HomeMy WebLinkAbout20183537.tiffCOLORADO
Division of Homeland Security
& Emergency Management
Department of Public Safety
Hazardous Materials Emergency Preparedness (HMEP) Grant Program
APPLICANT
INFORMATION
Organization
Grant
Name:
Program:
Hazardous Material
Weld
Emergency
Preparedness
County
(HMEP)
Grant
Program
POINT
OF CONTACT
1. Authorized
Name
Official
(the individual
authorized
to sign legal
documents
and
decisions
for
this
grant award)
Commissioner Steve
Moreno
Position
Commissioner Chair
Mailing
Address
PO Box 758
City
Greeley
STATE
Co
Zip
Code
80632
Phone
(no spaces)
9704004000
E-mail
Address
smoreno@weldgov.com
Signature
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Signature Date
2. Project
Name
Manager
(the
individual
managing the activites for this
grant
award)
Roy Rudisill
Position
Director, Office of
Emergency Management
Mailing
Address
PO Box 758
City
Greeley
STATE
Co
Zip Code
80632
Phone (no spaces)
9703046540
E-mail
Address
rrudisill@weldgov.com
Sig/19//deltd,/*Cs-c--2,---
Signature
/t
Signature Date
3. Fiscal
Officer
Name
(the individual
financially
and
fiscally
responsible
for expending the
grant
award)
Barb Connolly
Position
Controller
and
Purchasing
Director
_Mailing
Address
PO Box 758
City
Greeley
STATE [Co
Zip Code
80632
Phone
(no spaces)
9704004445
tie
E-mail
Address
bconnolly@weldgov.com
2018-3537
Signature
10\as
10\a
Signature Date
CC2 O‘5if-
HMEP Subrecipient Budget TEMPLATE
Applicant Information
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COLORADO
t '
FFATA/FSRS
Data
Report
V
Division of Homeland Security
'"
& Emergency Management
•
for Subrecipients
Denditmenf of A; ib1ic c;ifet,"
of federal
Funds
The FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY
and Emergency Management (DHSEM) to collect the following
This information is required by the Office of Management
SUB -AWARD REPORTING SYSTEM (FSRS).
ACT (FFATA) requires the Division of Homeland Security
information for each sub -award of $25,000.00 or more.
and Budget (OMB) and must be submitted by DHSEM into the
Grant Program
HMEP
Grant Year
2019
Award Number
18HMP19xxx
Subrecipient Legal Name
Weld County Government
Subrecipient Address
PO Box 758, 1150 O Street
Subrecipient City
Greeley
County
Weld
Subrecipient State
Colorado
Subrecipient Zip Code
80632-9596
Subrecipient DUNS * 4
075757955-9596
Parent Organization DUNS # if applicable
N/A
Primary Location of Performance of the Award (no post office box, this must be the actual physical location where the work is
being performed. If you have more than one project, pick one major project to report on)
Address
1150 O Street
City
Greeley
County
Weld
State
Colorado
Zip Code
80632-9596
Congressional District (can be found at www.house.gov)
4
System for Award Management (SAM)
Check One
Is Subrecipient Registered at System for Award Management (SAM)? (register at www.sam.gov)
x
YES
NO
Compensation for Top Five Executives
80% or more of the subrecipient prior year annual gross revenues are from Federal awards?
YES
x
NO
525 million or more of the subrecipient annual gross revenues are from federal funds?
YES
x
NO
The
public
does NOT have access to information about the
compensation of the
senior executives in the
YES
x
NO
subrecipient's organization filed under the Securities Exchange Commission (SEC) and IRS requirements?
*If Subrecipient answered "YES" to all
otherwise
three questions above,
enter "Not Required"
provide
in
the
the
S
"1.
highest
Official
paid executives and their
Name" cell below
compensation amounts,
1. Official Name
Not Required
Compensation Amount
2. Official Name
Compensation Amount
3. Official Name
Compensation Amount
4. Official Name
Compensation Amount
5. Official Name
Compensation Amount
Project Description (up to 4,000 characters)
Signature
Signature: Date:
Agency's Authorized Representative (usually the Grant Administrator or Program Manager or Coordinator)
By signing above, I certify that the information contained in this FFATA data report is complete and accurate to the best of my
knowledge.
PLEASE NOTE:
Answering "No" to the SAM.gov registration question, may
result in delayed issuance of your grant agreement and /or your
grant reimbursements.
Registration and "Active" status are required.
Registration is FREE! Please register as soon as possible as
activation of your status can take several weeks to complete.
Electronic Signatures Accepted.
COLORADO
Division of Homeland Security
& Emergency Management
Department of Public Safety
Hazardous Materials Emergency Preparedness (HMEP) Grant Program
Organization Name: Weld County
Total Award Amount: $ 120,000.00
Total Planning Activities: $ 115,000.00
Total Training Activites: $ 1,000.00
TOTAL HMEP BUDGET: $ 116,000.00
Type:
PLANNING
Budget
Lines
Item
Line Number
Description (Include Hazmat Type if applicable)
ACTIVITY
(Dropdown List)
TRANSPORT
MODE
(Dropdown List)
Quantity
Unit Cost
Total
Expended
Remaining Balances
Hire an employee to meet the listed items in the scope of work other than Hazmat plan development
Hazard Analysis
Other
I
$ 46,000.00
$ 46,000.00
$
-
$ 46,000.00
2
Develop a hazardous materials Transportation and response Plan via contractor
Plans Written
Other
I
$ 60,000.00
$ 60,000.00
$
-
$ 60,000.00
3
Plans Updated
Select
I
$ -
$ -
$
-
$
4
Hazard Analysis
Select
1
$ -
$
-
$ -
$ -
Hazard Analysis
Select
I
$ -
$
-
$ -
$ -
6
Hazard Analysis
Other
I
$ -
$
-
$ -
$ -
7
Hazard Analysis
Select
I
$ -
$
-
$ -
$ -
8
Exercise planning and Development related to transportation of hazardous materials and rail
Hazard Analysis
Highway
I
$ 3,000.00
$ 3,000.00
$
-
$ 3,000.00
9
Select
Select
$ -
$
-
$ -
10
Partisapation in National And State Conferences (NASTTPO,
LEPC, CoPA)
Hazard Analysis
Highway
3
$ 2,000.00
$ 6,000.00
$
-
$ 6,000.00
State
$ 115,000.00
$
-
$ 115,000.00
Weld County HMEP Subrecipient Budget
Planning
Iofl
COLORADO
Division of Homeland Security
Et Emergency Management
Department of Public Safety
Hazardous Materials Emergency Preparedness (HMEP) Grant Program
Organization Name: Weld County
Total Award Amount: $ 120,000.00
Total Planning Activities: $ 115,000.00
Total Training Activites: $ 1,000.00
TOTAL. HMEP BUDGET: $ 116,000.00
Type: TRAINING Budget Lines
Item
Line Number
Description
CAMEO Training no costs for this training
TYPE
(Dropdown List)
INITIAL or
REFRESHER
(Dropdown List)
Other I - Initial
TRAINING
COMPETENCIES
(Dropdown List)
Number
of
Trainees
Other ;U
Unit Cost
Total
Expended
LEPC Workshop to address Transportation hazards and Tier II facilites Other
R - Refresher Other
-1U S 20 0O
l .000.00
Remaining Balances
Select
Select Select
1,000.00
Select
Select
Select Select
Select Select
Select
Select Select
Select
Select Select
Select
Select
Select Select
Select Select
S
S
Iii
Select
1 I Select
Select
Select Select
Select Select
Select Select
Select
Select Select
14 Select
Select Select
Select
Select Select
1,000.00
► ,t►uo.uu
Weld Count) HMEP Subrectpient Budget
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