A2-1 CALFORNA DEPARTMENT OF FORESTRY AND FRE PROTECTON APPLCATON FOR FUNDNG COOPERATVE FORESTRY ASSSTANCE ACT OF 1978 VOLUNTEER FRE ASSSTANCE (VFA) PROGRAM Agreement #7FG \ 0 \ \ 1 A. DEPARTMENT/ORGANZATON: Organization Name: sonoma County Fire and Emergency Services Contact's First Name: wesley Contact's Last Name: Kitchel Street Address: 12300 County Center Dr, Suite 220B Mailing Address: 12300 County Center Dr, Suite 220B, Santa Rosa, CA, 95403 City: santa Rosa 1 County: sonoma Zip Code: 195403 State: california Phone Number: 1707-565-1152 DUNS Number:la0126444 CAL FRE Unit: LNU - Sonoma- Lake-Napa Unit Email Address: wesley.kitchel@sonoma-county.org To check to see what your DUNS number is, or to apply for one, please go to: https://iupdate.dnb.com/iupdate/companylookud.htm B. AREA TO BE SERVED BY AWARD (nclude areas covered by contract or written mutual aid agreements). Number of Communities :115 Area :1647 sq. miles Congressional District # : CA-l,6 Population: 1162,000 Annual Budget: 14,142,652 latitude N~o 0' EJ" 14 Longitude W 138 1 0 EJ' EJ" 43 Latitude must be between 32 and 42 degrees. Longitude must be between 114 and 125 degrees. Latitude and Longitude minutes and seconds must be between 0 and 60. Use a central point in the Applicant's service area for the general area covered by the project. All projects must have aproject area. C. ACTVTY: Annual number of emergency incidents. Fire: 1L-2_58 --' + EMS:L-6_06 ~ + Other: 1-17_2_7 --' = TOTAL: 1,591 D. NDAN TRBAL COMMUNTY (f project includes an ndian Tribal Community, please provide) : Population: Size (acres) : # of structures: Distance to nearest fire station (miles) : JUN 2 " ')015
E. Proposed Project (List individual items for funding) : Type tem Quantity Unit Cost tem Total 1. Communications KNG Commander Portable Radio 24 $1,447.00 $34,728.0C 2. Communications AA Battery holder (Clam Shell) 24 $48.75 $1,170.00 3. Communications VHF Antenna Flex 24 $26.25 $630.00 4. 8.75% Sales Tax $3,196.20 $3,196.20 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. A2-2
G. ADDTONAL NFORMATON (Briefly describe the area to be served: fire protection system, water system, equipment, facilitie staffing, hazards, etc. Briefly explain purpose of the proposed project): Limited to space below. A2-3 Sonoma County's County Service Area #40 (CSA #40) includes fifteen all-volunteer fire departments, which are coordinated by the Sonoma County Fire and Emergency Services Department. The 250 volunteers of CSA #40 provide primary response in Wildland/Urban nterface areas, as well as mutual aid to neighboring agencies including CalFire. Several of the communities within CSA #40 have been ranked as high-risk in the California Fire Plan, and wildland fires pose a continual, major threat. Because of the significant risks of emergency incidents in our response areas, our primary goal for funds awarded from the CalFire VFA grant is to provide compliant portable radio, clam shells, and antennas for as many volunteers as possible. These radios meet the newest State specifications and are interoperable with our surrounding agencies and with incident communications on strike team assignments. We will replace the oldest 2005 model radios that do not meet the current mandates. The investment in communications equipment will give the opportunity for our department to continue to provide staff and apparatus with the best life-saving equipment for response. Fire and Emergency Services provides annual training on the use of gear and equipment as well as wildland firefighting and other areas of fire suppression and safety. n addition to the original request(s), Applicants may list alternative projects for excess or unused funds, which the State will review during the initial application process. The State will determine which of the Applicant's projects are eligible for funding if excess or unused funds become available. Upon advanced written approval by the State, the applicant may use additional/excess funding up to the contract maximum amount to purchase State approved items in listed order of priority on their application. Deviations from the original application are considered an amendment and require prior approval before the amended expenditures can be made. The funds will be only for those projects accomplished and/or items purchased between Agreement Approval Date and June 30, 2016. The Recipient agrees to provide CAL FRE with itemized documentation of the Agreement project expenditures and bill CAL FRE as soon as the project is complete, but no later than September 1,2016. The Recipient gives CAL FRE or any authorized representative access to examine all records, books, papers, or documents relating to the Agreement. The Recipient shall hold harmless CAL FRE and its employees for any liability or inj ury suffered through the use of property or equipment acquired under this Agreement. The applicant certifies that to the best of applicant's knowledge and belief, the data in this application is true. certify that the a~/9,v{a~~afiac f ation is true and correct: "... 7. / / ntee's Authorized Representative Printed Name L-A Te_r_re 1 -' Title Fire Chief / Director Executed on: Jun 23, 2015 at Santa Rosa Date City
Grant Assurances for Cooperative Forestry Assistance Act of 1978 Volunteer Fire Assistance (VFA) A2-4 Contact's First Name: Wesley Contact's Last Name: Kitchel Street Address: 2300 County Center Dr, Suite 2208 Mailing Address: 2300 County Center Dr, Suite 220B, Santa Rosa, CA, 95403 City: Santa Rosa County: Sonoma Zip Code: 95403 State: California CAL FRE Unit: LNU - Sonoma- Lake-Napa Unit Phone Number: 707-565-1152 Email Address: wesley.kitchel@sonoma-county.org DUNS Number: 80126444 To check to see what your DUNS number is, or to apply for one, please go to: https:lliupdate.dnb.com/iupdate/companylookup.htm As the duly authorized representative of the applicant, certify that the applicant named above: 1. Has the legal authority to apply for the Volunteer Fire Assistance grant, of the Cooperative Forestry Assistance Act of 1978 and has the institutional, managerial and financial capability to ensure proper planning, management and completion of the grant. 2. Will assure that grant funds are used only for items requested and approved in the application. 3. Assures that all wildland fire response employees (full-time, part-time or volunteer) are fully equipped with appropriate wildland fire response personal protective equipment that meets NFPA 1977, Standard on Protective Clothing and Equipment for Wildland Fire Fighting, and are trained to a proficient level in the use of the personal protective equipment. Wildland fire suppression safety clothing and equipment includes: Safety helmet Goggles Ear Protection Fire-resistant (Le. Nomex) hood, shroud, or equivalent face and neck protection Fire-resistant (Le. Nomex) shirt and pants Gloves Safety work boots Wildland fire shelter Communications Equipment 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain for themselves or others, particularly those with whom they have a family, business or other ties. 6. Will comply with all applicable requirements of all other Federal laws, Executive orders, regulations, Program and Administrative requirements, policies and other requirements governing this program. 7. Will comply with USDA Forest Service Civil Rights requirements. See Forest Service Civil Rights literature here. 8. Understands that failure to comply with any of the above assurances may result in suspension, termination or reduction of grant funds.
".., =m A2-5 jgj n compliance with NFPA 1977 and trained in the use of Wildland PPE. o Not in compliance with NFPA 1977 but are applying for grant funding to purchase PPE and/or provide required training. The undersigned represents that he/she is authorized by the above named applicant to enter into this agreement for and on behalf of the said applicant. Printed Name of Authorized Agent: l,-w_e_s_le_y--:::k_it_c_h_e_1 ---' ~gnatureofauthorizedagent: ~~~~~~~&.~~~,-S~ -'~. ~-~..-;------------------~ Title of Authorized Agent: Assistant Chief Date: \June 23, 2015 '-----------------~ Organization Name: Sonoma County Fire and Emergency Services Page 5 of 5