2020/04/15 Council Agenda Packet

J . If previously denied,provide an explanation of why the request was denied, including which federal agency made the denial: Has the requesting organization ever been in violation of a federal civil rights statute, nondiscrimination provision of any federal program statute(e.g.,Sec.308 of the Robert T.Stafford Disaster Relief and Emergency Assistance Act of 1988), or any other programmatic term or condition related to nondiscrimination(e.g.,requirements to produce civil rights complaint data or a signed civil rights assurance),or entered into a remedial agreement as a result of a civil rights investigation during the past 3 years? No If yes,specify the disposition and/or corrective action that was.ordered and/or was, or will be, provided. Accordingly,applicants must disclose any finding by a Federal court or a Federal government agency, including an agency's civil rights office or the Civil Rights Division of the U.S. Department of Justice, and any efforts taken to cure the violation(s), as well as information regarding any remedial agreements. Applicants must also disclose any admissions of liability they have made regarding violations of Federal civil rights laws in their policing functions. G. Regional Sharing Agreement Will the requested controlled equipment provide a regional or multi jurisdictional capability? No If yes,provide the following information regarding the controlled equipment Regional Geographic size to be served(sq mi): Regional Population to be served: Provide the number of individuals with access: Have all entities within the regional sharing agreement implemented all required protocols,training, records keeping,and information collection and retention requirements prior to their personnel using the requested controlled equipment? H. Certification Statement By signing below,the authorized official certifies that the requesting organization: • Has adopted the required Policies and Protocols Requirements; • Meets the Training Requirements; • Will adhere to the Records Keeping Requirements; • Will adhere to After-Action Report Requirements; • If applicable, all entities within the regional sharing agreement have implemented or will implement all required protocols,training, records keeping, and information collection and retention requirements prior to acquisition of the controlled equipment. • Will abide by all applicable federal,state, local,and tribal laws, regulations, programmatic terms and conditions,and all requirements outlined in the Grant Programs Directorate Information Bulletin 407. Authorizing Official(Print Name): Signature: Date: Cassie Franklin I.FEMA Grant Programs Directorate Staff only Approved Signature: Date: Denied FEMA FORM 087-0-0-1 (03/16) 9 Page 3 of 6