FY17 FEMA Design Appl Agent and State ContractRESOLUTION
DESIGNATION OF APPLICANT'S AGENT
North Carolina Division of Emerqencv Manaqement
Organization Name (hereafter named Organization)
New Hanover Countv
Disaster Number:
FEMA-4285-DR-NC
Applicant's State Cognizant Agency for Single Audit purposes (lf Cognizant Agency is not assigned, please indicate):
Cherrv Bekaert. LLP
Applicant's Fiscal Year (FY) Start
Month: July Dav: 1
Applicant's Federal Employer's ldentification Number
56 6000324
Applicant's Federal lnformation Processing Standards (FIPS) Number
129- 99129- 00
PRIMARY AGENT SECONDARY AGENT
Agent's Name Lisa Wurtzbacher
Agent's Name
Ma(ha Wayne
Organization
New Hanover Countv
Organization
New Hanover County
Official Position
Chief Financial Officer
Official Position
Deoutv Chief Financial Officer
Mailing Address
230 Government Center Drive, Suite 165
Mailing Address
230 Government Center Drive, Suite 165
City,State, Zip
Wilminston, NC 28403
City ,State, Zip
Wilminqton. NC 28403
Daytime Telephone
910-798-7187
Daytime Telephone
910-798-7187
Facsimile Number
91 0-798-7806
Facsimile Number
91 0-798-7806
BE lT RESOLVED BY the governing body of the Organization (a public entity duly organized under the laws of the State of North
Carolina) that the above-named Primary and Secondary Agents are hereby authorized to execute and file applications for federal
and/or state assistance on behalf of the Organization for the purpose of obtaining certain state and federal flnancial assistance
under the Robert T. Stafford Disaster Relief & Emergency Assistance Act, (Public Law 93-288 as amended) or as otherwise
available. BE lT FURTHER RESOLVED that the above-named agents are authorized to represent and act for the Organization in all
dealings with the State of North Carolina and the Federal Emergency Management Agency for all matters pertaining to such
disaster assistance required by the grant agreements and the assurances printed on the reverse slde hereof. BE lT FINALLY
RESOLVED THAT the above-named agents are authorized to act severally. PASSED AND APPROVED this _20th_ day of
March .2017
GOVERNING BODY CERTIFYING OFFICIAL
Name and Title
Skip Watkins, County Commissioner Vice-Chairman
Name
Woody White
Name and Title
Jonathan Barfield, Jr., County Commissioner
Official Position
County Commissioner Chairman
Name and Title
Patricia Kusek, County Commissioner
Daytime Telephone
91 0-798-71 49
Name and Title
Rob Zapple, County Commissioner
Date:1
CERTIFICATION
l, Kvmberleigh G. Crowell , (Name) duly appointed and Clerk to the Board (Title) of the Governing Body, do
hereby certify that the above is a true and correct copy of a resolution passed and approved by the Governing Body
of New Hanover County (Organization) on the 20th day of 2017
Signature:e.
North Carolina Department of Public Safety
Division of Emergency Management
APPLICANT:DISASTER: Hurricane Matthew
FEMA- 4285-DR-NC
PUBLIC ASSISTANCE CFDA# 97.036
STATE - APPLICANT DTSASTER ASSISTANCE AGREEMENT
This Agreement made by and between the State of North Carolina, Dept. of Public Safety,
Division of Emergency Management ("the State") and -
("the
Applicant") shall be elfective on the date signed by the State and the Applicant. It shall apply to
ali disaster assistance funds provided by or through the State to the Applicant as a result ofthe
disaster called HUffiCane MattheW, and pursuant to the Disaster Declaration made by the
President of the United States numbered FEMA - 4285 - DR-NC.
The designated representative olthe Applicant (Applicant's Agent) certifies that:
1. He/She has legal authority to apply for assistance on behalfofthe Applicant pursuant to a
resolution duly adopted or passed by the Applicant's goveming body.
2. The Applicant shall provide all necessary financial and managerial resources to meet the
terms and conditions ofreceiving Federal and State disaster grant assistance.
3. The applicant shall use disaster assistance funds solely for the purpose for which these funds
are provided and as approved by the Govemor's Authorized Representative (GAR).
4. The Applicant is aware ofand shall comply with cost-sharing requirements ofFederal and
state disaster assistance: specifically that Federal assistance is limited to 75% ofeligible
expenditures, and that State assistance is limited to 25%o of the eligible costs. Altemate
projects selected by the Applicant may be etigible for only 7 5Yo of the approved Federal share
of estimated eligible costs.
5. The Applicant shall provide the following completed documentation to the State:
o Designation of Applicant's Agent;
. State-ApplicantDisasterAssistanceAgreement
o PrivateNon-Profit Organization Certification (ifrequired);
o Summary of Documentation Form itemizing actual costs expended for large
project payment requests;
o Monthly Progress Reportsl. Copies of Single Audit Reports as applicable.
Reviewed l0/23l2012 Page I of7 Rcv. 06/02
Ifthe Appticant fails to provide any ofthe above documentation, the State will be under
no obligation to reimburse the Applicant for eligible expenses.
6. The Applicant shall establish and maintain a proper accounting system to record expenditures
ofdisaster assistance funds in accordance with generally accepted accounting principals or as
directed by the Govemor's Authorized Representative. If applicable, the Applicant shall
conduct audit(s) pursuant to the Single Audit Act of 1984, 3l U.S.C. 17501 et. ggg., 44
C.F.R. Part 14, OMB Circular A-133, "Audits of States, Local Govemments and Non-profit
Organizations," and applicable North Carolina laws, rules and regulations.
7. The Applicant shall provide to the State monthly Progress Reports for all open large projects
funded by State and Federal disaster assistance grants. The first Progress Report will be due
on the lOth day ofthe first month following initiation ofthe project and subsequent Progress
Reports witl be due on the 1Oth day ofeach and every month thereafter until project
completion. Forms and reporting requirements will be provided by the Govemor's
Authorized Representative.
8. The Applicant, its employees and agents, including consultants, contractors and
subcontractors to be paid with funds provided under this Agreement, shall give State and
Federal agencies designated by the Govemor's Authorized Representative, full access to and
the right to examine all records and documents related to the use ofdisaster assistance funds.
9. The Applicant shall return to the state, within thirty (30) days ofa request by the Govemor's
Authorized Representative, any funds advanced to the Applicant that are not supported by
audit or other Federal or State review oldocumentation maintained by the Applicant.
10. The Applicant shall comply with atl applicable codes and standards in the completion of
eligible work to repair or replace damaged public facilities.
11. The Applicant shalt comply with all applicable provisions ofFederal and State statutes, rules
and regulations regarding the procurement of goods and services and regarding contracts for
the repair and restoration ofpublic facilities.
12. The Applicant shall begin and complete all items of work within the time limits established
by the Govemor's Authorized Representative and in accordance with applicable Federal and
State statues, rules and regulations.
13. The Applicant shall request a final inspection within ninety (90) days after completion of
each and every large project funded under this Agreement, or within ninety (90) days after
the expiration ofthe time limit established for each project under Paragraph 12 above,
whichever occurs first. Applicant shall present all supporting documentation to State andior
Federal inspectors at the time offinal inspection. The State, as Grantee, reserves the right
to conduct a finat inspection ofany large project after expiration ofthe ninety- (90) day
period and to reimburse Applicant only for costs documented at the time of final
inspection.
Reviewed l0/21l2012 Page 2 of 1 Rev. 06/02
14. The Applicant shall comply with all applicable Federal and State statutes, rules and
regulations for publicly financed or assisted contracts including, but not limited to, non-
discrimination, labor standard, and access by the physically handicapped.
15. The Applicant's Designated Agent shall execute and comply with the Lobbying Prohibition
document incorporated herein as Attachment A.
16. The Applicant's Designated Agent shall execute and comply with the Statement of
Assurances (SF 424D) document incorporated herein as Attachment B.
17. The Applicant shall not enter into cost-plus-percentage-of-cost contracts for debris removal,
emergency protective measures, or completion of disaster restoration or repair work.
18. The Applicant shall not enter into contracts for which payment is contingent upon receipt of
State or Federal funds.
19. The Applicant shall not enter into any contract with any entity that is debarred or suspended
from participation in Federal Assistance. The State and/or FEMA will not be under any
obligation to reimburse Applicant for payments made to a debarred or suspended contractor.
Applicant may search for debarred or suspended contractors on the "Excluded Parties List
System" (EPLS) at the following website: www.sam.gov.
20. The Applicant shall comply with the provisions of 42 U.S.C. a5155 (Section 312 of the
Stafford Act) which prohibits duplication of benefits. Applicant shall notify State
immediately if any other source of funds is available to offset disaster assistance provided
pursuant to this Agreement. Applicant agrees that eligible costs under this Agreement will
be reduced by duplicate benefits received from any other source.
2l . The Applicant shall comply with all uniform grant administration requirements required by
State and Federal statutes, rules and regulations, including but not limited to, the Robert T.
Stafford Disaster Relief and Emergency assistance Act, Public Law 93-288, as amended,
Title 44 of the Code of Federal Regulations, applicable OMB Circulars, and policy guidance
issued by the Federal Emergency Management Agency (FEMA).
22.|f the Applicant pays contractors, subcontractors or consultants with funds provided through
this Agreement then the Applicant shall include language in all contracts that binds the
contractor, subcontractor or consultant to the terms and conditions of this Agreement with the
State. Contractual arrangements with contractors, subcontractors or consultants shall in no
way relieve the Applicant of its responsibilities to ensure that all funds provided through this
Agreement are administered in accordance with all State and Federal requirements.
Reviewed 1012312012 Page 3 of7 Rev. 06/02
- Aa^^r F\ r)b\1
Date
s6-6000324
Applicant's Federal Tax I.D.
Number (required)
FOR THE APPLICANT:
,r, sto; u>-
Signature
Lisa Wurtzbacher
Typed Name
Chief Financial Officer
FOR THE STATE:
BY:
Date Signature
Typed Name
Reviewed 1012312012 Page 4 of 7 Rev. 06/02
Title
Tirle
ATTACHMENT A
LOBBYING PROHIBITION
The undersigned 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 for influencing or attempting to influence either directly
or indirectly an officer or employee of any State or Federal agency, a member of the
N.C. Legislature, 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) If 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-L.
"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 recipients
of funds under this Agreement shall certify and disclose accordingly.
This certification is a material representation 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 failure.
New Hanover Countv
Name of Applicant
-_D ,\
nv: JvoL L\)u--
Signature of Applicant's Designated Agent
Reviewed 1012312012 Page 5 of7 Rev. 06/02
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including tame for reviewing instructaons,
searching existing data sources, gathering and maintaaning the data needed, and completing and reviewing the coilection of information. Send
comments regarding the bulden estimate or any other aspecl of this collection of information, including suggestions for reduong this burden, to lhe
Office of Management and Budget, Paperwork Reduclion project (0348-0042), Washington DC 2O5Ot
PLEASE 89]9I RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADORESS
PROVIDED BY THE SPONSORING AGENCY
1. Has the legal authority to apply for Federal assistance,
and the institutional, managerial and financial capability
(including funds sufficient to pay lhe non-Federal shareof the project costs) to ensure proper planning,
management and completion of the project described in
lhis 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 assistancei and will establish a
proper accounting system in accordance with generally
accepted accounting standards or agency directives.
3. Will not dispose of, modify the use of, or change the
terms of the real property title, or other interest in the site
and facilities without permission and instructions from the
awarding agency. Will record the Federal interest in the
title of real property in accordance with awarding agency
directives and will include a covenant in the title of real
property acquired in whole or in part with Federal
assistance funds to assure non-discrimination during the
useful life of the project.
4. Will comply by the requirements of the assistance
awarding agency with regard to the drafting, review and
approval of construction plans and specifications.
5. Will provide and maintain competent and adequate
engineering supervision at the construction site to ensure
that the complete work conforms with the approved plans
and speciflcations and will furnish progress reports and
such other information as may be required by the
assistance awarding agency or State.
6. Will initiate and complete the work within the applicable
time frame after receipt of approval of the awarding
agency.
7. Will establish safeguards to prohibit employees from
using their positions for a purpose that constitutes or
presents the appearance of personal or organizational
conflict of interest, or personalgain.
ATTACHMENT B-I
ASS U RANC ES-CON STRU CTIO N PROGRAMS
8. Will comply with the lntergovernmental Personnel Act of
1970 (42 U.S.C. t>4728-2763) relating to prescribed
standards for merit systems for programs funded under
one of the 19 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).
9. Will comply with the Lead-Based Paint Poisoning
Prevention Act (42 U.S.C. r;4801 et seq.) which prohibits
lhe use of lead-based paint in construction or
rehabilitation of residence structures.
'10. Will comply with all Federal statures relating to non-
discrimination. These include but are not limited to: (a)
Tifle vt of the civit Righls Act of 1964 (p.L. 88-352)
which prohibits discrimination on the basis of race, coloror national origin; (b) Title lX of the Education
Amendments of 1972, as amended (20 U.S.C.:>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.:794), which prohibits
discrimination on the basis of handicaps; (d) the Age
Discriminalion Act of 1975, as amended (42 U.S.C. >r
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
nondiscriminalion on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism
Prevention, Treatmenl and Rehabilitalion Act of 1970
(P.1. 91-616), as amended relating io nondiscrimination
on the basis of alcohol abuse or alcoholism; (g) >>523
and 527 ol the Public Health Service Ad of 1912 (42
U.S.C. ,1290 dd-3 and 290 ee 3), as amended relating to
confidentiality of alcohol and drug abuse patient records,
(h) Tifle v t of the civit Rights Acl of 1968 (42 u.s.c.
))3601 et seq.), as amended relating to
nondiscrimination in the sale, rental, or financing of
housing ; (l) any other nondiscrimination provisions in the
specific statute(s) under which application for Federal
assistance is being madei and, (i) the requirements of
any other nondiscrimination statute(s) which may apply
to the application.
OMB Approval No. 0348-0042
NOTE: Certain of these assurances may not be applicable to your project or program. lf you have questions, please contact the
Awarding Agency. Further, certain Federal assistance awarding agencies may require applicants to certify to additional
assurances. lf such is the case, you will be notifled.
As the duly authorized representative of the applicant, I certify that the applicant:
Authorized for Loc€l Reproduclion
Previous Edilion Usable
Standard Form 424D (Rev. 7,97)
Prescribed by O[rB A-'102Page 6 of7
ATTACHMENT B-2
11.Will comply, or has already complied, with the
requirements of Titles ll and lll of the Uniform Relocation
Assistance and Real Property Acquisition Policies Act of
1970 (P.1.91-646) which provide for fair and equitable
treatment of persons displaced or whose property is
acquired as a result of Federal and federally-assisted
programs. These requirements apply to all interests in
real property acquired for project purposes regardless of
Federal participation in purchases.
Will comply with the provisions of the Hatch Act (5 U.S.C.
))1501-1508 and 7324-7328) which limit the political
activities of employees whose principal employment
activities are funded in whole or in part with Federal funds.
Will comply, as applicable, with the provisions of the
Davis-Bacon Act (40 U.S. C. >276a to 276a-7), the
Copeland Act (40 U.S.C. 276c and '18 U.S.C. >874), and
the Contract Work Hours and Safety Standards Act (40
U.S.C. ;:327-333) regarding labor standards for federally-
assisted construction subagreements.
Will comply 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.
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) 1151a: (b) notillcation of violating
facilities pursuant to EO 1 1738; (c) protection of wetlands
pursuant to EO 1'1990; (d) evaluation of flood hazards in
floodplains in accordance with Eo 'l'1988; (e) assurance
of project consistency with the approved State
management program developed under the Coastal Zone
Management Acl ol 1972 (16 U.S.C. D'1451 et seq.); (f)
conformity of Federal actions to State (Clean Air)
lmplementation Plans under Section 176(c) of the Clean
Air Act of 1955, as amended (42 U.S.C. ))7401 et seq.);
(g) protection of under ground 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.1.93-205).
Will comply with the Wild and Scenic Rivers Act of 1968
(16 U.S.C. >1271 el seq.) related to protecting
components or potential components of the national wild
and scenic rivers system.
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 1'1593
(identification and protection of historic properties), and
the Archaeological and Historic Preservation Act of '1974
(16 U.S.C. ))469a-1 et seq.).
Will cause to be performed the required financial and
compliance audits in accordance with the Single Audit Act
Amendments of 1996 and Ol\,48 Circular No. A-133,
'Audits of States, Local Governments, and Non-Profit
Organizations."
Will comply with all applicable requirements of all other
Federal laws, executive orders, regulations, and policies
governing this program.
12.
13.
14.
15.
16.
17.
18.
19.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
.,cl*- u\)t---
TITLE
Chief Financial Officer
APPLICANT ORGANIZATION
New Hanover County
DATE SUBMITTED
t^,I\q"r,.. &\, )or^\
Revierved l0/20/16 Page 7 of7 SF- 424D (Rev.7-97) Page 2