HomeMy WebLinkAbout13 - Mutual Aid Agreement for the COVID-19 Vaccination EffortQ �EwPpRT
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z NEWPORT BEACH
<,FORN'P City Council Staff Report
September 28, 2021
Agenda Item No. 13
TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL
FROM: Jeff Boyles, Fire Chief - 949-644-3101, jboyles@nbfd.net
PREPARED BY: Mary Locey, Administrative Division Manager, mlocey@nbfd.net
PHONE: 949-644-3352
TITLE: Mutual Aid Agreement with the County of Orange for the COVID-19
Vaccination Effort
ABSTRACT:
The Fire Department has participated in the countywide vaccination effort by providing
staffing in various capacities at local points of dispensing (PODs). The cost of staffing the
PODs is eligible for reimbursement from the Federal Emergency Management Agency
(FEMA) with requests made through the County of Orange (County). To facilitate
reimbursement, approval of a mutual aid agreement with the County is required. This item
is for the City Council's approval of the agreement to recover nearly $35,000 in federal
reimbursement.
RECOMMENDATIONS:
a) Determine this action is exempt from the California Environmental Quality Act (CEQA)
pursuant to Sections 15060(c)(2) and 15060(c)(3) of the CEQA Guidelines because
this action will not result in a physical change to the environment, directly or indirectly;
and
b) Approve the Mutual Aid Agreement with the County of Orange for the COVID-19
Vaccination Effort.
DISCUSSION:
On March 13, 2020, the President of the United States issued a Major Disaster
Declaration (FEMA -4482 -DR -CA) in response to the COVID-19 pandemic pursuant to
Section 501 (b) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act,
42 U.S.C. 5121-5207 (the "Stafford Act"). This action made the State of California, local
and Indian tribal governments, and certain private, non-profit organizations eligible to
apply for reimbursement from FEMA's Public Assistance (PA) Program.
On December 31, 2020, the County launched Operation Independence with the goal of
facilitating the vaccination of all willing community members by July 4, 2021. To
accomplish this, an incident management team was assigned to lead the organization of
mass vaccination sites, known as PODs. Because the PODs provide mutual benefit to
community members across the region, regardless of where they live or work, support for
staffing the PODs was requested of local jurisdictions. Staffing goals were set based upon
the proportion of community members living within each jurisdiction.
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Mutual Aid Agreement with the County of Orange for the COVID-19 Vaccination Effort
September 28, 2021
Page 2
As a mutual aid responding agency, the City of Newport Beach incurred expenses in
staffing vaccination PODs. Staff, consisting of sworn and civilian Fire Department
personnel, were identified to support the POD's based on their qualifications, licenses,
certifications, skills and availability.
FEMA determined that staffing costs for the PODs is eligible for reimbursement under its
PA program. FEMA and the California Office of Emergency Services (Cal OES) have
requested that PA reimbursements for local jurisdictions be submitted electronically
through county agencies. The County will serve as the aggregator and administrator of
claims for all jurisdictions supporting of the vaccination effort. The County shall then
reimburse the requesting jurisdictions solely based on what has been approved for
reimbursement by FEMA and Cal OES and upon receipt of federal reimbursement
funding.
To reimburse cities, mutual aid agreements are required between the County and each
requesting jurisdiction. The Orange County Board of Supervisors approved the standard
mutual aid agreement (MOA) on March 9, 2021. A revised MOA was approved by the
Board of Supervisors on July 27, 2021 and is attached to this staff report for the City
Council's approval (Attachment A).
To facilitate the necessary actions for obtaining federal financial assistance related to this
MOA, the City Council approved Cal OES Form 130 on November 10, 2020. The form is
valid for three years and authorizes the City Manager as an agent to provide for all matters
pertaining to State and FEMA reimbursements.
Staff recommends approval of the MOA, without changes, to potentially recover the
expenses of staffing the PODs. The City Manager will execute any actions that do not
materially change the terms in the MOA.
:9 k*Ta±M I M I :7±« 6
From December 2020, through June 2021, Fire Department personnel were assigned to
work the County PODs at the Huntington Beach Central Net Facility POD, the Disneyland
Super POD, and the OC Fairgrounds Super POD. Personnel from each division of the
department—administration, prevention, lifeguards, suppression, EMS, and management
—filled POD assignments, which included clinic management, patient registration, vaccine
administration, and observation periods. The table below provides a detailed breakdown
of the department's contribution to the vaccine effort.
POD Location Clinic Days
Vaccine's
Administered
HB Central Net 34
11,519
Disneyland 6
24,728
OC Fairgrounds 16
31,895
TOTAL 56
68,142
Note: The in-house vaccination clinics currently offered by the
Fire Department are not included above and are not eligible
for reimbursement under this MOA.
13-2
Mutual Aid Agreement with the County of Orange for the COVID-19 Vaccination Effort
September 28, 2021
Page 3
The cost of staffing the PODs was absorbed in the department's existing operating
budget, which is estimated to be $35,000. The MOA will allow the City of Newport Beach
to be reimbursed for these costs. Staff will work with the Finance Department to pull
accurate payroll data for completion of the MOA and submittal to the County. Revenue
received will be allocated to the Fire Department's intergovernmental revenue account
related to COVID expenditures (01040404-431135-D2020).
ENVIRONMENTAL REVIEW:
Staff recommends the City Council find this action is not subject to the California
Environmental Quality Act (CEQA) pursuant to Sections 15060(c)(2) (the activity will not
result in a direct or reasonably foreseeable indirect physical change in the environment)
and 15060(c)(3) (the activity is not a project as defined in Section 15378) of the CEQA
Guidelines, California Code of Regulations, Title 14, Chapter 3, because it has no
potential for resulting in physical change to the environment, directly or indirectly.
NOTICING:
The agenda item has been noticed according to the Brown Act (72 hours in advance of
the meeting at which the City Council considers the item).
ATTACHMENT:
Attachment A — Mutual Aid Agreement
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ATTACHMENT A
MUTUAL AID AGREEMENT
forthe
COVID-19 Vaccination Effort
This Mutual Aid Agreement ("AGREEMENT") between the County of Orange, a political subdivision of
the State of California, ("COUNTY" or "LEAD AGENCY") and City of Newport Beach ("MUTUAL AID
PARTNER" or "PROVIDING JURISDICTION") pertaining to mutual aid assistance provided under the
Orange County Operational Area Agreement ("OAA") is made and entered into as of
2021. COUNTY and MUTUAL AID PARTNER are individually referred to as
"PARTY" and collectively referred to as "PARTIES."
NOTE: Use of such an agreement does not guarantee state or federal reimbursement.
WHEREAS, this event and associated conditions will collectively be referred to as the Novel Coronavirus
COVID-19 Vaccination Effort ("COVID-19 Vaccination Effort"); and
WHEREAS, COVID-19 is a world-wide pandemic resulting in significant health and economic impacts
across the globe;
WHEREAS, on February 26, 2020, the Orange County Health Officer declared a Health Emergency;
WHEREAS, on February 26, 2020, the Chair of the Emergency Management Council issued a
Proclamation of Local Emergency pursuant to the requirements of the California Emergency Services Act,
which was ratified by the Board of Supervisors on March 2, 2020;
WHEREAS, on March 4, 2020, the Governor of the State of California proclaimed a state of emergency
in response to the COVID-19 pandemic pursuant to the California Emergency Services Act;
WHEREAS, on March 13, 2020, the President of the United States issued a Major Disaster Declaration
for California (FEMA -4482 -DR -CA) in response to the COVID-19 pandemic pursuant to section 501 (b) of
the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121-5207 (the "Stafford
Act"). This action made the State of California, local and Indian tribal governments and certain private
non-profit (PNP) organizations eligible to apply for reimbursement from the Federal Emergency
Management Agency (FEMA) Public Assistance (PA) Program'.
WHEREAS, the COUNTY has implemented a vaccination effort ("COVID-19 Vaccination Effort") intended
to vaccinate all eligible community members free -of -charge to curtail the impacts of COVID-19 on
residents throughout the County;
' See https://www.fema.gov/assistance/public/program-overview for more information.
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13-4
WHEREAS, residents in County unincorporated areas and those residing within the boundaries of
incorporated cities within the County of Orange are equally impacted by COVID-19 and will equally
benefit from receipt of COVID-19 vaccinations;
WHEREAS, implementation of the COVID-19 Vaccination Effort is an intensive effort requiring significant
resources and coordination across jurisdictions on a day-to-day basis;
WHEREAS, the County formed the Operation Independence Incident Management Team (IMT) to
coordinate the planning and operation of COVID-19 regional vaccination sites and mobile clinics,
including all staffing scheduling and obtaining services and supplies, equipment and facilities.
WHEREAS, COUNTY is seeking resources including but not limited to staffing, services and supplies,
equipment and facilities to ensure the safe, expeditious and effective operation of COVID-19 Vaccination
Effort vaccination sites;
WHEREAS, MUTUAL AID PARTNER is interested in providing staff to assist in the COVID-19 Vaccination
Effort;
WHEREAS, COUNTY and MUTUAL AID PARTNER wish to clarify the terms by which Mutual Aid assistance
and reimbursement will be provided by the Parties in implementing the COVID-19 Vaccination Effort;
WHEREAS, COUNTY and MUTUAL AID PARTNER are members of the Orange County Operational Area
(OA) for the coordination of Mutual Aid Emergency Response as provided for under the California
Emergency Services Act. The Orange County Operational Area Agreement describes the cooperative and
mutual handling of duties and responsibilities within Orange County related to disaster preparedness,
response and recovery, including the coordination of the emergency functions of the Operational Area
with all other public agencies, corporations, organizations, and affected private persons within the
Operational Area;
NOW, THEREFORE, COUNTY and MUTUAL AID PARTNER agree to the following terms to guide their
dealings as they pertain to participation in the COVID-19 Vaccination Effort.
A. Limitation of Liability
1. Indemnification
By MUTUAL AID PARTNER: MUTUAL AID PARTNER agrees to indemnify, defend with
counsel approved in writing by COUNTY, and hold COUNTY, its elected and appointed
officials, officers, employees, agents and those special districts and agencies which
COUNTY'S Board of Supervisors acts as the governing Board ("COUNTY Indemnitees")
harmless from any claims, demands or liability of any kind or nature, including but not
limited to personal injury or property damage, arising from or related to the services,
products or other performance provided by MUTUAL AID PARTNER pursuant to this
Agreement. If judgment is entered against MUTUAL AID PARTNER and COUNTY by a court
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13-5
of competent jurisdiction because of the concurrent active negligence of COUNTY or
COUNTY Indemnitees, MUTUAL AID PARTNER and COUNTY agree that liability will be
apportioned as determined by the court. Neither PARTY shall request a jury
apportionment.
ii. By COUNTY: COUNTY agrees to indemnify MUTUAL AID PARTNER, and hold MUTUAL AID
PARTNER, its elected and appointed officials, officers, employees, agents and those
special districts and agencies which COUNTY's Board of Supervisors acts as the governing
Board ("MUTUAL AID PARTNER Indemnitees") harmless from any claims, demands or
liability of any kind or nature, including but not limited to personal injury or property
damage, arising from or related to the services, products or other performance provided
by COUNTY pursuant to this Agreement. If judgment is entered against COUNTY and
MUTUAL AID PARTNER by a court of competent jurisdiction because of the concurrent
active negligence of MUTUAL AID PARTNER or MUTUAL AID PARTNER Indemnitees,
COUNTY and MUTUALAID PARTNER agree that liability will be apportioned as determined
by the court. Neither PARTY shall request a jury apportionment.
2. Waiver of Claims
i. Each PARTY hereto agrees to waive all claims against all other PARTIES hereto for any loss,
damage, personal injury or death occurring in consequence of the performance of this
Mutual Aid Agreement; provided, however, that such claim is not a result of gross
negligence or willful misconduct by a PARTY hereto or its personnel.
ii. Each PARTY to this Agreement waives all claims against all other PARTIES to this
Agreement for compensation for any loss, damage, personal injury, or death occurring to
personnel and/or equipment as a consequence of the performance of this agreement.
3. Governmental Immunity:
To the fullest extent authorized by law, all activities performed under this agreement are
deemed to be governmental functions. Neither COUNTY or MUTUAL AID PARTNER, nor
their employees, except in cases of willful misconduct, gross negligence, or bad faith shall
be liable for the death of or injury to persons, or for damage to property when complying
or attempting to comply with this Agreement.
4. Insurance:
i. Each PARTY shall be responsible for providing insurance for its own employees and
representatives.
ii. Claims for injuries incurred while participating in the COVID-19 Vaccination Effort will be
submitted under the Workers Compensation policy of the injured PARTY's employer. (i.e.,
3
13-6
COUNTY employees/volunteers will submit under the COUNTY's policy and MUTUAL AID
PARTNER employees/volunteers will submit under the MUTUAL AID PARTNER's policy.)
B. Billing and Reimbursement
1. Reimbursement Rules
Regardless of the source of funds by which Vaccination Effort Reimbursement Requests are
reimbursed, the PARTIES agree for the sake of consistency and accuracy:
i. To abide by the principles set forth in the Robert T. Stafford Disaster Relief and Emergency
Assistance Act, as Amended (Stafford Act), Title 42 of the United States Code (U.S.C.) §
5121 et seq.; Title 44 of the Code of Federal Regulations (C.F.R.), Part 206; and 2 C.F.R.,
Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements
for Federal Awards.
ii. To be guided by the concepts outlined within FEMA Public Assistance Program and Policy
Guide (Exhibit 2).
iii. To be further guided by COVID-19-specific response and recovery guidance issued by
federal and state agencies related to vaccination efforts.
2. MUTUAL AID PARTNER Responsibilities:
i. Submit Vaccination Effort Reimbursement Requests to COUNTY at a minimum of once
every 30 days according to schedule provided by COUNTY.
ii. Submit all Vaccination Effort Reimbursement Requests in the format attached to this
Agreement (Exhibit 1) or as otherwise may be required by the COUNTY for services
rendered by MUTUAL AID PARTNER representatives. Failure to submit timely Vaccination
Effort Reimbursement Requests in the recommended format may result in a denial of
reimbursement and require resubmittal of Request.
iii. Ensure that, for each Vaccination Effort Reimbursement Request submitted, all COVID-19
Vaccination Effort direct labor expenditures (includes labor burden and excludes
overhead) are documented and certified by the MUTUAL AID PARTNER to be in
compliance with COUNTY requirements.
iv. Ensure that for each Vaccination Effort Reimbursement Request submitted, all personnel
resources are reconciled with COUNTY vaccination site personnel records.
v. Exclude from each Vaccination Effort Reimbursement Request incidental expenditures
such as mileage, meals, lodging, etc.
4
13-7
vi. Provide any additional documentation requested by COUNTY in support of the MUTUAL
AID PARTNER's Vaccination Effort Reimbursement Request.
vii. Maintain records for audit, as described within the FEMA Public Assistance Program and
Policy Guide (Exhibit 2). MUTUAL AID PARTNER shall make records available for inspection
upon request of the COUNTY.
viii. Remedy any audit finding related to Vaccination Effort Reimbursement Requests,
including any audit finding identified under the Improper Payments Elimination and
Recovery Improvement Act (IPERIA).
ix. MUTUAL AID PARTNER agrees to provide sufficient documentation, as defined by the
COUNTY, to ensure adequate validation of costs for reimbursement. As necessary during
this public health crisis, MUTUAL AID PARTNER will assist with the COVID-19 Vaccination
Effort and ensure that cost documentation is submitted to the COUNTY for review and
verification to ensure County has complete cost documentation to support County
reimbursement requests.
3. COUNTY Responsibilities
i. Conduct an initial review for completeness of MUTUAL AID PARTNER Vaccination Effort
Reimbursement Request and supporting documentation for consistency with
Reimbursement Rules (Section B.1 herein).
ii. Submit MUTUAL AID PARTNER Vaccination Effort Reimbursement Request to third party
reimbursement funding grantors within 30 days of receipt of complete request, including
backup documentation, from MUTUAL AID PARTNER.
iii. Monitor the status of the MUTUAL AID PARTNER Vaccination Effort Reimbursement
Request and inform the MUTUAL AID PARTNER of progress.
iv. Work with MUTUAL AID PARTNER to resolve any issues with Vaccination Effort
Reimbursement Requests.
v. Reimburse MUTUAL AID PARTNER when the COUNTY has determined that sufficient
documentation has been received and reimbursement funds are available.
vi. In response to auditing or monitoring requests made by third party reimbursement
funding grantors, COUNTY will work with MUTUAL AID PARTNER to ensure adequate
documentation is gathered to effectively respond to requests for information.
5
13-8
4. Modifications
This agreement is subject to program modifications that may be made to Reimbursement
Rules by state and federal legislative and regulatory authorities.
C. Disputes
Any controversy or claim between the PARTIES arising out of or relating to this Agreement, or
the breach thereof, shall be settled by arbitration in accordance with the Rules of the American
Arbitration Association and judgment on the award rendered by the arbitrator(s) may be entered
in any court having jurisdiction thereof.
D. Termination
Any PARTY may withdraw from this Agreement upon 30 days written notice.
MUTUAL AID PARTNER:
(Signature)
Name:
Title:
Agency:
Date:
COUNTY OF ORANGE
(Signature)
Name:
Title:
Date:
APPROVED AS TO FORM:
GITY ATT'ORNEY'S OFFICE
Date: 'I/IH/z
Li
o . Harp, ttAomey
13-9
EXHIBIT 1
13-10
IEM / County will work withIEM / County will coordinate
Mutual Aid Partners to with County Auditor- County IMT Finance and IEM
resolve any issues presented Controller to pay appropriate will update and maintain a
by FEMA/CalOES on MAP MAP Invoices as each weekly MAP Claim and
submitted claims. reimbursement request is reimbursement status log.
approved by CalOE5/FEMA.
County IMT Finance will
notify IEM of MAP Claims
ready for their review
IEM will review jurisdiction
claims to ensure worksheets
and supporting
documentation meets
FEMA/Cal0E5 claim
requirements.
- If IEM identifies issues, IEM
will coordinate with
Jurisdiction to correct and
revise/update claim and
supporting documentation
Mutual Aid Partners
if issues are identified with a
County EMT Finance
County IMT Finance will
complete monthly claims,
County IMT Finance will
reconciles MAP claim
notify jurisdictions by email
upload worksheets and
download MAP Claims and
worksheets and backup data
to remind them of claim
supporting documentation
documentation from
against daily 204s and Check -
submission due dates. Email
into their appropriate folder
WebEOC and upload to
in/Check-Out/No-Show Logs
reminders will be sent weekly
in WebEOC-PrepareOC,
IMTMAP Sharepoint files
(database] from each POO
through the month of August.
COVI❑-19 Jurisdiction
site
information section
IEM / County will work withIEM / County will coordinate
Mutual Aid Partners to with County Auditor- County IMT Finance and IEM
resolve any issues presented Controller to pay appropriate will update and maintain a
by FEMA/CalOES on MAP MAP Invoices as each weekly MAP Claim and
submitted claims. reimbursement request is reimbursement status log.
approved by CalOE5/FEMA.
County IMT Finance will
notify IEM of MAP Claims
ready for their review
IEM will review jurisdiction
claims to ensure worksheets
and supporting
documentation meets
FEMA/Cal0E5 claim
requirements.
- If IEM identifies issues, IEM
will coordinate with
Jurisdiction to correct and
revise/update claim and
supporting documentation
if issues are identified with a
County IMT Finance/IEM
claim, County IMT Finance
IEM / County will submit
submits reviewed and
notifies and coordinates with
County IMT Fina7Team
MAP claim to FEMA/Ca1OES
approved MAP claims to the
jurisdiction to correct issues.
will meet every Thursday for
for reimbursement via the
County's Appl€cant
claim review and approval . Jurisdiction will submit a
FEMA PA Grants Portal.
Agent/€MT Team for e-mail
revlsesd invoice and
approval.
supporting documentation,
as needed.
IEM / County will work withIEM / County will coordinate
Mutual Aid Partners to with County Auditor- County IMT Finance and IEM
resolve any issues presented Controller to pay appropriate will update and maintain a
by FEMA/CalOES on MAP MAP Invoices as each weekly MAP Claim and
submitted claims. reimbursement request is reimbursement status log.
approved by CalOE5/FEMA.
County IMT Finance will
notify IEM of MAP Claims
ready for their review
IEM will review jurisdiction
claims to ensure worksheets
and supporting
documentation meets
FEMA/Cal0E5 claim
requirements.
- If IEM identifies issues, IEM
will coordinate with
Jurisdiction to correct and
revise/update claim and
supporting documentation
TABLE
Check . box ifincluded in w
Click on title to link to sheet
Eligible Expensesw
•UT FIRST
us
Q
w
Disaster Number (XXXX-DR-STATE): 4482 -DR -CA
I Cost Summary Roll -Up
Applicant Name:
County of Orange
F-1 Fringe Benefits
Category:
B
rl Labor - At POD Site or IMT
FI Labor - Outside POD Site or IMT
o
€
c
c
°'v,
Q
Prepared By:
Enter Name Person Completing
i_._I Invoice
Preparer Title:
Title of Person Completing
Department:
Enter Department
SUPPORTING • •
Jurisdiction:
City/Jurisdiction
1 Time Sheets
Mailing Address:
Street Address
I Payroll Registers (Proof of Payment)
City, State, Zip Code
I ICS 214 - ALL Employee Activity Logs
Office Phone I Fax Number:
Office Phone J Fax Number
I ICS 204 - Outside POD site or IMT
Contact Email:
Enter Email of Primary Contact
I Department/Agency Pay Policy**
Certified By &Title:
Enter Name, Title of Certifying Official
I Post Event Agreement**
Resource Type:
Emergency Management Mutual Aid
*" Only necessary to provide once
per jurisdiction
If Other Specify:
ATTENTION:
This is a protected form, with many cells locked in order to prevent
modifications to the general template. Please use caution if adding or deleting
rows to ensure formulas are maintained and copied correctly.
1P131W. 8" INI
Complete all yellow fields. Data will autopopulate other sheets in Excel Workbook.
- Yellow fields represent data that must be entered.
- Blue fields represent fields that are calculations or are autofilled
-Green fields represent totals that are transferred to the Cost Summary Roll -Up
If pages do not print correctly, select "View" and "Page Break Preview" and adjust
manually.
13-12
Eligibility For Reimbursement
deployed and must have a pre-executed MOU or Post-Event Agreement. All supporting
documentation must be provided. The expenses incurred may vary depending on the Type of
Mutual Aid provided.
Examples of Eligible Expenses:
Only labor and associated fringe benefits are being accepted for processing by the County at thi
Examples of Ineligible Expenses:
equipment
Hortal to Mortal Compensation
uommnauon or mileage an❑ rues Tor Tne same venicie
Counf7y-requesteO 1515or costs are eligible.
Non-labor resources provided by the county and requested through WebEOC may not
be eligible for reimbursement under public assistance unless specifically approved by
13-13
FEDERAL EMERGENCY MANAGEMENT AGENCY
COST SUMMARY ROLL -UP
APPLICANT
JURISDICTION CATEGORY DISASTER
County of Orange
City/Jurisdiction
B 4482 -DR -CA
CATEGORY
CLAIM COST
COMMENTS
ELIGIBLE COSTS
LABOR REGULAR TIME
$
Resources requested by the County and deployed at the
$
(At -POD)
POD site and IMT
LABOR OVERTIME
$
Resources requested by the County and deployed at the
$
(At -POD)
POD site and IMT
LABOR REGULAR TIME
$
Resources requested by the County and deployed outside
$
(Outside -POD)
the POD site and IMT
LABOR OVERTIME
$
Resources requested by the County and deployed outside
$
(Outside -POD)
the POD site and IMT
OTHER COSTS
$ -
$ -
(If pre -approved)
TOTAL
$ -
$ -
I certify that the above information was transcribed from timesheets, payroll records, equipment log, invoices, stock records or other
documents which are available for audit. This claim is for cost incurred within the approved Grant Performance Period.
By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the
expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the term and conditions of the
Federal award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to
criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title 18, Section 1001 and
Title 31, Section 3729-3730 and 3801-3812).
The above resources were requested by the County of Orange for Vaccination Efforts and provided or deployed by Mutual Aid
Partner certifying this report.
CERTIFICATION AND COMMENTS:
Certified by:
Date:
Enter Name, Title of Certifying Official
Applicant's records have been reviewed and found correct with the exceptions and/or comments noted below:
'' ?-14
Reviewed b IEM):
Date:
Enter Name, Title of !EM Compliance Reviewer
Reviewed b (orange County):
Date:
Enter Name, Title of OC Compliance Reviewer
13-15
County of
Holidays
Vacation Leave
Sick Leave
• Social Security
• Medicare
• Unemployment
• Worker's Comp
— Retirement
Health Benefits
Life Insurance Benefits
Other (De8mbe here)
(COMMENTS:
FEDERAL EMERGENCY MANAGEMENT AGENCY
APPLICANT'S BENEFITS CALCULATION WORKSHEET
ENTER TOTAL ANNUAL PAYROLL
REGULAR TIME % OVERTIME %
If the benefit is
applied to the
overtime fringe
rate, select the
proper box
r
r
F-
-
F-
r
(FIGURES
(FIGURES 1N BLUE AUTOMATICALLY "GO" TO THE FORCE ACCOUNT LABOR SHEETS)
I CERTIFY THAT THE INFORMATION ABOVE WAS TRANSCRIBED FROM PAYROLL RECORDS OR OTHER DOCUMENTS
WHICH ARE AVAILABLE FOR AUDIT.
CERTIFIED: Enter Name, Title of Certifying Official
DATE:
Only categories for overtime fringe benefits.
— Onty an overtime fringe benefit when supported by employee contract
13-16
FEDERAL EMERGENCY MANAGEMENT AGENCY
LABOR RECORD - At POD Site or IMT
APPLICANT JURISDICTION CATEGORY DISASTER #
County of Orange City/Jurisdiction B 4482 -DR -CA
EMPLOYEE NAME
(Last name, First name)/
TITLE
N
q
N
�
O
t7
�
DATES & HOURS WORKED
111
112
113
114
lis
116
117
118
119
1110
1 f 11
1112
1113
1114
1115 1116
1117
1118
1119
1120
1121
1122
1/23
1124
1125
1/26
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Titlo
OT
FORCE ACCOUNT LABOR PAGE 7 OF 11 13-17
FORCE ACCOUNT LABOR PAGE 8 OF 11 13-18
After review of the pay policy, are EXEMPT
employees eligible for OT?
No
Enter OT Rate
1.5
TOTAL REG HOURS
REG TIME
TOTAL
$
TOTAL OT HOURS
OT TOTAL
$ -
TOTAL HOURS
O
TOTAL COSI.
-
1127
1/28 1128
RATES/COSTS
1/30 1131 HOURLY BENEFIT
TOTAL HAS TOTAL HOURLY TOTAL COST
RATE RATE
S $ S
$ S S
S 5 5
S S S
S 5 S
S 5 5
5 5 S
5 S $
S S S
5 S 5
5 S S
5 5 $
S S S
$ 5 5
5 5 S
5 S S
S 5 $
S S S
S S S
S 5 S
S $ $
S S S
5 $ $
$ $ $
5 $ S
$ $ S
FORCE ACCOUNT LABOR PAGE 8 OF 11 13-18
FEDERAL EMERGENCY MANAGEMENT AGENCY
LABOR RECORD - Outside POD Site or IMT
APPLICANT JURISDICTION CATEGORY DISASTER #
County of Orange City/Jurisdiction B 4482 -DR -CA
EMPLOYEE NAME
)Last name, First name) I
TITLE
G
w
O
c7
DATES & HOURS WORKED
111
112
113
114
115
116
117
110
119
1/10
1111
1112
1113
1114
1115
1/16
1117
1110
1119
1120
1121
1122
1123
1124
1125
1126
Name
REG
Till.
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
Name
REG
Title
OT
FORCE ACCOUNT LABOR PAGE 9 OF 11 13-19
FORCE ACCOUNT LABOR PAGE 10 OF 11 13-20
After review of the pay policy, are EXEMPT
employees eligible for OT?
No
Enter OT Rate
1.5
TOTAL REG HOURS
REG TIME
TOTAL
$
TOTAL OT HOURS
OT TOTAL
f -
TOTAL HOURS
TOTAL COST
f
1127
1120
1129
1130
1131
RATESICOSTS
HOURLY BENEFIT
TOTAL HRS RATE RATE TOTAL HOURLY TOTAL COST
$ S $
S 5 5
$ S S
5 S 5
S S S
5 S $
S S 5
S S $
5 S S
S S $
5 S S
S S $
5 S S
5 S S
$ 5 S
$ S S
$ 5 5
$ $ S
S S S
S $ 5
S S S
$ $ 5
S S S
$ S 5
S 5 S
S S S
FORCE ACCOUNT LABOR PAGE 10 OF 11 13-20
Add Logo (optional)
INVOICE
City/Jurisdiction
Enter Department
CLAIM NO.
Street Address
INVOICE NO.
City, State, -Lip Code
DATE 9/14/2021
Office Phone I Fax Number
RESOURCE TYPE. Emergency Management Mutual Aid
Enter Email of Primary Contact
TO
County of Orange
IMT MAP - Claims
601 N Ross St., 4th Floor, Room 420
Santa Ana, CA 92701
71'F-834-4150
Disaster: COVID-14 PAYMENT TERMS
Vaccination PODS Due on receipt
DESCRIPTION QUANTITY TOTAL
Labor Straight Time At POD Site or IMT 0.40 $0.00
Labor Overtime At POD Site or IMT 0.00 WOO
Labor Straight Time Outside POD Site or IMT 100 $0.00
Labor Overtime Outsidc POD Site or WT 0.00 $0.00
OTHER COSTS
(If pre -approved) 54.00
0.00 Som
Make all checks payable to City/lunsdictron.
THANK YOU FOR YOUR BUSINESS?
Page 11 of 11 13-21
EXHIBIT 2
13-22
FEMA: Public Assistance Program and Policy Guide, Version 4, Effective June 1, 2020
can be found at the following link:
https://www.fema.gov/sites/default/files/documents/fema pappg-v4-updated-
links policy 6-1-2020.pdf
13-23