CONTRACT 3403 OtherSTATE OF CALIFORNIA ARNOLD SCHWARZENEGGER, Governo►
34 0 , O CALIFORNIA
r GOVERNOR'S OFFICE OF EMERGENCY SERVICES
P.O. BOX 419047
+� RANCHO CORDOVA, CALIFORNIA 95741 -9047 or
916- 845 -8510 Go-q-
FAX: 845 -8511 N_7a9qSWTkK
September 22, 2004
Steve Tsumura, Environmental Safety Manager
City of El Segundo Fire Department
314 Main Street
El Segundo, CA 90245
Dear Mr. Tsumura:
SUBJECT: HAZARDOUS MATERIALS EMERGENCY PREPAREDNESS (HMEP) GRANT
— PROJECT APPROVAL
The Governor's Office of Emergency Services (OES), Hazardous Materials Unit, has
received and reviewed your project application for the Shelter in Place, Public Information, and
Educational Materials Distribution. Your project has been approved for implementation starting
October 1, 2004.
The amount of grant funding for your project is broken down as follows:
HMEP Share: $6,400 (80% of Total Cost)
Match Share: $1,600 (20% of Total Cost)
Total Cost: $8,000
Enclosed with this letter of approval is an Assistance Agreement (SubGrant) (OES 167
HazMat). Before any award can be claimed and reimbursements paid, this subgrant must be
signed and returned to this office as explained on the form.
If you have any questions or concerns, please contact Diana Melroe, Grant Administrator,
at (916) 845 -8778 or by e -mail at diana.melroeCi-�oes.ca.gov.
Sincerely,
C
Moustafa Abou - Taleb, Manager
Hazardous Materials Unit
Enclosure
c: LEPC Chairperson
OES LEPC Staff Support
STATE OF CALIFORNIA
GOVERNOR'S OFFICE OF EMERGENCY SERVICES
ASSISTANCE AGREEMENT
1. ASSISTANCE NO.
2. RECIPIENT NO.
3. TYPE OF ACTION
4. PROJECT /BUDGET PERIOD
HMECA4033120
002
Subgrant Award
October 1, 2004 to September 30, 2005
dex Codes
5. SEND PAYMENT REQUEST TO
6. PAYMENT METHOD
7. TOTAL PROJECT/BUDGET COST
(Accou
(Accounting Office Use Only)
OES Accounting Department via
OES Hazardous Materials Unit
Reimbursement
$8,000
5411
8. RECIPIENT PROJECT MANAGER AND ADDRESS
9. DES REGIONAL COORDINATOR, ADDRESS, & PHONE #
Region 1
Region II
Reason III
Steve Tsumura, Environmental Safety Officer
314 Main Street
Sean Grady
Leonard Miller
Nellie Lee Barber
El Segundo, CA 90245
4671 Liberty Ave.,
1300 Clay Street,
645 Antelope Blvd. #13
Los Alamitos, CA
Suite 400
Red Bluff, CA 96080
90720 -5158
Oakland, CA 94612
(530) 529 -0409
(562) 795 -2912
(510) 286 -6745
Region IV
Region V
Region VI
10. PAYEE
Jerilyn Peterson
Roy Manning
Sean Grady
City of El Segundo Fire Department
P.O. Box 419047
2550 Mariposa Mall,
4671 Liberty Ave.
314 Main Street
Rancho Cordova, CA
Room 181
Los Alamitos, CA
El Segundo, CA 90245
95741 -9047
Fresno, CA 93721
90720 -5158
(916) 845 -8480
1 (559) 445 -5672
1 (562) 795 -2912
11. ASSISTANCE PROGRAM (CDFA PROGRAM)
12. PROJECT TITLE
HMEP 20.703
Shelter In Place, Public Information and Educational Distribution
16. OES STATE PROJECT COORDINATOR AND PHONE #
FUNDS
THIS ACTION
Diana Melroe (916) 845 -8778
17. OES FISCAL COORDINATOR AND PHONE #
13. Federal Share
$6,400
Linda Fong (916) 845 -8302
18. STATUTORY AUTHORITY
14. Recipients Match Share
$1,600
Federal Hazardous Materials Transportation Law, 49 U.S.C. 5101 et seq.
15. Total Project Cost
$8,000
19. REGULATORY AUTHORITY
Title 49 CFR, Part 110
NOTE: This Agreement must be completed in triplicate and two originals returned to the Office of Emergency Services (OES), Hazardous Materials
Unit, P. 0. Box 419047, Rancho Cordova, CA 95741 -9047 within 3 weeks after receipt or within any extension of time as may be granted by DES.
Receipt of a written refusal or failure to return the properly executed document within the prescribed time, may result in the withdrawal of this offer by
DES. Any change to this document by the recipient, subsequent to it being signed by the OES Award Official, who materially alters the document,
shall void the Agreement.
The United States of America, acting by and through the United States Department of Transportation and the California Governor's Office of
Emergency Services hereby offers assistance to the City of El Segundo Fire Department for 80% of all approved project costs incurred up to and not
exceeding $8,000. Recipients must contribute a minimum of 20% matching share to the total cost of the project. Recipients agree to provide the
OES Hazardous Materials Unit with quarterly project status reports and monthly /quarterly requests for payments that include costs incurred during the
quarter. Recipients agree to closely track all project work activities and associated costs. Recipients agree to submit to OES all supporting
documentation that substantiates all project costs, including the matching share. Recipients agree to provide written notification to the OES
Hazardous Materials Unit of any deviation from the project described in the project application. Recipients agree to refrain from implementing any
deviations unless approved by DES. Recipients agree to provide OES with information that depicts the outcome, results, or products of the project at
the end or prior to the end of the last quarter of the grant year. Recipients agree that failure to comply with any of these requirements may result in the
withdrawal of this offer.
FORM M O, .E . OR$ FFIC O . EMERG N` ERVfCE
SIGNATURE OF AWARD OFFICIAL
TYPE NAME AND TITLE DATE
`��lw%1G,ti
NANCY J. KONTOS, Fiscal Officer- ,��_o� j
This AgreementCA subject to applicable United States Department of Transportation statutory provisions and assistance regulations. In accepting this
award or amendment and any payments made pursuant thereto, (1) the undersigned represents that s(he) is duly authorized to act on behalf of the
recipient organization, and (2) the recipient agrees (a) with the requirements of the "Offer and Acceptance" clause, (b) that the award is subject to the
applicable provisions of 49 CFR § 110 et seq., 49 CFR Part 18, and of the provisions of this agreement, including the Articles of Agreement, and (c)
that acceptance of any payments constitutes an agreement by the payee that the amounts, if any found by OES to have been overpaid, will be
refunded in full to OES.
SI ATUR "
TYPE NAME AND TITLE D TE
Mary Strenn, City Manager
U/ OES 1Ca! zMat (10/02)