HomeMy WebLinkAboutIowa Flood Mitigation Board - Hawthorne Relief Wells - 8.18.2025Docusign Envelope ID: 1A9COD47-B21B-427C-A35E-B54EO2104AA3
IOWA LEVEE IMPROVEMENT FUND AWARD AGREEMENT
Between
Iowa Flood Mitigation Board
And
City of Waterloo
PROJECT TITLE: City of Waterloo Hawthorne Relief Wells
AGREEMENT NO: S17
FIPS NUMBER: 013-82425-00
AWARD DATE: 06/25/2025
DATE OF FUNDING AGREEMENT: 7/29/2025
PERFORMANCE PERIOD END DATE: 7/29/2027
STATE FUNDS OBLIGATED AMOUNT: $280,000.00
I. SCOPE OF WORK:
This Award Agreement (AGREEMENT) is to provide the City of Waterloo (SUBRECIPIENT)
with financial assistance from the Iowa Levee Improvement Fund. Total Project Budget is
$560,000.00. The total award is $280,000.00.
Project Costs — The state share shall not exceed $280,000.00 or (50%) of actual allowable award
costs, whichever is less.
These funds are to assist the SUBRECIPIENT with completing the approved scope of work in
accordance with the work schedule, milestones, and budget that were submitted to and approved
by Iowa Department of Homeland Security and Emergency Management (HSEM) and the Iowa
Flood Mitigation Board (FMB). Any modifications to the approved scope must be submitted
and approved by HSEM and changes to budget must be submitted to and approved by the FMB
prior to executing the changes. The SUBRECIPIENT is required to obtain all necessary permits
before any construction begins.
EHP Standard Conditions:
Any change to the approved scope of work will require re-evaluation for compliance with NEPA
and other Laws and Executive Orders.
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Acceptance of funding obligates the subrecipient to comply with all applicable federal, state, and
local requirements. If the subrecipient is subject to regulations from a federal agency or other
cognizant agencies, they must ensure compliance accordingly. If not, they are only required to
meet state and local requirements. Failure to secure the necessary environmental permits and
clearances at any required level may put state funding at risk.
II. AGREEMENTS
HSEM will provide financial oversight and management in the role of recipient/pass-through
entity based on the grant guidance in 2 CFR, Part 200, the grant financial guide and other state
and federal guidelines. HSEM will provide technical assistance and direction to the
SUBRECIPIENT on programmatic and financial requirements. HSEM will provide agreement
documents and quarterly reporting documents. all appropriate documents and forms and make
payments to the SUBRECIPIENT to complete the approved scope of work.
HSEM is responsible for monitoring the SUBRECIPIENT's activities to provide reasonable
assurance that the SUBRECIPIENT administers this award in compliance with HSEM
requirements. Responsibilities include reviewing the SUBRECIPIENT's records that support
receipts and expenditures, financial records are maintained and adequate for audit, proper cash
management, and expenditures are eligible and allowable. A pre -award risk assessment is
completed for each subrecipient to assist HSEM in determining the minimum level of monitoring
that will be needed throughout the life of this award.
Additionally, the SUBRECIPIENT will be monitored periodically by HSEM to ensure that the
program goals, objectives, timelines, budgets, and other related program criteria are being met.
Monitoring will be accomplished through a combination of office -based and on-site monitoring
visits. Monitoring will involve the review and analysis of the financial, programmatic, and
administrative records relative to each program, and will identify areas where technical
assistance and other support may be needed.
The SUBRECIPIENT will allow HSEM and auditors to access any necessary records and
financial information.
The SUBRECIPIENT must disclose in writing any potential conflicts of interest to HSEM.
The SUBRECIPIENT must disclose in writing to HSEM all violations of Federal and State
criminal law involving fraud, bribery, or gratuity violations potentially affecting the state award.
Failure to make required disclosures can result in any of the remedies described in 2 CFR, Part
200, Subpart D, Section 200.339, Remedies for noncompliance, including suspension or
debarment. (See also 2 CFR, Part 180 and 31 U.S.C. 3321.)
The SUBRECIPIENT and the SUBRECIPIENT's authorized representative agree to provide all
supervision, inspection, accounting, and other services necessary to complete the scope of work
from inception to closeout with the requirements set forth below.
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III. PERIOD OF PERFORMANCE
The approved Period of Performance for this award is from July 2025 through July 2027. All
work must be completed prior to the end of the Period of Performance. HSEM will not
reimburse the SUBRECIPIENT for costs that are encumbered before the award agreement date
or after the project close date.
If a time extension is needed, one must be requested at least 90 days prior to the end of the
Period of Performance. All requests must be supported by adequate justification submitted to
HSEM 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
performance period; milestones that are unmet; and a description of performance measures
necessary to complete the award. Without the justification, time extension requests will not be
processed.
IV. AUTHORITIES AND REFERENCES
The SUBRECIPIENT shall comply with all applicable laws and regulations. A non-exclusive
list of laws and regulations commonly applicable to state grants follows hereto for reference
only.
• 2 CFR, Part 200 - https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-
200?toc=1
• Iowa Code CH 418A- Iowa Levee Improvement Program
• SUBRECIPIENT's application that was received and approved by HSEM
V. GRANT MANAGEMENT SYSTEM
To ensure state funds are awarded and expended appropriately, the SUBRECIPIENT will
establish and maintain a grant management system as outlined in 2 CFR, Part 200, Subpart D,
Section 200.302 and internal controls in section 200.303. The standards for SUBRECIPIENT
organizations stem from the Office of Management and Budget's (OMB) uniform administrative
requirements and the cost principles in 2 CFR, Part 200, Subpart E. State, local and tribal
organizations must follow the uniform administrative requirements standards in 2 CFR Part 200.
These standards combined with the audit standards provided within 2 CFR, Part 200, Subpart F
plus the requirements of the Generally Accepted Accounting Principles constitute the basis for
all policies, processes and procedures set forth in this grant management system for the
SUBRECIPIENT.
The SUBRECIPIENT's grant management system must include:
• internal controls based on the American Institute for Certified Public Accountants
(AICPA) definitions and requirements in the government -wide administrative
requirements and cost principles
• a chart of accounts that includes a separate cost center, fund, or accounting codes for each
federal grant, program, or funding source
• procedures to minimize cash on hand in compliance with the Cash Management
Improvement Act (CMIA) and good business processes
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• the ability to track expenditures on a cash or accrual basis
• the ability to track expenditures in both financial and program budgets
• procedures to document all grant -related expenditures, broken down by budget line items
• procedures to ensure expenditures are eligible and allowable
• the ability to fulfill government -required financial reporting forms
VI. PROCUREMENT
This AGREEMENT requires that all procurement be executed by the SUBRECIPIENT within
the guidelines of 2 CFR, Part 200 Subpart D, Section 200.318 through Section 200.326 including
Appendix II which coinsides with Iowa Department of Administrative Services (DAS)
guidelines. Procurement standards must be in accordance with the written adopted procedures of
the SUBRECIPIENT, provided that the local procurement standards conform to applicable State
and Federal law and the standards identified in 2 CFR, Part 200. The SUBRECIPIENT must
maintain written standards of conduct covering conflicts of interest as outlined in 2 CFR, Part
200 Subpart D, Section 200.318. The SUBRECIPIENT will ensure that every purchase order or
other contract includes clauses required by Federal statutes and executive orders and their
implementing regulations. The SUBRECIPIENT must submit copies of its own written
procurement guidelines, written conflict of interest guidelines, bid documents and contract
documents to HSEM prior to awarding or executing contracts. No contract will be
accepted without HSEM's prior review.
VII. PAYMENT REQUEST PROCESS
The SUBRECIPIENT may submit a payment request up to 30 days prior to an anticipated
expenditure or disbursement. The SUBRECIPIENT must be able to account for the receipt,
obligation, and expenditure of funds.
Payments to subrecipients are based on eligible expenditures that are specifically related to the
approved award budget and scope of work. The SUBRECIPIENT has two options available to
them when requesting payments from HSEM. Subrecipients can request Reimbursement for
allowable expenditures already paid, or request an Advance for expenditures to be paid within
30 days.
Payments shall be limited to the documented cash requirements submitted by the
SUBRECIPIENT. The SUBRECIPIENT must submit a completed Payment Request Form and
provide supporting documentation of eligible award costs to receive payment of funds.
• Reimbursement requests must include payment verification (i.e. paid invoices, receipts,
payroll records with personnel activity reports, cancelled checks, general ledger print
outs, etc.). HSEM reserves the right to request that the SUBRECIPIENT submit
additional expenditure documentation upon request.
• Advance payment requests must include the detailed costs the SUBRECIPIENT is
obligated to pay (i.e. invoices, accepted quotes, executed contracts, or other documents).
Payment verification documents (same documents required for a Reimbursement request)
for the advance must be submitted to HSEM within 30 days after the advance, and before
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future advances are made. If the SUBRECIPIENT is unable to demonstrate; the
willingness to maintain written procedures that minimize the time elapsing between the
transfer of funds and disbursement by HSEM; a financial management system that meets
the standards for fund control and accountability as established in 2 CFR, Part 200; or is
considered a High Risk subrecipient; then reimbursement requests will be required.
No more than thirty (30) days should elapse between the date of receipt of a warrant and
pay out of the funds by the SUBRECIPIENT. All supporting documentation must be
submitted to HSEM immediately following the SUBRECIPIENT's pay out of the funds.
Required documents prior to payments from HSEM. Payment of funds will not be made to
the SUBRECIPIENT until HSEM has on file the following documents:
• Award Notification (attached to this AGREEMENT)
• Pre -Award Risk Assessment (attached to this AGREEMENT)
• Signed Award Agreement
• Substitute W9/Vendor Update Form (if not already on file at HSEM)
• Chart of Accounts verifying that unique revenue and expenditure accounts, cost centers
or account codes have been established within the SUBRECIPIENT's cash
management/accounting system for each program included in this AGREEMENT.
• Procurement documents: written procurement and conflict of interest documents, method
of procurement, bid specifications reviewed by HSEM, copy of approved and executed
contracts between the SUBRECIPIENT and contractor.
• Signed certification from the SUBRECIPIENT's authorized representative for the
payment request as outlined in 2 CFR, Part 200, Subpart D, Section 200.415.
VIII. REPORTING REQUIREMENTS
Quarterly programmatic and financial reports are required on the progress relative to the
approved scope of work as outlined in 2 CFR, Part 200, Subpart D, Section
200.328. Subrecipients are required to complete the quarterly progress report forms that are
provided by HSEM and submit them by the due dates stated by HSEM. Due dates are January
15, April 15, July 15, and October 15. The first report is due following the end of the
reporting period in which the funding was awarded by FMB. The reporting periods are
January -March, April -June, July -September, and October -December.
IX. CLOSE OUT
The SUBRECIPIENT must prepare and submit by the end of the Period of Performance, and/or
within 60 days of the completion of the approved scope of work; whichever comes first, all
required financial, performance and other reports as outlined in 2 CFR, Part 200 Subpart D,
Section 200.344 and Section 200.345. The SUBRECIPIENT must liquidate all obligations
incurred under the award by the end of the Period of Performance. All accounts must be settled,
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including reimbursements for any remaining allowable costs and refunds to HSEM of any
unobligated cash that was advanced.
X. RECORD RETENTION
The SUBRECIPIENT must retain records pertinent to the state award for three years after the
date of the final expenditure report is submitted.
XI. WAIVERS
No conditions or provisions of this AGREEMENT can be waived unless approved by HSEM and
the SUBRECIPIENT, in writing. Unless otherwise stated in writing, HSEM's failure to insist
upon strict performance of any provision of this AGREEMENT, or to exercise any right based
upon a breach, shall not constitute a waiver of any right or obligation specified under this
AGREEMENT.
XII. AMENDMENTS AND MODIFICATIONS
This AGREEMENT may be amended or modified in reference to the award funds provided,
administrative procedures, or any other necessary matter, but not to take effect until approved, in
writing, by FMB and the SUBRECIPIENT.
XIII. COMPLIANCE, TERMINATION AND OTHER REMEDIES
Unless otherwise stated in writing, HSEM requires strict compliance by the SUBRECIPIENT
and its authorized representative(s) with the terms of this AGREEMENT, and the requirements
of any applicable local, state and federal statute, rules, regulations.
FMB may suspend or terminate any obligation to provide funding or demand return of any
unused funds, following notice from FMB, if the SUBRECIPIENT fails to meet any obligations
under this AGREEMENT or fails to make satisfactory progress toward administration or
completion of said subaward. The SUBRECIPIENT is responsible for repayment of funds as a
result of subsequent refunds, corrections, overpayments, or disallowed costs for ineligible
expenditures.
The SUBRECIPIENT understands and agrees that FMB may enforce the terms of this
AGREEMENT by any combination or all remedies available to FMB under this AGREEMENT,
or under any other provision of law, common law, or equity.
XIV. INDEMNIFICATION
It is understood and agreed by FMB, HSEM, and the SUBRECIPIENT and its agents that this
AGREEMENT is solely for the benefit of the parties to this award and gives no right to any other
party. No joint venture or partnership is formed as a result of this AGREEMENT.
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The SUBRECIPIENT, on behalf of itself and its successors and assigns, agrees to protect, save,
and hold harmless FMB, HSEM, and the State of Iowa, and their authorized agents and
employees, from all claims, actions, costs, damages, or expenses of any nature whatsoever by
reason of the negligent acts, errors, or omissions of the SUBRECIPIENT or its authorized
representative, its contractors, subcontractors, assigns, agents, licensees, arising out of or in
connection with any acts or activities authorized by this AGREEMENT. The
SUBRECIPIENT's obligation to protect, save, and hold harmless as herein provided shall not
extend to claims or causes of action for costs, damages, or expenses caused by or resulting from
the negligent acts, errors, or omissions of FMB, HSEM, the State of Iowa, or any of their
authorized agents or employees.
The SUBRECIPIENT further agrees to defend FMB, HSEM, the State of Iowa, and their
authorized agents and employees against any claim or cause of action, or to pay reasonable
attorney's fees incurred in the defense of any such claim or cause of action, as to which the
SUBRECIPIENT is required to protect, save, or hold harmless said parties pursuant to paragraph
2 of this part. The SUBRECIPIENT's obligation to defend, or to pay attorney's fees for the
defense of such claims or causes of action as herein provided, shall not extend to claims or
causes of action for costs, damages, or expenses caused by or resulting from the negligent acts,
errors, or omissions of FMB, HSEM, the State of Iowa, or any of their authorized agents or
employees.
XV. ACKNOWLEDGMENTS
The SUBRECIPIENT shall include, in any public or private release of information regarding the
activities supported by this award, language that acknowledges the funding contribution by
HSEM and the Flood Mitigation Board.
XVI. INDEPENDENT CONTRACTOR STATUS OF APPLICANT
The SUBRECIPIENT, its officers, employees, agents and council members shall all perform
their obligations under this AGREEMENT as an independent contractor and not in any manner
as officers, employees or agents of FMB, HSEM or the State of Iowa. All references herein to
the SUBRECIPIENT shall include its officers, employees, city counciliboard members, and
agents.
FMB shall not withhold on behalf of any such officer, employee, city council/board member, or
agent, or pay on behalf of any such person, any payroll taxes, insurance, or deductions of any
kind from the funds paid to the SUBRECIPIENT for administrative purposes.
XVII. GOVERNING LAW, VENUE AND SEVERABILITY
The laws of Iowa shall govern this AGREEMENT and venue for any legal action hereunder shall
be in the Polk County District Court of Iowa. If any provision under this AGREEMENT or its
application to any person or circumstances is held invalid by any court of rightful jurisdiction,
said invalidity does not affect other provisions of this AGREEMENT which can be given effect
without the invalid provision.
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XVIII. NOTICES
The SUBRECIPIENT shall comply with all public notices or notices to individuals as required
by applicable state and federal laws, rules, and regulations and shall maintain a record of such
compliance.
XIX. RESPONSIBILITY FOR SUBAWARD
While HSEM undertakes to provide technical assistance to the SUBRECIPIENT and its
authorized representative in the administration of the award, said award remains the sole
responsibility of the SUBRECIPIENT in accomplishing award objectives and goals. HSEM
undertakes no responsibility to the SUBRECIPIENT, or any third party, other than what is
expressly set out in this AGREEMENT.
XX. NOTICES AND COMMUNICATIONS BETWEEN HSEM AND
SUBRECIPIENT
All written notices and communications to the SUBRECIPIENT by HSEM shall be to:
Jamie Knutson, City Engineer
City of Waterloo
715 Mulberry Street
Waterloo, IA 50703
Or the Alternate Point of Contact,
Wayne Castle, Assistant City Engineer
City of Waterloo
715 Mulberry Street
Waterloo, IA 50703
All written communications to HSEM by the SUBRECIPIENT and its authorized representative
shall be to:
Jeff Jackson
Office of Levee Safety
Iowa Department of Homeland Security and Emergency Management
7900 Hickman Road, Suite 500
Windsor Heights, IA 50324
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ENTIRE SUBAWARD AGREEMENT
This AGREEMENT sets forth the entire AGREEMENT between FMB and the SUBRECIPIENT
with respect to subject matter hereof. Commitments, warranties, representations and
understandings or agreements not contained, or referred to, herein or amended thereto shall not
be binding on either FMB or the SUBRECIPIENT. Except as may be expressly provided herein,
no alteration of any of the terms or conditions of this AGREEMENT will be effective without
written consent of both parties.
IN WITNESS WHEREOF, FMB and the SUBRECIPIENT have executed this AGREEMENT
by the signatures of authorized persons of both entities and on the dates indicated below:
Iowa Flood Mitigation Board: SPONSOR:
John Benson, Chair
City E&dlneer
8/5/2025
Date Date
DocuSigned by:
Signature o Authorized Representative (optional)
8/18/2025
Date
Attachments: Exhibit A: Award Notification
Exhibit B: Scope of Work
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Exhibit A: Award Notification
Award Letter
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IOWA.
KIM REYNOLDS
GOVERNOR
July 1, 2025
Jamie Knutson
City Engineer
City of Waterloo
715 Mulberry Street
Waterloo, IA 50703
SUBJECT: Iowa Levee Improvement Fund
Dear Mr. Knutson:
Homeland Security and
Emergency Management
JOHN R. BENSON, HOMELAND SECURITY ADVISOR
AND EMERGENCY MANAGEMENT DIRECTOR
The Iowa Flood Mitigation Board, on June 25, 2025, approved the Levee Improvement Fund
project application submitted by the City of Waterloo awarding the district $280,000 in matching
funds for the approved project. Per the application you have requested:
• $280,000 from the Levee Improvement Fund ($560,000 total project cost) to complete testing
of the Hawthorne Avenue storm water lift station relief wells and replacement.
We will be reaching out in the near future with a Funding Agreement and other required
documents that must be signed prior to the issuance of funds. Funds will be disbursed as
reimbursement for project costs incurred. Any modifications to the scope of work or budget
must have prior approval of the Flood Mitigation Board. Please notify us if there are any
anticipated changes.
If you have any questions or need assistance, please do not hesitate to call us at 515-725-3231, or
e-mail us at officeofleveesafety�ic,iowa.gov.
Sincerely,
John R. Benson
Flood Mitigation Board Chair
7900 HICKMAN ROAD I SUITE 500 1 WINDSOR HEIGHTS, IOWA 50324 1 515-725-3231
homelandsecurity. Iowa. gov
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Exhibit B: Scope of Work
Scope of Work from Application
Scope of Work: Description of the Solution & Mitigation Proposed:
This project will replace the existing north relief well and complete required flow testing of the
south relief well at the Hawthorne Avenue storm water lift station. Rehabilitation efforts to the
north well proved ineffective and the Army Corps of Engineers is requiring the well to be
replaced. Concurrent flow testing of the south well would allow both wells to be on the same
required 5 -year testing cycle.
Description of the Proposed Project:
The City is seeking financial assistance in the amount of $280,000.00 to ensure the testing,
abandonment, and construction of new relief wells can be completed. The relief wells are
located adjacent to the Hawthorne Avenue storm water lift station,
approximately 1,500 feet east of the La Porte Road & Hawthorne Avenue intersection.
They are located on the west toe of the levee prism.
Approved Budget
Cost Type
Description
Amount
Geotechnical Services
Testing, Cleaning, Geotechnical
$115,000.00
Engineering CE
Engineering Design, Project Management,
Environmental Permitting, Construction
m
Administration & Inspection
$45,000.00
Construction
Project Construction
$400,000.00
Total Project Cost:
$560,000.00
Total Award
State Cost Share/Funding Request
$280,000.00
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Pursuant to 2008 Iowa Acts, HF 2393, Iowa Code Section 8.11, all grant applications submitted to the State of
Iowa shall include a Minority Impact Statement. This is the state's mechanism to require grant applicants to
consider the potential impact of the grant project's proposed programs or policies on minority groups.
Please choose the statement(s) that pertains to this grant application. Complete all the information
requested for the chosen statement(s).
=The proposed grant project programs or policies could have a disproportionate or unique positive
impact on minority persons.
Describe the positive impact expected from this project
Indicate which group is impacted:
Women
Persons with a Disability
Blacks
Latinos
Asians
Pacific Islanders
American Indians
Alaskan Native Americans
Other
=The proposed grant project programs or policies could have a disproportionate or unique negative
impact on minority persons.
Describe the negative impact expected from this project
Present the rationale for the existence of the proposed program or policy.
Provide evidence of consultation of representatives of the minority groups impacted.
Indicate which group is impacted:
Women
Persons with a Disabi
General Project Application Minority Impact Statement (5/20/09) Tab J, Page 1
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Blacks
Latinos
Asians
Pacific Islanders
American Indians
Alaskan Native Americans
Other
The proposed grant project programs or policies are not expected to have a disproportionate or
unique impact on minority persons.
JPresent the rationale for determining no impact.
The flood control system was designed and constructed by the Corps of Engineers and is operated by the Cityl
11 hereby certify that the information on this form is complete and accurate, to the best of my knowledge:
(Quentin Hart
�DbcuSigned by:
8/18/2025
Definitions
"Minority Persons", as defined in Iowa Code Section 8.11, mean individuals who are women, persons with a disability, Blacks, Latinos,
Asians or Pacific Islanders, American Indians, and Alaskan Native Americans.
"Disability", as defined in Iowa Code Section 15.102, subsection 5, paragraph "b", subparagraph (1):
b. As used in this subsection:
(1) "Disability" means, with respect to an individual, a physical or mental impairment that substantially limits one or more of the
major life activities of the individual, a record of physical or mental impairment that substantially limits one or more of the
major life activities of the individual, or being regarded as an individual with a physical or mental impairment that
substantially limits one or more of the major life activities of the individual.
"Disability" does not include any of the following
(a) Homosexual or bisexuality.
(b) Transvestism, transsexualism, pedophilia, exhibitionism, voyeurism, gender identity disorders not
resulting from physical impairments or other sexual behavior disorders.
(c) Compulsive gambling, kleptomania, or pyromania
(d) Psychoactive substance abuse disorders resulting from current illegal use of drugs.
"State Agency", as defined in Iowa Code Section 8.11, means a department, board, bureau, commission, or other agency or authority of
the State of Iowa.
General Project Application Minority Impact Statement (5/20/09) Tab J, Page 2
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STATE OF IOWA
DESIGNATION OF APPLICANT'S INTERNAL AUTHORIZED REPRESENTATIVE
For the purpose of obtaining, complying with requirements of, and/or managing financial
assistance under IOWA CODE 29C, 29D, 418 and 418A as well as the Robert T. Stafford Disaster
Relief and Emergency Assistance Act (PL 100-707, as amended), the National Flood Insurance
Reform Act of 1994 (PL 103-325, as amended), or the High Hazard Potential Dam Program, 33
U.S.C. § 467f-2.
Jamie Knutson
(Print Name of Authorized Representative) (Signature and Date)
is hereby authorized to execute the functions initialed below on behalf of
City of Waterloo
(Applicant Entity)
8/5/2025
Project City of Waterloo Hawthorne Relief Wells Project S17
Title Hawthorne Avenue Lift Station Releif Well Replacement and Associated Work
(Describe the project for which these activities are authorized)
Initial Authorized Activities (Only initial next to the activities being assigned)
Sign application forms (SF -424, SF -424[A -D], GG &/or FF -104 [lobbying etc.], W9,
SF -LLL, & Minority Impact Statement) (does not include local match resolution)
Submit applications in online portals (e.g., EMGrants, FEMA GO, eGrants)
QH Submit Quarterly Reports to Iowa HSEM and/or FEMA
QH Submit Requests for Reimbursement or Advance Payment for subgrantee
QH Request Grant Closeout and confirm compliance with grant requirements
QH Request Grant Time Extensions
QH Request Grant Scope/Budget Adjustments
Quentin Hart, Mayor Kelley Felchle, City Clerk
Chief Executive Officer (Print Name and Title)
DocuSigned by:
66kv- iv, A of 8/18/2025
Signature and Date
Attested (Print Name and Title)
Signed by:
F 8/18/2025
Signa ure and Date
HSEM Form updated February 26, 2025