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2018-003 - Designation Of Applicant's Agent Resolution For Non-State Agencies - Cal OESRESOLUTION 2018 -OQ3 STATE 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 Town Council OF THE Town of Los Gatos (Governing Body) (Name of Applicant) THAT Town Manager OR (Title of Authorized Agent) Assistant Town Manager OR (Title of Authorized Agent) is hereby authorized to execute for and on behalf of the. Town of Los Gatos . 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 Town of T nc Gatoc , apublic 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 16th day of January 2018 Rob Rennie, Mayor (Name and Title of Governing Body Representative) Steve Leonardis, Vice Mayor (Name and Title of Governing Body Representative) CERTIFICATION I, Shelley Neis duly appointed and Clerk Administrator of (Name) (Title) Town of Los Gatos , do hereby certify that the above is a true and correct copy of a (Name of Applicant) Resolution passed and approved by the Town Council of the Town of Los Gatos (Governing Body) (Name of Applicant) on the 16th day of January 2018. \• _109_40J, lk Cal OES 130 (Rev.9 /13) Page 1 Clerk Administrator (Title) STATE OF CALIFORNIA GOVERNOR'S OFFICE OF EMERGENCY SERVICES Cal OES 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 Unified 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. 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 would sign the document as Secretary to the Board (not City Manager) to eliminate "Self Certification." Cal OES 130 (Rev.9 /13) Page 2 STATE OF CALIFORNIA GOVERNOR'S OFFICE OF EMERGENCY SERVICES Cal OES 89 Disaster No: 4301 & 4308 Cal OES ID No: 085 -44112 DUNS No: 966372955 PROJECT ASSURANCES FOR FEDERAL ASSISTANCE SUBRECIPIENT'S NAME: Town of Los Gatos (N.ofOr a . ti.) ADDRESS: 110 E. Main Street CITY: Los Gatos STATE: CA ZIP CODE: 95030 TELEPHONE: 408 - 354 -6832 FAX NUMBER: 408 - 399 -5786 AUTHORIZED AGENT: EMAIL ADDRESS: ASSURANCES — CONSTRUCTION PROGRAMS Note: Certain of these assurances may not be applicable to all of your projects. If you have questions, please contact the California Governor's Office of Emergency Services. Further, certain federal assistance 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 subrecipient named above: 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 Unites States, Federal Office of Inspector General 2 CFR 200.336, 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 assistance; 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 nondiscrimination during the useful life of the project. 4. Will comply with 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 specifications 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 personal gains. 8. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §§ 4801 et seq.), which prohibits the use of lead based pain in construction or rehabilitation of residence structures. Cal OES 89 (Rev.02 117) (Page 1 of 3) 9. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1%4 (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.0 §§ 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 prohibit discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §§ 6101- 6107) which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 93- 255) as amended, relating to nondiscrimination on the basis of drug abuse; (t) 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) §§ 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 alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. § 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) which may apply to the application. 10. Will comply, or has already complied, with the requirements of Titles 11 and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91 -646) which provides 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. 11. Will comply with the 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 $5,000 or more. 12. 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.O 91 -190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to ED 11738; (c) protection of wetlands pursuant to ED 11990; (d) evaluation of flood hazards in floodplains in accordance with ED 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. §§ 1451 et seq.); (t) 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. § 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.O. 93-205). 13. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§ 1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 14. 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), ED 11593 (identification and preservation of historic properties), and the Archeological and Historic Preservation Act of 1974 (16 U.S.C. 469a -1 et seq.). 15. Will comply with Standardized Emergency Management (SEMS) requirements as stated in the California Emergency Services Act, Government Code, Chapter 7 of Division 1 of Title 2, Section 8607.1(e) and CCR Title 19, Sections 2445, 2446, 2447, and 2448. 16. Subrecipients expending $750,000 or more in federal grant funds annually are required to secure an audit pursuant to OMB Uniform Guidance 2 CFR Part 200, Subpart F. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act of 1984 and the Single Audit Act Amendments of 1996. 17. Will disclose in writing any potential conflict of interest to the Federal awarding agency or pass - through entity in accordance with §200.112. 18. Will comply with all applicable requirements of all other federal laws, Executive Orders, regulations and policies governing this program. 19. Has requested through the State of California, federal financial assistance to be used to perform eligible work approved in the subrecipient application for federal assistance. Will, after the receipt of federal financial assistance, through the State of California, agree to the following: a. The state warrant covering federal financial assistance will be deposited in a special and separate account, and will be used to pay only eligible costs for projects described above; b. To return to the State of California such part of the funds so reimbursed pursuant to the above numbered application, which are excess to the approved actual expenditures as accepted by final audit of the federal or state government. c. In the event the approved amount of the above numbered project application is reduced, the reimbursement applicable to the amount of the reduction will be promptly refunded to the State of California. Cal DES 89 (Rev.02 /17) (Page 2 of 3) 20. The non - Federal entity for a Federal award must disclose, in a timely manner, in writing to the Federal awarding agency or pass - through entity all violations of Federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the Federal award §200.113. Failure to make required disclosures can result in any of the remedies described in §200.338 Remedies for noncompliance, including suspension or debarment. 21. Will not make any award or permit any award (subaward or contract) to any party which is debarred or suspended or is otherwise excluded from or ineligible for participation in Federal assistance programs under Executive Order 12549 and 12689, "Debarment and Suspension." "I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized by the above named subrecipient to enter into this agreement for and on behalf of the said subrecipiem, and by my signature do bind the subrecipient to the terms thereof." Arn Andrews PRINTED NAM SIGNATU OF AUTHORIZED CERTIFYING OFFICIAL Assistant Town Town Manager�1(X TITLE DATE Cal OES 89 (Rev.02 /17) (Page 3 of 3) STATE 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 Town Council OF THE Town of Los Gatos (Governing Body) (Name of Applicant) THAT Town Manager OR (Title ofAuthonred Agent) Assistant Town Manager OR fl ale of Authorized Agen1) is hereby authorized to execute for and on behalf of the Town of LOS Gatos , a public entity (Name of Applicant) established under the laws of the State of California, this application and to file it with the California Governors 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 ,'own of I nc Catnc , a Pohl is 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 Emereency 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 numbcgs) Passed and approved this 16th day of January , 2018 Rob Rennie, Mayor (Name and'fitle of Governing Body Representative) Steve Leonardis, Vice Mayor (Name and Title of Governing Body Representative) CERTIFICATION 1, Shelley Neis duty appointed and Clerk Administrator of (Name) (Title) Town of Los Gatos , do hereby certify that the above is a true and correct copy of a (Name ol'Applicam) Resolution passed and approved by the Town Council of the Town of Los Gatos (Governing Body) (Name ofApplicantl on the 16th day of JanuaU , 2018. �- ^a y\Oa D A(signaturcl Cal OES 130 (Rev.9/13) ('age 1 Clerk Administrator (Title)