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Home My WebLink AboutFD15-321 - Amendment - #A - Wa State Military Department - Emergency Management Performance Grant (EMPG) - 08/31/2015 ® T R, WASHiNc'roN ®®CUI( ent CONTRACT COVER SHEET This is to be completed by the Contract manager prior to submission to City Clerks Office. All portions are to be completed. Yf you have questions, please contact City Clerk's Office. Vendor Name: W6 StrAlt MikfrAry 1)trt- Vendor Number: JD Edwards Number Contract Number: FMC5-- ?]It'- �� This is assigned by City Clerk's Office Project Name: _(?} - 05 Lbi`l6%VG{{,ouj WjAVWAwLnf Kr yoariE� ( un d Description: VInterlocal Agreement ❑ Change Order SAmendment ❑ Contract ❑ Other: Contract Effective Date: ( p)l R Termination Date: } Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract manager: D, % Department: Contract Amount: Approval Authority: ❑ Department Director mmayor []City Council Detail: (i.e. address, location, parcel number, tax id, tc.): adccW10877 8 14 Washington State Military Department AMENDMENT 1. SUB-GRANTEE NAME/ADDRESS: 2. GRANT AGREEMENT NUMBER: 3. AMENDMENT NUMBER: City of Kent-OEM E15-135 A 24611 116th Ave SE Kent,WA 98030-4939 4. SUB-GRANTEE CONTACT, NAME/PHONE/EMAIL: 5. DEPARTMENT CONTACT, NAME/PHONE/EMAIL: Jennifer Keizer, 253-856-4342 Sierra Wardell, 253-512-7121 JDKeizer@ci.kent.wa.us Sierra.wardell mil.wa.gov 6. TIN or SSN: 7. CATALOG OF FEDERAL DOMESTIC ASST. (CFDA)#: S. FUNDING SOURCE NAME/Agreement#: 91-6001254 97.042 EMPG EMW-2014-EP-00033-S01 9. FUNDING AUTHORITY: Washington State Military Department(Department) and Department of Homeland Security (DHS) 10. DESCRIPTION/JUSTIFICATION OF AMENDMENT: The sub-grantee is requesting an extension to the grant agreement end date due to an unanticipated delay by the vendor in completing a communications van enhancement project. The delayed portion, phase II of the installation work, will be completed with 15EMPG funding. The funds original budgeted for phase II will be redirected from Organizational>Consultant/Contractors to Equipment to cover greater than anticipated costs and to Goods & Services to support operational expenses and other program sustainment costs previously identified in the application and agreement to and the addition of public education items. There are no significant impacts to the work plan activities. This amendment also updates the Department's Key Personnel. 11. AMENDMENT TERMS AND CONDITIONS: 1. Change the grant agreement expiration date from August 31, 2015 to September 30, 2015, 2. The overall grant agreement amount of$93,525 remains unchanged. 3. Update original Article I, Key Personnel, Exhibit A as follows: a Change Key Personnel from Kristin Ramos to Sierra Wardell, sierra.wardellp_mil.wa.gov (253) 512-7121. 4. Replace original Milestones Exhibit D with Revised Milestones Exhibit D attached to this amendment. 5. Replace original Budget Exhibit E with Revised Budget Exhibit E attached to this amendment. This Amendment is incorporated in and made a part of the Grant Agreement. Except as amended herein, all other terms and conditions of the Grant Agreement remain in full force and effect. Any reference in the original Grant Agreement or an Amendment to the "Grant Agreement" shall mean "Grant Agreement as amended". The Department and Sub-grantee acknowledge and accept the terms of this Amendment as identified above, effective on the final date of execution below. By signing this Amendment,the signatories warrant they have the authority to execute this Amendment. IN WITNESS WHEREOF, the parties have executed this Amendment: FOR THE DEPARTMENT: FOR THE SUB-GRANTEE: Signature Date idnat Date Richard A. Woodruff, Contracts Administrator Suzette�Gooke, Mayor Washington State Military Department era4 C Zw dac ® l o BOILERPLATE APPROVED AS TO FORM: Signature Date Jim Schneider, Fire Chief Brian E. Buchholz (signature on file) 6/1 312 0 1 2 Assistant Attorney General APPROVED AS TO FORM (if applicable): Applicant's Legal Review Date j Form Date: 10/27100 II DHS-FEMA-EMPG-FFY 14 Page 1 of 3 City of Kent OEM E15-135, Amendment A Exhibit D REVISED MILESTONE TIMELINE FFY14 Emergency Management Performance Grant Program MILESTONE TASK June 1, 2014 Start of Grant Agreement performance period. April 30, 2015 Submit reimbursement request August on1ti September 30, 2015 End of grant performance period. October15,2045 Submit final reimbursement request, additional reports, and/or November 15, 2015 deliverables. I DHS-FEMA-EMPG-FFY 14 Page 2 of 3 City of Kent OEM E15-135, Amendment A Exhibit E REVISED Budget Sheet FFY14 Emergency Management Performance Grant Program 14EMPG Grant Award $93,525.00 Adjustment $0.00 Amended 14EMPG Grant Award $93,525.00 SOLUTION Amended AREA BUDGET CATEGORY Original Amount Modification Amount NARRATIVE Planning,printing,softwa r,COOP and LEPC Z Goods &Services $ 1,250 $ $ _ 1,250 Pin nning materials zTravel/Per Diem $ Indirect $ - - Subtotof $ 1,250 $ $ 11250 Consultants/Contractors $ 19,175 $ (9,175) $ 10,000 For ECC u grades J ZEM Office Supplies,materials,instructional F support for day today operations,IT,copier N usage,phones and uniforms.ADD: emergency Z Goods &Services $ 1,300 $ 5,340 $ 6,640 preparedness public education items Travel/Per Diem $ $ p Indirect $ $ Subtotal $ 20,475 $ (3,835) $ 16,640 Tools/equipment-2 vehilce purchases for Kent OEM and Kent Communication Support Team °—_ (KCST),Tools/Equipment-OEM,ECC,DOC's E ui ment $ 64,000 $ 3,835 $ 67,835 Indirect $ $ $ Submtal $ 64,000 $ 3,835 $ 67,835 Supplies,Mterials,Instructional Supportfor LD Goods&Services- $ 1,000 $ $ ].,000 OEM Tralmrigs Z Z Travel/Conferences/Registration/PerDiem/Train Ing.Examplesx are WSEMA,EMI,IAEM,PIED, Travel/Per Diem $ 6,000 $ $ 6,000 �LEPC. Indirect $ $ $ Subtotal $ 7,000 $ $ 7,000 Supplies,Materials,I nstructi ona l support for '.. Goads &Services $ 800 $ - $ 800 OEM exercises. u w Travel/Per Diem $ - $ - $ - w Indirect $ $ $ subtotal $ 800 $ $ 800 TOTAL Grant Agreement Contract r:.3 �'$,+ s;"WW AMOUNT: $ 93,52S $ $ 93 525 • Subgrantee will provide a match of$93,525 50% of the total project cost(local/tribal budget plus EMPG award), of non- federal origin. • Cumulative changes to budget categories in excess of 10% of the grant agreement award will not be reimbursed without prior written authorization from the Department. • This award will not be used to supplant the local/tribal funds. • The Department's Reimbursement Spreadsheet will accompany each reimbursement request submitted. • The Sub-grantee agrees to make all records available to Military Department staff, upon request. Funding Source: U.S. Department of Homeland Security- PI#743PT— EMPG DHS-FEMA-EMPG-FFY 14 Page 3 of 3 City of Kent OEM E15-135, Amendment A SIGNATURE AUTHORIZATION FORM WASHINGTON STATE MILITARY DEPARTMENT Camp Murray, Washington 98430-5122 Please read instructions on reverse side before completing this form, NAME OF ORGANIZATION DATE SUBMITTED City of Kent - Office of Emergency Management PROJECT DESCRIPTION CONTRACT NUMBER EMPG - Emergency Management Performance Grant E15-135 1 . AUTHORIZING AUTHORITY SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE Suzette Cooke Mayor CJim Schneider Fire Chief 2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS SIGNATURE PRINT OR TYPE NAME TITLE Suzette Cooke Mayor Jim Schneider Fire Chief LI' ARIZED TO SIGN REQUESTS FOR REIMBURSEMENT NATURE PRINT OR TYPE NAME TITLE �0�� Jennifer KeizerEM Specialist Dominic Marzano Emergency Manager 11NAC-15V0L11H0MEIKARE B .. 1WPISIGNAUTH Revised 3103 INSTRUCTIONS FOR SIGNATURE AUTHORIZATION FORM This form identifies the persons who have the authority to sign contracts, amendments, and requests for reimbursement. It is required for the management of your contract with the Military Department (MD). Please complete all sections. One copy with original signatures is to be sent to MD with the signed contract, and the other should be kept with your copy of the contract. When a request for reimbursement is received, the signature is checked to verify that it matches the signature on file. The payment can be delayed if the request is presented without the proper signature. It is important that the signatures in MD's files are current. Changes in staffing or responsibilities will require a new signature authorization form. i 1 . Authorizing Authority. Generally, the person(s) signing in this box heads the governing body of the organization, such as the board chair or mayor. In some cases, the chief executive officer may have been delegated this authority. 2. Authorized to Sign Contracts/Contract Amendments. The person(s) with this authority should sign in this space. Usually, it is the county commissioner, mayor, executive director, city clerk, etc. 3. Authorized to Sign Requests for Reimbursement. Often the executive director, city clerk, treasurer, or administrative assistant have this authority. It is advisable to have more than one person authorized to sign reimbursement requests. This will help prevent delays in processing a request if one person is temporarily unavailable. If you have any questions regarding this form or to request new forms, please call your MD Program Manager. REQUEST FOR MAYOR'S SIGNATURE Print on Cherry-Colored Paper Routing Information: (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT) Approved by Director l Originator: Jenny Kelzer Phone (Originator): 253-856-4342 Date Sent: Sept. 1, 2015 Date.Required: Sept 4, 2015 Return Signed Document to: Dominic Marzano Contract Termination Date: Sept. 30, 2015 VENDOR NAME: Date Finance Notified: Washington State Military Deptarment (Holy required over contracts 20l000 and over or on any Grant) DATE OF COUNCIL APPROVAL: I) Date Risk Manager Notified: I' � Ir i a j_G1 (Required on Non-City.Standard Contracts/Agree cents) Has this Document been Specifically Account Number: �/A Authorized in the Budget? YES NO I Brief Explanation of Document: Amendment to EMPG (Emergency Management Performance Grant) to include a change in expiration date and revised milestone and budget. The overall grant agreement amount remains unchanged. All Contracts Must Be pouted Through The Law Department > (This area to be.completed by t �iw U J,, / Received: Approval of Law Dept.: i Law Dept. Comments: Date Forwarded to Mayor: Shaded Areas"To 3Be Completed By Administration .Staff Received: Recommendations and Comments: Disposition J Date Returned: �:ICNiIFO mS\Documml Pfoces- B `4curl lol l.lay Sg ire eovx 1 L I