Okaloosa County BOCC — January 19, 2016 — Bluewater Bay MSBU Agreement — reading text

information and return the signed form to the Division as requested. PROJECT #: 4177-06-R FUNDING AGENCY: Federal Emergency Management Agency AWARD AMOUNT: $97,680.00 OBLIGATION/ACTION DATE: June 23, 2015 SUBAWARD DATE (if applicable): DUNS#: 613277649 DUNS# +4: 38 *If your company or organization does not have a DUNS number, you will need to obtain one from Dun & Bradstreet at 866-705-5711 or use the web form (http://fedgov.dnb.com/webform). The process to request a DUNS number takes about ten minutes and is free of charge. BUSINESS NAME: Okaloosa, County of DBA NAME (IF APPLICABLE): PRINCIPAL PLACE OF BUSINESS ADDRESS: ADDRESS LINE 1: 101 East James Blvd., Rm 104, Crestview, FL 32536-3552 ADDRESS LINE 2: 101 East James Blvd., Room 104 ADDRESS LINE 3: CITY Crestview STATE FL ZIP CODE+4** 32536-3552 PARENT COMPANY DUNS# (if applicable): CATALOG OF FEDERAL DOMESTIC ASSISTANCE (CFDA#): 97.039 DESCRIPTION OF PROJECT (Up to 4000 Characters) The purpose of this Scope of Work (SOW) is to improve drainage for Okaloosa County, Florida; funded through the Hazard Mitigation Grant Program (HMGP), DR-4177-06-R, as approved by the Florida Division of Emergency Management (Division) and the Federal Emergency Management Agency (FEMA). The Recipient, Okaloosa County shall conduct Phase I of this project, which includes the preliminary engineering designs and calculations, surveys, permitting, and notices. No construction activities are approved at this time. The Recipient shall complete the Phase I work in accordance with all applicable federal, state and local laws, regulations and codes. All Phase I activities and deliverables shall be completed and submitted to the Division prior to June 23, 2016. PROJECT OVERVIEW: As a Hazard Mitigation Grant Program project, the Recipient proposes to improve the drainage for the areas Southwind Drive, Dominica Way, Aruba Way and Curacao Way in Niceville, Florida 32578. The Phase I design shall implement measures to determine modifications needed to improve the drainage and alleviate flooding. Mitigation activities for phase I shall include: • A topographic survey of the drainage basin to confirm the basin boundaries, pipe invert elevations, inlet top elevations, and other drainage features. • A hydraulic study and recommended improvements to the drainage system to mitigate future flooding. • Designs and permitting. Phase II is expected to include a series of pipe replacement improvements in four separate locations. The work shall include removal of existing pipe and drainage structures as necessary, followed by the installation of new reinforced concrete pipes and inlets consistent with the upgrade recommendations of the hydraulic study. The improvements, when completed, shall minimize or eliminate future structural damage and provide protection to the surrounding properties in the area; minimize recurring flooding and reduce repetitive flood loss to properties. The completed project shall provide protection against a 25-year storm event. 39  Verify the approved project description above, if there is any discrepancy, please contact the project manager. PRINCIPAL PLACE OF PROJECT PERFORMANCE (IF DIFFERENT THAN PRINCIPAL PLACE OF BUSINESS): ADDRESS LINE 1: This project will occur at various places throughout the drainage basin at locations ADDRESS LINE 2: to be determined in the course of the study. It is not possible to provide discreet ADDRESS LINE 3: Address locations. CITY Unincorporated Niceville Area STATE FL ZIP CODE+4** CONGRESSIONAL DISTRICT FOR PRINCIPAL PLACE OF PROJECT PERFORMANCE: **Providing the Zip+4 ensures that the correct Congressional District is reported. EXECUTIVE COMPENSATION INFORMATION: 1. 1. In your business or organization’s previous fiscal year, did your business or organization (including parent organization, all branches, and all affiliates worldwide) receive (a) 80 percent or more of your annual gross revenues from Federal procurement contracts (and subcontracts) and Federal financial assistance (e.g. loans, grants, subgrants, and/or cooperative agreements, etc.) subject to the Transparency Act, as defined at 2 CFR 170.320; , (b) $25,000,000 or more in annual gross revenues from U.S. Federal procurement contracts (and subcontracts) and Federal financial assistance (e.g. loans, grants, subgrants, and/or cooperative agreements, etc.) subject to the Transparency Act? Yes ___ No _X__ If the answer to Question 1 is “Yes,” continue to Question 2. If the answer to Question 1 is “No”, move to the signature block below to complete the certification and submittal process. 2. Does the public have access to information about the compensation of the executives in your business or organization (including parent organization, all branches, and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) Section 6104 of the Internal Revenue Code of 1986? Yes No If the answer to Question 2 is “Yes,” move to the signature block below to complete the certification and submittal process. [Note: Securities Exchange Commission information should be accessible at http//www.sec.gov/answers/execomp.htm. Requests for Internal Revenue Service (IRS) information should be directed to the local IRS for further assistance.] If the answer to Question 2 is “No” FFATA reporting is required. Provide the information required in the “TOTAL COMPENSATION CHART FOR MOST RECENTLY COMPLETED FISCAL YEAR” appearing below to report the “Total Compensation” for the five (5) most highly compensated “Executives”, in rank order, in your organization. For purposes of this request, the following terms apply as defined in 2 CFR Ch. 1 Part 170 Appendix A: “Executive” is defined as “officers, managing partners, or other employees in management positions”. “Total Compensation” is defined as the cash and noncash dollar value earned by the executive during the most recently completed fiscal year and includes the following: i. Salary and bonus. 40 ii. Awards of stock, stock options, and stock appreciation rights. Use the dollar amount recognized for financial statement reporting purposes with respect to the fiscal year in accordance with the Statement of Financial Accounting Standards No. 123 (Revised 2004) (FAS 123R), Shared Based Payments. iii. Earnings for services under non-equity incentive plans. This does not include group life, health, hospitalization or medical reimbursement plans that do not discriminate in favor of executives, and are available generally to all salaried employees. iv. Change in pension value. This is the change in present value of defined benefit and actuarial pension plans. v. Above-market earnings on deferred compensation which is not tax-qualified. vi. Other compensation, if the aggregate value of all such other compensation (e.g. severance, termination payments, value of life insurance paid on behalf of the employee, perquisites or property) for the executive exceeds $10,000. 41 TOTAL COMPENSATION CHART FOR MOST RECENTLY COMPLETED FISCAL YEAR (Date of Fiscal Year Completion __________________) Rank Total Compensation (Highest to Name for Most Recently Lowest) (Last, First, MI) Title Completed Fiscal Year 1 2 3 4 5 THE UNDERSIGNED CERTIFIES THAT ON THE DATE WRITTEN BELOW, THE INFORMATION PROVIDED HEREIN IS ACCURATE. SIGNATURE: NAME AND TITLE: Charles K. Windes, Jr., Chairman DATE: 42