HomeMy WebLinkAboutContract 57336-A2 DocuSign Envelope ID: EBC4C46B-E261-455B-90AB-09BC10DB6191
CSC No.57336-A2
STATE OF TEXAS TWDB Contract No. 1700012478
TRAVIS COUNTY TEXAS WATER DEVELOPMENT BOARD (TWDB)
and
CITY OF FORT WORTH, TEXAS
AMENDMENT NO. 2
This Contract, previously executed on December 24, 2020 and amended June 1S, 2021, is
hereby amended as follows:
1. Section I,Article I, Item 14, PROJECT COMPLETION DATE, is changed from March 21, 2022
to March 22, 2023.
2. Section I, Article I, Item 1S, CONTRACT EXPIRATION DATE, is changed from June 19, 2022 to
June 20, 2023.
3. EXHIBIT A is revised to include the Federal Emergency Management Agency award
document for this amendment, included as ATTACHMENT 1.
All other terms and conditions of TWDB Contract No. 1700012478 remain in effect.
IN WITNESS WHEREOF,the parties hereto cause this Amendment to be duly executed.
TEXAS WATER DEVELOPMENT BOARD CITY OF FORT WORTH
By: 40ZIOXIL By:
John T. Dupnik, P.G. Dana Burghdoff
Deputy Executive Administrator Assistant City Manager
Date:
4/6/2022 Date: 4/10/2022
OFFICIAL RECORD
CITY SECRETARY
TWDB Contract No. 1700012478 FT.WORTH, TX
Amendment No. 2, Page 1 of 1
4
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Tgnnette S. Goo�%ll �,� 00,
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By: Jannette S.Goodall(May 9,2022 16:02 CDT) �o i
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Name: Jannette S. Goodall „f° o�c d
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Title: City Secretary aIj °OOpoopO° a
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APPROVED AS TO FORM AND LEGALITY:
WIV,
By: Mack(May 9,2022 15:17 CDT)
Name: Douglas W.Black
Title: Senior Assistant City Attorney
CONTRACT AUTHORIZATION:
M&C:Not required
Form 1295:Not required
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH, TX
DocuSign Envelope ID: EBC4C46B-E261-455B-90AB-09BC10DB6191 TACHMENT 1
TWDB Contract No. 1700012478
Amendment No.2, Page 1 of—23—
DocuSign Envelope ID: EBC4C46B-E261-455B-90AB-09BC10DB6191
U.S.Department of Homeland Security
FEMA Region 6
800 N.Loop 288
Denton,TX 76209
Oti4A�\�a.
T y. FEMA
ND S6GJ;:,
January 27, 2022
Jeffrey Walker
Executive Administrator
Texas Water Development Board
P.O. Box 13231
Austin, Texas 78711-3231
Attention: Kathy Hopkins
Reference Award: EMT-2018-FM-EO02 (12)
Dear Mr. Walker:
Enclosed is an executed copy of FEMA Form 76-10A reflecting Amendment 12 to award
number EMT-2018-FM-EO02
This amendment serves to approve TWDB's twelve-month Period of Performance Extension
Request dated December 30, 2021. The amended Period of Performance is now August 14, 2017
through March 22, 2023.
By accepting this award, you assume certain administrative and financial responsibilities
including the timely submission of all financial and programmatic reports, resolution of all
interim audit findings, and the maintenance of a minimum level of cash on hand. Should you not
adhere to these responsibilities,you will be in violation of the terms of this award.
If you have any questions regarding this matter,please contact Carrie Robinette at
Carrie.robinette(cr�,fema.dhs.�,,ov or at(202) 549-4320.
Sincerely,
GREGORY G MANNING Dtea21022.0127�0,9,38 OSDO'MANNING
Greg Manning, CGMS
Assistance Officer
cc: Carrie Robinette, Grants Management Specialist,Mitigation Division
Attachments: FF 76-10A Package
Agreement Articles
wivw.fema.gov
TWDB Contract No. 1700012478
Amendment No.2, Page 2 of«23»
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DocuSign Envelope ID: EBC4C46B-E261-455B-90AB-09BC10DB6191
FY 2017
FLOOD MITIGATION ASSISTANCE PROGRAM
GRANT AGREEMENT ARTICLES
CFDA# 97.029
RECIPIENT: Texas Water Development Board
AGREEMENT NUMBER: EMT-2018-FM-E002
AMENDMENT NUMBER: A-12
DESIGNATED AGENCY: Federal Emergency Management Agency
PERFORMANCE PERIOD: August 14, 2017—March 22, 2023
GENERAL INFORMATION:
The Flood Mitigation Assistance (FMA) grant program provides funding to States,
Territories, Indian Tribal govermnents and communities to assist in their efforts to reduce or
eliminate the risk of repetitive flood damage to buildings and structures insurable under the
National Flood Insurance Program (NFIP).
ARTICLE I. FEMA AUTHORITY
The United States of America through the Department of Homeland Security's Federal
Emergency Management Agency (FEMA) agrees to grant to the State/Indian Tribal or
Territory government, hereinafter referred to as "the Recipient,"through its designated agency
named above, funds in the amount specified on the obligating document, to support the Flood
Mitigation Assistance Grant Program, authorized under Section 1366 of the National Flood
Insurance Act of 1968 (42 U.S.C. 4104c, the "NFIA" or"the Act"), as amended by the
National Flood Insurance Reform Act of 1994 (NFIRA), Public Law 103-325, the Bunning-
Bereuter-Blumenauer Flood Insurance Reform Act of 2004, Public Law 108-264, and by the
Biggert-Waters Flood Insurance Reform Act of 2012, Public Law 112-141.
The Recipient agrees to abide by the Grant Award terms and conditions as set forth in this
document.
TWDB Contract No. 1700012478
Amendment No.2, Page 5 of—23—
DocuSign Envelope ID: EBC4C46B-E261-455B-90AB-09BC10DB6191
ARTICLE II. PROJECT DESCRIPTION
The Recipient shall perform the work described in the application package and made a part of
these Grant Agreement Articles.
ARTICLE III. PERIOD OF PERFORMANCE
The period of performance shall be August 14, 2017 through March 22, 2023. All costs must be
incurred during the period of performance, including pre-award costs.
ARTICLE IV. AMOUNT AWARDED
This Grant Award is for the administration and completion of an approved Flood
Mitigation Assistance project. Funds approved under this Grant Agreement may
not be used for other purposes. If costs exceed the amount of FEMA funding
approved, then the Recipient shall pay the costs that are in excess of the approved
budget.
The approved budget for this Grant Award is shown in the Cost Review Section of
the grant application.
s't �`i> cip4 s�,9ahtle � its`ibY) Part
Federal Awards "Super Circular" [which supersedes 44 CFR Part 13, 2 CFR Part 215, and
Office of Management and Budget (OMB) Circulars A-21,A-50, A-87, A-89, A-102, A-110,
A-122, and A-133 as of December 26,2014], Title 2 CFR Part 170, Reporting Subaward and
Executive Compensation—Appendix A to Part 170—Award Term (see ARTICLE VII. TERMS
AND CONDITIONS), and the Hazard Mitigation Assistance Guidance to implement this Grant
Agreement.
ARTICLE V. COST SHARE
The cost-share requirement for this award varies by individual structures are noted below.
The cost-share for FMA is directed by the Biggert-Waters Flood Insurance Reform Act of 2012:
a. The FMA program offers up to 100% Federal cost-share funding for properties that are
designated as Severe Repetitive Loss (these properties must be identified as validated on
FEMA's FMA Severe Repetitive Loss list) where the Recipient also maintains a FEMA-
approved Standard or Enhanced Mitigation Plans or Tribal plan that includes a strategy for
mitigating existing and future repetitive loss properties.
b. The FMA program offers up to 90% Federal cost-share funding for properties that are
designated as Repetitive Loss (these properties must be identified on FEMA's FMA Repetitive
Loss list) where the Recipient also maintains a FEMA-approved Standard or Enhanced
TWDB Contract No. 1700012478
Amendment No.2, Page 6 of«23»
DocuSign Envelope ID: EBC4C46B-E261-455B-90AB-09BC10DB6191
Mitigation Plans or Tribal plan that includes a strategy for mitigating existing and future
repetitive loss properties.
The FMA program offers up to 75% Federal cost-share funding for all other activities and all other
insured properties.
ARTICLE VI. FEMA OFFICIALS
FEMA officials are as follows:
The Project Officer shall be an official at the FEMA Regional Office who will be responsible for
the monitoring of the activities as described in the application.
The Project Officer is: Carrie Robinette and can be reached at 202-549-4320
The Assistance Officer is the FEMA official who has full authority to negotiate, administer and
execute all business matters of the Grant Agreement.
The Assistance Officer is: Greg Manning, CGMS and can be reached at 940-383-7209
ARTICLE VII. TERMS AND CONDITIONS
The specific terms and conditions of this agreement are as follows:
Federal Funding Accountability and Transparency Act:
The Federal Funding Accountability and Transparency Act(FFATA) of 2006 (2 CFR Part 170)
requires Recipients to report certain information about themselves and their first-tier
Subrecipients for each Federal award of$25,000 or more awarded on or after October 1, 2010.
(See attached APPENDIX A to Part 170-Award term).
ASSURANCE COMPLIANCE:
The certifications signed by the Recipient in the application relating to maintenance of a Drug-
Free Workplace (44 CFR Part 17, Subpart F) and New Restrictions on Lobbying (44 CFR Part
18) apply to this grant agreement and are incorporated by reference.
Prohibition on Using Federal Funds.
The Recipient understands and agrees that it cannot use any Federal funds, either directly or
indirectly, in support of the enactment, repeal, modification or adoption of any law,regulation or
policy, at any level of government, without the express prior written approval of FEMA.
TWDB Contract No. 1700012478
Amendment No.2, Page 7 of«23»
DocuSign Envelope ID: EBC4C46B-E261-455B-90AB-09BC10DB6191
Compliance with Program Guidance.
The Recipient agrees that all use of funds under this Grant Agreement will be in accordance with
the Unified Hazard Mitigation Assistance Guidance at the time of the application.
BUDGET REVISIONS:
The Recipient shall follow prior approval requirements for budget revisions found in 2 CFR Part
200. Transfer of funds between total direct cost categories in the approved budget shall receive
the prior approval of FEMA when such cumulative transfers among those direct cost categories
exceed ten percent of the total budget.
If a Recipient estimates that it will have obligated funds remaining after the end of the
performance period, the Recipient must report this to the FEMA Regional Office at the earliest
possible time and ask for disposition instructions.
Acceptance of Post Award Changes
In the event FEMA determines that changes are necessary to the award document after an award
has been made, including changes to period of performance or terms and conditions, Recipients
will be notified of the changes in writing. Once notification has been made, any subsequent
drawdown of additional funds will indicate the Recipient's acceptance of the changes to the
award.
CLOSEOUT:
Reports Submission: Per 2 CFR Part 200, when the appropriate grant award performance period
expires, the Recipient shall submit the following documents within 90 days: (1) a final Financial
Report; (2) final Program Performance Report; (3) an inventory of equipment purchased under
each grant's funds; (4) an inventory of Federally-owned property; and(5) other required
documents specified by program regulation.
Report Acceptance: FEMA shall review the Recipient reports, perform the necessary financial
reconciliation, negotiate necessary adjustments between the Recipient and FEMA's records, and
close out the grant in writing.
Record Retention: Records shall be retained for 3 years (except in certain rare circumstances)
from the date the final Federal Financial Report is submitted to FEMA in compliance with 2 CFR
Part 200.
CONSTRUCTION PROJECT REQUIREMENTS:
1. Acceptance of Federal funding requires FEMA, the Recipient and any Subrecipients to
comply with all Federal, state and local laws prior to the start of any construction activity.
Failure to obtain all appropriate Federal, state and local environmental permits and clearances
may jeopardize Federal funding.
TWDB Contract No. 1700012478
Amendment No.2, Page 8 of«23»
DocuSign Envelope ID: EBC4C46B-E261-455B-90AB-09BC10DB6191
2. Any change to the approved scope of work will require re-evaluation by FEMA for Recipient
and Subrecipient compliance with the National Environmental Policy Act and other laws and
Executive Orders.
3. If ground disturbing activities occur during construction, the Recipient and any Subrecipients
must ensure monitoring of ground disturbance and, if any potential archeological resources
are discovered, the Subrecipient will immediately cease construction in that area and notify
the Recipient and FEMA.
COPYRIGHT:
The Recipient is free to copyright any original work developed in the course of or under this
Grant Agreement. FEMA reserves a royalty-tree, nonexclusive and irrevocable right to
reproduce, publish or otherwise use, and to authorize others to use the work for Government
purposes. Any publication resulting from work performed under this agreement shall include an
acknowledgement of FEMA financial support and a statement that the publication does not
constitute an endorsement by FEMA or reflect FEMA views.
COST SHARE:
The Recipient shall follow cost-sharing requirements mandated by program guidance, statute or
regulation and in compliance with 2 CFR Part 200. Cost-share funding shall be available with
the approval of each grant. Period of Performance extensions shall not be approved for delays
caused by lack of cost-share funding.
ENFORCEMENT:
FEMA enforcement remedies shall be processed as specified in 2 CFR Part 200, Enforcement
when the Terms and Conditions of this Grant Agreement are not met.
EQUIPMENT/SUPPLIES:
The Recipient must comply with the regulations listed in 2 CFR Part 200 and must be in
compliance with state laws and procedures.
FUNDS TRANSFER:
No transfer of funds to agencies other than those identified in the approved Grant Agreement
shall be made without prior approval of FEMA.
INSURANCE:
In compliance with Public Law 103-325, Title V National Flood Insurance Reform Act of 1973'
section 582 requires that any person receiving Federal assistance for the repair, replacement, or
restoration for damage to any personal or residential property at any time must maintain flood
insurance if the property is located in a Special Flood Hazard Area.
PAYMENT:
Recipient shall be paid using the FEMA Payment and Reporting System (PARS), provided
Recipient maintains and complies with procedures for minimizing the time between transfer of
funds from the US Treasury and disbursement by the Recipient and Subrecipients. The Recipient
commits itself to: 1) initiating cash drawdowns only when actually needed for its disbursement;
2) timely financial reporting per FEMA requirements, using the SF-425; and 3) imposing the
same standards of timing and amount upon any Subrecipient.
TWDB Contract No. 1700012478
Amendment No.2, Page 9 of«23»
DocuSign Envelope ID: EBC4C46B-E261-455B-90AB-09BC10DB6191
Subrecipients must comply with the same payment requirement as the Recipient and must
comply with the requirements specified in the Recipient's subaward Agreement.
DUPLICATION OF PROGRAMS:
FEMA will not provide assistance under its programs for activities that FEMA determines
another Federal program has a more specific or primary authority to provide. FEMA also will not
provide assistance for the applicant or subapplicant's legal obligations. FEMA may disallow or
recoup amounts that duplicate funding from other authorities.
DUPLICATION OF BENEFITS:
Hazard Mitigation Assistance (HMA) fiends cannot duplicate or be duplicated by funds received
by or available to Applicants, subapplicants, or project or planning participants from other
sources for the same purpose, such as benefits received from insurance claims, other assistance
programs (including previous project or planning grants and subawards from HMA programs),
legal awards, or other benefits associated with properties or damage that are or could be subject
of litigation.
Because the availability of other sources of mitigation grant or loan assistance is subject to
available information and the means of each individual applicant, HMA does not require proof
that other assistance (not including insurance) has been sought. However, it is the responsibility
of the property owner to report other benefits received, any applications for other assistance, the
availability of insurance proceeds, or the potential for other compensation, such as from pending
legal claims for damages, relating to the property. Amounts of other grants, loans or other
assistance designated for the same purpose as HMA funds, if received, may be used to reduce the
non-Federal cost-share.
Where the property owner has an insurance policy covering any loss to the property which relates
to the proposed HMA project, the means are available for receiving compensation for a loss or, in
the case of increased cost of compliance (ICC), assistance toward a mitigation project. FEMA
will generally require that the property owner file a claim prior to the receipt of HMA funds.
NON DISCRIMINATION:
The program must be administered in an equitable and impartial manner, without discrimination
on the grounds of race, color, religion, nationality, sex, age, or economic status. The program
complies with Title VI of the 1964 Civil Rights Act and other applicable laws. All
applicants/Recipients must comply with Title V1, including State and local governments
distributing Federal assistance.
Applicants/Recipients and Subapplicants/Subrecipients will ensure that no discrimination is
practiced. Applicants must consider fairness, equity, and equal access when prioritizing and
selecting project subapplications to submit with their application. Subapplicants and
Subrecipients must ensure fairness, equity and equal access when consulting and making offers
of mitigation to property owners that benefit from mitigation activities.
CHANGES IN SCOPE OF WORK:
Requests for changes to the scope of work(SOW) after award are permissible as long as they do
not change the nature or total project cost of the activity, properties identified in the
TWDB Contract No. 1700012478
Amendment No.2, Page 10 of«23»
DocuSign Envelope ID: EBC4C46B-E261-455B-90AB-09BC10DB6191
subapplication, the feasibility and effectiveness of the project, or the benefit cost ratio. Requests
must be supported by adequate justification from the applicant in order to be processed. The
justification is a description of the proposed change, a written explanation of the reason or
reasons for the change; an outline of remaining funds available to support the change; and a full
description of the work necessary to complete the activity. All approvals will be at FEMA's
discretion, and there is no guarantee that SOW changes will be approved.
PERFORMANCE PERIODS:
All grant award activities, including all projects and/or activities approved under each subaward,
shall be completed within the time period prescribed and authorized on the obligating documents.
All costs must be incurred within the approved performance period.
EXTENSIONS:
Requests for time extensions to the Period of Performance will be considered but will not be
granted automatically and must be supported by adequate justification submitted to the Regional
Office in order to be processed. This justification is a written explanation of the reason or
reasons for the delay; an outline of remaining funds available to support the extended Period of
Performance; and a description of performance measures necessary to complete the activity.
Without justification, extensions requests will not be processed. Financial and Performance
reports must be current in order for a time extension to be considered.
RECOUPMENT OF FUNDS:
FEMA will recoup mitigation planning grant funds for grants that do not meet the deliverable
criteria of an adopted, FEMA-approved mitigation plan by the end of the performance period.
RECOVERY OF FUNDS:
The Recipient will process the recovery of assistance paid to Subrecipients processed through
error, misrepresentation, or fraud or if funds are spent inappropriately. Recovered funds shall be
submitted to FEMA as soon as the funds are collected, but no later than 90 days from the
expiration date of the appropriate grant award agreement.
All fraud identifications will be reported to the FEMA Inspector General's office. The Recipient
agrees to cooperate with investigation conducted by the FEMA Inspector General's office.
REFUND,REBATE, CREDITS:
The Recipient shall transfer to FEMA the appropriate share, based on the Federal support
percentage, of any refund,rebate, credit or other amounts arising from the performance of this
agreement, along with accrued interest, if any. The Recipient shall take necessary action to effect
prompt collection of all monies due or which may become due and to cooperate with FEMA in
any claim or suit in connection with amounts due.
REPORTS:
Federal Financial Reports (SF-425)
The Recipient shall submit the Federal Financial Report(FFR, SF-425) within 30 days of the end
of the first Federal quarter following the initial Grant Agreement. The Recipient shall submit
quarterly FFRs thereafter until the grant ends. Reports are due on January 30, April 30, July 30,
TWDB Contract No. 1700012478
Amendment No.2, Page 11 of—23—
DocuSign Envelope ID: EBC4C46B-E261-455B-90AB-09BC10DB6191
and October 30. A report must be submitted for every quarter of the period of performance,
including partial calendar quarters, as well as for periods where no grant activity occurs. Future
awards and fund drawdowns may be withheld if these reports are delinquent.
Program Performance Reports (SF-PPR):
The Recipient shall submit the Program Performance Reports (SF-PPR) within 30 days of the
end of each quarter. The Regional Administrator may waive the initial report. The Recipient
shall submit quarterly PPRs thereafter until the grant ends. Reports are due on January 30, April
30, July 30, and October 30. PPRs shall report the name, completion status, expenditure, and
payment-to-date of each approved activity/subaward award under the Grant Award.
Final Reports:
The Recipient shall submit a final FFR and PPR 90 days after the end date of the performance
period.
TERMINATION:
The Recipient, Subrecipient, or FEMA may terminate grant award agreements by giving written
notice to the other party at least seven (7) calendar days prior to the effective date of the
termination. All notices are to be transmitted via registered or certified mail, return receipt
requested. The Recipient's authority to incur new costs will be terminated upon the date of
receipt of the notice or the date set forth in the notice. Any costs incurred up to the earlier of the
date of the receipt of the notice or the date of termination set forth in the notice will be negotiated
for final payment. Close out of the Grant Agreement will be commenced and processed as
prescribed under Article VII. 3.
ARTICLE VIII. GOVERNING PROVISIONS
The Recipient and any Subrecipients shall comply with all applicable laws and regulations. A
non-exclusive list of laws and regulations commonly applicable to FEMA grants is attached
hereto for reference only.
The Recipient and any Subrecipients shall also be bound by the Unified Hazard Mitigation
Assistance Guidance document.
Commonly Applicable Statutes and Regulations
Robert T. Stafford Disaster Relief and Emergency Assistance Act, Public Law 93-288, as
amended, 42 U.S.C. 5121 et seq., and Related Authorities
Section 1366 (42 USC 4104c), of the National Flood Insurance Act of 1968 (42 U.S.C. §
4104c. —the "NFIA" or "the Act"), as amended by the National Flood Insurance Reform
Act of 1994 (NFIRA), Public Law 103-325,the Bunning-Bereuter-Blumenauer Flood
Insurance Reform Act of 2004, Public Law 108-264, and Biggert-Waters Flood Insurance
Reform Act, Public Law 112-141.
Title 44 of the Code of Federal Regulations (CFR)
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44 CFR Part 79-Flood Mitigation Grants
44 CFR Part 80-Property Acquisition and Relocation for Open Space
44 CFR Part 9-Floodplain Management and Protection of Wetlands
44 CFR Part 10-Environmental Considerations
2 CFR Part 200-Uniform Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards "Super Circular"
31 CFR Part 205-Rules and Procedures for Efficient Federal-State Funds Transfers
2 CFR Part 170, Reporting Subaward and Executive Compensation—Appendix A to Part
170—Award Term (attached)
48 CFR Part 31.2 (Federal Acquisition Regulation)
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DEPARTMENT OF HOMELAND SECURITY (DHS)
STANDARD TERMS AND CONDITIONS 2017
The FY 2017 DHS Standard Terms and Conditions apply to all new Federal financial assistance awards funded in
FY 2017. The terms and conditions of DHS financial assistance awards flow down to subrecipients, unless a
particular award term or condition specifically indicates otherwise.
Assurances. Administrative Requirements.Cost Principles_and Audit Requirements
DHS financial assistance recipients must complete either the OMB Standard Form 424B Assurances—
Non-Construction Programs, or OMB Standard Form 424D Assurances—Construction Programs as
applicable. Certain assurances in these documents may not be applicable to your program,and the DHS
financial assistance office may require applicants to certify additional assurances. Applicants are required
to fill out the assurances applicable to their program as instructed by the awarding agency. Please
contact the financial assistance office if you have any questions.
DHS financial assistance recipients are required to follow the applicable provisions of the Uniform
Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards located at 2
C.F.R. Part 200, and adopted by DHS at 2 C.F.R. Part 3002.
DHS Snecific Acknowledaements and Assurances
All recipients, subrecipients, successors,transferees, and assignees must acknowledge and agree to
comply with applicable provisions governing DHS access to records,accounts,documents,
information,facilities, and staff.
1. Recipients must cooperate with any compliance reviews or compliance investigations conducted by
DHS.
2. Recipients must give DHS access to, and the right to examine and copy, records, accounts,
and other documents and sources of information related to the award and permit access to facilities,
personnel, and other individuals and information as may be necessary, as required by DHS
regulations and other applicable laws or program guidance.
3. Recipients must submit timely, complete, and accurate reports to the appropriate DHS
officials and maintain appropriate backup documentation to support the reports.
4. Recipients must comply with all other special reporting, data collection, and evaluation
requirements, as prescribed by law or detailed in program guidance.
5. If, during the past three years,the recipient has been accused of discrimination on the
grounds of race, color, national origin (including limited English proficiency), sex, age, disability,
religion,or familial status, the recipient must provide a list of all such proceedings, pending or
completed, including outcome and copies of settlement agreements to the DHS financial assistance
office and the DHS Office of Civil Rights and Civil Liberties (CRCL) by e-mail at crcl(&hcl.dhs.gov or
by mail at U.S. Department of Homeland Security Office for Civil Rights and Civil Liberties Building
410, Mail Stop#0190 Washington, D.C.20528.
6. In the event any court or administrative agency makes a finding of discrimination on
grounds of race, color, national origin (including limited English proficiency), sex,age, disability,
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religion, or familial status against the recipient, or the recipient settles a case or matter alleging such
discrimination, recipients must forward a copy of the complaint and findings to the DHS financial
assistance office and the CRCL office by e-mail or mail at the addresses listed above.
The United States has the right to seek judicial enforcement of these obligations.
............................................................................................................................................................................................................................................................................................................................................................
Acknowledgment of Federal Funding from All recipients must acknowledge their use of federal funding when
DHS issuing statements, press releases, requests for proposals, bid
invitations, and other documents describing projects or programs
funded in whole or in part with Federal funds.
............................................................................................................................................................................................................................................................................................................................................................
Activities Conducted Abroad All recipients must ensure that project activities carried on outside the
United States are coordinated as necessary with appropriate
government authorities and that appropriate licenses, permits, or
approvals are obtained.
...........................................................................................................................................................................................................................................................................................................................................................
Age Discrimination Act of 1975 All recipients must comply with the requirements of the Age
Discrimination Act of 1975(Title 42 U.S. Code.&6101 et sea.),
which prohibits discrimination on the basis of age in any program or
activity receiving Federal financial assistance.
........................................................................................................................................:................................................................................................................................................................................................................:
Americans with Disabilities Act of 1990 All recipients must comply with the requirements of Titles I, ll,
and III of the Americans with Disabilities Act,which prohibits
recipients from discriminating on the basis of disability in the
operation of public entities, public and private transportation
systems, places of public accommodation, and certain testing
entities. (42 U.S.C. & 12101— 12213).
........................................................................................................................................:................................................................................................................................................................................................................:
Best Practices for Collection and Use DHS defines personally identifiable information (PII)as any
of Personally Identifiable information that permits the identity of an individual to be directly or
Information(PII) indirectly inferred, including any information that is linked or linkable
to that individual.All recipients who collect PH are required to have
a publically-available privacy policy that describes standards on the
usage and maintenance of PH they collect. Award recipients may
also find as a useful resource the DHS Privacy Impact
Assessments: Privacy Guidance and Privacy template respectively.
........................................................................................................................................:................................................................................................................................................................................................................:
Civil Rights Act of 1964—Title VI All recipients must comply with the requirements of Title VI of the
Civil Rights Act of 1964(42 U.S.C.§2000d et sea.),which
provides that no person in the United States will, on the grounds of
race, color, or national origin, be excluded from participation in, be
denied the benefits of, or be subjected to discrimination under any
program or activity receiving Federal financial assistance. DHS
implementing regulations for the Act are found at 6 C.F. R., Part 21
and 44 C.F.R. Part 7.
.........................................................................................................................................................................................................................................................................................................................................................:
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...........................................................................................................................................................................................................................................................................................................................................................
Civil Rights Act of 1968 All recipients must comply with Title VI II of the Civil Rights Act of
1968,which prohibits recipients from discriminating in the sale,
rental,financing, and advertising of dwellings, or in the provision of
services in connection therewith, on the basis of race, color,
national origin, religion,disability,familial status, and sex 42 U.S.C.
3601 et sea.), as implemented by the Department of Housing and
Urban Development at 24 C.F.R. Part 100. The prohibition on
disability discrimination includes the requirement that new multifamily
housing with four or more dwelling units—i.e.,the public and
common use areas and individual apartment units(all units in
buildings with elevators and ground-floor units in buildings without
elevators)—be designed and constructed with certain accessible
features(See 24 C.F.R.& 100.201).
........................................................................................................................................:................................................................................................................................................................................................................:
Copyright All recipients must affix the applicable copyright notices of 17 U.S.C.
401 or 402 and an acknowledgement of Government sponsorship
(including award number)to any work first produced under Federal
financial assistance awards.
...........................................................................................................................................................................................................................................................................................................................................................
Debarment and Suspension All recipients are subject to the non-procurement debarment and
suspension regulations implementing Executive Orders 12549 and
12689, and 2 C.F.R. Part 180. These regulations restrict awards,
subawards,and contracts with certain parties that are debarred,
suspended, or otherwise excluded from or ineligible for
participation in federal assistance programs or activities.
........................................................................................................................................:................................................................................................................................................................................................................:
Drug-Free Workplace Regulations All recipients must comply with the Drug-Free Workplace Act of
1988(41 U.S.C. 701 et seg.),which requires all organizations
receiving grants from any Federal agency agree to maintain a
drug-free workplace. DHS has adopted the Act's implementing
regulations at 2 C.F.R Part 3001.
.........................................................................................................................................:................................................................................................................................................................................................................:
Duplication of Benefits Any cost allocable to a particular Federal award provided for in 2
C.F.R. Part 200, Subpart E may not be charged to other Federal
awards to overcome fund deficiencies, to avoid restrictions imposed
by Federal statutes, regulations, or terms and conditions of the
Federal awards,or for other reasons. However, this prohibition would
not preclude a recipient form shifting costs that are allowable under
two or more Federal awards in accordance with existing Federal
statutes, regulations, or the terms and conditions of the Federal
award.
.........................................................................................................................................................................................................................................................................................................................................................:
Education Amendments of 1972 (Equal All recipients must comply with the requirements of Title IX of the
Opportunity in Education Act)—Title IX Education Amendments of 1972(20 U.S.C. & 1681 et sea.),which
provide that no person in the United States will,on the basis of sex, be
excluded from participation in, be denied the benefits of, or be subjected.
to discrimination under any educational program or activity receiving
Federal financial assistance. DHS implementing regulations are
codified at 6 C.F.R. Part 17 and 44 C.F.R. Part 19
........................................................................................................................................................................................................................................................................................................................................................
Energy Policy and Conservation Act All recipients must comply with the requirements of 42 U.S.C.& 6201
which contain policies relating to energy efficiency that are defined in the.
state energy conservation plan issued in compliance with this Act.
........................................................................................................................................:................................................................................................................................................................................................................
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...........................................................................................................................................................................................................................................................................................................................................................
False Claims Act and Program Fraud Civil All recipients must comply with the requirements of 31 U.S.C.& 3729-
Remedies 3733 which prohibits the submission of false or fraudulent claims for
payment to the Federal Government. See 31 U.S.C. &3801-3812
which details the administrative remedies for false claims and
statements made.
.........................................................................................................................................................................................................................................................................................................................................................i
Federal Debt Status All recipients are required to be non-delinquent in their repayment
of any Federal debt. Examples of relevant debt include
delinquent payroll and other taxes, audit disallowances, and
benefit overpayments. See OMB Circular A- 129.
........................................................................................................................................:................................................................................................................................................................................................................:
Federal Leadership on Reducing Text All recipients are encouraged to adopt and enforce policies that ban text.
Messaging while Driving messaging while driving as described in E.O. 13513, including
conducting initiatives described in Section 3(a)of the Order when on
official Government business or when performing any work for or on
behalf of the federal government.
........................................................................................................................................:................................................................................................................................................................................................................i
All recipients must comply with Preference for U.S. Flag Air
Carriers: (air carriers holding certificates under 49 U.S.C.
Fly America Act of 1974 41102)for international air transportation of people and property
to the extent that such service is available, in accordance with
the International Air Transportation Fair Competitive Practices
Act of 1974(49 U.S.C. &40118)and the interpretative
guidelines issued by the Comptroller General of the United
States in the March 31, 1981,amendment to Comptroller
General Decision B-138942.
.........................................................................................................................................................................................................................................................................................................................................................:
Hotel and Motel Fire Safety Act of 1990 In accordance with Section 6 of the Hotel and Motel Fire Safety
Act of 1990, 15 U.S.C. &2225a, all recipients must ensure that
all conference, meeting, convention,or training space funded in
whole or in part with Federal funds complies with the fire
prevention and control guidelines of the Federal Fire Prevention
and Control Act of 1974, as amended, 15 U.S.C. &2225.
...........................................................................................................................................................................................................................................................................................................................................................
All recipients must comply with the Title VI of the Civil Rights Act
of 1964(Title VI) prohibition against discrimination on the basis of
Limited English Proficiency(Civil Rights national origin,which requires that recipients of federal financial
Act of 1964,Title VI) assistance take reasonable steps to provide meaningful access
to persons with limited English proficiency(LEP)to their
programs and services. For additional assistance and
information regarding language access obligations, please refer
to the DHS Recipient Guidance https://www.dhs.gov/guidance-
published-help-department- supported-organizations-provide-
meaninaful-access-people-limited and additional resources on
httD://www.leD.aov.
...........................................................................................................................................................................................................................................................................................................................................................
Lobbying Prohibitions All recipients must comply with 31 U.S.C. & 1352,which provides
that none of the funds provided under an award may be expended
by the recipient to pay any person to influence, or attempt 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 any Federal action
concerning the award or renewal.
.........................................................................................................................................:................................................................................................................................................................................................................:
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...........................................................................................................................................................................................................................................................................................................................................................
National Environmental Policy Act All recipients must comply with the requirements of the National
Environmental Policy Act(NEPA)and the Council on Environmental
Quality (CEQ) Regulations for Implementing the Procedural
Provisions of NEPA, which requires recipients to use all practicable
means within their authority, and consistent with other essential
considerations of national policy,to create and maintain conditions
under which people and nature can exist in productive harmony and
fulfill the social,economic, and other needs of present and future
generations of Americans.
...........................................................................................................................................................................................................................................................................................................................................................
Nondiscrimination in Matters Pertaining It is DHS policy to ensure the equal treatment of faith-based
to Faith- Based Organizations organizations in social service programs administered or supported
by DHS or its component agencies, enabling those organizations to
participate in providing important social services to beneficiaries. All
recipients must comply with the equal treatment policies and
requirements contained in 6 C.F.R. Part 19 and other applicable
statues, regulations,and guidance governing the participations of
faith-based organizations in individual DHS programs.
.........................................................................................................................................:.................................................................................................................................................................................................................
Non-supplanting Requirement All recipients who receive awards made under programs that
prohibit supplanting by law must ensure that Federal funds do not
replace(supplant) funds that have been budgeted for the same
purpose through non-Federal sources.
........................................................................................................................................:................................................................................................................................................................................................................:
Notice of Funding Opportunity All of the instructions, guidance, limitations, and other conditions
Requirements set forth in the Notice of Funding Opportunity(NOFO)for this
program are incorporated here by reference in the terms and
conditions of your award. All recipients must comply with any
such requirements set forth in the program NOFO.
..........................................................................................................................................................................................................................................................................................................................................................:
Patents and Intellectual Property Rights Unless otherwise provided by law, recipients are subject to the Bavh_
Dole Act, Pub. L. No. 96-517, as amended, and codified in 35 U.S.C.
200 et seq. All recipients are subject to the specific requirements
governing the development, reporting,and disposition of rights to
inventions and patents resulting from financial assistance awards
located at 37 C.F.R. Part 401 and the standard patent rights clause
located at 37 C.F.R.§401.14.
..........................................................................................................................................................................................................................................................................................................................................................:
Procurement of Recovered Materials All recipients must comply with Section 6002 of the Solid Waste
Disposal Act, as amended by the Resource Conservation and
RecovervAct.The requirements of Section 6002 include procuring
only items designated in guidelines of the Environmental Protection
Agency(EPA)at 40 C.F.R. Part 247 that contain the highest
percentage of recovered materials practicable, consistent with
maintaining a satisfactory level of competition.
........................................................................................................................................i................................................................................................................................................................................................................i
Reporting Subawards and All recipients are required to comply with the requirements set forth
Executive Compensation in the government-wide Award Term on Reporting Subawards and
Executive Compensation located at 2 C.F.R. Part 170, Appendix A,
the full text of which is incorporated here by reference in the terms
and conditions of your award.
........................................................................................................................................:.................................................................................................................................................................................................................
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...........................................................................................................................................................................................................................................................................................................................................................
SAFECOM All recipients who receive awards made under programs that
provide emergency communication equipment and its related
activities must comply with the SAFECOM Guidance for
Emergency Communication Grants, including provisions on
technical standards that ensure and enhance interoperable
communications.
...........................................................................................................................................................................................................................................................................................................................................................
Terrorist Financing All recipients must comply with E.O. 13224 and U.S. law that
prohibit transactions with, and the provisions of resources and
support to, individuals and organizations associated with terrorism.
It is the legal responsibility of recipients to ensure compliance with
the Order and laws.
........................................................................................................................................:................................................................................................................................................................................................................:
Trafficking Victims Protection Act of 2000 All recipients must comply with the requirements of the
government-wide award term which implements Section 106(g)of
the Trafficking Victims Protection Act of 2000, (TVPA)as amended
(22 U.S.C.§ 7104). The award term is located at 2 CFR 175.15,
the full text of which is incorporated here by reference in the terms
and conditions of your award.
........................................................................................................................................:................................................................................................................................................................................................................:
Rehabilitation Act of 1973 All recipients must comply with the requirements of Section 504 of
the Rehabilitation Act of 1973, 29 U.S.C. & 794, as amended,which
provides that no otherwise qualified handicapped individual in the
United States will, solely by reason of the handicap, be excluded
from participation in, be denied the benefits of, or be subjected to
discrimination under any program or activity receiving Federal
financial assistance.
..........................................................................................................................................................................................................................................................................................................................................................i
Reporting of Matters Related to Recipient If the total value of your currently active grants, cooperative
Integrity and Performance agreements, and procurement contracts from all Federal assistance
office exceeds$10,000,000 for any period of time during the period
of performance of this Federal award, you must comply with the
requirements set forth in the government-wide Award Term and
Condition for Recipient Integrity and Performance Matters located at
2 C.F.R. Part 200,Appendix XI I, the full text of which is incorporated
here by reference in the terms and conditions of your award.
.........................................................................................................................................................................................................................................................................................................................................................i
Universal Identifier and System All recipients are required to comply with the requirements set forth
of Award Management(SAM) in the government-wide Award Term regarding the System for
Award Management and Universal Identifier Requirements located
at 2 C.F.R. Part 25, Appendix A,the full text of which is
incorporated here by reference in the terms and conditions of your
award.
........................................................................................................................................t................................................................................................................................................................................................................:
USA Patriot Act of 2001 All recipients must comply with requirements of the Uniting and
Strengthening America by Providing Appropriate Tools Required to
Intercept and Obstruct Terrorism Act(USA PATRIOT Act),which
amends 18 U.S.C. 4& 175-175c.
........................................................................................................................................:.................................................................................................................................................................................................................
Use of DHS Seal, Logo and Flags All recipients must obtain permission from their financial assistance
office, prior to using the DHS seal(s), logos, crests or
reproductions of flags or likenesses of DHS agency officials,
including use of the United States Coast Guard seal, logo, crests
or reproductions of flags or likenesses of Coast Guard officials.
..........................................................................................................................................................................................................................................................................................................................................................i
Whistleblower Protection Act All recipients must comply with the statutory requirements for
whistleblower protections(if applicable)at 10 U.S.0 4 2409, 41
U.S.C.4712,and 10 U.S.C.
2324,41 U.S.C. 4304 and 4310.
.........................................................................................................................................................................................................................................................................................................................................................
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Appendix A to Part 170—Award term
I. Reporting Subawards and Executive Compensation.
a. Reporting of first-tier subawards.
Applicability. Unless you are exempt as provided in paragraph d. of this award
term, you must report each action that obligates $25,000 or more in Federal funds
that does not include Recovery funds (as defined in section 1512(a)(2) of the
American Recovery and Reinvestment Act of 2009, Pub. L. 111-5) for a subaward
to an entity (see definitions in paragraph e. of this award term).
2. Where and when to report.
i. You must report each obligating action described in paragraph a.I. of this
award term to http.//www.fsrs.gov.
ii. ii. For subaward information, report no later than the end of the month
following the month in which the obligation was made. (For example, if the
obligation was made on November 7, 2010, the obligation must be
reported by no later than December 31, 2010.)
What to report. You must report the information about each obligating action that
the submission instructions posted at http.//www.fsrs.gov specify.
b. Reporting Total Compensation of Recipient Executives.
Applicability and what to report. You must report total compensation for each of
your five most highly compensated executives for the preceding completed fiscal
year, if—
i. the total Federal funding authorized to date under this award is $25,000 or
more;
ii. in the preceding fiscal year, you received—
A. 80 percent or more of your annual gross revenues from Federal
procurement contracts (and subcontracts) and Federal financial
assistance subject to the Transparency Act, as defined at 2 CFR
170.320 (and subawards); and
B. $25,000,000 or more in annual gross revenues from Federal
procurement contracts (and subcontracts) and Federal financial
assistance subject to the Transparency Act, as defined at 2 CFR
170.320 (and subawards); and
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iii. The public does not have access to information about the compensation of
the executives 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)) or section
6104 of the Internal Revenue Code of 1986. (To determine if the public has
access to the compensation information, see the U.S. Security and
Exchange Commission total compensation filings at
http://www.sec.gov/answers/execomp.htm.)
Where and when to report. You must report executive total compensation
described in paragraph b.1. of this award term:
i. As part of your registration profile at http.//www.ccr.gov.
ii. By the end of the month following the month in which this award is made,
and annually thereafter.
c. Reporting of Total Compensation of Subrecipient Executives.
Applicability and what to report. Unless you are exempt as provided in paragraph
d. of this award term, for each first-tier subrecipient under this award, you shall
report the names and total compensation of each of the subrecipient's five most
highly compensated executives for the subrecipient's preceding completed fiscal
year, if—
i. in the subrecipient's preceding fiscal year, the subrecipient received—
A. 80 percent or more of its annual gross revenues from Federal procurement
contracts (and subcontracts) and Federal financial assistance subject to
the Transparency Act, as defined at 2 CFR 170.320 (and subawards); and
B. $25,000,000 or more in annual gross revenues from Federal procurement
contracts (and subcontracts), and Federal financial assistance subject to
the Transparency Act (and subawards); and
ii. The public does not have access to information about the compensation of
the executives 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)) or section
6104 of the Internal Revenue Code of 1986. (To determine if the public has
access to the compensation information, see the U.S. Security and
Exchange Commission total compensation filings at
http.//www.sec.gov/answers/execomp.htm.)
Where and when to report. You must report subrecipient executive total
compensation described in paragraph c.1. of this award term:
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i. To the recipient.
ii. By the end of the month following the month during which you make the
subaward. For example, if a subaward is obligated on any date during
the month of October of a given year (i.e., between October 1 and 31),
you must report any required compensation information of the
subrecipient by November 30 of that year.
d. Exemptions.
If, in the previous tax year, you had gross income, from all sources, under $300,000,
you are exempt from the requirements to report:
i. Subawards, and
ii. The total compensation of the five most highly compensated executives
of any subrecipient.
e. Definitions. For purposes of this award term:
1. Entity means all of the following, as defined in 2 CFR Part 25:
i. A Governmental organization, which is a State, local government, or
Indian tribe;
ii. A foreign public entity;
iii. A domestic or foreign nonprofit organization;
iv. A domestic or foreign for-profit organization;
V. A Federal agency, but only as a subrecipient under an award or
subaward to a non-Federal entity.
Executive means officers, managing partners, or any other employees in
management positions.
3. Subaward:
i. This term means a legal instrument to provide support for the performance
of any portion of the substantive project or program for which you received
this award and that you as the recipient award to an eligible subrecipient.
ii. The term does not include your procurement of property and services
needed to carry out the project or program (for further explanation, see
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Sec. _ .210 of the attachment to OMB Circular A-133, "Audits of States,
Local Governments, and Non-Profit Organizations").
iii. A subaward may be provided through any legal agreement, including an
agreement that you or a subrecipient considers a contract.
4. Subrecipient means an entity that:
i. Receives a subaward from you (the recipient) under this award; and
ii. Is accountable to you for the use of the Federal funds provided by the
subaward.
Total compensation means the cash and noncash dollar value earned by the
executive during the recipient's or subrecipient's preceding fiscal year and includes
the following (for more information see 17 CFR 229.402(c)(2)):
i. Salary and bonus.
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.
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CONTRACT AMENDMENT / TIME EXTENSION
Contract Amended Amount$550,000.00 BOARD APPROVAL DATE (IF APPLICABLE) 5/17/2018
CONTRACT# AMEND# CONTRACTOR DATE/
1700012478 2 City of Ft. Worth INITIALS
Procurement&Contract Services 0 Assignment Date:3/16/2022 — --- -- 3/28/2022 SJ
Sherry Jackson 0 Enter amendment information into CAS and Worklog
-------------- 0 Prepare Draft Amendment/CIF for internal review and
approval.Save in S:drive and email reviewers.
PCS Approval Does FFATA(Fed Funds)? Yes or No 3/28/2022
❑ Cameron Turner ❑✓ Sergio Rey If Yes,Fed Reporting to FSRS. SRey
PCS Manager reviews and approves
0 Kaye Schultz ❑ Contract Attorney reviews and approves KS 3/28/2022
Contract Manager/SME ❑✓ CM/SME reviews and approves 3/28/2022
❑✓ CM/SME provides Names/Emails needed for DocuSign CWR
Cody Ransone
-- -- - Contractor Signatory:bana Bur hdoff/Dana.Bur hdoff fortworthtexas. ov
Thomas Royce Hansen(needs to initial prior to
CC copies to: signature)/Thomas.Hansen@fortworthtexas.gov
Mike Bennett/mike.bennett@fortworthtexas.gov
✓ Kathy Hopkins -- — Manager review and approves kch 3/28/2022
0 Glenn Jennings ❑ Joseph Monyer Budget Officer confirms coding(please write in#s): gj 3-28-22
❑ Sharma Packer 0 Loren Sammon Fund: See CIF COBJ: MOF: EE 3//28/ 2
❑✓ Eldrisha Eubanks
❑April Weiss Dept: PCA: Work#: 3/28/22
AW 3/28/22
❑ Larry French 0 Saul Nuccitelli Division Director reviews and approves SN,3/28/22
❑ Carla Guthrie ❑ Clay Schultz
❑ Temple McKinnon ❑ Mark Wyatt
❑ Darrell Tompkins ❑
❑ Ashley Harden ❑ Richard Wade Deputy Executive Administrator or CFO reviews,approves [DocuSign]
❑ Edna Jackson ❑ Jessica Pena and signs transmittal letter (if budgetary change does not 91v
0 John T. Dupnik,P.G. ❑ Rebecca Trevino exceed a total contract value of$25,000) 4/6 2022
Procurement&Contract Services 0 All approvals have been received. SJ 3/29/2022
Sherry Jackson 0 Prepare FINAL Amendment&Contract Initiation Form (CIF)
0 Send for execution via DocuSign
4 FOR DOCUSIGN ONLY — CONTRACT ADMINISTRATION ONLY y
❑ LeeRoy Lopez ❑ Johnny Greenwood
0 Letty Molina Accounting Director reviews and approves
Contractor Contractor executes contract
Amanda Lavin Assistant Executive Administrator reviews and approves
Jeff Walker Executive Administrator reviews,approves and signs
(if budgetary change>$25,000
0 Eldrisha Eubanks (Payable Contract) Receives a copy
❑ April Weiss (Receivable Contract)
Procurement&Contract Services ❑Upload executed document(s)in to CAS
Sherry Jackson ❑Update Worklog ❑ Clean up Shared Drive
By signing this form,you are certifying that this packet and its contents meet with your approval.
Updated 6/22/2021
DocuSign Envelope ID:EBC4C46B-E261-455B-90AB-09BC10DB6191
TEXAS WATER DEVELOPMENT BOARD
CONTRACT INITTATION FORM
Nmv Contrart
An,endn,ent
Contract Manager Cody'ans,ne 2 Amendment No.(Capplicable)
DfOce/Divsion/Seenan WSC/FSCA/Gc
Phone Nu be, 512-475-1563 7e—HeFt-A1.r1,rt 1700012292
Contract No. 1700011418 Grant Yes
Payable Receie--able
Eanrd Approval Det,(N/Aifnodote)11
Expiration Date
05/17/18 58/14/1 06/20/23
Most Recent Au,endu,—L 6/15/2021 Wigh"Ir."t, �E6/19/2021 External Contract No EMT-2012414-E002,FMA-PI-06-TX-2017-008,
Execution Date: Expiration Date: CFDI No.97.029
Proposal Number 0000,138
Vendor ID#(aka:Tax Payer ID#)1750005286 'roman,
Vendor Name Citvof Fm-t Worth
50 ct Add—200T2—Street
City,Stati,Zip Fort Worth,'I'exas 76102 Retainage% See RelotV
Telephone Number(817]392-2714 Special lushvctions 100%reimbursed up Lo 90'Yoof the g—L funding a s per the
Vendor Cuntract Mgr/Email Address Mike Bennett/Nlilce.Bennett@torhvartht—.goy sLanda rd language'm Lhe co nLracL
Signer ofC-tract/Email Addressl Dana Burghdoff/Dana,Rurghdntf@fnrtworthtom-.gov t
FY17 FMA:The City of Fort Worth seeks to mitigate continuous Flood darnage
Contractor Share of Casts $ - by acquiring and demolishing two propertles
TWDII Share.of Costs $ 31,7,00.00
Receivable Shm'e of Loss $ 515'soo.00
Toll Contract Costs $ 550,000.00 Extendthe Project Completion D,teandtl,e Contract Expiration Date.
S) USAS(PYADDR/PYHOLD) RFQ/REP/RFA/RFC NOFO-Croats.ov
S) Franchise Tax Search ❑tteragency/Local
Sj SAM Check E uat-1 Date:11 29 2022 Purchase
SJ Debarred Vendor List Receivable Grant
S) Boycotticrael 9-Exempt
Sl lies to Sudan/Iran/Foreign Terrorist Organizadons/Designated Foreign Terrorist Org
N/A W-9 Rccclvcd(ncw contractor anl,.lf applreablc) _
BUDGET USE ONLY
TWDB SHARE
FUND COBT MOF DEPT PCA \Work# PREV AY AY Total Funds Expire
4-XXXX 4-XXXX 3-XXX 4-XXXX 5-XXXXX 6-XXXXXX 2022 2023
$ 24.500.00 $ $ $ 34,500.00 NA(PIF]
s $ 5 s
$ $ s $
$ $ $
$ $ $
$ $ s $
TWDBSubtotal $ 34,500.00 $ $ $ 34,500.00
RECEIVABLE SHARE
FUND COBj MOP DEPT PC.A Wnrlc# PREV AY AY Total Funds Expire
4-XXXX 4-XXXX -3-XXX 4-XXXX 5-XXXXX G-XXXXXX 2022 2023
cool 7611 F06 C344 21021 G02098 $ 515,500.00 $ $ $ 515,50C.00 NA,FED]
$ S
$ 5 $
$ $
$ $
$ s $
$ $
$ $
$ $
$ s $
$ $
$ $
$ s $
$ s $
R eceivnble Subtotal $ 515.500.00
Contractor Subtotal $ 3 $
Contract Total $ $5a,D11l1.DU $ $ S SS D,u0...0
APPROVAI.SIGNATURES and CDNFIRMATION DF COMPI.IANER WITH AGENCY POLICY&THE STATE.OF TEXAS CONTRACT MANAGEMENT GUIDE
M,sm,mg this form.yo—m veftiffi,,q that this contract ocketand Us tentsmeet,vithyonra yai
ProaarementscnntractSo,"'es Camero»Turner 3 29 202
Budget Director[and Budget Officer] Sharma Packer Gj: G� 4/1/2022
S4awu VA�LP 3/30/202
Contract Manager Cndy Roos— �I
Program Manager Kathy Hopkins G /4/2022
Dlusia„Dir—t- SaulNucciteni $ 4/5/2022
Legal C--1 Kaye Sehnitz 3/29/202
mnaneinl Operathn., Lem,Molina EE: A)N: aL, Katy.w,aa;"°. /30/202
Deputy ExccudwAdminlstrat- John Dupnik /6/2022
F---rd e Ad,—istramr[r De,,—] Jeff Walker AL: 0.� tual�Gr 11 0