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HomeMy WebLinkAbout156-04 RESOLUTION• • 1 RESOLUTION NO. 156-04 A RESOLUTION AUTHORIZING THE MAYOR TO APPLY FOR AND ACCEPT A STATE AND TRIBAL ASSISTANCE GRANT (STAG) FROM THE U. S. ENVIRONMENTAL PROTECTION AGENCY FOR SANITARY SEWER SYSTEM IMPROVEMENTS; DESIGNATING THE MAYOR AS THE CITY'S AUTHORIZED REPRESENTATIVE IN ALL MATTERS RELATING TO THE PROCUREMENT AND ADMINISTRATION OF SAID GRANT; AND APPROVING A BUDGET ADJUSTMENT RECOGNIZING $1,060,500.00 IN GRANT REVENUE. BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS: Section 1. That the City Council of the City of Fayetteville, Arkansas hereby authorizes the Mayor to apply for and accept a State and Tribal Assistance Grant (STAG) from the U. S. Environmental Protection Agency for sanitary sewer system improvements. Section 2. That the City Council of the City of Fayetteville, Arkansas hereby designates the Mayor as the City's Authorized Representative in all matters relating to the procurement and administration of said grant. Section 3. That the City Council of the City of Fayetteville, Arkansas hereby approves a budget adjustment recognizing $1,060,500.00 in grant revenue. PASSED and APPROVED this 5th day of October 2004. ATTEST: ...`.R1VTR'..,,� o Cf:t1Y'O. 3`G% • •A Cj' :FAYETTEVILLE: 3 By WARN t'ISY: Gas., ''/tTuOg aite`�.? By: 011/0'/Y)'u,(.t-' SONDRA SMITH, City Clerk Version 7/03 APPLICATION FOR FEDERAL ASSISTANCE 2. DATE SUBMITTED Applicant Identifier 1. TYPE OF SUBMISSION: Application Pre -application 3. DATE RECEIVED BY STATE State Application Identifier X • Construction Non -Construction X ❑ Construction Non -Construction 4. DATE RECEIVED BY FEDERAL AGENCY Federal Identifier 5. APPLICANT INFORMATION Legal Name: Organizational Unit: City of Fayetteville Department: Water and Wastewater Department Organizational DUNS: Division: Water and Sewer Operations Division Address: 113 West Mountain Street Name and telephone number of person to be contacted on matters involving this application (give area code) Street: 113 West Mountain Street Prefix: Mr. First Name: Greg City: Fayetteville Middle Name: County: Washington Last Name: Boettcher State: Arkansas (AR) Zip Code: 72701 Suffix: Country: USA Email: gboettcher(a)ci.fayetteville.ar.us 6. EMPLOYER IDENTIFICATION NUMBER (EIN): 71-6018462 Phone Number (give area code) (479) 575-8330 Fax Number (give area code) (479) 575-8257 8. TYPE OF APPLICATION: X New ■ Continuation • If Revision, enter appropriate letter(s) in box(es) (See back of form for description of letters.) Revision 7. TYPE OF APPLICANT: (See back of form for Application Types) C (Municipal Govemment) Other (specify) Other ( specify) 9. NAME OF FEDERAL AGENCY: 11 S. Environmental Protection Agency 10 CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 66-606 TITLE (Name of P ro Pin): State and Tribal Assistance Grants Account 11. DESCRIPTIVE TITLE OF APPLICANT S PROJECT: Sanitary Sewer Rehabilitation Project (EPA STAG Grant FY 2003/FY2004) for Basins 1(1, 2, 3, 4, 5, 11) and Minisystem Basins W (2, 27). Project includes variety of cost-effective sanitary sewer system rehabilitation activities including slip lining, cured -in-place liners, replacement and other methods as determined during final design. The project is predicted to include over 15,000 feet of sanitary sewer lines and appurtenances. 12. AREAS AFFECTED BY PROJECT (Cities, Counties, States, etc): City of Fayetteville, Arkansas (Farming on, Greenland Elkins) 13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF: Start Date: July 2004 Ending Date: August 2005 a. Applicant .3 b. Project 3 15. ESTIMATED FUNDING: (Combined Grants from FY 2003/FY2004) 16.1S APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS? Yes a Federal S 1,060,500 a. Yes X 11115 PREAPPLICATION/APPLICATION WAS MADE b. Applicant S 2,089,695 AVAILABLE TO THE STATE EXECUTIVE ORDER 12372 PROCESS FOR c. State f REVIEW 014 d. Local $ DATE: e. Other S b. No • 0 REVIEW PROGRAM IS NOT COVERED BY E. 0. 12372 OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR f. Program Income S 17.15 THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? g. TOTAL S 3,150,195 ■ Yes If"Yes" attach an explanation. X No 18. TO THE BEST OF DOCUMENT HAS BEEN ATTACHED ASSURANCES MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICAT1ON/PREAPPLICATION ARE TRUE AND CORRECT.- TFIE DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE IF THE ASSISTANCE 1S AWARDED. a Authorized Representative Prefix Mayor First Name Dan Middle Name Last Name Coody Suffix b. Title . - Mayor of Fayetteville/ c. Telephone Number (give area code) (479) 575-8330 d. Signature of Autho , ��� to � /I e. Date Sin / 5/0 / Previous Edition U Authorized for Local Reproduction tandard Form 4"24 (Kcv. 9 - Prescribed by OMB Circular A-IO2 v E PA United States Environmental Protection Agency Washington, D.C. EPA Project Control Number Certification Regarding Debarment, Suspension, and Other Responsibility Matters The prospective participant certifies to the best of its knowledge and belief that it and its principals: (a) (b) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; Have not within a three year period preceding this proposal been convicted of or had a civil judgement 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 indicted for or otherwise criminally or civilly charged by a government 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 a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of the award. In addition, under 18 USC Sec. 1001, a false statement may result in a fine of up to 510,000 or imprisonment for up to 5 years, or both. Mayor Dan Coody, Mayor of Fayetteville, Arkansas Typed Name & Titl Q Author.. d Representative Signature of Authorized Representativ 1 am unable to certify to the above statements. My explanation is attached. EPA Form 5700-49(11-88) Date We/0i • • EPA Project Control Number CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CON IRACTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing 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 the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into 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 influencing or attempting to influence an officer or employee of any agency, a Member of Congress in connection with this Federal contract, grant, loan, 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 shall require that the language of this certification be included in the award documents for all sub -awards at all tiers (including sub -contracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients shall certify and disclose accordingly. This certification 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 prerequisite 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 $10,000 and not more than $100,000 for each such failure. Ma or Dan aad Ma or of Fa etteville Arkansas Typed Nam d Representative _24044_ Dat Signature of Authorized ntative A 410PA Washington, DC 20460 Preaward Compliance Review Report for All Applicants Requesting Federal Financial Assistance FORM Approved OMB No. 2090-0014 Expires: 4-30-99 Note: Read Instructions before completing form. 1. A. Applicant (Name, City, State) City of Fayetteville, Arkansas B. Recipient (Name, City, State) City of Fayetteville, Arkansas C. EPA Project No. 11. Brief description of proposed project, program or activity. Sanitary sewer rehabilitation project for Basins 1 (1,2,3,4,5,11) and Minisystem Basins W (2,27). Project includes variety system rehabilitation activities including slip lining, cured -in-place liners, replacement determined during final design. The project is predicted to include over 15,000 feet appurtenances. (EPA STAG FY2003/FY2004) of cost-effective sanitary sewer and other methods as of sanitary sewer lines and 111. Are any civil rights lawsuits or complaints pending against applicant and/or recipient? If yes, list those complaints and the disposition of each complaint. 0 Yes t No IV. Have any civil rights compliance reviews of the applicant and/or recipient been conducted by any Federal agency during the two years prior to this application for activities which would receive EPA assistance? If yes, list those compliance reviews and status of each review. D Yes NNo V. Is any other Federal financial assistance being applied for or is any other Federal financial assistance being applied to any portion of this project program or activity? If yes, list the other Federal Agency(s), describe the associated work and the dollar amount of assistance. 0 Yes 6 No VI. If entire community under the applicant's plan, give reasons why. The project prioritization. This multi-year minimizes each customers jurisdiction is not served under the existing facilities/services, or will not be sery d under the proposed is part of an ongoing program that targets areas based upon ranking and continuing program benefits all customers by reducing backups and overflows plus user charges by reducing their charges for treatment of the excess wastewater flows. VH. Population Characteristics Number of People 1. A. Population of Entire Service Area 58,047 B. Minority Population of Entire Service Area 7,836 2. A. Population Currently Being Served 57,176 B. Minority Population Currently Being Served 7,718 3. A. Population to be Served by Project, Program or Activity 57,716 B. Minority Population to be Served by Project, Program or Activity 7,718 4. A. Population to Remain Without Service 871 B. Minority Population to Remain With Service 118 VIII. Will all new facilities or alterations to existing facilities financed by these funds be designed and constructed to be readily accessible to and usable by handicapped persons? If no, explain how a regulatory exception (40 CFR 7.70) applies. X Yes 0 No IX. Give the schedule for future projects, programs or activities (or of future plans), by which services will be provided to all beneficiaries within applicant's jurisdiction. If there is no schedule, explain why. Small isolated remote areas of the city do not currently have central sewer service. Development, growth and utility extensions will continue to reduce the portions of the population • that are unserved. All new residential developments in Fayetteville are served by central sanitary sewer service. X. 1 certify the statements 1 have made on this form and all attachments thereto are true, accurate and complete. 1 acknowledge that any knowingly false or mis • mg stateme • ay be punishable by fine or imprisonment or both under applicable law. A. Si:utho:. dM.. ,ir 'iMC..r ,' B. Tide of Authorized Official of Fayetteville, Arkansas C. Date /G / Q . ayor For the U.S. Environmental Protection Agency Approvedill" Authorized EPA Official Date • Disapproved EPA Fonn 4700-4 (Rev. 1/90) Previous editions arc obsolete. • • QUALITY MANAGEMENT PLAN x This program/project does not involve environmentally related measurements nor data generation; therefore, a Quality Management Plan is not required pursuant to the above referenced assistance regulations. This program/project involves environmentally related measurements or data generation; therefore, a Quality Management Plan which meets the requirements of: 40 CFR 30.54 for universities and non-profit organizations is attached or has been forwarded to the EPA Project Officer. 40 CFR 31.45 for State and local governments is attached or has been forwarded to the EPA Project Officer. Date orized Representative /441 City of Fayetteville, Arkansas Budget Adjustment Form • Budget Year 2004 Department: Water & Wastewater Division: Water & Sewer Maintenance Program: Sewer Mains Construction Dale Requested 10/5/2004 Adjustment Number Project or Item Requested: $1,060,500 is requested in the Sewer improvements account of the Sanitary Sewer Rehabilitation - EPA Rehab Grant Project. Project or Item Deleted: None. To recognize revenue of $1,060,500 in the Federal grants account. Justification of this Increase: Funding is needed will be used for sanitary sewer rehabilitation including slip linings, cured -in-place liners, replacement, and other methods. Justification of this Decrease: A grant was received from the Environmental Protection Agency for the purpose of sanitary sewer rehabilitation. Increase Budget (Decrease Revenue) Account Name Account Number Amount Project Number Sewer improvements 5400 5700 5815 00 1,060,500 02017 0401 Decrease Budget (Increase Revenue) Account Name Account Number Amount Project Number Federal grants. 5400 0940 4309 00 1,060,500 020/ 7 0 `1-v / Approval Signatures Budget Office Use Only Type: A B C Requested : y Date 9-1 udget Manager Date Department Director Date Aw 1 ices Finance & InteDi tor /O Date /O Mayor Date Date of Approval Posted to General Ledger Posted to Project Accounting Entered in Category Log Initial Date Initial Date Initial Date Initial Date NAME OF FILE: CROSS REFERENC Item # Date Resolution No. 156-04 w/grant application & budget adjustment Document • 1 09/15/04 memo to mayor & City Council 2 draft resolution 3 Letter of Transmittal - RJN Group 4 copy of application package 5 Exhibit A Project Location Map 6 draft resolution 7 project work plan 8 budget information g copy of project map 10 copy of letter EPA Region 6 11 summary of rehabiliation 12 copy of location map 5 13 copy of overall location map 14 copy of location map 1 15 copy of location map 2 16 copy of location map 3 17 copy of location map 4 18 Staff Review Form 19 Res. 156-04 with wrong date 20 copy of signed application package 21 memo to Greg Boettcher 22 copy of preliminary plat • ye eti�i le • /of is fop /56v� ` ri//x/5/t4. City Council Meeting of October 5, 2004 CITY COUNCIL AGENDA MEMO To: Mayor and City Council Thru: Hugh Earnest From: Greg Boettcher b Chief Administrative Officer Water/Wastewater Director Date: September 15, 2004 Subject: Resolution authorizing Mayor to execute State and Tribal Assistance Grant (STAG) Program Application with the Environmental Protection Agency (EPA) and to serve as the Fayetteville's designated representative relating to sanitary sewer rehabilitation improvements. RECOMMENDATION Fayetteville City Administration recommends approval of a resolution authorizing the Mayor to file the EPA STAG grant, execute all required documents, furnish required information and act as the city's designated representative for grant administration. BACKGROUND Fayetteville has been the recipient of $1,100,000.00 in EPA Grant Assistance from the State and Tribal Assistance Program, notificaiton of the awards being made on June 10, 2003 and May 17, 2004 (copies of EPA correspondence attached). The combined EPA grant funding is proposed to be leveraged with the city's ongoing sewer rehabilitation funding to accelerate the local program. The EPA grant provides a maximum of 55% of the costs with 45% being the required local match. On June 15, 2004, a contract with RJN Group was approved for the project's planning/design/bidding phase services. DISCUSSION Consultant efforts on the grant application, the environmental clearances and the design have proceeded concurrently. Attached are copies of the grant application forms and the categorical exclusion report that address the funding and environmental needs of the project. The project approach utilizes parallel work planes to expedite the completion time for the project. BUDGET IMPACT This project is a budgeted activity with the Fayetteville budget containing $2,753,627.90 in unencumbered funds for sanitary sewer rehabilitation, which will be combined with the net EPA Grant proceeds of $1,060,500.00 to create an adequate project budget of $3,814,127.90 Odor • • RESOLUTION NO. A RESOLUTION AUTHORIZING THE MAYOR TO APPLY FOR AND ACCEPT A STATE AND TRIBAL ASSISTANCE GRANT (STAG) FROM THE U S ENVIRONMENTAL PROTECTION AGENCY FOR SANITARY SEWER SYSTEM IMPROVEMENTS; DESIGNATING THE MAYOR AS THE CITY'S AUTHORIZED REPRESENTATIVE IN ALL MATTERS RELATING TO THE PROCUREMENT AND ADMINISTRATION OF SAID GRANT; AND APPROVING A BUDGET ADJUSTMENT RECOGNIZING $1,060,500.00 IN GRANT REVENUE. BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS: Section 1. That the City Council of the City of Fayetteville, Arkansas hereby authorizes the Mayor to apply for and accept a State and Tribal Assistance Grant (STAG) from the U. S. Environmental Protection Agency for sanitary sewer system improvements. Section 2. That the City Council of the City of Fayetteville, Arkansas hereby designates the Mayor as the City's Authorized Representative in all matters relating to the procurement and administration of said grant. Section 3. That the City Council of the City of Fayetteville, Arka�nsa hereby approves a budget adjustment recognizing $1,060,590,0,0y-tr'i :grant 4 revenue. PASSED and APPROVED this 5th day of October 2004. /APPROVED:: ATTES N COOD , Mayor By: I l SONDRA SMITH, ty/Clerk 1 Letter of Transmittal IRECEIVED SEP 0 3 2004 RUN Group, Inc. 12160 Abrams Road, Suite 400 Dallas, Texas 75243 (972) 437-4300 TO: Mr. Greg Boettcher, P.E. Water and Wastewater Director City of Fayetteville 113 West Mountain Street Fayetteville, AR 72701 CITY OF FAYETTEVILLE MAYOR'S OFHVt Date: 9/2/2004 Job No. 18-1959-00 Attention: Mr. Greg Boettcher, P.E. Reason: EPA forms Description 2 9/2/04 We are sending you ❑ Attached r Under Separate Cover Via El Shop Drawings r Prints C Plans 0 Samples Copy of Letter C Report G Change Order Gam' Other Next Day ithe following items. I: Specifications Copies Date No. Description 2 9/2/04 Application Package These are Transmitted as checked below: ❑ For Approval G For your Use ❑ As Requested • Approved as ✓ Approved as ✓ Returned for Corrections E For Review and Comment fJ FOR BIDS DUE 20 CJ Resubmit r Submit r Return Copies for Approval Copies for Distribution Corrected Prints Returned After Loan to Us r Remarks Copy to: File 18-1959-00 Signed: Hugh Kelso APPLICATION PACKAGE SUBMITTAL CHECKLIST X SF 424, 424A, 424C including object class categories worksheet and Key Contacts Form. X SF 424D Assurances - Construction Programs Clearinghouse Comments. X Certification Regarding Debarment, Suspension and Other Responsibility Matters. X Anti -Lobbying Recipient Certification must be completed and returned if you are requesting $100,000 or more in Federal funds. Please retain the Disclosure of Lobbying Activities" form for your use in reporting lobbying activities during the project period of the assistance award. NIA Current indirect cost rate negotiation agreement, if applicable. X Compliance Report - EPA Form 4700-4 X Quality Management Plan statement. If your project/program involves environmentally related measurements or data generation, a Quality Management Plan is required. X Workplan - prepared in accordance with instructions provided by your EPA Project Officer. NIA SF 3881 - ACH Vendor/Miscellaneous Payment Enrollment N/A Superfund specific requirements MAIL THE ORIGINAL AND ONE COPY OF YOUR COMPLETED APPLICATION TO: • Procurement and Grants Section (6MD-RP) Environmental Protection Agency 1445 Ross Ave., Suite 1200 Dallas TX 75202-2733 • INSTRUCTIONS FOR THE SF -424 Public reporting burden for this collection of information is estimated to average 45 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 (0348-0043), 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. This is a standard form used by applicants as a required face sheet for pre -applications and applications submitted for Federal assistance. It will be used by Federal agencies to obtain applicant certification that States which have established a review and comment procedure in response to Executive Order 12372 and have selected the program to be included in their process, have been given an opportunity to review the applicant's submission. Item Entry- Item. Entry. 1. Select Type of Submission. 11. Enter a brief descriptive title of the project. If more than one program is involved, you should append an explanation on a separate sheet. if appropriate (e.g., construction or real property projects), attach a map showing project location. For prcapplications, use a separate sheet to provide a summary description of this project. 2. Date application submitted to Federal agency (or State if applicable) and applicant's control number (if applicable) 12. List only the largest political entities affected (e.g., State, counties, cities). 3. State use only (if applicable). 13. Enter the proposed start date and end date of the project. 4. Enter Date Received by Federal Agency Federal identifier number: If this application is a continuation or revision to an existing award, enter the present Federal Identifier number. If for a new project, leave blank. 14. List the applicant's Congressional District and any District(s) affected by the program or project 5. Enter legal name of applicant, name of primary organizational unit (including division, if applicable), which will undertake the assistance activity, enter the organization's DUNS number (received from Dun and Bradstreet), enter the complete address of the applicant (including country), and name, telephone number, e-mail and fax of the person to contact on matters related to this application. 15. Amount requested or to be contributed during the first f inding/budget period by each contributor. Value of in kind contributions should be included on appropriate lines as applicable. If the action will result in a dollar change to an existing award, indicate only the amount of the change. For decreases, enclose the amounts in parentheses. If both basic and supplemental amounts are included, show breakdown on an attached sheet. For multiple program funding, use totals and show breakdown using same categories as item 15. 6. Enter Employer Identification Number (EIN) as assigned by the Internal Revenue Service. 16. Applicants should contact the State Single Point of Contact (SPOC) for Federal Executive Order 12372 to determine whether the application is subject to the State intergovernmental review process. 7. Select the appropriate letter in the space provided. 1. State Controlled A. State Institution of Higher B. County Learning C. Municipal J. Private University D. Township K. Indian Tribe E. Interstate L. Individual F. Intermunicipal M. Profit Organization G. Special District N. Other (Specify) H. independent School O. Not for Profit District Organization 17. This question applies to the applicant organization, not the person who signs as the authorized representative. Categories of debt include delinquent audit disallowances, loans and taxes. 8. Select the type from the following list: • "Ncw" means a new assistance award. - • "Continuation" means an extension for an additional funding/budget period for a project with a projected completion date. • `Revision" means any change in the Federal Government's financial obligation or contingent liability from an existing obligation. If a revision enter the appropriate letter. A increase Award B. Decrease Award C. Increase Duration D. Decrease Duration 18. To be signed by the authorized representative of the applicant. A copy of the governing body's authorization for you to sign this application as official representative must be on file in the applicant's office. (Certain Federal agencies may require that this authorization be submitted as part of the application.) 9. Name of Federal agency from which assistance is being requested with this application. 10. Use the Catalog of Federal Domestic Assistance number and title of the program under which assistance is requested. SF -424 (Rev. 7-97) Back OMB Approval No. 0348-0042 ASSURANCES - CONSTRUCTION PROGRAMS 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 (0348-0042), 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 assistance 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, I 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 costs) to ensure proper planning, management and completion of the project described in this application. 2. 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 assistance; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will not dispose of, modify the use of, or change the terms of the real property title, or other interest in the site and facilities without permission and instructions from the awarding agency. Will record the Federal interest in the title of real property in accordance with awarding agency directives and will include a covenant in the title of real property aquired in whole or in part with Federal assistance funds to assure non- discrimination during the useful life of the project. 4. Will comply with the requirements of the assistance awarding agency with regard to the drafting, review and approval of construction plans and specifications. 5. Will provide and maintain competent and adequate engineering supervision at the construction site to ensure that the complete work conforms with the approved plans and specifications and will furnish progress reports and such other information as may be required by the assistance awarding agency or State. 6. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 7. 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. Previous Edition Usable 8. Will comply with the Intergovernmental Personnel Act of 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). 9. 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 10. Will comply with all Federal statutes relating to non- discrimination. 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 (P1.. 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, 0) the requirements of any other nondiscrimination statute(s) which may apply to the application. Standard Form 424D (Rev. 7-97) Authorized for Local Reproduction Prescribed by OMB Circular A-102 • 11. 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 and federally -assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 12. Will comply with the 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. 13. 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. 14. Will comply 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. 15. 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). 16. 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. 17. 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.). • 18. 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." 19. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations, and policies governing this program. SIGNATURE OF ORIZED G RTIFYING OFFICIAL APPLICANT ORGANIZATION City of Fayetteville, Arkansas TITLE Mayor of Fayetteville, Arkansas DATE SUBMITTED September 2, 2004 SF -424D (Rev. 7-97) Back &EPA KEY CONTACTS FORM Form Approved () No:2030-0020 Approval Expires 12/3/02 Authorized Representative: Original awards acrid amendments will be sent to this individual for review and acceptance, unless otherwise indicated. Name: Mayor Dan Coody Title: Mayor of Fayetteville Complete Address. 113 West Mountain Street Fayetteville, Arkansas 72701 Phone Number: (479) 575 8330 Payee: Individual authorized to accept payments. Name: Steve Davis, Title: Financial and Administrative Services Director Mail Address: 113 West Mountain Street Fayetteville, Arkansas 72701 Phone Number (479) 575-8302 Administrative Contact: Individual from Sponsored Program Office to contact concerning administrative matters (i.e., indirect cost rate computation, rebudgeting requests etc) Name: Greg Boettcher Title: Water and Wastewater Director Mailing Address: 113 West Mountain Street Fayetteville, Arkansas 72701 Phone Number: FAX Number: E -Mail Address: (479) 575-8330 (479)575-8257 gboettcherQct.fayetteville.ar.us Principal Investigator: Individual responsible for the technical completion of the proposed work. Name. RJN Group, Inc. -Hugh Kelso -Engineering Consultant Title: Regional Vice President Mailing Address: 12160 Abrams Road, Ste 400 Dallas, Texas 75243 Phone Number: (972) 437-4300 FAX Number: (972) 437-2707 E -Mail Address: hkelso@rjn.com Web URL: EPA Form 5700-54 (Rev 4-02) • RESOLUTION NO. A RESOLUTION STATING THE CITY OF FAYETTEVILLE'S INTENT TO SEEK FUNDING THROUGH THE ENVIRONMENTAL PROTECTION AGENCY'S STATE AND TRIBAL ASSISTANCE GRANTS PROGRAM FOR SANITARY SEWER SYSTEM IMPROVEMENTS AND AUTHORIZING THE MAYOR TO PURSUE FUNDING AND EXECUTE APPLICATIONS AS THE CITY'S DESIGNATED REPRESENTATIVE. BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS: Section 1. That the Mayor of Fayetteville, Arkansas is authorized to prepare and submit documents which are necessary in applying for funding and establishing an administrative organization to implement activities pursuant to a Special Appropriations Project as funded by the Environmental Protection Agency through its State and Tribal Assistance Program. PASSED and APPROVED this 7'h day of September, 2004 APPROVED: By: DAN COODY, Mayor ATTEST: By: SONDRA SMITH, City Clerk • 1 • PROJECT WORK PLAN Project Title: Sanitary Sewer Rehabilitation in Basins 11-I5,111,112, 116,118, W-2, and W-27 Name of Applicant: City of Fayetteville, Arkansas Project Need: The objective of the project is to complete sanitary sewer rehabilitation to reduce Infiltration/Inflow, reduce maintenance problems and provide better service to customers, and reduce the occurrence of sanitary sewer overflows. Project Description and Activities: The Project will include the complete replacement of approximately 14,000 linear feet of sanitary sewer and point repairs at approximately 42 locations. The activities funded by this grant will only include the construction related activities and will not include planning, engineering, inspection activities, etc. The general location of the project area is shown on Exhibit A. Project Environmental Benefits: Project Schedule: The primary environmental benefit of this project will be to reduce sewer backups and the occurrence of sanitary sewer overflows. All of the sewer repairs that will be completed in this project are upstream of known backup or overflow locations. Repair of these sewers will reduce or eliminate the occurrence of sewerage backups into private residences and businesses and also reduce the occurrence of discharge of raw sewerage from overflowing manholes in the project area. The design of the improvements is currently underway utilizing non -grant funding. The construction phase of the project, which will be funded by this grant, is expected to be initiated in early to mid 2005 and be completed by mid 2006. Project Budget: See attached Form 424C. el9act) 1.10i11P3 anoIrid • • 15. Project (program) income $ .00 $ .00 $ 3,150,195 .00 16. TOTAL PROJECT COSTS (subtract #15 from #14) $ 3,793,185 .00 $ 0.00 $ FEDERAL FUNDING 14. SUBTOTAL 13. Contingencies 0 m O r , cc oNi % 11. Miscellaneous 10. Equipment 9. Construction 8. Demolition and removal 7. Site work 16. Project inspection fees 5. Other architectural and engineering fees 4. Architectural and engineering fees W m g o 2 g 6 m a mel .. kg 0 12. Land, structures, rights-of-way, appraisals, etc. ri O. 3 a a) °A 0 = i O 1 T I O 2 ' OMB Approval No. 0348-004� BUDGET INFORMATION - Construction Programs . NoTF Certain Federal assistance oroorams require additional computations to arrive at tM Federal sham of project costs eligible for participation. If such is the case, you will be notified. a s $ 286,381 .00 $ 3,506,804 .00 4, Z 5:_. o M Z D o $ 2,863,814 .00 N Z D o b Z D g $ 200,000 .00 $ N/A .00 $ 226,000 .00 H Z D o N o N N O CI s m ti O R H O S M 0 N 0 0 N S H S 0 H S (A 0 !R fR N 0 0 O 0 0 N $ 226,000 .00 fM O M pO O $ 15,000 .00 b. Costs Not Allowable for Participation 4, $ 286,381 .00 V1 !q Q NI $ 2,863,814 .00 N 1R N /A M (M $ .00 $ .00 0 0 aI m V O v9 o 6 26 E. Meadow Street, Suite 8 Fayetteville, AR 72701 479.444.6119 fax 479.444.6119 www.rjn.com September 7, 2004 EPA Region 6 RE: Request for Categorical Exclusion — Sanitary Sewer Rehabilitation in Fayetteville, Arkansas Dear In accordance with 40 CFR 6.107(d) and 40 CFR 6.107(e), the following project is submitted for review as a categorical exclusion from the requirements of an EPA environmental review. This project consists of rehabilitation of the sanitary sewer collection system to address maintenance and infiltration and inflow issues that contribute to sanitary sewer overflows (SSOs). The project consists of several line segments, many of which will be rehabilitated using trenchless methods, thereby minimizing any disturbances to the surface. The following provides details of the project for review. Project Description The project consists of rehabilitation of 14,024 feet of sanitary sewer main and 42. point repairs in various locations in the City of Fayetteville, Arkansas. The project consists of 84 main segments (manhole to manhole) in the City along with the point repairs. Maps are enclosed with this document that show the general location of each of the project segments. Each of these project segments are replacing existing facilities which appears to be addressed in 40 CFR 6.107 (d) 1. A summary of the proposed improvements is included in the attached Table 1. II. Project Background Some of these project segments were identified as significant infiltration and inflow sources as part of a Sanitary Sewer Evaluation Study for the Illinois River Watershed Basins 1-5, 18 and 19 and the White River Mini System 27 prepared for the City of Fayetteville and dated April 2002. This study utilized several methods including smoke testing and main televising to identify defects in the system. In some cases, trenchless methods such as cured in place pipe (CIPP) were used to address some of the problematic segments. The remaining segments in this project are primarily open cut or pipe bursting construction due to significant problems in the main that cannot be addressed with CIPP methods. Mr. XXX September 7, 2004 Page 2 The remaining project segments, including the pipe bursting projects in the Mount Sequoyah area, have been identified by the City of Fayetteville as maintenance issues or significant inflow/infiltration sources. Many of these segments have been televised and it appears that pipe bursting, a trenchless rehabilitation method, will be the most effective rehabilitation method. In some cases, open cut will be used to relocate the main away from private residences or other structures. These relocations should be in close proximity of the existing mains and will not include any undisturbed areas. Upon completion of the project, it is anticipated that there will be a significant reduction in inflow/infiltration in these project areas. Maintenance will also be improved due to reduced flow and less potential for blockages in the main. 111. Project Description A summary of the project segments is attached including the current proposed method of rehabilitation. The project numbers can be correlated with the maps provided. IV. Latitude and Longitude The general latitude and longitude of the overall project is Lat. 36° 02' 00" to 36° 06' 00" Long. 94° 07' 30" to 94° 12' 30" based on NGVD of 1929 Due to the environmental sensitivity of this project, we request your quick response to this request. It is anticipated that construction of the project will begin in early 2005, with completion in late 2005, early 2006. Please feel free to contact me at (214) 437-4300 if additional information or clarification of this project is required. Sincerely, RJN GROUP, INC. Michael G. McKay, P.E. Project Manager Attachments: Maps of Project Locations Table of Main Improvements RJN Group, Inc. Engineering and Information Mr. XXX September 7, 2004 Page 3 Table 1 SUMMARY OF REHABILITATION Project Listing Method Existing Diameter (in) Proposed Diameter (in) Length 1 LR2 Pipe Bursting 6 8 295 LR5 Open Cut 6 8 216 LR7 Open Cut 8 8 410 LR8 Open Cut 6 8 213 LR9 Open Cut 6 8 341 LRII Open Cut 6 8 289 LR12 Pipe Bursting 6 8 300 LR15 Open Cut 6 8 98 LR17 Open Cut 6 8 59 LR 18 Open Cut 6 8 13 LR19 Open Cut 6 8 187 LR22 Open Cut 10 10 103 LR23 Open Cut I 6 8 40 LR27 Pipe Bursting 6 8 185 LR28 Pipe Bursting 6 8 276 LR29 Open Cut 6 8 185 LR30 Open Cut 6 8 53 LR31 Pipe Bursting 6 8 147 LR32 Pipe Bursting 6 8 89 LR45 Open Cut 6 8 56 LR46 Open Cut 8 8 . 331 LR47 Open Cut 6 8 345 LR48 Open Cut 6 8 299 LR50 Open Cut 8 8 313 LR51 CIPP 10 10 369 LR51A Open Cut 8 8 240 LR55 Open Cut 6 8 47 LR59 Open Cut 6 8 270 LR61 Open Cut 6 8 56 LR63 Open Cut 6 8 473 LR68 Open Cut 8 8 483 FUN (Troup, Inc. Engineering and Information Technology Mr. XXX September 7, 2004 Page 4 Table 1 SUMMARY OF REHABILITATION Project Listing Method Existing Diameter (in) Proposed Diameter (in) Length 1 LRIOO Open Cut 6 8 440 LRIOI O I Open Cut 4 8 320 LRI02 Pipe Bursting 6 8 180 LR103 Pipe Bursting 6 8 147 LR104 Pipe Bursting 6 8 104 LR I05 Open Cut 6 8 177 LRI06 Pipe Bursting 6 8 95 LRI07 Pipe Bursting 6 8 111 LRI08 Pipe Bursting 6 8 237 LRI09 Pipe Bursting 6 8 95 LRI10 Open Cut 6 8 149 LRI11 Pipe Bursting 6 8 200 LR112 Point Repair 6 8 196 LR113 Open Cut 6 8 148 LRI 14 Open Cut 6 8 150 LRI I5 Open Cut 6 8 166 LRI16 Pipe Bursting 6 8 189 LRI 17 Pipe Bursting 6 8 285 LRI 18 Open Cut 6 8 330 LRI19 Pipe Bursting 8 8 423 LR120 Open Cut 8 8 372 LR121 Open Cut 6 8 377 LR122 Open Cut 6 8 232 LR123 Open Cut 6 8 155 LR124 Pipe Bursting 6 8 253 LR200 Pipe Bursting 6 15 97 LR201 Pipe Bursting 10 IS 29 LR202 Pipe Bursting 10 I5 340 LR203 Pipe Bursting 10 15 90 LR204 Pipe Bursting 10 15 50 LR205 Pipe Bursting 10 15 287 RJN Group, Inc. i Engineering and Information • Mr. XXX September 7, 2004 Page 5 Table I SUMMARY OF REHABILITATION Project Listing Method Existing Diameter (in) Proposed Diameter (in) Length 1 LR206 Pipe Bursting 10 15 182 LR207 Pipe Bursting 10 15 128 LR208 Pipe Bursting 10 15 148 LR209 Pipe Bursting 10 15 134 LR210 Pipe Bursting 10 15 41 LR211 Pipe Bursting 10 15 242 LR212 Pipe Bursting 10 15 241 LR213 Pipe Bursting 10 15 200 LR214 Pipe Bursting 10 15 68 Total Length 14,024 RJN Group, Inc. 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Y itiA a m p fl r 4 D m C In E o m i ` y -i _a A lr� w 11LQJI3 `. 3 11Y -m D 8a D am OI 21C c ^ 8my Cu Y ' p Y Y 4 y Y i Y n 554 mA NS 2 O • LL s � 2a C A Ym y41 ix,RM t wY w F C g 4 jT e'n bi FH$i e x l/1 7a �n sills v.rI onLE •OO ry .v b• �sIKLi f e e • ' � 1// p [ I V b+rn�4 i � 4r.• = {YIN •LIIr • Y I ii - ___ ,.a m \ 3i tt. In.t "O a P • m• Y m A E i t ... Y 3 . F sr i i i g�a Cr- z K$ va y O Y Y 2 O -( _j3 1r a i AAe a 4 e oZ a�ggY69R 3i 9 • STAFF REVIEW FORM • X AGENDA REQUEST X CONTRACT REVIEW GRANT REVIEW For the Fayetteville City Council Meeting of FROM: October 5, 2004 Greg Boettcher Water and Wastewater Water and Wastewater Name Division Department ACTION REQUIRED: Resolution authorizing Mayor to execute State and Tribal Assistance Grant (STAG) Program Application with the Environmental Protection Agency (EPA) and to serve as the Fayetteville's designated representative relating to sanitary sewer rehabilitation improvements. COST TO CITY: $0.00 Cost of this request 5400.5815.00 Account Number 02017.0401 Project Number BUDGET REV EW: Budget Manager $ 3,231,890.00 $ 478,262.10 Funds Used to Date $ 2,753,627.90 Remaining Balance x Budgeted Item Date CONT CT/GRANT/LEASE REVIEW: Acco nting Manager Date City Atto ey Date STAFF ION: Divis' n Head Date 9-tc Dep rtment Director Date i Finance & Internal Services Dir. Date Water/Wastewater Program Category / Project Name Sewer Mains Construction Program / Project Category Name Capital -Sewer Improvements Fund Name Budget Adjustment Attached Qfrilotj Internal A itor Date Purchasing Manager Date Cross Reference New Item: Yes Previous Ord/Res#: Orig. Contract Date Orig. Contract Number Rec'd in y 's Office _______ No 0 RESOLUTION NO. 156-04 A RESOLUTION STATING THE CITY OF FAYETTEVILLE'S INTENT TO SEEK FUNDING THROUGH THE ENVIRONMENTAL PROTECTION AGENCY'S STATE AND TRIBAL ASSISTANCE GRANTS PROGRAM FOR SANITARY SEWER SYSTEM IMPROVEMENTS AND AUTHORIZING THE MAYOR TO PURSUE FUNDING AND EXECUTE APPLICATIONS AS THE CITY'S DESIGNATED REPRESENTATIVE. BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS: Section 1. That the Mayor of Fayetteville, Arkansas is authorized to prepare and submit documents which are necessary in applying for funding and establishing an administrative organization to implement activities pursuant to a Special Appropriations Project as funded by the Environmental Protection Agency through its State and Tribal Assistance Program. PASSED and APPROVED thi 7h day of September, 2004 &% lil@QKITRr/'4._ ;FAYETTEVILLE; ATTEST:-"li�e�li1' By: 4≥ma/ czS,n,ita SONDRA SMITH, City Clerk APPLICATION PACKAGE SUBMITTAL CHECKLIST X SF 424, 424A, 424C including object class categories worksheet and Key Contacts Form. X SF 424D Assurances - Construction Programs Clearinghouse Comments. X Certification Regarding Debarment, Suspension and Other Responsibility Matters. X Anti -Lobbying Recipient Certification must be completed and returned if you are requesting $100,000 or more in Federal funds. Please retain the "Disclosure of Lobbying Activities" form for your use in reporting lobbying activities during the project period of the assistance award. NIA Current indirect cost rate negotiation agreement, if applicable. X Compliance Report - EPA Form 4700-4 X Quality Management Plan statement. If your project/program involves environmentally related measurements or data generation, a Quality Management Plan is required X ' Workplan - prepared in accordance with instructions provided by your EPA Project Officer. N/A SF 3881 - ACH Vendor/Miscellaneous Payment Enrollment N/A Superfund specific requirements MAIL THE ORIGINAL AND ONE COPY OF YOUR COMPLETED APPLICATION TO: Procurement and Grants Section (6MD-RP) Environmental Protection Agency 1445 Ross Ave., Suite 1200 Dallas TX 75202-2733 . __ Version 7/03 APPLICATION FOR 2. DATE SUBMITTED Applicant Identifier FEDERAL ASSISTANCE I. TYPE OF SUBMISSION: 3. DATE RECEIVED BY STATE State Application Identifier Application Pre -application X Construction X Construction 4. DATE RECEIVED BY FEDERAL AGENCY Federal Identifier ❑ Non -Construction ❑ Non -Construction 5. APPLICANT INFORMATION Legal Name: Organizational Unit: City of Fayetteville Department: Water and Wastewater Department Organizational DUNS: Division: Water and Sewer Operations Division Address: 113 West Mountain Street Name and telephone number of person to be contacted on matters involving this application (give area code) Street: Prefix: First Name: 113 West Mountain Street Mr. Greg City: Fayetteville Middle Name: County: Washington Last Name: Boettcher State: Arkansas (AR) Zip Code: Suffix: 72701 Country: Email: USA boettche ci.fa etteville.ar.us 6. EMPLOYER IDENTIFICATION NUMBER (EIN): Phone Number (give area code) Fax Number (give area code) 71-6018462 (479) 575-8330 (479) 575-8257 8. TYPE OF APPLICATION: 7. TYPE OF APPLICANT: (See back of form for Application Types) X New O Continuation O Revision If Revision, enter appropriate letter(s) in box(es) C (Municipal Government) (See back of form for description of letters.) Other (specify) Other ( specify) 9. NAME OF FEDERAL AGENCY: U.S. Environmental Protection Agency 10 CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT: Sanitary Sewer Rehabilitation Project (EPA STAG Grant FY 20031FY2004) for Basins 1(1, 2, 3, 4, 5, 11) and Minisystem Basins W (2, 27). Project includes 66-606 variety of cost-effective sanitary sewer system rehabilitation activities including slip lining, cured -in -place liners, replacement and other methods as determined TITLE (Name of Pro 8�): during final design. The project is predicted to include over 15,000 feet of State and Tribal Assistance Grants Account sanitary sewer lines and appurtenances. 12. AREAS AFFECTED BY PROJECT (Cities, Counties, States, etc): City of Fayetteville. Arkansas Fermin ton, Greenland, Elkins) 13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF: Start Date: Ending Date: a. Applicant b. Project July 2004 2005 3 3 _August 15. ESTIMATED FUNDING: 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE Combined Grants from FY 2003/FY2004) ORDER 12372 PROCESS? Yes a. Federal $1,060,500 a. Yes X THIS PREAPPLICATION/APPLICATION WAS MADE AVAILABLE TO THE STATE EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON DATE: b. No O PROGRAM IS NOT COVERED BY E. O. 12372 b. Applicant $ 2,089,695 c. State $ d. Local $ $ e. Other O OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW f. Program Income $ 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? ❑ Yes If"Yes" attach an explanation. X No R. TOTAL $3,150,195 18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION/PREAPPLICATION ARE TRUE AND CORRECT. THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED. a. Authorized Representative Prefix First Name Middle Name Mayor Dan Last Name Suffix Coody b. Title ' c. Telephone Number (give area code) Mayor ofFa en ille (479)575-8330 d. Signature of e i c. Date Signed 1 o. �' f i Standard Form 424 (Rev. 9-2003) Prescribed by OMB Circular A-102 Previous Edr n Usable Authorized for Local Reproduction THE SF -424 • Public reporting burden for this collection of information is estimated to average 43 minutes per response, memamg time for reviewing msuucuons, scarcning 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 (0348-0043). 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. This is a standard form used by applicants as a required face sheet for pre -applications and applications submitted for Federal assistance. It will be used by Federal agencies to obtain applicant certification that States which have established a review and comment procedure in response to Executive Order 12372 and have selected the program to be included in their process, have been given an opportunity to review the applicant's submission. Item: En Item: Entry: I. Select Type of Submission. II. Enter a brief descriptive title of the project. If more than one program is involved, you should append an explanation on a separate sheet. If appropriate (e.g., construction or real property projects), attach a map showing project location. For preapplications, use a u to sheet to rovide a summ descri tion of this project. 2. Date application submitted to Federal agency (or State if applicable) 12. List only the largest political entities affected (e.g., State, counties, and applicant's control number (if applicable) cities). 3. State use only (if applicable). 13. Enter the proposed start date and end date of the project. 4. Enter Date Received by Federal Agency Federal identifier number: If 14. List the applicant's Congressional District and any District(s) this application is a continuation or revision to an existing award, affected by the program or project enter the present Federal Identifier number. If for a new project, leave blank. 5. Enter legal name of applicant, name of primary organizational unit 15. Amount requested or to be contributed during the first (including division, if applicable), which will undertake the assistance funding/budget period by each contributor. Value of in kind activity, enter the organization's DUNS number (received from Dun contributions should be included on appropriate lines as applicable. and Bradstreet), enter the complete address of the applicant (including If the action will result in a dollar change to an existing award, country), and name, telephone number, e-mail and fax of the person indicate only the amount of the change. For decreases, enclose the to contact on matters related to this application, amounts in parentheses. If both basic and supplemental amounts are included, show breakdown on an attached sheet. For multiple program funding, use totals and show breakdown using same categories as item 15. 6. Enter Employer Identification Number (EIN) as assigned by the 16. Applicants should contact the State Single Point of Contact (SPOC) Internal Revenue Service. for Federal Executive Order 12372 to determine whether the a lication is subject to the State inte overnmental review rocess. 7. Select the appropriate letter in 17. This question applies to the applicant organization, not the person the space provided. I. State Controlled who signs as the authorized representative. Categories of debt A. State Institution of Higher include delinquent audit disallowances, loans and taxes. B. County Learning C. Municipal J. Private University D. Township K. Indian Tribe E. Interstate L. Individual F. Intermunicipal M. Profit Organization G. Special District N. Other (Specify) H. Independent School - O. Not for Profit District Or anization 8. Select the type from the following list: 18. To be signed by the authorized representative of the applicant. A • "New" means a new assistance award, copy of the governing body's authorization for you to sign this • "Continuation" means an extension for an additional application as official representative must be on file in the applicant's funding/budget period for a project with a projected office. (Certain Federal agencies may require that this authorization completion date, be submitted as part of the application.) • "Revision" means any change in the Federal Government's financial obligation or contingent liability from an existing obligation. If a revision enter the appropriate letter. A. Increase Award B. Decrease Award C. Increase Duration D. Decrease Duration 9. Name of Federal agency from which assistance is being requested with this a lication. 10. Use the Catalog of Federal Domestic Assistance number and title of the program under which assistance is requested. SF -424 (Rev. 7-97) Back C SEPA United States Environmental Protection Agency Washington, D.C. EPA Project Control Number Certification Regarding Debarment, Suspension, and Other Responsibility Matters The prospective participant certifies to the best of its knowledge and belief that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three year period preceding this proposal been convicted of or had a civil judgement 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 indicted for or otherwise criminally or civilly charged by a government 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 a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of the award. In addition, under 18 USC Sec. 1001, a false statement may result in a fine of up to $10,000 or imprisonment for, up to 5 years, or both. Mayor Dan C,pody, Mayor of Fayetteville, Arkansas Typed Naq(e & Title of of Authorized I am unable to certif10 to above statements. My explanation is attached. EPA Form 5700-49(11-88) /075/6 7" Date EPA Project Control Number CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing 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 the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into 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 influencing or attempting to influence an officer or employee of any agency, a Member of Congress in connection with this Federal contract, grant, loan, 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 shall require that the language of this certification be included in the award documents for all sub -awards at all tiers (including sub -contracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients shall certify and disclose accordingly. This certification 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 prerequisite 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 $10,000 and not more than $100,000 for each such failure. Typed Nfr e & Title �Authoriyed Representative .Iu t1 Washington, DC 20460 FORM Approved Preaward Compliance Review Report for OMB No. 2090-0014 questing Applicants Requesting Federal Financial Assistance Re Expires: 4-30-99 Note: Read Instructions before completing form. 1. A. Applicant (Name, City, State) B. Recipient (Name, City, State) C. EPA Project No. City of Fayetteville, Arkansas City of Fayetteville, Arkansas 11. Brief description of proposed project, program or activity. Sanitary sewer rehabilitation project (EPA STAG FY2003/FY2004) for Basins 1 (1,2,3,4,5,11) and Minisystem Basins W (2,27). Project includes variety of cost-effective sanitary sewer system rehabilitation activities including slip lining, cured -in -place liners, replacement and other methods as determined during final design. The project is predicted to include over 15,000 feet of sanitary sewer lines and appurtenances. 111. Are any civil rights lawsuits or complaints pending against applicant and/or recipient? If yes, list those complaints and p Yes the disposition of each complaint. 3No IV. Have any civil rights compliance reviews of the applicant and/or recipient been conducted by any Federal agency during Yes the two years prior to this application for activities which would receive EPA assistance? If yes, list those compliance reviews and status of each review. { No V. Is any other Federal financial assistance being applied for or is any other Federal financial assistance being applied to any Yes portion of this project program or activity? If yes, list the other Federal Agency(s), describe the associated work and the dollar amount of assistance. No VI. If entire community under the applicant's jurisdiction is not served under the existing facilities/services, or will not be served under the proposed plan, give reasons why. The project is part of an ongoing program that targets areas based upon ranking and prioritization. This multi -year continuing program benefits all customers by reducing backups and overflows plus minimizes each customers user charges by reducing their charges for treatment of the excess wastewater flows. VII. Population Characteristics Number of People I. A. Population of Entire Service Area 58,047 B. Minority Population of Entire Service Area 7,836 2. A. Population Currently Being Served 57,176 B. Minority Population Currently Being Served 7,718 3. A. Population to be Served by Project, Program or Activity 57,716 B. Minority Population to be Served by Project. Program or Activity 7,718 4. A. Population to Remain Without Service 871 B. Minority Population to Remain With Service 118 VIII. Will all new facilities or alterations to existing facilities financed by these funds be designed X Yes and constructed to be readily accessible to and usable by handicapped persons? If no, explain how a regulatory exception (40 CFR 7.70) applies. �No IX. Give the schedule for future projects, programs or activities (or of future plans), by which services will be provided to all beneficiaries within applicant's jurisdiction. If there is no schedule, explain why. Small isolated remote areas of the city do not currently have central sewer service. Development, growth and utility extensions will continue to reduce the portions of the population that are unserved. All new residential developments in Fayetteville are served by central sanitary sewer service. X. I certify that the statements] have made on this form and all attachments thereto are true, accurate and complete. I acknowledge that any knowingly false or mi a ing statemep1nay be punishable by fine or imprisonment or both under applicable law. A. Sign ure, utho d ificia B. Title ofAuthorized Official C. Date Mayor of Fayetteville, Arkansas /Q S ' For the U.S. Environmental Protection Agency Approved Authorized EPA Official Date Disapproved EPA Form 4700-4 (Rev. 1/90) Previous editions are obsolete. L QUALITY MANAGEMENT PLAN x This program/project does not involve environmentally related measurements nor data generation; therefore, a Quality Management Plan is not required pursuant to the above referenced assistance regulations. This program/project involves environmentally related measurements or data generation; therefore, a Quality Management Plan which meets the requirements of: 40 CFR 30.54 for universities and non-profit organizations is attached or has been forwarded to the EPA Project Officer. 40 CFR 31.45 for State and local governments is attached or has been forwarded to the EPA Project Officer. /O /5 /ago% Date FAYETTEfILLE � THE CITY OF FAYETTEVILLE, ARKANSAS City Clerk Division 113 West Mountain Fayetteville, AR 72701 Telephone: (479) 575-8323 Fax: (479) 718-7695 city_clerk@ci.fayetteville.ar.us DEPARTMENTAL CORRESPONDENCE To: Greg Boettcher Water/Wastewater Director From: Clarice Buffalohead-Pearman City Clerk Division Date: October 12, 2004 Re: Resolution No. 15b-04 The City Council passed the above resolution October 5, 2004, authorizing the application and acceptance of a State and Tribal Assistance Grant from the U.S. EPA. I have attached the original grant application. Also attached is a copy of the resolution along with a copy of the budget adjustment for the grant revenue. This resolution will be recorded in the city clerk's office and microfilmed. If anything else is needed please let the clerk's office know. Attachment(s) cc: Nancy Smith, Internal Auditor d4& '.�/1&. /5D9 XP - 97690201 -0 Page 1 ASSISTANCE ID NO. U.S. ENVIRONMENTAL PRO DOC ID AMEND# DATE OF AWARD A XP - 97690201 - 0 SEP 1 6 M. PROTECTION AGENCY YPEOFACTION MAILINGDATF New SEP22 2 2005 Cooperative Agreement PAYMENT METHOD: ACH# A7 ACH RECIPIENT TYPE: Send Payment Request to: Municipal Las Vegas Finance Center RECIPIENT: PAYEE: City of Fayetteville City of Fayetteville 113 West Mountain Street 113 West Mountain Street Fayetteville, AR 72701 Fayetteville, AR 72701 EIN: 71-6018462 PROJECT MANAGER EPA PROJECT OFFICER EPA GRANT SPECIALIST David Jurgens Rajen Patel Linda Lyons 113 West Mountain Street Water Quality Protection Division, 6WQ-AP Procurement and Grants Section, 6MD-RX Fayetteville, AR 72701 E -Mail: Lyons.Linda@epamail.epa.gov E -Mall: djurgens@ci.fayetteville.ar.us E -Mall: Patel.Rajen@epamail.epa.gov Phone: 214-665-7419 Phone: 479-575-8336 Phone: 214-665-2788 PROJECT TITLE AND DESCRIPTION AR -Sanitary Sewer Rehabilitation Project The project consists of rehabilitation of sanitary sewer main and point repairs at various locations in the City. Rehabilitation of sewer lines will utilize open cut replacement, cured -in -place piping and pipe bursting methods. The project is anticipated to significantly reduce the inflow/infiltration in the entire project area. thereby reducing the maintenance cost and sewer main blockages. BUDGET PERIOD PROJECT PERIOD TOTAL BUDGET PERIOD COST TOTAL PROJECT PERIOD COST 06/30/2005 - 09/30/2007 06/30/2005 - 09/30/2007 $1,928,182.00 $1,928,182.00 NOTE: The Agreement must be completed In duplicate and the Original returned to the appropriate Grants Management Office listed below, within 3 calendar weeks after receipt or within any extension of time as may be granted by EPA Receipt of a written refusal or failure to return the properly executed document within the prescribed time, may result in the withdrawal of the offer by the Agency Any change to the Agreement by the Recipient subsequent to the document being signed by the EPA Award Official, which the Award Official determines to materially alter the Agreement, shall void the Agreement. OFFER AND ACCEPTANCE The United States, acting by and through the U.S. Environmental Protection Agency (EPA), hereby offers Assistance/Amendment to the City of Fayetteville for 55.00 % of all approved costs Incurred up to and not exceeding _ $1.060.500 for the support of approved budget period effort described in application (including all application modifications) cited in the Project Title and Description above, signed 0111912005 included herein by reference. ISSUING OFFICE (GRANTS MANAGEMENT OFFICE) AWARD APPROVAL OFFICE ORGANIZATION I ADDRESS ORGANIZATION I ADDRESS Management Division. 6MO-RX U.S. EPA, Region 6 1445 Ross Avenue, Suite 1200 Water Quality Protection Division (6WQ) Dallas, TX 75202-2733 1445 Ross Avenue Dallas, TX 75202-2733 THE UNITED STATES OF AMERICA BY THE U.S. ENVIRONMENTAL PROTECTION AGENCY SIGNATURE OF AWARD OFJICIAL TYPED NAME AND TITLE DATE Miguel I. Flores, Director Water Quality Protection Division (6WQ) SEP 1 5 This agreement is subject to applicable U.S. Environmental Protection Agency statutory provisions and assistance regulations. In accepting this award or amendment and any payments made pursuant thereto, (1) the undersigned represents that he is duly authorized to act on behalf of the recipient organization, and (2) the recipient agrees (a) that the award is subject to the applicable provisions of 40 CFR Chapter 1, Subchapter B and of the provisions of this agreement (and all attachments), and (b) that acceptance of any payments constitutes an agreement by the payee that the amounts, if any found by EPA to have been overpaid will be refunded or credited In full to EPA. B ND ON BEHALF OF THE DESIGNATED RECIPIENT ORGANIZATION SIGNATURE TYPED NAME AND TITLE DIET ,-' Dan Coody. Mayor y EPA Funding Information XP -97690201-0 Page 2 FUNDS FORMER AWARD THIS ACTION AMENDED TOTAL EPA Amount This Action $ $ 1,060.500 $ 1.060,500 EPA In -Kind Amount $ $ $ 0 Unexpended Prior Year Balance $ S $ 0 Other Federal Funds $ S $ 0 Recipient Contribution $ $ 867,682 $ 867,682 State Contribution $ $ S 0 Local Contribution $ $ SO Other Contribution $ S SO Allowable Project Cost S 0 $ 1,928,182 $ 1,928.182 Assistance Program (CFDA) Statutory Authority Regulatory Authority 66.606 - Surveys - Studies - Investigations and Consolidated Appropriations Act of 2004 (PL 40 CFR PART 31 Special Purpose Grants 108-199) Consolidated Appropriations Resolution 2003 (PL 108-7) Fiscal Site Name DCN FY Approp. Code Budget Organization PRC Object Class Site/Project Cost Organization Obligation I Deobllgatlon • WA0016 05 E4C 0600OOM 202851 4183 1,060,50 1.060.500 XP - 97690201 - 0 Page 3 Approved Budget Program Element Classification (Construction) Approved Allowable Budget Period Cost 1. Administration Expense $0 2. Preliminary Expense $0 3. Land Structure, Right Of Way $0 4. Architectural Engineering Basic Fees $0 5. Other Architectural Engineering Fees $0 6. Project Inspection Fees $0 7. Land Development $0 8. Relocation Expenses So 9. Relocation Payments to Individuals & Bus. $0 10. Demolition and Removal $0 11. Construction and Project Improvement $1,928,182 12. Equipment $0 13. Miscellaneous $0 14. Total (Lines 1 thru 13) $1.928.182 15. Estimate Income $0 16. Net Project Amount (Line 14 minus 15) $1,928,182 17. Loss: Ineligible Exclusions $0 18. Add: Contingencies $0 19. Total (Share: Recip 45.00% Fed 55.00%) $1,928,182 20. TOTAL APPROVED ASSISTANCE AMOUNT $1.060.500 XP -97690201-0 Page 4 Administrative Conditions This Assistance Agreement is awarded in accordance with the Federal Grants and Cooperative Agreement Act of 1977. Areas of substantial EPA involvement, beyond the normal exercise of performance evaluation and program review, have been detailed in specific output objectives which resulted from negotiation between EPA and the recipient. These areas are included in the application for this award and have become a part of this Agreement. The recipient covenants and agrees that it will expeditiously initiate and timely complete the project work for which assistance has been awarded under this Agreement, in accordance with all applicable provisions of 40 CFR Chapter 1, Subchapter B. The recipient warrants, represents, and agrees that it and all its contractors, employees and representatives, will comply with all APPLICABLE provisions of 40 CFR Chapter 1, Subchapter B, INCLUDING BUT NOT LIMITED TO the provisions of 40 CFR Parts 31, 32, 34, and 35. This award may be reduced or terminated at such time the recipient fails to comply with the program objectives, grant award conditions, or Federal reporting requirements. 2. Recipient standards of administration, property management, procurement and financial management, as well as records and facilities of recipients, their contractors and subcontractors are subject to audit and inspection by the Comptroller General of the United States and the U.S. Environmental Protection Agency in accordance with Office of Management and Budget (OMB) Circulars A-87, A-102, or A -I 10, as appropriate, A-133 and 40 CFR Part 31. The recipient's standards governing procurement will be in accordance with 40 CFR, Part 31.36 and OMB Circular A- 102. The recipient shall maintain a financial management system which meets the requirements of 40 CFR Part 31.20. 3. Any State agency or agency of a political subdivision of a State which is using appropriated Federal funds shall comply with the requirements set forth in Section 6002 of the Resource Conservation and Recovery Act (RCRA) (42 U.S.C. 6962). Regulations issued under RCRA Section 6002 apply to any acquisition of an item where the purchase price exceeds $10,000 or where the quantity of such items acquired in the course of the preceding fiscal year was $10,000 or more. RCRA Section 6002 requires that preference be given in procurement programs to the purchase of specific products containing recycled materials identified in guidelines developed by EPA. These guidelines are listed in 40 CFR 247. 4. In accordance with EPA Order 1000.25 and Executive Order 13101, Greening the Government Through Waste Prevention, Recycling, and Federal Acquisition, the recipient agrees to use recycled paper for all reports which are prepared as a part of this agreement and delivered to EPA. This requirement does not apply to reports prepared on forms supplied by EPA, or to Standard Forms, which are printed on recycled paper and are available through the General Services Administration. Please note that Section 901 of Executive Order 13101, dated September 14, 1998, revoked Executive Order 12873, Federal Acquisition, Recycling, and Waste Prevention in its entirety. 5. In accordance with 40 CFR Part 31.41, the recipient shall submit an annual Financial Status Report (FSR), Standard Form 269 or 269A, to: Grants Team (6MD-RX) Environmental Protection Agency, The final Financial Status Report (FSR) is due on or before 90 days after the end of the budget period. In accordance with Agency policy, all project expenditures reported by the recipient shall be deemed to include both the Federal and recipient share of the expenditures. For construction grants when required in accordance with 40 CFR Part 31.41(e)(2)(iii), the Federal agency may substitute the Financial Status Report specified in Part 31.41(b) for the Outlay Report and Request for Reimbursement, Standard Form 271. The final Financial Status Report (FSR) shall be submitted to: Protection Agency Las Vegas Finance Center Las Vegas, Neveda 89193-8515 The recipient agrees to ensure that all conference, meeting, convention, or training space funded in whole or in part with federal funds, complies with the Hotel and Motel Fire Safety Under the Paperwork Reduction Act of 1995, Office of Management and Budget (OMB) clearance must be obtained prior to collecting information from 10 or more persons and will use EPA's name while collecting the information under this project. The term "person" means an individual, partnership, association, corporation, business, trust, or legal representative, an organized group of individuals, a State, territory, or local government or branch thereof, or a political subdivision of a State, territory, or local government or a branch of a political subdivision. The EPA Project Officer is responsible for requesting clearance In accordance with OMB Circular A-133, the recipient shall obtain a single audit if it expends S500,000 or more a year in federal awards. The recipient shall also submit a copy of the audit report to: Grants Team (6MD-RX) Environmental Protection Agency, Region 6 The Federal share of allowable expenditures chargeable to this assistance project will be financed by the EPA AUTOMATED CLEARING HOUSE (EPA-ACH) PAYMENT SYSTEM. The recipient will strictly adhere to the accounting and reporting procedures described in the EPA-ACH Recipient's Manual for the duration of the project. Four conditions should receive special attention: a. Cash drawdowns will be made only as actually needed for disbursements. The recipient will provide timely reporting of cash disbursements and balances through semi-annual submission (within fifteen (15) days after June 30 and December 31 of each calendar year) of the Federal Cash Transactions Report (SF -272) to: U.S. Environmental Protection Agency Las Vegas Finance Center P.O. Box 98515 Las Vegas, Nevada 89193-8515 c. The recipient will impose the same standards of timing and reporting on secondary recipients, if any. d. When a drawdown under the EPA-ACH Payment System occurs, the recipient must show the Assistance Agreement Number(s) under "Financial Data" on the EPA-ACH Payment Request Form. Requests for payment should be faxed to: (702) 798-2411 Las Vegas Finance Center Attention: Anedia Feaster 10. The recipient agrees to comply with the requirements of EPA's Program for Utilization of Small, Minority and Women's Business Enterprises in procurement under assistance agreements: a. The recipient accepts the applicable FY 2003 Minority Business Enterprise (MBE)/Women's Business Enterprise (WBE) "fair share" goals/objectives negotiated with the Arkansas Department of Environmental Quality as follows: MBE: CONSTRUCTION - 0%; SUPPLIES - 1.0%; SERVICES - .7%; EQUIPMENT - 1.91% WBE: CONSTRUCTION - 0%; SUPPLIES - 4.3%; SERVICES - 5.4%; EQUIPMENT - 3.35% If the recipient wishes to negotiate their own FY 2005 MBE/WBE goals, the recipient must submit proposed MBE/WBE goals based on an availability analysis, or, at their option, a disparity study, of qualified MBEs and WBEs to do the work in the relevant market for construction, services, supplies and equipment. The recipient agrees to submit proposed "fair share" objectives, together with the supporting availability analysis or disparity study, to the Regional MBE/WBE Coordinator within 30 days of award. EPA will conclude "fair share" negotiations within 30 days of receiving the submission. Once EPA approves the objectives, the recipient agrees to apply them in accordance with paragraphs l.(b)-(t). b. (1) The recipient agrees to ensure, to the fullest extent possible, that at least the applicable "fair share" objectives of Federal funds for prime contracts or subcontracts for supplies, construction, equipment or services are made available to organization owned or controlled by socially and economically disadvantaged individuals, women and Historically Black Colleges and Universities. (2) For assistance agreements related to research under the Clean Air Act Amendments of 1990, the recipient agrees to ensure, to the fullest extent possible, that at least the applicable "fair share" objectives of Federal funds for prime contracts or subcontracts for supplies, construction, equipment or services are made available to organizations owned or controlled by socially and economically disadvantaged individuals, women, disabled Americans, Historically Black Colleges and Universities, Colleges and Universities having a student body in which 40% or more of the students are Hispanic, minority institutions having a minority student body of 50% or more, and private and voluntary organizations controlled by individuals who are socially and economically disadvantaged. The recipient agrees to include in its bid documents the applicable "fair share" objectives and require all of its prime contractors to include in their bid documents for subcontracts the negotiated "fair share" percentages. d. The recipient agrees to follow the six affirmative steps or positive efforts stated in 40 CFR Section 30.44(b), 31.36(e), or 35.6580, as appropriate, and retain records documenting compliance. e. The recipient agrees to submit an EPA form 5700-52A "MBE/WBE Utilization Under Federal Grants, Cooperative Agreements and Interagency Agreements" beginning with the Federal fiscal year quarter the recipient receives the award and continuing until the project is completed. These reports must be submitted to the Regional MBE/WBE Coordinator within 30 days of the end of the Federal Fiscal quarter (January 30, April 30, July 30, and October 30). For assistance awards for continuing environmental programs and assistance awards with institutions of higher education, hospitals and other non-profit organizations, the recipient agrees to submit an EPA form 5700-52A to the Regional MBE/WBE Coordinator by October 30 of each year. (Reporting form available at www.ena.gov/osdbu.) f. If race and/or gender neutral efforts prove inadequate to achieve a "fair share" objective, the recipient agrees to notify EPA in advance of any race and/or gender conscious action it plans to take to more closely achieve the "fair share" objectives. 11. The recipient also agrees and is required to utilize the six affirmative steps if a contract is awarded under this agreement relative to small businesses in rural areas (SBRAs) in compliance with Section 129 of Public Law 100-50, 40 CFR 30.44(b) and 40 CFR 31.36(e). 12. EPA may take corrective action under 40 CFR Parts 30, 31, and 35, as appropriate, if the recipient fails to comply with the MBE/WBE terms and conditions. 13. The Recipient agrees that upon receipt of this funding assistance award, that the enclosed SF -3881 (ACH Vendor/Miscellaneous Payment Enrollment Form) will be completed and returned to the EPA Las Vegas Finance Center. The Recipient should further contact the EPA Project Officer listed on the first page of the Cooperative Agreement to obtain instructions for setting up the A Dual Signatory Process @ in the Electronic Funds Transfer (EFT) System. Thereafter, the Recipient will be supplied with appropriate forms and instructions for requesting reimbursements. 14. The assistance recipient agrees to comply with Executive Order 13202 (Feb. 22, 2001, 66 Fed. Reg. 11225 ) of February 17, 2001, entitled "Preservation of Open Competition and Government Neutrality Towards Government Contractors' Labor Relations on Federal and Federally Funded Construction Projects," as amended by Executive Order 13208 (April II, 2001, 66 Fed. Reg. 18717) of April 6, 2001, entitled "Amendment to Executive Order 13202, Preservation of Open Competition and Government Neutrality Towards Government Contractors' Labor Relations on Federal and Federally Funded Construction Projects. 15. In accordance with 40 CFR 30.27(b) or 31.36(j)(1), EPA's participation in the salary (excluding overhead) paid to individual consultants is limited to the maximum hourly rate for a level 4 of the Executive Schedule, which is currently approximately $67.22 per hour or 5537.76 per day (2005). 16. Pursuant to EPA's annual Appropriations Act, the chief executive officer of this recipient agency shall require that no grant funds have been used to engage in lobbying of the Federal Government or in litigation against the United States unless authorized under existing law. As mandated by this Act, the recipient agrees to provide certification to the award official via EPA Form 5700-53, Lobbying and Litigation Certificate , within 90 days after the end of project period. The form can be accessed at http://www.epa.gov/ogd/forms/adobe/5700-53.pdf. 17. Recipient shall abide by its respective OMB Circular (A-21, A-87, or A-122), which prohibits the use of federal grant funds for litigation against the United States. Any Part 30 recipient shall abide by its respective OMB Circular (A-21 or A-122), which prohibits the use of Federal grant funds to participate in various forms of lobbying or other political activities. 18. The recipient agrees to comply with Title 40 CFR Part 34, New Restrictions on Lobbying The recipient shall include the language of this provision in award documents for all subawards exceeding $100,000, and require that subrecipients submit certification and disclosure forms accordingly. 19. In accordance with the Byrd Anti -Lobbying Amendment, any recipient who makes a prohibited expenditure under Title 40 CFR Part 34 or fails to file the required certification or lobbying forms shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such expenditure. 20. Recipient shall fully comply with Subpart C of 40 CFR Part 32, entitled "Responsibilities of Participants Regarding Transactions." Recipient is responsible for ensuring that any lower tier covered transaction, as described in Subpart B of 40 CFR Part 32, entitled "Covered Transactions," includes a term or condition requiring compliance with Subpart C. Recipient is responsible for further requiring the inclusion of a similar term or condition in any subsequent lower tier covered transactions. Recipient acknowledges that failing to disclose the information required under 40 CFR 32.335 may result in the delay or negation of this assistance agreement, or pursuance of legal remedies, including suspension and debarment. 21. Recipient may access the Excluded Parties List System at wwweols.eov. This term and condition supersedes EPA Form 5700-49, "Certification Regarding Debarment, Suspension, and Other Responsibility Matters." 22. Allowable pre -award costs are approved starting June 30, 2005. Programmatic Conditions In accordance with the National Environmental Policy Act (NEPA), 42 U.S.C. § 4321 et sea., EPA is required to conduct an environmental review on the project funded by this grant. Accordingly: The recipient agrees to provide EPA, in a timely fashion, an environmental information document (EID) containing all the necessary information on the project including a written analysis of the alternatives and the environmental impacts of the project. The EID must be of sufficient scope and detail to enable EPA to perform an environmental review under NEPA and other Federal environmental statutes. The recipient agrees not to take any action on the project beyond conceptual design (Conceptual design is essentially the same as facility planning as defined in EPA's Construction Grants program), including but not limited to, beginning the preparation of plans and specifications, purchasing land, advertising or awarding design and/or construction contracts, initiating construction or requesting reimbursement from EPA for costs associated with such actions until such time as EPA has completed its environmental review in accordance with NEPA and 40 CFR Part 6 and 1500 et sea. Completion of this review will be evidenced by the issuance of a Categorical Exclusion (CE), the conclusion of the Finding of No Significant Impact (FNSI) process, or the issuance of a Record of Decision (ROD). The recipient agrees that, upon completion of the NEPA review, design and construction shall be undertaken in accordance with the results of that review, including but not limited to, the implementation of measures EPA identifies as reasonable to mitigate the environmental impacts of the project. EPA reserves the right to unilaterally terminate this grant in the event the recipient fails to comply with this condition, in accordance with 40 CFR Section 31.43. 2. This award is subject to all applicable Federal crosscutting laws and authorities as well as EPA, Office of Wastewater Management, policy guidance dated April 15, 2002 - attached hereto as Attachment A. 3. The recipient will work with the EPA Las Vegas Finance Center (LVFC) to setup the U.S. Department of Treasury's "Automated Standard Application For Payment" (ASAP) system. ASAP is an electronic payment system that the recipient will access via the Internet. Once enrolled in ASAP, the recipient should contact their EPA Project Officer for instructions on submitting the payment requests. The recipient will submit the reimbursement request Standard Form (SF) 271 (Attachment B) and appropriate invoices to their Project Officer for approval. When the Project Officer approves the payment, they will notify the recipient to withdraw the approved amount from the ASAP system. If the recipient has not completed the enrollment process for ASAP and is requesting payment, the recipient should contact their Project Officer to obtain instructions for setting up the "Dual Signatory Process" in the EPA "Automated Clearing House" (ACH) payment system. Once the recipient has been setup in ACH, the recipient will submit their payment requests to the Project Officer. The recipient will submit the reimbursement request SF -271, appropriate invoices, and the Payment Request Form (Attachment B) to their EPA Project Officer for approval. Recipients using ACH will be required to complete their enrollment in the ASAP system. Once enrolled in the ASAP system, the recipient will follow the procedures outlined in the paragraph above. 4. The recipient agrees to provide locational information/data (e.g., latitude and longitude) of the proposed project in accordance with instructions to be provided by EPA and submit the information to EPA Project Officer for its inclusion in an EPA national database. Federal laws and regulations shall apply except in those cases where State requirements are more stringent than Federal requirements. Where questions arise as to applicability, the EPA Project Officer should be contacted. 6. As a part of the environmental review, the recipient will ensure that all environmental review documentation developed will be consistent with the EPA Region 6 document, NEPA Handbook for SpecialAppropriation Projects, Attachment C. 7. Project management and execution will be very closely monitored by EPA representatives throughout the assistance agreement's project and budget periods. Effective implementation of the scope of work involves a jointly supported strong ongoing collaboration between the recipient and EPA. Technical assistance and coordination will be routine. EPA and the recipient will maintain a continuous dialogue for the rapid identification, solution, and escalation of problems to top level managers. In addition, EPA representatives will be specifically responsible for assuring that the following post -award activities take place: Review of periodic payment requests; Interim inspections; Review of change orders and claims; Review and approval of final payment requests; Analysis of environmental review documents for NEPA-compliance, if appropriate; and Determination that the project is capable of meeting its objectives. Also, EPA representatives will assure that the recipient understands and meets requirements related to the National Environmental Policy Act and numerous cross -cutting Federal authorities. 8. EPA Region 6 "Supplemental Conditions for Federally Assisted Water and Wastewater Treatment Facilities" attached hereto as Attachment D, must be included in all construction contract bidding documents, and shall control where a conflict arises with other contract provisions. Certain provisions also pertain to professional services contracts, and these provisions must be applied as appropriate. 9. Executed site certificate(s) shall be submitted to the EPA Project Officer, as evidence that sites, easements and rights -of -way have been acquired. 10. The recipient will ensure that any design and construction performed under this assistance agreement shall be consistent with the EPA document, Guidance on Quality Assurance for Environmental Technology, Design, Construction and Operation (EPA QA/G- 11), Attachment E. 11. All of the following must be submitted to and approved by EPA before recipient may advertise for bids for construction. 1. Plans and specifications and addenda to the plans and specifications. Architect/Engineer (A/E) agreement for construction services. c. A project schedule. All change orders executed after the award of contract must be submitted and approved by EPA. 12. The recipient agrees to submit proposed and existing procurement actions, including subcontracts, that will use EPA assistance for review as soon as available. All procurement actions must comply with the provisions of 40 CFR Part 31, specifically 40 CFR 31.36. 13. The recipient also agrees to provide forty-five (45%) percent of project costs with nonfederal matching funds. 14. The recipient agrees to meet the project schedule provided with the grant application or the most recent amended schedule approved by the EPA Project Officer unless justifiable delays occur due to unexpected circumstances. 15. The recipient understands that the use of recipient's work force to perform grant -funded construction is subject to provisions of OMB Circular No. A-87. Recipient agrees that the rates paid for direct labor and the types of fringe benefits for recipient's work force performing grant -funded construction will be in accordance with normal rates and benefits applicable to similar work performed by recipient's work force. Recipient agrees to maintain adequate file information to support both the basis for pay rates and benefits, and the total costs charged to the grant. p. RESOLUTION NO.156-04 z003 A RESOLUTION AUTHORIZING THE MAYOR TO APPLY FOR AND ACCEPT A STATE. AND TRIBAL ASSISTANCE GRANT (STAG) FROM THE U. S. ENVIRONMENTAL. PROTECIiON AGENCY FOR SANITARY SEWER SYSTEM IMPROVEMENTS; DFSIGNATING THE MAYOR AS THE CITY'S AUTHORIZED REPRESENTATIVE IN ALI., MATTERS RELATING TO 'I7-ll.: I'ROCUREMENT AND ADMINISTRATION OF SAID GRANT; AND APPROVING A BUDGET ADJUSTMENT RECOGNIZING $1,060,500.00 IN GRANT REVENUE. BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS: Section 1. That the City Council of the City of Fayetteville, Arkansas hereby authorizes the Mayor to apply for and accept a State and Tribal Assistance Grant (STAG) from the U. S. Environmental Protection Agency for sanitary sewer system improvements. Section 2. That the City Council of the City of Fayetteville, Arkansas hereby designates the Mayor as the City's Authorized Representative in all matters relating to the procurement and administration of said grant: Section 3. That the City Council of the City of Fayetteville, Arkansas hereby approves a budget adjustment recognizing $1,060,500.00 in grant revenue. PASSED and APPROVED this 5'h day of October 2004. A • .Fs gyp= :FAYETTEVILLE: = B' • . a A'ITFSI': ,�'�.;ti'GT0H 1 B3y: SONDRA SMITH, City Clerk lit w�5 OMB CONTROL NO.2030.0020 7f l9 /06 APPROVED: 12/30/02 APPROVAL EXPIRES: 12/31/05 C-� anti U.S. ENVIRONMENTAL PROTECTION AGENCY MBE/WBE UTILIZATION UNDER FEDERAL GRANTS, COOPERATIVE 3rd Quw tr AGREEMENTS, AND INTERAGENCY AGREEMENTS Aport PART 1. (Reports are required even if no procurements are made during the reporting period.) 1A. FEDERAL FISCAL YEAR 1B. REPORTING QUARTER (Check appropriate box) 200 6 0 1" (Oct -Dec) 0 2n° (Jan -Mar) x 3"1(AprJun) 0 4'" (Jul -Sep) 0 Annual 1C. REVISION HIGHLIGHT ITEMS TO BE REVISED AND PROVIDE EXPLANATION IN BLOCK No. 6 Year: Quarter: 2A. FEDERAL FINANCIAL ASSISTANCE AGENCY 3A. REPORTING RECIPIENT (Name and Address) (EPA Office Address - ATTN: DBE Coordinator) W.S. Environmental Protection Agency City of Fayetteville First Interstate Bank Tower at Fountain Place 1445 Ross Avenue, 12th Floor Suite 1200 113 West Mountain St. Dallas, TX 75202-2733 Fayetteville, AR 72701 2B. REPORTING CONTACT 2C. PHONE: 3B. REPORTING CONTACT (Recipient) 3C. PHONE: (EPA DBE Coordinator) (214)665-7406 Mayor Dan Coody (479) 575-8330 Debora N. Bradford, SDBUO 4A. FINANCIAL ASSISTANCE AGREEMENT ID NUMBER 4B. FEDERAL FINANCIAL ASSISTANCE PROGRAM (SRF State Recipients, Refer to Instructions for Completion of 4A, 5A, and SC) STAG Grant XP -97690201-0 5A. TOTAL ASSISTANCE AGREEMENT 5B. Check and skip to Block 5C. TOTAL PROCUREMENT AMOUNT THIS REPORTING AMOUNT No. 7 if no procurements PERIOD (ONLY include the amount not in any prior reporting and accomplishments period and procurements made by SRF Loan Recipients and Sub - EPA Share: $_1.060500 were made this reporting Recipients) period. $ (Exclude procurement amounts reported by Prime Contractors) Recipient Share: $ 867.682 5D. ACTUAL MBENVBE PROCUREMENT ACCOMPLISHED THIS 5E. ACTUAL MBEANBE PROCUREMENT ACCOMPLISHED THIS REPORTING PERIOD BY RECIPIENT (SRF State Recipients, Report REPORTING PERIOD BY LOAN RECIPIENTS, SUB -RECIPIENTS, State Procurement Activities Here) AND PRIME CONTRACTORS $ MBE $ WBE $ MBE $ WBE Construction Construction Equipment Equipment Services Services Supplies Supplies TOTAL TOTAL 6. COMMENTS: 7. NAME OF AUTHORIZED REPRESENTATIVE TITLE Mayor Dan Coody 8. GNATURREE OF AUTHORIZED REPRESENTATIVE DATE `& t D EPA F M 57 -52A - (5/96) available electronically at http://www.epa.gov/osdbu/570052a.pdf NOTE: THIS R IS DUE 30 DAYS AFTER THE END OF EACH FEDERAL FISCAL QUARTER OR ANNUAL SUBMISSION DATES ARE: January 30, April 30, July 30, and October 30* *SUBMISSION DATE FOR ANNUAL REPORTS 01/19/2006 14:50 501-682-0561 ANRC WRDD PAGE 02/02 APPROVA� ©p �V) U.S. ENVIRONMENTAL PROTECTION AGENCY MBE/BE UTILIZATION UNDER FEDERAL GRANTS, COOPERATIVE AGREEMENTS, AND INTERAGENCY AGREEMENTS //, PART I. (Rgt,orts are reasircdeven if DD Droearements are made during the retam_g ep riod-) US_ PA &II IA FEDERAL FISCAL 11B. REPORTING QUARTER (Check appropriate box) YEAR I' (Oa -Dec) ® 2d (Jae -Mar) 31° (AptInn) 0 (Jul -Sep) D Annual 2006 IC, REVISION I HIGHLIGHT ITEMS TO BE REVISED AND PROVIDE EXPLANATION IN BLOCK No. 6 Year. +I Quartrr. 2A, FEDERAL FINANCIAL ASSISTANCE AGENCY (EPA Office 3A. REPORTING RECIPIENT (Name and Address) Address - ATTN: DBE Coordinator) CITY OF FAYETTEVILLE ARKANSAS NATURA L RESOURCES COMMISSION 113 WEST MOUNFAIN 107 E-0Sf CAEffOL, SUITE 350 FAYETTEVILLE, ARKANSAS 72701 LITTLE ROCK, ARKANSAS 72201 2B. REPORTING CONTACT 2C. PHONE 35, REPORTING CONTACT ( Pte) : 3C. PHONE: (EPA DBE Coordlnatrx) (501) 683-0279 MAYOR DAN COODY SCOTT SAVOY (479)575-8790 4A. FINANCIAL ASSISTANCE AGREEMENT ID NUMBER 4B. FEDERAL FINANCIAL ASSISTANCE PROGRAM CLEAN WATER (SRI' State Rccipknts, Refer to Instructions for Compksion of4A. 5A, REVOLVING LOAN FUND and SC) 00183-CWRLF-L 5A. TOTAL ASSISTANCE 5B. Check and skip to Block 15C. TOTAL PROCUREMENT AMOUNT THIS REPORTING PERIOD AGREEMENT AMOUNT No. 7 If no prowtements and (ONLY include the amount not in any prior reporting period and procurements acvauplisimmnts were made made by SRI' Loan RecipLt, and Sub- Recipients) EPA Share: S7.S.000A00 this reporting period, g s Recipient Share: 53. SANAOo I I (Exclude procurement amounts reported by Prime CmMmtors) 5D. ACTUAL MBE WBE PROCUREMENT ACCOMPLISHED THIS REPORTING PERIOD BY RECIPIENT (SRP State Reci , .... . Report Sbdc Procurement Activities Here) SMBE SWBE Contrnetion Equipment Services Supplies TOTAL 5E. ACTUAL MBEJWEE PROCUREMENT ACCOMPLISHED THIS REPORTING PERIOD BY LOAN RECIPIENTS, SUB-RtCWIENfl AND PIU1vfE CONTRACTORS SMBE SWBE Coastructlon Equipment Services Supplies TOTAL TITLE MAYOR 26 EP(V FORM 5700-52A.(5/a6).veaabk eteafmme.0y as Atra:/Jwwweocaov10sJ28 57 52gr'Af NOTE: flfl&Rgtt IS DUE 30 DAYS AFTER THE END OF EACH FEDERAL FISCAL QUARTER OR ANNUAL: SUBMIMON DATE$ ARE: January 30, Apra 30. by J0. and Octebw 30• •ANNUAL REPORT 015 04 1/31/2006 8:51:35 City of Fayetteville Maintenance/Inquiry Docurnnt Item Action Reference Date Ref. Taken Brief Description W/S 9/27/2005 GRANT US EPA Cooperative Agreement - - - - - - - - - - - - - - - - - - - - - - - - - - Keywords....... - - - - - - - - - - - - . . .....: US EPA Cooperative Agreement US EPA agreement Water Quality $1,928,182.00 grant award grant Res. 156-04 File Reference #......: microfilm Security Class........: Retention Type: Expiration Date.......: **** Active **** Date for Cont/Referred: Name Referred to......: Press Cmd 6 to Update Cmdl-Return Cmd2-Check Out Cmd8-Retention Cmd3-End Press 'ENTER' to Continue Cmd5-Abstract Yes No (c) 1986-1992 Munimetrix Systems Corp. 015 08 City of Fayetteville 1/31/2006 Maintenance/Inquiry 8:52:04 Document Item Action Reference Date Ref. Taken Brief Description W/S 9/27/2005 GRANT USEPA Cooperative Agreement - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Abstract: XP -97690201-0 Grant Award Sept. 15, 2005 The United States, acting by and throught U.S. Environmental Protection Agency (EPA), hereby offers Assistance/Amendment to the City of Fayetteville for 55.00% of all approved costs incurred up to & not exceeding $1,060,500 for the support of approved budget period effort described in application cited in the Project Title & Description above signed 1/19/05 Cmdl-Return Cmd3-End Press 'ENTER' to Continue (c) 1986-1992 Munimetrix Systems Corp. From: Clarice Pearman To: Jurgens, David Subject: US EPA Cooperative Agreement report David, Attached is a copy of the above report for 2006. CC: Bell, Peggy; Deaton, Vicki