Mines of Spain Preserve America NPS Grant Agreement Dubuque
THE CITY OF
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DAB E ~~.;~~~
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Masterpiece on the Mississippi ~
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20Q7
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Preserve America Grant Agreement -- Mines of Spain Exhibit and
Education Program at the E.B. Lyons Interpretive Center
DATE: January 30, 2008
Planning Services Manager Laura Carstens is recommending approval of a Preserve
America Grant Agreement for the Mines of Spain Exhibit and Education Program where
the City would serve as the sponsor for this $150,000 grant.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
V
~~ ~:
Michael C. Van Milligen
MCVM/jh
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Laura Carstens, Planning Services Manager
THE CITY OF Dubuque
DUB E
Masterpiece on the Mississippi
2007
TO: Michael Van Milligen, City Manager
FROM: Laura Carstens, Planning Services Manager`~~~
SUBJECT: Preserve America Grant Agreement -- Mines of Spain Exhibit and
Education Program at the E.B. Lyons Interpretive Center
DATE: January 24, 2008
INTRODUCTION
This memo transmits an agreement fora $150,000 FY07 Preserve America grant for
the Mines of Spain Exhibit and Education Program at the E.B. Lyons Interpretive
Center, for the City Council's review and approval. A resolution in support is enclosed.
DISCUSSION
The Preserve America grant program of the National Park Service (NPS) provides
matching funds to designated communities to support preservation efforts through
heritage tourism, education and historic preservation planning. Dubuque was the first
city in Iowa designated as a Preserve America Community.
The City of Dubuque is the sponsor fora $149,000 FY06 Preserve America grant for the
Dubuque History Trail, on behalf of the Dubuque County Historical Society.
The City of Dubuque owns the existing E.B. Lyons Interpretive Center and 30
surrounding acres at the Mines of Spain State Recreation Area. The Iowa Department
of Natural Resources (IDNR) operates the Center and owns and manages 1,350 acres
in the park. The Friends of the Mines of Spain is anon-profit corporation that assists the
IDNR Park Staff in the administration of the Mines of Spain and the Interpretive Center.
The City of Dubuque would serve as the sponsor for this $150,000 FY07 Preserve
America grant on behalf of the Friends of the Mines of Spain.
The E.B. Lyons Interpretive Center serves as a visitor information center and park office
for the Mines of Spain. Displays and exhibits provide information about the history and
features of the park. It currently serves over 200,000 visitors annually and provides
hundreds of programs for school aged children, youth groups and families. Demand for
more programs and services has continued to increase over the years.
Preserve America Grant Agreement -- Mines of Spain page 2
The Friends group is leading a fundraising campaign to expand the current Center to
include more space for interpretive and educational purposes. The $1.7 million 6,300
square foot expansion will double the size of the Center and make it ADA accessible.
The City is a funding partner, and has committed $30,000 to the expansion.
With expansion and renovation of the Center, many more visitors can be served and
new programs implemented. The expansion would include:
(1) An auditorium for programs, special events and meetings;
(2) A biology lab and classroom for visitors and school programs ranging K-12;
(3) Creation of new exhibits and displays for visitors to explore the science and
history of the region; and
(4) A library/reference room to house field identification books, historic documents,
DVDs, videos, and reference materials.
The Mines of Spain Exhibit and Education Program will help create a major interpretive
program which tells the story of the Mines of Spain in a variety of formats:
• Curriculum-based field studies for school groups,
• Workshops and seminars,
• Publications (brochures, tour guides, maps),
• Educational materials,
• Indoor and outdoor exhibits,
• Interpretive signs,
• Audio-visual materials, and
• Electronic media (enhanced website).
The project will update and expand existing interpretive and educational exhibits,
displays, facilities and materials, focusing on raising awareness, appreciation, and
stewardship of the park's historic and natural resources.
BUDGET IMPACT
The total project budget for the Mines of Spain Exhibit and Education Program is
$300,000, with $150,000 from the Preserve America grant. The City is not obligated to
provide any match; however, the City must upfront $150,000 in direct costs for the
project design, production and installation. The City will pay 50% and the Friends group
will pay 50% match for expenses as the project progresses. The City then will submit
periodic reimbursement requests to the NPS as these project expenses are incurred.
RECOMMENDATION
I recommend that the City Council approve the enclosed resolution authorizing the
Mayor to sign the Preserve America grant agreement for the Mines of Spain Exhibit and
Education Program.
Enclosures
cc Jenny Larson, Budget Director
Gil Spence, Leisure Services Manager
Dr. Douglas Olk, President, Friends of the Mines of Spain
Preparers Laura Carstens Address: 50 W. 13th Street, Dubuque, IA 52001 Telephone: 589-4210
RESOLUTION NO. 43-08
RESOLUTION APPROVING A GRANT AGREEMENT WITH THE NATIONAL PARK
SERVICE FOR THE MINES OF SPAIN EXHIBIT AND EDUCATION PROGRAM
Whereas, the National Park Service has awarded the City of Dubuque a
$150,000 Fiscal Year 2007 Preserve America grant for the Mines of Spain Exhibit and
Education Program; and
Whereas, the Friends of the Mines of Spain will provide the local match for the
Preserve Grant Agreement for the Mines of Spain Exhibit and Education Program; and
Whereas, the City of Dubuque is willing to accept Preserve America funding.
NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY
OF DUBUQUE, IOWA:
Section 1. That the Mayor hereby is authorized to sign the Preserve America
Grant Agreement with the National Park Service for the Mines of Spain Exhibit and
Education Program.
Section 2. That the City of Dubuque agrees to abide by all local, state and
federal requirements applicable to the proposed budget.
Passed, approved and adopted this 4th day of February, 2008.
Roy D. Buol, Mayor
Attest:
Jeanne F. Schneider, City Clerk
United States Department of the Interior
NATIONAL PARK SERVICE
1849 C Sveet, N.W.
Washington, D.C. 20240
Preserve America Grant Agreement No. 19-07-PA-3056
Upon signarare of both parties below, the National Park Service (NPS) will have obligated with this Grant
Agreement the amount of $150,000 appropriated from the Historic Preservation Fund for the Preserve
America Grant Program by Public Law 110-5, which provides Fiscal Year 2007 appropriations to the
Department of the Interior. The term of this grant agreement is:
Beginning Date:
Ending Date:
January 1, 2008
January 31, 2010
In accepting this grant for the project entitled "Mines of Spain Exhibit and Education Program," evidenced by
signature below, the City of Dubuque, agrees to comply with Department of the Interior regulations and
requirements governing Federal grants stipulated in Office of Management and Budget (OMB) Circular A-102
(Administrative Requirements for Grants to State and Local Governments; see 43 CFR 12.42-12.92); Circular
A-87 (Cost Principles for Grants to State and Local Governments); and Circular A-133 (Audits of States,
Local Governments and Non-Profit Organizations). These requirements are hereby incorporated by reference
into this grant agreement. In accordance with 18 U.S.C. 1913, none of these funds may be used for lobbying
purposes as defined in the special conditions contained on the following pages. These special conditions are
also hereby incorporated into this grant award. The terms and conditions of this grant award shall be
extended to subrecipients and subcontractors.,
In witness thereof, the parties have executed this grant agreement as of the date entered below:
CITY OF DUBUQUE
Title: Mayor
Date signed
Attachments:
NATIONAL PARK SERVICE
Chief, Historic Preservation Grants Division
Date signed
X SF 424 Application for Federal Assistance
X Budget Changes/Special Grant Conditions
Grant Agreement (Page 2 of 6)
APPLICATION AND BUDGET CHANGES/SPECIAL CONDITIONS
GRANT NUMBER:
BEGINNING DATE:
ENDING DATE:
19-07-PA-3056
January 1, 2008
January 31, 2010
The terms of the grant award include the following special conditions necessary to obtain the objectives of the
grant, facilitate administration of the grant, and to protect the interests of the Federal Government. Grantee
noncompliance with these terms and conditions and the requirements of Office of Management and Budget
(OMB) Circulars A-102 and A-87 will cause disallowance of costs incurred under the grant. In addition to
other lawful remedies, in the event of noncompliance with any grant conditions, the grant may be suspended,
terminated or annulled pursuant to OMB Circular A-102 (see 43 CFR 12.83-12.84).
The grantee shall not assign or otherwise transfer final responsibility for this Grant Agreement, the grant, or
the project to any third party. The execution of subcontracts shall not alter or modify the obligations of the
grantee. However, the grantee may subcontract for performance ofproject-related work summarized in this
Grant Agreement. The grantee must administer this grant award free from conflict of interest, bribery,
"kickbacks," cost-plus-a-percentage-of--costs contracts, and other procurement practices prohibited by 43 CFR
12.76.
Special Condition #1, Limitations on Grant Expenditures. The term of availability of these grant funds is
from January 1, 2008, through January 31, 2010. All costs incurred must be billed to NPS by
Apri130, 2010. Expenses charged to this grant may not be incurred prior to the beginning date specified
above, or subsequent to the grant end date specified above (unless the Grant Agreement's end date is formally
extended in writing by NPS). Such expenditures may not exceed the maximum limits shown on this grant
award, or amendments subsequently approved in writing by NPS. The grantee assumes fiscal liability, without
recourse to NPS, for commitments that exceed the funds provided in the Grant Agreement.
Special Condition #2, Allowable Costs. All costs charged to the grant must be directly related to and
necessary for the achievement of the approved objectives and budget of this grant, as specified in Grant
Condition #15, below, unless an amendment is approved in writing by NPS. Expenses charged must be
incurred only for eligible costs in accordance with OMB Circular A-102 and OMB Circular A-87; and
supported by approved contracts, purchase orders, requisitions, bills, or other evidence of liability consistent
with generally established purchasing procedures and generally accepted accounting principles.
Special Condition #3 Nonfederal Matching Share. At least $150,000 in eligible nonfederal matching
contributions that are allowable and properly documented in accordance with 43 CFR 12.64 must be used
during the grant period to share the costs for this grant. Failure to use the required non-Federal matching
share will result in the disallowance of costs reimbursed, and/or the deobligation of remaining unexpended
funds.
Special Condition #4, Fundraising Costs: In accordance with OMB Circular A-87, Attachment B, Item 21,
costs of fundraising are not eligible costs chargeable to the grant for reimbursement or as eligible nonfederal
matching share contributions.
Special Condition #5 Performance Reports. An acceptable Interim Progress Report must be submitted to
NPS every six months during the grant period, with the initial Progress Report due not later than June 30,
2008, and the next report due not later than December 31, 2008. An acceptable Final Progress Report must
be submitted by Apri130, 2010. Failure to submit acceptable progress reports by the dates specified, and in
the format prescribed by NPS, may result in suspension of funds or other action. The final progress report
must include slides, photographs, copies of publication etc. showing the work accomplished under this grant.
Interim Reports and the Final Project Report must include the Standard Form 269A, Financial Status Report
Short Form, which is used to document financial obligations and outlays during the previous year. The final
payment will not be approved until all work in completed and an acceptable Final Progress Report is received
Grant Agreement (Page 3 of 6)
APPLICATION AND BUDGET CHANGES/SPECIAL CONDITIONS
GRANT NUMBER:
BEGINNING DATE:
ENDING DATE:
19-07-PA-3056
January 1, 2008
January 31, 2010
by NPS.
The grantee agrees to maintain close liaison with the NPS Grant Awarding Official throughout the grant
period. NPS reserves the right to request meetings, upon reasonable notice, with grantee project staff at
intervals during the course of project work. The grantee agrees to promptly notify the NPS Grant Awarding
Official should any of the following conditions become known to it:
a) Problems, delays, or adverse conditions that will materially affect the ability of the grantee (or its
subcontractors, if any) to attain project objectives, prevent the project from meeting planned
timetables, or preclude the completion of approved work;
b) The need for adjustment (revision) to the project budget; and
c) The lack of nonfederal matching share to meet the amount required by this Grant Agreement.
Interim and Final Reports should be sent to your grant reviewer's attention at the National Park Service in
Washington, DC. Mailing address: 1849 C Street, NW (org code 2256), Washington, DC 20240, physical
address: 1201 Eye St. NW (6~ Floor), Washington, DC 20005.
Special Condition #6, Prior Approval Requirements. The grantee may not, without written approval by
the NPS grant awarding official (that official whose signature/title appears on the grant award document, or
his designee), make changes in the approved scope of work or budget that would substantively alter the
approved scope of work (43 CFR 12.70).
Special Condition #7. Lobbying Prohibitions. Costs associated with activities or any form of
communication designed to influence in any manner a Member of Congress to favor or oppose any legislation
or appropriation are unallowable as a charge to this grant. None of the funds awarded may be used to process
any grant or contract documents which do not include the text of 18 U.S.C. 1913 prohibiting lobbying with
appropriated funds. Recipients shall not use any part of the appropriated funds for any activity or for the
publication or distribution of literature that in any way tends to promote public support or opposition to any
legislative proposal on which Congressional action is not complete.
Special Condition #S, Debarment and Suspension. In accordance with Executive Order 12549
"Debarment and Suspension" the grantee and its subgrantees must not make any award or permit any award
(by subgrant or contract) at any tier to any parry which is debarred or suspended or is otherwise excluded
from or ineligible for participation in Federal assistance programs under Executive Order 12549.
Special Condition #9. Financial Audit. The grantee shall obtain an audit of grant expenditure records in
accordance with OMB Circular A-133 which requires a Single Agency Audit for any grantee who expends at
least $500,000 of Federal grant funds (from all sources) in a fiscal year. Financial audits that include costs
incurred for this grant (including nonfederal matching share) must be transmitted to the Federal Audit
Clearinghouse, Data Preparation Division, U.S. Bureau of the Census, 1201 E. 10th Street, Jeffersonville,
Indiana 47132. A reasonable proportion of the costs of an acceptable audit performed in accordance with
OMB Circular A-133 may be charged to this grant.
If an audit is required, the grantee must complete and submit one signed copy of the Data Collection Form
for Reporting on Audits of States, Local Governments, and Non-Profit Organizations, SF-SAC, to the
National Park Service within 30 days of the grantee's receipt of the completed audit report. The form must be
signed by the grantee and auditor state whether the audit was completed, provide information about the
grantee, the results of the audit, the Employer Identification Number (EIN) and the Dun and Bradstreet
Grant Agreement (Page 4 of 6)
APPLICATION AND BUDGET CHANGES/SPECIAL CONDITIONS
GRANT NUMBER:
BEGINNING DATE:
ENDING DATE:
19-07-PA-3056
January 1, 2008
January 31.2010
(D&B) Data Universal Numbering System (DUNS). A copy of the SF-SAC is acceptable.
Special Condition #10, Record Keeping. The grantee must maintain the property, personnel, financial,
procurement and other records and accounts pertinent to the funds awarded by this grant in accordance with
43 CFR 12. The grantee and its contractors will permit on-site inspections by NPS representatives, and will
effectively require employees and board members to furnish such information as, in the judgment of NPS
representatives, may be relevant to a question of compliance with grant conditions and directives on the
effectiveness, legality and achievements of project work.
Special Condition #11, Access to Records. The Secretary of the Interior and the Comptroller General of
the United States, or any of their duly authorized representatives, shall have access for the purpose of financial
or programmatic audit and examination to any books, documents, papers, and records of the grantee that are
pertinent to the grant at all reasonable times during the period of retention provided for in 43 CFR 12.
Special Condition #12, Publicity and Press Releases: Press releases about this project must acknowledge
the grant assistance provided by NPS and copies of the press releases must be provided to NPS. The grantee
must transmit notice of any public ceremonies planned to publicize the project or its results in a timely enough
manner so that NPS, Department of the Interior, Congressional or other Federal officials can attend if desired.
Special Condition #13 Publications. The grantee must include acknowledgment of NPS grant support and a
nondiscrimination statement in all publications and videos assisted with grant monies and/or concerning NPS
grant-supported activities. At least three copies of each publication and video concerning NPS grant-assisted
activities, or published with NPS grant assistance, must be furnished to the NPS Grant Awarding Official within
30 calendar days of publication. All publications, including video and audio tapes, must contain the following
disclaimer and acknowledgement of NPS support: "This material is based upon work assisted by a grant from the
Department of the Interior, National Park Service. Any opinions, findings, and conclusions or recommendations
expressed in this material are those of the author(s) and do not necessarily reflect the views of the Department of
the Interior." All consultants hired by the grantee must be informed of this requirement. The National Park
Service shall have a royalty-free right to republish any published material generated by this grant.
Special Condition #14 Method of Payment. An SF-270, I~equert forAdvance or Beimburrement, must be faxed
to the NPS Grant Awarding Official for approval of payment requests. After NPS has notified the grantee by
fax or e-mail that the payment request is acceptable, the grantee can transmit the payment request on the
SMARTLINK payment system. Payment of grant funds will then be made by SMARTLINK electronic
transfer of funds to a specified bank account of the grantee.
NPS approval of payment requests is based on satisfaction of grant conditions and documentation that
matching funds have been expended at the same rate as federal funds. The fmal payment request (or
approximately 15%) will be held until all grant conditions are met, including submission of an acceptable Final
Project Report.
All approved advance payments must be expended within 30 days of the receipt of funds. An SF272, Cash
Transaction Report, must be completed and submitted to NPS at the end of the 30 days documenting that the
advanced funds have been liquidated.
Grant Agreement (Page 5 of 6)
APPLICATION AND BUDGET CHANGES/SPECIAL CONDITIONS
GRANT NUMBER:
BEGINNING DATE:
ENDING DATE:
19-07-PA-3056
January 1, 2008
January 31, 2010
Special Condition #15, Approved Budget and Scope of Work. The approved Summary of Objectives and
Results to be performed with this grant award is as follows: the Mines of Spain Exhibit and Education
Program will increase visitation, enhance interpretation, expand educational opportunities, and build
partnerships at this National Historic Landmark, in accordance with the Secretary of the Interior's Standards for
Archeology d~ Historic Preservation.
Program costs include:
a) Update and expand interpretive and educational exhibits
b) Create new exhibits to explore the science, culture, and history of the region
c) Tell Mine of Spain story through: curriculum studies, workshops, seminars, publications,
educational materials, indoor and outdoor exhibits, signs, audio-visual materials, and an
enhanced website
The approved Work/Cost Budget is summarized as follows:
Budget Item Federal Share Non-Federal Total
Consultant Fees $ 22,500 $ 22,500 $ 45,000
Travel and Per Diem $ 2,500 $ 2,500
Equipment $ 125 000 $ 125 000
$ 250,000
TOTAL GRANT (including non-Federal matching share) $ 150,000 $ 150,000 $ 300,000
Special Condition #16, Preagreement Costs. Any preagreement costs incurred must be approved in
writing by NPS and authorized to be charged to this grant in accordance with OMB Circular A-87.
Documentation of these preaward costs must be retained for review by the grantee's financial audit.
Special Condition #17. NPS Concurrence with Selection of Consultants. The grantee must submit
resumes and responses to its Requests for Proposals, along with its justification for which consultant(s) it
selects for grant-assisted work to the NPS Grant Awarding Official for concurrence by NPS. The
consultant(s) must have the requisite experience and training in historic preservation to oversee the
construction work to be performed and to manage this complex project. Contractors must be competitively
selected. Maximum hourly rates charged to this grant may not exceed 120% of a Federal Civil Service
GS-15, step 10 salary, which in Fiscal Year 2007 is $82.49 per hour or $G60 per day. Current salary tables
can be found on the Office of Personnel and Management website: www.opm.gov.
Special Condition #18. Compliance with Section 10G of the National Historic Preservation Act.
Pursuant to Section 106 of the National Historic Preservation Act, NPS and the grantee must complete the
consultation process stipulated in the regulations issued by the Advisory Council for Historic Preservation in
36 CFR 800 prior to the commencement of any construction work or ground disturbance associated with this
project. (Note that the NPS must receive a copy of the State Historic Preservation Officer's written approval
of the methodology or plan to be used for any archeological testing or ground-breaking prior to conducting
such testing or ground-breaking.) NPS has initiated the Section 106 consultation process with the State
Historic Preservation Officer (SHPO), by notifying the SHPO of the grant and sending the SHPO a copy of
the grant application. Now, to complete the Section 106 review, the grantee must submit plans and
specifications for the project to the SHPO. The grantee then must submit to the NPS Grant Awarding
Official copies of the following: 1) any written comments grantee receives from the SHPO in response to
submission of plans and specifications for the project, including any suggestions for modifying the project,
and 2) the SHPO's written concurrence with the project as proposed or as modified. In the event that the
grantee and the SHPO cannot reach agreement, the grantee must notify NPS in writing so that NPS may
participate in the conclusion of the consultation.
Grant Agreement (Page 6 of 6)
APPLICATION AND BUDGET CHANGES/SPECIAL CONDITIONS
GRANT NUMBER:
BEGINNING DATE:
ENDING DATE:
19-07-PA-3056
January 1, 2008
January 31, 2010
Special Condition #19 Compliance with the Secretary of the Interior's Standards. All grant-assisted
construction or ground disturbance must be reviewed by NPS to ensure that it meets the Secretary of the
Interior's Standards for Archeology and Historic Preservation, and the Secretary of the Interior's Standards for the
Treatment of Historic Properties. Work that does not comply with these Standards in the judgment of NPS will
not be reimbursed, and may cause the grant to be terminated and funds deobligated.
Special Condition #20, NPS Review of Architectural Plans and Specifications. The grantee must
submit plans and specifications for any construction or ground disturbance to the National Park Service for its
review and approval for compliance with the Secretary of the Interior's Standards forArcheology and Historic
Preservation, and the Secretary of the Interior's Standards for the Treatment of Historic Properties, and with the
Conditions listed in this Grant Agreement prior to the beginning ofgrant-assisted work on the property.
Special Condition #21, Requirement for Copies of Final Products The grantee must submit 3 copies of
any publications, reports, studies, or similar materials which are produced with this grant assistance, including
plans and specifications, historic structures reports, and feasibility studies. For items such as interpretive
signs or tourism events, photographs of the signs or events must be submitted.
Special Condition #22 Requirement for Project Sign. The grantee must erect and maintain a project sign
at the project site, if applicable. This sign must: be of reasonable and adequate design and construction to
withstand weather exposure; be of a size that can be easily read from the public right-of--way; and be
maintained in place throughout the project term as stipulated in this Grant Agreement. At a minimum, the
sign must contain the following statement: "[Name of Project) is being supported in part by a Preserve
America grant administered by the National Park Service, Department of the Interior." Additional information
briefly identifying the historical significance of the property or recognizing other contributors is encouraged
and permissible. Photographs of the sign must be included with the Final Report submitted to NPS. The cost
of fabricating and erecting this sign is an eligible cost for this grant.
I `,:
^
v.v, vCNdRmeni Or irle IrlTerlor
Certifications Regarding Debarment, Suspension and
Other Responsibility Matters, Drug-Free Workplace
Requirements and Lobbying
Persons signing this .form should refer to the regulations ~ Certification Regardng Debarment, Suspension, InefigibTity and
referenced below for complete instructions: Voluntary Exclusion -Lower Tier Covered Transactions - (See
Certification Regardng Debarment, Suspension, and Other
Responsib7tty Matters -Primary Covered Transactions -The
prospective primary participant further agrees by
submitting this proposal that it will include the clause titled
"Crertification Regarding Debarment, Suspension,
ineligibility-and Voluntary Exclusion -Lower Tier Covered
Transaction," provided by the department or agency
entering into this covered transaction, without modification,
in all bwer tier covered transactions and in all solicitations
for lower tier covered transactions. See below for language '
to be used or use this form for certification and sign. (See
Append'a A of Subpart D of 43 CFR Part 12.}
Appendoc B of Subpart D of 43 CFR Part 12)
Certification Regardng Drug-Free Workplace Requirements -
Afternate 1. (Grantees Other Than Individuals) and ARemate 11.
(Grantees Who are Individuals) - (See Appends C of Subpart D
of 43 CFR Part 12)
Signature on this form provides for compliance with certification
requirements under 43 CFR Parts 12 and 18. The certifications
shag be treated as a material representation of fact upon which
reliance wfil be placed when the Department of the Interior
determines to award the covered Vansaction, grant, cooperative
agreement or loan.
PART A: Cert~cation Regarding Debarment, Suspension, and Other Responsibility Matters -
Prlmary Covered Transactions
CHECI LlF THIS CERTIFICATION IS FOR A PRIMARY CO VERED TRANSACTION AND !S APPLICABLE.
(1) The prospective. primary participant certifies to the best of its knowledge and belief, that it and its prindpals:
(a) Are not presently debared, suspended, proposed Tor debarment, declared ineligible, or voluntan'ly excluded by any Federal
department or agency,
(b) Have notwithin athree-year period preceding this proposal been convicted of or had a ciwl judgment rendered against them
for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public
(Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or
receiving stolen property;
(c) Are not presently indcted for or otherwise criminaly or civilly charged by a governmental entity (Federal, State or local) with
commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and
(d) Have not within athree-year period preceding this applicatioNproposal had one or more public transactions (Federal, State
or local) terminated for cause or default.
(2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective
participant shall attach an explanation to this proposal.
PART B: Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - ' '
Lower Tier Covered Transactions
CHECI ~JF THIS CERTIFICATION 1S FOR A LOWER TIER COVERED TRANSACTIONAND /S APPLICABLE.
(1) The prospective bwer tier participant certifies, by submission of this proposal, that neither it nor its prindpals is presently debarred,
suspended, proposed for debarment, declared ineligible, or voluntan7y excluded from participation in this transaction by any Federal
department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of, the statements in this certification, such prospective
participant shaA attach an explanation to this proposal.
a-~o1o
June 1983
(This form replaces DI.193S, DI.19SI,
t~41935, p{.1956 anG Dt-19G7) ~-
PART C: Certification Regarding Drug-Free Workplace Requirements ~'
CHECI(_IF THIS CERTIFICATION !S FOR AN APPLICANT WHO IS NOT AN lNDNlDUAL
Alternate 1. (Grantees Other Than Individuals)
A The grantee certifies that it v+n'll or continue to provide adrug-free workplace by,
(a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of
a controlled substance is prohibited in the grantee's workplace _and.specitying the actions that wal be taken against
employees for violation of such prohibition;
(b) Establishing an ongoing drug-free awareness program to inform employees about-
(1) The dangers of drug abuse in the workplace;
2 The grantee's policy of maintaining adrug-free workplace;.
3 Any available drug counseling, rehabilitation, and employee assistance programs; and
~4; The penatbes that may be imposed upon employees for drug abuse violations occurring in the workplace;
(c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement
required by paragraph (a); .
(d) Notifying the employee.in the statement required by paragraph (a) that, as a condition of employment under the grant, the
employee wfil -
1 Abide by the terms of the statement: and ,
~2; Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace
no later than five calendar days after such conviction;
(e) Notifying the agenry in writing, within ten calendar days after receiving notice under subparagraph (d)(2) from an employee
~or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including
poslb'on title, to every grant officer on whose grant activity the convicted employee was working, unless the Federal agenry
has designated a cenUal point for the receipt of such notices. Notice shall include the identification numbets(s) of each
affected grant; '
(f) Taking one of the following actions, within 30 calendar days of recenng notice under subparagraph (d)(2), with respect to
any employee who is so convicted -
(1) TaWng appropriate personnel action against such an employee, up to and including termination, consistent with the
requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to partiapate satistactonly in a drug abuse assistance or rehabilitation program approved for
such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency,
(g) Making a good Earth effort to continue to maintain adrug-tree workplace through implementation of paragraphs (a) (b), (c),
(d), (e) and (f).
B. The grantee may insert in the space provided below the sites for the performance of work done in connection with the specific
grant
Place of Performance (Street address, city, county, state, zip code)
Check if there are workplaces on file that are not identified here.
PART D: Cert~cation Regarding Drug-Free Workplace Requirements
CHECK JF TH1S CERTIFICATION IS FOR AN APPLICANT WHO IS AN INDNIDUAL
Alternate 11. (Grantees Who Are Individuals)
(a) The grantee certifies that, as a condition of the grant, he or she wip not engage in the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance in conducting'any activity with the grant:
(b) . K convicted of a criminal drug offense resulting from a violation occurring during•the conduct of any grant activity, he or she
w~ report the conviction, in writing, within 10 calendar days of the conviction, to the grant officer or other designee, unless
the Federal agency designates a central point for the receipt of such notices. When notice is made to such a central point,
it shag include the identification number(s) of each affected grant
+'i
oi-aro
June 1995
(Tnls form replaces ON19S.9, DI-1954.
D1-1955, D{-1956 and DI.19W)
PART E: Certification Regarding Lobbying '
Certification for Contracts, Grants, Loans, and Cooperative Agreements
CHECK IF CERTIFICATION IS FOR THE AWARD OF ANY OF THE FOLLOWING AND
THE AMOUNT EXCEEDS 3100,000: A FEDERAL GRANT OR COOPERATIVE AGREEMENT;
SUBCONTRACT, OR SUBGRANT UNDER THE GRANT OR COOPERATNE AGREEMENT.
CHECK IF CERTIFICATION IS FOR THE AWARD OF A FEDERAL
LOAN EXCEEDING THE AMOUNT OF 5150,000, OR A SUBGRANT OR
SUBCONTRACT EXCEEDING 3100,000, UNDER THE LOAN.
The undersigned certifies, to the best of his or her knowledge and belief. that
(1) No Federal appropriated funds have been paid or wlil be paid, by or on behalf of the undersigned, to any person for influendng or
attempting to influence an officer or employee of an agency, a Member of Congress, and officer or employee of Congress. or an
employee of a Member of Congress in connection with the awardng of any Federal contract, the making of any Federal grant, the
making of any Federal ban, the entering rcrto of any cooperative agreement, and the extension, continuation. renewal, amendment,
• or modification of any Federal contract, grant, loan, or cooperative agreement
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influendng or attempting to
influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of
a Member of Congress in connection with this Federal contract, grant, ban, or cooperative agreement, the undersigned shall
complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shag require that the language of this certification be induded in the award documents for all subawards at an tiers
(nduding subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subredpients shag
certify accordingly.
This certfication is a material representation of fact upon which reliance was placed when this transaction was made or entered into.
Submission of this certification is a prerequlsfie for making or entering into this transaction imposed by Section 1352, title 31, U.S. Code.
Any person who fails to file the required certification shall be subject to a civil penalty of not less than 510,000 and not more than
3100,000 Tor each such talure.
As the authorized certifying official, l hereby certiry that the above spedfied certifications are true.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
Rov D Buol Mavor
TYPED NAME AND TITLE
DATE
D1-2010
June 1895
(TMs form replaces DM19S7, DI-1954,
p1-1935, DI.19S6 and Dr-1967)
ASSURANCES -NON-CONSTRUCTION PROGRAMS
OMB Approval No. 0348-0040
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET.
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
NOTE: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the
awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such
is the case, you will be notified.
As the duly authorized representative of the applicant, 1 certify that the applicant:
1. Has the legal authority to apply for Federal assistance
and the institutional, managerial and financial capability
(including funds sufficient to pay the non-Federal share
of project cost) to ensure proper planning, management
and completion of the project described in this
application.
Will give the awarding agency, the Comptroller General
of the United States and, if appropriate, the State,
through any authorized representative, access to and
the right to examine all records, books, papers, or
documents related to the award; and will establish a
proper accounting system in accordance with generally
accepted accounting standards or agency directives.
3. 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.
4. Will initiate and complete the work within the applicable
time frame after receipt of approval of the awarding
agency.
5. Will comply with the Intergovernmental Personnel Act of 7.
1970 (42 U.S.C. §§4728-4763) relating to prescribed
standards for merit systems for programs funded under
one of the 19 statutes or regulations specified in
Appendix A of OPM's Standards for a Merit System of
Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all Federal statutes relating to
nondiscrimination. These include but are not limited to:
(a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race, color
or national origin; (b) Title IX of the Education
Amendments of 1972, as amended (20 U.S.C. §§1681-
1683, and 1685-1686), which prohibits discrimination on
the basis of sex; (c) Section 504 of the Rehabilitation
Act of 1973, as amended (29 U.S.C. §794), which
prohibits discrimination on the basis of handicaps; (d)
the Age Discrimination Act of 1975, as amended (42
U.S.C. §§6101-6107), which prohibits discrimination
on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended,
relating to nondiscrimination on the basis of drug
abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970 (P.L. 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) §§523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee
3), as amended, relating to confidentiality of alcohol
and drug abuse patient records; (h) Title VIII of the
Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as
amended, relating to nondiscrimination in the sale,
rental or financing of housing; (i) any other
nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is being
made; and, Q) the requirements of any other
nondiscrimination statute(s) which may apply to the
application.
Will comply, or has already complied, with the
requirements of Titles II and III of the Uniform
Relocation Assistance and Real Property Acquisition
Policies Act of 1970 (P.L. 91-646) which provide for
fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal or
federally-assisted programs. These requirements apply
to all interests in real property acquired for project
purposes regardless of Federal participation in
purchases.
8. Will comply, as applicable, with provisions of the
Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328)
which limit the political activities of employees whose
principal employment activities are funded in whole or
in part with Federal funds.
Previous Edition Usable Standard Form 4248 (Rev. 7-97)
Authorized for Local Reproduction Prescribed by OMB Circular A-102
9. Will comply, as applicable, with the provisions of the Davis-
Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act
(40 U.S.C. §276c and 18 U.S.C. §874), and the Contract
Work Hours and Safety Standards Act (40 U.S.C. §§327-
333), regarding labor standards for federally-assisted
construction subagreements.
10. Will comply, if applicable, with flood insurance purchase
requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires
recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of
insurable construction and acquisition is $10,000 or more.
11. Will comply with environmental standards which may be
prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National
Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating
facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in
floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management
program developed under the Coastal Zone Management
Act of 1972 {16 U.S.C. §§1451 et seq.); (f) conformity of
Federal actions to State (Clean Air) Implementation Plans
under Section 176(c) of the Clean Air Act of 1955, as
amended (42 U.S.C. §§7401 et seq.); (g) protection of
underground sources of drinking water under the Safe
Drinking Water Act of 1974, as amended (P.L. 93-523);
and, (h) protection of endangered species under the
Endangered Species Act of 1973, as amended (P.L. 93-
205).
12. Will comply with the Wild and Scenic Rivers Act of
1968 (16 U.S.C. §§1271 et seq.) related to protecting
components or potential components of the national
wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance
with Section 106 of the National Historic Preservation
Act of 1966, as amended (16 U.S.C. §470), EO 11593
(identification and protection of historic properties), and
the Archaeological and Historic Preservation Act of
1974 (16 U.S.C. §§469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of
human subjects involved in research, development, and
related activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of
1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 et
seq.) pertaining to the care, handling, and treatment of
warm blooded animals held for research, teaching, or
other activities supported by this award of assistance.
16. Will comply with the Lead-Based Paint Poisoning
Prevention Act (42 U.S.C. §§4801 et seq.) which
prohibits the use of lead-based paint in construction or
rehabilitation of residence structures.
17. Will cause to be performed the required financial and
compliance audits in accordance with the Single Audit
Act Amendments of 1996 and OMB Circular No. A-133,
"Audits of States, Local Governments, and Non-Profit
Organizations."
18. Will comply with all applicable requirements of all other
Federal laws, executive orders, regulations, and policies
governing this program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
Mayor
APPLICANT ORGANIZATION DATE SUBMITTED
City of Dubuque, Iowa January 7, 2008
Standard Form 4246 (Rev. 7-97) Back