SAMPLE - HMEP Application & SF-424A (States & Territories).pdf

SECTION A - BUDGET SUMMARY

BUDGET INFORMATION - Non-Construction Programs OMB Number: 4040-0006 Expiration Date: 02/28/2025

Grant Program Function or

Activity

(a)

Catalog of Federal Domestic Assistance

Number (b)

Estimated Unobligated Funds New or Revised Budget

Federal (c)

Non-Federal (d)

Federal (e)

Non-Federal (f)

Total (g)

5. Totals

4.

3.

2.

1. $ $ $ $

HMEP Grant Year 1 20.703 241,041.00 60,067.00 301,108.00

241,041.00 60,067.00 301,108.00$

Standard Form 424A (Rev. 7- 97) Prescribed by OMB (Circular A -102) Page 1

SECTION B - BUDGET CATEGORIES

7. Program Income

d. Equipment

e. Supplies

f. Contractual

g. Construction

h. Other

j. Indirect Charges

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

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

(1)

Authorized for Local Reproduction Prescribed by OMB (Circular A -102) Page 1A

Standard Form 424A (Rev. 7- 97)

GRANT PROGRAM, FUNCTION OR ACTIVITY

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

Total6. Object Class Categories

a. Personnel

b. Fringe Benefits

c. Travel

HMEP Grant Year 1

46,000.00

6,951.00

6,390.00

14,000.00

6,000.00

145,500.00

0.00

16,200.00

241,041.00

241,041.00

46,000.00

6,951.00

6,390.00

14,000.00

6,000.00

145,500.00

0.00

16,200.00

241,041.00

241,041.00

SECTION D - FORECASTED CASH NEEDS

14. Non-Federal

SECTION C - NON-FEDERAL RESOURCES

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

$8.

9.

10.

11.

12. TOTAL (sum of lines 8-11)

15. TOTAL (sum of lines 13 and 14)

13. Federal

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

HMEP Grant Year 2 60,067.00 60,067.00

60,067.00 60,067.00

FUTURE FUNDING PERIODS (YEARS)

SECTION F - OTHER BUDGET INFORMATION

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

Authorized for Local Reproduction

$16.

17.

18.

19.

20. TOTAL (sum of lines 16 - 19)

21. Direct Charges: 22. Indirect Charges:

23. Remarks:

(a) Grant Program (b)First (c) Second (d) Third (e) Fourth

HMEP Grant Year 2

$0.00$241,041

Standard Form 424A (Rev. 7- 97) Prescribed by OMB (Circular A -102) Page 2

HAZARDOUS MATERIALS EMERGENCY PREPAREDNESS

(HMEP) GRANT PROGRAM

Application for States & Territories

FY2025-FY2027 Grant Cycle

PROJECT NARRATIVE

Planning activities funded by the Hazardous Materials Emergency Preparedness Planning and Training Grant will be used to develop, improve, and carryout emergency plans under the

Emergency Planning and Community Right-To-Know Act of 1986 (42 U.S.C. 11001 et seq.), see 49 U.S.C. 5116(a). Emergency responders who receive training under the HMEP training grant will have the ability to protect nearby persons, property, and the environment from the effects of accidents or incidents involving the transportation of hazardous material in accordance with existing regulations or National Fire Protection Association standards for competence of responders to accidents and incidents involving hazardous materials. (49 U.S.C 5116(b)).

Persons are not required to respond to the collection of information herein unless a currently valid

OMB control number is displayed. (5 CFR §§ 1320.5(b)(2) and 1320.6(a)(2))

OMB Control Number 2137-0586 2 Expiration Date: 07/30/2026

All information marked with an asterisk (*) is required.

PART A: APPLICANT CONTACT INFORMATION

* 1. APPLICANT NAME AND ADDRESS

*Organization Name: Calisota Emergency Management Agency

*Street Address: 2222 Cali Drive

*City: Cepda *State: CL *Zip Code: 88888

*Unique Entity Identifier (UEI): CEM6GNC88DE2

Organization Web Page: cema.com

* 2. CONTACT INFORMATION

*Authorized Representative:

*Last: Jonas *First: Michael

*Title: Director of Hazardous Materials Safety

*Phone: 111-222-3333 *Email: mjonas@cema.com

* Program Manager:

*Last: House *First: Susan

*Title: Grants Manager

*Phone: 111-222-3334 *Email: shouse@cema.com

* Finance Program Manager or Equivalent:

*Last: Benjamin *First: James

*Title: Senior Accountant

*Phone: 111-222-3335 *Email: jbenjamin@cema.com

OMB Control Number 2137-0586 3

Other Point of Contact for Grant Management

Last: Lewis First: Cody

Title: Training Coordinator

Phone: 111-222-3336 Email: clewis@cema.com

Other Point of Contact for Grant Management

Last: Carlton First: Lena

Title: Assistant Accounts Manager

Phone: 111-222-3337 Email: lcarlton@cema.com

*3. ORGANIZATION INFORMATION

*In the space below, provide your organization’s mission statement.

CEMA’s mission is to protect people and the environment by advancing the safe transportation of energy and other hazardous materials that are essential to our daily lives.

OMB Control Number 2137-0586 4

*Provide a brief history and description of your organization's structure.

CEMA was created in 1990 under the Division of Homeland Security to effectively deal with all types of domestic emergency situations and incidents. CEMA has a long history of ensuring the protection of all people and the environment from hazardous materials releases. CEMA is led by the Director of Hazardous Materials Safety, while the grants department is managed by the Grants Manager. The grants department also has support from our Senior Accountant, which manages all fiscal concerns.

OPTIONAL: You may also include an image of the organization’s internal structure, such as an organizational chart, that details the roles, responsibilities, and relationships between individuals.

OMB Control Number 2137-0586 5

*Provide a few of your organization’s top accomplishments over the past three years.

In the last three years, CEMA has exceeded all expectations under the HMEP Grant program. CEMA has trained over 5,000 first responders in dealing with hazardous materials. CEMA also completed three commodity flow studies, which enabled Calisota to have a better understanding of the travel patterns of hazardous materials throughout the area. Finally, using the data obtained from the commodity flow studies, Calisota was able to update the majority of all emergency plans and create new plans where they were most needed. CEMA hopes to continue to improve our emergency response capabilities in the future.

*Describe your organization’s expertise and capacity to manage Federal grant programs.

CEMA administers over $100 million in federal funds every fiscal year. The staff is comprised of multiple federal funding professionals that ensure the effective. In response to state and federal laws, regulations, program guidelines, CEMA has embraced its responsibilities to protect both State and federal funds.

CEMA has developed and implemented a grant detection system that incorporates all state and federal grant programs. The system provides fast and accurate platform for the collection and analysis of information, such as audit findings and risk assessments, that provide insight of the risks associated with sub recipients.

OMB Control Number 2137-0586 6

*4. LOCAL EMERGENCY PLANNING COMMITTEES (LEPC)

*Number of Active LEPCs: 10

*Number of Inactive LEPCS: 0

*Number of LEPCs projected to receive HMEP Grant Funds (as sub-recipients): 5

*5. TRANSPORTATION FEES

*Are transportation fees assessed and collected by your state or political subdivision of your state?

No

If YES, how much in transportation fees were collected in the past year?

Fees Collected

What percentage of the fees collected is used exclusively for purposes related to the transportation of hazardous materials?

Percentage

CEMA does not assess nor collect transportation fees.

OMB Control Number 2137-0586 7

PART B: STATEMENT OF WORK

Please be advised that you must provide information for each sub-grant, contract, or agreement (e.g., agreement with another state government entity) issued, awarded, or signed during the reporting period, along with the process used to select sub-grantees for the HMEP grant funding.

*1. NEEDS ASSESSMENT

* In the space below, include a brief statement outlining the HMEP planning and training needs of the jurisdiction. (Limit word count to 500 words)

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 three (3) year ‘schedule’ of training to the state.

Activities and Estimates for this application can be provided for the entire three-year cycle (FY 2025 – FY 2027) or for Year One of the cycle (FY 2025). Please indicate

The Activities and Estimates are for: ☐ Three-Year Cycle (FY25-27) Year One (FY25)

OMB Control Number 2137-0586 8

*2. PROGRAM GOALS

*In the table below, list up to ten overarching goals that your organization aims to achieve with the HMEP grant funds being requested. The Program Goals must align with PHMSA’s mission and top priorities as outlined in the Notice of Opportunity for Funds.

Goal Planning and Training Grant Goals

Ex. Increase First Responder attendance rate in HAZMAT training courses by 5% by September 2025.

Improve LEPC outreach by 10% from previous year to ensure region-wide engagement in HAZMAT awareness.

Increase first responder attendance to include VFDs, law enforcement, EMS, and Public Works employees

3 Update all emergency response plans in Calisota by the end of the performance period.

4 Enter Goal #4

5 Enter Goal #5

6 Enter Goal #6

7 Enter Goal #7

8 Enter Goal #8

9 Enter Goal #9

10 Enter Goal #10

SAMPLE APPLICATION

OMB Control Number 2137-0586 9

*3. ACTIVITIES SUPPORTING PROGRAM GOALS

*List the activities expected to be performed to achieve the Program Goals recorded above. For training, please record training activities that fall under the NFPA 472 core competencies or OSHA 29 CFR § 1910.120(q) that you plan to carry out with HMEP funds. For planning, please record planning activities that fall under section 303 of the Emergency Planning and Community Right- To-Know Act (EPCRA) (e.g., commodity flow studies, hazard risk analyses, writing or updating emergency plans, and conducting exercises). These activities must be allowable, allocable, and reasonable.

For each activity in the table below, select the activity type (planning or training), provide a detailed description of the activity, select the object class category under which the majority of the activity will be funded, provide estimates for the cost and completion date (month and year), and if applicable, an estimate of the numbers to be trained.

Activity Type

Activity Description Object Class Cost Completion Date Number to be Trained

Planning (e.g.) HAZMAT Planning Conference (NASTTPO) (e.g.) Travel (e.g.) $1,500 (e.g.) September 2025 (e.g.) N/A (e.g.)

Training (e.g.) HAZMAT Technician Level Training (e.g.) Contractual (e.g.) $21,800 (e.g.) July 2025 (e.g.) 100 (e.g.)

Training (e.g.) Cargo Tanker Emergency Response Training (e.g.) Contractual (e.g.) $10,000 (e.g.) December 2025 (e.g.) 50 (e.g.)

Planning LEPC Outreach Travel $7,900 Dec 2025 N/A

Training HAZMAT Operations Level Training for law enforcement.

Contractual $50,000 Sep 2026 300

Planning Update Emergency Response Plan Contractual $6,980 Aug 2025 N/A

Type Enter a detailed Activity Description Object Class Estimate Cost Estimate Date Number to Train

Type Enter a detailed Activity Description Object Class Estimate Cost Estimate Date Number to Train

OMB Control Number 2137-0586 10

*4. HMEP GRANT MONITORING

In the space below, provide a brief description of the monitoring and evaluation processes, including the quality control measures that will be implemented to track progress, assess outcomes, and ensure compliance with grant requirements, thereby ensuring the successful execution of HMEP-funded activities within the established timeline. If applicable, provide information on monitoring sub-recipients. (Limit word count to 500 words)

CEMA staff will conduct a review of the sub-recipient’s fiscal and program management procedures and policies to determine sub-grant program compliance using checklists to record findings. The staff will obtain copies of any missing documentation that is not in the Sub-Grant Folder such as applicable monthly reports or purchasing procedures. Staff will answer any questions the sub-recipient has regarding sub-grant program administration and management.

OMB Control Number 2137-0586 11

PART C: BUDGET NARRATIVE

REFER TO BUDGET NARRATIVE DOCUMENT

PART D: SUPPLEMENTAL ACTIVITIES

REFER TO BUDGET NARRATIVE DOCUMENT

OMB Control Number 2137-0586 12 Expiration Date: 07/30/2026

PART E: APPLICATION CERTIFICATION

The Authorized Representative must initial next to each statement below to indicate that your organization understands and agrees with the following:

MJ

The Applicant certifies that the total amount the State 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.

MJ

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

MJ

The Applicant certifies that it is complying with Sections 301 and 303 of EPCRA (42 U.S.C.

11001, 11003).

MJ

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.

MJ

The applicant certifies that the agency is compliant with the National Incident Management System (NIMS).

MJ

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

MJ

The Applicant certifies that the State Emergency Response Commission was provided the opportunity to review the grant application.

The Applicant 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.

Michael Jonas Michael Jonas

Authorized Representative Printed Name Authorized Representative Signature

Director of Hazardous Materials Safety 3/16/2025

Authorized Representative Title Date

OMB Control Number 2137-0586 13

HAZARDOUS MATERIALS EMERGENCY PREPAREDNESS

(HMEP) GRANT PROGRAM

Application for States & Territories

FY2025-FY2027 Grant Cycle

BUDGET NARRATIVE

Planning activities funded by the Hazardous Materials Emergency Preparedness Planning and Training Grant will be used to develop, improve, and carryout emergency plans under the

Emergency Planning and Community Right-To-Know Act of 1986 (42 U.S.C. 11001 et seq.), see 49 U.S.C. 5116(a). Emergency responders who receive training under the HMEP training grant will have the ability to protect nearby persons, property, and the environment from the effects of accidents or incidents involving the transportation of hazardous material in accordance with existing regulations or National Fire Protection Association standards for competence of responders to accidents and incidents involving hazardous materials. (49 U.S.C 5116(b)).

Persons are not required to respond to the collection of information herein unless a currently valid

OMB control number is displayed. (5 CFR §§ 1320.5(b)(2) and 1320.6(a)(2))

OMB Control Number 2137-0586 14 Expiration Date: 07/30/2026

All information marked with an asterisk (*) is required.

PART A: APPLICANT CONTACT INFORMATION

* 1. APPLICANT NAME AND ADDRESS

*Organization Name: Calisota Emergency Management Agency

*Street Address: 2222 Cali Drive

*City: Cepda *State: CL *Zip Code: 888888

*Unique Entity Identifier (UEI): CEM6GNC88DE2

PART B: STATEMENT OF WORK

REFER TO PROJECT NARRATIVE DOCUMENT

OMB Control Number 2137-0586 15 Expiration Date: 07/30/2026

PART C: BUDGET NARRATIVE

The total amounts recorded in this part must match the total amounts on the SF-424A form.

The budget narrative is essential for ensuring transparency of the proposed costs and justifying any expenses that may raise questions with the granting agency. It should also outline how the applicant will fulfill any cost-sharing (matching) requirements.

*1. PERSONNEL

Personnel costs refer to the salaries or wages of the employees working directly on the grant project.

• This category is limited to individuals employed by your organization. Those not employed by your organization should be classified as sub-recipients or contractors and listed under the Contractual object class category.

• Only include compensation paid for employees directly involved in grant activities.

• Costs must align with the compensation paid for similar roles within the organization.

In the table below, include the personnel title and their function, their annual salary (or hourly wage), the percentage of time dedicated to the project, and total cost to the grant for each individual. Add additional rows as needed. If Personnel costs will not be incurred, check the appropriate box.

☐ HMEP Funds will not be used for Personnel Costs

Personnel Title (Grant Function) Salary/Wage Dedicated

Time % Total Cost

HMEP Program Manager (Manages the HMEP Grant Program) (e.g.)

$75,000 (e.g.) 50% (e.g.) $37,500 (e.g.)

Grants Program Manager (Coordinates activities and oversees all HMEP activities)

$65,000 30% $19,500

Accounts Manager (Submits invoices and completes FFRs)

$65,000 15% $9,750

Training Coordinator (Coordinates all training courses for CEMA)

$50,000 30% $15,000

Administrative Assistant (Collects and logs all reports and invoices)

$35,000 5% $1,750

Personnel Title Salary/Wage Time % Total Cost

Total Personnel Costs: $46,000.00

OMB Control Number 2137-0586 16 Expiration Date: 07/30/2026

*2. FRINGE BENEFITS

Fringe Benefit costs refer to the allowances and services provided by employers to employees as additional compensation beyond regular salaries and wages. These include benefits such as the employer’s share of FICA, health insurance, workers’ compensation, and vacation.

• Personnel/salary costs must correspond with fringe benefit costs; PHMSA cannot pay fringe benefits for positions not listed in the Personnel section.

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

• Do not combine fringe benefit costs with direct salaries and wages in the Personnel section.

In the space below, include an explanation of how the Fringe Benefit amount is calculated (e.g., actual estimate, approved rate, etc.), along with a description of the specific benefits charged to the project and the associated benefit percentage. Complete the table; add additional rows as needed.

If Fringe Benefits costs will not be incurred, check the appropriate box.

☐ HMEP Funds will not be used for Fringe Benefit Costs

Fringe Benefits (Approved Rate) = 23.75% of salary. Salary = $65,000

FICA = $13,925.00

Deferred Compensation = $242.00 Retirement = $1,280.00

Personnel Title Total Benefits Dedicated

Time % Total Cost

HMEP Program Manager (e.g.) $35,000 (e.g.) 100% (e.g.) $35,000 (e.g.)

Grants Program Manager $15,447.00 30% $4,634

Accounts Manager $15,447.00 15% $2,317

Personnel Title Salary/Wage Time % Total Cost

Personnel Title Salary/Wage Time % Total Cost

Personnel Title Salary/Wage Time % Total Cost

Total Fringe Benefit Costs: $6,951.00

OMB Control Number 2137-0586 17 Expiration Date: 07/30/2026

*3. TRAVEL

Travel costs refer to expenses related to fieldwork or travel to professional meetings associated with grant activities.

In the table below, provide the travel purpose, a cost breakdown (e.g., number of persons travelling, airfare, lodging, local transportation, per diem, etc.) 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 in the Cost Breakdown column. Add additional rows as needed. If Travel costs will not be incurred, check the appropriate box.

☐ HMEP Funds will not be used for Travel Costs

Travel Purpose Cost Breakdown Total Cost

NASTTPO Conference (e.g.)

Two persons; Airfare: $2,400; Lodging: $2,000, Transportation: $1,600, M&IE: $1,800. (e.g.)

$7,800 (e.g.)

IAFC Conference

Three persons for three days. Airfare: $680 per round trip;

Lodging: $154 per day; Per Diem: $71 per day; Transportation:

$25 per day.

Total per person: $2,130.

$6,390.00

Travel Purpose Cost Breakdown Total Cost

Travel Purpose Cost Breakdown Total Cost

Travel Purpose Cost Breakdown Total Cost

Travel Purpose Cost Breakdown Total Cost

Total Travel Costs: $6,390.00

OMB Control Number 2137-0586 18 Expiration Date: 07/30/2026

*4. EQUIPMENT

Equipment costs refer to tangible, nonexpendable personal property with a useful life of over one year and an acquisition cost of $10,000 dollars or more per unit, unless the applicant has a clear and consistent written policy specifying a different threshold.

• Equipment purchased with HMEP funds must be exclusively used for HMEP training activities.

• Analyze the cost benefits of purchasing versus leasing equipment, particularly high‐cost items, and those subject to rapid technical advances.

• Purchases of less than $10,000 should be under Supplies or Other.

• Costs for rented or leased equipment should be listed under the Contractual or Other category, depending on the procurement method.

• Equipment must be justified as to how it will be used on the project.

In the table below, provide the description of each piece of equipment, its intended use in the project, the quantity required, and the unit price. Add additional rows as needed. If Equipment costs will not be incurred, check the appropriate box.

☐ HMEP Funds will not be used for Equipment Costs

Equipment Description Equipment Uses Qty. Unit Price

Training Trailor (e.g.) To provide HAZMAT training to rural areas (e.g.) 1 (e.g.) $50,000 (e.g.)

Tank Car Prop Tank car used to train and perform exercises. 1 $14,000

Equipment Description Equipment Use Qty. Unit Price

Equipment Description Equipment Use Qty. Unit Price

Total Equipment Costs: $14,000.00

OMB Control Number 2137-0586 19 Expiration Date: 07/30/2026

*5. SUPPLIES

Supplies costs refer to tangible personal property excluding equipment. Include the types of property in general terms. It is not necessary to document minor office supplies in detail (e.g., reams of paper, boxes of paperclips, etc.). However, applicants should provide the quantity and unit cost for larger supply items, such as computers and printers.

In the table below, provide the description of each supply item, its intended use in the project, the quantity, and the unit price for each item. Add additional rows as necessary. If Supply costs will not be incurred, check the appropriate box.

☐ HMEP Funds will not be used for Supplies Costs

Supply Description Supply Uses Qty. Unit Price

Office Supplies (e.g.) Office supplies for grant administration (e.g.) 1 (e.g.) $2,000 (e.g.)

Office Supplies Office Supplies for grant admin. 1 $3,000

Laptops To be used with CAMEO software to assist LEPCs with updating emergency plans

2 $1,500

Supply Description Supply Use Qty. Unit Price

Total Supplies Costs: $6,000.00

OMB Control Number 2137-0586 20 Expiration Date: 07/30/2026

*6. CONTRACTUAL

Contractual costs refer to services carried out by an individual or organization, other than the applicant, through a procurement arrangement. These costs are captured in two ways: subgrants and contracts.

A Subgrant is an award provided to a sub-recipient by the Prime Recipient. The sub-recipient carries out part of a program for which the applicant received Federal assistance. A sub-recipient is responsible for adherence to the applicable Federal program requirements specified in the Federal award and uses the Federal funds to carry out part of a program for a public purpose specified in authorizing statute.

A Contract is a legal instrument by which a Prime 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.

In the table below, list all subgrants and contracts that will be funded with HMEP funds. For each line item provide a description of the planning and training activities or specific contract goods and/or services, along with their estimated costs. Also provide the names of the sub-recipients and contractors. If the sub-recipients and/or contractors have not yet been determined, please note this in the Activity Description column. Once finalized, the list of sub-recipients and contractors must be submitted to HMEP Grant staff. Add additional rows as necessary.

If Contractual costs will not be incurred, check the appropriate box.

☐ HMEP Funds will not be used for Contractual costs

Contractual Type

Activity Description Estimated

Cost

Subgrant (e.g.)

Calisota County. HAZMAT Technician Training (e.g.)

Will be funded through HMEP Training to send three personnel for initial HAZMAT Technician training at the CEMA Training Academy in 2025 (3 x $3,000.00). These are estimated costs for training and based on training attendance requirements.

$9,000 (e.g.)

Contract (e.g.)

Contractor to be determined. Cargo Tank Emergency Response Workshop (e.g.)

To be conducted in the spring of 2025 (HMEP 3rd Quarter). Estimated cost of $15,000.00. Ensure that the CEMA volunteer team, CEMA emergency response personnel and other First Responders attending the Hazardous Materials Training Workshop are trained to respond HAZMAT gasoline tank trailer incidents. Provide 3rd party specialized training to team members to achieve a skill base necessary to respond to a MC-306/DOT-406 gasoline tank trailer transportation HAZMAT incident.

$15,000 (e.g.)

OMB Control Number 2137-0586 21 Expiration Date: 07/30/2026

Contractual Type

Activity Description Estimated

Cost

Contract

CEMA Training Academy. HAZMAT Awareness Courses

Will be funded from 10/1/2025 to 9/30/2026 to train 2,000 Emergency responders for HAZMAT Awareness (20 classes with 2,000 students x $40.00 = $80,000.00). These costs are derived from previous year's cost totals per student, per training type.

Training courses are scheduled to occur throughout the HMEP grant year.

The CEMA Training Academy provides the large majority of CEMA's core HAZMAT training for public sector responders. It is the central location for training responders in HAZMAT response, including those related to tanker trucks and railcars. This influx of qualified responders contributes to the safety of people, supports the mission of LEPCs, and helps to ensure that HAZMAT incidents, especially those involving transportation, are effectively managed.

$80,000

Contract

CEMA Training Academy. HAZMAT Technician courses

Will be funded from 10/1/2025 to 9/30/2026 to train 2,000 Emergency responders for HAZMAT Awareness (10 classes with 250 students x $200.00 = $50,000.00). These costs are derived from previous year's cost totals per student, per training type.

Training courses are scheduled to occur throughout the HMEP grant year.

The CEMA Training Academy provides the large majority of CEMA's core HAZMAT training for public sector responders. It is the central location for training responders in HAZMAT response, including those related to tanker trucks and railcars.

$50,000

Subgrant

Milton County. Site Visits and Update their emergency response plans.

Will be funded to conduct 30 visits (30 x $517.00/visit) to Extremely Hazardous Substance Facilities that transport HAZMAT in 2025. During these visits, staff will evaluate whether HAZMAT transportation routes minimize risk to surrounding communities, emergency response plans are adequate to address on-site transportation incidents and employee response training is up to date. Milton County will determine whether risk is effectively managed, plans conform to requirements of the Milton County Hazardous Substance Response Plan and generally accepted principles of emergency response planning and employee emergency response training is up to date.

$15,500

Subgrant OR Contract

Brief description of Activities/Goods/Services Cost

Total Contractual Costs: $145,500.00

OMB Control Number 2137-0586 22

*7. OTHER

Other costs refer to expenses that do not fall under the categories mentioned above, such as rent for buildings used for project activities, utilities, leased equipment, employee training tuition, and similar expenses. These other direct costs must be itemized.

In the table below, provide a detailed description of the Other Activities along with their related estimated costs. Be as specific as possible. Add additional rows as necessary.

If Other costs will not be incurred, check the appropriate box.

☐ HMEP Funds will not be used for Other costs

Activity Description Estimated Cost

Rent for training room for one month (e.g.) $5,000 (e.g.)

Stipends for ten volunteer first responders to attend HAZMAT Awareness Training.

(8-hour course at $25/hour = $200) ($200*10 volunteers = $2,000) ($2,000*20% cap = $400) (e.g.)

$400 (e.g.)

Telephone service for 12 months $2,400

Building rent for 12 months $13,800

Brief description of Other Activities Cost

Total Other Costs: $16,200.00

OMB Control Number 2137-0586 23 Expiration Date: 07/30/2026

*8. INDIRECT

Indirect costs are common or joint costs that benefit more than one project. 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 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 package. If the applicant does not have an approved indirect cost rate agreement, the applicant may be eligible for the 15% de minimis rate as outlined in 2 CFR § 200.414.

Please select the applicable option below and, if applicable, provide a description of how indirect costs will be calculated and the amount to be charged to the HMEP grant.

☒ HMEP Funds will not be used for Indirect costs

☐ Our organization does not have a current federal negotiated indirect cost rate.

We elect to use the 15% de minimis rate.

☐ Our federal negotiated indirect cost rate has yet to be approved.

A letter of renewal or letter of request is attached to the application package.

Once approved, the indirect cost agreement will be submitted to HMEP Grant Staff

CEMA will not charge indirect costs to the HMEP Grant.

Total Indirect Costs: 0

☐ Our federal negotiated indirect cost rate agreement is attached to the application package.

OMB Control Number 2137-0586 24 Expiration Date: 07/30/2026

*9. MATCH (COST SHARE)

The Match cost (or cost share) is the portion of project costs that is not funded by Federal funds, unless specifically authorized by Federal statute. For the HMEP Grant Program, the required match is 20% of the total project cost (which includes both the federal share and the non-federal share). To calculate the match cost, multiply the federal share by 25%. For example, if the federal share is $100,000, the match cost is calculated by multiplying $100,000 by 25%, which equals $25,000 ($100,000 x 0.25 = $25,000).

In the space below provide an explanation of how the Match will be met. Cash match (hard match) funds must be allowable costs for Federal funds. For third party in-kind match (soft match) funds, describe the methodology and assumptions used to determine the match. Documentation supporting the market value of in-kind match funds will be required by HMEP Grant staff.

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

Grants Program Manager (10% of time spent on HMEP) = $3,088 Accounts Manager (15% spent on HMEP) = $1,245 Administrative Assistant (5% spent on HMEP) = $568 Training Coordinator (30% spent on HMEP) = $6,367 Total Fringe Benefits Match Cost = $11,268

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

Total Match Costs: $60,067.00

OMB Control Number 2137-0586 25 Expiration Date: 07/30/2026

PART D: SUPPLEMENTAL ACTIVITIES

Supplemental funding may be available from the unexpended balances (remaining obligations) of the FY 2022-2024 grant cycle. To qualify for this funding, the following criteria must be met (but are not limited to):

1. Be classified as low or medium risk level,

2. Have submitted all FY 2022-2024 financial and progress reports on time, and

3. Have no more than 10% of the original FY 2022-2024 award remaining.

This section of the application serves as a PHMSA-approved “wish list,” allowing eligible HMEP recipients to list additional and allowable activities that could be funded with the supplemental funding. The total amount and allocation of supplemental funding has yet to be determined.

However, once finalized, the HMEP Grant Team will notify your organization with further details.

In the table below, provide the object class category, a brief description of potential activities eligible for supplemental funding, and their estimated costs. Add additional rows as necessary.

Object Class Activity Description Estimated Cost

Contractual (e.g.)

Subgrant for Calisota County to fund HAZMAT Specialist training courses (e.g.)

$25,000 (e.g.)

Equipment (e.g.) Purchase of a tanker trailer for HAZMAT training exercise drills (e.g.) $15,000 (e.g.)

Equipment Purchase of training trailor to conduct HAZMAT training.

$35,000

Contractual Subgrant to Flor County to complete a needs/capability assessment.

$10,000

Object Class Activity Description Cost

Object Class Activity Description Cost

Object Class Activity Description Cost

Total Supplemental Costs: $45,000