042-03
DESIGNATION OF APPLICANTS AGENT
RESOLUTION
BE IT RESOLVED BY:6F THE BOARD OF SUPERVISORS
(Governing Body)
OF
FREDERICK COUNTY, VA
(Public Entity)
THAT
GARY A. DUBRUELER
(Name of Incumbent)
DIRECTOR
(Official Position)
Is hereby authorized to execute for and in behalf of
Prederick County, VA ,a public entity established under the laws of the State of Virginia,
this application and to file it in the appropriate State Office for the purpose of obtaining certain Federal fmancial assistance
under the OIP, National Domestic Preparedness Office Grant Program(s), administered by the Commonwealth of Virginia.
That, Frederic1< County. v:a. a public entity established under the laws of the
Commonwealth of Virginia, hereby authorizes its agent to provide to the Commonwealth and to the Office of Justice
Programs (OJP) for aU matters pertaining to such Federal fmancial assistance any and all information pertaining to these
Grants as may be requested.
Passed and approved this
26th
day of
February
03
,20
RichRrd c. Shirlrlp- C},;li-rm.qn Rn~rr1 of ~l1pprv;~nT~
... (Name and Tile)
.("\00 ~,
\~ ~.Jl.,...:l, Chairman. Board of SlWervi,,;ors
Ol.Iame and Tile)
Administrator
CERTIFICATION
JOh11 R. Riley, Jr.
I,
(name)
Frederic1c County, Virqinia
(entity)
, duly appointed and
County Administrator
(Tille)
of
, do hereby certify that the above is a true and correct copy of a
Resolution passed and approved by the Boare of Suoervisors of
(Governing Body)
Frederick County, VA
(Public Entity)
On the
26th Day of
February . 20-O:l...
Date:
February 27. 2003
Coun~v Ad.;ni~~r~~nr
(OffiCial Position)
~~
(si , e)
Resolution No. 042-03
VDEM - OJP GRANT OM. REV 2.11/1812002
COUNTY OF FREDERICK, VIRGINIA
FIRE AND RESCUE DEPARTMENT
107 North Kent Street
Winchester. V A 22601
Gary A. DuBrueler
Director
Dennis D. Linaburg
Fire Marshal
MEMORANDUM
TO:
Board of Supervisors
FROM:
Gary A. DuBrueler, Director.t~
Fire and Rescue Department.a
SUBJECT:
U. S. Department of Justice Equipment
Grant Program
DATE:
February 13, 2003
The Virginia Department of Emergency Management has notified Frederick County in regard to
the U. S. Department ofJustice Equipment Grant Program. This grant program is te assist
Virginia localities in preparatien for their response to weapons .of mass destructien incidents.
Our locality must apply for these grants, which de net require any local government match. The
grants are as fellews:
GRANT
AWARD AMOUNT
,
FUNDS MUST BE
OBLIGATED BY:
1999 GR.\NT
$ 3,777.72
March 23, 2003
.
2000 GR.\NT
$ 8,743.62
July 31, 2004
2001 GRANT
$ 8,910.90
July 31, 2004
2002 GRANT
$32,087.14
July 31, 2004
Each jurisdicti.on must complete applications and required federal d.ocuments for each Grant year
in .order te receive funding. The applicatien contains a Designation .of Applicants Agent for the
grant process thr.ough which the grants must flow. Attached is a Designation.of Applicants
Agent Reselution that requires the approval .of the Beard .of Supervisors t.o appoint myself, Gary
A. DuBrueler, as the Designated Agent for Frederick County, Virginia. Although, there are f.our
separate grant applications, .one for each year, .only .one resolution signed by the Chairman of the
Director (540) 665-5618
.
Fire Marshal (540) 665-6350
.
Fax (540) 678-4739
Chairman of the Beard .of Supervisors is required. Upen receipt of these grant applicatiens and
the signed Res.olutien., VDEM will transfer the total grant amounts to the Caunty .of Frederick. It
is the respansibility .of the jurisdictien to determine what equipment will be purchased and to
ensure that .only eligtble equipment is procured.
If yeu have any questions .or concerns in regard te the grant applicatiens .or the attached
resolutien., please de not hesitate to contact me.
GAD:jlc
Attachment: as stated
Cc: File
VIRGINIA DEPARTMENT OF Ely.lERGENCY MANAGEMENT
DOMESTIC PREPAREDNESS PROGRAM
GRANT APPLICATION
Virginia Department of Emergency Management
10501 Trade Court
FUchrnond,VA. 23236
804-897-6500
Grant Funding Year
1999 1& 12000 D 12001 0 I 2002 0
I 2003 0
JURISDICTION/AGENCY Fredericlc Countv. Vircrinia
ADDRESS 107 North Kent Street
"..,'R'
winchester, Virginia 22601
:.:. ....~..::-. .~.: .-
. ''-.''': .-... ~ ,-' -". ,
- '.f~{'~..~", ...
":>f:~~~:~:"~"'"
TELEPHONE #
JURISDICTION EIN #
.' ..... .
,'. . '.
DESIGNATED AGENT
NAME
(540) 665-5683
I FAX # I (540) 667-0::70
.'" .... ,... . ',;... ...\::' ,.:" .
, ':." '.
Mr. Garv A. DuBrueler, Director
ADDRESS
Fire and Rescue Department
.......;..
.,
107 North Kent Street
......
. ""':?:--,.:.."
.... ~..-.. .
..... ~...
Winchester, Virginia 22601
.'.....:J~j1~:... :~'~..;,.;,',~ .
TELEPHONE #
(540) 665-5618
I FAX #
I (5~0) 678-4739
GRANT IS TO BE USED FOR: I POLICE ~ I FIRE 3ClI I HAZMAT}{3I I EM. MED. xKI
GRANT IS FORMULTI-JURISTICTIONAL USE: I YES 0 I NO till
IF YES FILL OUT ATTACHMENT A FOR EACH JURISDICTION PARTICIPATING IN PROPOSAL
OlP GRANT APPLICATION. REV 1. 11/1812002
ATTACHMENT A - MUL TI-JURlSTlCflONAL INFORMA TlON SHEET
I. JURISDICTION/AGENCY
ADDRESS
. r
TELEPHONE # I FAX # I
JURISDICTION EIN #
DESIGNATED AGENT
NAME . ,
ADDRESS
TELEPHONE # I FAX # I
EMAIL Address of Designated Agent:
"
,
2. JURISDICTION/AGENCY
ADDRESS
TELEPHONE # . I FAX # I
JURISDICTION EIN #
DESIGNATED AGENT
NAME
ADDRESS
TELEPHONE # I FAX # I
EMAIL Address of Designated Agent:
OlP GRANT APPLICATION A IT ACHMENT A. REV I, 1111812002
Equipment Coordination Certification
I certify that:
Use of these funds to meet immediate equipment replacement needs and address critical'
ongoing equipment needs will be coordinated with other ongoing Federal disaster
recovery initiatives related to the September 11,2001, terrorist attack on the World Trade
Center and with the State's domestic preparedness strategy.
Designated Agent of
Frederick County, Virginia
Locality
Gary A. DuBrueler
Name
Director
Tide
LEVELOFTRAnUNGAND EQUWMENT
PURCHASE AND USE
I certify that:
Use of these grant funds to purchase any of the equipment authorized by this grant is
done so with the express knowledge that there are levels of "training certification" that
may be required by Federal and State laws. rules and regulations to use such equipment.
To allow response personnel to have and use this equipment is done so by this
Jurisdiction having been informed of these restrictions and in no way is the
Commonwealth of Virginia and the Department of Domestic Preparedness; DOJ
responsible for any consequence of this use.
For any equipment that this Jurisdiction may purchase under this grant and it is
determined that our personnel require additional training and/or "certification" this
training and lor "certification' will be obtained prior to use of the equipment at issue.
Designated Agent of
Frederick County, Virginia
Locality
Gary A. DuBrueler
Name
Director
Tide
VOEM - OIP GRANT LEVEL OF TRAJNlNG, REV I, 11I1&I200Z
APPLICATION FOR
OMS Approval N 0348-0
O. 0
FEDERAL ASSISTANCE Z. DAT! SUBMITTED Appticanlldenbfie,
Feb. 27, 2003
11. TYP! Of suaMISSION: , ~. OATE RecelVEO BY STATe Slale Applicebon IdenUner
Applic.lion P,upplic.lion
o Conslruelion o Construction
.. DATe REceIVED BY FeDERAL AGeNCY Federal Jdenllfler
L'O Non-Conslruetion o Non-Const,uetlon
s. A'~lfeANT IN~OA"ATIOH
Legal Name: orgariizational Unit:
Fred"'..; r'k" ("nl1nh,. v; '-1""; n; '" Fire and Rescue
Add,ess (gtW city. CIJUn/)l Still., and zip CQd6): Name and telephone number 01 the person to be contacted on matters involving
107 North Kent Street this applicetion (gi..._ t:tXI.)
Winchester, Virginia 22601 ' Gary A. DuBrueler, Director
(540) 665-5618 -
e. EIIPLOyeR IOENTlFICATION NUMBER IEIN): 7. TYPE OF APPLICANT: ,_nte'.PPffJP,i.N "<<_fin 11(8) U
GW -I h nlnll 2 I q I () I A.. Slate H. Independent School Disl
B. County I. Slat. Controned Inslllution of Higner Leaming
I. TYPE OF APPLICATION: C. Municipal J. Private University
0. Township Ie. Indian Tribe
0 New 0 Continuation o Revision e. Inlerstal. L Individual
0 0 F. In18rmunicipal M. Pnofit Organization
If RMion. enter appropriateletter(s) in box(es): G. Special District N. Other (Specify):
A.. Increase Awanl B. Oecreas. Award C. Increase Ounllion
D. Decteas. Durabon Other ($p<<ily): I. NAME OF FEDeRAL AGeNCY:
'0. CATALOG OF FEOeRAL OOMeSTIC I I Ie . I I 11. DESCRIPTIve TITLE OF APPLICANT'S PROJeCT:
ASSISTANCE NUIIBER:
Tm.E:
f2.. AREAS 4FFeereo IY PROJECT (t:iI;.Z. eDllntils. sl.I.I, #M.J:
l~. PRoposeD PROJECT: ... CONGRESSIONAL DISTRICTS OF:
Stall Date ending Oate L Applielllr b. Pnoject
IS. ESTIIIATED FUNDING: 1'. IS APPLICATION SUBJeCT TO ReView BY STATe ExeCUTIVE OROER 12~rz PROCESS?
L Federal S .00 L YES. THIS PREAPPUCATlONlAPPLICATlON WAS MADE AVAILABl.E TO THE
STATE EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON:
b. Applicanl S .00 OATE
e. Slate S .00
b NO. D PROGRAM IS NOT COVERED BY E.O. 12372
d. LocaJ S .00 D
OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW
e.Olt1er S .00
I. Program Income S .00 1 r. IS THe APPLICANT DELlNoueNT ON ANY FeDERAL DEBT?
g. TOTAl. DYes If "Yes: attach an explanation. 0 No
S .00
II. TO THE BEST OF MY KNOWLEDGE AND BELIEF. ALL DATA IN THIS APPLICATlONrPREAPPLlCATlON ARe TRUE ANO CORRECT. THe DOCUMeNT HAS BeEN OULY
AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT ANO THE APPLICANT Wll.L COMPLY WITH THE ATTACHeD ASSURANces IF THE ASSISTANCE IS AWARDED
L Typed Name 01 Aulhollzed Represenrar;.e I b. Titte Co Telephone number
d. S;qna1Ul'1 0' AUUlOnZed Repllsenralive
e. Oate Signed
srandam Fg,m 4~4__ IREV 4-61
Disclosure of Lobbying Activities
Approved by OMB 0348-clO4E
Complete this form to disclose lobbying actiVIties pursuant to 31 U.S.C. 1352
IS.. r_ side fat InslNCl/cns.1
Public Reporting Burd.n tit rills colle~.on ollnlorma.cn Is utimallld to avlltage 30 m1nUlU per ",pollA..lncludlnll the lime br revlewtnlllnslru~.ons
.earching existing data sources. gathering and main"inIng Ihe da.. "..ded. al'd complelng ard revlewlng IIw. colle~.on olln/orma.on. S...d ~llIm1en~
regallling Ihls burd... ..tinalll Cl( lilY oilier asp.~ ollhls c:oIlectlon ollnlonnalbn.lncludlng sugge..ons tlr reoileng this blfl'den. tI:Ilhe Olllee 01 Managem...:
ard Budget, Paperwork Redu~tion Ptcj.~ (03.ca-C04lil. Washington. D.C. 20$03. .
t. Type 01 Federal ActIon: 2. Stetua 01 F.deral MUon: 3. Report Type:
O L contract 0 L bidloller/applicatlon 0 L Inlllal fDIng
b. grant b. inillal award b. material change
0;. cooperative agreement c:. post-award For Mstellal a.&nge Only:
cI. loan year quarw
.. loan guaranl.e
l loan Insurance
4. Nam. and Addresa 01 Repot1lng Entity:
o Prime 0 Subawardee "er
. if known:
.. of last raport
I 5. II Repor1lnll EnUIy In No. 4 Is Subawsnl.., enter Nule and Addre.. 01
I Prime:
I
I
!
i
I
I
~ 7.
!
i
!
Con"reuJanal Dlalrl~t. it known:
Fede..a: progrwn Name/DeacrlpUon:
COng....lonal District, if known:
I. Federal C.par1menllAg.ncy:
0-
lOa. Name and Address 01 Lobbying R.glstrant
(II individu31. last name. first name. MI):
CFDA Number. il8Pplicable:
19. A_dAmount,itknawn:
I S
b. IndlvldlMla Petlormlnll Servloes Qndudlnll add,... if cItIerant from No. 1 Cla.)
(last _. IItst NI/II8, MI):
S, Fed.raI A~don Numb.r, il knoWn:
.
NCI\lE IDm
1 1. Information requested through this lorm is authoriZed by Sec.319. 1
Pub.L 101-121.1035tal. 7S0,asamendedbysec.10;Pub.L 104. Slgnalure:
65. Stat. 700 (31 U.S.C. 1352). This disclosure ollobbylng aclivftles
is a material representallon ollact upon which reDance was placed
by the above when this transadlon was made or entered Into. This Print Nam.: Gary A. DuBrDeler
disclosure is required pursuanllo 31 U.S.C. 1352. This Inlormalion
win be reported to the Congress semiannually and will be available Director
lor public Inspeetlon. Any person who fails to file the required nUe:
clisclosure shall be subject 10 a eivll penalty of not less than $10.000 .
an~ not more than $100.000 lor each such failure. i T...p'...... No.:
-^... ~~"--._,---~.~..~--_._,-"
Board of Supervisors is required. Upon receipt ofthese grallt applications and the signed
Resolution, VDEM will transfer the total grant amounts to the County of Frederick. It is the
responsibility of the jurisdiction to determine what equipment will be purchased and to ensure
that only eligible equipment is procured.
If you have fu"1Y questions or concerns in regard to the grant applications or the attached
resolution, please do not hesitate to contact me.
G.A..D:j!c
Attachment: as stated
Cc: File