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Reply
To: firehousebob
Date: 03/16/2006
Subject: Request for Funds, Re: award number EMW-2004-FG-16909
From: firegrants@dhs.gov
This email is confirmation that your payment request for grant number EMW-20Q4-FG-16909 in the amount of
29771 has been approved. Your payment was accepted by our financial system on 0311612006. Please expect
an electronic payment to be made to the bank account identified in your SF 1199A, Direct Deposit Form, within 3
to 5 business days.
Go Back
https:/ /portal.fema.gov/firegrant/jsp/mail/maiffiody .jsp?msgid=496929
3/21/2006
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From:
To:
Date:
Subject:
<firegrants@dhs.gov>
<cockellr@ashland.or.us>
9/9/2005 1 :43: 17 AM
Award Notification (Application Number: EMW-2004-FG-16909)
Congratulations!
Your grant application submitted under the Emergency Preparedness and Response Directorate's
(EP&R/FEMA of DHS) FY 04 Assistance to Firefighters Grant Program has been approved for award.
Please go to https://portal.fema.gov. This will take you to the Assistance to Firefighters eGrants system.
Enter your User Name and Password as requested on the login screen (on the left). Your User Name and
Password are the same as those used to complete the application on-line. Once you are in the system,
the Status page will be the first screen you see. On the right side of the Status screen, you will see a
column entitled Action. In this column, you will see a link that says View Award Package. Click this link.
This link will take you to your award package. Please print your award package for your records.
While you are in the system, you will see a link that says Update 1199A in the Action column. Click this
link. This link will take you to the SF-1199A, Direct Deposit Sign-up Form. Please complete the SF-1199A
on-line if you have not already done so. Submit the form electronically. If you have not already mailed a
copy of your SF 1199A to FEMA, print the form (using the Print 1199A button),write your grant number on
the form, and take it to your bank to have the bottom portion completed and mailed to the following
address:
Department of Homeland Security
Emergency Preparedness and Response Directorate (EP&R/FEMA of DHS)
Attn: Assistance to Firefighters Grant
Grants Management Branch
Room 350
500 C Street, SW, Room 350
Washington, DC 20472
Due to delays in delivery of regular USPS mail to government offices, we suggest that you use USPS
priority mail or a commercial overnight delivery service to decrease the amount of time that elapses
between our request for information and your response. Please allow three weeks for the processing of
your SF 1199A. You will receive an email when your form has been approved. If you have any questions
regarding your SF-1199A, please call 1-866-274-0960 or 1-877-510-6762.
.
.
Panel Review
Page 4 of8
Agreement Articles
U.S. Department of Homeland Security
Washington, D.C. 20531
AGREEMENT ARTICLES
ASSISTANCE TO FIREFIGHTERS GRANT PROGRAM - Operations and Firefighter Safety program
GRANTEE: Ashland Fire & Rescue
PROGRAM: Operations and Firefighter Safety
AMENDMENT NUMBER:
AGREEMENT NUMBER: EMW-2004-FG-16909
Article I
Article II
Article III
Article IV
Article V
Article VI
Article VII
Article VIII
Article IX
Article X
Article XI
Article XII
Article I - Project Description
TABLE OF CONTENTS
Project Description
Grantee Concurrence
Period of Performance
Amount Awarded
Requests for Advances or Reimbursements
Budget Changes
Financial Reporting
Performance Reports
DHS Officials
Other Terms and Conditions
General Provisions
Audit Requirements
The grantee shall perform the work described in the approved grant application's Program Narrative. That
narrative is made a part of these grant agreement articles by reference. The purpose of the Assistance to
Firefighters Program is to protect the health and safety of the public and firefighting personnel against fire and
fire-related hazards. After careful consideration, DHS has determined that the grantee's project, as detailed in
submitted project narrative and budget information, submitted as part of the grantee's application (and
considered part of this agreement by reference), was consistent with the program's purpose and worthy of
award. As such, any material deviation from the approved program narrative must have prior written approval.
.
Article II - Grantee Concurrence
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By requesting and receiving Federal grant funds provided by this grant program, the grantee accepts and agrees
to abide by the terms and conditions of the grant as set forth in this document and the documents identified
below. All documents submitted as part of the application are made a part of this agreement by reference.
Article III - Period of Performance
The period of performance shall be from 02-SEP-05 to 01-SEP-06.
The grant funds are available to the grantee for obligation only during the period of performance of the grant
award. The grantee is not authorized to incur new obligations after the expiration date unless the grantee has
requested, and DHS has approved, a new expiration date. The grantee has 90 days after period of performance
to incur costs associated with closeout or to pay for obligations incurred during period of performance. Award
expenditures are for the purposes detailed in the approved grant application only. The grantee cannot transfer
funds or assets purchased with grant funds to other agencies or departments without prior written approval from
DHS.
Article IV - Amount Awarded
The amount of the award is detailed on the Obligating Document for Award attached to these articles. Following
are the budgeted estimates for object classes for this grant (including Federal share plus grantee match):
Personnel $0.00
Fringe Benefits $0.00
Travel $0.00
Equipment $33,078.00
Supplies $0.00
Contractual $0.00
Construction $0.00
Other $0.00
Indirect Charges $0.00
Total $33,078.00
Article V - Requests for Advances or Reimbursements
Grant payments under the Assistance to Firefighters Grant Program are made on an advance or reimbursable
basis for immediate cash needs. When the grantee needs grant funds and has obtained a user account, the
grantee fills out the on-line Request for Advance or Reimbursement. If the grantee has not obtained a user
account, an account may be obtained by calling the help desk at 1-866-274-0960.
Article VI - Budget Changes
Generally, changes in the budget-line items are permitted, as long as the original program narrative is
accomplished. The only exception to this provision is for grants where the Federal share is in excess of
$100,000.00. In grants where the Federal share exceeds $100,000.00, the budgeted line items can be changed,
but if the cumulative changes exceed ten (10) percent of the total budget, Changes must be pre-approved.
Article VII - Financial Reporting
.
The Request for Advance or Reimbursement mentioned above, will also be used for interim financial reporting
purposes. At the end of the performance period, or upon completion of the grantee's program narrative, the
grantee must complete, on-line, a final financial report that is required to close out the grant. The Financial
Status Report, is due within 90 days after the end of the performance period.
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Article VIII - Performance Reports
The grantee must submit a semi-annual and a final performance report to DHS. The final performance report
should provide a short narrative on what the grantee accomplished with the grant funds and any benefits derived
there from. The semi-annual report is due six months after the award date.
Article IX - DHS Officials
Program Officer: Tom Harrington, Deputy Chief of the Grants Program Office, is the Program Officer for this
grant program. The Program Officer is responsible for the technical monitoring of the stages of work and
technical performance of the activities described in the approved grant application.
Grants Assistance Officer: Christine Torres, is the Assistance Officer for this grant program. The Assistance
Officer is the Federal official responsible for negotiating, administering, and executing all grant business matters.
Grants Management Branch POC: Jacqueline Lee is the point of contact for this grant award and shall be
contacted for all financial and administrative grant business matters. If you have any questions regarding your
grant please call 202-646-4296.
Article X - Other Terms and Conditions
Pre-award costs directly applicable to the awarded grant are allowable if approved in writing by the DHS
Program Office.
Article XI - General Provisions
The following are hereby incorporated into this agreement by reference:
44 CFR, Emergency Management and Assistance
Part 7
Nondiscrimination in Federally-Assisted Programs
Uniform administrative requirements for grants and cooperative
agreements to state and local governments
Government-wide Debarment and Suspension (Non-procurement)
and Government-wide Requirements for Drug-free Workplace
(Grants)
New Restrictions on Lobbying
Part 13
Part 17
. Part 18
31 CFR 205.6 Funding Techniques
OMS Circular A-21 Cost Principles for Educational Institutions
OMS Circu,lar A-87 Cost Principles for State/local Governments, Indian tribes
OMS Circular A-122 Cost Principles for Non-Profit Organizations
OMS Circular A-
102
.
OMS Circular A-
110
Uniform Administrative Requirements for Grants and Agreements With State and Local
Governments Assistance to Firefighters Grant Application and Assurances contained therein.
Uniform Administrative Requirements for Grants and Agreements With Institutions of Higher
Education, Hospitals, and Other NonProfit Organizations Assistance to Firefighters Grant
Application and Assurances contained therein.
Article XII- Audit Requirements
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All grantees must follow the auditrequirements of OMS Circular A-133, Audits of States, Local Governments,
and Non-Profit Organizations. The main requirement of this OMS Circular is that grantees that expend
$500,000.00 or more in Federal funds (from all Federal sources) must have a single audit performed in
accordance with the circular.
As a condition of receiving funding under this grant program, you must agree to maintain grant files and
supporting documentation for three years upon the official closeout of your grant. You must also agree to make
your grant files, books, and records.available for an audit by DHS, the General Accounting Office (GAO), or their
duly authorized representatives to assess the accomplishments of the grant program or to ensure compliance
with any requirement of the grant program.
Additional Requirements if applicable
.
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Panel Review
1 a. AGREEMENT NO.
EMW-2004-FG-16909
6. RECIPIENT NAME AND
ADDRESS
Ashland Fire & Rescue
455 Siskiyou Blvd
Ashland
Oregon, 97520-1850
9. NAME OF RECIPIENT
PROJECT OFFICER
Robert Cocke"
11. EFFECTIVE DATE OF
THIS ACTION
02-SEP-05
Page 8 of8
FEDERAL EMERGENCY MANAGEMENT AGENCY
OBLIGATING DOCUMENT FOR AWARD/AMENDMENT
2. AMENDMENT 3. RECIPIENT NO. 4. TYPE OF 5. CONTROL NO.
NO. 93-6002117 ACTION W395176N
o AWARD
7. ISSUING OFFICE AND ADDRESS 8. PAYMENT OFFICE AND ADDRESS
ODP/Financial and Grants Management ODP/Financial Services Branch
Division 500 C Street, S.w., Room 723
500 C Street, S.w., Room 350 Washington DC, 20472
Washington DC, 20472
POC: Jacqueline Lee 202-646-4296
PHONE NO. 10. NAME OF PROJECT COORDINATOR PHONE NO.
541-482-2770 Tom Harrington 1-866-274-0960
12. METHOD OF
PAYMENT
SF-270
13. ASSISTANCE ARRANGEMENT
Cost Sharing
14. PERFORMANCE PERIOD
6~om:02-SEP- To:01-SEP-06
Budget Period
6~om:01-0CT- To:30-SEP-05
15. DESCRIPTION OF ACTION
a. (Indicate funding data for awards or financial changes)
PROGRAM NAME CFDA NO. ACCOUNTING DATA PRIOR AMOUNT CURRENT CUMMULATIVE
ACRONYM (AACS CODE) TOTAL AWARDED THIS TOTAL AWARD NON-
XXXX-XXX-XXXXXX-XXXXX- AWARD ACTION FEDERAL
XXXX-XXXX-X +OR(-) COMMITMENT
AFG 97.044 2005-62-0364RE-63000000- $0.00 $29,771.00 $29,771.00 $3,307.00
4101-R
TOTALS $0.00 $29,771.00 $29,771.00 $3,307.00
b. To describe changes other than funding data or financial changes, attach schedule and check here.
N/A
16 a. FOR NON-DISASTER PROGRAMS: RECIPIENT IS REQUIRED TO SIGN AND RETURN THREE (3) COPIES OF THIS DOCUMENT
TO FEMA (See Block 7 for address)
Assistance to Firefighters Grant recipients are not required to sign and return copies of this document. However, recipients should print and
keep a copy of this document for their records.
16b. FOR DISASTER PROGRAMS: RECIPIENT IS NOT REQUIRED TO SIGN
This assistance is subject to terms and conditions attached to this award notice or by incorporated reference in program legislation cited
above.
17. RECIPIENT SIGNATORY OFFICIAL (Name and Title)
N/A
18. FEMA SIGNATORY OFFICIAL (Name and Title)
Christine Torres
[ .Go ,BaEK.. J
....,,,,,,,... .... ...n,.
.
DATE
N/A
DATE
29-AUG-05
.. https://portal.fema.gov/firegrant/jsp/fire_adminl awards/spec/view _award -package. do ?agree... 9/9/2005
Application Number: EMW-2004-FG-16909
Page 1 of 22
Entire Application
Overview
Are you a member, or are you currently involved in the management, of the fire department Yes
applying for this grant?
If you answered No, please complete the information below and click on the Save and Continue button. If you
answered Yes, please do not complete the information requested below and click on the Save and Continue
button.
Note: If you answered No to the above question, the fields marked with an * are required.
Preparer Information
* Organization Name
* Address 1
Address 2
* City
* State
. Zip
. Is there a grant-writing fee associated with the
preparation of this request?
If you answered yes above, what is the fee?
No
$
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Application Number: EMW -2004-FG-16909
Contact Information
* Title
Prefix
* First Name
Middle Initial
* Last Name
* Business Phone
*Home Phone
Mobile Phone/Pager
Fax
*Email
. Title
Prefix
. First Name
Middle Initial
. Last Name
* Business Phone
'Home Phone
Mobile Phone/Pager
Fax
'Email
Page 2 of 22
Alternate Contact Information Number 1
Chief
Mr.
Keith
E
Woodley
541-482-2770 Ext.
541-482-2770 Ext.
541-488-5318
woodleyk@ashland.or.us
Alternate Contact Information Number 2
Asst Chief
Mr.
david
Hard
541-482-2770 Ext.
541-482-2770 Ext.
541-488-5318
hardd@ashland.or.us
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Application Number: EMW -2004-FG-16909
Applicant Information
Page 3 of 22
EMW-2004-FG-16909
Originally submitted on 04/0212004 by Robert Cockell (Userid: firehousebob)
Based on information you have provided, your department serves a Suburban community.
Contact Information:
Address: 455 Siskiyou Blvd.
City: Ashland
State: Oregon
Zip: 97520
Day Phone: 541-482-2770
Evening Phone: 541-301-4573
Cell Phone: 541-301-4573
Email: cockellr@ashland.or.us
Application number is EMW-2004-FG-16909
* Applicant Name
. Type of Applicant
If other, please enter the type of Applicant
* ElJljJlmI Iden1ificatioD_ NUJl1bel
* Does your organization have a PUNS Number?
If yes, please enter the D~~S NlJlJlber
Headquarters Physical Address
. Physical Address 1
Physical Address 2
. City
. State
. Zip
Mailing Address
. Mailing Address 1
Mailing Address 2
. City
. State
. Zip
Account Information
. Type of bank account
. Bank routing number - ~ digit number on the bottom
left hand corner of your check
'Your account number
Additional Information
, For this fiscal year (Federal) is your jurisdiction
Ashland Fire & Rescue
City
93-6002117
Yes
076395508
455 Siskiyou Blvd
Ashland
Oregon
97520 - 1850
Need help for ZIP+4?
455 Siskiyou Blvd
Ashland
Oregon
97520 - 1850
Need help for ZIP+4?
Checking
123000220
153602541069
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Application Number: EMW -2004-FG-16909
Page 4 of 22
receiving Federal funding from any other grant
program that may duplicate the purpose and/or scope No
of this grant request?
* If awarded this grant, will your jurisdiction expend
greater than $300,000 in Federal share funds during
the Federal fiscal year in which the grant was
awarded?
No
* Is the applicant gellllQ1L~ntQD_cmy~!;t~-.r.c!IJ:tel>t? No
If you answered yes to any of the additional questions
above, please provide an explanation in the space
provided below:
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* What percentage of your response area is protected 90 %
by hydrants?
* Does your department protect critical infrastructure of Yes
the State?
* How much of your jurisdiction's land use is for
agriculture, wild land, open space, or undeveloped
properties?
* What percentage of your jurisdiction's land use is for
commercial, industrial, or institutional purposes?
* What percentage of your jurisdiction's land is used
for residential purposes?
* How many active firefighters does the department
have who perform firefighting duties?
* How many personnel provide only EMS service
delivery?
* How many stations are in your department?
* Do you currently report to the National Fire Incident Yes
Reporting System (NFIRS)?
If you answered yes above, please enter your
EDI~lFDID
* What services does your department provide?
Structural Fire Suppression Medical First Response
Wildland Fire Suppression Basic Life Support
Airport Rescue Firefighting (ARFF) Advanced Life Support
Application Number: EMW -2004-FG-16909
Department Characteristics (Part I)
* Are you a member of a fjl];! Department'or
authorized representative of a fire department?
* Are you a member of Federal Fire Department or
contracted by the Federal government and solely
responsible for suppression of fires on Federal
property?
* What kind of Department do you represent?
If you answered combination, above, what is the
percentage of career firefighters in your department?
* What is the square mileage of your primary response 11
area?
* How many commercial, industrial, residential, or
institutional structures in your jurisdiction are more
than four stories tall?
* What is the permanent resident population of your
Primary/First Due Response Area or iurisdiction
?erv~d?
Page 5 of 22
Yes
No
All Paid/Career
%
12 %
32%
56%
114
21000
27
o
2
0012
Hazmat Operational Level
Hazmat Technical Level
Rescue Operational Level
Rescue Technical Level
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Application Number: EMW -2004-FG-16909
Department Characteristics (Part II)
* What is the total number of fire-related civilian fatalities in your
jurisdiction over the last three years?
* What is the total number of fire-related civilian injuries in your
jurisdiction over the last three years?
* What is the total number of fire-related firefighter fatalities in your 0
jurisdiction over the last three years?
* What is the total number of fire-related firefighter injuries in your
jurisdiction over the last three years?
* In an average year, how many times does your department
receive mutual/automatic aid?
* In an average year, how many times does your department
provide mutual/automatic aid?
* What was your department's estimated average annual operating
budget over the last three years?
* What percentage of your annual operating budget is dedicated to
personnel costs (salary, overtime and fringe benefits)?
* What percentage of your annual operating budget is derived from:
Enter numbers only, percentages must sum up to 100%
Taxes?
Grants?
Donations?
Fund drives?
Page 6 of22
1
3
2
20
50
3500000
82%
100%
0%
0%
0%
Other? 0 %
If you entered a value into Other field (other than 0), please explain
*How many vehicles does your department have in each of the categories below? Enter numbers only and enter
o if you do not have any of the vehicles below
a. Engines (or pumpers):
Pumper, PumperlTanker, Rescue/Pumper, Foam Pumper, CAFS Pumper, Quint 4
(Aerial device of less than 76 feet), Fire Boats (more than 13 feet long), Type I,
Type II, Type III Engine
b. Aerial Apparatus:
Aerial Ladder Truck, Telescoping, Articulating, Ladder Towers, Platform, Tiller 0
Ladder Truck, Quint (Aerial device of 76 feet or greater)
C. Tankers:
Tanker, Tender, Tanker/Pumper (Pumper with a tank that has a greater than 1,200 0
gallon capacity), Foam TankerlTender (greater than 1,200 gallon tank capacity)
d. Rescue Vehicles:
Rescue Squad, Rescue (Light, Medium, Heavy), Technical Rescue Vehicle
e. Brush/Quick attack:
Brush Truck, Patrol Unit (Pick up w/ Skid Unit), Quick Attack Unit, Mini-Pumper,
Type IV Engine
f. Other:
EMS Transport Unit, EMS Chase Vehicle, Air/Light Unit, Rehab Units, Hazardous
Materials Unit, Bomb Unit, Technical Support (Command, Operational
Support/Supply), Hose Tender, Salvage Truck, ARFF (Aircraft Rescue Firefighting),
Command/Mobile Communications Vehicle, Other Vehicle
Total Number
o
3
6
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Application Number: EMW -2004-FG-16909
Page 7 of22
Provide in the space below the following information only if you are applying for a firefighting vehicle: List all your
vehicles by type (for example, engines/pumpers, brush, rescue, etc.). Then provide the year each was
manufactured. If the department has more than two of any type, provide the total number of vehicles in that
category and the years the oldest and the newest were manufactured.
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Application Number: EMW-2004-FG-16909
Page 8 of22
Department Call Volume
* How many responses per year by category? (Enter whole numbers only: If you have no calls for any of the categories, enter 0)
Structure Fires
Vehicle Fires
Vegetation Fires
EMS
Rescue
Hazardous ConditionlMaterials Calls
Service Calls
Good Intent Calls/False Alarms
Other Calls and Incidents
77
13
80
1906
o
51
182
412
201
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Application Number: EMW -2004-FG-16909
Page 9 of 22
Request Information
. 1. Select a program for which you are applying. Remember. you can only apply for one program this year. You
can apply for as many activities within a program as you need.
\ifjlJU rnodifv your se-!ectiori, yuU '//i11 lost: dut~l <Silt21'2d Unddl" Uk uri~-dili~d ;:icrivity,i
Program Name
Operations and Firefighter Safety
. 2. Will this grant benefit more than one department?
Yes
If you answered Yes to Question 2 above. please explain. (You can only enter 4000 characters)
Yes. This grant will benefit more than one department.
Our department, Ashland Fire & Rescue, is located is Southern Oregon. Southern Oregon is geographically
isolated, located 300 miles in either direction to the closest metropoltan area; PorUand, OR to the north and
Sacramento, CA to the south.
We have mutual and automatic response agreements with 20+ small and medium size departments. Also, State
and Federal agencies. These departments serve a total of 260,000 citizens in two counties, spread over 4425
square miles. There are three large urban centers, and many hundreds of square miles of industrial/commercial,
suburban and rural occupancies. We rely not only on inter-department response, but also shared training and
overhead team support to provide for interoperability of equipment and t~nology with other fire departments
and local, state and Federal first responders.
We are requesting funding for RIT packs and firefighter corrmunications equipment. We are using the standards
from our auto/mutual aid departments to spec and build these packs. This wiD provide consistency and
interoperability for our regions 5 largest departments. Afl equipment wiD be inter-changeable with the
departments we respond with. We are also training to agreed upon standards and requirements with these
agencies. The voice ampification equipment wiD assure our fire ground and firefighter-to-firefighter
communications ts unmuffted and heard loud and clear by al jurisdictions involved in incident operations.
The award of this grant and subsequent addition of this equipment would allow us to support the mission of
Ashland fire & Rescue but also, the many other departments we currently respond with. The benefit of receiving
these funds would be widely felt in Southern Oregon and directly selVe some 20+ fire departmen1s and
hundreds of firefighters.
Request Details
The activities for program Operations and Firefighter Safety are listed in the table below.
Activity
Number of Entries
3
o
o
o
o
Total Cost
$ 33,078
$0
$0
$0
$0
Additional Funding
$0
$0
$0
$0
$0
Equipment
Modify Facilities
Personal Protective Equipment
Training
Wellness and Fitness Programs
Equipment
Equipment Details
1. What equipment will your department purchase with this grant? RIT Pack
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Application Number: EMW -2004-FG-16909
Page 10 of 22
Please provide further description of the item selected above or if
you selected Other above, please specify.
2. Number of units
'3. Cost per unit
'4. Generally the equipment purchased under this grant program:
Is necessary for basic firefighting capabilities, but has never been owned by this deparbnent
If you selected "replacing equipmenr (from 04) above, please
specify the age of equipment in years.
;'5. Generally the equipment purchased under this grant program:
Will bring the deparbnent into statutory compliance. Please explain
how this equipment will bring the department into statutory
compliance in the space provided to the right.
All inclusive-Spare air, search, tools,
rescue.
4 (whole number only)
$ 3807 (whole dollar amounts only)
Select Age
2. Both Federal (OSHA) and State
(Oregon) rules mandate that not only will
firefighters be trained to rescue their own
but, will also be appropriately equipped
for the task.
OSHA 29 CFR 1910.134
Oregon Administrative Rules for
Firefighters 437-002-0182
5(C)(d) Procedures for Interior Structural
FIre Fighting ("two-inl two-out rule")
adopted in Oregon July 7, 1998.
*6. Does this equIpment provide a health and safety benefit to the Yes
firefighters In your deparbnent? If yes, please fully explain in the
narrative section.
Close Window
Equipment
Equipment Details
* 1. What equipment will your department purchase with this grant?
Please provide further description of the item selected above or if
you selected Other above, please specify.
Other Communications (explain)
SCOTT "Talk-Around" voice
amplifier with radio interface. Enables
radio communications while wearing
SCBA.
*2. Number of units
*3. Cost per unit
k 4. Generally the equipment purchased under this grant program:
Is necessary for basic firefighting capabilities, but has never been owned by this deparbnent
If you selected "replacing equipment" (from 04) above, please
specify the age of equipment in years.
6 (whole number only)
$ 1400 (whole dollar amounts only)
Select Age
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Application Number: EMW -2004-FG-16909
'5. Generally the equipment purchased under this grant program:
Will bring the department into statutory compliance. Please explain
how this equipment wilt bring the department into statutory
compliance in the space provided to the right.
Page 11 of 22
Federal and State(Oregon) agencies
mandate appropriate means of
communication between employee(s)
inside an IDlH and outside.
OSHA 29 CFR 1910.134
(g)(3)(ii)
Visual, voice, or signal line
communication is maintained between
the employee(s) in the IDLH atmosphere
and the employee(s) located outside the
IDLH atmosphere;
Oregon Administrative Rules for
Arefighters 437-002-0182
5(C)(d) Procedures for Interior Structural
Fire Fighting ("lwo-inltwo-out rule")
adopted in Oregon 1998.
*6. Does this equipment provide a health and safety benefit to the Yes
firefighters in your department? If yes, please fully explain in the
narrative section.
Close Window
Equipment
Equipment Details
* 1. What equipment will your department purchase with this grant?
Please provide further description of the item selected above or if
you selected Other above, please specify.
*2. Number of units
*3. Cost per unit
*4. Generally the equipment purchased under this grant program:
Is necessary for basic firefighting capabilities, but has never been owned by. this department
If you selected "replacing equipment" (from Q4) above, please
specify the age of equipment in years.
*5. Generally the equipment purchased under this grant program:
M bring the department into statutory compliance. Please explain
how this equipment wilt bring the department into statutory
compliance in the space provided to the right.
Other Communications (explain)
Voice ampliphers for scba. Enables clear
communications while wearing SCBA.
27 (whole number only)
$ 350 (whole dollar amounts only)
Select Age
Federal and state (Oregon) agencies
mandate appropriate means of
communication between employee(s)
inside an IDLH and outside.
OSHA 29 CFR 1910.134
(g)(3)(ii)
Visual, voice, or signal line
communication is maintained between
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Page 12 of 22
the employee(s) in the IDLH atmosphere
and the employee(s) located outside the
IDLH atmosphere;
Oregon Administrative Rules for
Firefighters 437 ~002-0182
5(C)(d) Procedures for Interior Structural
Fire Fighting ("two-in/lwo-out rule")
adopted in Otegon 1998.
'6. Does this equipment provide a health and safety benefit to the Yes
firefighters in your department? If yes, please fully explain in the
narrative section.
Close Window
Budget
Suct9-~lQ_bjgQt CI<:i$$
a. Personnel
b. Fringe Benefits
$0
$0
$0
$ 33,078
$0
$0
$0
$0
$0
c. Travel
d. Equipment
e. Supplies
f. Contractual
g. Construction
h. Other
i. Indirect Charges
Indirect Cost Details
Agency Indirect Cost Agreement with
l1l9iH:~gLCosJ Ral~
Agreement Summary
Federal and AppHcant Share
Federal Share
Applicant Share
Federal Rate Sharing (%)
%
$ 29,771
$ 3,307
90/1 0
tiOfl::E~(teLgJRe~ltrg_~~ (The combined t\Jon-/=ederal Resources mllst equal the Applicant S:hare of $ 3.307)
a. Applicant
b. State
c. Local
$ 3,307
$0
$0
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Page 13 of 22
d. Other Sources $ 0
If you entered a value in Other Sources, include your explanation below. You can use this space to provide
information on the project, cost share match.
Total Budget
$ 33,078
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Page 14 of 22
Narrative Statement
Project Description
C Please provide your narrative statement in the space provided below (1) Project Description, (2) Financial .
Need, and (3) Cost-Benefit of Request:
PROJECT DESCRIPTION
Where the lives of firefighters are concerned, a functional RIT (Rapid Intervention Team) is the single most
important resource a fire department has to call on.
Ashland Fire & Rescue is requesting the funding of (4) "RIT packs" and SCBA communications amplifiers to
allow our Firefighters the best chance possible of surviving the unimaginable. Each of our 4 apparatus we own
will carry one of these new packs, allowing for the appropriate equipment to be on scene, regardless of which
vehicle was dispatched.
These "RIT packs" consist of spare air and mask with voice amplification, buddy breathing capabilties, a "RIT
Tarp", rescue harness, search rope and packs, hand Ights, and the necessary forcible entry tools to rescue a
falfen firefighter. We are using the standardS from our auto/mutual aid departments to spec and build these
packs. nus wiD provide consistency and interoperabifrty with our regions 5 largest departments. All equipment
will be inter-changeable with these departments.
As per NFPA, each firefighter has been issued their own SCBA mask. As stated in our budget, we are
requesting each mask be itted with voice ampfification capabilities. These Scott Voice Amplifiers will allow
direct, clear, voice communications regardless of the firefighter's position; in or out of the IDLH atmosphere.
Each of our 3 Captains and 3 "acting Captains" will have a Scott "talk-About" radio interface with this voice amp
system, alfowing the immediate, concise, sending and receiving of commands to all effected personnel.
This basic equipment will ensure the response we provide to a downed firefighter is timely, adequate and worthy
of the task at had.
FINANCIAL NEED
Oregon, as with mudl of the nation, has been hit hard by our recent recession. Otegon leads the nation in
unemployment. Our current state budget has an expected short faB of nearly 1 billon dollars. Education funding,
along with public safety has been slashed during this past year. Our state ranks first In the nation for Income
taxes as a percent of personal income. Coupled with voter approved property tax Imitations (limited to no more
than 3% per year) and no sales tax in Oregon. our revenue sources are over burdened and it is nearly
impossible to squeeze more monies from citizens that either just don't have it or refuse to give more than their
fair share. This trend is effecting all aspects of our wes... we have seen the closure of two of our 5 elementary
schoots and expect more before September. It is hard to expfafn to our constitutes that we need more funding
for equipment. when their children are being over crowded and under educated.
As a smaller community, Ashland has fel the impact of our states economic crisis. Our fiscal year begins July 1
and it appears now as though Ashland Fire & Rescue will see fewer funds this year than last. Tobacco
subventions have falen in the recent years; these important funds equal 1.75 firefighters. 'Nth increased call
volume and tower staffing than should be tn place, we have to settle with providing an increased level of service
with 8 static level of personnel.
COST -BENEFIT OF REQUEST
Our hope is to provide basic ireighting equipment. The end to which is for the rescue of not only the men and
women of Ashland Fire & Rescue, but also the many wes of the members of the departments we respond with.
Our isolated region demands that inter-agency reiance is paramount. Because of this, the award of this grant
and subsequent addition of this equipment would alfow us to not only support our mission, but also the many
other departments we currently respond with. The benefit of receiving these funds would be widely felt in
Southern Oregon and directly serve the majority of the areas firefighting resources. .
We are training to agreed upon standards and requirements with these agencies; our commitment to this is
steadfast and strong. These greatly needed funds will assure our success.
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OUR ORGANIZATION
The city of Ashland is geographically isolated. The only city larger than us is 20 miles away: Medford Oregon,
population 50,000. Urban sprawl is 200 miles to the north and 300 miles south of us in Caifomia. Our
permanent population is just over 20,000, but we have a transient POPulation of more than 300,000. This rise is
due largely in part to Southern Oregon Shakespeare Festival, which, is in its 80th season. Visitors come from
around the world to attend performances in one of the Festival's five large theater complexes. This lasts March
to October. Additionally, Ashland is home to Southern Oregon University. This brings 5500 students to our
community 9 months out of the year. 1200 of which, reside in the schools 10, 5-story dormitories. Growth in the
past 10 years has been predOminately comprised of retirement age population. The new demographics of our
city have created 13 large retirement and nursing home/care facilities. 12 of which, are multi story.
Ashland Fire & Rescue staffs two engines and two ambulances daily. One of each responds from our two
stations. We currently have a minimum staffing of 1 firefighters on duty per shifl:. We not only cover our city with
this staff, but our.firefighter/paramedics provide ALS ambulance transport to more than 650 square miles of
surrounding cities and county area. Also, we provide unlimited mutual and automatic aid to other municipalities,
county, state and federal agencies. We are also part of regional and state, all hazard mobilization strike teams
and task forces.
The make-up of our community and very Iinited staffing levels leave the citizens and firefighters of Ashland far
more vulnerable to fire incidents. The ability to save our own and trust the resources around us to do the same
has never been greater.
, Please describe any grants that you currently have with OHS including the AFG. for example, 2002 AFG grant
for vehicle or 2003 OOP grant for exercises. (Enter "N1A" if Not Applicable)
We currently have a 2003 Fire Prevention Grant for $45,000. This Grant was written by us to provide our Fire
Prevention Coop with a Fire Safety Trailer to educate our children and elderly.
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Page 16 of 22
Assurances and Certifications
Form 20-16A
You must read and sign these assurances by providing your password and checking the box at the
bottom of this page.
Note: Fields marked with an * are required.
Assurances Non-Construction Programs
Note: Certain of these assurances may not be applcable to your project or program. If you have any questions,
please contact the awarding agency. Further, certain Federal awarding agencies may require appfican1s 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 applicant:
1. Has the legal authority to apply for Federal assi.stance, and the institutional, managerial and
finandal capabitity (including funds sulfident to pay the non-Federal share of project costs) to
ensure proper planning, management and completion of the project described in this
applcation.
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
exanine all records, books, papers. or documen1s related to the award; and wiD establsh a
proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Wilt establsh safeguards to prohibit employees from using their positions for a purpose that
constitutes or presen1s the appearance of personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval
of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. Section 4728-4763)
relating to prescribed standards for merit systems for programs funded under one of the
nineteen statutes or regulations specified in Appendix A of OPM.s Standards for a Merit
System of Personnel Adninistration (5 C.F.R. 900, Subpart F).
6. Wilt comply with aD Federal statutes relating to nondiscrinination. These include but are not
limited to: (a) TrUe VI of the Civil Righ1s Act of 1964 (p.l. 88-352) which prohibi1s
discrimination on the basis of race. cotor or national origin; (b) Title IX of the Education
Amendments of 1972. as amended (20 U.S.C. Sections 1681-1683, and 1685-1686), which
prohibi1s discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973,
as amended (29 U.S.C. Section 794). which prohibi1s discrimination on the basis of
handicaps; (d)theAge OisaiIRnatiooAd of 1975, as amended (42 U.S.C. Sections 6101-
6107). which prohibits discrininafion on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (p.l. 92-255). as amended, relating to nondiscrimination on the basis
of drug abuse; (I) the Comprehensive Alcohol Abuse and Alcoholsm Prevention, Treatment
and Rehabiltation Ad. of 1910 (p.L. 91-616), as amended. relating to nondiscrimination on
the basis of ak:oItoI abuse or afcohoism; (g) Sections 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) TrUe VIII of the Civil Righ1s Acts
of 1968 (42 U.S.C. Section 3601 et seq.), as amended, relating to nondiscrimination in the
sale, rentat or finandng of housing; (i) any other nondiscrimination provisions in the spedfic
statute(s) under which application for Federal assistance is being made; and (j) the
requiremen1s of any other nondiscrinination statute(s) which may apply to the applcation.
7. Will compty. or has already complied, with the requirements of Title /I and III of the Uniform
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Relocation Assistance and Real Property Acquisition PoUcies Act of 1970 (P.L. 91-646)
which provide for fair and equitable treatment of persons displaced or whose property is
acquired as a result of Federal or Federally assisted programs. These requirements apply to
all interest in real property acquired for project purposes regardless of Federal participation in
purchases.
8. Will comply with provisions of the Hatch Act (5 U.S.C. Sections 1501-1508 and 7324-7328),
which Umit the poUtical activities of employees whose principal employment activities are
funded in whole or in part with Federal funds.
9. Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. Sections
276a to 276a-7), the Copeland Ad (40 U.S.C. Section 276c and 18 U.S.C. Sections 874),
and the Contract Work Hours and Safety Standards Act (40 U.S.C. Sections 327-:333),
regarding labor standards for Federally assisted construction sub agreements.
10. Will comply, if applicable, 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 partitipate in the program and to purchase flood insurance if the total
cost of insurable construction and acquisition is $10,000 or more.
11. WII 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) 11514; (b) notification of violating
facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d)
evaluation offload hazards in flood plains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the
Coastal Zone Management Ad of 1972 (16 U.S.C. Section 1451 et seq.); (f) 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. Section 7401 at 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.L. 93-205).
12. Will comply with the Wid and Scenic Rivers Act of 1968 (16 U.S.C. Sedion 1271 et seq.)
related to protecting components or potential components of the national wild and scenic
rivers system.
13. Will assist the awarding agency in assuring complance with Sedion 106 of the National
Historic Preservation Ad of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and
protection of historic properties), and the Archaeological and Historic Preservation Act of
1974 (16 U.S.C. 4693-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research,
development, and related activities supported by this award of assistance.
15. \Mil comply with the Laboratory Animal Welfare Act of 1966 (p.l. 89-544, as amended, 7
U.S.C. 2131 at seq.) pertaining to the care, handing, and treatment of warm blooded animals
held for research, teaching, or other activities supported by this award of assistance.
16. WII comply with the lead-Based Paint Poisoning Prevention Act (42 U.S.C. Section 4801 et
seq.) which prohibits the use of lead based paint in construction or rehabiUtation of residence
structures.
17. WI cause to be performed the required financial and compliance audits in accordance with
the Single Audit Act of 1984.
18. WII comply with all applicable requirements of all other Federal laws, executive orders,
regulations and policies governing this program.
19. It will comply with the minimum wage and maximum hours provisions of the Federal Fair
labor Standards Act (29 U.S.C. 201). as they apply to employees of institutions of higher
education, hospitals, and other non-profit organizations.
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Page 18 of22
Signed by Robert Cockel! on 03/17/2004
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Page 19 of 22
Form 20-16C
You must read and sign these assurances by providing your password and checking the box at the
bottom of this page.
Note: Fields marked with an " are required.
Certifications Regarding Lobbying, Debarment, Suspension and Other Responsibily Matters and Drug-Free
Workplace Requirements.
Applicants should refer to the regulations cited below to determine the certification to which they are required to
attest. Applicants should also review the instructions for certification included in the regulations before
completing this form. Signature on this form provides for compliance with certification requirements under 44
CFR Part 18, "New Restrictions on Lobbying; and 44 CFR Part 17, "Government-wide Debarment and
Suspension (Non-procurement) and Government-wide Requirements for Drug-Free Workplace (Grants)." The
certifications shall be treated as a material representation of fact upon which reliance will be placed when the
Department of Homeland Security (DHS) determines to award the covered transaction, grant, or cooperative
agreement.
1. Lobbying
A. As required by the section 1352. Title 31 ofthe US Code. and implemented at 44 CFR Part 18 for persons
(entering) into a grant or cooperative agreement over $100,000, as defined at 44CFR Part 18, the applicant
certifies that
(a) No Federat appropriated funds have been paid or will be paid by or on behalf of the
undersigned to any person for influencing or attempting to influence an officer or employee of any
agency. a Member of Congress, an officer or employee of congress. or an employee of a Member
of Congress in connection with the making of any Federal grant, the entering into of any
cooperative agreement and extension, continuation, renewal amendment or modification of any
Federal grant or cooperative agreement.
(b) If any other funds than Federal appropriated funds have been paid or win be paid to any person
for influencing or attempting to influence an officer or employee of any agency. a Member of
Congress, an ofker or empfoyee of congr8$S. or an employee of a Member of Congress in
connection with tIIis Federal gram or cooperative agreement. the undersigned shan complete and
submit Standard Form LLL. "Disclosure of Lobbying Activities". in accordance with its insbuctions.
(c) The undersigned shalf require that the language of this certification be included in the award
documents for aI the sub awardS at aI tiers (including sub grams, contracts under grants and
cooperative agreements and sub contract(s)) and that all sub recipien1s shall certify and disclose
accordingly.
2. Debarment. Suspension and other Responsibility Matters (Direct Recipient)
A. As required by Executive Order 12549, Debarment and Suspension, and implemented at 44CFR Part 67. for
prospective participants in primary covered transactions. as defined at 44 CFR Part 17, Section 17.51O-A. the
applicant certifies that it and its principals:
(a) Are not presently debarred. suspended. proposed for debarment, declared ineligible. sentenced
to a denial of Federal benefits by a State or Federal court, or voluntarily excluded from covered
transactions by any Federal department or agency.
(b) Have not within a three-year period preceding this applcation been convicted of or had a
civiHan judgment rendered against them for cormission of fraud or a criminal offense in
connection with obtaining, attempting to obtain or perform a public (Federal, State. or local)
transaction or contract under a pubIC transaction; violation of Federal or State antitrust statutes or
commission of embezzlement, theft. forgery, bribery. falsification or destruction of records, making
false statements. or receiving stolen property.
(c) Are not presently indicted for or otherwise criminally or civilly charged by a government entity
(Federal, State. or local) with commiSsion of any of the offenses enumerated in paragraph (1)(b) of
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Page 20 of 22
this certification: and
(d) have not within a three-year period preceding this application had one or more publiC
transactions (Federal, State, or local) terminated for cause or default; and
B. Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach an
explanation to this application.
3. Drug-Free Workplace (Grantees other than individuals)
As required by the Drug-Free Workplace Act of 1988, and implemented at 44CFR Part 17, Subpart F, for
grantees, as defined at 44 CFR part 17, Sections 17.615 and 17.620:
(A) The applicant certifies that it will continue to provide a drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture,
distribution, dispensing', possession, or use of a controlfed substance is prohibited in
the grantee's workplace and specifying the actions that will be taken against
employees for violation of such prohibition;
(b) Establishing an on-going drug free awareness program to inform employees
about:
(1) The dangers of drug abuse in the workplace;
(2) The grantees 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
vio~tions occurring in the workplace;
(c) Making it a requirement that each employee to be engaged in the performance of
the grant to 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 win:
(1) Abide by the tefms of the statement and
(2) NOtify the employee in writing of his or her conviction for a violation
of a aininal drug statute occurring in the workplace no later than five
calendar days after such conviction.
(e) Notifying the agency, in writing within 10 calendar days after receiving notice
under subpaJagraph (d)(2) tom an employee or otherwiSe receiving actual notice of
such conviction. Employers of convicted employees must provide notice, including
position title, to the applcable DHS awarding office. i.e. regional office or DHS oflice.
(I) Taking one of the following adions, against such an employee, within 30 calendar
days of receiving notice under subparagraph (d)(2), with respect to any employee
who is so convicted:
(1) Taking appropriate personnel action against such an employee, up
to and including temination, consistent with the requiremen1s of the
Rehabilitation Ad of 1913, as amended; or
(2) Requiring such employee to participate satisfadorily in a drug abuse
assistance or rehabilitation program approved for such purposes by a
Federal" State, or focal heafth, law enforcement or other appropriate
agency .
(g) Making a good faith effort to continue to maintain a drug free workplace through
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Page 21 of22
implementation of paragraphs (a), (b), (c), (d), (e), and (1).
(8) The grantee may insert in the space provided below the site(s) for the performance of work
done in connection with the specific grant:
Place of Performance
Street
City
State
Zip
Action
If your place of performance is different from the physical address provided by you in the Applicant
Infonnation, click on Add Place of Performance button above to ensure that the correct place of
peffonnanee has been specified. You can add multiple addresses by repeating this process multiple
times.
Section 17.630 of the regulations provide that a grantee that is a Slate may elect to make one certification in each
Federal fiscal year. A copy of which should be included with each appication for DHS funding. Slates and State
agencies may elect to use a Statewide certification.
Signed by Robert Cockell on 03/17/2004
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Page 22 of 22
FEMA Standard Form LLL
Only complete if applying for a grant for more than $100,000 and have lobbying activities. See Form 20-16C for
lobbying activities definition.
This form is not applicable
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