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HomeMy WebLinkAboutCOMPLETION OF APPLICANTS PROJECT WORKSHEETS - CITY OF WATERLOO STREET DEPT MEMORANDUM FOR THE RECORD FEMA-1688-DR-IA Subject: Completion of Applicant's Project Worksheets Applicant Name: y c \,JA 1 { 1 PAID #: 0 \3 - - :C Kick-Off Meeting Date: 4 / c)1 The number of small and large project worksheets written for each category is listed below. If there is no reported damage within a category, please mark the category N/A. Discuss this information with the applicant and review it for accuracy at the exit briefing. If the Applicant concurs,they should sign the memo, in addition to the FEMA and State,Public Assistance Coordinator(PACs). PROJECT WORKSHEET SUMMARY Completed Categories: Small Projects Large Projects Total#of PWS Category A: Debris Clearance / f Category B: Protective Measures Donated ResourceNolunteer Credit Category C: Road Systems Category D: Water Control Facilities Category E.: Buildings&Contents Category F: Public Utilities Systems Category G: Other(Recreational) Total Number of Project Worksheets To the best of our knowledge,damage surveys in all categories of work have been completed and all Project Worksheets have been written. (Examples of exceptions are sites under water, Demolition Projects,etc.) Projects which may require further consideration or monitoring are listed in the comment section below: Comment Section: FEMA PAC: ‘,/ Date: � d State PAC: Date: n//7A.-) 7 Applicant Representative: Date: S �� 67 If additional damage is found, the Applicant must notify the State in writing by this date: 2007. Send to: Iowa Emergency Management Agency,Camp Dodge, Iowa,50131. Federal Emergency Management Agency Project Worksheet Declaration No. Project No. FIPS No. Date Category FEMA- 1688 DR- IA NN-28 013-UG110-00 05/15/07 B Damaged Facility: Work Completed as of Date Per Cent. Emergency Response 04/06/2007 100% Applicant: County: Waterloo Street Department Black Hawk Location: Latitude: Longitude: City Wide Damage Description&Dimensions: Federal disaster#1688 was declared for the state of Iowa to suplement state and local recovery efforts in the areas struck by severe winter storms during the period of February 23,2007,through March 2,2007. This Project Worksheet addresses the heavy ice accumulation which occurred several times during the incident period on streets throughout the city. This heavy ice accumulation posed a threat to public health and safety. Scope of Work: REIMBURSE APPLICANT FOR FORCE ACCOUNT OVERTIME LABOR(584.5 HRS),REGULAR TIME LABOR,NOT ELIGIBLE(730 HRS),EQUIPMENT(1091 HRS)AND MATERIALS(SAND 1046 T AND SALT 1018 T)FOR ACTIONS TAKEN BEFORE,DURING AND AFTER THE DECLARED EVENT TO PROTECT PUBLIC HEALTH AND SAFETY. THESE ACTIONS INCLUDED STOCKPILING SALT/SAND A DAY BEFORE THE EVENT, SALTING AND SANDING EXTENSIVELY THE FIRST 2 DAYS OF THE INCIDENT PERIOD AND LATER PLOWING SNOW OFF THE ICE(NOT ELIGIBLE)TO APPLY MORE SALT TO THE ICE. THIS PROCEDURE WENT ON DURING THE ENTIRE INCIDENT PERIOD WITH HEAVIER APPLICATIONS OF SAND/SALT AT THE END OF THE EVENT. 209 HRS.OF THE TOTAL OVERTIME LABOR WERE WORKED ON SUNDAY 2/25/07 AT DOUBLE TIME PER UNION CONTRACT. Does the Scope of Work change the pre-disaster conditions at the site? OYES U NO Special Considerations issues included? DYES ElNO Is there insurance coverage on this facility? ❑YES 2 NO Hazard Mitigation proposal included? DYES El NO Project Costs Item Code Narrative Quant. Unit Unit Price Cost WORK COMPLETE 0 1 9007 LABOR 1.0 LS 21571.00 21,571 2 9008 EQUIPMENT 1.0 LS 31529.00 31,529 3 9009 MATERIALS 1.0 LS 55359.00 55,359 t 0 0 0 0 0 0 Total Cost $108,459 PREPARED 13Y: NcrlandII I I,I:: PAC/PO APPLICANT. ,q(14pc1::1.5 17/67 PHONk: .3(Q�� FEDERAL EMERGENCY MANAGEMENT AGENCY WORK COMPLETED TO DATE COST SUMMARY SHEET APPLICANT FIPS# DISASTER# Waterloo Street Department 013-UGI10-00 FEMA- 1688 DR- IA LOCATION/SITE PROJECT REF# COUNTY CATEGORY City Wide NN-28 Black Hawk B DESCRIPTION OF WORK PERFORMED PERIOD COVERING Emergency Response 02/23/2007 to 3/2/07 CLAIM COST COMMENTS(FEMA USE ONLY) ELIGIBLE COSTS FORCE LABOR ACCOUNT $ 21,571.00 $ 21,571.00 FORCE ACCOUNT EQUIPMENT $ 27,059.00 $ 31,529.00 MATERIALS $ 55,359.00 $ 55,359.00 RENTAL EQUIPMENT #REF! #REF! CONTRACT COSTS #REF! #REF! TOTAL #REF! $ 108,459.00 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. rU S S (off CERTIFIED TITLE DATE Applicant's records have been reviewed and found correct with the exceptions as noted. 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C c.,. $ x o z ' z o % o i o z o i. ° i. x ' z o -- FEDERAL EMERGENCY MANAGEMENT AGENCY FRINGE BENEFIT RATE SHEET APPLICANT FIPS# : DISASTER # Waterloo Street Department 013-UGI10-00 FEMA- 1688 DR- IA LOCATION/SITE PROJECT REF# COUNTY CATEGORY City Wide NN-28 Black Hawk B REGULAR EMPLOYEES PART TIME EMPLOYEES REGULAR TIME OVERTIME REGULAR TIME OVERTIME HOLIDAY PAY* 0.000% 0.0000 VACATION* 0.000% 0.0000 SICK LEAVE* 0.000% 0.0000 SOCIAL SECURITY 0.0000 6.4500 6.4500 6.4500 MEDICARE 0.0000 1.2000 1.2000 1.2000 UNEMPLOYMENT 0.0000 0.0000 WORKER'S COMP 0.0000 0.0000 RETIREMENT** 0.0000 5.7500 HEALTH INSURANCE* #DIV/0! #DIV/0! LIFE INSURANCE #DIV/0! #DIV/0! OTHER 0.0000 OTHER 0.0000 TOTAL #DIV/0! #DIV/0! 13.4000 7.6500 7.6500 NOTE: Fill out"Data"sheet first. 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H z cc, >' - C H 7 5 H H 6, 2 E. 0 < U ClC V it o. c a Y i- U z C = E _ = o v g c U i I. ^- 0 a c. 0 0 0 c i- - U FEDERAL EMERGENCY MANAGEMENT AGENCY MATERIAL SUMMARY SHEET APPLICANT FIPS# DISASTER # Waterloo Street Department 013-UGI10-00 FEMA 1688 DR - IA LOCATION/SITE PROJECT REFERENCE# CATEGORY _ City Wide NN-28 _ B DESCRIPTION OF WORK PERFORMED PERIOD COVERING Emergency Response 02/23/2007 to 3/2/07 INFO FROM DATE DATE (CHECK ONE) VENDOR DESCRIPTION QNTY UNIT PRICE TOTAL PRICE PURCH USED INV STOCK BMC Aggregates Sand 1046.22 $ 5.23 $ 5,471.73 Varies XX CARGILL, INC Salt 1018.73 $ 48.97 $ 49,887.21 Varies XX $ TOTAL $ 55,358.94 I certify that the above information was obtained from payroll records, invoices, or other documents that are available for audit • (( 11 CERTIFY TITLE \ DATE SHT OF FEDERAL EMERGENCY MANAGEMENT AGENCY SPECIAL CONSIDERATIONS QUESTIONS APPLICANT: Waterloo Street Department PROJECT NAME: Emergency Response FIPS#: 013-UGI10-00 PROJECT# NN-28 DATE: 05/14/07 1. Does the damaged facility or item of work have insurance and/or is it an insurable risk?(e.g.buildings,equipment, vehicles, etc.) ❑YES Q NO ❑UNSURE Comments: 2.Is the damaged facility located within a floodplain or coastal high hazard area,or does it have an impact on a floodplain or wetland? ❑YES Q NO ❑UNSURE Comments: 3.Is the damaged facility or item of work located within or adjacent to a Coastal Barrier Resource System Unit or an otherwise protected area? ❑YES Q NO ❑UNSURE Comments: 4. Will the proposed facility repairs/reconstruction change the pre-disaster condition?(e.g.,footprint,material,location,capacity,use or function) ❑YES ❑� NO ❑UNSURE Comments: 5.Does the applicant have a hazard mitigation proposal or would the applicant like technical assistance for a hazard mitigation proposal? ❑YES ❑✓ NO ❑UNSURE Comments: 6.Is the damaged facility on the National Register of Historic Places or the state historic listing? Is it older then 50 years?Are there more, similar buildings near the site? ❑YES L NO ❑UNSURE Comments: 7. Are there any pristine or undisturbed areas on,or near,the project site?Are there large tracts of forestland? ❑YES ❑✓ NO ❑UNSURE Comments: 8. Are there any hazardous materials at or adjacent to the damaged facility and/or item of work? ❑YES D NO ❑UNSURE Comments: 9.Are there any other environmentally or controversial issues associated with the damaged facility and/or item of work? ❑YES ❑✓ NO ❑UNSURE Comments: 10. Will there be any debris stored or placed outside a certified landfill,or is there any debris stored or placed in a floodplain or wetland? ❑YES El NO ❑UNSURE Comments: SHT OF