Sample Application.pdf

BUDGET INFORMATION - Non-Construction Programs OMB Approval No. 0348-0044

SECTION A - BUDGET SUMMARY

Grant Program

Function Catalog of Federal

Domestic Assistance Estimated Unobligated Funds New or Revised Budget or Activity Number Federal Non-Federal Federal Non-Federal Total

(a) (b) (c) (d) (e) (f) (g)

1. $ $ $ $ $

2.

3.

4.

5. Totals $ $ $ $ $

SECTION B - BUDGET CATEGORIES

GRANT PROGRAM, FUNCTION OR ACTIVITY Total

(1) (2) (3) (4) (5)

a. Personnel $ $ $ $ $

b. Fringe Benefits

c. Travel

d. Equipment

e. Supplies

f. Contractual

g. Construction

h. Other

i. Total Direct Charges (sum of 6a-6h)

j. Indirect Charges

k. TOTALS (sum of 6i and 6j) $ $ $ $ $

7. Program Income $ $ $ $ $

Authorized for Local Reproduction Standard Form 424A (Rev. 7-97) Previous Edition Usable Prescribed by OMB Circular A-102

6. Object Class Categories

HMEP Grant 20.703 220,090.00 55,023.00 275,113.00

0.00

0.00

0.00

0.00 0.00 220,090.00 55,023.00 275,113.00

Federal Non-Federal

46,000.00 0.00 46,000.00

0.00 16,834.00 16,834.00

6,390.00 0.00 6,390.00

0.00 0.00 0.00

6,000.00 0.00 6,000.00

145,500.00 0.00 145,500.00

0.00 0.00 0.00

16,200.00 38,189.00 54,389.00

220,090.00 55,023.00 0.00 0.00 275,113.00

0.00 0.00 0.00

220,090.00 55,023.00 0.00 0.00 275,113.00

0.00

SECTION C - NON-FEDERAL RESOURCES

(a) Grant Program (b) Applicant (c) State (d) Other Sources (e) TOTALS

8. $ $ $ $

9.

10.

11.

12. TOTAL (sum of lines 8-11) $ $ $ $

SECTION D - FORECASTED CASH NEEDS

Total for 1st Year 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter

13. Federal $ $ $ $ $

14. Non-Federal

15. TOTAL (sum of lines 13 and 14) $ $ $ $ $

SECTION E - BUDGET ESTIMATES OF FEDERAL FUNDS NEEDED FOR BALANCE OF THE PROJECT

(a) Grant Program FUTURE FUNDING PERIODS (Years)

(b) First (c) Second (d) Third (e) Fourth

16. $ $ $ $

17.

18.

19.

20. TOTAL (sum of lines 16-19) $ $ $ $

SECTION F - OTHER BUDGET INFORMATION

21. Direct Charges: 22. Indirect Charges:

23. Remarks:

Authorized for Local Reproduction Standard Form 424A (Rev. 7-97) Page 2

HMEP 16,834.00 0.00 38,189.00 55,023.00

0.00

0.00

0.00

16,834.00 0.00 38,189.00 55,023.00

0.00

0.00

0.00 0.00 0.00 0.00 0.00

HMEP

0.00 0.00 0.00 0.00

220090 0.00

HAZARDOUS MATERIALS EMERGENCY

PREPAREDNESS (HMEP) GRANT PROGRAM

Calisota Sample Application

PART A: GRANTEE INFORMATION

1. GRANTEE NAME AND ADDRESS:

Grantee Name: Calisota Emergency Management Agency

Street Address:2222 Cali Drive

City: Cepda State: Calisota _ Zip Code 88888

Web Page (If applicable):

2. CONTACT INFORMATION:

a. Authorized Representative:

Name (Last) Jonas First: Michael Initial: K

Title: Director

Phone: 111-333-7777 Fax:111-333-6644 Email Address: Mjonas@cali.gov

b. Program Manager:

Name (Last) House First: Susan Initial: L

Title: Grants Coordinator

Phone: 111-333-9311 Fax:111-333-6644 Email Address: Shouse@cali.gov

c. Finance Program Manager or Equivalent:

Name (Last) Benjamin First: James Initial:

Title: Senior Accountant Phone: 111-333-5555

d. Other Point of Contact for Grant:

Name (Last) Lewis First: Cody Initial:

Title: Training Coordinator

Phone: 111-333-9811 Fax: Email Address: Clewis@cali.gov

e. Other Point of Contact for Grant:

Name (Last) First: Initial:

Title:

Phone: Fax: Email Address:

3. ORGANIZATION INFORMATION:

Provide information about your organization. This should include: (1) your organization’s mission;

(2) a brief overview of the structure of your organization, programs, leadership, and special expertise; and (3) your organization’s experience and capacity to manage Federal grant programs.

Mission The mission of Calisota Emergency Management Agency is to facilitate the protection of life and property against man‐made and natural disasters by directing the state's efforts in the areas of prevention, preparedness, mitigation, response, and recovery.

Organizational Structure State level planning for hazardous materials emergency preparedness is a collaborative process.

CEMA is the lead state agency for coordinating All‐Hazards planning and response. CEMA is responsible for the Calisota Emergency Operations Plan. Calisota employs a functional annex for

Hazardous Materials Response Emergency Support Function (ESF‐10), Hazardous Materials. With the assistance of the HMEP Grant, CEMA established the Hazardous Materials Program Office within the Training Section at the Calisota Training Center (CTC). Training is offered at a central location at CTC and is field delivered at locations throughout the state to accommodate training needs in different jurisdictions. Field delivered courses are hosted by local jurisdictions upon request. State preparedness is advanced through a robust hazardous materials training program in partnership with the Calisota Fire Academy. CEMA utilizes the HMEP Grant to provide high quality, effective guidance on hazardous materials emergency preparedness to local partners, as well as to increase emergency responder’s understanding of state and local chemical hazards. This is accomplished through the administration and coordination of Local Emergency Planning Committees (LEPC) throughout the state, managed by the HMEP/LEPC Coordinator.

PART B: TRANSPORTATION FEES

Are transportation fees assessed and collected by your state, political subdivision of your State, or Tribe? No

If yes, how much in transportation fees was collected in the last year?

N/A

What percentage of the fees collected is used solely for the purpose related to the transportation of hazardous materials?

N/A

PART C: STATEMENT OF WORK

Please note you will be required to provide information for each sub-grant, contract, or agreement (e.g., agreement with another part of the state government) issued or awarded, entered into, or signed during the reporting period and the process of selecting sub-grantees to receive the HMEP grant funding.

1. NEEDS ASSESSMENT. Include a brief statement that indicates the HMEP planning and training needs of the jurisdiction.

Each of the Local Emergency Response Committees (LEPCs) conducts a training need’s assessment of their region approximately three to six (3-6) months prior to the new grant cycle.

The data collected from their need’s assessment will determine which areas in their region are lacking specific skills sets, what courses and at what training levels are needed to increase training levels to better respond to hazardous materials transportation incidents. The data will be prioritized so that those lacking the ‘high’ priority skills sets will receive training during immediately. Once the capability gap has been identified, the LEPC submits a 3-yr ‘schedule’ of trainings to the State.

2. GOALS AND OBJECTIVES

Use the following table to list the programs goals and objectives for the HMEP grant funds requested. The programs goals must align with PHMSA’s mission and top priorities as outlined in the application guidance document provided in the application package. PHMSA will require a progress report during the performance period and at the end of the performance period detailing the programs accomplished goals and outcomes. (Insert more rows to the table if more space is needed)

Goal# Planning and Training Grant Goals and Objectives 1 The goal of the Training Program is to maximize the number of individuals trained to a level consistent with the demands of their positions as potential first responders.

Calisota Training Task Force (TTF) Sub-Committee of the SERC has developed training protocols to ensure courses provided are developed or certified by the National Fire Protection Association (NFPA) and OSHA. Course materials from the International Association of Fire Fighters (IAFF) have also been used for HMEP-sponsored training.

2 The purpose of the State’s HMEP Planning Program is to protect the population, infrastructure and environment by improving emergency planning and response for transportation related incidents involving hazardous materials. The HMEP Planning Grant funds enhance the LEPC planning process and emergency plan documents that each LEPC prepares.

3. ACTIVITIES SUPPORTING PROGRAM GOALS

List activities to be performed under each goal listed in Part C above. Activities must be allowable, allocable and reasonable. For planning activities, please include activities planned under section 303 of the Emergency Planning and Community Right-To-Know Act (EPCRA) (e.g. commodity flow studies, hazard risk analyses, emergency plans to be written, emergency plans to be updated, and emergency plans to be exercised). For training activities, please list all training activities including trainings that fall under the NFPA 472 core competencies or OSHA 29 CFR § 1910.120(q) you plan to carry out with HMEP funds. Provide training type, training activity description, number of courses to be held, and the projected number of individuals to be trained. PHMSA will require a progress report during the performance period and at the end of the performance period detailing other accomplished training activities (Insert more rows to the table, as needed, to document all other projected training activities).

GRANTEE ACTIVITY INFORMATION

Planning or

Training?

Activity Description Projected # of Courses to held (if applicable)

Projected number to be trained

Estimated

Activity

Cost

Projected

Start/End

Date

Training Hazmat Awareness Courses

This course will provide first responders with the knowledge and skills to: Understand what hazardous substances are and the risk associated with them in an incident; Recognize the presence of hazardous substances in an emergency;

Understand the role of the emergency responder at the Awareness level, including site security and control; Have understanding of the U.S.

Department of Transportation Emergency Response Guidebook; Realize the need for additional resources, call for appropriate assistance, and to make appropriate notifications to the community.

This course also includes counter-terrorism curriculum.

8 200 $5,000 per course.

$40,000 total cost

Q1-Q4

Training Hazmat Technician Courses –

The course provides the essential knowledge, skills, and abilities to operate offensively or defensively at an incident involving the release of hazardous materials. The objectives of the course are to teach participants: to classify, identify, and verify known and unknown material by using field survey instruments and equipment; to select and use the proper chemical protective

3 60 $8,000 per course

$ 24,000 total

Q2-Q4 equipment provided to the hazardous materials Technician; to understand hazard and risk assessment techniques for Hazmat and CBRNE environments; to be able to perform advanced control, containment, and/or confinement operations within the capabilities of the resources and personal protective equipment available; and to develop action plans within the parameters of the State plan for statewide response to WMD events.

Training IAFC Hazmat Conference –

The IAFC's Hazmat Conference provides the latest classroom, hands-on and field trip-based training on what's new in hazmat, covering all aspects of hazmat, including transportation, safety, WMD, gear, terrorism, mass decontamination, bioterrorism and more. The hazmat exhibit floor includes outdoor demonstrations of hazardous materials gear and equipment.

1 3 $6,390 Q3

Training Hazmat IQ for Propane Course

16-hour Propane IQ course is a hands-on exploration of handling propane emergencies.

Disasters involving propane are one of the most common and most deadly types of emergency that first responders will encounter. Therefore, this course centers around tactical considerations, flaring operations, leak control options, and container assessment.

3 60 $6,500 per course.

$19,500 total

4. LEPCs SUB-AWARDS INFORMATION

Total Number of Active LEPCs 56

Total Number of Inactive LEPCs1 2

Total Number of LEPCs 2 projected to receive HMEP Grant Funds as sub-awards

a. Briefly explain your LEPCs/sub-grantees selection process or the methodology you plan to use to select LEPCs to sub-award the HMEP planning funds.

LEPCs are awarded funding according to the level of risk they present. Each LEPC is taken through a risk assessment by the CEMA Grant Manager. Each LEPC is rated according to past performance, population, commodity flow and the number of past incidents involving HAZMAT in transport. The data is entered into an algorithm which calculates the amount of funding each LEPC receives.

b. List the names of subgrantees you plan to sub-award HMEP funds to and the corresponding sub-award amount, (PHMSA will require a progress report during the performance period and at the end of grant period detailing LEPCs awarded HMEP funds, sub-award amounts, and LEPCs accomplished activities. (Insert more rows to the table if more space is needed)

SUB-GRANTEE ACTIVITY INFORMATION

Sub-grantee Name

(Region or

District)

Planning or

Training?

Activity Description Projected # of

Courses to be held (if applicable)

Projected number to be trained

Estimated Activity

Costs

Projected Activity Start and End Date

Milton County

Planning

Update and exercise emergency response plans

1 N/A $15,000 Q2-Q3

Brice County

Training Crude oil rail incident training

1 15 $10,000 Q3-Q4

Fillmore County

Planning Conduct hazard analysis

1 N/A $10,000 Q2-Q3

Gitmore

Training Ethanol Training 1 10 $7,000 Q3

1 An inactive LEPC is one that has not met in a year.

2 Number of LEPCs planned to receive HMEP grant funds through sub-awards. These are LEPCs whose proposals for HMEP grant funds have been received or proposals are under solicitation.

6. HMEP Monitoring. Briefly provide a description of the monitoring and evaluation of the activities that will be conducted to ensure that the grant activities are successfully carried out according to the activity timeline. Include an explanation of quality control measures.

All activities will be monitored via requiring quarterly progress reports, and pre-and post-testing for all training classes. All HMEP activities progress and expenditures will be tracked to ensure Calisota is on track with the schedule.

PART D: BUDGET NARRATIVE

In addition to completing the Planning and Training activities in the section above, complete a budget narrative to explain each line item of your project costs.

The budget narrative is extremely important as it provides transparency for proposed costs and justification for costs that may appear questionable to the granting agency, and it provides details of how and where the applicant will satisfy cost‐sharing requirements (matching).

Consider the following when completing the Budget Narrative section:

1. PERSONNEL

Personnel costs are the employee salaries working directly on the grant project. Include the number, type of personnel, the percentage of time dedicated to the project, hourly wage (or salary) and total cost to the grant.

• This category is limited to only persons employed by your organization. Those not employed by your agency shall be classified as subgrantees or contractors and should be listed under the “Contractual” object class.

• Only include compensation paid for employees engaged in grant activities.

• Costs should be consistent with that paid for similar types of work within the organization.

Arms

Planning Write emergency response plans and conduct response drill

1 25 $20,000 Q2-Q4

Position Description of

HMEP Duties Salary Percentage of Time on HMEP Total Amount Charging to

HMEP

Grants Program Manager

Coordinates activities and oversees all

HMEP

activities

$65,000 30% $19,500

Accounts Manager Submits invoices and FFRs. Also, reconcile

HMEP

expenses monthly

$ 65,000 15% $9,750

Administrative Assistant

Receives and logs all reports and invoices submitted by subrecipients

$35,000 5% $1,750

Training Coordinator

Coordinates all training courses for CEMA

$50,000 30% $15,000

Total Cost to

HMEP

$46,000

2. FRINGE BENEFITS

Fringe Benefit costs are the allowances and services provided by employers to their employees as compensation in addition to regular salaries and wages. Fringe costs are benefits paid to employees, including the cost of employer’s share of FICA, health insurance, workers’ compensation, and vacation. Include how the fringe benefit amount is calculated (i.e., actual fringe benefits estimate, approved rate, etc. Include a description of specific benefits charged to a project and the benefit percentage. Additional considerations:

• The personnel/salaries should have corresponding fringe; and vice‐versa. PHMSA cannot pay fringe benefits for a position that is not listed in the Personnel section.

• Explain what is included in the benefit package and at what percentage.

• Fringe benefits are only allowable for the percentage of time devoted to the grant project.

• The applicant should not combine the fringe benefit costs with direct salaries and wages in the personnel category.

No fringe benefits charged to HMEP, but will be used as an in-kind match.

3. TRAVEL

Travel costs are those costs requested for field work or for travel to professional meetings associated with grant activities. Provide the purpose, method of travel, number of persons traveling, number of days, and estimated cost for each trip. If details of each trip are not known at the time of application submission, provide the basis for determining the amount requested.

Number of people 3 Travel Description

IAFC Conference

Airfare $680 per roundtrip Lodging $154 x 3 days Mileage N/A Per diem $71 per day x 3 days Parking $25 per day x 3 days Total Cost $ 2,130 per person Total Cost for 3 people

$6,390

4. EQUIPMENT

Equipment costs includes those items that are tangible, nonexpendable, personal property having a useful life of more than one year and an acquisition cost of $5,000 or more per unit ‐ unless the applicant has a clear and consistent written policy that determines a different threshold. Include a description, quantity and unit price for all equipment.

Purchases of less than $5,000 should be listed under “Supplies” or “Other.”

Each item of equipment must be identified with the corresponding cost. General‐purpose equipment must be justified as to how it will be used on the project.

Analyze the cost benefits of purchasing versus leasing equipment, particularly high‐cost items and those subject to rapid technical advances. List rented or leased equipment costs in the “Contractual” or “Other” category, depending upon the procurement method.

No equipment will be charged to the HMEP grant.

5. SUPPLIES

Supplies are tangible personal property other than equipment. Include the types of property in general terms. It is not necessary to document office supplies in great detail (for example:

reams of paper, boxes of paperclips, etc.). However, applicants should include a quantity and unit cost for larger cost supply items such as computers and printers.

$ 3,000 will be allocated for supplies such as copy paper, pens, ink cartridges, and folders will be purchased as needed to administer the HMEP grant.

$3,000 will be allocated to purchase two laptops that will be load with CAMEO software to assist counties with updating their response plans.

Total supply cost: $6000.00

6. CONTRACTUAL

Contractual costs are those services carried out by an individual or organization, other than the applicant, in the form of a procurement relationship. There are two ways to capture costs in this category: subgrants and contracts.

A Subgrant – is an award provided by a pass‐through entity (State or Territory) to a subrecipient.

That subrecipient carries out part of a program for which the State or Territory received Federal support. A subgrantee has its performance measured in relation to whether objectives of a Federal program were met; has responsibility for programmatic decision making; is responsible for adherence to applicable Federal program requirements specified in the Federal award; and (in accordance with its agreement), uses the Federal funds to carry out a program for a public purpose specified in authorizing statute, as opposed to providing goods or services for the benefit of the pass‐through entity.

A Contract ‐ is a legal instrument by which a Grantee Recipient purchases property or services needed to carry out the project or program under an award. A contract/contractor provides the goods and services within normal business operations; provides similar goods or services to many different purchasers; normally operates in a competitive environment;

and provides goods or services that are ancillary to the operation of the Federal program.

For all contractual line‐item costs, include the rationale for the amount of the costs and include the specific contract goods and/or services provided and the related expenses for those goods and services. Simply entering the statement “contractual services” will not be considered sufficient for the requirement of completing this section.

Subgrants must be listed under Contractual in the SF‐424A. They must be clearly identified as subgrants in the budget narrative.

Activity Description Total Cost Hazmat Awareness Course

CEMA will contract with a vendor to conduct 8 Hazmat Awareness Courses.

The cost per class is projected to be $5,000 based on past contracts for this course

$40,000

Hazmat Technician Courses

CEMA will contract with a vendor to conduct 3 Hazmat Technician courses.

$24,000

The cost per class is approximately $8,000 based on past contracts for this course.

Hazmat IQ for Propane Courses

Ceme will contract with a vendor to conduct 3 Hazmat IQ for Propane courses. The cost per class is approximately $6,500 based on past contracts for this type of course.

$19,500

Milton County (subgrant)

Milton county will update their emergency response plans and conduct an exercise for update plans

$15,000

Brice County (subgrant)

Brice county will host a crude oil rail incident training

$10,000

Fillmore County (subgrant)

Fillmore county will conduct a hazards risk analysis.

$10,000

Gitmore County (subgrant)

Gitmore County will conduct ethanol training.

$7,000

Arms County Write emergency response plans and conduct drill exercise for plans

$20,000

Total Contractual Cost

$145,500

7. OTHER

Other costs do not fit any of the aforementioned categories, such as rent for buildings used to conduct project activities, utilities, leased equipment, employee training tuition, etc. “Other” direct costs must be itemized.

8. INDIRECT

Costs (if applicable): Indirect costs are allowable in the HMEP grant. If the rate will not be approved by the application due date, attach the letter of renewal or letter of request that you sent to your cognizant agency to your application. The applicant must include a signed copy of the approved negotiated rate agreement that is valid as of the date of the application. If the applicant does not have an approved indirect cost rate agreement, the applicant may be eligible for the 10% de minimis rate provided by 2 CFR § 200.414.

Telephone service for 12 months

$2,400

Copier lease for 12 months

$1,800

Building rent for 12 months

$12,000

Total Cost $16,200

No indirect costs.

9. MATCH

Match: The total matching requirement should be listed in Section A and Section C of the SF‐ 424A line‐item budget. Please only include the Federal‐share of costs in Section B of the SF‐ 424A. The budget narrative is where the matching requirements should be captured. Within the applicable object class category in the budget narrative, (Personnel, Supplies, etc), detail the matching requirements.

Please ensure that the match is clearly identified in the budget narrative. Provide an explanation as to the amount to be matched and how it was determined. Matching funds should be described in the same manner as if they were the Federal share of costs. List all staff positions by title. Give annual salary exclusive of fringe benefits, job title, role in the HMEP grant (this may differ from the organizational job title), and percentage of time assigned to the HMEP grant, and total cost for the budget period. Base the allocation of salaries for individuals that have responsibilities in both the planning and training areas on realistic estimates of where the time is actually spent. Include only those positions directly funded by the HMEP grant (in whole or in part) or that are part of required matching. For the salaries used as third‐party in‐ kind contributions (“soft match”), explain the methodology and assumptions used.

Calisota will meet the match requirement through the following:

1. Fringe benefits of the personnel identified in the personnel object will be used as part of the match.

2. The remaining match requirement will be met by participants’ time spent in training or conducting an HMEP project.

Position Percentage of Time on HMEP Total Amount Charging to

HMEP

Grants Program Manager 30% $8,654 Accounts Manager 15% $1,245 Administrative Assistant 5% $568 Training Coordinator 30% $6,367 Total Fringe Benefits Used as match

$16,834

PART E: CERTIFICATIONS

Authorized Representatives should initial next to each statement below to indicate that your agency understands and agrees with the following:

1. The Applicant certifies that the total amount the State or Indian tribe expends (except amounts of the Federal Government) to develop, improve, and carry out emergency plans will at least equal the average level of expenditure for the last 5 years.

MKJ

2. The Applicant certifies that all training activities conducted are consistent with the competencies identified in NFPA 472 or OSHA 29 § 1910.120.

3. The Applicant certifies that it i s complying with Sections 301 and 303 of EPCRA (42 U.S.C. 11001, 11003).

4. The Applicant certifies that it will make available not less than 75 percent of the funds granted for the purpose of planning or training public sector emergency response employees.

5. I certify that the agency is compliant with the National Incident Management System (NIMS).

6. The applicant certifies that the person(s) it authorized to provide training has an auditable accounting system.

7. The Applicant certifies that the State or Tribal Emergency Response Commission were provided the opportunity to review the grant application.

APPLICATION CERTIFICATION

The Grantee certifies to the best of its knowledge and belief that this application is correct and complete for the planned activities under the HMEP Grant Program Funding Requirements.

Grantee Authorized Representative Signature

Printed Name: Michael K Jonas

Title: Director

Date: 11/10/2020