I-S66-274-0960
'14. PERFORMANCE PERIOD
From:3'I -J U L-09 To 30-J U L-10
BudgetPeriod
From:14-JAN- To:30-SEP-09
09
CURRENT
TOTALAWARD
$16,648.00
$16,648.00
CUMMULATIVE
NON-
FEDERAL
COMMITMENT
$4,162.00
$4,162.00
b. To describe changes ofher than funding dafa or financial changes, attach schedule and cheGc here.
N/A
16 a. FOR NON-DISASTER PROGRAMS: RECIPIENT IS REQUIRED TO SIGN AND RETURN THREE (3) COPIES OF THIS DOCUMENT TO FEMA
(See Block 7 for address)
Assistance to Firefighters Grant - Fire Preventlon and Safery Program recipients are not required to sign and return copies of this document. However,
recipients should print and keep a copy of this document for their records.
16b. FOR DISASTER PROGRAMS: RECIPIENT IS NOT REQUIRED TO SIGN
This assisfance is subject to terms and conditions attached to this award notice or by incorporated reference in program legislation cited above.
17. RECIPIENT SIGNATORY OFFICIAL (Name and Title)
N/A
'18. FEMA SIGNATORY OFFICIAL (Name and Title)
Nica Mafhes
Go Back
DATE
N/A
DATE
26JUL-09
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Print Application 09-923 Page 1 of 23
Preparerinformation
Prefix
First Name
Middle Initial
Last Name
Organization Name
Address 1
City
State
Zip
Business Phone
Home Phone
Mobile Phone/Pager
Emaii
� fs there a grant-writing fee associated with the
preparation of this request?
If you answered yes above, what is the fee?
Entire Application
Preparer Information
Ms_
Jill
LaCasse
St. Paul Fire Dept
100 E 11 th St
St. Paul
Minnesota
55101 -
6512286257 Ext.
j i I I.I acasse@ci. stpau I. m n. u s
No
$
Are you the person to be contacted on matters involving this application? Yes
If yes, please specify: Primary Contact
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Print Application 09-923 Page 2 of 23
Contact Information
= Title
Prefix
° First Narr�e
Middle Initial
' Last Name
- Business Phone
•Home Phone
Mobile Phone/Pager
Fax
°Email
• Title
Prefix
° First Name
Middle Initial
� Last Name
� Business Phone
°liome Phone
Mobile Phone/Pager
Fax
•Email
Primary Contact Information
Public Education Officer
Ms.
Paula
Peterson
6512286203 Ext.
6517747580 Ext.
pau I a. pete rson @ci. stpa u I. m n. us
Alternate Contact Information
Fire Marshal
N/A
Steve
Zaccard
651-228-6201 Ext.
651-214-5993 Ext.
steve.zacca rd @ci.stpau I. m n. u s
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Applicant Information
EMW-2008-FP-01563
Originally submitted on 03/06/2009 by Jill LaCasse (Userid: pjpeterson)
Contact Information:
Address: 900 E 91th St
City: St. Paul
State: Minnesota
Zip: 55101
Day Phone:6512286257
Evening Phone:
Cell Phone:
Email: jill.lacasse@ci.stpaul.mn.us
Application number is EMW-2008-FP-01563
* Organization Name
° Type of Applicant
If other, please enter the type of Applicant
� Are you a Fire Department?
If yes, what type of department do you represent?
If you answered combination, above,
what is the percentage of career members in your organization?
° Are you a non-fire based EMS?
° Type of community served?
° Employer ldentification Number
• What is your DUNS Number�
Please describe your organization and(or community that you serve
* Piease describe your organization's need for Federal financial
assistance.
° What is the permanent resident population of your Primary/First-
Due Response Area or jurisdiction served?
Headquarters Physical Address
Saint Paul Department of Fire and Safety Services
Fire Department
Yes
Career
No
Urban
41-6005521
153857347
Provide fire suppression, emergency medical
services, hazardous materials response,
community risk reduction and public education
services for 235,000 residents of the City of
Saint Paul. Saint Paul is a multi-cultural urban
area that includes the highest concentration of
Hmong residents in the U.S., as well and a large
number of Latino residents.
The Governor of Minnesota has greatly reduced
Local Government Aid to Saint Paul. In 2009,
we may see a 12% reduction in State aid
resulting in significant lay-offs throughout the
City's wark force including an estimated 59 fire
fighter postions. Budgets are being trimmed to
less than bare bones and deep concem for
public safery is thematic in conversations among
city residents.
280000
Note: If you are IIOt a fire department or EMS
organization, you may enter a zero.
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Print Application
09-923
• Physicai Address 1 100 East 11th SVeet
Physical Address 2
`City Saint Paul
� State Minnesota
' Z�P 55101 - 2227
Mailing Address
• Maii�ng Addressl 100 East 11th Street
Mailing Address2
' C�tY Saint Paul
' State Minnesota
' Z�P 55101 - 2227
Account information
� Type of bank account Checking
• Bank routing number - 9 di it number on the bottom left hand 091000022
comer of your check
•Your account number 180111054532
Add ition al I nfo rmation
� This fiscai year, are you receiving Federal funding from any other
grant program for the same purpose for which you are applying for No
this grant?
• This fiscal year, are you receiving Federai funding from any other Yes
grant pragram regardless of purpose?
� Is the applicant delinquent on any federal debt? No
If you answered yes to any of the additional questions above, please
provide an explanation in the space provided below:
2008 Assistance to Firefighters Grant for turnout
gear, vehicfe extrication training and fire hose.
Page 4 of 23
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Request Information
• 1. Select one of the choices listed below. You can apply for a maximum of 3 projects within an activity.
(If you modify your selection, you will lose data entered under the onginal 2ctivity.)
Program Name
Fire Prevention and Safety
Request Details
The number of projects and cost for the activity Fire Prsvention and Safety are listed in the table below.
Activity
Fire Prevention and Safety
Number of Projects
Total Cost
$ 20,810
View Project
Project Information
'1. Project
Multi-Hazard Prevention Programs
`If you selected other, above, please specify
`2. Who is the target audience for the planned project?
High risk group
*3. What is your estimated size of the target audience?
How was this target audience determined?
:1�PI�]
Informal Assessment
Briefly describe method used (required if selected other than Review of local fire data (NFIRS).
"None of the above" above)
"4. Describe the steps or methods that will be used to
achieve the goal and objectives of this project.
'5. Will you; organization periodically evaluate the projecYs
impact on the community?
An assessment of local NFIRS data and fiire investigation
reports will be conducted. The project will focus in areas of
St. Paul as determined by the "Invest St. Paul" program
that targets all city services in St. Paul's highest risk
neighborhoods. Census data will be examined to
determine cultural make up of those neighborhoods and a
list of community pianning districts and leaders will be used
to help learn about that community and to market the
program. A self-assessment safety checklist will be
developed and marketed to residents in high-risk
neighborhoods. A Standard Operating Procedure wili be
developed, fire staff trained to conduct verification, and
install equipment. A 2nd project requesting a mobile
cooking fire demo trailer will be submitted. Evaluation will
be developed.
Yes
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If you answered Yes to question 5 above, please specify:
Evaluation will be two-fold.
Process evaluation will consist of tracking the number of
homes who take part in Project Safe Haven, the number
and type of hazards identified, the number of smoke
alarms, CO detectors and Stove Top extinguishers
distributed. Also, the number of events and people viewing
the cooking fire demonstration will be tracked. Outcome
evaluation will consist of tracking and correlating the
number and severity of cooking fires within the target
neighborhoods. Program materials, techniques and
procedures wili be monitored continually to ensure
maximum efficiency and effectiveness. Feedback from
project participants will be
requested and applied to program procedures, materials
and methods.
`6. Is it the applicant's intention to continue delivering this
program after the grant year?
Yes
`7. In the space provided below, please provide a brief synopsis of the proposed project:
To develop, demonstrate and implement Project Safe Haven, a program where residents conduct home safety self-
assessments and have fire protection equipment installed by fire personnel. General safety hazards will be covered with
an emphasis on fire hazards, particularly those that lead to cooking fires. Fire Department staff will conduct verification
checks, provide safety education, install lithium smoke alarms, digital CO detectors, and StoveTop fire extinguishers.
Project Safe Haven wiil be conducted in three phases and will focus in the highest fire risk neighborhoods. Community
involvement will be an integral part of program development. Evaluation will be on-going to monitor the program's
outcome. A cooking fire demo unit will requested as an educational tool (see project #2).
'8. In the space provided below, please explain the experience you have in managing the type of project you are
proposing:
Saint Paul Fire has a long history of developing successful public safety programs. In St. Paul, young chiidren playing
with fire was the leading cause of fire deaths. To prevent this, Follow The Footsteps To Fire Safety was developed which
ied to a 78% reduction in our Fire Play Intervention Program enrollment. We've been honored to receive two national
awards: "Outstanding Community Education initiative" award from the National Safety Council, and the "Rolf Jensen
Partnership Award" for Project Fire Wise from NFPA. The successful and extensive implementation of Risk Watch
resulted in significant injury REDUCTIONS:
Leading injuries down 23%, falls-25%, MVA32%, bike-53%,pedestrian-26%, burns-32%. We are confident in our ability
to successfully develop and evaluate our proposed program.
'9. The narrative portion of the application should contain supporting information that allows for evaluation of this
project. If you are applying for a grant in the Fire Prevention and Safety Activity, your Narrative Statement must
address the evaluation elements outlined in the Program Guidance ().
Keep in mind that the evaluation of your application will aiso be based on a Gear understanding of your proposal, your
ability to meet the objectives of the program, and your probability of successfully delivering your project to the population
targeted. You need to fully explain how the funds will be used to accomplish the goals of your project. To that end be
sure to include descriptionsrustification for all budgeted items - items not justified may be disallowed.
Your narrative may not exceed five pages of te�ct. You may either type your project narrative in the space provided
below or create the text in your word processing system and then copy it into the space provided below. Images and
attachments are not allowed.
Vulnerability Statement for Project Number One — Project Safe Haven
Two informal assessments of fires and fire deaths in Saint Paul, MN, were recently conducted. A five year study of fire
death data was completed and a two year assessment of all fire causes was made. 7hese studies revealed that cooking
was the leading cause of fires and the second leading cause of fire deaths in St. Paul. In addition, iwo Geographical
Information Systems {GIS) studies were conducted to map where cooking fires were occurring and where fire fatalities
occurred.
The assessments and GIS studies showed that in five years:
- there were 12 fire deaths
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- four deaths (33%) occurred in Ward #1 (there are a 7 Wards
in Saint Paul).
- cooking was the second leading cause of fire deaths (17%)
- 42% of the fire deaths resulted from careless smoking.
In iwo years:
- 60% of all structure fires were cooking related.
- 35% of all fires were cooking related.
- 65% occurred in single family dwellings.
- The majority of cooking fires occurred in specific Wards
witfiin the City — Wards #1, #2, #6 and # 7.
Target Population:
Pro}ect Safe Haven wilf focus on residents of owner-occupied single Eamily homes, duplexes and townhomes in the
highest risk areas of St. Paul. Owner-occupied residences are chosen because the City's Certificate of Occupancy
program inspects all rental property on a regular basis leaving residents in owner-occupied homes lacking any safety
inspection programs. Each owner will complete a home safety self-assessment then forward a request for a visit by fire
fighters or public educators who will verify and install smoke alarms, carbon monoxide detectors, and Stove Top fire
extinguisher units; verify and observe the residents' fire escape plan; distribute personalized packets of safety
information; award a certificate and other incentives and follow-up within one year to reinforce safety information. The
program will target residents in those neighborhoods where the majority of fire deaths occurred and where most cooking
fires happen — specifically, Wards 1, 2, 6 and 7. These Wards coincide with areas also targeted by the City's Invest St.
Paul program which focuses all city services in specific high-risk neighborhoods. The Saint Paul Department of Planning
and Economic Development identified Invest St. Paul areas based on crime and fire rate, poverty, and low education
level. Logic dictates, therefore, to choose these areas as the focus for Project Safe Haven.
Target Population Characteristics:
Demographic studies of the Invest St. Paul neighborhoods where we propose to pilot Project Safe Haven, revealed
specific population features. There is a high ratio of minorities with 55% being African-American; a high number of
immigrants (40%), and a high population density (over 5000 per square mile). In addition, 30% of adults have no high
school diploma and a total of 20% are at or below the poverty level. It should also be noted that Saint Paul, MN, has the
highest number of Southeast Asian Hmong immigrants(US census, 2000) than any other city in the U.S. with many fiving
within Invest St. Paul neighborhoods. Hmong community elders indicate that, until recently, a formal written language
was not part of the Hmong culture. Because of this, many adults are visual and auditory leamers — with information being
past from one generation to the next through story telling, pictures, and the verbal exchange of information. This is true
for many adults of this population and especially true for the elders. Our target popuiation experiences a high number of
cooking related fires, are of minority or immigrant populations, are poor and have not reached high levels of education.
Program Summary
Project Safe Maven involves residents completing a home safety checklist followed by a visit from fire personnel who
observe fire escape drifls, verify and/or instafl smoke afaRns, CO detectors and Stove Top fire extinguisher units, give
personalized packets of safety information, offer safety advice and award the participant with a certificate and program
incentives. A follow-up visit during the year following the verification check wi�l also take place. Fire safety education will
consist of individual sessions within the home and a demonstration of cooking fires and how to prevent them through the
use of a mobile cooking fire demonstration unit (grant request project #2, following).
Goals and Objectives of Project Safe Haven
Our main goal is to reduce cooking related fires among residents within high risk neighborhoods. It is recognized that
large scale fire loss reduction is best accomplished over time and only after a large number of people participate in a
treatment program — in this case, Project Safe Haven. The purpose of this proposal is to acquire funding for start up costs
to implement Project Safe Haven in at least 100 homes during the first year and in at least 200 homes during each of the
following five years.
Objectives for Year #1 (FEMA grant duration)
1. Reduce the number of cooking fires by 5% (24) in the first
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year.
2. Marhet Project Safe Haven to at least 600 homes.
3. Complete Project Safe Haven in at least 100 homes by the end
of the grant year (Year #1).
4. Obtain design plans and build a mobile cooking fire
demonstration unit and within the first year, present it to
10,000 people attending at least 20 local events.
(See grant project #2)
Methods and Budget Justification
A variety of inethods and steps will be taken in order to accomplish our goal and objectives. During the grant year,
purchases will be made to accomplish these objectives. Using grant funds, we will:
1. Develop a resident self-assessment check list to include details on safety hazards related to cooking, smoking,
heating, and scalds. The check Iist will also include questions on other hazards -child safety, motor vehicle safety, child
passenger safety, drowning, poisoning and suffocation. We will use funds to hire a graphic artist to produce and revise a
full-color checklist and print at least 1000 copies.
2. Develop a standardized mechanism of program delivery through the Standard Operating Procedure development
process and conduct training sessions for fire suppression and prevention staff. Funds will be used for training supplies.
3. Formalize working partnerships with home visiting nurses and
social service programs to market the program and provide translation for non-English speaking participants. Formal
Letters of Understanding wili be signed by program directors and the Fire Chief. Specific agencies include House Calls;
program for high risk residents and seniors; Vietnamese Social Services, Hmong American Partnership Program, Public
Health visiting nurses, Lao Family Center, Jimmy Lee Recreation Center, area schools, churches, grocery stores, etc. No
grant funds will be used for this activity.
4. Market the program to targeted households through mailings,
public education programs, fire station tours, community events, District Planning Councils, web sites, public and private
health and safety agencies, literacy programs, schools, parent groups, senior centers, Fire Play Intervention Program,
home visits by nurses and social workers, partnership agencies, etc. Grant funds will be used to purchase a printer and
ink cartridges in order to develop marketing materials and certificates for homeowners who complete the program.
5. install at least 700 lithium smoke alarms, 100 digital carbon monoxide detectors, 100 pairs of Stove Top fire
extinguishers u�its in homes of program participants. Provide andlor install strobe smoke alarms for those that are deaf
or hard of hearing. Grant funds will be used to purchase this equipment.
6. Assemble one tool kit for each of three fire districts with adequate supplies for installation of above mentioned fire
protection equipmen:. Funds will be used to purchase tools, nuts, bolts, digital thermometers, kit boxes, etc.
7. Purchase five (5) intemet capable cell phones and plans for
use during program implementation (one per district and one for each of two public educators). Mobile access to the
internet is necessary to get the most up to date information available to answer some questions which may come up
during the verification visit. For some topics - e.g. car seats, appliance recalis, safety technology, a printed informational
brochure may become outdated quickly. One cell phone per district and one per public educator is needed to quickly
access the latest information on-site.
8. Program each cell phone with a list of reliable internet sites for easy access to safety information during validation visit.
For example, web sites of FEMA, USFA, NFPA, CPSC, Buckle Up Made Easy, CDC, MN State Fire Marshal's Office, etc.
No grant funds will be used for this activity.
9. Assemble a variety of home safety literature in order to
create a personalized packet of safety information for each household. While some information is regularly updated,
some remains constant so existing literature can be used. Grant funds will be used to purchase literature, create and
print materials on the requested printer.
10. Present each household with a magnetic FD clip, a$10 gift card that can be used for food, and a certificate. Grant
funds will be used for these items as incentives to participate in the program. In our experience, residents who really
need this type of program may be reluctant to invite fire personnel into their homes. An incentive is needed to promote
participation and gift cards to buy food or other home supplies provides this added benefit.
11. Monitor number of cooking fires and interview fire fighters for feedback on program implementation methods. Adjust
as needed. No grant funds will be used for this activity.
12. Contact each participant and conduct a one year follow up visit to review information, address safety concerns and
reinforce safe behaviors. No grant funds will be used for this activity.
13. Develop a Safe Haven folder in AMANDA— an existing computerized tracking system used by City's inspection
programs.
No grant funds will be used for this activity.
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Project Safe Haven Objectives for Years #2 -#6, Subsequent to grant year.
1. Complete Project Safe tiaven in at feast 200 homes per year
for the five years following the gran! year (total 1000).
2. Continue presenting fhe mobile cooking fire unit to at least
10,000 people yeariy (Project 2, details following)
Program implementation will take place in three phases:
Phase 1: Develop and Pilot in fire box #34 (high risk area)
Phase 2: Focus in 4 high fire risk Wards of St. Paul
Phase 3: Implement City-wide (on-going}
Phases 1 and 2 wi11 be conducted during the FEMA grant year. Activities conducted will include program development,
printing, training, marketing plan development and implementation within the area designated as high risk. Roll-out of
Project Safe Haven will take place in fire box #34, located in one of the high fire risk areas in St. Paul's Ward #7. Phase 2
will be conducted concurrently extending the program into other designated high risk areas. Another project being
described in this grant process (following) is the construction of a mobile cooking fire demonstration unit that will be used
to distribute and reinforce information on cooking fire prevention at various events within the high fire risk areas and
throughout the city. This unit will be constructed to demonstrate how easily grease fires start and spread and how to
extinguish them safely. One of our Fire Investigators has extensive experience with such demonstrations and will be
responsible for the activity. Personnel on all shifts will be trained to conduct demonstrations.
Process evaluation will consist of tracking the number of marketing contacts (goal: 600) and the number of home owners
who complete the Safe Haven program successfully (100 in the first year), the number of cooking fire hazards identified
(via AMANDA data system), the number of lithium smoke alarms and CO detectors, and Stove Top extinguishers
installed.
Outcome evaluation will consist of tracking the number of cooking fires and determining the reduction percentage v✓hen
compared to previous years. The number of cooking fires extinguished by the Stove Top extinguisher units will be
tracked. Statistics will be collected through the AMANDA program, Fire Investigators, and the DepartmenYs NFIRS data
base.
Cost-Benefit:
The Saint Paul Fire Department fully commits to implementing the program for at Ieast 6 years and beyond. While the
first year cost per home will be less than $200, the cost per home will decline over time since some of the costs are for
equipment that will last for years. As can be seen in the budget, every dollar requested will go directly into program
development, materials and fire equipment that will provide years of protection. in St. Paul, the response to a single
cooking fire consists of 3 engines, 1 ladder truck, 1 rescue squad and 1 district fire chief. When compared to the cost of
suppressing a single cooking fire, costs associated with a targeted, scientific prevention program are extremely low.
Sustainability:
The Saint Paul Fire Department is committed to reducing fires through Project Safe Haven on an on-going basis.
Through our Fire Play intervention and Footsteps Programs, child fire play has declined by 78%, and through Risk
Watch, child injuries have declined by 23%. Several of our most effective public education programs have been in
existence for 25 years, proving time and time again that prevention programs work. We understand and accept that
prevention is best measured over time and hereby commit our staff and resources to that end. Once Project Safe Haven
is fully developed, tradition will be followed and it will become an accepted and valued component of our mission and
culture.
Financial Need:
The Governor of Minnesota recently announced that Local Government Aid to cities will be REDUCED each year by 27%
resulting in a$43.8 million loss to the City of St. Paul in the next biennium. The Saint Paul Fire Department alone faces a
$14 million budget shortfall which will result in, among other things, the possible reduction in program support and the
elimination of 55 — 60 fire fighter positions. At a time when financial resources are at their breaking point, the need for
well-planned fire prevention programs that are adequately fi�anced becomes increasingly clear.
End Note
The Saint Paui Fire Department wishes to thank all grant reviewers for their time, effort and careful consideration of all
grant applications.
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Budget Item
`Item
"Select Object Ciass
If you selected other above, piease specify
` Number of units
' Cost per unit
Strobe smoke alarm
Equipment
10 (Wholenum6eronly)
$ 90 (Whole dollar amounis only)
` Description
The space to the nght can be used to provide fudher
dariflcation on the costs �i.e. personnei costs: Gentex model 7109LS strobe smoke alarm for hearing impaire with battery
number of hours/rate/staff; or meeting costs: number back-up
of ineetings/days/aHendees). Budgetjustificafion
should be included in the project nar26ve.
Budget Item
Item
*Select Object Class
NFPA fire safety brochures (100 count)
Supplies
If you selected other above, please specify
Number of units 4(Whole number only)
* Cost per unit
$ 35 (Whole dollar amounts only)
* Description
The space to the right can be used to provide further
dariscat;on on me costs (i.e. persor.nei casts: 100 each NFPA brochures - Fire Prevention All Over the Home, 10 tips for
number of hours/rate/sfaff; or meeting cosLs: number fire safety, Exit Drills in the Home, Carbon Monoxide brochure
of ineetlngs/days/akendees). Budgetjustification
shoulC be included in the prqect narrative.
Budgst Item
'Item
YSelect Object Class
American Sensors Lithium Battery Smoke Alarms
Equipment
If you selected other above, please specity
' Number of units 100 �whoie number oniy)
" Cost per unit
$21 (Wholedollaramountsonly)
` Description
The space to the right can be used to provide further
clarification on tne costs (i.e. personne� costs: 10-year lithium battery smoke alarms
number of hours/rate/staff; or meeting cosis: number
of ineetings/days/attendees). Budgetjustification
should be included in the project narrative.
Budget Item
'Item
"SelecY Object Class
Kidde digital carbon monoxide detectors
Equipment
If you selected other above, please specify
* Number of units 100 (Whole number only)
` Cost per unit
$ 22 �VJhole doliar amounts only)
* Description
The space to the right can be used to provide further Digital CO detectors
clarification on the costs (i.e. person�el costs:
number of hours/rate/sFaff; or meeting costs: number
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of ineetings/days/attendees). Budgetjustification
should be inGuded i� the projed narrative.
Budgetltem
'Item Stove Top Fire Extinguishers
'Select Object Glass Equipment
If you selected other above, please specify
' Number of units 100 (VYhole number only)
` Cost per unit $ 57 (Whoie dollaramounts oniy)
` Description
The space to the right can be used to provide further
aarificatio� on u,e costs (t.e. personnei cosrs: price of unit is per pair = 100 pairs of stove top e�inguishers.
number of hours/rate/staff; or meeting cosis: number
of ineetings/days/aBendees). Budgetjustification
should be included in the project narrafive.
Budget Item
'Item Intemet capable cell phone
*Select Object Class Equipment
If you selected other above, please specify
� Number of units 5�wnoie number oniy)
� Cost per unit $ 135 (Whole dollar amounts oNy)
` Description
The space to the right can be used to provide further
ciariflcation on tne cosrs (i.e. Personnei costs: Verizon touch screen internet capable phone
number of hours/rate/staff; or meeting cosis: number
of ineetingsldays/attendees). Budgetjustification
should be inGudetl in the project narrative.
Budget Item
*Item Cell phone plans
"Select Object Class Equipment
If you selected other above, please specify
* Number of u�its 12 pnrnoie number onry)
� Cost per unit $ 382 (Whole dollar amounis oniy)
` Description
The space to the right can be used to provide further
aartscation on the costs �i.e. Personnei casts: Monthly charge for intemet cell phone plan for 5 phones
number of hours/rate/staff; or meeting costs: number
of ineetings/days/attendees). Budget justification
should be included in the prqect narrative.
Budget Item
`Item
'Select Object Class
If you selected other above, please specify
� Number of units
` Cost per unit
` Description
The space to the right can be used to provide further
Graphic design
Contractual
1 (Whole number only)
$ 400 (Whole dollar amounts only)
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clarificaGOn on the cos� (i.e. personnel costs:
number of hours/ratelstaff; or meeting cosis: number graphic design services for program materials
of ineetingsPoayslakendees). Budgetjustification
shouid be included in the project nartative.
Budget Item
*Item Black ink cartridges
*Select Object Ciass Supplies
If you selected other above, pfease specify
' Number of units 10 (Whole number only)
' Cost per u(lit $ 32 (Whole dollar amounts only)
* Description
The space to the right can be used to provide further
darircation on the costs (i.e. person�ei cost�: black ink cartridges needed for printer
number of hours/rate/staff; or meeting cosis: number
of ineetings/days/attendees). Sudgetjus6fication
should be inGUded in the projed narrative.
Budget Item
`Item Tool box
`Select Object Class Equipment
If you selected other above, piease specify
` Number of units 3(Whole number only)
� Cost pef uflit $ 10 (Whole dollar amounLs only)
' Description
The space to the right ran be used to provide turther
Caritcason on me costs (i.e. personnei cos�s: Menards tool boxes for tools needed for equipment installation
number of hours/rate/staff; or meeting costs: number
of ineeti�sldays/aHendees). Budgetjustification
should be included in the project narrative.
Budget Item
"Item Battery operated screwdriver
`Select Object Class Equipment
If you se!ected other above, please specify
* Number of units 3(whote number onty)
' CoSt pef UnJt $ 10 (Whole dollar amounts only)
* Description
The space to the right can be used to provide further
clari�ication on the costs (i.e. personnel costs: fo� inStallation of Smoke alarmS co detectors,
number of hours/rate/staff; or meeting costs: number 2tC.
of ineetings/days/aHendees). Budgetjustification
should be included in the project narrative.
Budget Item
`Item
"Select Qbject Class
If you selected other above, please speciiy
` Number of units
' Cost per unit
4" flat tip screwdrivers
Equipment
3 (Wholenumberonly)
$ 5 (Whole doliar amounis only)
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' Description
The space to the right can be used to provide further
clarificatior on the costs (i.e. personnel costs: to inStall Safety equipment
rumber of hours/rate/staff; er meeting cos�: number
of ineeGngsPoays/attendees). Budgetjustification
should be included in the project narrative.
Budget Item
*Item 4" philips screwdrivers
`Select Object Class Equipment
If you selected other above, please specify
' Nu[Tib2� of unitS 3(VJhole number only)
` CoSf Pef l!(llf $ 5 (VJhole dollar amounts only)
� Description
The space to the right ran be used to provide turther
Gariscaeon on the cosrs (i.e. personnei costs: for installation of equipment
number of hours/rate/stafl; or meeting costs: number
of ineetings/days/aBendees). Budget jusfif cation
should be included in the project nar2tive.
Budget Item
*Item tape measures
'Select Object Class Equipment
If you selected other above, piease specify
' Number of units 3(Whole number only)
' Cost pef L'nit $ 10 (Whole doilar amounis only)
" Description
The space to the right can be used to provide further
aariscation on the costs (i.e. personnei costs: for measuring where to install smoke alarms, CO detectors, etc.
number of hours/rate/staff; or meeting cosis: number
of ineetings/days/attendees). BudgetjusGfication
shauld be included in the project narretive.
Budget Item
`Item 10" claw hammers
*Select Qbject Class Equipment
If you selected other above, please specifij
* Number of units 3 plvnoie number oniy)
" COSt pef Unit $ 4 (Whole dollar amounts only)
` Description
The space to the right can be used to provide further
c�arification on the costs (i.e. personnel costs: for tool kit to install safety equipment
number of hours/rate/staff; or meeting cosis: number
of ineetings/days/attendees). Budget justification
should be included in the projeci narrative.
Budget Item
`ltem
'Select Object Ciass
If you selected oifier above, please specify
' Number of units
9-volt batteries
Equipment
7 00 (4vhole num6er only)
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' Cost per unit $ 1 (vuhole doliar amounts oniy)
' Description
Tfie space to the nght can be used to provide further
Garir,cation on tne coscs (i.e. personnei costs: to replace inexisting battery operated smoke alarms.
number of hours/rate/staff; or meeting costs: number
of ineetings/days/attendees). Budget justification
should be included in the project narrative.
Budget Item
`Item Printing
'Select Object Class Other
If you selected other above, piease specify Services
` Number of units 1000 (Whole number only)
` Cost per unit $ 1 (Whole doilar amounts orly)
* Description
The space to the nght ran be used to provide further
clari8cat;on on the casts (i.e. personnel costs: full color brochures and ro am materials
number of hours/rate!staff; or meeting costs: number P g
of ineetings/days/akendees). Budget justification
should be induded in the project narrative.
Budget Item
`Item HP Office Jet printer
'Select Object Class Equipment
If you selected other above, pEease specify
* Number of units 1(Whole number only)
� Cost per unit $ 319 (Whole dollar amounts only)
* Description
The space to the right can be used to provide further
ciarit,cation on the costs (i.e. personnet costs: o�ce printer needed for printing promotional certificates and other program
number of hours/rate/sfaff; or meedng costs: number fnatefials
of ineefings/days/attendees). Budgetjustification
should be included in the project narrative.
Budget Item
'Item HP ink cartridges
`Select Object Class Supplies
if yeu selected other above, please specify
� Number of units 10 (Whole number only)
' Cost per unit $ 55 (VJhole dollar amounfs only)
* Description
The space to the right can be used to provide further
dariscaeon on the costs (i.e. personnei costs: color ink cartridges needed for printer
number of hours/rate/staff: or meefing costs: number
of ineetings/days/attendees). Budgetjustification
should be induded in the project namative.
Budget Item
'Item digital thermometer
'Select Object Class Equipment
If you selected other above, piease specify
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' Number of units 3(Whcle number onry)
` Cost pef unit $ 30 (VJhole dollar amounts only)
' Description
The spax to the right can be used to provide further
uariscation on u,e costs (i.e. personnei costs: used to read temperature of water temp for scald prevention
number of hours/rate/staff; or meeting costs: number
of ineetings/days/aflendees). Budget justification -
shouid be inGuded in the prqect narrative.
Budget Item
`Item FD clip magnets
�Select Object Class Supplies
If you selected other above, please specify
` Number of units 100 (Whole number only)
' Cost pe� unit $ 1 (Whole dollar amounts only)
* Description
The space to the right can be used to provide further
aariecation on tne costs �i.e. personnei cosrs: Item to be given as award for program participation
number of hours/rate/staH; or meeting costs: number
of ineeGngs/days/aHendees). Budgetjustification
should be inGuded in the prqect nartative.
Budget Item
'Item Cub FoodsfTarget gift cards
`Select Object Class Supplies
If you selected other above, please specify
' Number of units 100 (Whole number only)
' Cost pef Unit $ 15 (Whole dollar amounts only)
` Description
The space to the right can be used to provide further
Garificacion on r�e costs (i.e. personnei costs: Gift cards to be used to be used as incentives to participate in program.
number of hours/rate/staff: or meeting costs: number
of ineetings/days/aflendees). Budgetjustification
should be included in the project narrative.
Budget
Budqet Object Class
Personnel
Benefits
Travel
E ui ment
Supplies
Contractual
Construction
Other
Indirect Charpes
0
0
0
16,800
2,610
400
0
1,000
0
Budget Amount
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Indirect Cost Details
Agency Indirect Cost Agreement with
Indirect Cost Rate %
Agreement Summary
Total Federal and Applicant Share
Federal Share $ 16,648
Applicant Share $ 4,162
Federal Rate Sharing (% � SO/20 (Administrztively changed)
' NOfI-FBd8f8I R850u�C2S (The combined Non-Federal Resources must equa! the Applicanf Sha2 of $ 4,162)
a. Appiicant $ 4,162
b. State $ p
c. Locai $ p
d. Other Sources $ 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 $ 20,810
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Narrative Statement
The narrative for Fire Prevention and Safety is provided when adding Fire Prevention and Safety Projects under the
Request Details section.
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Assurances and Certifications
FEMA Form 20-76A
You must read and sign these assurances by providing your password and checking the box at the bottom of
this page.
Note: Fields marked with an * are required.
Assurances Non-Construction Programs
Note: Certain of these assurances may not be applicable to your project or program. If you have any questions, please
contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional
assurances. If such is the case, you will be notified.
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 peohibit 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 ofi 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) Titfe Vf of the Civii 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; (� 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 alcohof 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 Q) the requirements of any other nondiscrimination statute(s) which may apply to
the application.
7. Will comply, or has already complied, with the requirements of Title II and III of the Uniform
Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide
for fair and equitable treatment of persons displaced or whose property is acquired as a result of
Federal or Federally assisted programs. These requirements apply to all interest in real property
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acquired for project purposes regardless of Federal participation in purchases.
8. Wili comply with provisions of the Hatch Act (5 U.S.C. Sections 1501-1508 a�d 7324-7328), which
limit the political activities of emp!oyees ti�hose principal employment activities are funded in whole or
in part wifh Federal funds.
9. Will comply, as applicable, with the provisions of the Davis-Bacon F�.ct (40 U.S.C. Sections 276a to
276a- 7), the Copeland Act (40 U.S.C. Section 276c and 18 U.S.C. Sections 874); and the Contract
Work Hours and Safety Standards Act (40 U.S.C. Sections 327-333), regarding labor standards for
federally assisted construction sub agreements.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood
Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area
to participate in the program and to purchase flood insurance if the total cost of insurable construction
and acquisition is $10,000 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a)
institution of environmental quality control measures under the National Environmental Policy Act of
1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to
EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in
floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved
State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C.
Section 1451 et seq.); (� conformity of Federal actions to State (Clean Air) Implementation Plans
under Section 176(c) of the Clean Air Act of 1955, as amended (42 U.S.C. Section 7401 et seq.); (g)
protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as
amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species
Act of 1973, as amended, (P.L. 93-205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. Section 1271 et seq.) related to
protecting components or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic
Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and protection of
historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469a-1
et seq.).
14. WiII 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 Mimal 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 animais 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 pertormed the required financial and compliance audits in accordance with the
Single Aud it Act of 1984.
18. Will comply with all applicab�e requirements of all other Federal laws, executive orders, regulations
and policies goveming this program.
19. It will comply with the minimum wage and maximum hours provisions of the Federal Fair Labor
Standards Act (29 U.S.C. 201), as they apply to employees of institutions of higher education,
hospitals, and other non-profit organizations.
Signed by Jiil LaCasse on 02110l2069
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Form 20-16C
You must read and sign these assurances by providing your password and checking the box at the bottom of
this page.
Note: Fields marked with an * are required.
Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibilities Matters; and Drug-Free Workplace
Requirements.
Applicants should refer to the regulations cited below to determine the certification to which they are required to attest.
Applicants should aiso review the instructions for certificafion included in the regulations before completing this form.
Signature on this form provides for compiiance with cert�cation requirements under 44 CFR Part 18, "New Restrictions
on Lobbying; and 44 CFR Part 17, "Government-wide Debarment and suspension (Non-procurementj and Government-
wide Requirements for Drug-Free Workp�ace (Grants)." The certifications shall be treated as a material representation of
fact upon which reliance will be placed when the Federal Emergency Management Agency (FEMA) determines to award
the covered transaction, grant, or cooperative agreement.
1. LOBBYING
A. As required by 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 o�cer or empioyee of any agency, a Member of
Congress, an o�cer 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 cooperalive agreement, the undersigned shalf compfete and submit Standard Form LLL,
"Disclosure of Lobbying Activities", in accordance with its instructions.
(c) The undersigned shall require that the language of this certificatiora be included in the award documents
for all the sub awards at all tiers (including sub grants, contracts under grants and cooperative agreements
and sub contract(s)) and that all sub recipients shall certify and disclose accordingly.
2. Debarment, Suspension and Other Responsibility Matters (Direct Recipient)
As required by Executive Order 12549, Debarment and Suspension, and implemented at 44CFR Part 67, for prospective
participants in primary covered transactions, as defined at 44 CFR Part 17, Section 17.510-A, the applicant certifies that
it and its principals:
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, sentenced to a
denial of Federal benefits by a State or Federal court, or voluntarily excluded from covered transactions by
any Federat 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 stole� property.
(c) Are not presently indicted for or othenvise 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
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B. Where the applicant is unabie to certify to any of the stataments in this certification, he or she shall attach an
explanation to this application.
3. Drug-Free Workplace (Grantees other than individuals)
As required by the Drug-Free Workplace Act of 1988, and implemented at 44CFR Part 17, Subpart F, for grantees, as
defined at 44 CFR paR 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} Notitying 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 corvicted employees must provide notice, including position title, to
the applicable FEMA awarding office, i.e. regional office or FEMA office.
(fl 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 enfoccement 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 (�.
(Ei) The grantee may insert in the space provided below the site(s) for the pertormance of work done in
connection with the specific grant:
Place of Performance
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S,reet City State Zip Action
If your place of performance is different from the physical address provided by you in the Applicant Information,
click on Add Place of Pertormance button above to ensure that the correct place of pefformance 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 certifcation in each Federal
fiscal year. A copy of which should be included with each application for FEMA funding. States and State agencies may
elect to use a Statewide certification.
Signed by Jill LaCasse on 02I10l2009
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Standard Form LLL
Only complete if applying for a grant for more than $100,000 and have lobbying activities. See Form 20-16C for lobbying
activifies definition.
This form is not applicable
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