FY 16 EMERG MGT NCEM Excercise MOU 15041
Homeland Security Grant Program “HSGP”
CFDA #: 97.067
Fiscal Year 2015
Grant Award #: EMW-2015-SS-00062-S01
MEMORANDUM OF AGREEMENT (MOA)
Between
Recipient: Sub-Recipient:
State of North Carolina New Hanover County
Department of Public Safety Tax ID/EIN #: 56-6000-323A
Emergency Management DUNS#: 040029563
MOA # 1504-21 MOA Amount: $3,500.00
DPS Fund Code: 1502-7A12- 35H1 MOA Period of Performance to - 9/01/2015 to 8/31/2017
1. Purpose. The purpose of this Memorandum of Agreement (MOA) is to establish responsibilities and procedures
to implement the terms of the US Department of Homeland Security (USDHS) HSGP Grant Program. A copy of
the complete federal grant instructions is available at www.fema.gov.
This Agreement is to set forth terms by which the State of North Carolina, Department of Public Safety, North
Carolina Emergency Management (Recipient), shall provide HSGP funding to the Sub-Recipient to fund projects
related to Emergency Management Planning, Operations, Equipment Purchases, Trainings and Exercises. For
more detailed description of the project approved for MOA# 1504-21. Please see Attachment 1 for detailed Scope
of Work.
2. Program Authorization and Regulations:
This Agreement is authorized under the provisions of: 1) Public Law 112-74, The Department of Homeland
Security Appropriations Act, 2015 (Pub. L. No. 113-76); The 9/11 Commission Act of 2007; 3) Public Law 107-
56, (6 U.S.C. § 101 et seq.), the USA Patriot Act of 2001; 4) Public Law 107-296, the Homeland Security Act of
2002; 5) Public Law 109-295, The Post-Katrina Emergency Management Reform Act of 2006, 6 U.S.C. 752(c);
6) the implementing recommendations or regulations of each Act or Law, if any; 7) the U.S. Department of
Homeland Security, FY 2015 HSGP Notice of Funding Opportunity Announcement (NOFOA) available at
www.fema.gov 9) applicable Grants Programs Directorate (GPD) Information Bulletins available at
www.fema.gov; and 10) the N.C. Emergency Management Act, Chapter 166A of the North Carolina General
Statutes.
Projects managed by the Recipient (State) on behalf of Sub Recipient (Only)
By checking this Box I request that the Recipient Retain Funds effective 9/1/2015. Sub-Recipient has agreed to
receive grant funds from Recipient. Sub-Recipient: desires for the North Carolina Emergency Management to conduct
activities described in Attachment 1 of this MOA, on its behalf with its allocation of $3,500.00 awarded through the
FY 2015 HSGP. Sub-Recipient authorizes Recipient to provide the funds to the State of North Carolina, Department
of Public Safety, North Carolina Emergency Management to conduct Planning, Equipment Purchases, Trainings and
Exercises activities to improve prevention, protection, preparedness, response and recovery. Please see Attachment 1
for detailed Scope of Work.
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3. Compensation: Recipient agrees that it will pay the Sub-Recipient complete and total compensation for the
services to be rendered by the Sub-Recipient. Payment to the Sub-Recipient for expenditures under this
Agreement will be reimbursed after the Sub-Recipient’s cost report is submitted and approved for eligible scope
of work activity. The original signed copy of this Award and MOA must be signed by the Official(s) authorized
to sign below and returned to North Carolina Emergency Management no later than 45 after award date. The
grant shall be effective upon return of the executed Grant Award and Memorandum of Agreement and
final approval by North Carolina Emergency Management of the grant budget and program narrative.
Grant funds will be disbursed (according to the approved project budget) upon receipt of evidence that funds have
been invoiced and products received and/or that funds have been expended (i.e., invoices, contracts, itemized
expenses, etc.) and/or that all work activities are completed.
4. Funding Eligibility Criteria: Federal funds administered through the State are available to local governments to
assist in the cost of developing and maintaining a "Comprehensive Emergency Management" program.
Continued HSGP funding is contingent upon completion of all HSGP funding requirements. The following
eligibility criteria must be adhered to during the Grant Program:
A. Every participant must:
i. be established as a State, Local, or Non-Profit agency by appropriate resolution/ ordinance;
ii. Complete any procurement(s) and expenditures no later than 8/31/2017.
iii. Provide quarterly progress reports to NCEM Branch or Grants office personnel using the latest Grant
Quarterly Report form by the following dates: January 15th , April 15th, July 15th and October 15th.
B. File Retention: Sub-Recipient is required to maintain records and (invoices) of this grant for five (5) years
after termination of the grant, or audit if required, or longer where required by law, as outlined below,
attached and incorporated by reference. However, if litigation, claim or audit has been initiated prior to the
expiration of the five-year period and extends beyond the five-year period, the records shall be retained until
all litigation, claims or audit findings involving the records have been resolved. Files must be avaiable for
review by North Carolina Emergency Management Staff for site visits, project closeout and future audits.
i. Sub-Recipient must include appropriate documentation in the file, including but not limited to the
following documents:
1. Grant Award and Memorandum of Agreement/ Memorandum of Understanding and Supporting
Appendices
2. Completed appropriate cost report forms with invoices and proof(s) of payment
3. Audit Findings and Corrective Action Plans
4. Equipment Inventory records with photo documentation of labeling
C. Employees must be covered by an approved Pay Plan. However, the Director may be exempt from this
requirement.
D. The political subdivision must have an acceptable local travel regulation plan or accept the state travel
regulations.
5. Conditions: The Sub-Recipient certifies that it understands and agrees that funds will only be expended for those
projects outlined in the funding amounts as individually listed in the FY 2015 HSGP Application Packet,
incorporated by reference herein. The Recipient certifies that it understands and agrees to comply with the general
and fiscal terms and conditions of the grant including special conditions; to comply with provisions of the
applicable laws, rules and policies governing these funds; that all information is correct; that there has been
appropriate coordination with affected agencies; that it is duly authorized to commit the Sub-recipent to these
requirements; that costs incurred prior to grant application approval will result in the expenses being absorbed by
the Sub-recipent; and that all agencies involved with this project understand that all federal funds are limited to a
36-month period.
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6. Supplantation: Sub-recipents are required to provide assurance that grant funds will not be used to supplant or
replace local or state funds or other resources that would otherwise have been available for homeland security
activities. In compliance with that mandate, the Sub-Recipient certifies that the receipt of federal funds through
North Carolina Emergency Management shall in no way supplant or replace state or local funds or other resources
that would have been made available for homeland security activities.
7. Compliance. Sub-recipent shall comply with the applicable statutes, ordinances, regulations, licensing
requirements, policies, guidelines and requirements, reporting requirements and certifications and other regulatory
matters that are applicable to the conduct of its business and purchase requirements performed under this MOA,
including those of federal requirements and State and local agencies having appropriate jurisdiction and found in
the applicable FY 2015 HSGP Notice of Funding Opportunity Announcement (NOFOA). Sub-recipent shall be
wholly responsible for the purchases to be made under this MOA and for the supervision of its employees and
assistants. Failure to comply with the specified conditions will result in the return of this grant award to North
Carolina Emergency Management.
8. Responsibilities:
A. The Recipient shall:
i. Provide funding to the Sub-Recipent to perform the work activities as described herein.
ii. Conduct a review of the project to ensure that it is in accordance with HSGP requirements.
iii. The performance period for the award to the State of North Carolina, Department of Public Safety, North
Carolina Emergency Management, ends on 8/31/2017.
iv. Directly monitor the completion of this project.
B. The Sub-Recipient shall:
i. Expend FY 2015 HSGP Grant Program funds in accordance with the applicable USDHS and HSGP
NOFOA, the Grant Application Package, and the Grant Award and Special Conditions documents,
incorporated by reference herein, of this MOA for the performance of the work activities.
ii. Utilize State of North Carolina and/or local procurement policies and procedures for the expenditure of
funds, and conform to applicable State and Federal law and the standards identified in the Procurement
Standards Sections of 44 Code of Federal Regulations (CFR) Part 13 and 2 CFR Part 200. Sub-Recipient
must follow procurement procedures and policies as outlined in the applicable USDHS and HSGP
NOFOA and the USDHS and Financial Management Guide. Sub-Recipient shall comply with all
applicable laws, regulations and program guidance. Sub-Recipient must comply with the most recent
version of the funding Administrative Requirements, Cost Principles, and Audit requirements.
Administrative and procurement practices must conform to applicable federal requirements. A non-
exclusive list of regulations commonly applicable to DHS grants are listed below, codified in the
following guidance: ; 2 CFR 215; 2 CFR Parts 225, 220, and 230 (formerly OMB Circulars A-87, A21
and A-122); 15 CFR Part 24; Federal Acquisition Regulations (FAR), Part 31.2; and 2 CFR 200 Sub-part
F and 44 CFR Part 14; 28 CFR Part 23 “Criminal Intelligence Systems Operating Policies”; 49 CFR Part
1520 “Sensitive Security Information”; Public Law 107-296, The Critical Infrastructure Act of 2002; Title
VI of the Civil Rights Act of 1964, as amended, 42 U.S.C. 2000 et. seq.; Title IX of the Education
Amendments of 1972, as amended, 20 U.S.C. 1681 et. seq; Section 504 of the Rehabilitation Act of 1973,
as amended, 29 U.S.C. 794; The Age Discrimination Act of 1975, as amended, 20 U.S.C. 6101 et. seq.;
Cash Management Improvement Act (CMIA) and its implementing regulations at 31 CFR Part 205;
FEMA Grant Programs Directorate, Grants Management Division, Match Guidance; Certifications and
Assurances regarding Lobbying 31 U.S.C. 1352, Drug-Free Workplace Act, as amended, 41 U.S.C. 701
et. seq. and Certification Regarding Drug-Free Workplace Requirements, Debarment and Suspension
Executive Orders 12549 and 12689 and 44 CFR Part 17 and Certification Regarding Debarment,
Suspension and Other Responsibility Matters; Assurances as listed in SF 424B and SF 424D, 28 CFR
Parts 66, 67, 69, 70 and 83; and Grant Award and Special Conditions documents.
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C. Sub-Recipient must take possession of all purchased equipment, receive any grant-eligible service and/or
complete work activities prior to seeking reimbursement from the Recipient.
D. Complete the procurement(s) process not later than 8/31/2017.
E. Provide quarterly progress reports to the Homeland Security Grant Manager, DPR chair, and/or Branch Office
by the following dates: 15th January, 15th April, 15th July and 15th October each calander the grant is active.
Attachment 2
F. Provide a list at project completion phase to the Homeland Security Grant Manager, DPR chair, and/or
Branch Office listing all items purchased through the grant.
G. Comply with the applicable federal statutes, regulations, policies, guidelines and requirements, reporting
requirements and certifications as outlined in the applicable HSGP NOFOA and Grant Award and Special
Conditions documents.
H. Maintain a grant management filing system as required in this MOA and Attachment 3.
I. Comply with current federal suspension and debarment regulations pursuant to 2 CFR 200 Sub-part F and
OMB Circular A-133 which states in pertinent part that “effective November 26, 2003, when a non-federal
entity enters into a covered transaction with an entity at a lower tier, the non-federal entity must verify that the
entity is not suspended or debarred or otherwise excluded. Sub-Recipient shall be responsible to ensure that it
has checked the federal System for Awards Management (SAM) https://www.sam.gov/portal/public/SAM/
and the State Debarred Vendors Listing, http://www.pandc.nc.gov/actions.asp to verify that contractors or
sub- Recipients have not been suspended or debarred from doing business with the federal government”.
J. Ensure that HSGP funds are not used to support the hiring of any personnel for the purposes of fulfilling
traditional public safety duties or to supplant traditional public safety positions and responsilibities.
K. Non-supplanting Requirement. Federal grant funds will be used to supplement existing funds, and will not
replace (supplant) funds that have been appropriated for the same purpose.
L. All materials publicizing or resulting from award activities shall contain this acknowledgement: “This
project was supported by a Federal award from the U.S. Department of Homeland Security, Office of
Grants and Training and Department of Public Safety, North Carolina Emergency Management.” Use of
the federal program logo must be approved by DHS. Printed as a legend, either below or beside the logo shall
be the words “Funded by U.S. Department of Homeland Security.
M. The purchase or acquisition of any additional materials, equipment, accessories or supplies or completion of
any work activities beyond those identified in this MOA shall be the sole responsibility of Sub-Recipient and
shall not be reimbursed under this MOA. Sub-Recipient shall prominently mark any equipment purchased
with grant funding as follows: “Purchased with funds provided by the U.S. Department of Homeland
Security.”
N. Sub-Recipient shall have sole responsibility for the maintenance, insurance, upkeep, and replacement of any
equipment procured pursuant to this Agreement unless hand receipted or transferred.
O. Sub-Recipient shall maintain an effective property management system that complies with the following
requirements. Equipment is defined as tangible, non-expendable property having a useful life of more than
one year and an acquisition cost of $5,000 or more per unit. Sub-Recipient may have property management
guidelines that are more restrictive, requiring a unit of equipment with a value of less than $5,000 to be
inventoried; if so, such equipment purchased under this award allocation shall be included on the report
submitted to Recipient.
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i. Recipient and Sub-Recipient shall take an initial physical inventory of any equipment. The Grant
Summary, Cost Reports with backup documentation, Certificate of Title, and any other Sub-Recipient
reports or inventory reports that include information regarding the grant, vendor, invoice number, cost per
item, number of items, description, location, condition and identification number may be used to meet this
requirement. The Sub-Recipient must provide quarterly updates until all funds are expended.
ii. Sub-Recipient must ensure a control system exists to ensure adequate safeguards to prevent loss,
damage or theft. Sub-Recipient shall be responsible for replacing or repairing equipment which is
willfully or negligently lost, stolen, damaged, or destroyed. Any loss, damage or theft of the property
must be investigated and fully documented, and made part of the official project records.
iii. Sub-Recipient or equipment owner must ensure adequate maintenance procedures exist to keep the
equipment in good condition.
iv. Disposition Procedures. Sub-Recipient may dispose of the equipment when the original or
replacement equipment acquired under the grant award is no longer needed for the original project or
program. Items with a fair market value of less than $5,000 may be retained, transferred or otherwise
disposed of with prior approval of Recipient and in accordance with disposition requirements in 2
C.F.R. Part 200. Items with a current per unit standard federal or fair market value in excess of
$5,000 may be retained, transferred or otherwise disposed of with prior Recipient approval in
accordance with disposition requirements in 2 C.F.R. Part 200. Sub-Recipient must provide
documentation that includes the method used to determine current fair market value.
v. Only authorized equipment listed in the Authorized Equipment List (AEL), with appropriate grant
listed are eligible for purchases from this grant. For more guidance visit www.fema.gov.
P. No indirect or administrative costs will be charged to this allocation award.
Sub-Recipients must utilize equipment as intended in their project application to NCEM. Any variation from
this intended use must be requested in writing and approved by NCEM.
i. Any equipment purchased under the Homeland Security Grant is subject to use as a regional asset to
be utilized by the US DHS, North Carolina Emergency Management, or Domestic Preparedness
Region partners and statewide as needed. Failure to adhere to this policy might result in revocation of
funds allocated for the purchase of said equipment.
R. Each Sub-Recipient must have a DUNS Number, prior to any funds being released. DUNS Numbers may be
obtained from either of the following web links: www.dnb.com or http://fedgov.dnb.com/webform.
S. System for Award Management (SAM) registration is required for all applicants. Each Sub-Recipient shall
ensure that your organization’s name, address, DUNS number and EIN are up to date in SAM and that the
DUNS number used in SAM is the same one used to apply for all FEMA awards. SAM information can be
found at http://www.sam.gov. Future payments will be contingent on the information provided in SAM;
therefore it is imperative that the information is correct.
T. The purchase or acquisition of any additional materials, equipment, accessories or supplies, or the provision
of any training, exercise or work activities beyond that identified in this MOA shall be the sole responsibility
of Sub-Recipient and shall not be reimbursed under this MOA.
U. HSGP Sub-Recipients certify that they have read and agree to abide by the Sub-Recipient instructions
provided in the sub-receipeint instructions document provided by NCEM.
9. Funding: All terms and conditions of this MOA are dependent upon and subject to the allocation of funds from
the DHS and NCEM for the purpose set forth and the MOA shall automatically terminate if funds cease to be
available.
A. All terms and conditions of this MOA are dependent upon and subject to the allocation of funds from
USDHS, FEMA and Recipient for the purposes set forth and the MOA shall automatically terminate if funds
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cease to be available. Allowable costs shall be determined in accordance with the applicable USDHS
Program Guidelines, which include, but may not be limited to, the FY 2015 HSGP NOFOA, available at:
www.fema.gov, 2 CFR Parts 200 Sub-part F, 215, 220, 225, and 230, Federal Acquisition Regulations (FAR)
Part 31.2, OMB Circulars A-21 and the USDHS Financial Management Guide available at www.dhs.gov.
Allowable costs are also subject to the approval of the State Administrative Agent for the State of North
Carolina, the Secretary of the Department of Public Safety.
10. Taxes: Sub-Recipient shall be considered to be an independent Sub- Recipient and as such shall be responsible
for all taxes.
11. Warranty. As an independent sub-recipient, the Sub-Recipient will hold the Recipient harmless for any liability
and personal injury that may occur from or in connection with the performance of this Agreement to the extent
permitted by the North Carolina Tort Claims Act. Nothing in this Agreement, express or implied, is intended to
confer on any other person any rights or remedies in or by reason of this Agreement. This Agreement does not
give any person or entity other than the parties hereto any legal or equitable claim, right or remedy. This
Agreement is intended for the sole and exclusive benefit of the parties hereto. This Agreement is not made for the
benefit of any third person or persons. No third party may enforce any part of this Agreement or shall have any
rights hereunder. This Agreement does not create, and shall not be construed as creating, any rights enforceable
by any person not a party to this Agreement. Nothing herein shall be construed as a waiver of the sovereign
immunity of the State of North Carolina.
12. Audit Requirements: For all homeland security grant programs, Sub-Recipient is responsible for obtaining
audits in accordance with 2 CFR 200 Subpart F.
13. State Property. Sub-Recipient shall be responsible for the custody and care of any property purchased with
HSGP funds furnished for use in connection with the performance of this Agreement and shall reimburse the
Recipient for any loss or damage to said property until the property is disposed of in accordance with HSGP
Program requirements. Recipient will not be held responsible for any property purchased under this MOU/MOA.
Title to the property purchased with HSGP funds shall be in the Sub-Recipient unles noted in section 2 of the
MOA.
14. Points of Contact. To provide consistent and effective communication between Sub-Recipient and the
Department of Public Safety, North Carolina Emergency Management, each party shall appoint a Principal
Representative(s) to serve as its central point of contact responsible for coordinating and implementing this MOA.
The Department of Public Safety, North Carolina Emergency Management contact shall be, Assistant Director for
Planning & Homeland Security and the Homeland Security Grants Management Staff, and NCEM Branch Staff.
The Sub-Recipient point of contact shall be the HSGP Program Manager or the person designated by the Sub-
Recipient . All confidential information of either party disclosed to the other party in connection with the services
provided hereunder will be treated by the receiving party as confidential and restricted in its use to only those uses
contemplated by the terms of this MOA. Any information to be treated as confidential must be clearly marked as
confidential prior to transmittal to the other party. Neither party shall disclose to third parties, the other party's
confidential information without written authorization to do so from the other party. Specifically excluded from
such confidential treatment shall be information that: (i) as of the date of disclosure and/or delivery, is already
known to the party receiving such information; (ii) is or becomes part of the public domain, through no fault of
the receiving party; (iii) is lawfully disclosed to the receiving party by a third party who is not obligated to retain
such information in confidence; or (iv) is independently developed at the receiving party by someone not privy to
the confidential information.
15. Public Records Access: While this information under Federal control is subject to requests made pursuant to the
Freedom of Information Act (FOIA), 5 U.S.C. §552 et. seq., all determinations concerning the release of
information of this nature are made on a case-by-case basis by the FEMA FOIA Office. This agreement may be
subject to the North Carolina Public Records Act, Chapter 132 of the North Carolina General Statutes.
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16. Subcontracting: If Sub-Recipient subcontracts any or all purchases or services required under this Agreement,
then Sub-Recipient agrees to include in the subcontract that the subcontractor is bound by the terms and
conditions of this MOA. Sub-Recipient and any subcontractor agree to include in the subcontract that the
subcontractor shall hold Recipient harmless against all claims of whatever nature arising out of the subcontractor's
performance of work under this MOA. If Sub-Recipient subcontracts any or all purchases or services required
under this MOA, a copy of the executed subcontract Agreement must be forwarded to Recipient. A contractual
arrangement shall in no way relieve Sub-Recipient of its responsibilities to ensure that all funds issued pursuant to
this grant be administered in accordance with all state and federal requirements. Sub-Recipient is bound by all
special conditions of this grant award as set out in the Grant Application Package and the Grant Award and
Special Conditions documents, incorporated by reference herein, as well as all terms, conditions and restrictions
of the applicable HSGP NOFOA referenced herein.
17. Situs: This Agreement shall be governed by the laws of North Carolina and any claim for breach or enforcement
shall be filed in State Court in Wake County, North Carolina.
18. Antitrust Laws: This Agreement is entered into in compliance with all State and Federal antitrust laws.
19. Other Provisions/Severability: Nothing in this Agreement is intended to conflict with current laws or regulations
of the State of North Carolina, Department of Public Safety, North Carolina Emergency Management, or the Sub-
Recipient. If a term of this agreement is inconsistent with such authority, then that term shall be invalid, but the
remaining terms and conditions of this agreement shall remain in full force and effect.
20. Compliance with the law: Sub-Recipient shall be wholly responsible for the purchases to be made under this MOA
and for the supervision of its employees and assistants. Sub-Recipient shall be responsible for compliance with all
laws, ordinances, codes, rules, regulations, licensing requirements and other regulatory matters that are applicable
to the conduct of its business and purchase requirements performed under this MOA, including those of federal
requirements and State and local agencies having appropriate jurisdiction and found in the FY 2015 HSGP
NOFOA.
21. Entire Agreement: This Agreement and any annexes, exhibits and amendments annexed hereto and any
documents incorporated specifically by reference represent the entire agreement between the parties and
supersede all prior oral and written statements or agreements.
22. Modification. This Agreement may be amended only by written amendments duly executed by the Recipient and
the Sub-Recipient.
23. Termination. The terms of this agreement, as modified with the consent of all parties, will remain in effect until
2/28/2018. Either party upon thirty (30) days advance written notice to the other party may terminate this
agreement. Upon approval by USDHS, FEMA and the issuance of the Grant Adjustment Notice, if this MOA is
extended, the termination date for the extension will be the date listed in the applicable USDHS, FEMA Grant
Adjustment Notice, incorporated by reference herein. If USDHS suspends or terminates funding in accordance
with 2 CFR 200 and the FY2015 HSGP NOFOA, incorporated by reference herein, the Sub-Recipient shall
reimburse North Carolina Emergency Management for said property and/or expenses.
24. Budget and Scope of Work:
SUB-RECIPIENT shall implement the HSGP Grant project summarized below and as described in the approved
project application. That Application is hereby incorporated by reference into this Agreement. The AGENCY/
Recipient shall reimburse eligible costs according to the following expenditures:
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A. Funding Summary
Project Costs:
Federal Share: $ 3,500.00
State Share: $ 0.00
Local Share: $ 0.00
TOTAL: $ 3,500.00
B. Scope of Work Summary
Please see Attachment 1 for a detailed Scope of Work description.
C. Reports to be provided during Period of Performance
SUB-RECIPIENT must also provide a semi-annual summary (progress report); no later than July 15th to the
HSGP Grant Manager and/or Field Planner to ensure that the project deliverables are being met, and that each
grant contract is operating within budget.
D. Reports to be Provided at the Conclusion of Work (if applicable )
i. Quarterly project progress reports.
ii. Sub-Recipient involved legal action that pertains to Planning Training Exercise and Equipment
purchased with HSGP ;
iii. After action report from exercise;
iv. Training course roster and description
v. Any other documentation that would be pertinent.
vi. Any invoices detailing the expenses associated with the project
25. Lobbying Prohibition: The Sub-Recipient certifies, to the best of his or her knowledge and belief, that:
A. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
person or employee of any state or federal agency, a member of the N.C. General Assembly, a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with
the awarding of any Federal contract, the making of any Federal Grant, the making of any Federal loan, the
entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or
modification of any Federal contract, grant, loan, or cooperative agreement.
B. In any funds other 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
contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-
LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions.
C. The undersigned shall require that the language of this certification be included in the award documents for all
sub-awards at all tiers (including subcontracts, sub grants, and contracts under grants, loans, and cooperative
agreements) and that all sub-recipients shall certify and disclose accordingly.
This certification is a material representative of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each
such failure.
☐☐☐☐ Sub- Recipient agrees to comply with above requirements
26. Assurance of Compliance with Title VI of the Civil Rights Act of 1964: During the performance of this
contract, the contractor, for itself, its assignees and successors in interest (hereinafter referred to as the
“contractor”) agrees as follows:
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A. Compliance with Regulations: The contractor shall comply with the Regulations relative to nondiscrimination
in Federally-Assisted Programs of the 2 C.F.R. 200 and North Carolina regulation as they may be amended
from time to time, (hereinafter referred to as the Regulations), which are herein incorporated by reference and
made a part of this contract.
B. Nondiscrimination: The contractor, with regard to the work performed by it during the contract, shall not
discriminate on the grounds of race, sex, or national origin in the selection and retention of subcontractors,
including procurements of materials and leases of equipment. The contractor shall not participate either
directly or indirectly in the discrimination prohibited by Section 21.5 of the Regulations, including
employment practices when the contract covers a program set forth in Appendix B of the Regulations.
C. Solicitation for Subcontracts, Including Procurements of Materials and Equipment: In all solicitations either
by competitive bidding or negotiation made by the contractor for work to be performed under a subcontract,
including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be
notified by the contractor of the contractors obligations under this contract and the Regulations relative to
nondiscrimination on the grounds of race, color, sex, or national origin.
D. Information and Reports: The contractor shall provide all information and reports required by the Regulations
or directives issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of
information, and its facilities as my be determined by the Recipient or the Research and Special Programs
Administration (RSPA) to be pertinent to ascertain compliance with such Regulations, orders and
instructions. Where any information required of a contractor is in the exclusive possession of another who
fails or refuses to furnish this information the contractor shall so certify to the Recipient or the Research and
Special Programs Administration as appropriate, and shall set forth what efforts it has made to obtain such
information.
E. Sanctions for Noncompliance: In the event of the contractors noncompliance with nondiscrimination
provisions of this contract, the Recipient shall impose contract sanctions as it or the Research and Special
Programs Administration may determine to be appropriate, including, but not limited to:
i. Withholding of payments to the contractor under the contract until the contractor complies; and/or
ii. Cancellation, termination, or suspension of the contract, in whole or in part.
F. Incorporation of Provisions: The contractor shall include the provisions of every subcontract, including
procumbent of materials and leases of equipment, unless exempt by the Regulations, or directives issued
pursuant thereto. The contract shall take such action with respect to any subcontract or procurements as the
Recipient or the Research and Special Programs Administration may direct as a means of enforcing such
provisions including sanctions for noncompliance: Provide, however, that in the event a contractor becomes
involved in, or is threatened with, litigation with a subcontract or supplier as a result of such direction, the
contractor may request the Recipient to enter into such litigation to protect the of the Recipient and, in
addition the contractor may request the United States to enter such litigation to protect the interests of the
United States.
☐☐☐☐ Sub- Recipient agrees to comply with above requirements
27. Assurance of Compliance with Title VI of the Civil Rights Act of 1964: Sub-Recipient HEREBY AGREES
THAT as a condition to receiving any federal financial assistance from the USDHS it will comply with Title VI
of the Civil Rights Act of 1964, 78 Stat. 252, 42 U.S.C. 2000d-42 U.S.C. 2000d-4 (hereinafter referred to as the
Act) and all requirements imposed by or pursuant to 2 CFR Sub Part F , Nondiscrimination in Federally-Assisted
Programs of the USDHS - Effectuation of Title VI of the Civil Rights Act of 1964 (hereinafter referred to as the
Regulations) and other pertinent directives, to the end that in accordance with the Act, Regulations, and other
pertinent directives, no person in the United States shall, on the grounds of race, color, sex or national origin, be
excluded from participation in, be denied the benefits of, or be otherwise discrimination under any program or
activity for which the Sub-Recipient receives federal financial assistance from the USDHS, and HEREBY GIVES
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ASSURANCE THAT it will promptly take any measures necessary to effectuate this agreement. This assurance is
required by subsection 21.7(a) (1) of the Regulations. More specifically and without limiting the above general
assurance, the Sub-Recipient hereby gives the following specific assurance with respect to the project:
A. That the Sub-Recipient agrees that each "program" and each "facility" as defined in subsections 21.23(e) and
21.23(b) of the Regulations, will be (with regard to a "program") conducted, or will be (with regard to
("facility") operated in compliance with all requirements imposed by, or pursuant to, the Regulations.
B. That the Sub-Recipient shall insert the following notification in all solicitations for bids for work or material
subject to the Regulations and, in adapted form in all proposals for negotiated agreements:
i. The Sub-Recipient, in accordance with Title VI of the Civil Rights Act of 1964, 78 Stat. 252, 42 U.S.C.
2000d to 2000d-4 and 2 CFR Sub Part F issued pursuant to such Act, hereby notifies all bidders that it
will affirmatively insure that in regard to any contract entered into pursuant to this advertisement,
minority, business enterprises will be afforded full opportunity to submit bids in response to this
invitation and will not be discriminated against on the grounds of race, color, sex or national origin in
consideration for an award.
C. That the Sub-Recipient shall insert the clauses of this agreement in every contract subject to the Act and the
Regulations.
D. That this assurance obligates the Recipient for the period during which federal financial assistance is extended
to the project.
E. The Sub-Recipient shall provide for such methods of administration for the program as are found by the
Secretary of USDHS or the official to whom he delegates specific authority to give reasonable guarantee that
is, other recipients, sub Recipients, contractors, subcontractors, transferees, successors in interest, and other
participants of federal financial assistance under such program will comply with all requirements imposed or
pursuant to the Act, the Regulations and this assurance.
F. The Sub-Recipient agrees that the United States has a right to seek judicial enforcement with regard to any
matter arising under the Act, and Regulations, and this assurance.
THIS ASSURANCE is given in consideration of and for the purpose of obtaining any and all federal grants,
loans, contracts, property, discounts or other federal financial assistance extended after the date hereof to the
Recipient by the USDHS and is binding on it, other recipients, sub Recipients, contractors, subcontractors,
transferees, successors in interest and other participants in the Department of Transportation Program. The
person or persons whose signatures appear below are authorized to sign this assurance on behalf of the
recipients.
☐☐☐☐ Sub- Recipient agrees to comply with above requirements
28. ASSURANCE OF COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964
The following clauses shall be included in all deeds, licenses, leases, permits, or similar instruments entered into
by Sub-Recipient executed in expending these grant funds.
The [Sub-Recipient, licensee, lessee, permittee, etc., as appropriate] for herself/himself, his/her heirs, personal
representatives, successors in interest, and assigns, as a part of the consideration hereof, does hereby covenant and
agree [in the case of deeds and leases add "as a covenant running with the land"] that in the event facilities are
constructed, maintained, or otherwise operated on the said property described in this [deed, license, lease, permit,
etc.] for a purpose for which a USDHS program or activity is extended or for another purpose involving the
provision of similar services or benefits, the Sub-Recipient, licensee, lessee, permittee, etc.] shall maintain and
operate such facilities and services in compliance with all other requirements imposed pursuant to 2 CFR Sub Part
F and as said Regulations may be amended.
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That in the event of breach of the above nondiscrimination covenants, Sub-Recipient shall have the right to
terminate the [license, lease, permit, etc.] and to re-enter and repossess said land and the facilities thereon, ,and
hold the same as if said [licenses, lease, permit, etc.] had never been made or issued.
That in the event of breach of any of the above nondiscrimination covenants, Sub-Recipient shall have the right
to re-enter said lands and facilities thereon, and the above-described lands and facilities shall thereupon revert to
and vest in and become the absolute property of Sub-Recipient and its assigns.
The following shall be included in all deeds, licenses, leases, permits, or similar agreements entered into by Sub-
Recipient.
The [Sub-Recipient, licensee, lessee, permittee, etc., as appropriate] for herself/himself, his/her personal
representatives, successors in interest, and assigns, as a part of the consideration hereof, does hereby covenant and
agree [in case of deeds, and leases add "as a covenant running with the land"] that (1) no person on the grounds of
race, color, sex, or national origin shall be excluded from participation in, be denied the benefits of, or be
otherwise subjected to discrimination in the use of said facilities, (2) that in the construction of any improvements
on, over or under such land and the furnishing services thereon, no person on the grounds of race, color, sex, or
national origin shall be excluded from the participation in, be denied the benefits of, or be otherwise subjected to
discrimination, and (3) that the [Sub-Recipient, licensee, lessee, permittee, etc.] shall use the premises in
compliance with all other requirements imposed by or pursuant 2 CFR Sub Part F Effectuation of Title VI of the
Civil Rights Act of 1964, and as said Regulations may be amended.
That in the event of breach of any of the above nondiscrimination covenants, Sub-Recipient shall have the right
to terminate the [license, lease, permit, etc.] and to re-enter and repossess said land and the facilities thereon, and
hold the same as if said [license, lease, permit, etc.] had never been made or issued.
That in the event of breach of any of the above nondiscrimination covenants, Sub-Recipient shall have the right
to re-enter said land and facilities thereon, and the above-described lands and facilities shall thereupon revert to
and vest in and become the absolute property of Sub-Recipient and its assigns.
* Reverted clause and related language to be used only when it is determined that such a clause is necessary in
order to effectuate the purpose of Title VI of the Civil Rights Act of 1964.
☐☐☐☐ Sub- Recipient agrees to comply with above requirements:
29. Assurance of Compliance with Privacy Act: The Sub-Recipient agrees:
A. To comply with the provisions of the Privacy Act of 1974, 5 U.S.C. §552A and regulations adopted there
under, when performance under the program involves the design, development, or operation of any system or
records on individuals to be operated by the Sub-recipient, its third-party contractors, subcontractors, or their
employees to accomplish a USDHS function.
B. To notify USDHS when the Sub-Recipient or any of its third-party contractors, subcontractors,, sub
recipients, or their employees anticipate a system of records on behalf of USDHS in order to implement the
program, if such system contains information about individuals name or other identifier assigned to the
individual. A system of records subject to the Act may not be used in the performance of this Agreement until
the necessary and applicable approval and publication requirements have been met.
C. To include in every solicitation and in every third-party contract, sub-grant, and when the performance of
work, under that proposed third-party contract, sub grant, or sub agreement may involve the design,
development, or operation of a system of records on individuals to be operated under that third-party contract,
sub grant, or to accomplish a USDHS function, a Privacy Act notification informing the third party
contractor, or sub Recipient, that it will be required to design, develop, or operate a system of records on
individuals to accomplish a USDHS function subject to the Privacy Act of 1974, 5 U.S.C. §552a, and
applicable USDHS regulations, and that a violation of the Act may involve the imposition of criminal
penalties; and
D. To include the text of Subsections a through c in all third party contracts, and sub grants under which work
for this Agreement is performed or which is award pursuant to this Agreement or which may involve the
design, development, or operation of a system of records on behalf of the USDHS.
☐☐☐☐ Sub- Recipient agrees to comply with above requirements
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30. Certification Regarding Drug-Free Workplace Requirements (Sub Recipients Other Than Individuals):
This certification is required by the regulations implementing the Drug-Free Workplace Act of 1988, 44 CFR Part
17, Sub Part F. The regulations, published in the January 31, 1989 Federal Register, require certification by sub-
Recipient, prior to award, that they will maintain a drug-free workplace. The certification set out below is a
material representation of act upon which reliance will be placed when the agency determines to award the grant.
False certification or violation of the certification shall be grounds for suspension of payments, suspension or
termination of grants, or government-wide suspension of debarment, (See 44 CFR Part 2)
(a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession
or use of a controlled substance is prohibited in the Sub- Recipients workplace and specifying the actions that will
be taken against employees for violation of such prohibition.
(b) Establishing a drug-free awareness program to inform employees about:
(1) The dangers of drug abuse in the workplace;
(2) The Sub-recipient’s policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace
(c) Making it a requirement that each employee to be engaged in the performance of the grant 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 employer of any criminal drug statute conviction for a violation occurring in the workplace no
later than five days after such conviction;
(e) Notifying the agency within ten days after receiving notice under subparagraph (d)(2), from an employee or
otherwise receiving actual notice of such conviction;
(f) Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), with respect
to any employee who is convicted -
(1) Taking appropriate personnel action against such an employee, up to and including termination, or
(2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program
approved for such purpose 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 (g).
Place(s) of Performance: The Sub- Recipient shall insert in the space provided below the site(s) for the
performance of work done in connection with the specific grant (street address, city, county, state, zip code)
☐☐☐☐ Sub- Recipient agrees to comply with above requirements:
31. Execution and Effective Date: This grant shall become effective upon return of this original Grant Award and
Memorandum of Agreement, properly executed on behalf of the Sub-recipient, to North Carolina Emergency
Management and will become binding upon execution of all parties to the Agreement. The terms of this
Agreement will become effective 09/01/2015. The last signature shall be that of Frank L. Perry, Secretary for the
North Carolina Department of Public Safety.
32. Term of this Agreement: This agreement shall be in effect from 9/01/2015 to 8/31/2017.
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IN WITNESS WHEREOF, the parties have each executed this Agreement and the parties agree that this
Agreement will be effective as of 9/1/2015.
N.C. DEPARTMENT OF NEW HANOVER COUNTY
PUBLIC SAFETY 230 GOVERNMENT CENTER DRIVE
DIVISION OF EMERGENCY MANAGEMENT WILMINGTON NC 28403
1636 GOLD STAR DR
RALEIGH, NC 27607
BY: _________________________________________ BY: __________________________
MICHAEL A. SPRAYBERRY, DIRECTOR
NORTH CAROLINA EMERGENCY MANAGEMENT
APPROVED AS TO PROCEDURES:
BY: _________________________________________ BY: __________________________
JAMES J. CHEROKE, CONTROLLER
DEPARTMENT OF PUBLIC SAFETY
BY: __________________________________________
WILLIAM POLK, ASSISTANT GENERAL COUNSEL
REVIEWED FOR THE DEPARTMENT OF
PUBLIC SAFETY, BY WILLIAM POLK,
DPS ASSISTANT GENERAL COUNSEL, TO FULFILL THE
PURPOSES OF THE US DEPARTMENT OF
HOMELAND SECURITY GRANT PROGRAMS
BY: __________________________________________
FRANK L. PERRY, SECRETARY
DEPARTMENT OF PUBLIC SAFETY
THIS MOA WAS PREVIOUSLY APPROVED AS TO FORM BY THE NORTH CAROLINA DEPARTMENT OF JUSTICE
FOR THE FY 2015 HOMELAND SECURITY GRANT PROGRAM ONLY AND IS SUBJECT TO EXECUTION BY
FRANK L. PERRY, SECRETARY OF THE DEPARTMENT OF PUBLIC SAFETY. THIS MOU/MOA SHOULD NOT BE
USED FOR OTHER MOUs/MOAs FOR THE HSGP FOR OTHER FISCAL YEARS.
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Attachment 1
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Exercise Request
Exercise Sponsor Point of Contact Information
*Submitted By New Hanover County
*Exercise Name NHC Hurricane Exercises 2016
Location New Hanover County
Sponsoring Agency New Hanover County
Military Installation
For Official Use Only
MOA #
Status Approved Status Date 08/28/2015
*Scenario (check all that apply)
Chemical Release or Threat Nuclear Release or Threat
Cyber Natural Disaster
Radiological Release or Threat Explosive Detonation or Threat
Agriculture Active Shooter
Other Scenario
*Type (check all that apply)
Drill Full-Scale Exercise (FSE) Functional Exercise (FE) Game
Planning Conference Seminar Tabletop Exercise (TTX) Workshop
*Focus (check all that apply)
Prevention Protection Mitigation Response
Recovery
Other Focus
*Scope (check all that apply)
Local Only Regional (within State) Private/Corporation Multi-State
VOAD (Red Cross, etc.) Local/State National Level Exercise Multi-Local
Federal/State/Local
Other Scope
Organization New Hanover County
County Manager
County Tax ID
Contact Name Kristen Skinner
Address 230 Government Drive
City/State/Zip Wilmington, NC 28403 Phone 910-798-6905
Email
https://terms.ncem.org/TRS/exerciseRequest.do?exrId=103
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*Major Participating Agencies/Organizations
*Estimated Budget
Attached Documents
Addtional Notes
kskinner@nhcgov.com
County EM County Fire County Health County Rescue Squad County SAR
Local Law Enforcement State Agencies
Other:
Various
Schedule
Provide Final Proposal to
NCEM
Prepare Exercise Plan
Mail Notice of Exercise
Conduct Exercise between
and
Complete Action Report
Brief Exercise Overview:
NHC Hurricane Exercises
EOC and EPIC
Individual Care Coordination Center (IC-3)
Co-location Shelter
Long Term Care Emergency Planning Workshop
Special Needs Call Down Drill
Funds will be used for supplies, mostly meals for
participants.
Description Cost
1 Meals 2500.00
2 Supplies 1000.00
3
4
TOTAL $3,500.00
Document Browse...
Description
Select Description Document
https://terms.ncem.org/TRS/exerciseRequest.do?exrId=103
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Attachment 2
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QUARTERLY PROGRESS REPORT
Subgrantee: County
FY15 HSGP – MOA #
Funds Expended Prior Quarters:
Quarter (list dates): Grant Award: $ Funds Expended this Quarter:
Activities Metric Current Status
1. (ex. List needs
identified, items in
vendor negotiation,
purchased, placed in
service, etc.)
Quarterly Progress Reports are due:
January 15
April 15
July 15
October 15
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Attachment 3
Required Sub-Grantee File Documentation
Sub-grantee or sub-recipient must meet the financial administration requirements in 44 CFR Part 13 and must
maintain a file for each homeland security grant award. The files must be available for review by the North
Carolina Division of Emergency Management – Homeland Security Branch Staff for site visits, project closeout
and future audits.
Sub-grantee or sub-recipient must include appropriate documentation in the file, including but not limited to the
following documents:
Grant Award Letter
Memorandum of Agreement/ and Supporting Appendices
Quarterly Progress Reports
Completed cost report forms with invoices and proof(s) of payment
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