Attachment 1STATE OF CALIFORNIA
GOVERNOR’S OFFICE OF EMERGENCY SERVICES Cal OES ID No: ______________________
Cal OES 130
DESIGNATION OF APPLICANT'S AGENT RESOLUTION
FOR NON-STATE AGENCIES
BE IT RESOLVED BY THE OF THE
(Governing Body) (Name of Applicant)
THAT , OR
(Title of Authorized Agent)
, OR
(Title of Authorized Agent)
is hereby authorized to execute for and on behalf of the , a public entity
(Name of Applicant)
established under the laws of the State of California, this application and to file it with the California Governor’s Office of Emergency
Services for the purpose of obtaining certain federal financial assistance under Public Law 93-288 as amended by the Robert T. Stafford
Disaster Relief and Emergency Assistance Act of 1988, and/or state financial assistance under the California Disaster Assistance Act.
THAT the ________________________________________________, a public entity established under the laws of the State of California,
(Name of Applicant)
hereby authorizes its agent(s) to provide to the Governor’s Office of Emergency Services for all matters pertaining to such state disaster
assistance the assurances and agreements required.
Please check the appropriate box below :
This is a universal resolution and is effective for all open and future disasters up to three (3) years following the date of approval below.
This is a disaster specific resolution and is effective for only disaster number(s) ________________________
Passed and approved this day of , 20
(Name and Title of Governing Body Representative)
(Name and Title of Governing Body Representative)
CERTIFICATION
I, , duly appointed and of
(Na me) (Title)
, do hereby certify that the above is a true and correct copy of a
(Na me of Applicant)
Resolution passed and approved by the of the
(Governing Body) (Name of Applicant)
on the day of , 20 .
(Signature) (Title)
Cal OES 130 (Rev.9/13) Page 1
STATE OF CALIFORNIA
GOVERNOR’S OFFICE OF EMERGENCY SERVICES
Cal OES 130 - Instructions
Cal OES Form 130 Instructions
A Designation of Applicant’s Agent Resolution for Non-State Agencies is required of all Applicants to be eligible to
receive funding. A new resolution must be submitted if a previously submitted Resolution is older than three (3) years
from the last date of approval, is invalid or has not been submitted.
When completing the Cal OES Form 130, Applicants should fill in the blanks on page 1. The blanks are to be filled in as
follows:
Resolution Section:
Governing Body: This is the group responsible for appointing and approving the Authorized Agents.
Examples include: Board of Directors, City Council, Board of Supervisors, Board of Education, etc.
Name of Applicant: The public entity established under the laws of the State of California. Examples include: School
District, Office of Education, City, County or Non-profit agency that has applied for the grant, such as: City of San Diego,
Sacramento County, Burbank U nified School District, Napa County Office of Education , University Southern California .
Authorized Agent: These are the individuals that are authorized by the Governing Body to engage with the Federal Emergency
Management Agency and the Governor’s Office of Emergency Services regarding grants applied for by the Applicant. There are
two ways of completing this section:
1. Titles Only: If the Governing Body so chooses, the titles of the Authorized Agents would be entered here, not
their names. This allows the document to remain valid (for 3 years) if an Authorized Agent leaves the position
and is replaced by another individual in the same title . If “Titles Only” is the chosen method, this document
must be accompanied by a cover letter naming the Authorized Agents by name and title. This cover letter can
be completed by any authorized person within the agency and does not require the Governing Body’s signature.
2. Names and Titles: If the Governing Body so chooses, the names and titles of the Authorized Agents would be
listed. A new Cal OES Form 130 will be required if any of the Authorized Agents are replaced, leave the position
listed on the document or their title changes.
Governing Body Representative: These are the names and titles of the approving Board Members.
Examples include: Chairman of the Board, Director, Superintendent, etc. The names and titles cannot be one of the
designated Authorized Agents, and a minimum of two or more approving board members need to be listed.
Certification Section:
Name and Title: This is the individual that was in attendance and recorded the Resolution creation and approval.
Examples include: City Clerk, Secretary to the Board of Directors, County Clerk, etc. This person cannot be one of the
designated Authorized Agents or Approving Board Member (if a person holds two positions such as City Manager and
Secretary to the Board and the City Manager is to be listed as an Authorized Agent, then the same person holding the
Secretary position wou ld sign the document as Secretary to the Board (not City Manager) to eliminate “Self
Certification.”
Cal OES 130 (Rev.9/13) Page 2