HomeMy WebLinkAboutDEP GO136DEP AGREEMENT NO. G0136
STATE OF FLORIDA
GRANT AGREEMENT
PURSUANT TO
ENVIRONMENTAL PROTECTION AGENCY GRANT AWARD(S)
THIS AGREEMENT is entered into between the STATE OF FLORIDA DEPARTMENT OF
ENVIRONMENTAL PROTECTION, whose address is 3900 Commonwealth Boulevard, Tallahassee, Florida 32399-3000
(hereinafter referred to as the "Department" or "DEP") and the CITY OF CAPE CANAVERAL, whose address is Public
Works Department, 105 Polk Avenue, Cape Canaveral, Florida 32920, (hereinafter referred to as "Grantee" or
"Recipient"), a local government, to provide funding for the Banana River Baffle Boxes Project.
WHEREAS, the Department is the recipient of federal financial assistance from the Environmental Protection
Agency (EPA); and,
WHEREAS, the Florida Department of Environmental Protection was awarded funding by the Environmental
Protection Agency pursuant to Grant Agreement No. C9-99451504-0; and,
WIIEREAS, the Grantee has been determined to be a subrecipient of federal financial assistance from the U.S.
Environmental Protection Agency (EPA); and,
WHEREAS, the Grantee is responsible for complying with the appropriate federal guidelines in performance of its
activities pursuant to this Agreement.
NOW, THEREFORE, in consideration of the premises and the mutual benefits to be derived herefrom, the
Department and the Grantee do hereby agree as follows:
1. The Grantee does hereby agree to perform in accordance with the terms and conditions set forth in this Agreement,
Attachment A (Grant Work Plan), and all attachments and exhibits named herein which are attached hereto and
incorporated by reference. For purposes of this Agreement, the terms "Contract" and "Agreement" and the terms
"Grantee", 'Recipient" and "Contractor", are used interchangeably.
2. This Agreement shall begin upon execution by both parties and shall remain in effect for a period of thirty-six (36)
months, inclusive. The Grantee shall be eligible for reimbursement for work performed on or after the date of
execution and until the expiration of this Agreement. The Grantee may document expenditures made on or after
August 1, 2004 for purposes of meeting its match requirement. This Agreement may be amended to provide for
additional services if additional funding is made available by EPA and/or the Legislature.
3. A. As consideration for the services rendered by the Grantee under the terms of this Agreement, the
Department shall pay the Grantee on a cost reimbursement basis in an amount not to exceed $263,402.00
toward the total project cost described in Attachment A.
B. The Grantee shall be reimbursed on a cost reimbursement basis for all eligible project costs upon receipt
and acceptance of a properly completed Payment Request Summary Form (provided as Attachment B).
The Chief Financial Officer requires detailed supporting documentation of all costs under a cost
reimbursement agreement. In accordance with the Contract Payment Requirements (attached hereto and
made a part hereof as Attachment C), the Grantee shall comply with the minimum requirements set forth
therein. Invoices shall be accompanied by supporting documentation and other requirements as follows:
1. Salaries/Wages - The Grantee shall not be reimbursed for direct salaries or multipliers (i.e.,
fringe benefits, overhead, and/or general and administrative rates) for Grantee's employees.
2. Contractual (Subcontractors) - Reimbursement requests for payments to subcontractors must be
substantiated by copies of invoices with backup documentation identical to that required from the
DEP Agreement No. G0136, Page 1 of 10
Grantee. Subcontracts that involve payments for direct salaries shall clearly identify the
personnel involved, salary rate per hour, and hours/time spent on the project. All multipliers
used (i.e. fringe benefits, overhead, and/or general and administrative rates) shall be supported
by audit. If the Department determines that multipliers charged by any subcontractor exceeded
the rates supported by audit, the Grantee shall be required to reimburse such funds to the
Department within thirty (30) days of written notification. Interest on the excessive charges shall
be calculated based on the prevailing rate used by the State Board of Administration. Invoices
for reimbursement of fixed price subcontracts approved by the Department shall be documented
by copies of the paid invoices.
3. Travel - Requests for reimbursement of travel expenses are not authorized under the terms of
this Agreement.
4. E ui ment - The purchase of non -expendable equipment costing $ I,000 or more is not
authorized under the terms of this Agreement.
C. The Grantee may be required to submit a cost allocation plan to the Department in support of its
multipliers (overhead, indirect, general administrative costs, and fringe benefits). All bills for amounts
due under this Agreement shall be submitted in detail sufficient for a proper pre -audit and post -audit
thereof. State guidelines for allowable costs can be found in the Department of Financial Services'
Reference Guide for State Expenditures at www.dbfstate.fl.us/aadir/reference guide and allowable costs
for Federal Programs can be found under 48 CFR Part 31 at http://www.aceess.g�o gov_/nara/cfi/cfr table
search.html and OMB Circulars A-87, A-122, A-21, as applicable, at
http://wkvw.whitehouse gov/omb/circulars/index.html#numerical. Five copies of each invoice, including
appropriate backup documentation, shall be submitted to the Department's Grant Manager.
D. The Grantee will limit its participation in the salary rate (excluding overhead) paid to individual
consultants retained by grantee's or by a grantee's contractors or subcontractors to the maximum daily
rate for GS -18. This limitation applies to consultation services for designated individuals with specialized
skills who are paid at a daily or hourly rate. This rate does not include transportation and subsistence
costs for travel performed. Subagreements with firms for services, which are awarded using the
procurement requirements contained in 40 CFR 31.36, are not affected by this limitation.
E. The parties hereto understand and agree that this Agreement does require a cost sharing or match on the
part of the Grantee. The Grantee is responsible for providing $179,601.00 in cash or third party in-kind,
towards the work funded under this Agreement. All cost sharing/match shall meet the federal
requirements established in 48 CFR Part 31 and OMB Circulars A-87, A-122, A-21, as applicable.
F. Allowable costs will be determined in accordance with the cost principles applicable to the organization
incurring the costs. For purposes of this Agreement, the following cost principles are incorporated by
reference,
local or Indian tribal
Private non-profit organization other than (1) an
institution of higher education, (2) hospital, or (3)
organization named in OMB Circular A-122 as not
suject to that circular.
Education Institutions
For-profit organization other than a hospital and an
organization named in OMB A-122 as not subject
to that circular.
DEP Agreement No. GO136, Page 2 of 10
-Applicable Cost
OMB Circular A-87
OMB Circular A-122
OMB Circular A-21
48 CFR Part 31, Contract Cost Principles and
Procedures, or uniform cost accounting standards
that comply with cost principles acceptable to the
federal aaencv_
G. The table below identifies the funding supporting this Agreement and EPA Grants providing the funds.
EPA Grant Number CFDA Program Title Funding Amount
C9-99451504-0 66.460 LN092oint Source Im lementation $263,402.00
Total Fundin $263,402.00
4. The State of Florida's performance and obligation to pay under this Agreement is contingent upon an annual
appropriation by the Legislature. The parties hereto understand that this Agreement is not a commitment of future
appropriations.
5. A. The Grantee shall submit progress reports in accordance with the schedule contained in Attachment A.
Progress reports shall be submitted in conjunction with the Payment Request Summary Form, described in
paragraph 3.B. Progress reports shall describe the work performed, problems encountered, problem
resolution, schedule updates and proposed work for the next reporting period. The Grantee shall utilize
the Progress Reporting Form, attached hereto and made a part hereof as Attachment D, for submitting its
progress report. Reports shall be submitted to the Department's Grant Manager no later than twenty (20)
days following the completion of the reporting period. The final report shall be submitted no later than
thirty (30) days prior to the completion date of the Agreement. The Department's Grant Manager shall
have ten (10) calendar days to review deliverables submitted by the Grantee.
B. The Grantee agrees to comply with the requirements of EPA's Program for Utilization of Small, Minority,
and Women's Business Enterprises in procurement under this Agreement.
1. The Grantee accepts the Minority Business Enterprise/Women's Business Enterprise
(MBE/WBE) "Fair Share" goals and objectives negotiated with EPA as follows:
2. If the Grantee does not want to rely on the applicable State's MBE/WBE goals, the Grantee
agrees to submit proposed MBE/WBE goals based on availability of qualified minority and
women -owned business to do work in the relevant market for construction, services, supplies and
equipment. "Fair Share" objectives must be submitted to the EPA Grants Management Office,
61 Forsyth Street, Atlanta, GA 30303 within thirty (30) calendar days of award and approved by
EPA no later than thirty (30) calendar days thereafter. Copies of all correspondence with EPA
shall also be forwarded to the Department's Grant Manager.
3. The Grantee agrees to ensure, to the fullest extent possible, that at least the applicable "Fair
Share" objectives of Federal funds for prime contracts or subcontracts for supplies, construction,
equipment or services are made available to organizations owned or controlled by socially and
economically disadvantaged individuals, women and Historically Black Colleges and
Universities.
4. The Grantee agrees to include in its bid documents the applicable "Fair Share" objectives and
require all of its prime contractors to include in their bid documents for subcontracts the
negotiated "Fair Share" percentages.
5. The Grantee agrees to follow the six affirmative steps or positive efforts stated in 40 C.F.R.
30.44(b), 40 C.F.R. 31.36(e), or 40 C.F.R. 35.6580, as appropriate, and retain records
documenting compliance.
DEP Agreement No. G0136, Page 3 of 10
FloMQ/nVrRF
IndusGoal
Architectural & En ineerin Servicesd 15% WBE
Commodities 17% WBE
Contractual Services d 36% WBE
Construction (non SRF d I I %WBE
2. If the Grantee does not want to rely on the applicable State's MBE/WBE goals, the Grantee
agrees to submit proposed MBE/WBE goals based on availability of qualified minority and
women -owned business to do work in the relevant market for construction, services, supplies and
equipment. "Fair Share" objectives must be submitted to the EPA Grants Management Office,
61 Forsyth Street, Atlanta, GA 30303 within thirty (30) calendar days of award and approved by
EPA no later than thirty (30) calendar days thereafter. Copies of all correspondence with EPA
shall also be forwarded to the Department's Grant Manager.
3. The Grantee agrees to ensure, to the fullest extent possible, that at least the applicable "Fair
Share" objectives of Federal funds for prime contracts or subcontracts for supplies, construction,
equipment or services are made available to organizations owned or controlled by socially and
economically disadvantaged individuals, women and Historically Black Colleges and
Universities.
4. The Grantee agrees to include in its bid documents the applicable "Fair Share" objectives and
require all of its prime contractors to include in their bid documents for subcontracts the
negotiated "Fair Share" percentages.
5. The Grantee agrees to follow the six affirmative steps or positive efforts stated in 40 C.F.R.
30.44(b), 40 C.F.R. 31.36(e), or 40 C.F.R. 35.6580, as appropriate, and retain records
documenting compliance.
DEP Agreement No. G0136, Page 3 of 10
6. The Grantee agrees to submit a report documenting MBEIWBE utilization under federal grants
in conjunction with the required progress reports (see paragraph 5.A).
7. If race and/or gender neutral efforts prove inadequate to achieve a "Fair Share" objective, the
Grantee agrees to notify the Department and EPA in advance of any race and/or gender
conscious action it plans to take to more closely achieve the "Fair Share" objective.
8. In accordance with Section 129 of Public Law 100-590, the Small Business Administration
Reauthorization and Amendment Act of 1988, the recipient agrees to utilize and to encourage
any prime contractors under this Agreement to utilize small businesses located in rural areas to
the maximum extent possible. The Grantee agrees to follow the six affirmative steps stated in 40
C.F.R.. 30.44(b), 40 C.F.R. 31.36, or 40 C.F.R. 35.6580, as appropriate, in the award of any
contracts under this Agreement.
C. Pursuant to EPA Order 1000.25, dated January 24, 1990, the recipient agrees to use recycled paper for all
reports which are prepared as a part of this Agreement and delivered to the Department. This requirement
does not apply to reports which are prepared on forms supplied by EPA. This requirement applies even
when the cost of recycled paper is higher than that of virgin paper.
D. A draft comprehensive final report (hard copy and electronic) must be submitted no later than sixty (60)
days prior to the completion date of the Agreement. The Department will review the draft final report and
provide comments for inclusion in the final report within 30 days. Five (5) hard copies, plus one
electronic copy in Adobe.pdf format or Microsoft Word Format, of a comprehensive final report must be
submitted no later than the completion date of the Agreement. The Grantee's final report shall include an
accounting of all project expenses, a report of all matching funds contributed on behalf of the Grantee,
and a statement acknowledging that the project has been supported by a grant from the U.S.
Environmental Protection Agency. The following language shall be included on the cover page of the
final project report:
"This project and the preparation of this report was funded in part by a Section 319 Nonpoint Source
Management Program Implementation grant from the U.S. Environmental Protection Agency through an
agreement/contract with the Nonpoint Source Management Section of the Florida Department of
Environmental Protection. The total cost of the project was $[show actual amounts, of which $ show
actual amount or [show actual percentaees percent was provided by the U.S. Environmental Protection
Agency."
Additionally, all other final deliverables required by this Agreement (such as booklets, pamphlets, videos,
scientific papers, etc.) which were funded in whole or in part by federal sources shall include the language
below to acknowledge the federal government's participation in the project.
"This (booklet, pamphlet, video, paper, etc. as appropriate) was funded in part by a Section 319
Nonpoint Source Management Program Implementation grant from the U.S. Environmental Protection
Agency through an agreement/contract with the Nonpoint Source Management Section of the Florida
Department of Environmental Protection."
The Grantee agrees to provide a' copy of any draft report and/or final report to the Department before
making, or allowing to be made, a press release, publication, or other public announcement of the
project's outcome. This shall not be construed to be a limitation upon the operation and applicability of
Chapter 119, Florida Statutes.
6. Each party hereto agrees that it shall be solely responsible for the negligent or wrongful acts of its employees and
agents. However, nothing contained herein shall constitute a waiver by either party of its sovereign immunity or
the provisions of Section 768.28, Florida Statutes.
DEP Agreement No. G0136, Page 4 of 10
7. A. The Department may terminate this Agreement at any time in the event of the failure of the Grantee to
fulfill any of its obligations under this Agreement. Prior to termination, the Department shall provide
thirty (30) calendar days written notice of its intent to terminate and shall provide the Grantee an
opportunity to consult with the Department regarding the reason(s) for teen nation.
B. The Department may terminate this Agreement for convenience by providing the Grantee with thirty (30)
calendar days written notice.
C. The parties hereto may agree to terminate this Agreement for convenience as evidenced by written
amendment of this Agreement. The amendment shall establish the effective date of the termination and
the procedures for proper closeout of the Agreement.
D. This Agreement may be unilaterally canceled by the Department for refusal by the Grantee to allow public
access to all documents, papers, letters, or other material made or received by the Grantee in conjunction
with this Agreement, unless the records are exempt from Section 24(a) of Article I of the State
Constitution and Section 119.07(1), Florida Statutes.
8. If the Grantee materially fails to comply with the terms and conditions of this Agreement, including any Federal or
State statutes, rules or regulations, applicable to this Agreement, the Department may take one or more of the
following actions, as appropriate for the circumstances.
A. Temporarily withhold cash payments pending correction of the deficiency by the Grantee.
B. Disallow (that is, deny both use of funds and any applicable matching credit for) all or part of the cost of
the activity or action not in compliance.
C. Wholly or partly suspend or terminate this Agreement.
D. Withhold further awards for the project or program.
E. Take other remedies that may be legally available.
F. Costs of the Grantee resulting from obligations incurred by the Grantee during a suspension or after
termination of the Agreement are not allowable unless the Department expressly authorizes them in the
notice of suspension or termination. Other Grantee costs during suspension or after termination which are
necessary and not reasonably avoidable are allowable if the following apply.
1- The costs result from obligations which were properlyincurred by the recipient before the
effective date of suspension or termination, are not in anticipation of it, and in the case of
termination, are noncancellable.
2. The cost would be allowable if the Agreement were not suspended or expired normally at the end
of the funding period in which the termination takes place.
G. The remedies identified above, do not preclude the Grantee from being subject to debarment and
suspension under Executive Orders 12549 and 12689.
A. The Grantee shall maintain books, records and documents directly pertinent to performance under this
Agreement in accordance with generally accepted accounting principles consistently applied. The
Department, the State, or their authorized representatives shall have access to such records for audit
purposes during the term of this Agreement and for five years following Agreement completion. In the
event any work is subgranted or subcontracted, the Grantee shall similarly require each subgrantee and
subcontractor to maintain and allow access to such records for audit purposes.
DEP Agreement No. G0136, Page 5 of 10
B. The Grantee agrees that if any litigation, claim, or audit is started before the expiration of the record
retention period established above, the records shall be retained until all litigation, claims or audit findings
involving the records have been resolved and final action taken.
C. Records for real property and equipment acquired with Federal funds shall be retained for five years
following final disposition.
10. In addition to the provisions contained in paragraph 9 above, the Grantee shall comply with the applicable
provisions contained in Attachment E, Special Audit Requirements. A revised copy of Attachment E, Exhibit -
1, must be provided to the Grantee with each amendment which authorizes a funding increase or decrease. - The
revised Exhibit -1 shall summarize the funding sources supporting the Agreement for purposes of assisting the
Grantee in complying with the requirements of Attachment E. If the Grantee fails to receive a revised copy of
Attachment E, Exhibit -1, the Grantee shaII notify the Department's Grants Development and Review Manager at
8501245-2361 to request a copy of the updated information.
11. A. The Grantee shall not subcontract work under this Agreement without the prior_ written consent of the
Department's Grant Manager, unless the subcontractor has been identified in the Grant Work Plan. The
Grantee agrees to be responsible for the fulfillment of all work elements included in any subcontract and
agrees to be responsible for the payment of all monies due under any subcontract. It is understood and
agreed by the Grantee that the Department shall not be liable to any subcontractor for any expenses or
liabilities incurred under the subcontract and that the Grantee shall be solely liable to the subcontractor for
all expenses and liabilities incurred under the subcontract.
B. The Grantee agrees to comply with the procurement requirements contained in 40 C.F.R. 31.36 for its
selection of subcontractors.
C. The Grantee agrees to notify the Department of all subcontractors not identified in the Grant Work Plan
no Iess than twenty days prior to the effective date of the subcontracts for the purpose of approval by the
Department. The Grantee agrees to provide the Department with an executed copy of all subcontracts
within ten days after the effective date of the agreement.
D. The Department of Environmental Protection supports diversity in its procurement program and requests
that all subcontracting opportunities afforded by this Agreement embrace diversity enthusiastically. The
award of subcontracts should reflect the full diversity of the citizens of the State of Florida. The
Department will be glad to famish a list of minority owned businesses for consideration in subcontracting
opportunities.
12. A. The Grantee certifies that no Federal appropriated funds have been paid or will be paid, on or after
December 22, 1989, by or on behalf of the Grantee, to any person for influencing or attempting to
influence an officer or employee of an agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress, in connection with the awarding, renewal, amending
or modifying of any Federal contract, grant, or cooperative agreement. If any non -Federal funds are used
for lobbying activities as described above, the Grantee shall submit Attachment IF, Standard
Form -LLL, "Disclosure of Lobbying Activities" (attached hereto and made a part hereof), and shall file
quarterly updates of any material changes. The Grantee shall require the language of this certification to
be included in all subcontracts, and all subcontractors shall certify and disclose accordingly. 140 CFR 34]
B. In accordance with Section 216.347, Florida Statutes, the Grantee is hereby prohibited from using funds
provided by this Agreement for the purpose of lobbying the Legislature, the judicial branch or a state
agency.
C. Pursuant to the Lobbying Disclosure Act of 1995, any organization described in Section 501(c)4 of the
Internal Revenue Code of 1986 shall not be eligible for subgrants under this Agreement, unless such
organization warrants that it does not, and will not, engage in lobbying activities prohibited by the Act as
a special condition of the subgrant. This restriction does not apply to loans made pursuant to approved
revolving loan programs or to contracts awarded using proper procurement procedures.
DEP Agreement No. G0136, Page 6 of 10
D. The Grantee's Chief Executive Officer shall certify that no funds provided under this Agreement have
been used to engage in the lobbying of the Federal Government or in litigation against the United States
unless authorized under existing Iaw. The Grantee shall submit Attachment G, "Lobbying and
Litigation Certificate" (attached hereto and made a part hereof) to the Department within ninety (90)
days following the completion of the Agreement period.
13. The Grantee shall comply with all applicable federal, state and local rules and regulations in performing under this
Agreement. The Grantee acknowledges that this requirement includes compliance with all applicable federal, state
and local health and safety rules and regulations. The Grantee further agrees to include this provision in all
subcontracts issued as a result of this Agreement.
14. The Department's Grant Manager (which may also be referred to as the Department's Project Manager) for this
Agreement is identified below.
15. The Grantee's Grant Manager (which may also be referred to as the Grantee's Project Manager) for this Agreement
is identified below.
VJeffRatliff'of Ca e Canaveral
ic WorksPolk Avenue
Cape Canaveral, Florida 32920
Telephone No.: 3211868-1240
Fax No.: 32118 58-1233
E-mail Address: iaratliff cRbellsouth_nPt
16. To the extent required by law, the Grantee will be self-insured against, or will secure and maintain during the life
of this Agreement, Workers' Compensation insurance for all of his employees connected with the work of this
project and, in case any work is subcontracted, the Grantee shall require the subcontractor similarly to provide
Workers' Compensation Insurance for all of the latter's employees unless such employees are covered by the
protection afforded by the Grantee. Such self-insurance program or insurance coverage shall comply fully with the
Florida Workers' Compensation law. In case any class of employees engaged in hazardous work under this
Agreement is not protected under Workers' Compensation statutes, the Grantee shall provide, and cause each
subcontractor to provide, adequate insurance satisfactory to the Department, for the protection of his employees
not otherwise protected.
17. The Grantee warrants and represents that it is self-funded for liability insurance, appropriate and allowable under
Florida law, and that such self-insurance offers protection applicable to the Grantee's officers, employees, servants
and agents while acting within the scope of their employment with the Grantee.
I8. The Grantee covenants that it presently has no interest and shall not acquire any interest which would conflict in
any manner or degree with the performance of services required.
DEP Agreement No. G0136, Page 7 of 10
19. The purchase of non -expendable personal property or equipment costing $1,000 or more is not authorized under
the terms of this Agreement.
20. The Department may at any time, by written order designated to be a change order, make any change in the work
within the general scope of this Agreement (e.g., specifications, timeline within current authorized Agreement
period, method or manner of performance, requirements, etc.). All change orders are subject to the mutual
agreement of both parties as evidenced in writing. Any change order, which causes an increase or decrease in the
Grantee's cost or time, shall require formal amendment to this Agreement.
21, The Hotel and Motel Fire Safety Act of 1990 (Public Law 101-391) establishes a number of fire safety standards
which must be met for hotels and motels. The Grantee acknowledges that Federal funds may not be used to
sponsor a conference, meeting, or training seminar held in a hotel or motel which does not meet the requirements
of the Hotel and Motel Fire Safety Act of 1990.
22. If the Grantee's project involves environmentally related measurements or data generation, including the
development of models that may be used in regulatory decisions, the Grantee shall develop and implement quality
assurance practices consisting of policies, procedures, specifications, standards, and documentation sufficient to
produce data of quality adequate to meet project objectives and to minimize loss of data due to out -of -control
conditions or malfunctions. All sampling and analyses performed under this Agreement must conform with the
requirements set forth in Chapter 62-160, Florida Administrative Code, and the Quality Assurance Requirements
for Department Agreements, attached hereto and made part hereof as Attachment H.
23. A. No person, on the grounds of race, creed, color, national origin, age, sex, or disability, shall be excluded
from participation in; be denied the proceeds or benefits of; or be otherwise subjected to discrimination in
performance of this Agreement.
B. An entity or affiliate who has been placed on the discriminatory vendor Iist may not submit a bid on a
contract to provide goods or services to a public entity, may not submit a bid on a contract with a public
entity for the construction or repair of a public building or public work, may not submit bids on leases of
real property to a public entity, may not award or perform work as a contractor, supplier, subcontractor, or
consultant under contract with any public entity, and may not transact business with any public entity.
The Florida Department of Management Services is responsible for maintaining the discriminatory vendor
list and intends to post the list on its website. Questions regarding the discriminatory vendor list may be
directed to the Florida Department of Management Services, Office of Supplier Diversity at 850/487-
09I5.
24. A. In accordance with Executive Order 12549, Debarment and Suspension (40 CFR 32), the Grantee agrees
and certifies that neither it, nor its principals, is presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation in this transaction by any Federal
department or agency; and, that the Grantee shall not knowingly enter into any lower tier contract, or other
covered transaction, with a person who is similarly debarred or suspended from participating in this
covered transaction, unless authorized in writing by EPA to the Department.
B. Upon execution of this Agreement by the Grantee, the Grantee shall complete, sign and return a copy of
the form entitled "Certification Regarding Debarments, Suspension, Ineligibility and Voluntary Exclusion
- Lower Tier Federally Funded Transactions", attached hereto and made a part hereof as Attachment 1:.
C. As required by paragraphs A and B above, the Grantee shall include the language of this section, and
Attachment I in all subcontracts or lower tier agreements executed to support the Grantee's work under
this Agreement.
25. The Environmental Protection Agency and Department, reserve a royalty -free, nonexclusive, and irrevocable
license to reproduce, publish or otherwise use, and to authorize others to use, for government purposes:
A. The copyright in any work developed under a grant, subgrant, or contract under a grant or subgrant.
DEP Agreement No. G0136, Page 8 of 10
B. Any rights of copyright to which a grantee, subgrantee or a contractor purchases ownership with grant
support.
26. The Grantee agrees to comply with, and include as appropriate in contracts and subgrants, the provisions contained
in Attachment J, Contract Provisions, attached hereto and made a ' part hereof. In addition, the Grantee
acknowledges that the applicable regulations listed in Attachment K, Regulations, attached hereto and made a
part hereof, shall apply to this Agreement.
27. Land acquisition is not authorized under the terms of this Agreement.
28. This Agreement represents the entire agreement of the parties. Any alterations, variations, changes, modifications
or waivers of provisions of this Agreement shall only be valid when they have been reduced to writing, duly signed
by each of the patties hereto, and attached to the original of this Agreement, unless otherwise provided herein.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
DEP Agreement No. G0136, Page 9 of 10
IN WITNESS WHEREOF, the parties have caused this Agreement to be duly executed, the day and year last
written below.
CITY OF CAPE CANAVERAL
By:
Tide:*
Date:.2 Da c
FEID No.: 59-0974636
STATE OF FLORIDA DEPARTMENT OF
ENVIRONMENTAL PROTECTION
By: I �Q
Sec or desi ee
Date: � �J
David Worley, DEP Grant Manager
Alp
DEP Co tracts Administrator
Approved as to form and legality:
DEP ttorney
*For Agreements with governmental boards/commissions: If someone other than the Chairman signs this Agreement, a
resolution, statement or other document authorizing that person to sign the Agreement on behalf of the governmental
board/commission must accompany the Agreement.
List of attachments/exhibits included as part of this Agreement:
Specify
Letter/
Type
Number
Description (include number of pages)
Attachment
A
Grant Work Plan 8 Pages)
Attachment
B
Payment Request Summga Form and Instructions 2 Pages
Attachment
C
Contract Pa ent Requirements I Page)
Attachment
D
ProgEess Report Form 2 Pages)
Attachment
E
Special Audit Requirements 5 Pages)
Attachment
F
Disclosure of Lobb)dng Activities 2 Pa es
Attachment
G
Lobb3jng and Litigation Certificate 1 Page)
Attachment
H
Qualijy Assurance Requirements 4 Pa es
Attachment
I
Certification Regarding Debarment/Sus ension 2 Pages)
Attachment
7
Contract Provisions 3 Pages)
Attachment
K
Re ulations 1 Pa e
DEP Agreement No. G0136, Page 10 of 10
ATTACHMENT A
GRANT WORK PLAN
BANANA RIVER BAFFLE BOXES
COOPERATING ORGANIZATIONS:
I . Cape Canaveral Public Works Department (City)
2. Indian River Lagoon Program, St. Johns River Water Management District (SJRWMD)
PROJECT LOCATION:
NPS Priority Watershed: Indian River Lagoon
Hydrologic Unit Code: 03080202
The project, a series of baffle boxes, is located approximately three blocks east and adjacent to the Banana
River Lagoon, and approximately four miles south of SR 528. The longitude of the project sites are near
80i60' 05" and the latitude is 28i40'06". The site is Iocated within the Sections 15 and 22, Township 24
South, Range 37 East in Brevard County, within the city limits of Cape Canaveral.
Implementing the Best Management Practices (BMPs) will be part of the City's Iong term goal of
providing stormwater treatment for the whole City. The proposed baffle boxes in this project will provide
significant treatment of Total Suspended Solids (TSS), heavy metals, and nutrients for three of the City's
sic drainage basins.
The total drainage basin for this site is 403 acres of single family residential, commercial, and industrial
area. The vast majority of this watershed drains westward to the Banana River in the Indian River Lagoon
(IRL), designated by EPA as an "estuary of national significance," also a state priority waterbody
designated under the Surface Water Improvement & Management Program (SWIM), and part of the state's
Unified Watershed Assessment. The proposed baffle boxes in this project will provide significant
treatment of Total Suspended Solids (TSS), heavy metals, and nutrients for this drainage basin.
POLLUTION- REDUCTION STRATEGY:
This project has been incorporated as part of the City of Cape Canaveral's 5 -year Capital Improvement
Plan. Cape Canaveral's receiving waters is the Banana River, a waterbody segment of the Indian River
Lagoon — segment I.C.1 of the Indian River Lagoon as specified in the IRLSWIM plan (Appendix 5,
SWIM, revised 1994). The City's stormwater utility uses the SWIM Plan and IRLCCMP as guidance for
the City's stormwater program — see IRLCCMP Progress Report, City of Cape Canaveral. The concept
proposed for 319 funding embraces several of the Actions in the Indian River Lagoon Comprehensive
Conservation and Management, Plan (IRLCCMP) (Appendix 5, IRLCCMP, revised 1998)).
Implementation of stormwater improvements to small drainage basins is generally described in the Indian
River Lagoon National Estuary Program's Comprehensive Conservation and Management Plan, revised in
1998 under the Freshwater and Stormwater Discharge Section, Recommendations for Small Drainage
Systems, Action FSD-13. Specifically, Action 13.03. Where appropriate, implement technologies, such as
"baffle boxes" and catch basin inserts, to provide additional stormwater treatment in existing drainage
systems. These technologies may provide interim or final solutions for older drainage systems." As well
as, Action 13.04, "Include stormwater `system retrofitting and upgrades in projects such as road
maintenance and widening, utility system repairs and upgrades, urban renewal or redevelopment, or similar
projects." Both actions appear to address the component accomplished when implementing stormwater
improvements such as that described in this proposal. This urban stormwater retrofit BMP satisfies these
Actions of the IRLCCMP: FSD-4, FSD-6, FSD 11, FSD13, W-6, W-7, PIE -2 and PIE -4. The City has
actively involved the community in the City's Capital Improvement Program, which includes this project —
involving them in the planning stage and improvement of the project area. As with all of City's major
storinwater improvement projects, an educational sign will be erected at the site which describes the
improvement and the need for stormwater management within the County for resource protection (FSD-11,
PIE -3, PIE -4).
DEP Agreement No. G0136, Attachment A, Page 1 of 8
ESTIMATED POLLUTANT LOAD REDUCTION:
The stormwater strategy for this project will be the reduction of suspended solids from runoff using baffle
boxes to trap sediment. Currently there are no stormwater treatment practices employed in these drainage
basins. Nutrient Separating Baffle Boxes at each of the three outfall pipes will prevent sediment and
floating trash from entering the Banana River, providing a reduction in TSS and nutrients.
Stormwater loading rates are calculated from the report "Stormwater Loading Rate Parameters for Central
and South Florida", Harvey Harper, 1994. From Brevard County studies, Dr. Pandit, 1995, it is estimated
that a baffle box will remove 80% of TSS and 30% Total Phosphorus,
Banana River Baffle Boxes
The drainage basin for this site is 403 acres of single family residential, commercial, and industrial area.
The following annual pollutant loads are projected at this site:
Area
Estimated Annual Loadings
LIndustrial
TSS
Loading
Area Rate
ac k lac- r
Residential Area
Commercial Area
TSS
Total P
TSS
Total P
Loading
Loading
Loading
Loading
Area Rate
Rate
Area Rate
Rate
ac k lac- r
k ac- r
ac k lac- r
k lac- r'
170.8 1 56.1
.594
189.2 435
1.96
Area
Totals
LIndustrial
TSS
Loading
Area Rate
ac k lac- r
Total P
Loading
Rate
k lac- r
Total Total
Annual Annual
TSS Load TP Load
k r k r
158
. 383
1.24
108,314 525
The proposed improvement for these 3 outfalls is 3 Nutrient Separating Baffle Boxes treating 403 acres.
Estimated Removal Efficiency for Baffle Boxes
Parameter Removal
Efficiency
Annual Load Reduction
(kg/yr)
TSS 80%
86,651
Total P 30%
158
PROJECT OBJECTIVES:
In 1994, Woodward -Clyde, consultants under contract to the Indian River Lagoon National Estuary
Program (IRLNEP), published eight volumes of technical reports describing the historical data reviewed,
their assessment of the data and its reliability. The three reports considered pertinent for Cape Canaveral
are the following : Status and Trends Summary of the Lagoon, The Preliminary Water and Sediment
Quality Assessment of the Indian River Lagoon, and Loadings Assessment of the Indian River Lagoon. In
these volumes, of literature, the Cape Canaveral area of the Lagoon (including Banana River, Sykes Creek
and Newfound Harbor) is designated by Woodward Clyde as Segment -113. Segment IB, known as the
Banana River basin, is further divided into 2 sub -basins within the basin. The largest pollutant loadings in
DEP Agreement No. G0136, Attachment A, Page 2 of 8
this segment are contributed by the smaller subbasin of Sykes Creek, due largely to the intensive land use
and built -out area. This area does not contain the Cape Canaveral Area. The reports summarize that the
Cape Canaveral area has observe a steady decline in seagrasses with the continued development of the area.
Woodward -Clyde listed priority issues for the Lagoon as follows: (1) reduction of stormwater runoff loads
from the urban areas; (2) the initiation of studies to determine if septic tanks are impacting the Lagoon by
contributing fecal coliform and excess nutrients; (3) the retrofitting of stormwater systems in developed
urban areas including US Highway 1; and (4) the use of best management practices (BMPs) in stormwater
treatment.
Section 303(d) of the Clean Water Act (CWA) requires states to submit lists of surface waters that do not
mect applicable water quality standards (impaired waters) after implementation of technology based
effluent limitations, and establish Total Maximum Daily Loads (TMDLs) for these waters on a prioritized
schedule. TMDLs establish the maximum amounts of pollutants that a water body can assimilate without
causing exceedances of water quality standards. Development of TMDLs is an important step toward
restoring our waters to their designated uses. In order to achieve the water quality benefits intended by the
CWA, it is critical that TMDLs, once developed, be implemented as soon as possible. FDEP has listed the
IRL watershed and given it a low priority for developing TMDLs. Completion dates for developing
TMDLs for this water body is 2010.
To date, Pollutant Load Reduction Goals (PLRGs) have not been established for the Rockledge area or for
other waters in the vicinity. The St. Johns River Water Management District (SJRWMD) has initiated the
PLRG development process and is refining the model to develop goals for this area.
As noted in the City's recently completed Stormwater Master Plan, (Stottler Stagg & Associates, Sept.
2000) several long term data sets analyzed by Brevard County's Office of Natural Resource Management
(1987-1994) reflect a decline in sea grass beds in the Banana River Lagoon in the Cape Canaveral vicinity.
This report also notes, "Increased nutrient Ioads in the basin from urban growth and treated sewage
discharges have resulted in water degradation, as seen in loss of seagrass beds and declining harvest of
fish." It also states, "One of the major purposes for upgrading the City's stormwater plan for Cape
Canaveral would be to improve the water quality at the City's major outfalls to the Banana River."
Therefore, the goal of the proposed project is to improve the duality of stormwater runoff from the 403 -acre
basin to the Banana River through three major outlets.
The primary objectives of this project is to provide water quality treatment for the untreated stormwater
discharges to the River. The water quality treatment will also allow flood protection improvements in areas
where this is needed. The objectives to be achieved by this project include:
• To reduce water quality impacts to the receiving water body, Banana River and the Indian River
Lagoon.
• To design and implement a permittable project by federal, state, and local jurisdictional agencies.
• To implement a cost effective project.
Match for this project will be provided through the City's Stormwater Utility Fee, which has a single family
residence fee of $3/month or $36/year
PROJECT DESCRIPTION:
Background: The City of Cape Canaveral Iies on the barrier island of Brevard County. Stottler Stagg and
Associates completed a Stormwater Master Plan for Cape Canaveral in 2000. Three of the major drainage
basins identified in the Masterplan were the Central, Holman, and Center Drainage basins. These basins
consist of 403 acres of commercial and residential property, which discharges to the Banana River via three
54" concrete pipes. At the outfall of these 54" pipes, considerable sand bars have built up due to
sedimentation. The basins are almost completely built out, with little or no vacant land for stormwater
DEP Agreement No. G01.36, Attachment A, Page 3 of 8
ponds. The strategy proposed in the Masterplan for retrofitting these basins is to construct Nutrient
Separating baffle boxes along Central Avenue, Holman Avenue, and Center Street near the outfalls of the
54" pipes. According to the CCMP for the Indian River Lagoon, the pollutants of concern for this area are
suspended solids and nutrients. Using baffle boxes at outfalls has proven to be an effective BMP for
treating suspended sediments and nutrients in gross pollutants.
SPECIFIC OUTPUTSIDELIVERABLES (e.g. reports, manuals, videos, maps, BMPs, meetings, field
days, issued permits, etc.) A complete list of all tasks and their outputs:
Task 1: Survey Project Site
Description: The City's engineering consultant will prepare a complete survey of the baffle box locations.
Expected Results: A complete, efficient and cost effective survey.
Deliverables: A complete survey of the project locations.
Task 2: Engineering Design
Description: The City's engineering consultant will prepare design specifications and construction
documents for installation of three baffle boxes along Central Avenue, Holman Avenue, and Center Street.
(Post construction surface water monitoring will be conducted over a 1+ year time frame, see Task 6
below.) The baffle boxes will be installed in existing street right-of-ways.
Ex ected Results: A complete, efficient, and cost effective design with permits.
Deliverables: A complete set of design and construction drawings with construction specifications.
Task 3 : Prepare, Send, Receive, Evaluate and Award Construction Bid
Description: City personnel will prepare, advertise for, send, receive, and evaluate bids for construction of
the Nutrient Separating baffle boxes. An award will be made, contracts signed and notice to proceed given.
Ex ccted Results: A number of received competitive bids will be evaluated and a responsible low bid that
is within budget will be selected.
Deliverables: A construction contract with a Notice to Proceed given to the responsible low bidder.
Task 4: Construction of Stormwater Facilities
Description: The City's selected contractor will construct the baffle boxes.
Ex ected Results: Complete and adequately constructed facilities.
Deliverables: The acceptance of the facilities as completed facilities according to design.
Task 5: Post Grant Project Administration
Description: After the grant has been awarded, the City's grant administrator shall provide ongoing
monitoring of project schedules to assure compliance with timelines outlined in the grant contract.
Required grant quarterly reports to DEP, construction contract coordination with DEP, Quality Assurance
Monitoring plans, stormwater monitoring reports, and preliminary and final project reports will be written
by the grant administrator.
Exl2ccted Results: Continual monitoring of the grant status will provide a smooth flow of the required work
for the various phases of this project as well as compliance with grant contract schedules. Compliance with
grant schedules will enhance future opportunities for grant acquisition as well as maintaining positive
relationships with affected citizens.
Deliverables: Quarterly reports to DEP, stormwater monitoring reports, and preliminary and final project
reports will be written.
Task 6: Implementation of Water Quality Monitoring Program
Description: At the outfall location, background monitoring will be conducted to determine mean event
concentrations for standard pollutant parameters. After construction is completed, 3 samples will be taken
with auto -samplers at the inflow and outflow points of one of the baffle boxes.
Ex ected Results: This monitoring plan will provide data for measuring the effectiveness of the use of a
baffle box.
Deliverables: Monthly stormwater reports, storm event auto -sampler reports, and an annual stormwater
analysis reports will be completed.
DEP Agreement No. G0136, Attachment A, Page 4 of 8
Task 7: Implementation of Education Component
Description:
esch tpio_n: The public education component will include coverage of the project in the City of Cape
Canaveral website accessible to all residents and news items in local sections of three local newspapers.
Press releases will be distributed upon project completion and educational signage will be provided on site.
Expected Results: The public education component will include coverage of the project in the City of Cape
Canaveral website and news items in local sections of a local newspaper. Press releases will be distributed
upon project completion and educational signage will be provided on site. The City of Cape Canaveral will
administer this component.
Deliverables: Quarterly information regarding the status of the project conveyed to the public. Slides will
be taken throughout the design and construction phases of the project and will be provided with the final
report. Educational signage will be provided on site.
PROJECT MILESTONES: (including start, completion and reporting dates):
Soon after the award is announced a surface water -monitoring plan will be developed and provided to
FDEP within the three-month timeline requested in the grant guidelines.
Task 1: Survey Project Site
Task 2: Engineering Design
Task 3: Prepare, Send, Receive, Evaluate and
Construction Bid
Task 4: Construction of Stormwater Facilities
Task 5: Post Grant Project Administration
Task 6: Im lementation of Water Quality Moi
Task 7: lm lementation of Education
Progress Reports & Invoices
Draft Final Report
Final Report & Invoice
Start
Com let
Month 1
Month 2
Month 3
Month 5
AwardEE Month 6
Month 8
EDUCATION AT BANANA RIVER BAFFLE BOXES
Month 10 Month 13
Month 4
Month 19
Month 13
Month 19
Month 5
Month 17
Month 34 f
Month 35
The City of Cape Canaveral updates its website regularly with articles for cityresidents informing them of
the activities that are ongoing by city staff and describing the various capital projects around the
municipality. These articles will carry updates of the status of this 319(h) grant project, as one of the
projects that is being accomplished with stormwater utility fee receipts.
There are also two newspapers in circulation, the Florida Today and Orlando Sentinel. The Florida Today
is the local newspaper. The Florida Today has daily local sections during -!he week. The reporters for these
papers are always looking for good stories to report. This project is assured of providing plenty of
opportunities for reporting over the year- long project. Press releases will also be issued to the local media
upon completion of the project's construction.
Finally, photos will be taken throughout the design and construction phases of the project. They will be
provided with the final report. Also, educational signage with information about contributing agencies will
be installed in the Cape Canaveral area as well as a public education kiosk explaining the stormwater
improvements and its water quality benefits to the IRL for eliminating suspended solids and freshwater
contribution.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
DEP Agreement No, G0136, Attachment A, Page 5 of 8
PROJECT BUDGET: $439,003
GRANT FUNDING REQUESTED: $263,402 from 319(h)
BUDGET BY ACTIVITY:
PROJECT FUNDING ACTIVITY
Staff
Travel
Equipment
Supplies
Contractual (BMP Implementation/ Construction)
Monitoring
Public Education
Other (draft and final reports) Post -Award Grant
Administration
319 $ AMOUNT
MATCHING FUNDS
By Source Enti
0
0
0
0
$134,601 (CC SU)
$30,000 (CC SU)
$5,000 (CC SU)
$10,000 (CC SU)
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
DEI' Agreement No. G0136, Attachment A, Page 6 of 8
TOTAL PROJECTED COST:
$443,003
% Match = 40%
y
CC SU: Cape Canaveral Stormwater Utility
BUDGET BY TASK:
TASK
Task 1: Survey Project Site
319 h FUNDS
NON FEDERAL MATCH
Task 2: Engineering Design
0.
$18,000 (CC SU)
Task 3: Prepare, Send, Receive, Evaluate
0
$59,800 (CC SU)
and Award Construction Bid
0
$3,000 (CC SU)
Task 4: Construction of Stormwater
Facilities
$263,402
$53,801 (CC SU)
Task 5: Post Award Grant Administration
Task 6: Water Quality Monitoring Program
$10,000 (CC SU)
Task 7: Education Component
0
$30,000 (CC SU}
0
$5,000 (CC SU)
TOTAL
$263,402
$179,601
% Match = 60'
% Match = 40%
TOTAL PROJECTED COST:
$443,003._
CC SU: Cape Canaveral Stormwater Utility
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
DEI' Agreement No. G0136, Attachment A, Page 6 of 8
APPENDIX I - Preliminary Surface Water Monitoring at Cape Canaveral
Introduction:
The City has proposed a balanced and comprehensive approach to stormwater management in order to
minimize pollutant discharges into the Cape Canaveral project area. The final Water Quality Monitoring
Plan will be developed in coordination with the Florida Department of Environmental Protection (FDEP).
The final Plan will be submitted within three months of the grant award and will be designed to improve
water quality and comply with maintenance and monitoring requirements.
Basel Le Data.
Baseline data on current water quality will be derived from grab samples, modeling and monitoring efforts
of the SJRWMD and FDEP within the Cape Canaveral project area.
The City will use the best available data for establishing baseline water quality standards for the various
Best Management Practices (BMPs). Data collected during preconstruction monitoring activities will be
used, as well as that available from technical literature and reports.
The effectiveness of this project in reducing Stormwater loadings will be quantified via water quality
monitoring. This monitoring shall include background monitoring of surface waters during non -rain fall
conditions. This background monitoring will enable the general physicochemical of the receiving water to
be characterized under baseline conditions. Ater significant rainfall events, the City will take Influent
sampling. The samples will be analyzed for appropriate constituents based upon baseline data and
(upstream) and Effluent (downstream) water samples either by automated instrumentation or by manual
perm
requirements. It is anticipated that no less than three (3) storm events shall be monitored. Flow shalt
I i
monitored to enable pollutant loadings to be calculated. A full list of analysts is presented below.
All laboratory analyses will be performed in accordance with USEPA and FDEP approved protocols. The
selected firm will maintain a FDEP approved Comprehensive Quality Assurance Plan and Florida
Department of Health certification.
Lead Agency: City of Cape Canaveral and/or Selected firm through the bidding process
Frequency of Testing Locations for Base Flow: Surface water, twice
Frequency of Testing for Storm Events: Surface Water and Discharge, via hand -sampling or automated
equipment, three
Number of Testing Locations: Discharge, three; Storm -event samplers, two per location
Testing Parameters: Surface water
Influent Testing:
Total Kjeldahl Nitrogen (TKN)
Nitrate and Nitrate -N
Ammonia -N
Total Phosphorus
Biological Oxygen Demand (BOD)
Total Suspended Solids (TSS)
Effluent Testing:
Total Kjeldahl Nitrogen (TKN)
Nitrate and Nitrate -N
Ammonia -N
Total Phosphorus
Biological Oxygen Demand (BOD)
Total Suspended Solids (TSS)
Daily Total Rain Fall
Discharge Velocity Flow
DEP Agreement No. G0I36, Attachment A, Page 7 of 8
ReRe�g:
A component of this project involves developing a detailed and systematic record-keeping system to
monitor maintenance activities on each BMP element. Logs will be kept detailing equipment and
procedures used in maintaining/cleaning and operating the respective BMPs/controls. A systematic
evaluation will be incorporated into the Water Quality Monitoring Plan to gauge the overall effect of the
full set of BMP improvements on both the quality of water discharged through the outfall, and the water
quality of the Cape Canaveral project area. Water samples from the outfall wiII be periodically collected,
tested and analyzed to develop trend curves. It is estimated that semiannual review reports will be
produced.
Coordination:
Copies of semiannual reports will be provided to SJRWMD, FDEP, and Cape Canaveral Public Works
Department.
Duration:
12 months
Conclusion:
This Draft Performance and Water Quality Monitoring Plan is conceptual in nature and will be
considerably refined based on input received from the SJRWMD, FDEP and other concerned agencies or
parties.
Budge
The total budget for monitoring, including labor, equipment lease and analytical services, is $30,000.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
DEP Agreement No. G0136, Attachment A, Page 8 of 8
ATTACHMENT B
PAYMENT REQUEST SUMMARY FORM
GRANTEE: Cftj of Cape Canaveral
DEP AGREEMENT NO.: G0136
DATE OF REQUEST:
AMOUNT
REQUESTED:$
GRANTEE'S GRANT MANAGER:
PAYMENT REQUEST NO.:
PERFORMANCE
PERIOD:
PERCENT MATCHING
REQUIRED:
GRANT EXPENDITURES SUMMARY SECTION
CATEGORY OF EXPENDITURE
Salaries
Fringe Benefits
Travel (if authorized)
Subc)ntracting:
Planning
Design
Construction
Construction Related Costs
Equipment Purchases
Supplies/Other Expenses
Land
.Indirect
TOTALS
Date of Grant thro
AMOUNT OF
THIS REQUEST
NIA
N/A
N/A
NIA
N/A
NIA
$
h End -of -Grant Period
T
CUM
PA
NIA
NIA
NIA
N/A
NIA
NIA
TOTAL
MATCHING TOTAL
CUMULATIVE FUNDS CUMULATIVE
PAYMENTS MATCHING
FUNDS
N/A N/A
NIA N/A
N/A NIA
$
NIA N/A
N/A N/A
N/A N/A
$ $
AGREEMENT AMOUNT $ $
Less Total Cumulative Payments of: $ $
TOTAL REMAINING IN GRANT $ $
GRANTEE CERTIFICATION .
The undersigned certifies that the amount being requested for reimbursement above
was for items that Nvere charged to and utilized only for the above cited grant activities.
Grantee's Grant Manager's Signature Grantee's Fiscal Agent
Print Name Print Name
Telephone Number Telephone Number
DEP Agreement No. G0136, Attachment B, Page 1 of 2
AGREEMENT AMOUNT $ $
Less Total Cumulative Payments of: $ $
TOTAL REMAINING IN GRANT $ $
GRANTEE CERTIFICATION .
The undersigned certifies that the amount being requested for reimbursement above
was for items that Nvere charged to and utilized only for the above cited grant activities.
Grantee's Grant Manager's Signature Grantee's Fiscal Agent
Print Name Print Name
Telephone Number Telephone Number
DEP Agreement No. G0136, Attachment B, Page 1 of 2
INSTRUCTIONS FOR COMPLETING
ATTACHMENT B
PAYMENT REQUEST SUMMARY FORM
GRANTEE: Enter the name of the grantee's agency.
DEP AGREEMENT NO.: This is the number on your grant agreement.
DATE OF REQUEST: This is the date you are submitting the request.
AMOUNT REQUESTED: This should match the amount on the "TOTAL AMOUNT " line for the "AMOUNT OF THIS
REQUEST' column.
GRANTEE'S GRANT MANAGER: This should be the person identified as grant manager in the grant agreement.
PAYMENT REQUEST NO.: This is the number of your payment request, not the quarter number.
PERFORMANCE PERIOD: This is the beginning and ending date of the invoice period.
PERCENT MATCHING REQUIRED: Enter your match requirement here.
GRANT EXPENDITURES S UMMAR Y SECTION.
"AMOUNT OF THIS REQUEST" COLUMN: Enter the amount that was paid out during the invoice period. This must
be by budget category as in the currently approved budget in the current Grant Work Plan of your grant Agreement. Do not
claim expenses in a budget category that does not have an approved budget. Do not claim items that are not specifically
identified in the current Budget Narrative section of the current Grant Work Plan. Enter the column total on the "TOTALS"
line. Enter the budget amount on the "AGREEMENT AMOUNT' line. Enter the total cumulative amount of this request
and all previous payments on the "LESS TOTAL CUMULATIVE PAYMENTS OF' line. Deduct the "LESS TOTAL
CUMULATIVE PAYMENTS OF' from the "AGREEMENT AMOUNT' for the amount to enter on the "TOTAL
REMAINING IN GRANT' line.
"TOTAL CUMULATIVE PAYMENTS" COLUMN: Enter the cumulative amounts that have. been paid to date for
expenses by budget category. The fmal report should show the total of all payments, first through the final payment, etc.
Enter the column total on the "TOTALS" Iine. Do not enter anything in the shaded areas.
"MATCHING FUNDS" COLUMN: Enter the amount to be claimed as match for the invoice period. This needs to be
shown under specific budget categories according to the currently approved Grant Work Plan. Enter the total on the
"TOTALS" line for this column. Enter the match budget amount on the "AGREEMENT AMOUNT' line for this column.
Enter the total cumulative amount of this and any previous match claimed on the ."LESS TOTAL CUMULATIVE
PAYMENTS OF' line for this column. Deduct the "LESS TOTAL CUMULATIVE PAYMENTS OF" from the
"AGREEMENT AMOUNT"for the amount to enter on the "TOTAL REMAINING IN GRANT' line.
"TOTAL CUMULATIVE MATCHING FUNDS" COLUMN: Enter the cumulative amount you have claimed to date
for match by budget category. Put the total of all on the Iine titled "TOTALS." The final report should show the total of all
claims, first claim through the final claim, etc. Do not enter anything in the shaded areas.
GRANTEE CERTIFICATION: Must be signed by both the Grantee's Grant Manager as identified in the grant
agreement and the Grantee's Fiscal Agent.
NOTE: If claiming reimbursement for travel, you must include copies of receipts and a copy of the travel
reimbursement form approved by the Department of Financial Services, Chief Financial Officer.
DEP Agreement No. G0136, Attachment B, Page 2 of 2
ATTACHMENT C
Contract Payment Requirements
Florida Department of Financial Services, Reference Guide for State Expenditures (March 2003)
Cost Reimbursement Colttracts
Invoices for cost reimbursement contracts must be supported by an itemized listing of expenditures by category
(salary, travel, expenses, etc.) Supporting documentation must be provided for each amount for which reimbursement
is being claimed indicating that the item has been paid. Check numbers may be provided in lieu of copies of actual
checks. Each piece of documentation should clearly reflect the dates of service. Only expenditures for categories in
the approved contract budget should be reimbursed.
Listed below are examples of types of documentation representing the minimum requirements:
(1) Salaries: A payroll register or similar documentation should be submitted. The payroll register
should show gross salary charges, fringe benefits, other deductions and net pay. If an
individual for whom reimbursement is being claimed is paid by the hour, a document
reflecting the hours worked times the rate of pay wiII be acceptable.
(2) Fringe Benefits: Fringe Benefits should be supported by invoices showing the amount paid on behalf of the
employee (e.g., insurance premiums paid). If the contract specifically states that fringe
benefits will be based on a specified percentage rather than the actual cost of fringe
benefits, then the calculation for the fringe benefits amount must be shown.
Exception: Governmental entities are not required to provide check numbers or copies of
checks for fringe benefits.
(3) Travel: Reimbursement for travel must be in accordance with Section 112.061, Florida Statutes,
which includes submission of the claim on the approved State travel voucher or electronic
means.
(4) Other direct costs: Reimbursement will be made based on paid invoices/receipts. If nonexpendable property is
purchased using State funds, the contract should include a provision for the transfer of the
property to the State when services are terminated. Documentation must be provided to
show compliance with Department of Management Services Rule 60A-1.017, Florida
Administrative Code, regarding the requirements for contracts which include services and
that provide for the contractor to purchase tangible personal property as defined in Section
273.02, Florida Statutes, for subsequent transfer to the State.
(5) In-house charges: Charges which may be of an internal nature (e.g., postage, copies, etc.) may be reimbursed
on a usage log which shows the units times the rate being charged. The rates must be
reasonable.
(6) Indirect costs: If the contract specifies that indirect costs will be paid based on a specified rate, then the
calculation should be shown.
Pursuant to 216.346, Florida Statutes, a contract between state agencies including any contract
involving the State University system or the State Community College system, the agency
receiving the contract or grant moneys shall charge no more than 5 percent of the total cost of the
contract or grant for overhead or indirect cost or any other cost not required for the payment of
direct costs.
The Florida Department of Financial Services, Reference Guide to State Expenditures (March, 2003) can be found at
the following web address: www.dbf.state.fl.us/aadir/reference Luide.
DEP Agreement No. G0136, Attachment C, Page 1 of 1
ATTACHMENT D
PROGRESS REPORT FORM
DEP Agreement No. G4136, Attachment D, Page 1 of 2
(continued from page 1)
Identify below, and attach copies of, any relevant work products being submitted for the project for this
reporting period (e.g., report data sets, links to on-line photographs, etc.)
Summarize and provide supporting documentation regarding your efforts in meeting the MBEIW13E
requirements contained in paragraph 5.B. of the Agreement
Provide a project budget update, comparing the project budget to actual costs to date.
I
Budget Category Total Project Expenditures this Reporting Project Funding
Bud et Period
Balance
Please refer to the Payment Request Summary Form for the total cumulative payment amount prior to this report.
This report is submitted in accordance with the reporting requirements of DEP Agreement No. G0136 and
accurately reflects the activities and costs associated with the subject project.
Signature of Grantee's Grant Manager Date
DEP Agreement No. G0136, Attachment D, Page 2 of 2
ATTACHMENT E
SPECIAL AUDIT REQUIREMENTS
The administration of resources awarded by the Department of Environmental Protection (which may be referred to
as the "Department"' "DEP'; 7DEP" or "Grantor", or other name in the contract/agreement) to the recipient
(which may be referred to as the "Contractor", Grantee" or other name in the contract/agreement) may be subject
to audits and/or monitoring by the Department of Environmental Protection, as described in this attachment.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A-133 and Section 215.97, F.S., as
revised (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by
Department staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By
entering into this Agreement, the recipient agrees to comply and cooperate with any monitoring procedures/processes
deemed appropriate by the Department of Environmental Protection. In the event the Department of Environmental
Protection determines that a limited scope audit of the recipient is appropriate, the recipient agrees to comply with
any additional instructions provided by the Department to the recipient regarding such audit. The recipient further
agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the
Chief Financial Officer or Auditor General.
AUDITS
PART 1: FEDERALLY FUNDED
This part is applicable if the recipient is a State or local government or a non-profit organization as defined in OMB
Circular A-133, as revised.
In the event that the recipient expends $500,000 or more in Federal awards in its fiscal year, the recipient
must have' a single or program -specific audit conducted in accordance with the provisions of OMB Circular
A-133, as revised. EXHIBIT I to this Agreement indicates Federal funds awarded through the Department
of Environmental Protection by this Agreement, In determining the Federal awards expended in its fiscal
year, the recipient shall consider all sources of Federal awards, including Federal resources received from
the Department of Environmental Protection. The determination of amounts of Federal awards expended
should be in accordance with the guidelines established by OMB Circular A-133, as revised. An audit of the
recipient conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as
revised, will meet the requirements of this part.
2. In connection with the audit requirements addressed in Part I, paragraph 1., the recipient shall fulfill the
requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133, as
revised.
If the recipient expends less than $500,000 in Federal awards in its fiscal year, an audit conducted in
accordance with the provisions of OMB Circular A-133, as revised, is not required. In the event that the
recipient expends less than $500,000 in Federal awards in its fiscal year and elects to have an audit
conducted in accordance with the provisions of OMB Circular A-133, as revised, the cost of the audit must
be paid from non -Federal resources (i.e., the cost of such an audit must be paid from recipient resources
obtained from other than Federal entities).
4. The recipient may access information regarding the Catalog of Federal Domestic Assistance (CFDA) via
the intemet at htt :1112.46.245.173/cfda/cfda.htnxl.
DEP 55-215 (09104)
DEP Agreement No. G0136, Attachment E, Page 1 of 5
PART II: STATE FUNDED
This part is applicable if the recipient is a nonstate entity as defined by Section 215.97(2)(1), Florida Statutes.
1. In the event that the recipient expends a total amount of State financial assistance equal to or in excess of
$300,000 in any fiscal year of such recipient ($500,000 for fiscal years ending on or after September 30,
2004), the recipient must have a State single or project -specific audit for such fiscal year in accordance with
Section 215.97, Florida Statutes; applicable rules of the Executive Office of the Governor and the Chief
Financial Officer; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations), Rules of the Auditor General. EXHIBIT 1 to this Agreement indicates State financial
assistance awarded through the Department of Environmental Protection by this Agreement. In determining
the State financial assistance expended in its fiscal year, the recipient shall consider all sources of State
fmancial assistance, including State financial assistance received from the Department of Environmental
Protection, other state agencies, and other nonstate entities. State financial assistance does not include
Federal direct or pass-through awards and resources received by a nonstate entity for Federal prograrn
matching requirements.
2. In connection with the audit requirements addressed in Part II, paragraph 1, the recipient shall ensure that
the audit complies with the requirements of Section 215.97(7), Florida Statutes. This includes submission of
a financial reporting package as defined by Section 215.97(2)(d), Florida Statutes, and Chapters 10.550
(local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General.
3• If the recipient expends less than $300,000 in State financial assistance in its fiscal year ($500,000 for fiscal
years ending on or after September 30, 2004), an audit conducted in accordance with the provisions of
Section 215.97, Florida Statutes, is not required. In the event that the recipient expends less than $300,000
in State financial assistance in its fiscal year ($500,000 for fiscal years ending on or after September 30,
2004), and elects to have an audit conducted in accordance with the provisions of Section 215.97, Florida
Statutes, the cost of the audit must be paid from the non -State entity's resources (i.e., the cost of such an
audit must be paid from the recipient's resources obtained from other than State entities).
4• For information regarding the Florida Catalog of State Financial Assistance (CSFA), a recipient should
access the Florida Single Audit Act website located at lrttp://state.fi.us/fsaa/-atalog or the Governor's
Office of Policy and Budget website Iocated at
h ://www.m orida.com/m orida/ overnment/contacts/o bOffice.html for assistance. In addition to the
above websites, the following websites may be accessed for information: Legislature's Website
http:// vww.Ieg.state flus/, Governor's Website h :/hvww.m orida.com/ Department of Financial
Services' Website hUR://www.dbf state. fl.us/ and the-- Auditor General's Website
hM://vnvw.state.fl.us/audRe .
PART III: OTHER AUDIT REQUIREMENTS
(NOTE: This part would be used to sped any additional audit requirements imposed by the State awarding entity
that are solely a matter of that State alva1 cling entity's policy (i. e., the audit is not required by Federal or State laws
and is not in conflict ititla other Federal or State audit requirements). Pursuant to Section 215.97 7 nr , Florida
Statutes, State agencies may conduct or arrange for audits of State financial assistance that are in addition to audits
conducted in accordance with Section 215.97, Florida Statutes. In such an event, the State awarding agency must
arrange for funding the fill cost of such additional audits.)
PART IV: REPORT SUBMISSION
1 • Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and
required by PART I of this Attachment shall be submitted, when required by Section .320 (d), OMB
Circular A-133, as revised, by or on behalf of the recipient directly to each of the following:
DEP 55-215 (09104)
DEP Agreement No. G01.36, Attachment E, Page 2 of 5
A. The Department of Environmental Protection at the following address:
Audit Director
Florida Department of Environmental Protection
Office of the Inspector General, MS 40
2600 Blair Stone Road
Tallahassee, Florida 32399-2400
B. The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of
copies required by Sections .320 (d)(1) and (2), OMB Circular A-133, as revised, should be
submitted to the Federal Audit Clearinghouse), at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville, IN 47132
C. Other Federal agencies and pass-through entities in accordance with Sections .320 (e) and (f)
OMB Circular A-133, as revised. '
Pursuant to Section .320(f), OMB Circular A-133, as revised, the recipient shall submit a copy of the
reporting package described in Section .320(c), OMB Circular A-133, as revised, and any management
letters issued by the auditor, to the Department of Environmental Protection the following address:
Audit Director
Florida Department of Environmental Protection
Office of the Inspector General, MS 40
2600 Blair Stone Road
Tallahassee, Florida 32399-2400
3• Copies of financial reporting packages required by PART H of this Attachment shall be submitted by or on
behalf of the recipient dir— ectly to each of the following:
A. The Department of Environmental Protection at the following address:
Audit Director
Florida Department of Environmental Protection
Office of the Inspector General, MS 40
2600 Blair Stone Road
Tallahassee, Florida 32399-2400
B. The Auditor General's Office at the following address:
State of Florida Auditor General
Room 401, Claude Pepper Building
I I i West Madison Street
Tallahassee, Florida 32399-1450
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
DEP 55-215 (09/04)
DEP Agreement No. G0136, Attachment E, Page 3 of 5
4. Copies of reports or management Ietters required by PART III of this Attachment shall be submitted by or
on behalf of the recipient dir_ ectly to the Department of Environmental Protection at the following address:
Audit Director
Florida Department of Environmental Protection
Office of the Inspector General, MS 40
2600 Blair Stone Road
Tallahassee, Florida 32399-2400
5. Any reports, management letters, or other information required to be sub ed to the Deparrtraent of
Environmental Protection pursuant to this Agreement shall be submitted timely in accordance with OMB
Circular A-133, Florida Statutes, or Chapters 10,550 (local governmental entities) or 10.650 (nonprofit and
for-profit organizations), Rules of the Auditor General, as applicable.
6. Recipients, when submitting financial reporting packages to the Department of Environmental Protection for
audits done in accordance with OMB Circular A-133, or Chapters 10.550 (local governmental entities) or
10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, should indicate the date that
the reporting package was delivered to the recipient in correspondence accompanying the reporting
package.
PART V: RECORD RETENTION
The recipient shall retain sufficient records demonstrating its compliance with the terms of this Agreement for a
period of 5 years from the date the audit report is issued, and shall allow the Department of Environmental
Protection, or its designee, Chief Financial Officer, or Auditor General access to such records upon request. The
recipient shall ensure that audit working papers are made available to the Department of Environmental Protection,
or its designee, Chief Financial Officer, or Auditor General upon request for a period of 3 years from the date the
audit report is issued, unless extended in writing by the Department of Environmental Protection,
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
DEP 55-215 (09/04)
DEP Agreement No. G0I369 Attachment E, Page 4 of 5
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ATTACHMENT F
Approved by 014IB
DISCLOSURE OF LOBBYING ACTIVITIES 0348-0046
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352
(See reverse for public burden disclosure.)
I. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
a. contract
b. ant a. 6id/offer/application a, initial filing
c. cooperative agreement b, initial award b. material change
d. loan c. post -award
c. loan guarantee
For Material Change Only:
f loan insurance
year quarter
date of last report
4. Name and Address of Reporting Entity:
5. If Reporting Entity in No. 4 is Subawardee, Enter Name
El PrimeSubawardee
�
and Address of Prime:
Tier_ ifknotvn:
Congressional District, ifknowrr:
Congressional District, pnotvrt:
6. Federal Department/Agency:
7. Federal Program Name/Description:
CFDA Number, if applicable:
8. Federal Action Number, if known:
9. Award Amount, ifknoivrr:
I0. a. Name and Address of Lobbying Entity
(lf indivldrral, last name, frst name. MI):
b. Individuals Performing Services (including address if
derent from No. 10a)
ff
(last name, first name, Ml):
(alfaclt Canlhnratiat: Slreet(s)
SF-LLLA, i necessa )
11. Information requester) through this form is authorized by7tille3lU.S.C.5lgnature:
section 1352. This disclosure of lobbying activitiesterialrepresentation
of fact upon which reliance was placed byabove
when this transaction was made or into.
PrintName:
entered Thhis disclouired
Pursuant to 31 U.S.C. 1352. This information will be reported to Congress
Title:
semi-annually and will be available for public inspection. Any person who
fails to file the required disclosure shall be subject to a civil penalty of not
less than $10,000 and not more than 5100,000 for each such failure.
Telephone No.: Date:
Federal Use Only:
Authorized for Local Reproduction
Standard Form — LLL (Rev 7 -- 97)
Form DEP 55-221 (01101)
Page l of 2
DEP 55-215 (0I/02)
DEP Agreement No. 00I36, Attachment F, Page I of 2
INSTRUCTIONS FOR COMPLETION OF SF -LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at
the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31
U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any
lobbying entity 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 a covered
Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the
implementing guidance published by the Office of Management and Budget for additional information.
I. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to
influence the outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a followup report caused by a material
change to the information previously reported, enter the year and quarter in which the change occurred.
Enter the date of the last previously submitted report by the reporting entity for this covered Federal
action.
4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional
District, if known. Check the appropriate classification of the reporting entity that designates if it is or
expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first
subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts,
subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks "Subawardee", then enter the full name, address,
city, state and zip code of the prime Federal recipient. Include Congressional District, if known.
6. Enter the name of the Federal agency malting the award or loan commitment. Include at least one
organizational level below agency name, if known. For example, Department of Transportation, United
States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter
the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements,
loans, and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in
item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement
number; the contract, grant, or loan award number; the application/proposal control number assigned
by the Federal agency). Include prefixes, e.g., "RFP -DE -90-001."
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency,
enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.
10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting
entity identified in item 4 to influence the covered Federal action.
(b) Enter the full names of the individual(s) performing services, and include full address if different
from 10 (a). Enter Last Name, First Name, and Middle Initial (MI).
11. The certifying official shall sign and date the form, print his/her name, title and telephone number.
According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it
displays a valid ON -IB Control Number. The valid ONIB control number for this information collection is OMB No. 0348-0046. Public
reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send, comments regarding the burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to the Office of Nlana ement and Budget, Paperwork Reduction Project 0348-0046), Washington, D.C. 20503.
Forst DEP 55-221 (01101)
Page 2 of 2
DEP 55-215 (01/02)
DEP Agreement No. GO136, Attachment F, Page 2 of 2
ATTACHMENT G
Fenn Avx0E-4OhlH N4 a�aaoao AgAnnlEx», r71=
RA LOBBYING AND LITIGATION CERTIFICATES'
� 11-
I hereby certify that none of these funds have been used to engage in the lobbying of
the Federal Government or in litigation against the United States unless authorized
under existing law.
Chief Executive Officer Assistance Agreement Numbers)**
Date
*Complete this form pursuant to the 2001 Department of Veterans Affairs and Housing and Urban
Development, and Independent Appropriations Acts, Public Law 106.277, Section 424 and 2400 Department
of Veterans Affairs and Housing and
Urban Development, and Independent Appropriations Acts, Public Law X06-74, Section 426 and airy other
subsequent Appropriation Act requirements.
** f certifying for more than one grant number and more space is needed, please list additional numbers in
the space provided below.
please mail this formto your Cvmt specialist DO NOT send this information to the Office ofMmagement & Budget.
Burden Statement- The annual public reporting and record keeping burden for this collection ofinfonnation is estimated to average
5 minutes per respondent Burdtnmeans the total time, effort, or financial resources a Tcnded by persons to generate, maintain,
retain, or disclose orprovide information to or for a Federal agency. This includes the time needed to review Instructions; develop,
acquire, install, and utilize technology and systems for the purposes of collecting, validating, and verifying information, processing
and maintaining infonuation, and disclosing and providing information; adjust the trusting ways to comply v" any pre"is
applicable instructions and requirements; train petsomet to be able to respond to a collection of information; search data souroucelys;
complete and review the collection of infom>ation; and transmit or otherwise disclose the information. An agency may not conduct
or sponsor, and a person is not required to respond to, a collection of information unless it displays a surrensyvalid OMS control
number_ The OMB control numbers for EPA's regulations are listed in 40 CFR Part 9 and 48 CER Chapter 15.
Send comments on the Agency's need for this inforunrtion, the accuracy of the provided burden estimates, and any suggested
methods for mittimiang respondent burden, including through the use of automated collection techniques to the Director,
Regulatory Information Division, U.S. Enviroamcrtal pro Agency (2137), 401 IvL SL, S.W. Washington, D.C. 2t1a60; and to
the Offce of Information and Regulatory Affairs, Office of Management and Budget, 725 17th Street, NW, Washinggton, DC
20503, Attention: Desk Officer for EPA. Include the EPA ICR number and OMB control number in any correspondence,
EPA Foran 3700.53 (Rev. 2-02)
DEP Agreement No. GO136, Attaclunent G, Page I of 1
ATTACHMENT H
Quality Assurance Requirements
7 . All sampling and analyses performed under this Contract must conform to the requirements set forth in Chapter
62-160, Florida Administrative Code (F.A.C.) and "Requirements for Field and Analytical Work performed for
the Department of Environmental Protection under Contract" (DEP-QA-002102), February 2002.
2. LABORATORIES
a. The CONTRACTOR shall ensure that all laboratory testing activities are performed by laboratories
certified by the Florida Department of Health Environmental Laboratory Certification Program (DoH
ELCP) for all applicable matrix/method/analyte combinations to be measured.
b. If the laboratory is not certified for some or all of the proposed test measurements, the laboratory shall
apply for certification within one month of Contract execution. Within six months of Contract execution,
the laboratory shall be fully certified for all applicable matrix/method/analyte combinations to be
performed. Regardless of when the laboratory receives certification, the laboratory must implement all
applicable standards of the National Environmental Laboratory Accreditation Conference {NELAC) upon
Contract execution.
C. Laboratories shall maintain certification as specified in item 2.a above during the life of the Contract.
Should certification for an analyte or test method be lost, all affected tests shall be immediately sub-
contracted to a laboratory with current DoH ELCP certification in the appropriate matrix/method/analyte
combination(s). The CONTRACTOR shall notify the DEP contract manager in writing before such
changes are made.
d. A copy of the DoH ELCP Certificate and the associated list of specific fields of accreditation for each
contracted or sub -contracted laboratory shall be provided to 'the DEP contract manager upon Contract
execution or upon receiving DoH certification (see items 2.a and 2.b above).
e. The CONTRACTOR shall ensure that an acceptable initial demonstration of capability (IDOL), as
described in Appendix C of Chapter 5 of NELAC Standards is performed. Each laboratory haat performs
any of the proposed matrix/method/analyte combination(s) must have the requisite IDOC documentation
and supporting laboratory records. IDOCs shall be performed before the test procedure is used to generate
data for this Contract. If requested by the Department, documentation that supports the IDOC shall be
made available for review.
f. When performance test samples are not required by DoH ELCP for certification, or certification is not
required (see item 2.g below), the laboratory shall obtain, analyze and evaluate performance test samples,
standard reference materials (SRM) or other externally assayed quality control (QC) samples, hereinafter
known collectively as quality control check (QCC) samples.
(i) The laboratory shall ensure that the selected QCC samples(s) represent all matrix/method/analyte
combinations that are not subject to certification requirements. --
00 These samples shall be analyzed at six-month intervals and the results shall be within the acceptable
range established by the QCC sample provider.
(Iii) Before providing analytical services for this Contract, the laboratory must provide to the DEP contract
manager the results of the QCC sample(s) and the associated acceptable range(s) as established by the
QCC sample provider. The submitted results must be from QCC samples that have been completed
within six months prior to the submission date.
g. For those test measurements for which the Department has determined that certification by the DoH ELCP
is not necessary, all laboratory activities associated with the test measurements shall conform to the NELAC
Quality Systems (Chapter 5) Standards.
h. Any non-standard laboratory procedure or methods (i.e., those not approved by DEP for standard
environmental analyses) that are proposed for use shall be submitted for review and approval in accordance
with DEP-QA-001/01, "New and Alternative Analytical Laboratory Methods," ,February 1, 2004. These
procedures or methods shall be approved by the DEP contract manager before use under this Contract and
must be cited or described in the required planning document (see Section 6).
1. The CONTRACTOR shall ensure that Practical Quantitation Limits (PQLs) and Method Detection Limits
(MDLs) are established for the Contract, and are listed in the planning document (see Section 6),
12/02/2004
DEP Agreement No. G0136, Attachment H, Page 1 of 9
f. The CONTRACTOR shall ensure that the selected laboratory test methods can provide results that meet the
Contract data quality objectives.
k. The CONTRACTOR shall ensure that all laboratory testing procedures follow the analytical methods as
approved in the planning document (see Section 6).
1. The CONTRACTOR shall ensure that the essential laboratory quality control measures are consistent with
Chapter 5 of the NELAC standards. In addition, the CONTRACTOR shall ensure that the quality control
requirements specified in the attached addenda are followed.
3. FIELD ACTIVITIES
a. "Sample" refers to samples that have been either collected or analyzed under the terms of this Contract.
b. The CONTRACTOR shall ensure that all sample collection and field testing activities are performed in
accordance with the Department's "Standard Operating Procedures for Field Activities" (DEP-SOP-00I/01,
February I, 2004). The specific standard operating procedures (SOPS) shall be cited in the planning
document (see Section 6).
C. Any non-standard field procedure shall be submitted for review and approval to the DEP contract manager
in accordance with section FA 2000 of DEP-SOP-001/01. All non-standard procedures and methods must
be approved by the DEP contract manager before use under this Contract and must be cited or described in
the planning document.
d. Per the quality control measures outlined in the DEP SOPS (FQ 1000 and the calibration requirements of
the FT -series for field testing), the CONTRACTOR shall ensure that the following field quality controls
(and any additional quality control measures specified in the addenda) are incorporated into the project
design:
(I) Matrix -Related Quality Controls - The CONTRACTOR shall ensure that the Iaboratory is provided
with sufficient sample volume to analyze at least one set of matrix spikes, and either matrix spike
duplicates or laboratory duplicates as follows:
(1) The first time a sample from a sample collection matrix (see Table FA 1000-1) is collected;
(2) One in each additional 20 samples of the sample collection matrix, after the first 20 samples; and
(3) The last time samples are collected for the sample collection matrix.
Field duplicates (not to be confused as laboratory duplicates) shall be collected and analyzed at a
frequency of 5% of the total number of samples collected for each matrix/analyte combination (see FQ
1220).
(1) All field duplicate results greater than the PQL should agree within 20% RPD for each measured
analyte. In the event that the field duplicate agreement is not observed, the CONTRACTOR shall
investigate and attempt to determine the cause of poor precision. The outcome of these
investigations shall be reported including corrective measures to minimize future problems.
(Ili) Field -Generated Blanks — Blanks associated with field activities as defined in FQ 1210 of the DEP
SOPS, shall be collected according to the requirements of FQ 1 ti
(1) If the reported analyte is reported in any field blank, equipment blank or trip blank, the
CONTRACTOR shall investigate and attempt to determine -the cause unless the affected samples
are at least 10 times the reported blank value. The outcome of these investigations shall be
reported including corrective measures to minimize future occurrences.
4. REPORTING Docu IENTATION AND RECORDS RETENTION
a. The CONTRACTOR shall ensure that all laboratory and field records as outlined in Rules 62-160.240 and
.340, F.A.C. are retained for a nminimum of five years after the project completion.
b. All field and laboratory records that'are associated with work performed under this Contract shall be
organized so that any information can be quickly and easily retrieved for inspection, copying or distribution.
C. The CONTRACTOR shall ensure that all Iaboratory reports are issued in accordance with NELAC
requirements. These reports shall be submitted to the DEP contract manager and shall include the followin
information: g
> Laboratory sample identification (ID) and associated Field ID
► Analytical/test method
► Parameter name
> Analytical result (including dilution factor)
► Result unit
12/02/2004
DEP Agreement No. GO 136, Attachment H, Page 2 of 9
► Applicable DEP Qualifiers per Table 1 of Chapter 62-160, F.A.C.
► Result comment(s) to include corrective/preventive actions taken for any failed QC, unacceptable
measurement or other problem related to the analysis of the samples
► Date and time of sample preparation (if applicable)
► Date and time of sample analysis
► Laboratory verification results of field preservation
0 Sample matrix
► DoH ELCP certification number for each laboratory (must be associated with the test result(s)
generated by the laboratory)
► MDL
1 PQL
/ Sample type (such as blank, duplicate, etc.)
> Field and laboratory blank results:
• Laboratory blank results (results for any laboratory blank analysis as
required by the method and the planning document) (see Section 6);
• Field quality control results including trip blanks, field blanks, equipment
blanks, and field replicates as specified in the planning document (see
Section 6)
► Results of sample matrix spikes, laboratory duplicates or matrix spike duplicates, as applicable
► Results of surrogate spike analysis (if performed)
► Results of laboratory control samples (LCS)
► Link between each quality control sample and the related sample results
► Acceptance criteria for each reported quality control measure
d. The CONTRACTOR shall ensure that the following field -related information is reported to the
DEP contract manager:
► Site and/or facility name, address and phone number
► Field ID for each sample container and the associated analytes (test methods) for which the
container was collected
► Date and time of sample collection
► Sample collection depth
► Sample collection method identified by the DEP SOP number
► If performed, indicate samples that were filtered
► Field test measurement results:
• DEP SOP followed
• Parameter name
• Result
• Result unit
• Applicable Data Qualifiers per Table 1 of Chapter 62-160, F.A.C.
► Narrative comments discussing corrective/preventive actions taken for any failed QC or
5. AuDiTs unacceptable field measurement or other problems related to the sampling event.
a. AUDITS By THE DEPARTMENT— Pursuant to Rule 62-160.650, F.A.C., the Department may conduct audits of
field and/or Iaboratory activities. In addition to allowing Department representatives to conduct onsite
audits, the CONTRACTOR, upon request, must provide the Department with the requested information,
including all field and laboratory records pertinent to the contracted field and laboratory activities. If an
audit by the Department results in a determination that the data are not usable for the contracted proposed
purpose, the DEP contract manager shall pursue remedies available to the Department including those
outlined in Addendum 1.
b. PLANNING REVIEW AUDITS —
(I) Initial: Prior to the completion of the sampling and analysis events, and as specified in the addendum,
the CONTRACTOR and all associated subcontractors shall review the planning document (see Section
6 below) relative to the completed field and laboratory activities to determine if the data quality
objectives are being met, identify any improvements to be made to the process, and refine the sampling
1202/2004
DEP Agreement No. GO 136, Attachment H, Page 3 of 9
and/or analytical design or schedule. Within one month of the review, a summary of the review,
including any corrective action plans or amendments to the planning document, shall be sent to the
DEP contract manager, and a copy shall be maintained with the permanent project records.
00 Ongoing: Planning reviews as described in item (1) above shall occur annually.
C. QUALITY SYSTEMS AUDITS — The CONTRACTOR and all subcontractors shall ensure that any required
Iaboratory and field quality system and management systems audits are performed according to the
documented in the CONTRACTOR's and subcontractors' records. respective Quality Manuals for each contracted and sub -contracted entity. These audits shall be
d. STATEMENTS OF USABILITY — As a part of the audit process and the final report, the CONTRACTOR shall
provide statements about data usability relative to the Project Data Quality Objectives and Data Quality
Indicators specified in the planning document.
6. PLANNING DOCUMENT
a. The CONTRACTOR shall submit the planning document specified in the addendum to this attachment to
the DEP contract manager no Iater than 120 days prior to the commencement of field and laboratory
activities. Failure to submit the planning document by the above-mentioned time shall result in a delay of
approval to begin work until the document has been submitted to the Department and approved by the DEP
contract manager.
b. The CONTRACTOR and subcontractors may submit a version of the planning document to the Department
for approval no more than three times. If the CONTRACTOR fails to obtain approval for the planning
document after the third (final) submission to the Department, the DEP contract manager may suspend or
terminate the Contract.
C. The DEP Contract number shall appear on the title page of the submitted planning document. Within forty-
five (45) days of receipt of properly identified documents- by the Department, the Department shall review
and either approve the planning document or provide comments to the CONTRACTOR and affected
subcontractors as to why the planning document is not approved. If further revisions are needed, the
CONTRACTOR shall then have fifteen (15) days from the receipt of review comments to respond. The
Department shall respond to all revisions to the planning document within thirty (30) days of receipt.
d. If the review of the planning document by the Department is delayed, through no fault of the
CONTRACTOR shall have the option, after the planning document is approved,
CONTRACTOR, beyond sixty (60) days after the planning document is received by the Department, of requesting and the
receiving an extension in the term of the Contract for a time period not to exceed the period of delayed
review and approval. This option must be exercised at least sixty (60) days prior to the current termination delayed
date of the Contract.
e. Work may not begin for specific Contract tasks until approval has been received by the CONTRACTOR
from the DEP contract manager. Sampling and analysis for the Contract may not begin until the planning
document has been approved.
f. Once approved, the CONTRACTOR shall follow the protocols specified in the approved planning
document including, but not limited to:
► Ensuring that all stated quality control measures are collected, analyzed and evaluated for
acceptability,
► Using only the protocols approved in the planning document; and
► Using only the equipment approved in the planning document.
g. If any significant changes in procedures or test methods, changes in subcontractor organizations, or changes
in key personnel occur, the CONTRACTOR shall submit appropriate revisions to the planning document to
the DEP contract manager for review. The proposed revisions may not be implemented until they have
been approved by the DEP contract manager. If the CONTRACTOR fails to submit the required revisions,
the DEP contract manager may suspend or terminate the Contract.
T. DELIVERABLES
a. The following lists the expected schedule for the deliverables that are associated with the Quality Assurance
requirements of this Contract:
0) Copy of DoH ELCP Certificate(s) and the associated list of specific fields of accreditation, per item 2.d
above.
(II) Copies of the QCC sample results per item 2.£ above.
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DEP Agreement No. GO136, Attachment H, Page 4 of 9
(III} Non-standard laboratory or field procedures — The CONTRACTOR shall submit to the DEP contract
manager all required information necessary for review of non-standard procedures per items 2.h. and
3.b. above.
(IV) Reports of planning review audits as specified in item 5.b. above.
(V) Statements of Usability as specified in item 5.d. above.
(VI) Planning document per Section 6, above.
b. Failure to provide any of the above items may result in the pursuit of remedies available to the Department.
12/02/2004
DEP Agreement No. G0136, Attachment H, Page 5 of 9
Addendum 1
Modifications to Attachment H, Quality Assurance Requirements
1. Failure to comply with any requirement of this attachment may result in:
a. Immediate termination of the Contract.
b. Withheld payment for the affected activities.
C. Contract suspension until the requirement(s) has been met.
d. A request to refund already disbursed payments.
e. A request to redo work affected by the non compliance.
f. Other remedies available to the Department.
2. LABORATORIES
e. The following quality control addenda must be followed:
{i} Addendum 2, Quality Control Requirements for Laboratories Performing Chemical Analysis with the
following modifications:
(1) 1. b. After the first 20 samples from the sample collection matrix.
(2) 8. deleted
(3) 9. deleted
(li} Addendum 3, Quality Control Requirements for Laboratories Performing Microbiological Testing,
I FIELD ACTIVITIES
a. The following Section 3 requirements are amended as follows:
(i) 3.d.i. (2) After the first 20 matrix samples.
(4) Field duplicates (item 3.d.ii) shall not be collected
4. REPORTING, DOCUMENTATION AND RECORDS RETENTION
a. The CONTRACTOR shall submit the data electronically using the following format:
(i) Excel 97 file or Access 2000 file. Adobe PDF file with final report.
b. In addition to the information in item 4.d, the CONTRACTOR shall ensure that the following field
information is reported:
(I) N/A
b. AUDITS
a. The initial planning review audit will be performed in accordance with Section 5.b.I within 30
days of completion of the first sampling event.
$. PLANNING DOCUMENT
a. Per Section 6 requirements, the type of planning document to be submitted is a:
(i) -Qualily Assurance Project Plan (QAPP). This document shall be submitted to the DEP Project
Manager for review and approval. The plan shall be consistent with the EPA Document EPA-QA/R-5,
EPA Requirements for Quality Assurance Project Plans, dated March 2001.
b. When the approved planning document requires modification, at the discretion of the DEP Project Manager
the amendments shall be:
(I) Provided in a new planning document, or
(li) Provided as amended sections of the current document, or
(Ili) Documented through written or electronic correspondence that becomes part of the planning document.
7. DELIVERABLES
a. The following deliverables are not required under the terms of this Contract:
(i) 7.a.iii deleted.
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12/02/2004
DEP Agreement No. GO 136, Attachment H, Page 6 of 9
Addendum 2
Quality Control Requirements for Laboratories Performing Chemical Analysis
In addition to the quality control requirements outlined in Chapter 5 of the NELAC Standards, the following quality
control measures shall be implemented for this Contract. Note: "Sample" refers to samples that have been either
collected or analyzed under the terms of this Contract.
1. Matrix -Related Quality Control Samples - The CONTRACTOR shall ensure that samples associated with this
Contract are used for matrix spikes, and either laboratory duplicates or matrix spike duplicates. The laboratory
shall analyze these samples:
a. The first time a sample from a sample collection matrix (see Table FA 1000-1) is collected.
b. After the first 20 samples from the sample collection matrix, at least one matrix spike and either laboratory
duplicates or matrix spike duplicates in each additional 20 samples of the sample collection matrix.
C. The last collection event for the sample collection matrix.
d. Spike levels must be at concentrations specified in item 3 below.
e. The results of matrix spikes must meet the specific acceptance criteria established for the Contract or the
data must be appropriately qualified.
#. Sample duplicates or matrix spike duplicates must be evaluated for precision criteria established for the
Contract. If the selected sample concentration is expected to be below the laboratory's PQL, then matrix
spike duplicates must be used.
2. Per NELAC Chapter 5 requirements, as least one Laboratory Control Sample (LCS also known as Laboratory
Fortified Blank) shall be prepared, analyzed and evaluated with each batch of 20 samples or less.
a. If the LCS is unacceptable, the samples associated with the LCS shall be reprocessed with a new LCS. If
samples cannot be reprocessed, the data must be appropriately qualified.
3. Spiking/Fortification Requirements - All spike fortifications must take place prior to any required sample
preparation steps (e.g., sample extraction, sample digestion, etc.). The final concentration of any spike
fortification shall be at the applicable level identified below.
a. If any of the samples in the preparation batch are non -detect, the spiking Ievel must not be greater than 2
times the Contract -established practical quantitation Iimit (PQL).
b. The concentration in a spiked sample cannot exceed 5 times the highest concentration of any contracted
sample in the preparation batch.
4. Instrument Calibration — The following discussions supplement the method specified calibration procedures,
which must be followed:
a. Initial Calibration Requirements
(�) Unless otherwise specified by the method, all sample results shall be based on the initial calibration
curve responses.
(II) If a linear regression is used, the correlation coefficient shall be equal to or greater than 0.995.
(ill) Immediately after performing an initial calibration, the accuracy of the calibration shall be verified
using a second source. A second source may be a standard, a Standard Reference Material (SRM), or
other sample type with a verified concentration such as a QC Check Sample. The standard must have
been prepared from a different lot or vendor, and the verified SRM or QC Check sample must have
been verified by an organization that is external to the laboratory.
(IV) Sample analysis cannot proceed if an initial calibration is unacceptable.
b. Continuing Calibration Requirements:
(I} When an initial calibration is not performed on the day of analysis, a continuing calibration standard
shall be analyzed, evaluated and determined to be acceptable prior to analyzing samples.
(H) A continuing calibration standard shall be analyzed and evaluated at the end of the analytical run.
(III} For each analytical run, the analytical sensitivity must be evaluated using a continuing calibration
standard prepared at the PQL. The analyzed value of this standard must be within 70 — 130% of the
expected value. If this PQL check fails, the blank and associated sample results must be reported as
"estimated" per Chapter 62-160, F.A.C. unless the affected results are at Ieast 10 times the absolute
value of the observed bias.
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DEP Agreement No. GO136, Attachment H, Page 7 of 9
(f V) The samples shall be chronologically bracketed between acceptable continuing calibration evaluations.
(V) If a continuing calibration verification fails, samples run after the failure must be reanalyzed or
appropriately qualified.
C. Sample results below the practical quantitation limit (PQL) and above the highest calibration standard shall
be appropriately qualified.
5. Blanks
a. If the analyte is detected in any analytical blank, the sample results that are associated with the blank must
be reported with the appropriate qualifier from Chapter 62-160, F.A.C., unless the affected results are at
least 10 times the calculated blank value.
b. Sample results must be bracketed with an acceptable beginning and ending analytical blanks.
reanalyzing a new aliquot of the blank unless the sample results associated with
C. If the analyte is detected in the field blank, equipment blank or trip blank, the result must be confirmed by
times the calculated blank value. The laboratory must investigate sufficiently to the blank are at least 10determine that positive
blank results are not due to a laboratory error, and report results with appropriate qualifiers and/or
comments.
6. If any quality control measure or calibration verification (including those specified above) fails, samples that are
associated with the failure must be reanalyzed, if possible. Sample data that are associated with a failed quality
control measure must be appropriately qualified as specified in Chapter 62-160, F.A.C. An explanatory
comment must be attached to the final report for each result that has a qualifier code other than U, I, or A. Any
additional qualifier codes used but not explicitly provided for in Chapter 62-160, F.A.C. must be identified and
defined in the report.
7. The reported MDL and PQL for each sample must be adjusted for dilution factors, and any relevant preparation
weights and volumes.
8. Field duplicates - The CONTRACTOR shall ensure that field duplicates (not to be confused as
laboratory duplicates) are analyzed. All field duplicate results greater than the PQL should agree
within 20% RPD for each measured analyte. In the event that field duplicate agreement is not
observed, the laboratory must investigate sufficiently to determine that poor precision is not due to a
laboratory error, and report the results with appropriate qualifiers and/or comments.
9. For all organic analyses using either gas chromatography or HPLC, analytes with concentrations above the
method detection limit shall be confirmed by at least one of the qualitative identification measures listed below.
Confirmation must occur the first time an analyte is detected at a sampling point.
Second column/same detector
> Second column/alternate detector
/ Same colunnn/alternate detector
Mass spectrometry
> Alternate wavelength
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12/02/2004
DEP Agreement No. GO 136, Attachment H, Page 8 of 9
Addendum 3
Quality Control Requirements for Laboratories performing Microbiological Testing
In addition to the quality control requirements outlined in Chapter 5 of the NELAC Standards, the following quality control
measures shall be implemented for this Contract. Note: "Sample" refers to samples that have been either collected or
analyzed under the terms of this Contract.
1. Blanks
a. If the membrane filter technique was used, the sample set(s) shall be associated with a beginning and
ending filtration blank.
b. The results of any blank must be < 1 CFU/100 mL or the associated sample results must be reported
with the appropriate qualifier from Chapter 62-160, F.A.C.
C. All duplicate results shall be evaluated per method specifications. In the event that field duplicate
agreement is not observed, the laboratory must investigate sufficiently to determine that poor precision
is not due to a laboratory error, and report the results with appropriate qualifiers and/or comments.
2. All microbiological analyses must conform to requirements for facilities, personnel and equipment specifications and
quality control measures discussed in AWWA Standard Methods 20`I' edition, section 9020.
3. At least 10% of the samples (or one per test run) shall be duplicated.
4. Colony Counts
a. The laboratory shall make every attempt to ensure that colony counts are in the ideal range of 20 — 60 colonies per
plate. Reported values from colony plate counts outside this range shall be qualified with a 'B" (unless reported
value is from a 100 mL sample and the count is less than 20).
b. If all counts are above 60, the result shall be calculated and reported from the highest dilution. This result must be
reported as "estimated".
C. The laboratory shall follow the reporting requirements specified in the method for other results that are outside the
ideal range (item 3.a of Addendum 3)
d. If the sample result is "too numerous to count (TNTC)" the laboratory shall report the filtration volume with the
data qualifier 'W'.
e. Colony counts from samples that have been verified shall be adjusted based on the verification results as specified
in the method.
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12/02/2004
DEP Agreement No. GO136, Attachment H, Page 9 of 9
ATTACMgENTI
CERTIFICATION REGARDING DEBARMENTS, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION -LOWER TIER FEDERALLY FUNDED TRANSACTIONS
AEP AGREEMENT NO: G0136
1. The undersigned hereby certifies that neither it nor its principals is presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.
2. The undersigned also certifies that it and its principals:
(a) Have not within a three-year period preceding this certification been convicted of or had a civil judgment rendered
against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or
performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or
State anti-trust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property.
(b) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or
local) with commission of any of the offenses enumerated in paragraph 2.(a) of this Certification; and
(c) Have not within a three-year period preceding this certification had one or more public transactions (Federal, State or
local) terminated for cause or default.
3. Where the undersigned is unable to certify to any of the statements in this certification, an explanation shall be attached to this
certification.
Dated this �^ day of , 20
Authorized Signature/Contractor
Typed Name/Title
Contractor's Firm Name
Street Address
Building, Suite Number
City/State/Zip Code
Form DEP 55-220 (01101) Area Code/Telephone Number
12102/200=4
DEP Agreement No. GO 136, Attachment I, Page 1 of 2
INSTRUCTIONS FOR CERTIFICATION REGARDING DEBARMENT,
SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION -
LOWER TIER FEDERALLY FUNDED TRANSACTIONS
I. 13y signing and submitting this form, the certifying party is providing the certification set out below.
2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was
entered into. If it is later determined that the certifying party knowingly rendered an erroneous certification, in addition to other
remedies available to the Federal Government, the Department of Environmental Protection (DEP) or agencies with which this
transaction originated may pursue available remedies, including suspension and/or debarment.
3. The certifying party shall provide immediate written notice to the person to which this contract is submitted if at any time the
certifying party learns that its certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary
covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the
Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this
contract is submitted for assistance in obtaining a copy of those regulations.
5. The certifying party agrees by submitting this contract that, should the proposed covered transaction be entered into, it shall not
knowingly enter into any lower tier contract, or other covered transaction with a person who is proposed for debarment under 48
CFR 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered
transaction, unless authorized by the DEP or agency with which this transaction originated.
Debarment, Suspension, Ineligibility and Voluntary Exclusion
6. The certifying party further agrees by executing this contract that it will include this clause titled "Certification Regarding
-Lower Tier Covered Transaction," without modification, in all
contracts or lower tier covered transactions and in all solicitations for lower tier covered transactions.
7• A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction
that it is not is proposed for debarment under 48 CFR 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded
from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and
frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the
Nonprocurement List (Telephone No. (202) 501-4740 or (202) 5014873.)
8. Nothing contained in the foregoing shall be construed to require establishment of_a system of records in order to render in good
faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary course of business dealings.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly
enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR 9, subpart 9.4,
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies
available to the Federal Government, the DEP or agency with which this transaction originated may pursue available remedies,
including suspension and/or debarment.
DEP FORM 55-220 (01101)
DEP Agreement No. GO 136, Attachment I, Page 2 of 2
ATTACHMENT d
Contract Provisions
All contracts, awarded by a recipient including small purchases, shall contain the following provisions as
applicable:
1• Equal Employment Opportunity - All contracts shall contain a provision requiring compliance with
E.O. 11246, "Equal Employment Opportunity," as amended by E.O. 11375, "Amending Executive
Order 11246 Relating to Equal Employment Opportunity," and as supplemented by regulations at 41
CFR part 60, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity,
Department of Labor."
2. Copeland "Anti -Kickback" Act (18 U.S.C. 874 and 40 U.S.C. 276c) - All contracts and subgrants in
excess of $2,000 for construction or repair awarded by recipients and subrecipients shall include a
provision for compliance with the Copeland "Anti -Kickback" Act (18 U.S.C. 874), as supplemented by
Department of Labor regulations (29 CFR part 3, "Contractors and Subcontractors on Public Building
or Public Work Financed in Whole or in Part by Loans or Grants from the United States"). The Act
provides that each contractor or subrecipient shall be prohibited from inducing, by any means, any
person employed in the construction, completion, or repair of public work, to give up any part of the
compensation to which he is otherwise entitled. The recipient shall report all suspected or reported
violations to the Federal awarding agency.
3. Davis -Bacon Act, as amended (40 U.S.C. 276a to a-7) - When required by Federal program
legislation, all construction contracts awarded by the recipients and subrecipients of more than $2,000
shall include a provision for compliance with the Davis -Bacon Act (40 U.S.C. 276a to a-7) and as
supplemented by Department of Labor regulations (29 CFR part 5, "Labor Standards Provisions
Applicable to Contracts Governing Federally Financed and Assisted Construction"). Under this Act,
contractors shall be required to pay wages to laborers and mechanics at a rate not less than the
minimum wages specified in a wage determination made by the Secretary of Labor. In addition,
contractors shall be required to pay wages not less than once a week. The recipient shall place a copy of
the current prevailing wage determination issued by the Department of Labor in each solicitation and
the award of a contract shall be conditioned upon the acceptance of the wage determination. The
recipient shall report all suspected or reported violations to the Federal awarding agency. EPA does
not consider work performed under the 319 grants to fall under the definition of construction.
Therefore, this provision does not apply to this specific agreement number.
4. Contract Work Hours and Safety Standards Act (40 U.S.C. 327.333) - Where applicable, all
contracts awarded by recipients in excess of $2000 for construction contracts and in excess of $2,500
for other contracts that involve the employment of mechanics or laborers shall include a provision for
compliance with Sections 102 and 107 of the Contract Work Hours and Safety Standards Act (40
U.S.C. 327-333), as supplemented by Department of Labor regulations (29 CFR part 5). Under Section
102 of the Act, each contractor shall be required to compute the wages of every mechanic and laborer
on the basis of a standard work week of 40 hours. Work in excess of the standard work week is
Permissible provided that the worker is compensated at a rate of not Iess than 1 '/z times the basic rate of
pay for all hours worked in excess of 40 hours in the work week. Section 107 of the Act is applicable to
construction work and provides that no laborer or mechanic shall be required to work in surroundings
or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not
apply to the purchases of supplies or materials or articles ordinarily available on the open market, or
contracts for transportation or transmission of intelligence.
DEP Agreement No. GO 136, Attaclunent J, Page 1 of 3
ATTACHMENT K
REGULATIONS
Formal regulations concerning administrative procedures for EPA grants appear in Title 40 of the Code
of Federal Regulations. Grant program administrative regulations appear in Subchapter B; other
regulations of general applicability appear in Subchapter A. Other EPA regulations also impact grant
programs. The following list contains regulations and Office of Management and Budget Circulars which
may apply to the work performed under this Agreement.
Subchapter A - General
40 C.F.R. 4 Uniform relocation assistance and real property acquisition for federal and federally
assisted programs
40 C.F.R. 12 Nondiscrimination on the basis of handicap in programs or activities conducted by
EPA
40 C.F.R. 29 Intergovernmental review of EPA programs and activities
40 C.F.R. 30 Uniform administrative requirements for grants and agreements with institutions of
higher education, hospitals and other nonprofit organizations
Subchapter B -- Grants and Other Federal Assistance
40 C.F.R. 31 Uniform, administrative requirements for grants and cooperative agreements to state
and local governments
40 C.F.R. 32 Govern:mentwide debarment and suspension (nonprocurement) and
governmentwide requirements for drug-free work place (grants); Clean Air Act and
Clean Water Act ineligibility of facilities in performance of federal contracts,
ants and loans
40 C.F.R. 34 New restrictions on Iobbying
40 C.F.R. 35 State and local assistance
Other Federal Regulations
48 C.F.R. 31 Contract Cost Principles and Procedures, or uniform cost accounting standards that
com ly with cost rinci les acceptable to the federal aeencv
Office of Man agement and Budget Circulars
A-21 Cost Principles for Educational Institutions
A-87 Cost Principles for State, Local, and Indian Tribal Governments
A-122 Cost Principles for Non -Profit Organizations
A-133 Audit Reauirementi
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DEP Agreement No. GO 136, Attaclunent K, Page 1 of 1
5. Rights to Inventions Made Under a Contract or Agreement - Contracts or agreements, for the
performance of experimental, developmental, or research work shall provide for the rights of the
Federal Government and the recipient in any resulting invention in accordance with 37 CFR part 401,
"Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government
Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the
awarding agency.
6. Clean Air Act (42 U.S.C. 7401 et seq.), and the Federal Water Pollution Control Act (33 U.S.C.
1251 et seq.), as amended - Contracts and subgrants of amounts in excess of $100,000 shall contain a
provision that requires the recipient to agree to comply with all applicable standards, orders or
regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401 et seq.) and the Federal Water
Pollution Control Act as amended (33 U.S.C. 1251 et seq.). Violations shall be reported to the Federal
awarding agency and the Regional Office of the Environmental Protection Agency (EPA).
7. Byrd Anti -Lobbying Amendment (31 U.S.C. 1352) - Contractors who apply or bid for an award of
$100,000 or more shall file the required certification. Each tier certifies to the tier above that it will not
and has not used Federal appropriated funds to pay any person or organization for influencing or
attempting to influence an officer or employee of any agency, a member of Congress, officer or
employee of Congress, or an employee of a member of Congress in connection with obtaining any
Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier shall also disclose any
lobbying with non -Federal funds that takes place in connection with obtaining any Federal award. Such
disclosures are forwarded from tier to tier up to the recipient.
8. Debarment and Suspension (E.O.s 12549 and 12689) - No contract shall be made to parties listed on
the General Services Administration's List of Parties Excluded from Federal Procurement or
Nonprocurement Programs in accordance with E.O.s 12549 and' 12689, "Debarment and Suspension."
This list contains the names of parties debarred, suspended, or otherwise excluded by agencies, and
contractors declared ineligible under statutory or regulatory authority other than E.O. 12549.
Contractors ' with awards that exceed the small purchase threshold shall provide the required
certification regarding its exclusion status and that of its principal employees.
9. Section 508 of the Federal Water Pollution Control Act, as amended (33 U.S.C. 1368) and Section
1424(e) of the Safe Drinking Water Act, (42 U.S.C. 300h -3(e)) - Contracts and subgrants of amounts
in excess of $100,000 shall contain a provision that requires the recipient to agree to comply with all
applicable standards, orders or regulations issued pursuant to Section 508 of the Federal Water
Pollution Control Act, as amended (33 U.S.C. 1368) and Section 1424(e) of the Safe Drinking Water
Act, (42 U.S.C. 300h -3(e)). Violations shall be reported to the Federal awarding agency and the
Regional Office of the Environmental Protection Agency (EPA).
10. Compliance with all Federal statutes relating to nondiscrimination. These include but are not
limited to: (a) Title VI of the Civil Rights Act of I964 (P.L. 88-352) which prohibits discrimination on
the basis of sex; (b) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 795), which
prohibits discrimination on the basis of handicaps; (c) the Age Discrimination Act of 1975, as amended
(42 U.S.C. 6101-6107), which prohibits discrimination on the basis of age; (d) the Drug Abuse Office
and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of
drug abuse; (e) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and
Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of
alcohol abuse or alcoholism; (f) 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; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. 3601 et sect.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (h) any other. nondiscrimination provisions
DEP Agreement No. GO 136, Attachment 7, Page 2 of 3
in the specific statute(s) made; and, (i) the requirements of any other nondiscrimination statute(s) which
may apply.
11. Compliance with the requirements of Titles H and III of the Uniform Relocation Assistance and
Real Property Acquisition Policies 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 interests in real property acquired for project purposes
regardless of Federal participation in purchases.
12. Compliance with the provision of the Hatch Act (5 U.S.C. 1501 — 1508 and 7324 — 7328) which
limit the political activities of employees whose principal employment activities are funded in whole or
in part with Federal funds.
13. 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 participate in the program and to purchase flood insurance if the total cost of insurable construction
and acquisition is $10,000 or more.
14. Compliance with environmental standards which may be prescribed 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
EP 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in
floodplain in accordance with EO 11988; (e) assurance of project consistency with the approved State
management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. 1451 et
seq.); (1) 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. 7401 et 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).
15. Compliance with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1271 et seq.) related to
protecting components or potential components of the national wild and scenic rivers system.
16. Compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16
U.S.C. 470), EO 12593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.)
17. Compliance with P.L. 93-348 regarding the protection of human subjects involved in research,
development, and related activities supported by this award of assistance.
18- Compliance with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C.
2131 et seq.) pertaining to the care, handling, and treatment of warm bloodied animals held for
research, teaching, or other activities supported by this Agreement.
19. Compliance with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.) which
prohibits the use of lead based paint in construction or rehabilitation of residence structures.
20. Compliance with the mandatory standards and policies relating to energy efficiency which are
contained in the State energy conservation plan issued in accordance with the Energy Policy and
Conservation Act (Pub. L. 94-163, 89 Stat. 871).
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DEP Agreement No. GO136, Attachment J, Page 3 of 3