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HomeMy WebLinkAboutAgreements/Contracts - Sheriff & Jail (002)Washington State Military Department CONTRACT FACE SHEET 1. Contractor Name and Address: 2. Contract Amount: 3. Contract Number Grant, County of dba Grant County Sheriff's $ 46,831 E24-004 Office, Emergency Management Division 35 C Street NW Ephrata, WA 98823-1685 4. Contractor's Contact Person, phone number, email: 5. Contract Start Date 6. Contract End Date Josh Sainsbury, (509) 750-7306 July 1, 2023 June 30, 2024 sainsbu rantcount wa. ov 7. MD Program Manager, phone number/, email: 8. Unique Entity Identifier (UEI) # 9. UBI # (state revenue): Steven G. Williams, (509) 545-2030 ZL6WM26K8KR5 132-001-884 steven.williams@mil.wa.gov 10. Funding Authority: Washington State Military Department (Department) and the Energy Facility Site Evaluation Council (EFSEC) 11. Funding Source Agreement #: 12. Program Index # & Obj/Subobj 13. CFDA # & Title: 14. TIN or SSN: EMD — CGS — EP (2024-25) 74803 NZ NA 91-6001319 15. Service Districts: 16. Service Area by County(ies): 17. Women/Minority-Owned, State (BY LEGISLATIVE DISTRICT): 12, 13 Grant County Certified?: X N/A ❑ NO (BY CONGRESSIONAL DISTRICT): 4 ❑ YES, OMWBE # 18. Contract Classification: 19. Contract Type (check all that apply): ❑ Personal Services ❑ Client Services X Public/Local Gov't X Contract ❑ Grant ❑ Agreement ❑ Collaborative Research ❑ A/E ❑ Other ❑ Intergovernmental (RCW 39.34) ❑ Interagency 20. Contractor Selection Process: 21. Contractor Type (check all that apply) X "To all who apply & qualify" ❑ Competitive Bidding ❑ Private Organization/Individual ❑ For -Profit ❑ Sole Source ❑ A/E RCW ❑ N/A X Public Organization/Jurisdiction X Non -Profit ❑ Filed w/OFM? ❑ Advertised? ❑ YES ONO ❑ VENDOR X SUBRECIPIENT ❑ OTHER 22. BRIEF DESCRIPTION: To provide EFSEC pass-through dollars (SFY 2024) for the county to conduct radiological emergency preparedness program duties relating to the Columbia Generating Station nuclear power plant. IN WITNESS WHEREOF, the Department and Contractor acknowledge and accept the terms of this contract, including all referenced exhibits and attachments which are hereby incorporated in and made part hereof, and have executed this contract as of the date and year written below. This Contract Face Sheet, Special Terms and Conditions (Exhibit A), General Terms and Conditions (Exhibit B), Statement of Work (Exhibit C), Budget (Exhibit D), and all other documents, exhibits, and attachments govern the rights and obligations of the parties to this contract. No other understandings, oral or otherwise, regarding the subject matter of this contract shall be deemed to exist or to bind any of the parties hereto. In the event of an inconsistency in this contract, unless otherwise provided herein, the inconsistency shall be resolved by giving precedence in the following order: (a) Applicable Federal and State Statutes and Regulations (b) Statement of Work (c) Special Terms and Conditions (d) General Terms and Conditions, and if attached, (e) EFSEC Award Document (f) Any other provisions of the contract incorporated by reference. This contract contains all the terms and conditions agreed upon by the parties. No other understandings, oral or otherwise, regarding the subject matter of this contract shall be deemed to exist or to bind any of the parties hereto. WHEREAS, the parties hereto have executed this contract on the day and year last specified below. FOR THE DEPARTMENT: NOR THE CONTRACTOR: -01- Z3 Signature Date Si nature Date Regan Anne Hesse, Chief Financial Officer Joh ` �9c�a�, Undersheriff Washington Military Department for BOILERPLATE APPROVED AS TO FORM: Dierk Meierbachtol (signature on file) 6/20/2022 Grant County Sheriffs Office Assistant Attorney General Form Date: 10/27/00 SFY 2024 (EFSEC) Page 1 of 15 Grant County Sheriff's Office, E24-004 Exhibit A Washington Military Department SPECIAL TERMS AND CONDITIONS Energy Facility Site Evaluation Council (EFSEC) ARTICLE I -- COMPENSATION SCHEDULE: This is a fixed price, reimbursement contract. Within the total Contract Amount, authorized travel, subcontracts, salaries and wages, benefits, printing, equipment, and other goods and services or other budget categories will be reimbursed on an actual cost basis unless otherwise provided in this contract. Any travel or subsistence reimbursement allowed under the contract shall be paid in accordance with rates set pursuant to RCW43.03.050 and RCW 43.03.060 as now existing or hereafter amended and in agreement with federal rates. Receipts and/or backup documentation for any approved Budget line items, including travel related expenses that are authorized under this contract, must be maintained by the Contractor and made available upon the request of the Department. Reimbursement under the contract will only be made consistent with the contract Budget and authorized changes to the Budget. ARTICLE II -- REPORTS: In addition to the reports as may be required elsewhere in this contract, the Contractor shall prepare and submit the following reports to the Department's Key Personnel: Financial #/Copies Completion Date Quarterly Invoices 1 No Later than the 15th day following the end of the Quarter Final Invoice 1 July 30, 2024 (shall not exceed overall contract amount) All contract work must end on June 30, 2024. However, the Contractor has up to 30 days after the Contract end date to submit all final billing. TP.r.hnimgI Quarterly Reports #/Copies Completion Date No Later than the 5th day following the end of the Quarter All contract work must end on June 30, 2024. However, the Contractor has up to 30 days after the expiration date to submit all final reports and/or deliverables. ARTICLE III -- KEY PERSONNEL: The individuals listed below shall be considered Key Personnel. The Key Personnel for each of the parties shall be the contact person for all communications and billings regarding the performance of this Contract. Any substitution of Contractor's Key Personnel must be made by written notification to the Military Department. SFY 2024 (EFSEC) Page 2 of 15 Grant County Sheriffs Office, E24-004 CONTRACTOR: MILITARY DEPARTMENT: Name: Josh Sainsbury Name: Steven G. Williams Title: Chief Deputy Title: Program Manager Email: jsainsbury@grantcountywa.gov Email: steven.williams@mil.wa.gov Phone: (509) 750-7306 Phone: (253) 512-7410 ARTICLE IV -- ADDITIONAL SPECIAL CONDITIONS AND MODIFICATION TO GENERAL CONDITIONS: 1 No funds received under this contract shall be used for any purpose other than for performance of tasks described in the Statement of Work (Exhibit C) and consistent with the Budget (Exhibit D). 2. The Contractor shall provide a match of $0 of non-federal origin. Said match may be in the form of goods, services, and in-kind services. 3. This contract is contingent upon the receipt of Energy Facility Site Evaluation Council (EFSEC) funds provided solely for the purpose of supporting the development of radiological emergency preparedness relating to the Columbia Generating Station nuclear power plant. The Contractor acknowledges that since this contract involves EFSEC funding, the period of performance described herein will likely begin prior to the availability of funds. Contractor agrees that it will not hold the Department or the State of Washington liable for any damages, claims for reimbursement, or any type of payment whatsoever for services performed under this contract prior to the provision and distribution of appropriated funds, or if funds are not appropriated or provided by EFSEC to fund this contract. SFY 2024 (EFSEC) Page 3 of 15 Grant County Sheriffs Office, E24-004 Exhibit B Washington Military Department GENERAL TERMS AND CONDITIONS Energy Facility Site Evaluation Council (EFSEC) 1. DEFINITIONS --As used throughout this contract, the following terms shall have the meaning set forth below: a. "Department" shall mean the Washington Military Department, as a state agency, any division, section, office, unit or other entity of the Department, or any of the officers or other officials lawfully representing that Department. b. "The Adjutant General" as it is used herein shall mean the Director of the Washington Military Department. The term "Authorized Department Representative" shall mean those persons who have written authorization to sign Department contracts and represent Department as signed and directed by The Adjutant General. C. "Contractor" shall mean that firm, organization, group, individual, or other entity performing services under this contract, and shall include all employees of the Contractor. It shall include any subcontractor retained by the prime Contractor as permitted under the terms of this agreement. d. "Subcontractor" shall mean one, not in the employment of the Contractor, who is performing all or part of those services under this contract through a separate contract with the Contractor. The terms "subcontractor" and "subcontractors" mean subcontractor(s) in any tier. e. "WAC" is defined and used herein to mean the Washington Administrative Code. f. "RCW" is defined and used herein to mean the Revised Code of Washington. 2. CONTRACTOR NOT EMPLOYEE OF AGENCY -- The Contractor, and/or employees or agents performing under this agreement are not employees or agents of the Department in any manner whatsoever. The Contractor will not be presented as nor claim to be an officer or employee of the Department or of the State of Washington by reason hereof, nor will the Contractor make any claim, demand, or application to or for any right, privilege or benefit applicable to an officer or employee of the Department or of the State of Washington, including, but not limited to, Workers' Compensation coverage, unemployment insurance benefits, social security benefits, retirement membership or credit, or privilege or benefit which would accrue to a civil service employee under Chapter 41.06 RCW; OFM Reg. 4.3.1.1.8. It is understood that if the Contractor is another state department, state agency, state university, state college, state community college, state board, or state commission, that the officers and employees are employed by the State of Washington in their own right. If the Contractor is an individual currently employed by a Washington State agency, the Department shall obtain proper approval from the employing agency or institution before entering into this contract. A statement of "no conflict of interest" shall be submitted to the Department. 3. COMPLIANCE WITH APPLICABLE LAW The Contractor and all subcontractors shall comply with, and the Department is not responsible for determining compliance with, any and all applicable federal, state, tribal government, and local laws, regulations, and/or policies. This obligation includes, but is not limited to, Ethics in Public Service (RCW 42.52); Covenant Against Contingent Fees (48 C.F.R. Sec. 52.203-5); Public Records Act (RCW 42.56); and safety and health regulations. In the event of the Contractor's or a subcontractor's noncompliance or refusal to comply with any law or policy, the Department may rescind, cancel, or terminate the contract in whole or in part. The Contractor is responsible for any and all costs or liability arising from the Contractor's failure to comply with applicable law. 4. NONDISCRIMINATION -- During the performance of this agreement, the Contractor shall comply with all federal and state nondiscrimination statutes and regulations. These requirements include, but are not limited to: a. Nondiscrimination in Employment: The Contractor shall not discriminate against any employee or applicant for employment because of race, color, sex, sexual orientation, religion, national origin, creed, marital status, age, Vietnam era or disabled veterans status, or the presence of any sensory, mental, or physical handicap. This requirement does not apply, however, to a religious corporation, association, educational institution or society with respect to the employment of individuals of a particular religion to perform work connected with the carrying on by such corporation, association, educational institution or society of its activities. b. The Contractor shall take action to ensure that employees are employed and treated during employment without discrimination because of their race, color, sex, sexual orientation religion, national origin, creed, SFY 2024 (EFSEC) Page 4 of 15 Grant County Sheriffs Office, E24-004 marital status, age, Vietnam era or disabled veterans status, or the presence of any sensory, mental, or physical handicap. Such action shall include, but not be limited to, the following: Employment, upgrading, demotion, or transfer, recruitment or recruitment selection for training, including apprenticeships and volunteers. 5. NONCOMPLIANCE WITH NONDISCRIMINATION LAWS -- In the event of the Contractor's noncompliance or refusal to comply with any nondiscrimination law, regulation, or policy, this contract may be rescinded, canceled or terminated in whole or in part, and the Contractor may be declared ineligible for further contracts with the Department. The Contractor shall, however, be given a reasonable time in which to cure this noncompliance. Any dispute may be resolved in accordance with the "Disputes" procedure set forth herein. 6. MINORITY AND WOMEN -OWNED BUSINESS ENTERPRISES -- In accordance with the legislative findings and policies set forth in Chapter 39.19 RCW, the State of Washington encourages participation in all its contracts by MWBE firms certified by the Office of Minority and Women's Business Enterprises (OMWBE). To the extent possible, the Contractor will solicit and encourage minority-owned and women -owned business enterprises who are certified by the OMWBE under the state of Washington certification program to apply and compete for work under this contract. Voluntary numerical MWBE participation goals have been established, and are indicated herein: Minority Business Enterprises: (MBE's): 10% and Woman's Business Enterprises (WBE's): 6%. 7. SUBCONTRACTING -- All subcontracts entered into pursuant to this contract shall incorporate this contract in full by reference. Neither the Contractor nor any Subcontractor shall enter into subcontracts for any of the work contemplated under this contract and after original contract award, without obtaining prior written approval of the Department. Contractor shall use a competitive process in award of any contracts with subcontractors that are entered into after original contract award. The Military Department may request a copy of any and/or all subcontracts that exist for work being completed under this contract. In no event shall the existence of the subcontract operate to release or reduce the liability of the Contractor to the Department for any breach in the performance of the Contractor's duties. This clause does not include Contracts of employment between the Contractor and personnel assigned to work under this Contract. 8. INDEMNIFICATION -- To the fullest extent permitted by the law, the Contractor expressly agrees to and shall indemnify, defend and hold harmless the State and its agencies, officials, agents and employees from and against all claims, actions, costs, damages, or expenses of any nature arising out of or incident to the Contractor's or any subcontractor's performance or failure to perform the contract. The Contractor's obligation to indemnify, defend and hold harmless also includes any claim by the Contractor's agents, employees, representatives or any subcontractor or its employees. The Contractor's obligation to defend includes payment of any costs or attorneys' fees. The Contractor's obligation shall not include such claims that may be caused by the sole negligence of the State and its agencies, officials, agents, and employees. If the claims or damages are caused by or result from the concurrent negligence of (a) the State, its agents or employees and (b) the Contractor, its subcontractors, agents, or employees, this indemnity provision shall be valid and enforceable only to the extent of the negligence of the Contractor or its subcontractors, agents, or employees. The Contractor expressly agrees to waive its immunity under Title 51 RCW (Industrial Insurance) to the extent required to indemnify, defend, and hold harmless the State and its agencies, officials, agents or employees. 9. COVENANT AGAINST CONTINGENT FEES -- The Contractor warrants that no person or selling agency has been employed or retained to solicit or secure this contract upon an agreement or understanding for a commission, percentage, brokerage, or contingent fee, excepting bona fide employees or bona fide established commercial or selling agency maintained by the Contractor for the purpose of securing business. The Department shall have the right, in the event of breach of this clause by the Contractor, to annul this contract without liability or, in its discretion, to deduct from the contract price or consideration or otherwise recover the full amount of such commission, percentage, brokerage, or contingent fee. 10. NONASSIGNABILITY -- Neither this contract, nor any claim arising under this contract, nor the work to be provided under this contract, and any claim arising thereunder, shall be assigned or delegated by either party in whole or in part, without the express prior written consent of the other party, which consent shall not be unreasonably withheld. 11. AMERICANS WITH DISABILITIES ACT (ADA) OF 1990, PUBLIC LAW 101-336, 42 U.S.C. 12101 et seq. and its implementing regulations, 28 CFR Part 35. The Contractor must comply with the ADA, which provides comprehensive civil rights protection to individuals with disabilities in the areas of employment, public accommodations, state and local government services, and telecommunication. SFY 2024 (EFSEC) Page 5 of 15 Grant County Sheriff's Office, E24-004 12. RECORDS, MONITORING AND AUDIT ACCESS a. The Contractor shall perform under the terms of the contract, and the Department has responsibility for reasonable and necessary monitoring of the Contractor's performance. The Department shall conduct contract monitoring activities on a regular basis. Monitoring means any planned, ongoing, or periodic activity that measures and ensures contractor compliance with the terms, conditions, and requirements of a contract. Monitoring involves prudent collection of information about Contractor operations and is not limited to site visits or the completion of formal reviews. Monitoring may include periodic contractor reporting to the Department, Department review of audit reports, invoice reviews, onsite reviews and observations, and surveys. Adequate documentation is essential for effective contract monitoring and will include copies of letters, meeting notes, and records of phone conversations as evidence that conscientious monitoring has occurred during the period of the contract. b. The Contractor shall maintain books, records, documents, and other evidence and accounting procedures and practices that sufficiently and properly reflect all direct and indirect costs of any nature expended in the performance of this contract. These records shall be subject at all reasonable times to inspection, review, or audit by personnel duly authorized by the Department, the Office of the State Auditor, and federal officials so authorized by law, rule, regulation, or contract. The Contractor will retain all books, records, documents, and other materials relevant to this contract for six (6) years from the date contract final payment is made hereunder, and make them available for inspection by persons authorized under this provision. C. The Department or the State Auditor or any of their representatives and federal officials so authorized by law, rule, regulation, or contract shall have full access to and the right to examine during normal business hours and as often as the Department or the State Auditor may deem necessary, all of the Contractor's records with respect to all matters covered in this contract. Such representatives shall be permitted to audit, examine, and make excerpts or transcripts from such records and to make audits of all contracts, invoices, materials, payrolls, and records of matters covered by this contract. Such rights last for six (6) years from the date final payment is made hereunder. d. The Contractor shall cooperate with and freely participate in any other monitoring or evaluation activities conducted by the Department that are pertinent to the intent of this contract. 13. ACCESS TO PUBLIC RECORDS a. The parties acknowledge that the Department is subject to the Public Records Act, Chapter 42.56 RCW, and that records prepared, owned, used or retained by the Department relating to the conduct of government or the performance of any governmental or proprietary function are available for public inspection or copying, except as exempt under RCW 42.56 or other statute which exempts or prohibits disclosure of specific information or records. b. The Contractor shall provide access to data generated under this contract to the Department and the State Auditor at no additional cost. This includes access to all information that supports the findings, conclusions, and recommendations of the Contractor's reports, including computer models and methodology for those models. C. Access to Data. The contractor shall provide access to all data generated under the contract to the Department, the Joint Legislative Audit and Review Committee, and the Office of the State Auditor at no additional cost. For the purposes of this requirement, "data" includes all information that supports the findings, conclusions and recommendations of the contractor's reports, including computer models and methodology for those models. 14. DISCLOSURE -- The use or disclosure by any party of any information concerning the Department for any purpose not directly connected with the administration of the Department's or the Contractor's responsibilities with respect to services provided under this contract is prohibited except by prior written consent of the Department or as required to comply with the Public Records Act or court order. Contractor acknowledges that the Department is subject to Chapter 42.56 RCW, the Public Records Act, and that this Contract shall be a public record as defined in RCW 42.56.0.10. Any specific information that is claimed by the Contractor to be confidential or proprietary must be clearly identified as such by the Contractor. To the extent consistent with Chapter 42.56 RCW, the Department shall maintain the confidentiality of all such information marked confidential or proprietary. If a request is made to view the Contractor's information, the Department will notify the Contractor of the request and the date that such records will be released to the requester unless Contractor obtains a court order enjoining that disclosure. If the Contractor fails to obtain the court order enjoining disclosure, the Department will release the requested information on the date specified. 15. RIGHTS IN DATA -- The parties hereto agree that all works originating from this contract shall be "works for hire" as defined by the U.S. Copyright Act of 1976 and shall be owned by the Department and/or the State of Washington. Unless otherwise provided, this contractual term applies to all works including, but not limited to, reports, graphic SFY 2024 (EFSEC) Page 6 of 15 Grant County Sheriffs Office, E24-004 design and logos, documents, files, pamphlets, advertisements, publications, books, magazines, surveys, studies, computer programs, films, tapes, and/or sound reproductions prepared by an employee within the scope of employment, and also to all works specially ordered or commissioned for use as a contribution to a collective work, as a part of a motion picture or other audiovisual work, as a translation, as a supplementary work, as a compilation, as an instructional text, as a test, as answer material for a test, or as an atlas. Ownership includes the right to copyright, patent, register, and the ability to transfer these rights. Work delivered under the contract, but which does not originate therefrom, shall be transferred to the Department with a nonexclusive, royalty -free, irrevocable license to publish, translate, reproduce, deliver, perform, dispose of, and to authorize others to do so; provided, that such license shall be limited to the extent which the Contractor has a right to grant such a license. The Contractor shall exert all reasonable effort to advise the Department, at the time of delivery of works furnished under this contract, of all known or potential invasions of privacy contained therein and of any portion of such document which was not produced in the performance of this contract. The Department shall receive prompt written notice of each notice or claim or copyright infringement received by the Contractor with respect to any works created under this contract. The Contractor shall not affix any restrictive markings upon any works, and if such markings are affixed, the Department shall have the right at any time to modify, remove, obliterate, or ignore such markings. 16. PUBLICITY -- The Contractor agrees to submit to the Department all advertising and publicity matters relating to this contract wherein the Department's name is mentioned or language used from which the connection of the Department's name may, in the Department's judgment, be inferred or implied. The Contractor agrees not to publish or use such advertising and publicity matters without the prior written consent of the Department. 17. PRIVACY -- Personal information collected, used or acquired in connection with this contract shall be used solely for the purposes of this contract. Contractor and its subcontractors agree not to release, divulge, publish, transfer, sell or otherwise make known to unauthorized persons personal information without the express written consent of the Department or as provided by law. Contractor agrees to implement physical, electronic and managerial safeguards to prevent unauthorized access to personal information. The Department reserves the right to monitor, audit, or investigate the use of personal information collected, used or acquired by the Contractor through this contract. The monitoring, auditing or investigating may include but is not limited to "salting" by the Department. Contractor shall certify return or destruction of all personal information upon expiration of this contract. Salting is the act of placing a record containing unique but false information in a database that can be used later to identify inappropriate disclosure of data contained in the database. Any breach of this provision may result in termination of the contract and the demand for return of all personal information. The Contractor agrees to indemnify and hold harmless the Department for any damages related to the Contractor's unauthorized use of personal information. For purposes of this provision, personal information includes, but is not limited to, information identifiable to an individual that relates to a natural person's health, finances, education, business, use or receipt of governmental services, or other activities, names, addresses, telephone numbers, social security numbers, driver license numbers, financial profiles, credit card numbers, financial identifiers and other identifying numbers. 18. TREATMENT OF ASSETS a. Title to all property furnished by the Department shall remain with the Department. Title to all property purchased by the Contractor, for the cost of which the Contractor is entitled to be reimbursed as a direct item of cost under this contract, shall pass to and vest in the Department upon delivery of such property by the vendor. Title to other property, the cost of which is reimbursable to the Contractor under the contract, shall pass to and vest in the Department upon (i) issuance for use of such property in the performance of this contract, or (ii) commencement of use of such property in the performance of this contract, or (iii) reimbursement of the cost thereof by the Department in whole or in part, whichever first occurs. b. Any property of the Department furnished to the Contractor shall, unless otherwise provided herein, or approved by the Department, be used only for the performance of this contract. C. The Contractor shall be responsible for any loss or damage to property of the Department that results from the negligence of the Contractor or which results from the failure on the part of the Contractor to maintain and administer that property in accordance with sound management practices. d. Upon the happening of loss or destruction of, or damage to, any Department property, the Contractor shall notify the Department thereof and shall take all reasonable steps to protect that property from further damage. e. The Contractor shall surrender to the Department all property of the Department prior to settlement upon completion, termination, or cancellation of this agreement. SFY 2024 (EFSEC) Page 7 of 15 Grant County Sheriffs Office, E24-004 All reference to the Contractor under this clause shall include any of the Contractor's employees or agents or subcontractors. 19. SITE SECURITY — While on Department premises, Contractor, its agents, employees, or subcontractors shall conform in all respects with physical, fire or other security regulations. 20. ATTORNEY'S FEES — In the event of litigation or other action brought to enforce contract terms or alternate dispute resolution process, each party agrees to bear its own attorney's fees and costs. 21. TAXES — All payments accrued on account of payroll taxes, unemployment contributions, any other taxes, insurance or other expenses for the Contractor or its staff shall be the sole responsibility of the Contractor. 22. TRAVEL AND SUBSISTENCE REIMBURSEMENT -- Unless the contract specifically provides for different rates, any travel or subsistence reimbursement expressly authorized under the contract shall be paid in accordance with rates set pursuant to RCW 43.03.050 and RCW 43.03.060 and the State Administrative and Accounting Manual (SRAM) Chapter 10.90 — Travel Rates, http://www.ofm.wa.gov/policy/10.90.htm as now existing or amended. Receipts and documentation for travel or subsistence expenses that are authorized under this contract must be maintained by the Contractor and be made available to the Department upon request. 23. LICENSING AND ACCREDITATION STANDARDS -- Unless exempt from registration by law, the Contractor shall complete registration with the Department of Revenue, and be responsible for payment of all taxes due on payments made under this Contract. WAC 458-20-101. The Contractor shall comply with all applicable local, state, and federal licensing and accrediting requirements/standards, necessary in the performance of this contract. (See RCW 19.02 for state licensing requirements/definitions.) The Contractor shall provide to the Department all identification codes/numbers that apply to the business as required in the state and federal revenue laws and regulations. Identifications such as the State Department of Revenue number, federal employee identification number, state certification number of a minority/women-owned business enterprise, and any other applicable registration identification that may exist should be provided. The Contractor shall be responsible for payment of all related licensing, accreditation and other related fees and charges. 24. CERTIFICATION REGARDING DEBARMENT, SUSPENSION OR INELIGIBILITY -- If federal funds are the basis for this contract, the Contractor certifies that the Contractor is not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in this contract by any federal department or agency. If requested by Washington Military Department, the Contractor shall complete and sign a Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion form. Any such form completed by the Contractor for this Contract shall be incorporated into this Contract by reference. Further, the Contractor agrees not to enter into any arrangements or contracts related to this contract with any party that is debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in this contract by any federal department or agency. In addition, the state debarment laws shall apply: RCW 39.19.090; RCW 39.12.065 (3). 25. ADVANCE PAYMENTS PROHIBITED — The Department shall make no payments in advance or in anticipation of services or supplies to be provided under this contract. Contractor shall not invoice the Department in advance of delivery of such goods or services. RCW 43.88.160; Washington State Constitution, Article VIII, § 5 26. LOSS OR REDUCTION OF FUNDING -- In the event funding from state, federal, or other sources is withdrawn, reduced, or limited in any way after the effective date of this contract and prior to normal completion, the Department may immediately terminate the contract in its sole discretion under the "Termination for Convenience" clause, without the ten (10) day notice requirement. Alternatively, the parties may renegotiate the terms of this contract under the "CONTRACT MODIFICATIONS" provision to comply with new funding limitations and conditions, although the Department has no obligation to do so. 27. WAIVER OF DEFAULT -- Waiver of any default shall not be deemed to be a waiver of any subsequent default. Waiver of breach of any provision of the contract shall not be deemed to be a waiver of any other or subsequent breach and shall not be construed to be a modification of the terms of the contract unless stated to be such in writing, signed by the Director and attached to the original contract. 28. CONTRACT MODIFICATIONS — This contract contains all the terms and conditions agreed upon by the parties. No other understandings, oral or otherwise, regarding the subject matter of this agreement shall be deemed to exist or bind the parties hereto unless made in writing and signed by the parties. The Department and the Contractor may, from time to time, request changes to the contract. Any such changes that are mutually agreed upon by the parties to this contract shall be incorporated herein by written amendment to this contract. It is mutually agreed and SFY 2024 (EFSEC) Page 8 of 15 Grant County Sheriff's Office, E24-004 understood that no alteration or variation of the terms of this contract shall be valid unless made in writing and signed by the parties hereto, and that any other understanding or agreements, oral or otherwise, are not incorporated herein and shall not be binding unless made in writing and signed by the parties hereto. 29. LIMITATION OF AUTHORITY -- "Authorized Signature" Only the assigned Authorized Signature for the Department or the assigned delegate by writing (delegation to be made prior to action) shall have the express, implied, or apparent authority to alter, amend, modify, or waive any clause or condition of this contract. Furthermore, any alteration, amendment, modification, or waiver of any clause or condition of this contract is not effective or binding unless made in writing and signed by the authorized person. 30. DISPUTES -- Except as otherwise provided in this contract, when a bona fide dispute arises between the parties and it cannot be resolved through discussion and negotiation, either party may request a dispute resolution board to resolve the dispute. A request for a dispute resolution board shall be in writing, state the disputed issues, state the relative positions of the parties, and be sent to all parties. The board shall consist of a representative appointed by the Department, a representative appointed by the Contractor and a third party mutually agreed upon by both parties. The determination of the dispute resolution board shall be final and binding on the parties hereto. Each party shall bear the cost for its member of the dispute resolution board and its attorney fees and costs, and share equally the cost of the third board member. 31. RECAPTURE OF FUNDS -- In the event that the Contractor fails to expend funds under this Contract in accordance with state laws and/or the provisions of this Contract, the Agency reserves the right to recapture state funds in an amount equivalent to the extent of the noncompliance in addition to any other remedies available at law or in equity. Such right of recapture shall exist for a period not to exceed six (6) years following Contract termination. Repayment by the Contractor of funds under this recapture provision shall occur within 30 days of demand. In the event that the Agency is required to institute legal proceedings to enforce the recapture provision, the Agency shall be entitled to its costs thereof, including reasonable attorneys' fees. 32. CONFLICT OF INTEREST -- The Department may, by written notice to the Contractor, terminate this contract if it is found after due notice and examination by The Adjutant General or the Authorized Department Representative that there is a violation of Chapter 42.52 RCW, Ethics in Public Service, or any, similar statute involving the Contractor in the procurement of, or performance under, this contract. 33. TERMINATION FOR CONVENIENCE -- Notwithstanding any provisions of this contract, the Contractor may terminate this contract by providing written notice of such termination, specifying the effective date thereof, at least thirty (30) days prior to such date. Notwithstanding any other provisions of this contract, the Department may, by ten (10) days written notice, beginning on the second day after the mailing of the written notice, terminate this contract, in whole or in part. If this contract is so terminated, the Department shall be liable only for payment required under the terms of this contract for services rendered or goods delivered prior to the effective date of termination. Upon notice of termination for convenience, the Department reserves the right to suspend all or part of the contract, withhold further payments, and prohibit the Contractor from incurring additional obligations of funds. 34. TERMINATION OR SUSPENSION FOR CAUSE -- In the event the Department determines the Contractor has failed to comply with the conditions of this contract in an acceptable and timely manner, the Department has the right to suspend or terminate this contract. The Department shall notify the Contractor in writing of the need to take corrective action. If the default or violation is not corrected after ten (10) days or within a reasonable timeframe as determined by the Department, the contract shall be deemed terminated. The Department reserves the right to suspend all or part of the contract, withhold further payments, or prohibit the Contractor from incurring additional obligations of funds during investigation of the alleged compliance breach and pending corrective action by the Contractor or a decision by the Department to terminate the contract. In the event this contract is terminated as provided above, the Department shall be entitled to pursue the same remedies against the Contractor as it could pursue in the event of a breach of the contract by the Contractor. The rights and remedies of the Department provided for in this clause shall not be exclusive and are in addition to any other rights and remedies provided by law. The existence of facts upon which The Adjutant General or the Authorized Department Representative makes any determination under this clause shall be an issue and may be reviewed as provided in the "Disputes" clause of this contract. The termination shall be deemed to be a "Termination for Convenience" if it is determined that the Contractor: (1) was not in default, or (2) failure to perform was outside of the Contractor's control, fault or negligence. The rights and remedies of the Department provided in this contract are not exclusive and are in addition to any other rights and remedies provided by law. SFY 2024 (EFSEC) Page 9 of 15 Grant County Sheriffs Office, E24-004 35. TERMINATION PROCEDURE -- Upon termination of this contract, the Department, in addition to any other rights provided in this contract, may require the Contractor to deliver to the Department any property specifically produced or acquired for the performance of such part of this contract as has been terminated. The Department shall pay to the Contractor the agreed upon price, if separately stated, for completed work and services accepted by the Department, and the amount agreed upon by the Contractor and the Department for (i) completed work and services for which no separate price is stated, (ii) partially completed work and services, (iii) other property or services which are accepted by the Department, and (iv) the protection and preservation of property; provided, that if the termination is due to default, The Adjutant General or the Authorized Department Representative shall determine the extent of the liability of the Department. Failure to agree with such determination shall be a dispute within the meaning of the "Disputes" clause of this contract. The Department may withhold from any amounts due the Contractor such sum as The Adjutant General or the Authorized Department Representative determines to be necessary to protect the Department against potential loss or liability. The rights and remedies of the Department provided in this section shall not be exclusive and are in addition to any other rights and remedies provided by law or under this contract. After receipt of a notice of termination, and except as otherwise directed by the Department, the Contractor shall: a. Stop work under the contract on the date, and to the extent specified, in the notice; b. Place no further orders or subcontracts for materials, services, or facilities except as may be necessary for completion of such portion of the work under the contract as is not terminated; C. Assign to the Department, in the manner, at the times, and to the extent directed by The Adjutant General or the Authorized Department Representative, all of the rights, title, and interest of the Contractor under the orders and subcontracts so terminated, in which case the Department has the right, at its discretion, to settle or pay any or all claims arising out of the termination of such orders and subcontracts. d. Settle all outstanding liabilities and all claims arising out of such termination of orders and subcontracts, with the approval or ratification of the Department to the extent The Adjutant General or the Authorized Department Representative may require, which approval or ratification shall be final for all the purposes of this clause; e. Transfer title to the Department and deliver in the manner, at the times, and to the extent directed by the Department any property which, if the contract had been completed, would have been required to be furnished to the Department; f. Complete performance of such part of the work as shall not have been terminated by the Department; and g. Take such action as may be necessary, or as the Department may require, for the protection and preservation of the property related to this contract which is in the possession of the Contractor and in which the Department has or may acquire an interest. 36. GOVERNING LAW AND VENUE -- This contract shall be construed and enforced in accordance with, and the validity and performance hereof shall be governed by, the laws of the state of Washington. In the event of a lawsuit involving this contract, venue shall be proper only in Thurston County. The Contractor, by execution of this contract, acknowledges the jurisdiction of the courts of the state of Washington in this matter. 37. SEVERABILITY -- If any provision of this contract or any provision of any document incorporated by reference shall be held invalid, such invalidity shall not affect the other provisions of this contract which can be given effect without the invalid provision, and to this end the provisions of this contract are declared to be severable. 38. DATE COMPLIANCE — If applicable to this contract, the Contractor is responsible for ensuring that all materials and equipment installed as part of this contract shall accurately process date/time data between year calculations, to the extent that other information technology, used in combination with the information technology being acquired, properly exchanges date/time data with it. 39. HISTORICAL AND CULTURAL ARTIFACTS — The Contractor agrees that if historical, archaeological data, or cultural artifacts, relics or specimens are discovered during and as the result of contract activities such as construction, the Contractor shall immediately stop those specific activities and notify the local historical preservation officer, the state's historical preservation officer at the Washington State Department of Archeology and Historic Preservation, and the Department's contact person for this contract. 40. INDUSTRIAL INSURANCE -- If Vendor has operations in Washington, this section shall apply. If Vendor has no operations in Washington, this section shall NOT apply. SFY 2024 (EFSEC) Page 10 of 15 Grant County Sheriff's Office, E24-004 a. Contractor employments excluded from mandatory coverage are listed in RCW 51.12.020 and include sole proprietors, partners, corporate officers and certain others. The Contractor may elect optional coverage for these employments. b. Prior to performing work under this contract, the Contractor shall provide or purchase industrial insurance coverage for the Contractor's employees, as may be required of an "employer" as defined in Title 51 RCW (Industrial Insurance), and shall maintain full compliance with Title 51 RCW during the course of this contract. To protect the State's interest, if either the Contractor or someone employed by the Contractor is injured while performing work under the contract, the Contractor's employees should be covered by industrial insurance. The Contractor shall comply with the provisions of Title 51 RCW (Industrial Insurance). If the Contractor fails to provide industrial insurance coverage or fails to pay premiums or penalties on behalf of its employees as may be required by law, the Department may collect from the Contractor the full amount payable to the Industrial Insurance accident fund. The Department may deduct the amount owed by the Contractor to the accident fund from the amount payable to the Contractor by the Department under this contract, and transmit the deducted amount to the Department of Labor and Industries (L&I). This provision does not waive any of L&I's rights to collect from the Contractor. RCW 51.04.060. No employer or worker shall exempt himself or herself from the burden or waive the benefits of this title. C. The Contractor shall be prepared, upon request, to provide documentation of industrial insurance coverage for any workers employed by the Contractor. The Department will not be responsible for payment of industrial insurance premiums or for any other claim or benefit for this Contractor, or any subcontractor or employee of the Contractor, which might arise under the industrial insurance laws during performance of duties and services under this contract. 41. RESPONSIBILITIES OF THE PARTIES -- Each party to this contract hereby assumes responsibility for claims and/or damages to persons and/or property resulting from any negligent act or omissions on the part of itself, its employees, its officers, and its agents. Neither party assumes any responsibility to the other party for the consequences of any negligent claim, act, or omission of any person, agency, firm, or corporation not a part to this contract. 42. EXECUTIVE ORDER 13-03 - WORKERS' RIGHTS The Contractor represents and warrants that the Contractor does not require its employees, as a condition of employment, to sign or agree to mandatory individual arbitration clauses or class or collective action waivers. The Contractor further represents and warrants that, during the term of this contract, the Contractor shall not, as a condition of employment, require its employees to sign or agree to mandatory individual arbitration clauses or class or collective action waivers. SFY 2024 (EFSEC) Page 11 of 15 Grant County Sheriffs Office, E24-004 AnNews, STATEMENT OF WORK Energy Facility Site Evaluation Council (EFSEC) SFY24 Grant County Radiological Emergency Preparedness (REP) Program INTRODUCTION: The Washington State Military Department (the Department), Emergency Management Division (EMD), coordinates emergency management activities and implements the Washington State Fixed Nuclear Facility Plan. Through an interagency agreement, the Energy Facility Site Evaluation Council (EFSEC) provides funds for emergency preparedness services in support of Energy Northwest's Columbia Generating Station Emergency Response Plan. The Department is authorized through this interagency agreement to subcontract with certain Washington counties for emergency preparedness (EP) services including coordination of response roles, plans, exercises, and other details. The following Scope of Work outlines the responsibilities of Grant County Sheriff's Office, under this contract. SFY 2024 (EFSEC) Page 12 of 15 Grant County Sheriff's Office, E24-004 Program Activity Frequency A. UPDATE OF PLANS AND LETTERS OF AGREEMENT 1. Grant County Chemical and Radiological plan; revise as necessary to Annually or As needed incorporate any needed updates to the plan and procedures for training, drills, exercises, and changes in the notification process. 2. Provide draft revisions for annual review and comment to Energy Northwest, Annually or As needed WA State EMD and local organizations for any updates or corrections. 3. Conduct periodic review of letters of agreement or memoranda of Annually or As needed understanding with entities, jurisdictions, and disciplines that may be involved during a radiological incident. 4. Attend planning meetings (issues) related to Energy Northwest for As Scheduled coordination, planning, and training that may impact Grant County's preparedness efforts. B. PUBLIC EDUCATION AND INFORMATION 1. Participate in community Outreach Programs (e.g., schools, civic groups). As Requested 2. Make available program emergency preparedness information to ingestion Annually zone residents and businesses. C. RADIOLOGICAL EMERGENCY RESPONSE TRAINING 1. Ensure initial and annual training is provided for Emergency Operations Annually or As needed Center (EOC) personnel and first responders (i.e., Elected officials, law enforcement, fire service, public works, dispatchers, emergency workers, volunteers) involved in the Fixed Nuclear Facility (FNF) plan. Training may be done in cooperation with the Washington Department of Health (WDOH), Washington Department of Agriculture (WSDA), WA State EMD and Energy Northwest. 2. Attend and participate in other REP program training or training pertinent for As Scheduled Emergency Management to include but not limited to: CC, RPPR, REEC, RPPP, REP-DIR, HSEEP, PIO, IS (1007 2007 700, 800), ICS (3001400)7 G- 235 (Planning) 3. Maintain training attendance records and outlines of training subject matter. As Requested Provide copies to FEMA Region X, Energy Northwest, and WA State EMD as requested. SFY 2024 (EFSEC) Page 12 of 15 Grant County Sheriff's Office, E24-004 D. DRILLS AND EXERCISES 1 - Participate in scheduled off year drills, dressed rehearsals, and evaluated As Scheduled exercises (2024 ingestion). Work with the Energy Northwest Emergency Planner to include Grant County in their drills and exercises when the exercise scenario identifies a risk to Grant County. Seek a Columbia Generating Station representative to participate at the Emergency Coordination Center on behalf of the Facility exercises and Drills as necessary. 2. Participate in JIS/JIC, Food Control drills, or exercises/drills related to the As Scheduled REP program. 3. Participate in the exercise development process for evaluated exercises, As Scheduled attend exercise planning team meetings, and develop required exercise E. 24 -STAFFING 1 . Emergency Management will adequately train and staff the Emergency Ongoing Coordination Center and will maintain 24-hour staffing for protracted F. EMERGENCY FACILITIES AND EQUIPMENT 1.1 Emergency Management will maintain an operational Emergency Ongoing Coordination (ECC) Center at 35 C Street NW, Ephrata, Washington. The ECC will maintain current wall charts and maps for the Chemical and Radiological Plan and program. Periodic reviews will aid in identifying needed changes and improvements for efficient and effective coordination 2. Emergency Management maintains and tests the CEMNET radio, a Weekly communications capability to communicate with the State EOC. This radio will be tested when staff is available to assure connectivity is made with the State 3. Maintain Emergency Worker Kits for WSP by inspecting OSL dosimeters, Semi-annually recharge/replace 0-20R DRD, ensure KI is current, and procedures are 4. Maintain radiological detection instruments for calibration in accordance with Annually the manufacturer's recommendations. Grant County Emergency Management has Canberra MCB2 ; s which do not require calibration and Canberra Ultra Radiac Plus detectors which require annual calibration. 5. Maintain Emergency Alert System (EAS) and ensure equipment is always Quarterly G. ALERT AND NOTIFICATION 1 - Maintain an updated Alert & Notification list, for suspected changes, with the Quarterly Multi Agency Communication Center, Grant County's single point dispatch H. ADMINISTRATION 1. Review and update as needed annual budget and work plan, submit to Annually EFSEC for approval. 2. Submit performance reports to WA State EMD to document program Quarterly 8FY2O240EF8EC> Page 13of15 Grant County Sheriffs Office, E24'004 3. Provide sufficient information and documentation to WA State EMD to assist Annually in the development of the Annual Letter of Certification. 4. Conduct administrative functions such as correspondence, financial Ongoing monitoring and tracking, submission/requests for reimbursements, monitor compliance for State and Federal audit requirements, etc. SFY 2024 (EFSEC) Page 14 of 15 Grant County Sheriffs Office, E24-004 Exhibit D BUDGET SHEET Energy Facility Site Evaluation Council (EFSEC) Contract expenditures shall be documented according to the following categories when appropriate: ITEM DESCRIPTION COST A. Salaries and Wages $ 30,500 B. Benefits $ 12,000 C. Personal Contracts $ 0 E. Goods & Services $ 1,200 G. Travel $ 3,131 J. Capital Outlay $ 0 TOTAL $ 461631 Up to 10 percent (+/-) of any single budget category amount may be shifted between approved budget objects. Final signed invoice voucher (A-19) to be submitted with final performance report and deliverables. A-1 9's not to exceed total amount of contract award. NOTE: Maintain expenditures within the listed budget categories. SFY 2024 (EFSEC) Page 15 of 15 Grant County Sheriffs Office, E24-004 Washington Military Department Contract Number: E24-004 Debarment, Suspension, Ineligibility or Voluntary Exclusion Certification Form NAME Doing business as (DBA) Grant County Sheriffs Office, Emergency Management ADDRESS Applicable Procurement WA Uniform Business Federal Employer Tax PO Box 37 or Solicitation #, if any: Identifier (UBI) Identification #: Ephrata, WA 98823 136000784 91-6001319 This certification is submitted as part of a request to contract. Instructions For Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion --Lower Tier Covered Transactions READ CAREFULLY BEFORE SIGNING THE CERTIFICATION. Federal regulations require contractors and bidders to sign and abide by the terms of this certification, without modification, in order to participate in certain transactions directly or indirectly involving federal funds. 1. By signing and submitting this proposal, the prospective lower tier participant 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 prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the department, institution or office to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had 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 meaning set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under the applicable CFR, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," without modification, in all 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 proposed for debarment under applicable CFR, debarred, suspended, ineligible, or voluntarily excluded from covered transactions, 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 List of Parties Excluded from Federal Procurement and Non -procurement Programs. 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 activity. 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 applicable CFR, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion --Lower Tier Covered Transactions The prospective lower tier participant certifies, by submission of this proposal or contract, 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. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this form. Bidder or Contractor Signature: Date: Print Name and Title: JOe Krie"1heriff Washington Military Department Contract Number: E24-004 FEDERAL DEBARMENT, SUSPENSION INELIGIBILITY and VOLUNTARY EXCLUSION (FREQUENTLY ASKED QUESTIONS) What is "Debarment, Suspension, Ineligibility, and Voluntary Exclusion"? These terms refer to the status of a person or company that cannot contract with or receive grants from a federal agency. In order to be debarred, suspended, ineligible, or voluntarily excluded, you must have: • had a contract or grant with a federal agency, and • gone through some process where the federal agency notified or attempted to notify you that you could not contract with the federal agency. • Generally, this process occurs where you, the contractor, are not qualified or are not adequately performing under a contract, or have violated a regulation or law pertaining to the contract. Why am I required to sign this certification? You are requesting a contract or grant with the Washington Military Department. Federal law (Executive Order 12549) requires Washington Military Department ensure that persons or companies that contract with Washington Military Department are not prohibited from having federal contracts. What is Executive Order 12549? Executive Order 12549 refers to Federal Executive Order Number 12549. The executive order was signed by the President and directed federal agencies to ensure that federal agencies, and any state or other agency receiving federal funds were not contracting or awarding grants to persons, organizations, or companies who have been excluded from participating in federal contracts or grants. Federal agencies have codified this requirement in their individual agency Code of Federal Regulations (CFRs). What is the purpose of this certification? The purpose of the certification is for you to tell Washington Military Department in writing that you have not been prohibited by federal agencies from entering into a federal contract. What does the word "proposal" mean when referred to in this certification? Proposal means a solicited or unsolicited bid, application, request, invitation to consider or similar communication from you to Washington Military Department. What or who is a "lower tier participant"? Lower tier participants means a person or organization that submits a proposal, enters into contracts with, or receives a grant from Washington Military Department, OR any subcontractor of a contract with Washington Military Department. If you hire subcontractors, you should require them to sign a certification and keep it with your subcontract. What is a covered transaction when referred to in this certification? Covered Transaction means a contract, oral or written agreement, grant, or any other arrangement where you contract with or receive money from Washington Military Department. Covered Transaction does not include mandatory entitlements and individual benefits. Sample Debarment, Suspension, Ineligibility, Voluntary Exclusion Contract Provision Debarment Certification. The Contractor certifies that the Contractor is not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in this Contract by any Federal department or agency. If requested by Washington Military Department, the Contractor shall complete a Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion form. Any such form completed by the Contractor for this Contract shall be incorporated into this Contract by reference. SIGNATURE AUTHORIZATION FORM WASHINGTON STATE MILITARY DEPARTMENT Camp Murray, Washington 98430-5122 Please read instructions on reverse side before completing this form. NAME OF ORGANIZATION DATE SUBMITTED Grant County Sheriffs Office, Emergency Management �oI2- 'IN 1 2, 3 PROJECT DESCRIPTION CONTRACT NUMBER To provide EFSEC pass-through dollars (SFY 2024) for the county to E24-004 conduct radiological emergency preparedness program duties. p 1. AUTHORIZING AUTHORITY SIGNATURE PRINT OR TYPE NAME TITLE/TERM OF OFFICE - Joe Kriete Sheriff 2022 Ts f John McMillan Undersheriff 2022 2. AUTHORIZED TO SIGN CONTRACTS/CONTRACT AMENDMENTS SIGNATURE PRINT OR TYPE NAME TITLE - Joe Kriete Sheriff i.._ John McMillan Undersheriff 3. AUTHORIZED TO SIGN REQUESTS FOR REIMBURSEMENT SIGNATURE PRINT OR TYPE NAME TITLE Josh Sainsbury Chief Deputy Mireya Garcia EM Specialist \\NAC-1\VOL1\HOME\KARENB\....\WP\SIGNAUTH Revised 3/03 INSTRUCTIONS FOR SIGNATURE AUTHORIZATION FORM This form identifies the persons who have the authority to sign contracts, amendments, and requests for reimbursement. It is required for the management of your contract with the Military Department (MD). Please complete all sections. One copy with original signatures is to be sent to MD with the signed contract, and the other should be kept with your copy of the contract. When a request for reimbursement is received, the signature is checked to verify that it matches the signature on file. The payment can be delayed if the request is presented without the proper signature. It is important that the signatures in MD's files are current. Changes in staffing or responsibilities will require a new signature authorization form. 1. Authorizing Authority. Generally, the person(s) signing in this box heads the governing body of the organization, such as the board chair or mayor. In some cases, the chief executive officer may have been delegated this authority. 2. Authorized to Sign Contracts/Contract Amendments. The person(s) with this authority should sign in this space. Usually, it is the county commissioner, mayor, executive director, city clerk, etc. 3. Authorized to Sign Requests for Reimbursement. Often the executive director, city clerk, treasurer, or administrative assistant have this authority. It is advisable to have more than one person authorized to sign reimbursement requests. This will help prevent delays in processing a request if one person is temporarily unavailable. If you have any questions regarding this form or to request new forms, please call your MD Program Manager. Department: Emergency Management Grantor: Washington State Military Department Grant No. 2023 EFSEC E24-004 Date signed: July 5, 2023 GRANT COUNTY BOARD OF COUNTY COMMISSIONERS Rob Jones, Chair 1 Cindy Cart,Vice Chair Danny St ne, Member ATTEST: E i BarbarA J. Vas ue C Oerk.,df the Board °'