memo regarding request to initiate processing a … · ac)r••••nt or bendaent of an...
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![Page 1: MEMO REGARDING REQUEST TO INITIATE PROCESSING A … · Ac)r••••nt or bendaent of an Exietinc; ACJr••••nt . To : Deborah Haretedt, Grant• speciali•t. Grant• Inforaation](https://reader033.vdocument.in/reader033/viewer/2022060408/5f0fe4a97e708231d44668d9/html5/thumbnails/1.jpg)
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Cate Augua t 24 1992
Sullject Rbullqubullbullt to Initiate Procbullbullbullinq of superfund CooperativeAc)rbullbullbullbullnt or bendaent of an Exietinc ACJrbullbullbullbullnt
To Deborah Haretedt Grantbull specialibulltGrantbull Inforaation and Mana9nt Section - PCI
Superfund Project OfficerLorento ThampntuProa
Thia ibull to adviabull you that I concur with thbull followin9 application (or requeat for bullbullbullndMnt to an exiatin9 application) Plbullbullbullbull initiate proceaeinq of thbull award docuent approving t hibull r equeat when all outatandinq adainietrativbull and fiacal r equir9bullentbull have been addrbullbullbulled
amppplloaats MA Depar~nt of Eny i renpgul Protection
cooperatiTe atrbullbullbullntt 1voo1126-ol-6 (if abullndMnt to an eatabliahed a9rebullbullbullnt)
Mature of ampaqueat1 Initial Avard_ _
~~~~~d~~rod Egtlttension__ Revibulled scope of Work__ other__
TJPbull of atrbullbullbullbullts support bullybullncyMna9aMnt aaaibulltancbull __
~~rr--Re-hl InviipoundI9atlon Peaalblllty Study_x_ bull -11 Debull19Operation and Miliitenance __ Initial llaMdial Meaeur e __ Enforcnt__ TAG__
Othbullrbull--------------- shy- rbullouts$9 MO bull aouraa o f hD41l Prior Year Unobli9atad Balance $______
(Cora Pr09rn Only) current Year oo ___o_
~t~ t ~middot~~~~ch aaparate aheat of paper if bull naceaaary)
~tmiddotci~h ~~~~_-conditionbull ar e unchan9ad1shy
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JJ 11 1~1l I rr 1 ( irJil fi(I
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1~~11~1~middot~ =~~middot~~~- Ml ~ - bullbulltcoubullbullbullCt ~ 95000 bullbullbull
V001726middot01-6 GiU fil a abullbullbullbullbullbullbull0 oucdegbull bullbull bulloJCct deg bullbull MbullVtltU
Coopontivo Agro-nt for PSC Roaourcbullbullbull Inc PlUllr MA - Amendment
bullAMI UAlffllCOMTIUONVNI MHHchUMttbull Doputmnt of Environmnul Pr~oction -Abull vbull 0 11111 r_ INbull I middot1bull11
lfICtA4 COatMIHI obull 1bullIT1111C1I
Incroau in fundin9 to covor the following costbullbull (1) Coit of contractorbull support for rHponbull to public comonta on the PropoMd1Plan aGd 12) coet incroaH for the contractor a orovioualv comolotod vork due to rotrOACtiw middot Jncreau in indirect cobullt ~Atampa bullbull a mult of yoarly auaita bull
ITamp AIPHYAampt
573-5730
____ t-Dun--ibull-bulluobne--r111JJllabull1middotoJllltllgtyf~Lmiddotbull_bull______+~-fLlzbull~lc1___J-bull-1gt_-__1_0_____
IVNH ClltllfCAT tfllOVllU
Tiii AMOltltllT -ObullCr IJoOft 1bull o o- o~~middot~middot-
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II UtJICUllI f tt 11 11 U IC t tt O 11IfJtJIU11 ICU J lllJI H Cf 0 d 0 U Cl bulltlii
$ bull slc 6bullbullbull 2 tf FA 1 ~ R L l 8 4 1111bull
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IJil Corrmonwecllh ol MassoctgtJse11s Executive omce ot Enwormental Allois irDepartment of Environmental Protection (
19 Auquat 1992 Merrill s Hohman Director Waate Mana9e11ent Division US EPA JFX Federal Building Bobullton MA 02203
RE PSC Resources Palmer -- Clearinghouae Review of Allendllent
Dear Mr Hohaan
Plbullbullbullbull note that an A95 Clearin9houae Review haa been applied for reqardinq the attached aaendaent to the PSC Resources Cooperative Agrbullbullbullnt
If you should have any questions on thia aatter please contact the Coaonwealtha Executive Office of Counitiea and Developaent at 727-7001
Thank you very bulluch
DEP
cc Lorenzo Thantu Helen Waldorf Bill Harkinbull Tony JCurpaaka Martin Horne Filo
fAX(111)151-1MI bull T~(t11)2tl-6500
bullI
~ Merrill s Hohman Director waste Management Division US EPA JFK Federal Building Boston MA 02203 19 Auqust 1992
RE PSC Resources Palmer -- Amendment to Cooperative Aqr8ement
Dear Hr HohJlan
The Oepartaent of Envirormental Protection (DEP) hereby requests an aaendaent to the PSC Resources RIFS Cooperative AgreeMnt to increase the contractual budget by $95 1 000 tor a nev total budqet of $1 635787
The attached table provides the details of this request_) Thbull Reaedial Investigation and Feasibility Study Reportbull have
been coapleted by the contractor and accepted bullbull final by both IPA and DIP However funding is required to cover the costs ot contractor support for responding to pulgtlic co-nts on the reporta In addition OEP contractor indirect cost ratea (ICRa) have increased retroactively as a result of yearly audits and additional funding is needed to cover the reaultinq coat increaaea tor previoualy cobullple ted work
If you have any questions or require any additional information pleaae contact Janine co-artord at (617) 556-1121
Thank you very much
poundroly gclt-l~ c Colbullan
Assistant Couissioner Bureau of Waste Site Cleanup
cc Lorenzo Thantu Helen Waldorf Bill Harkinbull Tony Kurpaska Martin Horne Janine Commerford
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APPLICATION FOR FEDERAL ASSISTANCE 08 19 92
-- _ i _ --~----
Oshy j Oc-shy11~ n~
~ Coaaonwealth ~f Hauachuaetu
One Winter Street 5th troor Boston Ha 02108
__GIJtt I0 I 2 I 2 Ia 14 I
0 cc- gtalshy_-- [i D
___ t - shy cu-a ri-oshy o~
~zardeua Sub1tanct RuponH Trult Fund
-shy_____ ___ ______
ililliaa Harkins (617) 292-5906 anine Commerford (617) 556-1121
middot bull~---middot IU a S-shy M~ld-0
bull - shy l ~_ i--t ca _~ Q T _ __ L
middot ----shy 1111 _~Cl M deg9~-----
US EPA Region I ====---- lLLJmiddotLLlalz _~ middot e~ous Substance lesponH Trust Fund ~ir1~middot~~0d1F~~~~y ___ Site
Palr Ka ~ten County
1~
Dl11 08 25 92
middotshy __ I
01bull lI-middot- -- 1635787
lt1eMMS1bull~ loUDtbullbulllllll~fIOll----middot M~--- ltWTIOOflllD_M___ClftlllolCMl-NWIU_____cltbullN-iAllCCbullbullbull-shy __-shynbullbullu 1 S GuenbaW1 Commissioner
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Attachllent 1
81992 Aaendmient PSC Rbullbullourcebull Cooperative Agreement Budget
Budget Current Changbull Kow category Budget Requeated Budget
Peraonnel 23 969 23969
Fringe 9441 9441
Travel
Equipunt
suppliea
contractual 1499446 95 000 1594446
Other 1416 1416
Total Direct 1534272 95 000 1629272
Indirect 6515 6515
TOTAL RZQUUTED COOPERATIVE AGREEllEllT AllOUllT $1635787
~
ASSUAAHCES - NO~ONSTRUCTION PROGAAMS
c or u ~ 1ublbull lr middot p1ust conacl tht awardlllC 11tncJ F~u~ Fedcn arOinl a1t ncirs ma) req11in bullPPllunU
uinr~iy to addi tional UtWanctt Usuch it Ult cue you will bt bullUftlCi
Jutht ciuly au~horid rrirucnt11tit orthe 1t1llica1t I ttriy that tht 1t1alica11t
l Hu tht lrtbullI authorit) to aiply ror Federal auisWln and tht Witutional manattrial and (11amp1Cial capability (incltMlinl funds aWIWtnL I pbullJ ht non-Federal ahan or prejtd cosul ll ensurt proper planninc man111m11nt and cobullmiddot pinion oftit irojed ducribed ill UW appicatioA
Will ivt the abullardinC qtnt) ht Coapuolltr General or Lit tniLed StalS and it appro9fiaa the StaI hrouch ampDJ aulhoried nprnentatit accru to lid Iht ifht o esamirit all record1 books paitn or docucenu nlattd deg tht award anc wiil HtabliJh I priptt ICOllfttinc lflUI in acconianlaquo with 11nerally acuptad accountln(
sancarU or bullrbulln~cy direcCmiddot 3 Will ntablish WtfWds to prohibil 1mploy111
frabull u1in1 their positions for a partgtOH that CGftlit11t11 or 11rH1nU lhbull apptamplUCI of perlOCIAI orpNaUoMl amllicL ol ~wut or personal
wm lnitiat1 and complete tht work witbin ht
j a1aolt ti=e Craml ampAir lICli ti aIPOval ol Ihi awardinl ~middot
5 Will comply bull i th tb1 latu10Y1rnmotal Ptnoooal Act or 1970 42 USC 11 421-41131 rtlatinc deg prucriMd sWMlarU tor muit bullJN= tor pre(lampIU llftdlt one or Ult 1Wi1tetn satut11 or reWations 1cJtid in Apptndis A ol OPMs tanda-ds for 1 11bullrit S11t1m ol enoMbull I Adminisiation(5CFllto0 S~FI
I WUl eoCply wilh amp11 Ftd1ral Ntuttl nlatiI WI oonifiJcr ~mination Thbull incl11d1 but an not limiocl to al TiUc VI ol the CiTil Rirhu Ae or 1964 (PI 11-352) wNcb proilibiU dixmination on the buis o( tact color or nationI ori(Jl (bl Title IX or thbull poundd11cation Amniclmenu or 1972 u arnendc (20 usc n 1611-1613 and 1amp15middot1616) which prohibits Gitcriminad011 on tht basis or wz (c) Seltion ~04 or the Phabilitation Act of lfi3 as amtndc tZ9 C SC 1 794) which prohibiU ditbull cicination on the basis or haclicapt (dl ht Att OiKrinination Act o( us at uncncitd (42 L SC11 6101 middot 6107) which prohibiLS cliscrirGmiddot
ination on tht basis of ace
(~l ti1 Dnac bltl ()CiCI and T111t111nt Act of u lPL g ~51 abull amended nlatinc to non~tion on thbull buis of dNi alNM tn Iha Compnhtnsivt AloDhol Ablilll and Alcohoolilm PnvenUoa Tnaunent and lehallilitstioll Act or 1910 (PL tl middot l51Sl as amended relaUnc lo nondi1eriminamption on the buil of alCDbol abUM or aieonolisa lampl 11 s3 and s1 of the hblit Heal~ Srtie9 Adol191 (42 JSC 90 Odmiddot3 and tO 3) as abullndbulld r1adnc 0 curl4111tiality or alcohol and dNI ab111 uent ~(bl Tit1 VIII C Ibo Clril Ri(hll Act ol IHI (11 USC I 3601 tt MCl middotl as amended nlatin1 U sonbull ditcrlzWaatioll ~ thbull 1bullbull renaal or rinandnc oC hnsin r (il an ) otbtr nondiscrimiHion 1royensioDI in the slK 111tuteltsl uUr wbich ncatillD for FOtral usiawa ii Mini mati1 and ltU thbull ciuir11n1nu 1C tlhttno~tioa siawl(s) wbidt IU) appi) o
U1 applicadoL wm bull 1w alndr UH iu u1 _ o1nu o m rJIM uu 1l1localioo Aa1i1tanU and Ital ProptrY Acquiaitiile PoliciU Act ol ll10 ltPL tl6411 which Wt or lair aM ~It_ r -~ a -1Lr1Ftda-l or ianllJ _shyTht11 ~menu apply o all UdeftlU ia rul pro1J11rtY a~ ror proja u or Federal putici_don it p~
I Will comply witb ti1 proNioal fl hi Haldi Act (5 USC II l50lmiddotl50I an m4om11 whldl limit tht political activitin of 1=ploy11bull who11 1rincipal 1mploy=1nt actifitia ara fuded in whole or in re with Ftd1raltwm
9 wmcomply as alicalllbull wih the pnNions or thbull OariJBtooo Ati (40 USC If 1715amp bull 276amiddot 1) Iht eo1anc Act (40 USC I Tk and 11 C SC H 114l and Iht ConUUt Wdeg Hows end Sa1t1 Standsrcbull AC (40 USC fl 327middot3331anti lcbor 1tampndardbull ror [lclually usisad constn1Cion subarreerutnU
~u 1bull-1
---caooao--middot
Ai11hotized lor Loal Reproducion
10 Will tomply if applicablt with noo4 insurance purchaH r~uirtmtnls o( Stclion 1021al a( lht rlood Diu1ltt Proltetion Actor 1973 IPL 93-2341 middothich r~11irt1 rtcipianll in a special nooc1 bampurd aruloparticipallintkprocTampmandtopurchaH nood inluranct ir tht toll] COi l o( in1unblt cons truction and acquisition it $10000 or more
11 Will comply with environmental standards wh ich tnaY bt prucribtd pursuant lo tht follow inc la) inst itut ion of tnyenironn1tntal quality control m1a1urt1 under tht Joiational Enyenironmtntal Policy Act or IHI (PL 91 middot1901 and EHcutivt Order CEO 11514 (b notircat ion of yeniolaUn1 facilit iu pursuant 0 EO 11138 lei pnitection of wetlands punuanl deg EO 11990 tdl eval111ition of nood haurdt in noodplainl in accordanct with EO 11981 ltlaHWampnet of ptojtct con1 istucy with the approyentd Statt manatmtnt pro1ram dtvtloptd under the Cr111tal Zone ~ana1emtnt Act of 1912 (16 C SC U 1451 et Hq) CO conlormity of Ffftf9I actions lo Stale Claar Airl lmpltmentatioA Plam under Secion 1714cl of tht Clear Air Act of lt55 U amended (42 CSC t 740lttwq l(ampl pr0Ktiontl~aowa1 olclrinkinf water udtr lhl Wo Oriakinl W1ter Act ol 1174 u amtrMW CPL ts-5Ul u4 (bl proampocUoa of olMlanrer-4 1pecit1 undtr tbt Endanprtd Sptcitt Act or 1rrs u -- CPL IS-2061
12 WUI umply with iht W~t IDll ScetUc Riven Act of IHI nl USC II 1111 ot seqI rtlaLH to proKdnf coipoataU or pewntlal eempooaau of lM natioaaJ wild and ICtnic riven 1yawm
~llfttdegJf-r(~
oWif GrIZ~~
Dep t nviron11en tal Prot ection BWSC
13 fl ill a11i1t lht bullmiddotard in1 bull1bullncy in a11ur in1 coinpliuice with Sction 106 of the lationalr Hisioric PAMrvation Act or It u amended (1 1 l SC 470) EO 11593 (ident ification nd pnttction of h iuoric proptrtiu) and the ArchaHIOfuI and Hilloric Prt1trvation Act of 197fll6CSC 469amiddotlttseqI shy
14 Will comply with P L 933415 re1ard in1 the prMKlictn of human 1ubjocta inyenolvtd in rHtarch aklp1n1nt and rt lattd actMUu suppontd by this 1wani of auiatance
15 Will comply with tht Laboralory Animal W11C1tt Act of 1966 IPL 89middot544 a1 amtndtd 7 1 SC 21Jl 1t wqI per1ainin1 to tht can handlinc ancl lnatmeat tf warm blood1d animalbull hold ror rtsarCh teachin1 or other acUYitiu wpporllCI by this awani elauistana
11 Will ro111ply with tht Le1d-Bued Paint Pobonln1 pnuon Act 142 CSC H 410l tt Nq ) which prohibits thbull Ult or Ind ba1td pa inl i n conauuctlon or rth1bllltation o( roaidenct
11 VRill CHM t bt performed amphe required flnaticial aflll cembulllibullnct aviill in acconlaact witb tha 5Ucte Audit Act of 1914
tt Will -ply with alt applicUle requinmtntaof all other federal ia oucuu nrulabonlc policin pftlftint this prorram
IlWwlite$iuHt-fOlllMIJl~ NIC( WUllllionCCo60
Certific3tion Regarding Debarment Suspension and Other Responsibility Matters
The pros~ivbull participant cenllits to the best of its knowledge and belief that it and its principals
a) Ara net presently debarred susoended prooostd for d1blrment decared ineliQible or vclumariy exdudalt trorn cov1rtd transacuons by any Feat~ department or 1g1ncybull
b) Have ro wi1hin a LVH year oeriod pmedlng this prol)Oul been convicted ct or toad a cM jud9ement ttndarte aQtinslt IJlm tor comnvssion ol traud or a cnillMi cllense in coMacuon with orasnin anemptLnQ to obtain or parlonninljl a PIJbfic (Federal Statbull or local) transaction ot contrac underbull iillic transaction violation ol Feotlll or State aruruc salUlH or commmion ol emoeiament tntft torgery bribtty lalsiflcalion or d11tn1cuon ol ~s makin lalst sattments or rrIMng sOlenpropttty
(CJ NI nCll pretenlly irdCed falt Ot - cMmlffy Ot civly ~-Id by I q anlily (Fshy_ Stlll or lccal) wih commillion ol any of lhl oftenus enumtratld W paragraph (1)~1 ot Oil
(d) ~~W~i=e=~or~~~J~ had one 0t men~ I und~ tt11 e fl6al ClltmlN on tNI cenbtion rMY et roundl for rtjteJon d ttil PfODOl9 or termination ot me award 1n IOdlion una1t 11 use sec 1001 a ta111 atamert may ruur in 1 ltnt ot up
middot 10 510000 OI imprisonmllI fOt up to fllrl or both shy
Daniel Gr11nb1um Com1issiontl
-0 I am unable to certify 10 the above saltmtntS My txplanauon is aracttd
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Itbullbullimiddotmiddotr~Ibulll
rrfIfibulli
u SIA1U l lll0Ubull llii~h~Jfltgt A-i C~ w-sGTO oiilO __
2xi ~SEPA PROCUREMENT SYSTEM CERTIFICATION - -middot- IO J1 l
AllICANTSNAM( ASSIS1ANCl uucATION NuMatll ept Environmental ProtectionBWSC
V001726-0l-6 1111CAHTS A00111lSS
One Winter Street 5th floor Botton Ha 02108
HCllON I - INSTRUCTIONS
I I I I
iiJill 1t-1 Irrbull fltllr ISbull
The aoolicani must comoleie end submit copy of th1S form with Heh 1pplic111on lor EPA A1usi1nce 11 tnbull 1pphc1n1 hes cenlfbulltd its procurement 1ys11m 10 EPA w11h1n 1n1 oas1 ~ yHfl 11nd 11111ys11m hH not been 1uo1t1n11111v r1v1sed complete Pin A in S1c11on IL thin s1Gn end Cite tne form It tne 1v111m nas not bun c1n1fied w11n Ult 0-112 veers comolbulltbull Pin 8 then sion ind dllt lht form
HCTION II - CEATlflCATION
A 1eHirm1n11the1pphcan1 n11 w11h1n the Piii 2 yurs cenif1ed10EPA th1111s orocurem1n1 MOHTHIYlAI 1y11em comolis w11n 40CFP Pen 331nd1n111t1e 1ys1em mH11 thbull reQu1remen11 in 40
FR p n Tn f h Ii n I 11 I n
B BHed upon my ev11u111on of tne bullPohcants procurement sys11m I u 1uthonzed rtoresen1111ve of 111bull applicant Chtcll one of tht lollowingJ
LJ 1 CERTIFY lhlt tlMI apptican11 procurement IYltbullm will rnH1111 of the reQuiremenll of 40 CFA Pin 33 before undertaking 1ny procuremam 1e1ion witn EPA 1111stance
CRTI1I CAII0 10R CXH1Jc18 I GRgtJn S LOgtH8 ))lp OOP R)IJV JC lJ~
Tbbull undbullrbulligDbull6 certifiebull to the bebullt of b bull or her bowlbull49bull uad belief that
(1) bullo Pederamp appropriated fwidJI bampTbull b41bullD or will be pLid by or OD babalf of tbe udeniqned to LDJ pbullrbullo11 tor infl11uci119 or attoap ti119 to i11Clue11ce u officer or aaployee of any a9uay a Weaber of Co119rbullbullbull u officer or -ploy of Co119rbullbullbull or u aaployee of a gttaab4ir of CoD9reH iD coanection witb the awu4ing Of ampZIJ 7ederal CODtract tbe aakin9 ltgtf ampllJ 1e0araJ VdegUt the aal i n9 or uiy rederal lou tba enteri D9 iDto of uy COOJgt9iratiwe a9reect ampAd tbe ute11iaio11 co11tiDuatio11 rellewampl aauDut o r aodificatio11 of uy 7ederal co11tract 9ruit loampJl or cooperathmiddote a9reellt
(2 J If ampllJ fa4a otller thu 1bull4bullral appropriat ~ habullbull beaD paid or will N paid to uy pe=aoa for lltl-ciJa9 or atteaptiD9 to iaflaeacbull u oficer or aplOJbullbull of u7 atuor a bull--ltoer of CODZbullaa or u employee of a bullmMr of CDaigraaa ia couectioa wit~ thia Jederal ooatract qzaat lou or tibullbull agreoae11t tbbull va4eraiped alaa11 complete ud sUait ltaaampamprt hrashytLL tgti tdoaure Jon to aaport Lo~iia9bull ia acoortuce Titll ita iDatructiona
CJ) Tbbull undenipbulld aball require that Ubull lupava of Uia certificatioa ba iacluded ia tte bullbullaz4 of docaauta for ampll bullubawazdbull at all tiara (bclu4iD9 amicoatracta robqruta aad coDtract1 oder 9r uta loau ud cooperatibull agrebulluta) ampad tUt middot amp11 bullubr ecipi bullDt a allampll cbullrtty ud 41aclobullbullmiddot acoor4i1a9ly
Thia certificrtioll ibull a uteria l r epr eHDtamptioa ot fact apoa which r a liuce wu placed wbea thia tranaactioa wu aamp4a or utered into Bubaiaaioa ot thi a ctirtificatioa ia a prereqdaite for bullakin9 or bull DteriDq into thia trusaction iapose-4 b1 leotioa 1352 Title 31 u1 eode by peraoa who taila to til e Ue reqaired certiication aball be subject to a ciTil peulty ot DOt lua thaa s10ooo ~4 raquoot aorbull thampll t100ooo for eacll such failure
Da niel S Gre~nbaum Commiuionn nnn DD l ITLK or AVnOlllED UPllllJrDnn
if~or lou~~arrmn ~efri ~
- barcode 580527
- barcodetext SDMS Doc ID 580527
![Page 2: MEMO REGARDING REQUEST TO INITIATE PROCESSING A … · Ac)r••••nt or bendaent of an Exietinc; ACJr••••nt . To : Deborah Haretedt, Grant• speciali•t. Grant• Inforaation](https://reader033.vdocument.in/reader033/viewer/2022060408/5f0fe4a97e708231d44668d9/html5/thumbnails/2.jpg)
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1~~11~1~middot~ =~~middot~~~- Ml ~ - bullbulltcoubullbullbullCt ~ 95000 bullbullbull
V001726middot01-6 GiU fil a abullbullbullbullbullbullbull0 oucdegbull bullbull bulloJCct deg bullbull MbullVtltU
Coopontivo Agro-nt for PSC Roaourcbullbullbull Inc PlUllr MA - Amendment
bullAMI UAlffllCOMTIUONVNI MHHchUMttbull Doputmnt of Environmnul Pr~oction -Abull vbull 0 11111 r_ INbull I middot1bull11
lfICtA4 COatMIHI obull 1bullIT1111C1I
Incroau in fundin9 to covor the following costbullbull (1) Coit of contractorbull support for rHponbull to public comonta on the PropoMd1Plan aGd 12) coet incroaH for the contractor a orovioualv comolotod vork due to rotrOACtiw middot Jncreau in indirect cobullt ~Atampa bullbull a mult of yoarly auaita bull
ITamp AIPHYAampt
573-5730
____ t-Dun--ibull-bulluobne--r111JJllabull1middotoJllltllgtyf~Lmiddotbull_bull______+~-fLlzbull~lc1___J-bull-1gt_-__1_0_____
IVNH ClltllfCAT tfllOVllU
Tiii AMOltltllT -ObullCr IJoOft 1bull o o- o~~middot~middot-
L r~shy _~
II UtJICUllI f tt 11 11 U IC t tt O 11IfJtJIU11 ICU J lllJI H Cf 0 d 0 U Cl bulltlii
$ bull slc 6bullbullbull 2 tf FA 1 ~ R L l 8 4 1111bull
bullbullbull bullbull bullbullbull bullbull bullbullbull bull bull
bull 0
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IJil Corrmonwecllh ol MassoctgtJse11s Executive omce ot Enwormental Allois irDepartment of Environmental Protection (
19 Auquat 1992 Merrill s Hohman Director Waate Mana9e11ent Division US EPA JFX Federal Building Bobullton MA 02203
RE PSC Resources Palmer -- Clearinghouae Review of Allendllent
Dear Mr Hohaan
Plbullbullbullbull note that an A95 Clearin9houae Review haa been applied for reqardinq the attached aaendaent to the PSC Resources Cooperative Agrbullbullbullnt
If you should have any questions on thia aatter please contact the Coaonwealtha Executive Office of Counitiea and Developaent at 727-7001
Thank you very bulluch
DEP
cc Lorenzo Thantu Helen Waldorf Bill Harkinbull Tony JCurpaaka Martin Horne Filo
fAX(111)151-1MI bull T~(t11)2tl-6500
bullI
~ Merrill s Hohman Director waste Management Division US EPA JFK Federal Building Boston MA 02203 19 Auqust 1992
RE PSC Resources Palmer -- Amendment to Cooperative Aqr8ement
Dear Hr HohJlan
The Oepartaent of Envirormental Protection (DEP) hereby requests an aaendaent to the PSC Resources RIFS Cooperative AgreeMnt to increase the contractual budget by $95 1 000 tor a nev total budqet of $1 635787
The attached table provides the details of this request_) Thbull Reaedial Investigation and Feasibility Study Reportbull have
been coapleted by the contractor and accepted bullbull final by both IPA and DIP However funding is required to cover the costs ot contractor support for responding to pulgtlic co-nts on the reporta In addition OEP contractor indirect cost ratea (ICRa) have increased retroactively as a result of yearly audits and additional funding is needed to cover the reaultinq coat increaaea tor previoualy cobullple ted work
If you have any questions or require any additional information pleaae contact Janine co-artord at (617) 556-1121
Thank you very much
poundroly gclt-l~ c Colbullan
Assistant Couissioner Bureau of Waste Site Cleanup
cc Lorenzo Thantu Helen Waldorf Bill Harkinbull Tony Kurpaska Martin Horne Janine Commerford
I I I I
iiJill1bull11rrbull( ir11
f f1 I
I I I I
middot
)
APPLICATION FOR FEDERAL ASSISTANCE 08 19 92
-- _ i _ --~----
Oshy j Oc-shy11~ n~
~ Coaaonwealth ~f Hauachuaetu
One Winter Street 5th troor Boston Ha 02108
__GIJtt I0 I 2 I 2 Ia 14 I
0 cc- gtalshy_-- [i D
___ t - shy cu-a ri-oshy o~
~zardeua Sub1tanct RuponH Trult Fund
-shy_____ ___ ______
ililliaa Harkins (617) 292-5906 anine Commerford (617) 556-1121
middot bull~---middot IU a S-shy M~ld-0
bull - shy l ~_ i--t ca _~ Q T _ __ L
middot ----shy 1111 _~Cl M deg9~-----
US EPA Region I ====---- lLLJmiddotLLlalz _~ middot e~ous Substance lesponH Trust Fund ~ir1~middot~~0d1F~~~~y ___ Site
Palr Ka ~ten County
1~
Dl11 08 25 92
middotshy __ I
01bull lI-middot- -- 1635787
lt1eMMS1bull~ loUDtbullbulllllll~fIOll----middot M~--- ltWTIOOflllD_M___ClftlllolCMl-NWIU_____cltbullN-iAllCCbullbullbull-shy __-shynbullbullu 1 S GuenbaW1 Commissioner
middotshy I I 11 LJ( ~ - Authorized tOiLocal Reproduc~HrOPV ti-
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1Ji 11fvr l hil I
Attachllent 1
81992 Aaendmient PSC Rbullbullourcebull Cooperative Agreement Budget
Budget Current Changbull Kow category Budget Requeated Budget
Peraonnel 23 969 23969
Fringe 9441 9441
Travel
Equipunt
suppliea
contractual 1499446 95 000 1594446
Other 1416 1416
Total Direct 1534272 95 000 1629272
Indirect 6515 6515
TOTAL RZQUUTED COOPERATIVE AGREEllEllT AllOUllT $1635787
~
ASSUAAHCES - NO~ONSTRUCTION PROGAAMS
c or u ~ 1ublbull lr middot p1ust conacl tht awardlllC 11tncJ F~u~ Fedcn arOinl a1t ncirs ma) req11in bullPPllunU
uinr~iy to addi tional UtWanctt Usuch it Ult cue you will bt bullUftlCi
Jutht ciuly au~horid rrirucnt11tit orthe 1t1llica1t I ttriy that tht 1t1alica11t
l Hu tht lrtbullI authorit) to aiply ror Federal auisWln and tht Witutional manattrial and (11amp1Cial capability (incltMlinl funds aWIWtnL I pbullJ ht non-Federal ahan or prejtd cosul ll ensurt proper planninc man111m11nt and cobullmiddot pinion oftit irojed ducribed ill UW appicatioA
Will ivt the abullardinC qtnt) ht Coapuolltr General or Lit tniLed StalS and it appro9fiaa the StaI hrouch ampDJ aulhoried nprnentatit accru to lid Iht ifht o esamirit all record1 books paitn or docucenu nlattd deg tht award anc wiil HtabliJh I priptt ICOllfttinc lflUI in acconianlaquo with 11nerally acuptad accountln(
sancarU or bullrbulln~cy direcCmiddot 3 Will ntablish WtfWds to prohibil 1mploy111
frabull u1in1 their positions for a partgtOH that CGftlit11t11 or 11rH1nU lhbull apptamplUCI of perlOCIAI orpNaUoMl amllicL ol ~wut or personal
wm lnitiat1 and complete tht work witbin ht
j a1aolt ti=e Craml ampAir lICli ti aIPOval ol Ihi awardinl ~middot
5 Will comply bull i th tb1 latu10Y1rnmotal Ptnoooal Act or 1970 42 USC 11 421-41131 rtlatinc deg prucriMd sWMlarU tor muit bullJN= tor pre(lampIU llftdlt one or Ult 1Wi1tetn satut11 or reWations 1cJtid in Apptndis A ol OPMs tanda-ds for 1 11bullrit S11t1m ol enoMbull I Adminisiation(5CFllto0 S~FI
I WUl eoCply wilh amp11 Ftd1ral Ntuttl nlatiI WI oonifiJcr ~mination Thbull incl11d1 but an not limiocl to al TiUc VI ol the CiTil Rirhu Ae or 1964 (PI 11-352) wNcb proilibiU dixmination on the buis o( tact color or nationI ori(Jl (bl Title IX or thbull poundd11cation Amniclmenu or 1972 u arnendc (20 usc n 1611-1613 and 1amp15middot1616) which prohibits Gitcriminad011 on tht basis or wz (c) Seltion ~04 or the Phabilitation Act of lfi3 as amtndc tZ9 C SC 1 794) which prohibiU ditbull cicination on the basis or haclicapt (dl ht Att OiKrinination Act o( us at uncncitd (42 L SC11 6101 middot 6107) which prohibiLS cliscrirGmiddot
ination on tht basis of ace
(~l ti1 Dnac bltl ()CiCI and T111t111nt Act of u lPL g ~51 abull amended nlatinc to non~tion on thbull buis of dNi alNM tn Iha Compnhtnsivt AloDhol Ablilll and Alcohoolilm PnvenUoa Tnaunent and lehallilitstioll Act or 1910 (PL tl middot l51Sl as amended relaUnc lo nondi1eriminamption on the buil of alCDbol abUM or aieonolisa lampl 11 s3 and s1 of the hblit Heal~ Srtie9 Adol191 (42 JSC 90 Odmiddot3 and tO 3) as abullndbulld r1adnc 0 curl4111tiality or alcohol and dNI ab111 uent ~(bl Tit1 VIII C Ibo Clril Ri(hll Act ol IHI (11 USC I 3601 tt MCl middotl as amended nlatin1 U sonbull ditcrlzWaatioll ~ thbull 1bullbull renaal or rinandnc oC hnsin r (il an ) otbtr nondiscrimiHion 1royensioDI in the slK 111tuteltsl uUr wbich ncatillD for FOtral usiawa ii Mini mati1 and ltU thbull ciuir11n1nu 1C tlhttno~tioa siawl(s) wbidt IU) appi) o
U1 applicadoL wm bull 1w alndr UH iu u1 _ o1nu o m rJIM uu 1l1localioo Aa1i1tanU and Ital ProptrY Acquiaitiile PoliciU Act ol ll10 ltPL tl6411 which Wt or lair aM ~It_ r -~ a -1Lr1Ftda-l or ianllJ _shyTht11 ~menu apply o all UdeftlU ia rul pro1J11rtY a~ ror proja u or Federal putici_don it p~
I Will comply witb ti1 proNioal fl hi Haldi Act (5 USC II l50lmiddotl50I an m4om11 whldl limit tht political activitin of 1=ploy11bull who11 1rincipal 1mploy=1nt actifitia ara fuded in whole or in re with Ftd1raltwm
9 wmcomply as alicalllbull wih the pnNions or thbull OariJBtooo Ati (40 USC If 1715amp bull 276amiddot 1) Iht eo1anc Act (40 USC I Tk and 11 C SC H 114l and Iht ConUUt Wdeg Hows end Sa1t1 Standsrcbull AC (40 USC fl 327middot3331anti lcbor 1tampndardbull ror [lclually usisad constn1Cion subarreerutnU
~u 1bull-1
---caooao--middot
Ai11hotized lor Loal Reproducion
10 Will tomply if applicablt with noo4 insurance purchaH r~uirtmtnls o( Stclion 1021al a( lht rlood Diu1ltt Proltetion Actor 1973 IPL 93-2341 middothich r~11irt1 rtcipianll in a special nooc1 bampurd aruloparticipallintkprocTampmandtopurchaH nood inluranct ir tht toll] COi l o( in1unblt cons truction and acquisition it $10000 or more
11 Will comply with environmental standards wh ich tnaY bt prucribtd pursuant lo tht follow inc la) inst itut ion of tnyenironn1tntal quality control m1a1urt1 under tht Joiational Enyenironmtntal Policy Act or IHI (PL 91 middot1901 and EHcutivt Order CEO 11514 (b notircat ion of yeniolaUn1 facilit iu pursuant 0 EO 11138 lei pnitection of wetlands punuanl deg EO 11990 tdl eval111ition of nood haurdt in noodplainl in accordanct with EO 11981 ltlaHWampnet of ptojtct con1 istucy with the approyentd Statt manatmtnt pro1ram dtvtloptd under the Cr111tal Zone ~ana1emtnt Act of 1912 (16 C SC U 1451 et Hq) CO conlormity of Ffftf9I actions lo Stale Claar Airl lmpltmentatioA Plam under Secion 1714cl of tht Clear Air Act of lt55 U amended (42 CSC t 740lttwq l(ampl pr0Ktiontl~aowa1 olclrinkinf water udtr lhl Wo Oriakinl W1ter Act ol 1174 u amtrMW CPL ts-5Ul u4 (bl proampocUoa of olMlanrer-4 1pecit1 undtr tbt Endanprtd Sptcitt Act or 1rrs u -- CPL IS-2061
12 WUI umply with iht W~t IDll ScetUc Riven Act of IHI nl USC II 1111 ot seqI rtlaLH to proKdnf coipoataU or pewntlal eempooaau of lM natioaaJ wild and ICtnic riven 1yawm
~llfttdegJf-r(~
oWif GrIZ~~
Dep t nviron11en tal Prot ection BWSC
13 fl ill a11i1t lht bullmiddotard in1 bull1bullncy in a11ur in1 coinpliuice with Sction 106 of the lationalr Hisioric PAMrvation Act or It u amended (1 1 l SC 470) EO 11593 (ident ification nd pnttction of h iuoric proptrtiu) and the ArchaHIOfuI and Hilloric Prt1trvation Act of 197fll6CSC 469amiddotlttseqI shy
14 Will comply with P L 933415 re1ard in1 the prMKlictn of human 1ubjocta inyenolvtd in rHtarch aklp1n1nt and rt lattd actMUu suppontd by this 1wani of auiatance
15 Will comply with tht Laboralory Animal W11C1tt Act of 1966 IPL 89middot544 a1 amtndtd 7 1 SC 21Jl 1t wqI per1ainin1 to tht can handlinc ancl lnatmeat tf warm blood1d animalbull hold ror rtsarCh teachin1 or other acUYitiu wpporllCI by this awani elauistana
11 Will ro111ply with tht Le1d-Bued Paint Pobonln1 pnuon Act 142 CSC H 410l tt Nq ) which prohibits thbull Ult or Ind ba1td pa inl i n conauuctlon or rth1bllltation o( roaidenct
11 VRill CHM t bt performed amphe required flnaticial aflll cembulllibullnct aviill in acconlaact witb tha 5Ucte Audit Act of 1914
tt Will -ply with alt applicUle requinmtntaof all other federal ia oucuu nrulabonlc policin pftlftint this prorram
IlWwlite$iuHt-fOlllMIJl~ NIC( WUllllionCCo60
Certific3tion Regarding Debarment Suspension and Other Responsibility Matters
The pros~ivbull participant cenllits to the best of its knowledge and belief that it and its principals
a) Ara net presently debarred susoended prooostd for d1blrment decared ineliQible or vclumariy exdudalt trorn cov1rtd transacuons by any Feat~ department or 1g1ncybull
b) Have ro wi1hin a LVH year oeriod pmedlng this prol)Oul been convicted ct or toad a cM jud9ement ttndarte aQtinslt IJlm tor comnvssion ol traud or a cnillMi cllense in coMacuon with orasnin anemptLnQ to obtain or parlonninljl a PIJbfic (Federal Statbull or local) transaction ot contrac underbull iillic transaction violation ol Feotlll or State aruruc salUlH or commmion ol emoeiament tntft torgery bribtty lalsiflcalion or d11tn1cuon ol ~s makin lalst sattments or rrIMng sOlenpropttty
(CJ NI nCll pretenlly irdCed falt Ot - cMmlffy Ot civly ~-Id by I q anlily (Fshy_ Stlll or lccal) wih commillion ol any of lhl oftenus enumtratld W paragraph (1)~1 ot Oil
(d) ~~W~i=e=~or~~~J~ had one 0t men~ I und~ tt11 e fl6al ClltmlN on tNI cenbtion rMY et roundl for rtjteJon d ttil PfODOl9 or termination ot me award 1n IOdlion una1t 11 use sec 1001 a ta111 atamert may ruur in 1 ltnt ot up
middot 10 510000 OI imprisonmllI fOt up to fllrl or both shy
Daniel Gr11nb1um Com1issiontl
-0 I am unable to certify 10 the above saltmtntS My txplanauon is aracttd
I I I I
Itbullbullimiddotmiddotr~Ibulll
rrfIfibulli
u SIA1U l lll0Ubull llii~h~Jfltgt A-i C~ w-sGTO oiilO __
2xi ~SEPA PROCUREMENT SYSTEM CERTIFICATION - -middot- IO J1 l
AllICANTSNAM( ASSIS1ANCl uucATION NuMatll ept Environmental ProtectionBWSC
V001726-0l-6 1111CAHTS A00111lSS
One Winter Street 5th floor Botton Ha 02108
HCllON I - INSTRUCTIONS
I I I I
iiJill 1t-1 Irrbull fltllr ISbull
The aoolicani must comoleie end submit copy of th1S form with Heh 1pplic111on lor EPA A1usi1nce 11 tnbull 1pphc1n1 hes cenlfbulltd its procurement 1ys11m 10 EPA w11h1n 1n1 oas1 ~ yHfl 11nd 11111ys11m hH not been 1uo1t1n11111v r1v1sed complete Pin A in S1c11on IL thin s1Gn end Cite tne form It tne 1v111m nas not bun c1n1fied w11n Ult 0-112 veers comolbulltbull Pin 8 then sion ind dllt lht form
HCTION II - CEATlflCATION
A 1eHirm1n11the1pphcan1 n11 w11h1n the Piii 2 yurs cenif1ed10EPA th1111s orocurem1n1 MOHTHIYlAI 1y11em comolis w11n 40CFP Pen 331nd1n111t1e 1ys1em mH11 thbull reQu1remen11 in 40
FR p n Tn f h Ii n I 11 I n
B BHed upon my ev11u111on of tne bullPohcants procurement sys11m I u 1uthonzed rtoresen1111ve of 111bull applicant Chtcll one of tht lollowingJ
LJ 1 CERTIFY lhlt tlMI apptican11 procurement IYltbullm will rnH1111 of the reQuiremenll of 40 CFA Pin 33 before undertaking 1ny procuremam 1e1ion witn EPA 1111stance
CRTI1I CAII0 10R CXH1Jc18 I GRgtJn S LOgtH8 ))lp OOP R)IJV JC lJ~
Tbbull undbullrbulligDbull6 certifiebull to the bebullt of b bull or her bowlbull49bull uad belief that
(1) bullo Pederamp appropriated fwidJI bampTbull b41bullD or will be pLid by or OD babalf of tbe udeniqned to LDJ pbullrbullo11 tor infl11uci119 or attoap ti119 to i11Clue11ce u officer or aaployee of any a9uay a Weaber of Co119rbullbullbull u officer or -ploy of Co119rbullbullbull or u aaployee of a gttaab4ir of CoD9reH iD coanection witb the awu4ing Of ampZIJ 7ederal CODtract tbe aakin9 ltgtf ampllJ 1e0araJ VdegUt the aal i n9 or uiy rederal lou tba enteri D9 iDto of uy COOJgt9iratiwe a9reect ampAd tbe ute11iaio11 co11tiDuatio11 rellewampl aauDut o r aodificatio11 of uy 7ederal co11tract 9ruit loampJl or cooperathmiddote a9reellt
(2 J If ampllJ fa4a otller thu 1bull4bullral appropriat ~ habullbull beaD paid or will N paid to uy pe=aoa for lltl-ciJa9 or atteaptiD9 to iaflaeacbull u oficer or aplOJbullbull of u7 atuor a bull--ltoer of CODZbullaa or u employee of a bullmMr of CDaigraaa ia couectioa wit~ thia Jederal ooatract qzaat lou or tibullbull agreoae11t tbbull va4eraiped alaa11 complete ud sUait ltaaampamprt hrashytLL tgti tdoaure Jon to aaport Lo~iia9bull ia acoortuce Titll ita iDatructiona
CJ) Tbbull undenipbulld aball require that Ubull lupava of Uia certificatioa ba iacluded ia tte bullbullaz4 of docaauta for ampll bullubawazdbull at all tiara (bclu4iD9 amicoatracta robqruta aad coDtract1 oder 9r uta loau ud cooperatibull agrebulluta) ampad tUt middot amp11 bullubr ecipi bullDt a allampll cbullrtty ud 41aclobullbullmiddot acoor4i1a9ly
Thia certificrtioll ibull a uteria l r epr eHDtamptioa ot fact apoa which r a liuce wu placed wbea thia tranaactioa wu aamp4a or utered into Bubaiaaioa ot thi a ctirtificatioa ia a prereqdaite for bullakin9 or bull DteriDq into thia trusaction iapose-4 b1 leotioa 1352 Title 31 u1 eode by peraoa who taila to til e Ue reqaired certiication aball be subject to a ciTil peulty ot DOt lua thaa s10ooo ~4 raquoot aorbull thampll t100ooo for eacll such failure
Da niel S Gre~nbaum Commiuionn nnn DD l ITLK or AVnOlllED UPllllJrDnn
if~or lou~~arrmn ~efri ~
- barcode 580527
- barcodetext SDMS Doc ID 580527
![Page 3: MEMO REGARDING REQUEST TO INITIATE PROCESSING A … · Ac)r••••nt or bendaent of an Exietinc; ACJr••••nt . To : Deborah Haretedt, Grant• speciali•t. Grant• Inforaation](https://reader033.vdocument.in/reader033/viewer/2022060408/5f0fe4a97e708231d44668d9/html5/thumbnails/3.jpg)
I
I I
IJil Corrmonwecllh ol MassoctgtJse11s Executive omce ot Enwormental Allois irDepartment of Environmental Protection (
19 Auquat 1992 Merrill s Hohman Director Waate Mana9e11ent Division US EPA JFX Federal Building Bobullton MA 02203
RE PSC Resources Palmer -- Clearinghouae Review of Allendllent
Dear Mr Hohaan
Plbullbullbullbull note that an A95 Clearin9houae Review haa been applied for reqardinq the attached aaendaent to the PSC Resources Cooperative Agrbullbullbullnt
If you should have any questions on thia aatter please contact the Coaonwealtha Executive Office of Counitiea and Developaent at 727-7001
Thank you very bulluch
DEP
cc Lorenzo Thantu Helen Waldorf Bill Harkinbull Tony JCurpaaka Martin Horne Filo
fAX(111)151-1MI bull T~(t11)2tl-6500
bullI
~ Merrill s Hohman Director waste Management Division US EPA JFK Federal Building Boston MA 02203 19 Auqust 1992
RE PSC Resources Palmer -- Amendment to Cooperative Aqr8ement
Dear Hr HohJlan
The Oepartaent of Envirormental Protection (DEP) hereby requests an aaendaent to the PSC Resources RIFS Cooperative AgreeMnt to increase the contractual budget by $95 1 000 tor a nev total budqet of $1 635787
The attached table provides the details of this request_) Thbull Reaedial Investigation and Feasibility Study Reportbull have
been coapleted by the contractor and accepted bullbull final by both IPA and DIP However funding is required to cover the costs ot contractor support for responding to pulgtlic co-nts on the reporta In addition OEP contractor indirect cost ratea (ICRa) have increased retroactively as a result of yearly audits and additional funding is needed to cover the reaultinq coat increaaea tor previoualy cobullple ted work
If you have any questions or require any additional information pleaae contact Janine co-artord at (617) 556-1121
Thank you very much
poundroly gclt-l~ c Colbullan
Assistant Couissioner Bureau of Waste Site Cleanup
cc Lorenzo Thantu Helen Waldorf Bill Harkinbull Tony Kurpaska Martin Horne Janine Commerford
I I I I
iiJill1bull11rrbull( ir11
f f1 I
I I I I
middot
)
APPLICATION FOR FEDERAL ASSISTANCE 08 19 92
-- _ i _ --~----
Oshy j Oc-shy11~ n~
~ Coaaonwealth ~f Hauachuaetu
One Winter Street 5th troor Boston Ha 02108
__GIJtt I0 I 2 I 2 Ia 14 I
0 cc- gtalshy_-- [i D
___ t - shy cu-a ri-oshy o~
~zardeua Sub1tanct RuponH Trult Fund
-shy_____ ___ ______
ililliaa Harkins (617) 292-5906 anine Commerford (617) 556-1121
middot bull~---middot IU a S-shy M~ld-0
bull - shy l ~_ i--t ca _~ Q T _ __ L
middot ----shy 1111 _~Cl M deg9~-----
US EPA Region I ====---- lLLJmiddotLLlalz _~ middot e~ous Substance lesponH Trust Fund ~ir1~middot~~0d1F~~~~y ___ Site
Palr Ka ~ten County
1~
Dl11 08 25 92
middotshy __ I
01bull lI-middot- -- 1635787
lt1eMMS1bull~ loUDtbullbulllllll~fIOll----middot M~--- ltWTIOOflllD_M___ClftlllolCMl-NWIU_____cltbullN-iAllCCbullbullbull-shy __-shynbullbullu 1 S GuenbaW1 Commissioner
middotshy I I 11 LJ( ~ - Authorized tOiLocal Reproduc~HrOPV ti-
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1 bull
-1 bull
I
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4
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I I I I
1Ji 11fvr l hil I
Attachllent 1
81992 Aaendmient PSC Rbullbullourcebull Cooperative Agreement Budget
Budget Current Changbull Kow category Budget Requeated Budget
Peraonnel 23 969 23969
Fringe 9441 9441
Travel
Equipunt
suppliea
contractual 1499446 95 000 1594446
Other 1416 1416
Total Direct 1534272 95 000 1629272
Indirect 6515 6515
TOTAL RZQUUTED COOPERATIVE AGREEllEllT AllOUllT $1635787
~
ASSUAAHCES - NO~ONSTRUCTION PROGAAMS
c or u ~ 1ublbull lr middot p1ust conacl tht awardlllC 11tncJ F~u~ Fedcn arOinl a1t ncirs ma) req11in bullPPllunU
uinr~iy to addi tional UtWanctt Usuch it Ult cue you will bt bullUftlCi
Jutht ciuly au~horid rrirucnt11tit orthe 1t1llica1t I ttriy that tht 1t1alica11t
l Hu tht lrtbullI authorit) to aiply ror Federal auisWln and tht Witutional manattrial and (11amp1Cial capability (incltMlinl funds aWIWtnL I pbullJ ht non-Federal ahan or prejtd cosul ll ensurt proper planninc man111m11nt and cobullmiddot pinion oftit irojed ducribed ill UW appicatioA
Will ivt the abullardinC qtnt) ht Coapuolltr General or Lit tniLed StalS and it appro9fiaa the StaI hrouch ampDJ aulhoried nprnentatit accru to lid Iht ifht o esamirit all record1 books paitn or docucenu nlattd deg tht award anc wiil HtabliJh I priptt ICOllfttinc lflUI in acconianlaquo with 11nerally acuptad accountln(
sancarU or bullrbulln~cy direcCmiddot 3 Will ntablish WtfWds to prohibil 1mploy111
frabull u1in1 their positions for a partgtOH that CGftlit11t11 or 11rH1nU lhbull apptamplUCI of perlOCIAI orpNaUoMl amllicL ol ~wut or personal
wm lnitiat1 and complete tht work witbin ht
j a1aolt ti=e Craml ampAir lICli ti aIPOval ol Ihi awardinl ~middot
5 Will comply bull i th tb1 latu10Y1rnmotal Ptnoooal Act or 1970 42 USC 11 421-41131 rtlatinc deg prucriMd sWMlarU tor muit bullJN= tor pre(lampIU llftdlt one or Ult 1Wi1tetn satut11 or reWations 1cJtid in Apptndis A ol OPMs tanda-ds for 1 11bullrit S11t1m ol enoMbull I Adminisiation(5CFllto0 S~FI
I WUl eoCply wilh amp11 Ftd1ral Ntuttl nlatiI WI oonifiJcr ~mination Thbull incl11d1 but an not limiocl to al TiUc VI ol the CiTil Rirhu Ae or 1964 (PI 11-352) wNcb proilibiU dixmination on the buis o( tact color or nationI ori(Jl (bl Title IX or thbull poundd11cation Amniclmenu or 1972 u arnendc (20 usc n 1611-1613 and 1amp15middot1616) which prohibits Gitcriminad011 on tht basis or wz (c) Seltion ~04 or the Phabilitation Act of lfi3 as amtndc tZ9 C SC 1 794) which prohibiU ditbull cicination on the basis or haclicapt (dl ht Att OiKrinination Act o( us at uncncitd (42 L SC11 6101 middot 6107) which prohibiLS cliscrirGmiddot
ination on tht basis of ace
(~l ti1 Dnac bltl ()CiCI and T111t111nt Act of u lPL g ~51 abull amended nlatinc to non~tion on thbull buis of dNi alNM tn Iha Compnhtnsivt AloDhol Ablilll and Alcohoolilm PnvenUoa Tnaunent and lehallilitstioll Act or 1910 (PL tl middot l51Sl as amended relaUnc lo nondi1eriminamption on the buil of alCDbol abUM or aieonolisa lampl 11 s3 and s1 of the hblit Heal~ Srtie9 Adol191 (42 JSC 90 Odmiddot3 and tO 3) as abullndbulld r1adnc 0 curl4111tiality or alcohol and dNI ab111 uent ~(bl Tit1 VIII C Ibo Clril Ri(hll Act ol IHI (11 USC I 3601 tt MCl middotl as amended nlatin1 U sonbull ditcrlzWaatioll ~ thbull 1bullbull renaal or rinandnc oC hnsin r (il an ) otbtr nondiscrimiHion 1royensioDI in the slK 111tuteltsl uUr wbich ncatillD for FOtral usiawa ii Mini mati1 and ltU thbull ciuir11n1nu 1C tlhttno~tioa siawl(s) wbidt IU) appi) o
U1 applicadoL wm bull 1w alndr UH iu u1 _ o1nu o m rJIM uu 1l1localioo Aa1i1tanU and Ital ProptrY Acquiaitiile PoliciU Act ol ll10 ltPL tl6411 which Wt or lair aM ~It_ r -~ a -1Lr1Ftda-l or ianllJ _shyTht11 ~menu apply o all UdeftlU ia rul pro1J11rtY a~ ror proja u or Federal putici_don it p~
I Will comply witb ti1 proNioal fl hi Haldi Act (5 USC II l50lmiddotl50I an m4om11 whldl limit tht political activitin of 1=ploy11bull who11 1rincipal 1mploy=1nt actifitia ara fuded in whole or in re with Ftd1raltwm
9 wmcomply as alicalllbull wih the pnNions or thbull OariJBtooo Ati (40 USC If 1715amp bull 276amiddot 1) Iht eo1anc Act (40 USC I Tk and 11 C SC H 114l and Iht ConUUt Wdeg Hows end Sa1t1 Standsrcbull AC (40 USC fl 327middot3331anti lcbor 1tampndardbull ror [lclually usisad constn1Cion subarreerutnU
~u 1bull-1
---caooao--middot
Ai11hotized lor Loal Reproducion
10 Will tomply if applicablt with noo4 insurance purchaH r~uirtmtnls o( Stclion 1021al a( lht rlood Diu1ltt Proltetion Actor 1973 IPL 93-2341 middothich r~11irt1 rtcipianll in a special nooc1 bampurd aruloparticipallintkprocTampmandtopurchaH nood inluranct ir tht toll] COi l o( in1unblt cons truction and acquisition it $10000 or more
11 Will comply with environmental standards wh ich tnaY bt prucribtd pursuant lo tht follow inc la) inst itut ion of tnyenironn1tntal quality control m1a1urt1 under tht Joiational Enyenironmtntal Policy Act or IHI (PL 91 middot1901 and EHcutivt Order CEO 11514 (b notircat ion of yeniolaUn1 facilit iu pursuant 0 EO 11138 lei pnitection of wetlands punuanl deg EO 11990 tdl eval111ition of nood haurdt in noodplainl in accordanct with EO 11981 ltlaHWampnet of ptojtct con1 istucy with the approyentd Statt manatmtnt pro1ram dtvtloptd under the Cr111tal Zone ~ana1emtnt Act of 1912 (16 C SC U 1451 et Hq) CO conlormity of Ffftf9I actions lo Stale Claar Airl lmpltmentatioA Plam under Secion 1714cl of tht Clear Air Act of lt55 U amended (42 CSC t 740lttwq l(ampl pr0Ktiontl~aowa1 olclrinkinf water udtr lhl Wo Oriakinl W1ter Act ol 1174 u amtrMW CPL ts-5Ul u4 (bl proampocUoa of olMlanrer-4 1pecit1 undtr tbt Endanprtd Sptcitt Act or 1rrs u -- CPL IS-2061
12 WUI umply with iht W~t IDll ScetUc Riven Act of IHI nl USC II 1111 ot seqI rtlaLH to proKdnf coipoataU or pewntlal eempooaau of lM natioaaJ wild and ICtnic riven 1yawm
~llfttdegJf-r(~
oWif GrIZ~~
Dep t nviron11en tal Prot ection BWSC
13 fl ill a11i1t lht bullmiddotard in1 bull1bullncy in a11ur in1 coinpliuice with Sction 106 of the lationalr Hisioric PAMrvation Act or It u amended (1 1 l SC 470) EO 11593 (ident ification nd pnttction of h iuoric proptrtiu) and the ArchaHIOfuI and Hilloric Prt1trvation Act of 197fll6CSC 469amiddotlttseqI shy
14 Will comply with P L 933415 re1ard in1 the prMKlictn of human 1ubjocta inyenolvtd in rHtarch aklp1n1nt and rt lattd actMUu suppontd by this 1wani of auiatance
15 Will comply with tht Laboralory Animal W11C1tt Act of 1966 IPL 89middot544 a1 amtndtd 7 1 SC 21Jl 1t wqI per1ainin1 to tht can handlinc ancl lnatmeat tf warm blood1d animalbull hold ror rtsarCh teachin1 or other acUYitiu wpporllCI by this awani elauistana
11 Will ro111ply with tht Le1d-Bued Paint Pobonln1 pnuon Act 142 CSC H 410l tt Nq ) which prohibits thbull Ult or Ind ba1td pa inl i n conauuctlon or rth1bllltation o( roaidenct
11 VRill CHM t bt performed amphe required flnaticial aflll cembulllibullnct aviill in acconlaact witb tha 5Ucte Audit Act of 1914
tt Will -ply with alt applicUle requinmtntaof all other federal ia oucuu nrulabonlc policin pftlftint this prorram
IlWwlite$iuHt-fOlllMIJl~ NIC( WUllllionCCo60
Certific3tion Regarding Debarment Suspension and Other Responsibility Matters
The pros~ivbull participant cenllits to the best of its knowledge and belief that it and its principals
a) Ara net presently debarred susoended prooostd for d1blrment decared ineliQible or vclumariy exdudalt trorn cov1rtd transacuons by any Feat~ department or 1g1ncybull
b) Have ro wi1hin a LVH year oeriod pmedlng this prol)Oul been convicted ct or toad a cM jud9ement ttndarte aQtinslt IJlm tor comnvssion ol traud or a cnillMi cllense in coMacuon with orasnin anemptLnQ to obtain or parlonninljl a PIJbfic (Federal Statbull or local) transaction ot contrac underbull iillic transaction violation ol Feotlll or State aruruc salUlH or commmion ol emoeiament tntft torgery bribtty lalsiflcalion or d11tn1cuon ol ~s makin lalst sattments or rrIMng sOlenpropttty
(CJ NI nCll pretenlly irdCed falt Ot - cMmlffy Ot civly ~-Id by I q anlily (Fshy_ Stlll or lccal) wih commillion ol any of lhl oftenus enumtratld W paragraph (1)~1 ot Oil
(d) ~~W~i=e=~or~~~J~ had one 0t men~ I und~ tt11 e fl6al ClltmlN on tNI cenbtion rMY et roundl for rtjteJon d ttil PfODOl9 or termination ot me award 1n IOdlion una1t 11 use sec 1001 a ta111 atamert may ruur in 1 ltnt ot up
middot 10 510000 OI imprisonmllI fOt up to fllrl or both shy
Daniel Gr11nb1um Com1issiontl
-0 I am unable to certify 10 the above saltmtntS My txplanauon is aracttd
I I I I
Itbullbullimiddotmiddotr~Ibulll
rrfIfibulli
u SIA1U l lll0Ubull llii~h~Jfltgt A-i C~ w-sGTO oiilO __
2xi ~SEPA PROCUREMENT SYSTEM CERTIFICATION - -middot- IO J1 l
AllICANTSNAM( ASSIS1ANCl uucATION NuMatll ept Environmental ProtectionBWSC
V001726-0l-6 1111CAHTS A00111lSS
One Winter Street 5th floor Botton Ha 02108
HCllON I - INSTRUCTIONS
I I I I
iiJill 1t-1 Irrbull fltllr ISbull
The aoolicani must comoleie end submit copy of th1S form with Heh 1pplic111on lor EPA A1usi1nce 11 tnbull 1pphc1n1 hes cenlfbulltd its procurement 1ys11m 10 EPA w11h1n 1n1 oas1 ~ yHfl 11nd 11111ys11m hH not been 1uo1t1n11111v r1v1sed complete Pin A in S1c11on IL thin s1Gn end Cite tne form It tne 1v111m nas not bun c1n1fied w11n Ult 0-112 veers comolbulltbull Pin 8 then sion ind dllt lht form
HCTION II - CEATlflCATION
A 1eHirm1n11the1pphcan1 n11 w11h1n the Piii 2 yurs cenif1ed10EPA th1111s orocurem1n1 MOHTHIYlAI 1y11em comolis w11n 40CFP Pen 331nd1n111t1e 1ys1em mH11 thbull reQu1remen11 in 40
FR p n Tn f h Ii n I 11 I n
B BHed upon my ev11u111on of tne bullPohcants procurement sys11m I u 1uthonzed rtoresen1111ve of 111bull applicant Chtcll one of tht lollowingJ
LJ 1 CERTIFY lhlt tlMI apptican11 procurement IYltbullm will rnH1111 of the reQuiremenll of 40 CFA Pin 33 before undertaking 1ny procuremam 1e1ion witn EPA 1111stance
CRTI1I CAII0 10R CXH1Jc18 I GRgtJn S LOgtH8 ))lp OOP R)IJV JC lJ~
Tbbull undbullrbulligDbull6 certifiebull to the bebullt of b bull or her bowlbull49bull uad belief that
(1) bullo Pederamp appropriated fwidJI bampTbull b41bullD or will be pLid by or OD babalf of tbe udeniqned to LDJ pbullrbullo11 tor infl11uci119 or attoap ti119 to i11Clue11ce u officer or aaployee of any a9uay a Weaber of Co119rbullbullbull u officer or -ploy of Co119rbullbullbull or u aaployee of a gttaab4ir of CoD9reH iD coanection witb the awu4ing Of ampZIJ 7ederal CODtract tbe aakin9 ltgtf ampllJ 1e0araJ VdegUt the aal i n9 or uiy rederal lou tba enteri D9 iDto of uy COOJgt9iratiwe a9reect ampAd tbe ute11iaio11 co11tiDuatio11 rellewampl aauDut o r aodificatio11 of uy 7ederal co11tract 9ruit loampJl or cooperathmiddote a9reellt
(2 J If ampllJ fa4a otller thu 1bull4bullral appropriat ~ habullbull beaD paid or will N paid to uy pe=aoa for lltl-ciJa9 or atteaptiD9 to iaflaeacbull u oficer or aplOJbullbull of u7 atuor a bull--ltoer of CODZbullaa or u employee of a bullmMr of CDaigraaa ia couectioa wit~ thia Jederal ooatract qzaat lou or tibullbull agreoae11t tbbull va4eraiped alaa11 complete ud sUait ltaaampamprt hrashytLL tgti tdoaure Jon to aaport Lo~iia9bull ia acoortuce Titll ita iDatructiona
CJ) Tbbull undenipbulld aball require that Ubull lupava of Uia certificatioa ba iacluded ia tte bullbullaz4 of docaauta for ampll bullubawazdbull at all tiara (bclu4iD9 amicoatracta robqruta aad coDtract1 oder 9r uta loau ud cooperatibull agrebulluta) ampad tUt middot amp11 bullubr ecipi bullDt a allampll cbullrtty ud 41aclobullbullmiddot acoor4i1a9ly
Thia certificrtioll ibull a uteria l r epr eHDtamptioa ot fact apoa which r a liuce wu placed wbea thia tranaactioa wu aamp4a or utered into Bubaiaaioa ot thi a ctirtificatioa ia a prereqdaite for bullakin9 or bull DteriDq into thia trusaction iapose-4 b1 leotioa 1352 Title 31 u1 eode by peraoa who taila to til e Ue reqaired certiication aball be subject to a ciTil peulty ot DOt lua thaa s10ooo ~4 raquoot aorbull thampll t100ooo for eacll such failure
Da niel S Gre~nbaum Commiuionn nnn DD l ITLK or AVnOlllED UPllllJrDnn
if~or lou~~arrmn ~efri ~
- barcode 580527
- barcodetext SDMS Doc ID 580527
![Page 4: MEMO REGARDING REQUEST TO INITIATE PROCESSING A … · Ac)r••••nt or bendaent of an Exietinc; ACJr••••nt . To : Deborah Haretedt, Grant• speciali•t. Grant• Inforaation](https://reader033.vdocument.in/reader033/viewer/2022060408/5f0fe4a97e708231d44668d9/html5/thumbnails/4.jpg)
~ Merrill s Hohman Director waste Management Division US EPA JFK Federal Building Boston MA 02203 19 Auqust 1992
RE PSC Resources Palmer -- Amendment to Cooperative Aqr8ement
Dear Hr HohJlan
The Oepartaent of Envirormental Protection (DEP) hereby requests an aaendaent to the PSC Resources RIFS Cooperative AgreeMnt to increase the contractual budget by $95 1 000 tor a nev total budqet of $1 635787
The attached table provides the details of this request_) Thbull Reaedial Investigation and Feasibility Study Reportbull have
been coapleted by the contractor and accepted bullbull final by both IPA and DIP However funding is required to cover the costs ot contractor support for responding to pulgtlic co-nts on the reporta In addition OEP contractor indirect cost ratea (ICRa) have increased retroactively as a result of yearly audits and additional funding is needed to cover the reaultinq coat increaaea tor previoualy cobullple ted work
If you have any questions or require any additional information pleaae contact Janine co-artord at (617) 556-1121
Thank you very much
poundroly gclt-l~ c Colbullan
Assistant Couissioner Bureau of Waste Site Cleanup
cc Lorenzo Thantu Helen Waldorf Bill Harkinbull Tony Kurpaska Martin Horne Janine Commerford
I I I I
iiJill1bull11rrbull( ir11
f f1 I
I I I I
middot
)
APPLICATION FOR FEDERAL ASSISTANCE 08 19 92
-- _ i _ --~----
Oshy j Oc-shy11~ n~
~ Coaaonwealth ~f Hauachuaetu
One Winter Street 5th troor Boston Ha 02108
__GIJtt I0 I 2 I 2 Ia 14 I
0 cc- gtalshy_-- [i D
___ t - shy cu-a ri-oshy o~
~zardeua Sub1tanct RuponH Trult Fund
-shy_____ ___ ______
ililliaa Harkins (617) 292-5906 anine Commerford (617) 556-1121
middot bull~---middot IU a S-shy M~ld-0
bull - shy l ~_ i--t ca _~ Q T _ __ L
middot ----shy 1111 _~Cl M deg9~-----
US EPA Region I ====---- lLLJmiddotLLlalz _~ middot e~ous Substance lesponH Trust Fund ~ir1~middot~~0d1F~~~~y ___ Site
Palr Ka ~ten County
1~
Dl11 08 25 92
middotshy __ I
01bull lI-middot- -- 1635787
lt1eMMS1bull~ loUDtbullbulllllll~fIOll----middot M~--- ltWTIOOflllD_M___ClftlllolCMl-NWIU_____cltbullN-iAllCCbullbullbull-shy __-shynbullbullu 1 S GuenbaW1 Commissioner
middotshy I I 11 LJ( ~ - Authorized tOiLocal Reproduc~HrOPV ti-
ii
i c
N
0 ~
4 ~
i 4
~
~
J
-0
4 s
s s
s 4
~
i ~
~
~
~
~
lI
~
I
middotl bulli 1poundabull
E
J
~
e sect
sect ~
Ic
p 0
oj
2 ~
yen
t
5
1 1l
I Is middot
~
~ J
~
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i
middot ll
111middot ~
~
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-~ -
4
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~
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)
ii N
N
N
i
bullll 0
0 0
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i
l
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bull l
i bull
e 1
iih 3 l
bull 1
I l
a l i
i I
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l
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~I
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1 bull
-1 bull
I
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Attachllent 1
81992 Aaendmient PSC Rbullbullourcebull Cooperative Agreement Budget
Budget Current Changbull Kow category Budget Requeated Budget
Peraonnel 23 969 23969
Fringe 9441 9441
Travel
Equipunt
suppliea
contractual 1499446 95 000 1594446
Other 1416 1416
Total Direct 1534272 95 000 1629272
Indirect 6515 6515
TOTAL RZQUUTED COOPERATIVE AGREEllEllT AllOUllT $1635787
~
ASSUAAHCES - NO~ONSTRUCTION PROGAAMS
c or u ~ 1ublbull lr middot p1ust conacl tht awardlllC 11tncJ F~u~ Fedcn arOinl a1t ncirs ma) req11in bullPPllunU
uinr~iy to addi tional UtWanctt Usuch it Ult cue you will bt bullUftlCi
Jutht ciuly au~horid rrirucnt11tit orthe 1t1llica1t I ttriy that tht 1t1alica11t
l Hu tht lrtbullI authorit) to aiply ror Federal auisWln and tht Witutional manattrial and (11amp1Cial capability (incltMlinl funds aWIWtnL I pbullJ ht non-Federal ahan or prejtd cosul ll ensurt proper planninc man111m11nt and cobullmiddot pinion oftit irojed ducribed ill UW appicatioA
Will ivt the abullardinC qtnt) ht Coapuolltr General or Lit tniLed StalS and it appro9fiaa the StaI hrouch ampDJ aulhoried nprnentatit accru to lid Iht ifht o esamirit all record1 books paitn or docucenu nlattd deg tht award anc wiil HtabliJh I priptt ICOllfttinc lflUI in acconianlaquo with 11nerally acuptad accountln(
sancarU or bullrbulln~cy direcCmiddot 3 Will ntablish WtfWds to prohibil 1mploy111
frabull u1in1 their positions for a partgtOH that CGftlit11t11 or 11rH1nU lhbull apptamplUCI of perlOCIAI orpNaUoMl amllicL ol ~wut or personal
wm lnitiat1 and complete tht work witbin ht
j a1aolt ti=e Craml ampAir lICli ti aIPOval ol Ihi awardinl ~middot
5 Will comply bull i th tb1 latu10Y1rnmotal Ptnoooal Act or 1970 42 USC 11 421-41131 rtlatinc deg prucriMd sWMlarU tor muit bullJN= tor pre(lampIU llftdlt one or Ult 1Wi1tetn satut11 or reWations 1cJtid in Apptndis A ol OPMs tanda-ds for 1 11bullrit S11t1m ol enoMbull I Adminisiation(5CFllto0 S~FI
I WUl eoCply wilh amp11 Ftd1ral Ntuttl nlatiI WI oonifiJcr ~mination Thbull incl11d1 but an not limiocl to al TiUc VI ol the CiTil Rirhu Ae or 1964 (PI 11-352) wNcb proilibiU dixmination on the buis o( tact color or nationI ori(Jl (bl Title IX or thbull poundd11cation Amniclmenu or 1972 u arnendc (20 usc n 1611-1613 and 1amp15middot1616) which prohibits Gitcriminad011 on tht basis or wz (c) Seltion ~04 or the Phabilitation Act of lfi3 as amtndc tZ9 C SC 1 794) which prohibiU ditbull cicination on the basis or haclicapt (dl ht Att OiKrinination Act o( us at uncncitd (42 L SC11 6101 middot 6107) which prohibiLS cliscrirGmiddot
ination on tht basis of ace
(~l ti1 Dnac bltl ()CiCI and T111t111nt Act of u lPL g ~51 abull amended nlatinc to non~tion on thbull buis of dNi alNM tn Iha Compnhtnsivt AloDhol Ablilll and Alcohoolilm PnvenUoa Tnaunent and lehallilitstioll Act or 1910 (PL tl middot l51Sl as amended relaUnc lo nondi1eriminamption on the buil of alCDbol abUM or aieonolisa lampl 11 s3 and s1 of the hblit Heal~ Srtie9 Adol191 (42 JSC 90 Odmiddot3 and tO 3) as abullndbulld r1adnc 0 curl4111tiality or alcohol and dNI ab111 uent ~(bl Tit1 VIII C Ibo Clril Ri(hll Act ol IHI (11 USC I 3601 tt MCl middotl as amended nlatin1 U sonbull ditcrlzWaatioll ~ thbull 1bullbull renaal or rinandnc oC hnsin r (il an ) otbtr nondiscrimiHion 1royensioDI in the slK 111tuteltsl uUr wbich ncatillD for FOtral usiawa ii Mini mati1 and ltU thbull ciuir11n1nu 1C tlhttno~tioa siawl(s) wbidt IU) appi) o
U1 applicadoL wm bull 1w alndr UH iu u1 _ o1nu o m rJIM uu 1l1localioo Aa1i1tanU and Ital ProptrY Acquiaitiile PoliciU Act ol ll10 ltPL tl6411 which Wt or lair aM ~It_ r -~ a -1Lr1Ftda-l or ianllJ _shyTht11 ~menu apply o all UdeftlU ia rul pro1J11rtY a~ ror proja u or Federal putici_don it p~
I Will comply witb ti1 proNioal fl hi Haldi Act (5 USC II l50lmiddotl50I an m4om11 whldl limit tht political activitin of 1=ploy11bull who11 1rincipal 1mploy=1nt actifitia ara fuded in whole or in re with Ftd1raltwm
9 wmcomply as alicalllbull wih the pnNions or thbull OariJBtooo Ati (40 USC If 1715amp bull 276amiddot 1) Iht eo1anc Act (40 USC I Tk and 11 C SC H 114l and Iht ConUUt Wdeg Hows end Sa1t1 Standsrcbull AC (40 USC fl 327middot3331anti lcbor 1tampndardbull ror [lclually usisad constn1Cion subarreerutnU
~u 1bull-1
---caooao--middot
Ai11hotized lor Loal Reproducion
10 Will tomply if applicablt with noo4 insurance purchaH r~uirtmtnls o( Stclion 1021al a( lht rlood Diu1ltt Proltetion Actor 1973 IPL 93-2341 middothich r~11irt1 rtcipianll in a special nooc1 bampurd aruloparticipallintkprocTampmandtopurchaH nood inluranct ir tht toll] COi l o( in1unblt cons truction and acquisition it $10000 or more
11 Will comply with environmental standards wh ich tnaY bt prucribtd pursuant lo tht follow inc la) inst itut ion of tnyenironn1tntal quality control m1a1urt1 under tht Joiational Enyenironmtntal Policy Act or IHI (PL 91 middot1901 and EHcutivt Order CEO 11514 (b notircat ion of yeniolaUn1 facilit iu pursuant 0 EO 11138 lei pnitection of wetlands punuanl deg EO 11990 tdl eval111ition of nood haurdt in noodplainl in accordanct with EO 11981 ltlaHWampnet of ptojtct con1 istucy with the approyentd Statt manatmtnt pro1ram dtvtloptd under the Cr111tal Zone ~ana1emtnt Act of 1912 (16 C SC U 1451 et Hq) CO conlormity of Ffftf9I actions lo Stale Claar Airl lmpltmentatioA Plam under Secion 1714cl of tht Clear Air Act of lt55 U amended (42 CSC t 740lttwq l(ampl pr0Ktiontl~aowa1 olclrinkinf water udtr lhl Wo Oriakinl W1ter Act ol 1174 u amtrMW CPL ts-5Ul u4 (bl proampocUoa of olMlanrer-4 1pecit1 undtr tbt Endanprtd Sptcitt Act or 1rrs u -- CPL IS-2061
12 WUI umply with iht W~t IDll ScetUc Riven Act of IHI nl USC II 1111 ot seqI rtlaLH to proKdnf coipoataU or pewntlal eempooaau of lM natioaaJ wild and ICtnic riven 1yawm
~llfttdegJf-r(~
oWif GrIZ~~
Dep t nviron11en tal Prot ection BWSC
13 fl ill a11i1t lht bullmiddotard in1 bull1bullncy in a11ur in1 coinpliuice with Sction 106 of the lationalr Hisioric PAMrvation Act or It u amended (1 1 l SC 470) EO 11593 (ident ification nd pnttction of h iuoric proptrtiu) and the ArchaHIOfuI and Hilloric Prt1trvation Act of 197fll6CSC 469amiddotlttseqI shy
14 Will comply with P L 933415 re1ard in1 the prMKlictn of human 1ubjocta inyenolvtd in rHtarch aklp1n1nt and rt lattd actMUu suppontd by this 1wani of auiatance
15 Will comply with tht Laboralory Animal W11C1tt Act of 1966 IPL 89middot544 a1 amtndtd 7 1 SC 21Jl 1t wqI per1ainin1 to tht can handlinc ancl lnatmeat tf warm blood1d animalbull hold ror rtsarCh teachin1 or other acUYitiu wpporllCI by this awani elauistana
11 Will ro111ply with tht Le1d-Bued Paint Pobonln1 pnuon Act 142 CSC H 410l tt Nq ) which prohibits thbull Ult or Ind ba1td pa inl i n conauuctlon or rth1bllltation o( roaidenct
11 VRill CHM t bt performed amphe required flnaticial aflll cembulllibullnct aviill in acconlaact witb tha 5Ucte Audit Act of 1914
tt Will -ply with alt applicUle requinmtntaof all other federal ia oucuu nrulabonlc policin pftlftint this prorram
IlWwlite$iuHt-fOlllMIJl~ NIC( WUllllionCCo60
Certific3tion Regarding Debarment Suspension and Other Responsibility Matters
The pros~ivbull participant cenllits to the best of its knowledge and belief that it and its principals
a) Ara net presently debarred susoended prooostd for d1blrment decared ineliQible or vclumariy exdudalt trorn cov1rtd transacuons by any Feat~ department or 1g1ncybull
b) Have ro wi1hin a LVH year oeriod pmedlng this prol)Oul been convicted ct or toad a cM jud9ement ttndarte aQtinslt IJlm tor comnvssion ol traud or a cnillMi cllense in coMacuon with orasnin anemptLnQ to obtain or parlonninljl a PIJbfic (Federal Statbull or local) transaction ot contrac underbull iillic transaction violation ol Feotlll or State aruruc salUlH or commmion ol emoeiament tntft torgery bribtty lalsiflcalion or d11tn1cuon ol ~s makin lalst sattments or rrIMng sOlenpropttty
(CJ NI nCll pretenlly irdCed falt Ot - cMmlffy Ot civly ~-Id by I q anlily (Fshy_ Stlll or lccal) wih commillion ol any of lhl oftenus enumtratld W paragraph (1)~1 ot Oil
(d) ~~W~i=e=~or~~~J~ had one 0t men~ I und~ tt11 e fl6al ClltmlN on tNI cenbtion rMY et roundl for rtjteJon d ttil PfODOl9 or termination ot me award 1n IOdlion una1t 11 use sec 1001 a ta111 atamert may ruur in 1 ltnt ot up
middot 10 510000 OI imprisonmllI fOt up to fllrl or both shy
Daniel Gr11nb1um Com1issiontl
-0 I am unable to certify 10 the above saltmtntS My txplanauon is aracttd
I I I I
Itbullbullimiddotmiddotr~Ibulll
rrfIfibulli
u SIA1U l lll0Ubull llii~h~Jfltgt A-i C~ w-sGTO oiilO __
2xi ~SEPA PROCUREMENT SYSTEM CERTIFICATION - -middot- IO J1 l
AllICANTSNAM( ASSIS1ANCl uucATION NuMatll ept Environmental ProtectionBWSC
V001726-0l-6 1111CAHTS A00111lSS
One Winter Street 5th floor Botton Ha 02108
HCllON I - INSTRUCTIONS
I I I I
iiJill 1t-1 Irrbull fltllr ISbull
The aoolicani must comoleie end submit copy of th1S form with Heh 1pplic111on lor EPA A1usi1nce 11 tnbull 1pphc1n1 hes cenlfbulltd its procurement 1ys11m 10 EPA w11h1n 1n1 oas1 ~ yHfl 11nd 11111ys11m hH not been 1uo1t1n11111v r1v1sed complete Pin A in S1c11on IL thin s1Gn end Cite tne form It tne 1v111m nas not bun c1n1fied w11n Ult 0-112 veers comolbulltbull Pin 8 then sion ind dllt lht form
HCTION II - CEATlflCATION
A 1eHirm1n11the1pphcan1 n11 w11h1n the Piii 2 yurs cenif1ed10EPA th1111s orocurem1n1 MOHTHIYlAI 1y11em comolis w11n 40CFP Pen 331nd1n111t1e 1ys1em mH11 thbull reQu1remen11 in 40
FR p n Tn f h Ii n I 11 I n
B BHed upon my ev11u111on of tne bullPohcants procurement sys11m I u 1uthonzed rtoresen1111ve of 111bull applicant Chtcll one of tht lollowingJ
LJ 1 CERTIFY lhlt tlMI apptican11 procurement IYltbullm will rnH1111 of the reQuiremenll of 40 CFA Pin 33 before undertaking 1ny procuremam 1e1ion witn EPA 1111stance
CRTI1I CAII0 10R CXH1Jc18 I GRgtJn S LOgtH8 ))lp OOP R)IJV JC lJ~
Tbbull undbullrbulligDbull6 certifiebull to the bebullt of b bull or her bowlbull49bull uad belief that
(1) bullo Pederamp appropriated fwidJI bampTbull b41bullD or will be pLid by or OD babalf of tbe udeniqned to LDJ pbullrbullo11 tor infl11uci119 or attoap ti119 to i11Clue11ce u officer or aaployee of any a9uay a Weaber of Co119rbullbullbull u officer or -ploy of Co119rbullbullbull or u aaployee of a gttaab4ir of CoD9reH iD coanection witb the awu4ing Of ampZIJ 7ederal CODtract tbe aakin9 ltgtf ampllJ 1e0araJ VdegUt the aal i n9 or uiy rederal lou tba enteri D9 iDto of uy COOJgt9iratiwe a9reect ampAd tbe ute11iaio11 co11tiDuatio11 rellewampl aauDut o r aodificatio11 of uy 7ederal co11tract 9ruit loampJl or cooperathmiddote a9reellt
(2 J If ampllJ fa4a otller thu 1bull4bullral appropriat ~ habullbull beaD paid or will N paid to uy pe=aoa for lltl-ciJa9 or atteaptiD9 to iaflaeacbull u oficer or aplOJbullbull of u7 atuor a bull--ltoer of CODZbullaa or u employee of a bullmMr of CDaigraaa ia couectioa wit~ thia Jederal ooatract qzaat lou or tibullbull agreoae11t tbbull va4eraiped alaa11 complete ud sUait ltaaampamprt hrashytLL tgti tdoaure Jon to aaport Lo~iia9bull ia acoortuce Titll ita iDatructiona
CJ) Tbbull undenipbulld aball require that Ubull lupava of Uia certificatioa ba iacluded ia tte bullbullaz4 of docaauta for ampll bullubawazdbull at all tiara (bclu4iD9 amicoatracta robqruta aad coDtract1 oder 9r uta loau ud cooperatibull agrebulluta) ampad tUt middot amp11 bullubr ecipi bullDt a allampll cbullrtty ud 41aclobullbullmiddot acoor4i1a9ly
Thia certificrtioll ibull a uteria l r epr eHDtamptioa ot fact apoa which r a liuce wu placed wbea thia tranaactioa wu aamp4a or utered into Bubaiaaioa ot thi a ctirtificatioa ia a prereqdaite for bullakin9 or bull DteriDq into thia trusaction iapose-4 b1 leotioa 1352 Title 31 u1 eode by peraoa who taila to til e Ue reqaired certiication aball be subject to a ciTil peulty ot DOt lua thaa s10ooo ~4 raquoot aorbull thampll t100ooo for eacll such failure
Da niel S Gre~nbaum Commiuionn nnn DD l ITLK or AVnOlllED UPllllJrDnn
if~or lou~~arrmn ~efri ~
- barcode 580527
- barcodetext SDMS Doc ID 580527
![Page 5: MEMO REGARDING REQUEST TO INITIATE PROCESSING A … · Ac)r••••nt or bendaent of an Exietinc; ACJr••••nt . To : Deborah Haretedt, Grant• speciali•t. Grant• Inforaation](https://reader033.vdocument.in/reader033/viewer/2022060408/5f0fe4a97e708231d44668d9/html5/thumbnails/5.jpg)
I I I I
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APPLICATION FOR FEDERAL ASSISTANCE 08 19 92
-- _ i _ --~----
Oshy j Oc-shy11~ n~
~ Coaaonwealth ~f Hauachuaetu
One Winter Street 5th troor Boston Ha 02108
__GIJtt I0 I 2 I 2 Ia 14 I
0 cc- gtalshy_-- [i D
___ t - shy cu-a ri-oshy o~
~zardeua Sub1tanct RuponH Trult Fund
-shy_____ ___ ______
ililliaa Harkins (617) 292-5906 anine Commerford (617) 556-1121
middot bull~---middot IU a S-shy M~ld-0
bull - shy l ~_ i--t ca _~ Q T _ __ L
middot ----shy 1111 _~Cl M deg9~-----
US EPA Region I ====---- lLLJmiddotLLlalz _~ middot e~ous Substance lesponH Trust Fund ~ir1~middot~~0d1F~~~~y ___ Site
Palr Ka ~ten County
1~
Dl11 08 25 92
middotshy __ I
01bull lI-middot- -- 1635787
lt1eMMS1bull~ loUDtbullbulllllll~fIOll----middot M~--- ltWTIOOflllD_M___ClftlllolCMl-NWIU_____cltbullN-iAllCCbullbullbull-shy __-shynbullbullu 1 S GuenbaW1 Commissioner
middotshy I I 11 LJ( ~ - Authorized tOiLocal Reproduc~HrOPV ti-
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Attachllent 1
81992 Aaendmient PSC Rbullbullourcebull Cooperative Agreement Budget
Budget Current Changbull Kow category Budget Requeated Budget
Peraonnel 23 969 23969
Fringe 9441 9441
Travel
Equipunt
suppliea
contractual 1499446 95 000 1594446
Other 1416 1416
Total Direct 1534272 95 000 1629272
Indirect 6515 6515
TOTAL RZQUUTED COOPERATIVE AGREEllEllT AllOUllT $1635787
~
ASSUAAHCES - NO~ONSTRUCTION PROGAAMS
c or u ~ 1ublbull lr middot p1ust conacl tht awardlllC 11tncJ F~u~ Fedcn arOinl a1t ncirs ma) req11in bullPPllunU
uinr~iy to addi tional UtWanctt Usuch it Ult cue you will bt bullUftlCi
Jutht ciuly au~horid rrirucnt11tit orthe 1t1llica1t I ttriy that tht 1t1alica11t
l Hu tht lrtbullI authorit) to aiply ror Federal auisWln and tht Witutional manattrial and (11amp1Cial capability (incltMlinl funds aWIWtnL I pbullJ ht non-Federal ahan or prejtd cosul ll ensurt proper planninc man111m11nt and cobullmiddot pinion oftit irojed ducribed ill UW appicatioA
Will ivt the abullardinC qtnt) ht Coapuolltr General or Lit tniLed StalS and it appro9fiaa the StaI hrouch ampDJ aulhoried nprnentatit accru to lid Iht ifht o esamirit all record1 books paitn or docucenu nlattd deg tht award anc wiil HtabliJh I priptt ICOllfttinc lflUI in acconianlaquo with 11nerally acuptad accountln(
sancarU or bullrbulln~cy direcCmiddot 3 Will ntablish WtfWds to prohibil 1mploy111
frabull u1in1 their positions for a partgtOH that CGftlit11t11 or 11rH1nU lhbull apptamplUCI of perlOCIAI orpNaUoMl amllicL ol ~wut or personal
wm lnitiat1 and complete tht work witbin ht
j a1aolt ti=e Craml ampAir lICli ti aIPOval ol Ihi awardinl ~middot
5 Will comply bull i th tb1 latu10Y1rnmotal Ptnoooal Act or 1970 42 USC 11 421-41131 rtlatinc deg prucriMd sWMlarU tor muit bullJN= tor pre(lampIU llftdlt one or Ult 1Wi1tetn satut11 or reWations 1cJtid in Apptndis A ol OPMs tanda-ds for 1 11bullrit S11t1m ol enoMbull I Adminisiation(5CFllto0 S~FI
I WUl eoCply wilh amp11 Ftd1ral Ntuttl nlatiI WI oonifiJcr ~mination Thbull incl11d1 but an not limiocl to al TiUc VI ol the CiTil Rirhu Ae or 1964 (PI 11-352) wNcb proilibiU dixmination on the buis o( tact color or nationI ori(Jl (bl Title IX or thbull poundd11cation Amniclmenu or 1972 u arnendc (20 usc n 1611-1613 and 1amp15middot1616) which prohibits Gitcriminad011 on tht basis or wz (c) Seltion ~04 or the Phabilitation Act of lfi3 as amtndc tZ9 C SC 1 794) which prohibiU ditbull cicination on the basis or haclicapt (dl ht Att OiKrinination Act o( us at uncncitd (42 L SC11 6101 middot 6107) which prohibiLS cliscrirGmiddot
ination on tht basis of ace
(~l ti1 Dnac bltl ()CiCI and T111t111nt Act of u lPL g ~51 abull amended nlatinc to non~tion on thbull buis of dNi alNM tn Iha Compnhtnsivt AloDhol Ablilll and Alcohoolilm PnvenUoa Tnaunent and lehallilitstioll Act or 1910 (PL tl middot l51Sl as amended relaUnc lo nondi1eriminamption on the buil of alCDbol abUM or aieonolisa lampl 11 s3 and s1 of the hblit Heal~ Srtie9 Adol191 (42 JSC 90 Odmiddot3 and tO 3) as abullndbulld r1adnc 0 curl4111tiality or alcohol and dNI ab111 uent ~(bl Tit1 VIII C Ibo Clril Ri(hll Act ol IHI (11 USC I 3601 tt MCl middotl as amended nlatin1 U sonbull ditcrlzWaatioll ~ thbull 1bullbull renaal or rinandnc oC hnsin r (il an ) otbtr nondiscrimiHion 1royensioDI in the slK 111tuteltsl uUr wbich ncatillD for FOtral usiawa ii Mini mati1 and ltU thbull ciuir11n1nu 1C tlhttno~tioa siawl(s) wbidt IU) appi) o
U1 applicadoL wm bull 1w alndr UH iu u1 _ o1nu o m rJIM uu 1l1localioo Aa1i1tanU and Ital ProptrY Acquiaitiile PoliciU Act ol ll10 ltPL tl6411 which Wt or lair aM ~It_ r -~ a -1Lr1Ftda-l or ianllJ _shyTht11 ~menu apply o all UdeftlU ia rul pro1J11rtY a~ ror proja u or Federal putici_don it p~
I Will comply witb ti1 proNioal fl hi Haldi Act (5 USC II l50lmiddotl50I an m4om11 whldl limit tht political activitin of 1=ploy11bull who11 1rincipal 1mploy=1nt actifitia ara fuded in whole or in re with Ftd1raltwm
9 wmcomply as alicalllbull wih the pnNions or thbull OariJBtooo Ati (40 USC If 1715amp bull 276amiddot 1) Iht eo1anc Act (40 USC I Tk and 11 C SC H 114l and Iht ConUUt Wdeg Hows end Sa1t1 Standsrcbull AC (40 USC fl 327middot3331anti lcbor 1tampndardbull ror [lclually usisad constn1Cion subarreerutnU
~u 1bull-1
---caooao--middot
Ai11hotized lor Loal Reproducion
10 Will tomply if applicablt with noo4 insurance purchaH r~uirtmtnls o( Stclion 1021al a( lht rlood Diu1ltt Proltetion Actor 1973 IPL 93-2341 middothich r~11irt1 rtcipianll in a special nooc1 bampurd aruloparticipallintkprocTampmandtopurchaH nood inluranct ir tht toll] COi l o( in1unblt cons truction and acquisition it $10000 or more
11 Will comply with environmental standards wh ich tnaY bt prucribtd pursuant lo tht follow inc la) inst itut ion of tnyenironn1tntal quality control m1a1urt1 under tht Joiational Enyenironmtntal Policy Act or IHI (PL 91 middot1901 and EHcutivt Order CEO 11514 (b notircat ion of yeniolaUn1 facilit iu pursuant 0 EO 11138 lei pnitection of wetlands punuanl deg EO 11990 tdl eval111ition of nood haurdt in noodplainl in accordanct with EO 11981 ltlaHWampnet of ptojtct con1 istucy with the approyentd Statt manatmtnt pro1ram dtvtloptd under the Cr111tal Zone ~ana1emtnt Act of 1912 (16 C SC U 1451 et Hq) CO conlormity of Ffftf9I actions lo Stale Claar Airl lmpltmentatioA Plam under Secion 1714cl of tht Clear Air Act of lt55 U amended (42 CSC t 740lttwq l(ampl pr0Ktiontl~aowa1 olclrinkinf water udtr lhl Wo Oriakinl W1ter Act ol 1174 u amtrMW CPL ts-5Ul u4 (bl proampocUoa of olMlanrer-4 1pecit1 undtr tbt Endanprtd Sptcitt Act or 1rrs u -- CPL IS-2061
12 WUI umply with iht W~t IDll ScetUc Riven Act of IHI nl USC II 1111 ot seqI rtlaLH to proKdnf coipoataU or pewntlal eempooaau of lM natioaaJ wild and ICtnic riven 1yawm
~llfttdegJf-r(~
oWif GrIZ~~
Dep t nviron11en tal Prot ection BWSC
13 fl ill a11i1t lht bullmiddotard in1 bull1bullncy in a11ur in1 coinpliuice with Sction 106 of the lationalr Hisioric PAMrvation Act or It u amended (1 1 l SC 470) EO 11593 (ident ification nd pnttction of h iuoric proptrtiu) and the ArchaHIOfuI and Hilloric Prt1trvation Act of 197fll6CSC 469amiddotlttseqI shy
14 Will comply with P L 933415 re1ard in1 the prMKlictn of human 1ubjocta inyenolvtd in rHtarch aklp1n1nt and rt lattd actMUu suppontd by this 1wani of auiatance
15 Will comply with tht Laboralory Animal W11C1tt Act of 1966 IPL 89middot544 a1 amtndtd 7 1 SC 21Jl 1t wqI per1ainin1 to tht can handlinc ancl lnatmeat tf warm blood1d animalbull hold ror rtsarCh teachin1 or other acUYitiu wpporllCI by this awani elauistana
11 Will ro111ply with tht Le1d-Bued Paint Pobonln1 pnuon Act 142 CSC H 410l tt Nq ) which prohibits thbull Ult or Ind ba1td pa inl i n conauuctlon or rth1bllltation o( roaidenct
11 VRill CHM t bt performed amphe required flnaticial aflll cembulllibullnct aviill in acconlaact witb tha 5Ucte Audit Act of 1914
tt Will -ply with alt applicUle requinmtntaof all other federal ia oucuu nrulabonlc policin pftlftint this prorram
IlWwlite$iuHt-fOlllMIJl~ NIC( WUllllionCCo60
Certific3tion Regarding Debarment Suspension and Other Responsibility Matters
The pros~ivbull participant cenllits to the best of its knowledge and belief that it and its principals
a) Ara net presently debarred susoended prooostd for d1blrment decared ineliQible or vclumariy exdudalt trorn cov1rtd transacuons by any Feat~ department or 1g1ncybull
b) Have ro wi1hin a LVH year oeriod pmedlng this prol)Oul been convicted ct or toad a cM jud9ement ttndarte aQtinslt IJlm tor comnvssion ol traud or a cnillMi cllense in coMacuon with orasnin anemptLnQ to obtain or parlonninljl a PIJbfic (Federal Statbull or local) transaction ot contrac underbull iillic transaction violation ol Feotlll or State aruruc salUlH or commmion ol emoeiament tntft torgery bribtty lalsiflcalion or d11tn1cuon ol ~s makin lalst sattments or rrIMng sOlenpropttty
(CJ NI nCll pretenlly irdCed falt Ot - cMmlffy Ot civly ~-Id by I q anlily (Fshy_ Stlll or lccal) wih commillion ol any of lhl oftenus enumtratld W paragraph (1)~1 ot Oil
(d) ~~W~i=e=~or~~~J~ had one 0t men~ I und~ tt11 e fl6al ClltmlN on tNI cenbtion rMY et roundl for rtjteJon d ttil PfODOl9 or termination ot me award 1n IOdlion una1t 11 use sec 1001 a ta111 atamert may ruur in 1 ltnt ot up
middot 10 510000 OI imprisonmllI fOt up to fllrl or both shy
Daniel Gr11nb1um Com1issiontl
-0 I am unable to certify 10 the above saltmtntS My txplanauon is aracttd
I I I I
Itbullbullimiddotmiddotr~Ibulll
rrfIfibulli
u SIA1U l lll0Ubull llii~h~Jfltgt A-i C~ w-sGTO oiilO __
2xi ~SEPA PROCUREMENT SYSTEM CERTIFICATION - -middot- IO J1 l
AllICANTSNAM( ASSIS1ANCl uucATION NuMatll ept Environmental ProtectionBWSC
V001726-0l-6 1111CAHTS A00111lSS
One Winter Street 5th floor Botton Ha 02108
HCllON I - INSTRUCTIONS
I I I I
iiJill 1t-1 Irrbull fltllr ISbull
The aoolicani must comoleie end submit copy of th1S form with Heh 1pplic111on lor EPA A1usi1nce 11 tnbull 1pphc1n1 hes cenlfbulltd its procurement 1ys11m 10 EPA w11h1n 1n1 oas1 ~ yHfl 11nd 11111ys11m hH not been 1uo1t1n11111v r1v1sed complete Pin A in S1c11on IL thin s1Gn end Cite tne form It tne 1v111m nas not bun c1n1fied w11n Ult 0-112 veers comolbulltbull Pin 8 then sion ind dllt lht form
HCTION II - CEATlflCATION
A 1eHirm1n11the1pphcan1 n11 w11h1n the Piii 2 yurs cenif1ed10EPA th1111s orocurem1n1 MOHTHIYlAI 1y11em comolis w11n 40CFP Pen 331nd1n111t1e 1ys1em mH11 thbull reQu1remen11 in 40
FR p n Tn f h Ii n I 11 I n
B BHed upon my ev11u111on of tne bullPohcants procurement sys11m I u 1uthonzed rtoresen1111ve of 111bull applicant Chtcll one of tht lollowingJ
LJ 1 CERTIFY lhlt tlMI apptican11 procurement IYltbullm will rnH1111 of the reQuiremenll of 40 CFA Pin 33 before undertaking 1ny procuremam 1e1ion witn EPA 1111stance
CRTI1I CAII0 10R CXH1Jc18 I GRgtJn S LOgtH8 ))lp OOP R)IJV JC lJ~
Tbbull undbullrbulligDbull6 certifiebull to the bebullt of b bull or her bowlbull49bull uad belief that
(1) bullo Pederamp appropriated fwidJI bampTbull b41bullD or will be pLid by or OD babalf of tbe udeniqned to LDJ pbullrbullo11 tor infl11uci119 or attoap ti119 to i11Clue11ce u officer or aaployee of any a9uay a Weaber of Co119rbullbullbull u officer or -ploy of Co119rbullbullbull or u aaployee of a gttaab4ir of CoD9reH iD coanection witb the awu4ing Of ampZIJ 7ederal CODtract tbe aakin9 ltgtf ampllJ 1e0araJ VdegUt the aal i n9 or uiy rederal lou tba enteri D9 iDto of uy COOJgt9iratiwe a9reect ampAd tbe ute11iaio11 co11tiDuatio11 rellewampl aauDut o r aodificatio11 of uy 7ederal co11tract 9ruit loampJl or cooperathmiddote a9reellt
(2 J If ampllJ fa4a otller thu 1bull4bullral appropriat ~ habullbull beaD paid or will N paid to uy pe=aoa for lltl-ciJa9 or atteaptiD9 to iaflaeacbull u oficer or aplOJbullbull of u7 atuor a bull--ltoer of CODZbullaa or u employee of a bullmMr of CDaigraaa ia couectioa wit~ thia Jederal ooatract qzaat lou or tibullbull agreoae11t tbbull va4eraiped alaa11 complete ud sUait ltaaampamprt hrashytLL tgti tdoaure Jon to aaport Lo~iia9bull ia acoortuce Titll ita iDatructiona
CJ) Tbbull undenipbulld aball require that Ubull lupava of Uia certificatioa ba iacluded ia tte bullbullaz4 of docaauta for ampll bullubawazdbull at all tiara (bclu4iD9 amicoatracta robqruta aad coDtract1 oder 9r uta loau ud cooperatibull agrebulluta) ampad tUt middot amp11 bullubr ecipi bullDt a allampll cbullrtty ud 41aclobullbullmiddot acoor4i1a9ly
Thia certificrtioll ibull a uteria l r epr eHDtamptioa ot fact apoa which r a liuce wu placed wbea thia tranaactioa wu aamp4a or utered into Bubaiaaioa ot thi a ctirtificatioa ia a prereqdaite for bullakin9 or bull DteriDq into thia trusaction iapose-4 b1 leotioa 1352 Title 31 u1 eode by peraoa who taila to til e Ue reqaired certiication aball be subject to a ciTil peulty ot DOt lua thaa s10ooo ~4 raquoot aorbull thampll t100ooo for eacll such failure
Da niel S Gre~nbaum Commiuionn nnn DD l ITLK or AVnOlllED UPllllJrDnn
if~or lou~~arrmn ~efri ~
- barcode 580527
- barcodetext SDMS Doc ID 580527
![Page 6: MEMO REGARDING REQUEST TO INITIATE PROCESSING A … · Ac)r••••nt or bendaent of an Exietinc; ACJr••••nt . To : Deborah Haretedt, Grant• speciali•t. Grant• Inforaation](https://reader033.vdocument.in/reader033/viewer/2022060408/5f0fe4a97e708231d44668d9/html5/thumbnails/6.jpg)
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Attachllent 1
81992 Aaendmient PSC Rbullbullourcebull Cooperative Agreement Budget
Budget Current Changbull Kow category Budget Requeated Budget
Peraonnel 23 969 23969
Fringe 9441 9441
Travel
Equipunt
suppliea
contractual 1499446 95 000 1594446
Other 1416 1416
Total Direct 1534272 95 000 1629272
Indirect 6515 6515
TOTAL RZQUUTED COOPERATIVE AGREEllEllT AllOUllT $1635787
~
ASSUAAHCES - NO~ONSTRUCTION PROGAAMS
c or u ~ 1ublbull lr middot p1ust conacl tht awardlllC 11tncJ F~u~ Fedcn arOinl a1t ncirs ma) req11in bullPPllunU
uinr~iy to addi tional UtWanctt Usuch it Ult cue you will bt bullUftlCi
Jutht ciuly au~horid rrirucnt11tit orthe 1t1llica1t I ttriy that tht 1t1alica11t
l Hu tht lrtbullI authorit) to aiply ror Federal auisWln and tht Witutional manattrial and (11amp1Cial capability (incltMlinl funds aWIWtnL I pbullJ ht non-Federal ahan or prejtd cosul ll ensurt proper planninc man111m11nt and cobullmiddot pinion oftit irojed ducribed ill UW appicatioA
Will ivt the abullardinC qtnt) ht Coapuolltr General or Lit tniLed StalS and it appro9fiaa the StaI hrouch ampDJ aulhoried nprnentatit accru to lid Iht ifht o esamirit all record1 books paitn or docucenu nlattd deg tht award anc wiil HtabliJh I priptt ICOllfttinc lflUI in acconianlaquo with 11nerally acuptad accountln(
sancarU or bullrbulln~cy direcCmiddot 3 Will ntablish WtfWds to prohibil 1mploy111
frabull u1in1 their positions for a partgtOH that CGftlit11t11 or 11rH1nU lhbull apptamplUCI of perlOCIAI orpNaUoMl amllicL ol ~wut or personal
wm lnitiat1 and complete tht work witbin ht
j a1aolt ti=e Craml ampAir lICli ti aIPOval ol Ihi awardinl ~middot
5 Will comply bull i th tb1 latu10Y1rnmotal Ptnoooal Act or 1970 42 USC 11 421-41131 rtlatinc deg prucriMd sWMlarU tor muit bullJN= tor pre(lampIU llftdlt one or Ult 1Wi1tetn satut11 or reWations 1cJtid in Apptndis A ol OPMs tanda-ds for 1 11bullrit S11t1m ol enoMbull I Adminisiation(5CFllto0 S~FI
I WUl eoCply wilh amp11 Ftd1ral Ntuttl nlatiI WI oonifiJcr ~mination Thbull incl11d1 but an not limiocl to al TiUc VI ol the CiTil Rirhu Ae or 1964 (PI 11-352) wNcb proilibiU dixmination on the buis o( tact color or nationI ori(Jl (bl Title IX or thbull poundd11cation Amniclmenu or 1972 u arnendc (20 usc n 1611-1613 and 1amp15middot1616) which prohibits Gitcriminad011 on tht basis or wz (c) Seltion ~04 or the Phabilitation Act of lfi3 as amtndc tZ9 C SC 1 794) which prohibiU ditbull cicination on the basis or haclicapt (dl ht Att OiKrinination Act o( us at uncncitd (42 L SC11 6101 middot 6107) which prohibiLS cliscrirGmiddot
ination on tht basis of ace
(~l ti1 Dnac bltl ()CiCI and T111t111nt Act of u lPL g ~51 abull amended nlatinc to non~tion on thbull buis of dNi alNM tn Iha Compnhtnsivt AloDhol Ablilll and Alcohoolilm PnvenUoa Tnaunent and lehallilitstioll Act or 1910 (PL tl middot l51Sl as amended relaUnc lo nondi1eriminamption on the buil of alCDbol abUM or aieonolisa lampl 11 s3 and s1 of the hblit Heal~ Srtie9 Adol191 (42 JSC 90 Odmiddot3 and tO 3) as abullndbulld r1adnc 0 curl4111tiality or alcohol and dNI ab111 uent ~(bl Tit1 VIII C Ibo Clril Ri(hll Act ol IHI (11 USC I 3601 tt MCl middotl as amended nlatin1 U sonbull ditcrlzWaatioll ~ thbull 1bullbull renaal or rinandnc oC hnsin r (il an ) otbtr nondiscrimiHion 1royensioDI in the slK 111tuteltsl uUr wbich ncatillD for FOtral usiawa ii Mini mati1 and ltU thbull ciuir11n1nu 1C tlhttno~tioa siawl(s) wbidt IU) appi) o
U1 applicadoL wm bull 1w alndr UH iu u1 _ o1nu o m rJIM uu 1l1localioo Aa1i1tanU and Ital ProptrY Acquiaitiile PoliciU Act ol ll10 ltPL tl6411 which Wt or lair aM ~It_ r -~ a -1Lr1Ftda-l or ianllJ _shyTht11 ~menu apply o all UdeftlU ia rul pro1J11rtY a~ ror proja u or Federal putici_don it p~
I Will comply witb ti1 proNioal fl hi Haldi Act (5 USC II l50lmiddotl50I an m4om11 whldl limit tht political activitin of 1=ploy11bull who11 1rincipal 1mploy=1nt actifitia ara fuded in whole or in re with Ftd1raltwm
9 wmcomply as alicalllbull wih the pnNions or thbull OariJBtooo Ati (40 USC If 1715amp bull 276amiddot 1) Iht eo1anc Act (40 USC I Tk and 11 C SC H 114l and Iht ConUUt Wdeg Hows end Sa1t1 Standsrcbull AC (40 USC fl 327middot3331anti lcbor 1tampndardbull ror [lclually usisad constn1Cion subarreerutnU
~u 1bull-1
---caooao--middot
Ai11hotized lor Loal Reproducion
10 Will tomply if applicablt with noo4 insurance purchaH r~uirtmtnls o( Stclion 1021al a( lht rlood Diu1ltt Proltetion Actor 1973 IPL 93-2341 middothich r~11irt1 rtcipianll in a special nooc1 bampurd aruloparticipallintkprocTampmandtopurchaH nood inluranct ir tht toll] COi l o( in1unblt cons truction and acquisition it $10000 or more
11 Will comply with environmental standards wh ich tnaY bt prucribtd pursuant lo tht follow inc la) inst itut ion of tnyenironn1tntal quality control m1a1urt1 under tht Joiational Enyenironmtntal Policy Act or IHI (PL 91 middot1901 and EHcutivt Order CEO 11514 (b notircat ion of yeniolaUn1 facilit iu pursuant 0 EO 11138 lei pnitection of wetlands punuanl deg EO 11990 tdl eval111ition of nood haurdt in noodplainl in accordanct with EO 11981 ltlaHWampnet of ptojtct con1 istucy with the approyentd Statt manatmtnt pro1ram dtvtloptd under the Cr111tal Zone ~ana1emtnt Act of 1912 (16 C SC U 1451 et Hq) CO conlormity of Ffftf9I actions lo Stale Claar Airl lmpltmentatioA Plam under Secion 1714cl of tht Clear Air Act of lt55 U amended (42 CSC t 740lttwq l(ampl pr0Ktiontl~aowa1 olclrinkinf water udtr lhl Wo Oriakinl W1ter Act ol 1174 u amtrMW CPL ts-5Ul u4 (bl proampocUoa of olMlanrer-4 1pecit1 undtr tbt Endanprtd Sptcitt Act or 1rrs u -- CPL IS-2061
12 WUI umply with iht W~t IDll ScetUc Riven Act of IHI nl USC II 1111 ot seqI rtlaLH to proKdnf coipoataU or pewntlal eempooaau of lM natioaaJ wild and ICtnic riven 1yawm
~llfttdegJf-r(~
oWif GrIZ~~
Dep t nviron11en tal Prot ection BWSC
13 fl ill a11i1t lht bullmiddotard in1 bull1bullncy in a11ur in1 coinpliuice with Sction 106 of the lationalr Hisioric PAMrvation Act or It u amended (1 1 l SC 470) EO 11593 (ident ification nd pnttction of h iuoric proptrtiu) and the ArchaHIOfuI and Hilloric Prt1trvation Act of 197fll6CSC 469amiddotlttseqI shy
14 Will comply with P L 933415 re1ard in1 the prMKlictn of human 1ubjocta inyenolvtd in rHtarch aklp1n1nt and rt lattd actMUu suppontd by this 1wani of auiatance
15 Will comply with tht Laboralory Animal W11C1tt Act of 1966 IPL 89middot544 a1 amtndtd 7 1 SC 21Jl 1t wqI per1ainin1 to tht can handlinc ancl lnatmeat tf warm blood1d animalbull hold ror rtsarCh teachin1 or other acUYitiu wpporllCI by this awani elauistana
11 Will ro111ply with tht Le1d-Bued Paint Pobonln1 pnuon Act 142 CSC H 410l tt Nq ) which prohibits thbull Ult or Ind ba1td pa inl i n conauuctlon or rth1bllltation o( roaidenct
11 VRill CHM t bt performed amphe required flnaticial aflll cembulllibullnct aviill in acconlaact witb tha 5Ucte Audit Act of 1914
tt Will -ply with alt applicUle requinmtntaof all other federal ia oucuu nrulabonlc policin pftlftint this prorram
IlWwlite$iuHt-fOlllMIJl~ NIC( WUllllionCCo60
Certific3tion Regarding Debarment Suspension and Other Responsibility Matters
The pros~ivbull participant cenllits to the best of its knowledge and belief that it and its principals
a) Ara net presently debarred susoended prooostd for d1blrment decared ineliQible or vclumariy exdudalt trorn cov1rtd transacuons by any Feat~ department or 1g1ncybull
b) Have ro wi1hin a LVH year oeriod pmedlng this prol)Oul been convicted ct or toad a cM jud9ement ttndarte aQtinslt IJlm tor comnvssion ol traud or a cnillMi cllense in coMacuon with orasnin anemptLnQ to obtain or parlonninljl a PIJbfic (Federal Statbull or local) transaction ot contrac underbull iillic transaction violation ol Feotlll or State aruruc salUlH or commmion ol emoeiament tntft torgery bribtty lalsiflcalion or d11tn1cuon ol ~s makin lalst sattments or rrIMng sOlenpropttty
(CJ NI nCll pretenlly irdCed falt Ot - cMmlffy Ot civly ~-Id by I q anlily (Fshy_ Stlll or lccal) wih commillion ol any of lhl oftenus enumtratld W paragraph (1)~1 ot Oil
(d) ~~W~i=e=~or~~~J~ had one 0t men~ I und~ tt11 e fl6al ClltmlN on tNI cenbtion rMY et roundl for rtjteJon d ttil PfODOl9 or termination ot me award 1n IOdlion una1t 11 use sec 1001 a ta111 atamert may ruur in 1 ltnt ot up
middot 10 510000 OI imprisonmllI fOt up to fllrl or both shy
Daniel Gr11nb1um Com1issiontl
-0 I am unable to certify 10 the above saltmtntS My txplanauon is aracttd
I I I I
Itbullbullimiddotmiddotr~Ibulll
rrfIfibulli
u SIA1U l lll0Ubull llii~h~Jfltgt A-i C~ w-sGTO oiilO __
2xi ~SEPA PROCUREMENT SYSTEM CERTIFICATION - -middot- IO J1 l
AllICANTSNAM( ASSIS1ANCl uucATION NuMatll ept Environmental ProtectionBWSC
V001726-0l-6 1111CAHTS A00111lSS
One Winter Street 5th floor Botton Ha 02108
HCllON I - INSTRUCTIONS
I I I I
iiJill 1t-1 Irrbull fltllr ISbull
The aoolicani must comoleie end submit copy of th1S form with Heh 1pplic111on lor EPA A1usi1nce 11 tnbull 1pphc1n1 hes cenlfbulltd its procurement 1ys11m 10 EPA w11h1n 1n1 oas1 ~ yHfl 11nd 11111ys11m hH not been 1uo1t1n11111v r1v1sed complete Pin A in S1c11on IL thin s1Gn end Cite tne form It tne 1v111m nas not bun c1n1fied w11n Ult 0-112 veers comolbulltbull Pin 8 then sion ind dllt lht form
HCTION II - CEATlflCATION
A 1eHirm1n11the1pphcan1 n11 w11h1n the Piii 2 yurs cenif1ed10EPA th1111s orocurem1n1 MOHTHIYlAI 1y11em comolis w11n 40CFP Pen 331nd1n111t1e 1ys1em mH11 thbull reQu1remen11 in 40
FR p n Tn f h Ii n I 11 I n
B BHed upon my ev11u111on of tne bullPohcants procurement sys11m I u 1uthonzed rtoresen1111ve of 111bull applicant Chtcll one of tht lollowingJ
LJ 1 CERTIFY lhlt tlMI apptican11 procurement IYltbullm will rnH1111 of the reQuiremenll of 40 CFA Pin 33 before undertaking 1ny procuremam 1e1ion witn EPA 1111stance
CRTI1I CAII0 10R CXH1Jc18 I GRgtJn S LOgtH8 ))lp OOP R)IJV JC lJ~
Tbbull undbullrbulligDbull6 certifiebull to the bebullt of b bull or her bowlbull49bull uad belief that
(1) bullo Pederamp appropriated fwidJI bampTbull b41bullD or will be pLid by or OD babalf of tbe udeniqned to LDJ pbullrbullo11 tor infl11uci119 or attoap ti119 to i11Clue11ce u officer or aaployee of any a9uay a Weaber of Co119rbullbullbull u officer or -ploy of Co119rbullbullbull or u aaployee of a gttaab4ir of CoD9reH iD coanection witb the awu4ing Of ampZIJ 7ederal CODtract tbe aakin9 ltgtf ampllJ 1e0araJ VdegUt the aal i n9 or uiy rederal lou tba enteri D9 iDto of uy COOJgt9iratiwe a9reect ampAd tbe ute11iaio11 co11tiDuatio11 rellewampl aauDut o r aodificatio11 of uy 7ederal co11tract 9ruit loampJl or cooperathmiddote a9reellt
(2 J If ampllJ fa4a otller thu 1bull4bullral appropriat ~ habullbull beaD paid or will N paid to uy pe=aoa for lltl-ciJa9 or atteaptiD9 to iaflaeacbull u oficer or aplOJbullbull of u7 atuor a bull--ltoer of CODZbullaa or u employee of a bullmMr of CDaigraaa ia couectioa wit~ thia Jederal ooatract qzaat lou or tibullbull agreoae11t tbbull va4eraiped alaa11 complete ud sUait ltaaampamprt hrashytLL tgti tdoaure Jon to aaport Lo~iia9bull ia acoortuce Titll ita iDatructiona
CJ) Tbbull undenipbulld aball require that Ubull lupava of Uia certificatioa ba iacluded ia tte bullbullaz4 of docaauta for ampll bullubawazdbull at all tiara (bclu4iD9 amicoatracta robqruta aad coDtract1 oder 9r uta loau ud cooperatibull agrebulluta) ampad tUt middot amp11 bullubr ecipi bullDt a allampll cbullrtty ud 41aclobullbullmiddot acoor4i1a9ly
Thia certificrtioll ibull a uteria l r epr eHDtamptioa ot fact apoa which r a liuce wu placed wbea thia tranaactioa wu aamp4a or utered into Bubaiaaioa ot thi a ctirtificatioa ia a prereqdaite for bullakin9 or bull DteriDq into thia trusaction iapose-4 b1 leotioa 1352 Title 31 u1 eode by peraoa who taila to til e Ue reqaired certiication aball be subject to a ciTil peulty ot DOt lua thaa s10ooo ~4 raquoot aorbull thampll t100ooo for eacll such failure
Da niel S Gre~nbaum Commiuionn nnn DD l ITLK or AVnOlllED UPllllJrDnn
if~or lou~~arrmn ~efri ~
- barcode 580527
- barcodetext SDMS Doc ID 580527
![Page 7: MEMO REGARDING REQUEST TO INITIATE PROCESSING A … · Ac)r••••nt or bendaent of an Exietinc; ACJr••••nt . To : Deborah Haretedt, Grant• speciali•t. Grant• Inforaation](https://reader033.vdocument.in/reader033/viewer/2022060408/5f0fe4a97e708231d44668d9/html5/thumbnails/7.jpg)
I
l ~ -
4
0
l ~
I I I I
1Ji 11fvr l hil I
Attachllent 1
81992 Aaendmient PSC Rbullbullourcebull Cooperative Agreement Budget
Budget Current Changbull Kow category Budget Requeated Budget
Peraonnel 23 969 23969
Fringe 9441 9441
Travel
Equipunt
suppliea
contractual 1499446 95 000 1594446
Other 1416 1416
Total Direct 1534272 95 000 1629272
Indirect 6515 6515
TOTAL RZQUUTED COOPERATIVE AGREEllEllT AllOUllT $1635787
~
ASSUAAHCES - NO~ONSTRUCTION PROGAAMS
c or u ~ 1ublbull lr middot p1ust conacl tht awardlllC 11tncJ F~u~ Fedcn arOinl a1t ncirs ma) req11in bullPPllunU
uinr~iy to addi tional UtWanctt Usuch it Ult cue you will bt bullUftlCi
Jutht ciuly au~horid rrirucnt11tit orthe 1t1llica1t I ttriy that tht 1t1alica11t
l Hu tht lrtbullI authorit) to aiply ror Federal auisWln and tht Witutional manattrial and (11amp1Cial capability (incltMlinl funds aWIWtnL I pbullJ ht non-Federal ahan or prejtd cosul ll ensurt proper planninc man111m11nt and cobullmiddot pinion oftit irojed ducribed ill UW appicatioA
Will ivt the abullardinC qtnt) ht Coapuolltr General or Lit tniLed StalS and it appro9fiaa the StaI hrouch ampDJ aulhoried nprnentatit accru to lid Iht ifht o esamirit all record1 books paitn or docucenu nlattd deg tht award anc wiil HtabliJh I priptt ICOllfttinc lflUI in acconianlaquo with 11nerally acuptad accountln(
sancarU or bullrbulln~cy direcCmiddot 3 Will ntablish WtfWds to prohibil 1mploy111
frabull u1in1 their positions for a partgtOH that CGftlit11t11 or 11rH1nU lhbull apptamplUCI of perlOCIAI orpNaUoMl amllicL ol ~wut or personal
wm lnitiat1 and complete tht work witbin ht
j a1aolt ti=e Craml ampAir lICli ti aIPOval ol Ihi awardinl ~middot
5 Will comply bull i th tb1 latu10Y1rnmotal Ptnoooal Act or 1970 42 USC 11 421-41131 rtlatinc deg prucriMd sWMlarU tor muit bullJN= tor pre(lampIU llftdlt one or Ult 1Wi1tetn satut11 or reWations 1cJtid in Apptndis A ol OPMs tanda-ds for 1 11bullrit S11t1m ol enoMbull I Adminisiation(5CFllto0 S~FI
I WUl eoCply wilh amp11 Ftd1ral Ntuttl nlatiI WI oonifiJcr ~mination Thbull incl11d1 but an not limiocl to al TiUc VI ol the CiTil Rirhu Ae or 1964 (PI 11-352) wNcb proilibiU dixmination on the buis o( tact color or nationI ori(Jl (bl Title IX or thbull poundd11cation Amniclmenu or 1972 u arnendc (20 usc n 1611-1613 and 1amp15middot1616) which prohibits Gitcriminad011 on tht basis or wz (c) Seltion ~04 or the Phabilitation Act of lfi3 as amtndc tZ9 C SC 1 794) which prohibiU ditbull cicination on the basis or haclicapt (dl ht Att OiKrinination Act o( us at uncncitd (42 L SC11 6101 middot 6107) which prohibiLS cliscrirGmiddot
ination on tht basis of ace
(~l ti1 Dnac bltl ()CiCI and T111t111nt Act of u lPL g ~51 abull amended nlatinc to non~tion on thbull buis of dNi alNM tn Iha Compnhtnsivt AloDhol Ablilll and Alcohoolilm PnvenUoa Tnaunent and lehallilitstioll Act or 1910 (PL tl middot l51Sl as amended relaUnc lo nondi1eriminamption on the buil of alCDbol abUM or aieonolisa lampl 11 s3 and s1 of the hblit Heal~ Srtie9 Adol191 (42 JSC 90 Odmiddot3 and tO 3) as abullndbulld r1adnc 0 curl4111tiality or alcohol and dNI ab111 uent ~(bl Tit1 VIII C Ibo Clril Ri(hll Act ol IHI (11 USC I 3601 tt MCl middotl as amended nlatin1 U sonbull ditcrlzWaatioll ~ thbull 1bullbull renaal or rinandnc oC hnsin r (il an ) otbtr nondiscrimiHion 1royensioDI in the slK 111tuteltsl uUr wbich ncatillD for FOtral usiawa ii Mini mati1 and ltU thbull ciuir11n1nu 1C tlhttno~tioa siawl(s) wbidt IU) appi) o
U1 applicadoL wm bull 1w alndr UH iu u1 _ o1nu o m rJIM uu 1l1localioo Aa1i1tanU and Ital ProptrY Acquiaitiile PoliciU Act ol ll10 ltPL tl6411 which Wt or lair aM ~It_ r -~ a -1Lr1Ftda-l or ianllJ _shyTht11 ~menu apply o all UdeftlU ia rul pro1J11rtY a~ ror proja u or Federal putici_don it p~
I Will comply witb ti1 proNioal fl hi Haldi Act (5 USC II l50lmiddotl50I an m4om11 whldl limit tht political activitin of 1=ploy11bull who11 1rincipal 1mploy=1nt actifitia ara fuded in whole or in re with Ftd1raltwm
9 wmcomply as alicalllbull wih the pnNions or thbull OariJBtooo Ati (40 USC If 1715amp bull 276amiddot 1) Iht eo1anc Act (40 USC I Tk and 11 C SC H 114l and Iht ConUUt Wdeg Hows end Sa1t1 Standsrcbull AC (40 USC fl 327middot3331anti lcbor 1tampndardbull ror [lclually usisad constn1Cion subarreerutnU
~u 1bull-1
---caooao--middot
Ai11hotized lor Loal Reproducion
10 Will tomply if applicablt with noo4 insurance purchaH r~uirtmtnls o( Stclion 1021al a( lht rlood Diu1ltt Proltetion Actor 1973 IPL 93-2341 middothich r~11irt1 rtcipianll in a special nooc1 bampurd aruloparticipallintkprocTampmandtopurchaH nood inluranct ir tht toll] COi l o( in1unblt cons truction and acquisition it $10000 or more
11 Will comply with environmental standards wh ich tnaY bt prucribtd pursuant lo tht follow inc la) inst itut ion of tnyenironn1tntal quality control m1a1urt1 under tht Joiational Enyenironmtntal Policy Act or IHI (PL 91 middot1901 and EHcutivt Order CEO 11514 (b notircat ion of yeniolaUn1 facilit iu pursuant 0 EO 11138 lei pnitection of wetlands punuanl deg EO 11990 tdl eval111ition of nood haurdt in noodplainl in accordanct with EO 11981 ltlaHWampnet of ptojtct con1 istucy with the approyentd Statt manatmtnt pro1ram dtvtloptd under the Cr111tal Zone ~ana1emtnt Act of 1912 (16 C SC U 1451 et Hq) CO conlormity of Ffftf9I actions lo Stale Claar Airl lmpltmentatioA Plam under Secion 1714cl of tht Clear Air Act of lt55 U amended (42 CSC t 740lttwq l(ampl pr0Ktiontl~aowa1 olclrinkinf water udtr lhl Wo Oriakinl W1ter Act ol 1174 u amtrMW CPL ts-5Ul u4 (bl proampocUoa of olMlanrer-4 1pecit1 undtr tbt Endanprtd Sptcitt Act or 1rrs u -- CPL IS-2061
12 WUI umply with iht W~t IDll ScetUc Riven Act of IHI nl USC II 1111 ot seqI rtlaLH to proKdnf coipoataU or pewntlal eempooaau of lM natioaaJ wild and ICtnic riven 1yawm
~llfttdegJf-r(~
oWif GrIZ~~
Dep t nviron11en tal Prot ection BWSC
13 fl ill a11i1t lht bullmiddotard in1 bull1bullncy in a11ur in1 coinpliuice with Sction 106 of the lationalr Hisioric PAMrvation Act or It u amended (1 1 l SC 470) EO 11593 (ident ification nd pnttction of h iuoric proptrtiu) and the ArchaHIOfuI and Hilloric Prt1trvation Act of 197fll6CSC 469amiddotlttseqI shy
14 Will comply with P L 933415 re1ard in1 the prMKlictn of human 1ubjocta inyenolvtd in rHtarch aklp1n1nt and rt lattd actMUu suppontd by this 1wani of auiatance
15 Will comply with tht Laboralory Animal W11C1tt Act of 1966 IPL 89middot544 a1 amtndtd 7 1 SC 21Jl 1t wqI per1ainin1 to tht can handlinc ancl lnatmeat tf warm blood1d animalbull hold ror rtsarCh teachin1 or other acUYitiu wpporllCI by this awani elauistana
11 Will ro111ply with tht Le1d-Bued Paint Pobonln1 pnuon Act 142 CSC H 410l tt Nq ) which prohibits thbull Ult or Ind ba1td pa inl i n conauuctlon or rth1bllltation o( roaidenct
11 VRill CHM t bt performed amphe required flnaticial aflll cembulllibullnct aviill in acconlaact witb tha 5Ucte Audit Act of 1914
tt Will -ply with alt applicUle requinmtntaof all other federal ia oucuu nrulabonlc policin pftlftint this prorram
IlWwlite$iuHt-fOlllMIJl~ NIC( WUllllionCCo60
Certific3tion Regarding Debarment Suspension and Other Responsibility Matters
The pros~ivbull participant cenllits to the best of its knowledge and belief that it and its principals
a) Ara net presently debarred susoended prooostd for d1blrment decared ineliQible or vclumariy exdudalt trorn cov1rtd transacuons by any Feat~ department or 1g1ncybull
b) Have ro wi1hin a LVH year oeriod pmedlng this prol)Oul been convicted ct or toad a cM jud9ement ttndarte aQtinslt IJlm tor comnvssion ol traud or a cnillMi cllense in coMacuon with orasnin anemptLnQ to obtain or parlonninljl a PIJbfic (Federal Statbull or local) transaction ot contrac underbull iillic transaction violation ol Feotlll or State aruruc salUlH or commmion ol emoeiament tntft torgery bribtty lalsiflcalion or d11tn1cuon ol ~s makin lalst sattments or rrIMng sOlenpropttty
(CJ NI nCll pretenlly irdCed falt Ot - cMmlffy Ot civly ~-Id by I q anlily (Fshy_ Stlll or lccal) wih commillion ol any of lhl oftenus enumtratld W paragraph (1)~1 ot Oil
(d) ~~W~i=e=~or~~~J~ had one 0t men~ I und~ tt11 e fl6al ClltmlN on tNI cenbtion rMY et roundl for rtjteJon d ttil PfODOl9 or termination ot me award 1n IOdlion una1t 11 use sec 1001 a ta111 atamert may ruur in 1 ltnt ot up
middot 10 510000 OI imprisonmllI fOt up to fllrl or both shy
Daniel Gr11nb1um Com1issiontl
-0 I am unable to certify 10 the above saltmtntS My txplanauon is aracttd
I I I I
Itbullbullimiddotmiddotr~Ibulll
rrfIfibulli
u SIA1U l lll0Ubull llii~h~Jfltgt A-i C~ w-sGTO oiilO __
2xi ~SEPA PROCUREMENT SYSTEM CERTIFICATION - -middot- IO J1 l
AllICANTSNAM( ASSIS1ANCl uucATION NuMatll ept Environmental ProtectionBWSC
V001726-0l-6 1111CAHTS A00111lSS
One Winter Street 5th floor Botton Ha 02108
HCllON I - INSTRUCTIONS
I I I I
iiJill 1t-1 Irrbull fltllr ISbull
The aoolicani must comoleie end submit copy of th1S form with Heh 1pplic111on lor EPA A1usi1nce 11 tnbull 1pphc1n1 hes cenlfbulltd its procurement 1ys11m 10 EPA w11h1n 1n1 oas1 ~ yHfl 11nd 11111ys11m hH not been 1uo1t1n11111v r1v1sed complete Pin A in S1c11on IL thin s1Gn end Cite tne form It tne 1v111m nas not bun c1n1fied w11n Ult 0-112 veers comolbulltbull Pin 8 then sion ind dllt lht form
HCTION II - CEATlflCATION
A 1eHirm1n11the1pphcan1 n11 w11h1n the Piii 2 yurs cenif1ed10EPA th1111s orocurem1n1 MOHTHIYlAI 1y11em comolis w11n 40CFP Pen 331nd1n111t1e 1ys1em mH11 thbull reQu1remen11 in 40
FR p n Tn f h Ii n I 11 I n
B BHed upon my ev11u111on of tne bullPohcants procurement sys11m I u 1uthonzed rtoresen1111ve of 111bull applicant Chtcll one of tht lollowingJ
LJ 1 CERTIFY lhlt tlMI apptican11 procurement IYltbullm will rnH1111 of the reQuiremenll of 40 CFA Pin 33 before undertaking 1ny procuremam 1e1ion witn EPA 1111stance
CRTI1I CAII0 10R CXH1Jc18 I GRgtJn S LOgtH8 ))lp OOP R)IJV JC lJ~
Tbbull undbullrbulligDbull6 certifiebull to the bebullt of b bull or her bowlbull49bull uad belief that
(1) bullo Pederamp appropriated fwidJI bampTbull b41bullD or will be pLid by or OD babalf of tbe udeniqned to LDJ pbullrbullo11 tor infl11uci119 or attoap ti119 to i11Clue11ce u officer or aaployee of any a9uay a Weaber of Co119rbullbullbull u officer or -ploy of Co119rbullbullbull or u aaployee of a gttaab4ir of CoD9reH iD coanection witb the awu4ing Of ampZIJ 7ederal CODtract tbe aakin9 ltgtf ampllJ 1e0araJ VdegUt the aal i n9 or uiy rederal lou tba enteri D9 iDto of uy COOJgt9iratiwe a9reect ampAd tbe ute11iaio11 co11tiDuatio11 rellewampl aauDut o r aodificatio11 of uy 7ederal co11tract 9ruit loampJl or cooperathmiddote a9reellt
(2 J If ampllJ fa4a otller thu 1bull4bullral appropriat ~ habullbull beaD paid or will N paid to uy pe=aoa for lltl-ciJa9 or atteaptiD9 to iaflaeacbull u oficer or aplOJbullbull of u7 atuor a bull--ltoer of CODZbullaa or u employee of a bullmMr of CDaigraaa ia couectioa wit~ thia Jederal ooatract qzaat lou or tibullbull agreoae11t tbbull va4eraiped alaa11 complete ud sUait ltaaampamprt hrashytLL tgti tdoaure Jon to aaport Lo~iia9bull ia acoortuce Titll ita iDatructiona
CJ) Tbbull undenipbulld aball require that Ubull lupava of Uia certificatioa ba iacluded ia tte bullbullaz4 of docaauta for ampll bullubawazdbull at all tiara (bclu4iD9 amicoatracta robqruta aad coDtract1 oder 9r uta loau ud cooperatibull agrebulluta) ampad tUt middot amp11 bullubr ecipi bullDt a allampll cbullrtty ud 41aclobullbullmiddot acoor4i1a9ly
Thia certificrtioll ibull a uteria l r epr eHDtamptioa ot fact apoa which r a liuce wu placed wbea thia tranaactioa wu aamp4a or utered into Bubaiaaioa ot thi a ctirtificatioa ia a prereqdaite for bullakin9 or bull DteriDq into thia trusaction iapose-4 b1 leotioa 1352 Title 31 u1 eode by peraoa who taila to til e Ue reqaired certiication aball be subject to a ciTil peulty ot DOt lua thaa s10ooo ~4 raquoot aorbull thampll t100ooo for eacll such failure
Da niel S Gre~nbaum Commiuionn nnn DD l ITLK or AVnOlllED UPllllJrDnn
if~or lou~~arrmn ~efri ~
- barcode 580527
- barcodetext SDMS Doc ID 580527
![Page 8: MEMO REGARDING REQUEST TO INITIATE PROCESSING A … · Ac)r••••nt or bendaent of an Exietinc; ACJr••••nt . To : Deborah Haretedt, Grant• speciali•t. Grant• Inforaation](https://reader033.vdocument.in/reader033/viewer/2022060408/5f0fe4a97e708231d44668d9/html5/thumbnails/8.jpg)
Attachllent 1
81992 Aaendmient PSC Rbullbullourcebull Cooperative Agreement Budget
Budget Current Changbull Kow category Budget Requeated Budget
Peraonnel 23 969 23969
Fringe 9441 9441
Travel
Equipunt
suppliea
contractual 1499446 95 000 1594446
Other 1416 1416
Total Direct 1534272 95 000 1629272
Indirect 6515 6515
TOTAL RZQUUTED COOPERATIVE AGREEllEllT AllOUllT $1635787
~
ASSUAAHCES - NO~ONSTRUCTION PROGAAMS
c or u ~ 1ublbull lr middot p1ust conacl tht awardlllC 11tncJ F~u~ Fedcn arOinl a1t ncirs ma) req11in bullPPllunU
uinr~iy to addi tional UtWanctt Usuch it Ult cue you will bt bullUftlCi
Jutht ciuly au~horid rrirucnt11tit orthe 1t1llica1t I ttriy that tht 1t1alica11t
l Hu tht lrtbullI authorit) to aiply ror Federal auisWln and tht Witutional manattrial and (11amp1Cial capability (incltMlinl funds aWIWtnL I pbullJ ht non-Federal ahan or prejtd cosul ll ensurt proper planninc man111m11nt and cobullmiddot pinion oftit irojed ducribed ill UW appicatioA
Will ivt the abullardinC qtnt) ht Coapuolltr General or Lit tniLed StalS and it appro9fiaa the StaI hrouch ampDJ aulhoried nprnentatit accru to lid Iht ifht o esamirit all record1 books paitn or docucenu nlattd deg tht award anc wiil HtabliJh I priptt ICOllfttinc lflUI in acconianlaquo with 11nerally acuptad accountln(
sancarU or bullrbulln~cy direcCmiddot 3 Will ntablish WtfWds to prohibil 1mploy111
frabull u1in1 their positions for a partgtOH that CGftlit11t11 or 11rH1nU lhbull apptamplUCI of perlOCIAI orpNaUoMl amllicL ol ~wut or personal
wm lnitiat1 and complete tht work witbin ht
j a1aolt ti=e Craml ampAir lICli ti aIPOval ol Ihi awardinl ~middot
5 Will comply bull i th tb1 latu10Y1rnmotal Ptnoooal Act or 1970 42 USC 11 421-41131 rtlatinc deg prucriMd sWMlarU tor muit bullJN= tor pre(lampIU llftdlt one or Ult 1Wi1tetn satut11 or reWations 1cJtid in Apptndis A ol OPMs tanda-ds for 1 11bullrit S11t1m ol enoMbull I Adminisiation(5CFllto0 S~FI
I WUl eoCply wilh amp11 Ftd1ral Ntuttl nlatiI WI oonifiJcr ~mination Thbull incl11d1 but an not limiocl to al TiUc VI ol the CiTil Rirhu Ae or 1964 (PI 11-352) wNcb proilibiU dixmination on the buis o( tact color or nationI ori(Jl (bl Title IX or thbull poundd11cation Amniclmenu or 1972 u arnendc (20 usc n 1611-1613 and 1amp15middot1616) which prohibits Gitcriminad011 on tht basis or wz (c) Seltion ~04 or the Phabilitation Act of lfi3 as amtndc tZ9 C SC 1 794) which prohibiU ditbull cicination on the basis or haclicapt (dl ht Att OiKrinination Act o( us at uncncitd (42 L SC11 6101 middot 6107) which prohibiLS cliscrirGmiddot
ination on tht basis of ace
(~l ti1 Dnac bltl ()CiCI and T111t111nt Act of u lPL g ~51 abull amended nlatinc to non~tion on thbull buis of dNi alNM tn Iha Compnhtnsivt AloDhol Ablilll and Alcohoolilm PnvenUoa Tnaunent and lehallilitstioll Act or 1910 (PL tl middot l51Sl as amended relaUnc lo nondi1eriminamption on the buil of alCDbol abUM or aieonolisa lampl 11 s3 and s1 of the hblit Heal~ Srtie9 Adol191 (42 JSC 90 Odmiddot3 and tO 3) as abullndbulld r1adnc 0 curl4111tiality or alcohol and dNI ab111 uent ~(bl Tit1 VIII C Ibo Clril Ri(hll Act ol IHI (11 USC I 3601 tt MCl middotl as amended nlatin1 U sonbull ditcrlzWaatioll ~ thbull 1bullbull renaal or rinandnc oC hnsin r (il an ) otbtr nondiscrimiHion 1royensioDI in the slK 111tuteltsl uUr wbich ncatillD for FOtral usiawa ii Mini mati1 and ltU thbull ciuir11n1nu 1C tlhttno~tioa siawl(s) wbidt IU) appi) o
U1 applicadoL wm bull 1w alndr UH iu u1 _ o1nu o m rJIM uu 1l1localioo Aa1i1tanU and Ital ProptrY Acquiaitiile PoliciU Act ol ll10 ltPL tl6411 which Wt or lair aM ~It_ r -~ a -1Lr1Ftda-l or ianllJ _shyTht11 ~menu apply o all UdeftlU ia rul pro1J11rtY a~ ror proja u or Federal putici_don it p~
I Will comply witb ti1 proNioal fl hi Haldi Act (5 USC II l50lmiddotl50I an m4om11 whldl limit tht political activitin of 1=ploy11bull who11 1rincipal 1mploy=1nt actifitia ara fuded in whole or in re with Ftd1raltwm
9 wmcomply as alicalllbull wih the pnNions or thbull OariJBtooo Ati (40 USC If 1715amp bull 276amiddot 1) Iht eo1anc Act (40 USC I Tk and 11 C SC H 114l and Iht ConUUt Wdeg Hows end Sa1t1 Standsrcbull AC (40 USC fl 327middot3331anti lcbor 1tampndardbull ror [lclually usisad constn1Cion subarreerutnU
~u 1bull-1
---caooao--middot
Ai11hotized lor Loal Reproducion
10 Will tomply if applicablt with noo4 insurance purchaH r~uirtmtnls o( Stclion 1021al a( lht rlood Diu1ltt Proltetion Actor 1973 IPL 93-2341 middothich r~11irt1 rtcipianll in a special nooc1 bampurd aruloparticipallintkprocTampmandtopurchaH nood inluranct ir tht toll] COi l o( in1unblt cons truction and acquisition it $10000 or more
11 Will comply with environmental standards wh ich tnaY bt prucribtd pursuant lo tht follow inc la) inst itut ion of tnyenironn1tntal quality control m1a1urt1 under tht Joiational Enyenironmtntal Policy Act or IHI (PL 91 middot1901 and EHcutivt Order CEO 11514 (b notircat ion of yeniolaUn1 facilit iu pursuant 0 EO 11138 lei pnitection of wetlands punuanl deg EO 11990 tdl eval111ition of nood haurdt in noodplainl in accordanct with EO 11981 ltlaHWampnet of ptojtct con1 istucy with the approyentd Statt manatmtnt pro1ram dtvtloptd under the Cr111tal Zone ~ana1emtnt Act of 1912 (16 C SC U 1451 et Hq) CO conlormity of Ffftf9I actions lo Stale Claar Airl lmpltmentatioA Plam under Secion 1714cl of tht Clear Air Act of lt55 U amended (42 CSC t 740lttwq l(ampl pr0Ktiontl~aowa1 olclrinkinf water udtr lhl Wo Oriakinl W1ter Act ol 1174 u amtrMW CPL ts-5Ul u4 (bl proampocUoa of olMlanrer-4 1pecit1 undtr tbt Endanprtd Sptcitt Act or 1rrs u -- CPL IS-2061
12 WUI umply with iht W~t IDll ScetUc Riven Act of IHI nl USC II 1111 ot seqI rtlaLH to proKdnf coipoataU or pewntlal eempooaau of lM natioaaJ wild and ICtnic riven 1yawm
~llfttdegJf-r(~
oWif GrIZ~~
Dep t nviron11en tal Prot ection BWSC
13 fl ill a11i1t lht bullmiddotard in1 bull1bullncy in a11ur in1 coinpliuice with Sction 106 of the lationalr Hisioric PAMrvation Act or It u amended (1 1 l SC 470) EO 11593 (ident ification nd pnttction of h iuoric proptrtiu) and the ArchaHIOfuI and Hilloric Prt1trvation Act of 197fll6CSC 469amiddotlttseqI shy
14 Will comply with P L 933415 re1ard in1 the prMKlictn of human 1ubjocta inyenolvtd in rHtarch aklp1n1nt and rt lattd actMUu suppontd by this 1wani of auiatance
15 Will comply with tht Laboralory Animal W11C1tt Act of 1966 IPL 89middot544 a1 amtndtd 7 1 SC 21Jl 1t wqI per1ainin1 to tht can handlinc ancl lnatmeat tf warm blood1d animalbull hold ror rtsarCh teachin1 or other acUYitiu wpporllCI by this awani elauistana
11 Will ro111ply with tht Le1d-Bued Paint Pobonln1 pnuon Act 142 CSC H 410l tt Nq ) which prohibits thbull Ult or Ind ba1td pa inl i n conauuctlon or rth1bllltation o( roaidenct
11 VRill CHM t bt performed amphe required flnaticial aflll cembulllibullnct aviill in acconlaact witb tha 5Ucte Audit Act of 1914
tt Will -ply with alt applicUle requinmtntaof all other federal ia oucuu nrulabonlc policin pftlftint this prorram
IlWwlite$iuHt-fOlllMIJl~ NIC( WUllllionCCo60
Certific3tion Regarding Debarment Suspension and Other Responsibility Matters
The pros~ivbull participant cenllits to the best of its knowledge and belief that it and its principals
a) Ara net presently debarred susoended prooostd for d1blrment decared ineliQible or vclumariy exdudalt trorn cov1rtd transacuons by any Feat~ department or 1g1ncybull
b) Have ro wi1hin a LVH year oeriod pmedlng this prol)Oul been convicted ct or toad a cM jud9ement ttndarte aQtinslt IJlm tor comnvssion ol traud or a cnillMi cllense in coMacuon with orasnin anemptLnQ to obtain or parlonninljl a PIJbfic (Federal Statbull or local) transaction ot contrac underbull iillic transaction violation ol Feotlll or State aruruc salUlH or commmion ol emoeiament tntft torgery bribtty lalsiflcalion or d11tn1cuon ol ~s makin lalst sattments or rrIMng sOlenpropttty
(CJ NI nCll pretenlly irdCed falt Ot - cMmlffy Ot civly ~-Id by I q anlily (Fshy_ Stlll or lccal) wih commillion ol any of lhl oftenus enumtratld W paragraph (1)~1 ot Oil
(d) ~~W~i=e=~or~~~J~ had one 0t men~ I und~ tt11 e fl6al ClltmlN on tNI cenbtion rMY et roundl for rtjteJon d ttil PfODOl9 or termination ot me award 1n IOdlion una1t 11 use sec 1001 a ta111 atamert may ruur in 1 ltnt ot up
middot 10 510000 OI imprisonmllI fOt up to fllrl or both shy
Daniel Gr11nb1um Com1issiontl
-0 I am unable to certify 10 the above saltmtntS My txplanauon is aracttd
I I I I
Itbullbullimiddotmiddotr~Ibulll
rrfIfibulli
u SIA1U l lll0Ubull llii~h~Jfltgt A-i C~ w-sGTO oiilO __
2xi ~SEPA PROCUREMENT SYSTEM CERTIFICATION - -middot- IO J1 l
AllICANTSNAM( ASSIS1ANCl uucATION NuMatll ept Environmental ProtectionBWSC
V001726-0l-6 1111CAHTS A00111lSS
One Winter Street 5th floor Botton Ha 02108
HCllON I - INSTRUCTIONS
I I I I
iiJill 1t-1 Irrbull fltllr ISbull
The aoolicani must comoleie end submit copy of th1S form with Heh 1pplic111on lor EPA A1usi1nce 11 tnbull 1pphc1n1 hes cenlfbulltd its procurement 1ys11m 10 EPA w11h1n 1n1 oas1 ~ yHfl 11nd 11111ys11m hH not been 1uo1t1n11111v r1v1sed complete Pin A in S1c11on IL thin s1Gn end Cite tne form It tne 1v111m nas not bun c1n1fied w11n Ult 0-112 veers comolbulltbull Pin 8 then sion ind dllt lht form
HCTION II - CEATlflCATION
A 1eHirm1n11the1pphcan1 n11 w11h1n the Piii 2 yurs cenif1ed10EPA th1111s orocurem1n1 MOHTHIYlAI 1y11em comolis w11n 40CFP Pen 331nd1n111t1e 1ys1em mH11 thbull reQu1remen11 in 40
FR p n Tn f h Ii n I 11 I n
B BHed upon my ev11u111on of tne bullPohcants procurement sys11m I u 1uthonzed rtoresen1111ve of 111bull applicant Chtcll one of tht lollowingJ
LJ 1 CERTIFY lhlt tlMI apptican11 procurement IYltbullm will rnH1111 of the reQuiremenll of 40 CFA Pin 33 before undertaking 1ny procuremam 1e1ion witn EPA 1111stance
CRTI1I CAII0 10R CXH1Jc18 I GRgtJn S LOgtH8 ))lp OOP R)IJV JC lJ~
Tbbull undbullrbulligDbull6 certifiebull to the bebullt of b bull or her bowlbull49bull uad belief that
(1) bullo Pederamp appropriated fwidJI bampTbull b41bullD or will be pLid by or OD babalf of tbe udeniqned to LDJ pbullrbullo11 tor infl11uci119 or attoap ti119 to i11Clue11ce u officer or aaployee of any a9uay a Weaber of Co119rbullbullbull u officer or -ploy of Co119rbullbullbull or u aaployee of a gttaab4ir of CoD9reH iD coanection witb the awu4ing Of ampZIJ 7ederal CODtract tbe aakin9 ltgtf ampllJ 1e0araJ VdegUt the aal i n9 or uiy rederal lou tba enteri D9 iDto of uy COOJgt9iratiwe a9reect ampAd tbe ute11iaio11 co11tiDuatio11 rellewampl aauDut o r aodificatio11 of uy 7ederal co11tract 9ruit loampJl or cooperathmiddote a9reellt
(2 J If ampllJ fa4a otller thu 1bull4bullral appropriat ~ habullbull beaD paid or will N paid to uy pe=aoa for lltl-ciJa9 or atteaptiD9 to iaflaeacbull u oficer or aplOJbullbull of u7 atuor a bull--ltoer of CODZbullaa or u employee of a bullmMr of CDaigraaa ia couectioa wit~ thia Jederal ooatract qzaat lou or tibullbull agreoae11t tbbull va4eraiped alaa11 complete ud sUait ltaaampamprt hrashytLL tgti tdoaure Jon to aaport Lo~iia9bull ia acoortuce Titll ita iDatructiona
CJ) Tbbull undenipbulld aball require that Ubull lupava of Uia certificatioa ba iacluded ia tte bullbullaz4 of docaauta for ampll bullubawazdbull at all tiara (bclu4iD9 amicoatracta robqruta aad coDtract1 oder 9r uta loau ud cooperatibull agrebulluta) ampad tUt middot amp11 bullubr ecipi bullDt a allampll cbullrtty ud 41aclobullbullmiddot acoor4i1a9ly
Thia certificrtioll ibull a uteria l r epr eHDtamptioa ot fact apoa which r a liuce wu placed wbea thia tranaactioa wu aamp4a or utered into Bubaiaaioa ot thi a ctirtificatioa ia a prereqdaite for bullakin9 or bull DteriDq into thia trusaction iapose-4 b1 leotioa 1352 Title 31 u1 eode by peraoa who taila to til e Ue reqaired certiication aball be subject to a ciTil peulty ot DOt lua thaa s10ooo ~4 raquoot aorbull thampll t100ooo for eacll such failure
Da niel S Gre~nbaum Commiuionn nnn DD l ITLK or AVnOlllED UPllllJrDnn
if~or lou~~arrmn ~efri ~
- barcode 580527
- barcodetext SDMS Doc ID 580527
![Page 9: MEMO REGARDING REQUEST TO INITIATE PROCESSING A … · Ac)r••••nt or bendaent of an Exietinc; ACJr••••nt . To : Deborah Haretedt, Grant• speciali•t. Grant• Inforaation](https://reader033.vdocument.in/reader033/viewer/2022060408/5f0fe4a97e708231d44668d9/html5/thumbnails/9.jpg)
ASSUAAHCES - NO~ONSTRUCTION PROGAAMS
c or u ~ 1ublbull lr middot p1ust conacl tht awardlllC 11tncJ F~u~ Fedcn arOinl a1t ncirs ma) req11in bullPPllunU
uinr~iy to addi tional UtWanctt Usuch it Ult cue you will bt bullUftlCi
Jutht ciuly au~horid rrirucnt11tit orthe 1t1llica1t I ttriy that tht 1t1alica11t
l Hu tht lrtbullI authorit) to aiply ror Federal auisWln and tht Witutional manattrial and (11amp1Cial capability (incltMlinl funds aWIWtnL I pbullJ ht non-Federal ahan or prejtd cosul ll ensurt proper planninc man111m11nt and cobullmiddot pinion oftit irojed ducribed ill UW appicatioA
Will ivt the abullardinC qtnt) ht Coapuolltr General or Lit tniLed StalS and it appro9fiaa the StaI hrouch ampDJ aulhoried nprnentatit accru to lid Iht ifht o esamirit all record1 books paitn or docucenu nlattd deg tht award anc wiil HtabliJh I priptt ICOllfttinc lflUI in acconianlaquo with 11nerally acuptad accountln(
sancarU or bullrbulln~cy direcCmiddot 3 Will ntablish WtfWds to prohibil 1mploy111
frabull u1in1 their positions for a partgtOH that CGftlit11t11 or 11rH1nU lhbull apptamplUCI of perlOCIAI orpNaUoMl amllicL ol ~wut or personal
wm lnitiat1 and complete tht work witbin ht
j a1aolt ti=e Craml ampAir lICli ti aIPOval ol Ihi awardinl ~middot
5 Will comply bull i th tb1 latu10Y1rnmotal Ptnoooal Act or 1970 42 USC 11 421-41131 rtlatinc deg prucriMd sWMlarU tor muit bullJN= tor pre(lampIU llftdlt one or Ult 1Wi1tetn satut11 or reWations 1cJtid in Apptndis A ol OPMs tanda-ds for 1 11bullrit S11t1m ol enoMbull I Adminisiation(5CFllto0 S~FI
I WUl eoCply wilh amp11 Ftd1ral Ntuttl nlatiI WI oonifiJcr ~mination Thbull incl11d1 but an not limiocl to al TiUc VI ol the CiTil Rirhu Ae or 1964 (PI 11-352) wNcb proilibiU dixmination on the buis o( tact color or nationI ori(Jl (bl Title IX or thbull poundd11cation Amniclmenu or 1972 u arnendc (20 usc n 1611-1613 and 1amp15middot1616) which prohibits Gitcriminad011 on tht basis or wz (c) Seltion ~04 or the Phabilitation Act of lfi3 as amtndc tZ9 C SC 1 794) which prohibiU ditbull cicination on the basis or haclicapt (dl ht Att OiKrinination Act o( us at uncncitd (42 L SC11 6101 middot 6107) which prohibiLS cliscrirGmiddot
ination on tht basis of ace
(~l ti1 Dnac bltl ()CiCI and T111t111nt Act of u lPL g ~51 abull amended nlatinc to non~tion on thbull buis of dNi alNM tn Iha Compnhtnsivt AloDhol Ablilll and Alcohoolilm PnvenUoa Tnaunent and lehallilitstioll Act or 1910 (PL tl middot l51Sl as amended relaUnc lo nondi1eriminamption on the buil of alCDbol abUM or aieonolisa lampl 11 s3 and s1 of the hblit Heal~ Srtie9 Adol191 (42 JSC 90 Odmiddot3 and tO 3) as abullndbulld r1adnc 0 curl4111tiality or alcohol and dNI ab111 uent ~(bl Tit1 VIII C Ibo Clril Ri(hll Act ol IHI (11 USC I 3601 tt MCl middotl as amended nlatin1 U sonbull ditcrlzWaatioll ~ thbull 1bullbull renaal or rinandnc oC hnsin r (il an ) otbtr nondiscrimiHion 1royensioDI in the slK 111tuteltsl uUr wbich ncatillD for FOtral usiawa ii Mini mati1 and ltU thbull ciuir11n1nu 1C tlhttno~tioa siawl(s) wbidt IU) appi) o
U1 applicadoL wm bull 1w alndr UH iu u1 _ o1nu o m rJIM uu 1l1localioo Aa1i1tanU and Ital ProptrY Acquiaitiile PoliciU Act ol ll10 ltPL tl6411 which Wt or lair aM ~It_ r -~ a -1Lr1Ftda-l or ianllJ _shyTht11 ~menu apply o all UdeftlU ia rul pro1J11rtY a~ ror proja u or Federal putici_don it p~
I Will comply witb ti1 proNioal fl hi Haldi Act (5 USC II l50lmiddotl50I an m4om11 whldl limit tht political activitin of 1=ploy11bull who11 1rincipal 1mploy=1nt actifitia ara fuded in whole or in re with Ftd1raltwm
9 wmcomply as alicalllbull wih the pnNions or thbull OariJBtooo Ati (40 USC If 1715amp bull 276amiddot 1) Iht eo1anc Act (40 USC I Tk and 11 C SC H 114l and Iht ConUUt Wdeg Hows end Sa1t1 Standsrcbull AC (40 USC fl 327middot3331anti lcbor 1tampndardbull ror [lclually usisad constn1Cion subarreerutnU
~u 1bull-1
---caooao--middot
Ai11hotized lor Loal Reproducion
10 Will tomply if applicablt with noo4 insurance purchaH r~uirtmtnls o( Stclion 1021al a( lht rlood Diu1ltt Proltetion Actor 1973 IPL 93-2341 middothich r~11irt1 rtcipianll in a special nooc1 bampurd aruloparticipallintkprocTampmandtopurchaH nood inluranct ir tht toll] COi l o( in1unblt cons truction and acquisition it $10000 or more
11 Will comply with environmental standards wh ich tnaY bt prucribtd pursuant lo tht follow inc la) inst itut ion of tnyenironn1tntal quality control m1a1urt1 under tht Joiational Enyenironmtntal Policy Act or IHI (PL 91 middot1901 and EHcutivt Order CEO 11514 (b notircat ion of yeniolaUn1 facilit iu pursuant 0 EO 11138 lei pnitection of wetlands punuanl deg EO 11990 tdl eval111ition of nood haurdt in noodplainl in accordanct with EO 11981 ltlaHWampnet of ptojtct con1 istucy with the approyentd Statt manatmtnt pro1ram dtvtloptd under the Cr111tal Zone ~ana1emtnt Act of 1912 (16 C SC U 1451 et Hq) CO conlormity of Ffftf9I actions lo Stale Claar Airl lmpltmentatioA Plam under Secion 1714cl of tht Clear Air Act of lt55 U amended (42 CSC t 740lttwq l(ampl pr0Ktiontl~aowa1 olclrinkinf water udtr lhl Wo Oriakinl W1ter Act ol 1174 u amtrMW CPL ts-5Ul u4 (bl proampocUoa of olMlanrer-4 1pecit1 undtr tbt Endanprtd Sptcitt Act or 1rrs u -- CPL IS-2061
12 WUI umply with iht W~t IDll ScetUc Riven Act of IHI nl USC II 1111 ot seqI rtlaLH to proKdnf coipoataU or pewntlal eempooaau of lM natioaaJ wild and ICtnic riven 1yawm
~llfttdegJf-r(~
oWif GrIZ~~
Dep t nviron11en tal Prot ection BWSC
13 fl ill a11i1t lht bullmiddotard in1 bull1bullncy in a11ur in1 coinpliuice with Sction 106 of the lationalr Hisioric PAMrvation Act or It u amended (1 1 l SC 470) EO 11593 (ident ification nd pnttction of h iuoric proptrtiu) and the ArchaHIOfuI and Hilloric Prt1trvation Act of 197fll6CSC 469amiddotlttseqI shy
14 Will comply with P L 933415 re1ard in1 the prMKlictn of human 1ubjocta inyenolvtd in rHtarch aklp1n1nt and rt lattd actMUu suppontd by this 1wani of auiatance
15 Will comply with tht Laboralory Animal W11C1tt Act of 1966 IPL 89middot544 a1 amtndtd 7 1 SC 21Jl 1t wqI per1ainin1 to tht can handlinc ancl lnatmeat tf warm blood1d animalbull hold ror rtsarCh teachin1 or other acUYitiu wpporllCI by this awani elauistana
11 Will ro111ply with tht Le1d-Bued Paint Pobonln1 pnuon Act 142 CSC H 410l tt Nq ) which prohibits thbull Ult or Ind ba1td pa inl i n conauuctlon or rth1bllltation o( roaidenct
11 VRill CHM t bt performed amphe required flnaticial aflll cembulllibullnct aviill in acconlaact witb tha 5Ucte Audit Act of 1914
tt Will -ply with alt applicUle requinmtntaof all other federal ia oucuu nrulabonlc policin pftlftint this prorram
IlWwlite$iuHt-fOlllMIJl~ NIC( WUllllionCCo60
Certific3tion Regarding Debarment Suspension and Other Responsibility Matters
The pros~ivbull participant cenllits to the best of its knowledge and belief that it and its principals
a) Ara net presently debarred susoended prooostd for d1blrment decared ineliQible or vclumariy exdudalt trorn cov1rtd transacuons by any Feat~ department or 1g1ncybull
b) Have ro wi1hin a LVH year oeriod pmedlng this prol)Oul been convicted ct or toad a cM jud9ement ttndarte aQtinslt IJlm tor comnvssion ol traud or a cnillMi cllense in coMacuon with orasnin anemptLnQ to obtain or parlonninljl a PIJbfic (Federal Statbull or local) transaction ot contrac underbull iillic transaction violation ol Feotlll or State aruruc salUlH or commmion ol emoeiament tntft torgery bribtty lalsiflcalion or d11tn1cuon ol ~s makin lalst sattments or rrIMng sOlenpropttty
(CJ NI nCll pretenlly irdCed falt Ot - cMmlffy Ot civly ~-Id by I q anlily (Fshy_ Stlll or lccal) wih commillion ol any of lhl oftenus enumtratld W paragraph (1)~1 ot Oil
(d) ~~W~i=e=~or~~~J~ had one 0t men~ I und~ tt11 e fl6al ClltmlN on tNI cenbtion rMY et roundl for rtjteJon d ttil PfODOl9 or termination ot me award 1n IOdlion una1t 11 use sec 1001 a ta111 atamert may ruur in 1 ltnt ot up
middot 10 510000 OI imprisonmllI fOt up to fllrl or both shy
Daniel Gr11nb1um Com1issiontl
-0 I am unable to certify 10 the above saltmtntS My txplanauon is aracttd
I I I I
Itbullbullimiddotmiddotr~Ibulll
rrfIfibulli
u SIA1U l lll0Ubull llii~h~Jfltgt A-i C~ w-sGTO oiilO __
2xi ~SEPA PROCUREMENT SYSTEM CERTIFICATION - -middot- IO J1 l
AllICANTSNAM( ASSIS1ANCl uucATION NuMatll ept Environmental ProtectionBWSC
V001726-0l-6 1111CAHTS A00111lSS
One Winter Street 5th floor Botton Ha 02108
HCllON I - INSTRUCTIONS
I I I I
iiJill 1t-1 Irrbull fltllr ISbull
The aoolicani must comoleie end submit copy of th1S form with Heh 1pplic111on lor EPA A1usi1nce 11 tnbull 1pphc1n1 hes cenlfbulltd its procurement 1ys11m 10 EPA w11h1n 1n1 oas1 ~ yHfl 11nd 11111ys11m hH not been 1uo1t1n11111v r1v1sed complete Pin A in S1c11on IL thin s1Gn end Cite tne form It tne 1v111m nas not bun c1n1fied w11n Ult 0-112 veers comolbulltbull Pin 8 then sion ind dllt lht form
HCTION II - CEATlflCATION
A 1eHirm1n11the1pphcan1 n11 w11h1n the Piii 2 yurs cenif1ed10EPA th1111s orocurem1n1 MOHTHIYlAI 1y11em comolis w11n 40CFP Pen 331nd1n111t1e 1ys1em mH11 thbull reQu1remen11 in 40
FR p n Tn f h Ii n I 11 I n
B BHed upon my ev11u111on of tne bullPohcants procurement sys11m I u 1uthonzed rtoresen1111ve of 111bull applicant Chtcll one of tht lollowingJ
LJ 1 CERTIFY lhlt tlMI apptican11 procurement IYltbullm will rnH1111 of the reQuiremenll of 40 CFA Pin 33 before undertaking 1ny procuremam 1e1ion witn EPA 1111stance
CRTI1I CAII0 10R CXH1Jc18 I GRgtJn S LOgtH8 ))lp OOP R)IJV JC lJ~
Tbbull undbullrbulligDbull6 certifiebull to the bebullt of b bull or her bowlbull49bull uad belief that
(1) bullo Pederamp appropriated fwidJI bampTbull b41bullD or will be pLid by or OD babalf of tbe udeniqned to LDJ pbullrbullo11 tor infl11uci119 or attoap ti119 to i11Clue11ce u officer or aaployee of any a9uay a Weaber of Co119rbullbullbull u officer or -ploy of Co119rbullbullbull or u aaployee of a gttaab4ir of CoD9reH iD coanection witb the awu4ing Of ampZIJ 7ederal CODtract tbe aakin9 ltgtf ampllJ 1e0araJ VdegUt the aal i n9 or uiy rederal lou tba enteri D9 iDto of uy COOJgt9iratiwe a9reect ampAd tbe ute11iaio11 co11tiDuatio11 rellewampl aauDut o r aodificatio11 of uy 7ederal co11tract 9ruit loampJl or cooperathmiddote a9reellt
(2 J If ampllJ fa4a otller thu 1bull4bullral appropriat ~ habullbull beaD paid or will N paid to uy pe=aoa for lltl-ciJa9 or atteaptiD9 to iaflaeacbull u oficer or aplOJbullbull of u7 atuor a bull--ltoer of CODZbullaa or u employee of a bullmMr of CDaigraaa ia couectioa wit~ thia Jederal ooatract qzaat lou or tibullbull agreoae11t tbbull va4eraiped alaa11 complete ud sUait ltaaampamprt hrashytLL tgti tdoaure Jon to aaport Lo~iia9bull ia acoortuce Titll ita iDatructiona
CJ) Tbbull undenipbulld aball require that Ubull lupava of Uia certificatioa ba iacluded ia tte bullbullaz4 of docaauta for ampll bullubawazdbull at all tiara (bclu4iD9 amicoatracta robqruta aad coDtract1 oder 9r uta loau ud cooperatibull agrebulluta) ampad tUt middot amp11 bullubr ecipi bullDt a allampll cbullrtty ud 41aclobullbullmiddot acoor4i1a9ly
Thia certificrtioll ibull a uteria l r epr eHDtamptioa ot fact apoa which r a liuce wu placed wbea thia tranaactioa wu aamp4a or utered into Bubaiaaioa ot thi a ctirtificatioa ia a prereqdaite for bullakin9 or bull DteriDq into thia trusaction iapose-4 b1 leotioa 1352 Title 31 u1 eode by peraoa who taila to til e Ue reqaired certiication aball be subject to a ciTil peulty ot DOt lua thaa s10ooo ~4 raquoot aorbull thampll t100ooo for eacll such failure
Da niel S Gre~nbaum Commiuionn nnn DD l ITLK or AVnOlllED UPllllJrDnn
if~or lou~~arrmn ~efri ~
- barcode 580527
- barcodetext SDMS Doc ID 580527
![Page 10: MEMO REGARDING REQUEST TO INITIATE PROCESSING A … · Ac)r••••nt or bendaent of an Exietinc; ACJr••••nt . To : Deborah Haretedt, Grant• speciali•t. Grant• Inforaation](https://reader033.vdocument.in/reader033/viewer/2022060408/5f0fe4a97e708231d44668d9/html5/thumbnails/10.jpg)
10 Will tomply if applicablt with noo4 insurance purchaH r~uirtmtnls o( Stclion 1021al a( lht rlood Diu1ltt Proltetion Actor 1973 IPL 93-2341 middothich r~11irt1 rtcipianll in a special nooc1 bampurd aruloparticipallintkprocTampmandtopurchaH nood inluranct ir tht toll] COi l o( in1unblt cons truction and acquisition it $10000 or more
11 Will comply with environmental standards wh ich tnaY bt prucribtd pursuant lo tht follow inc la) inst itut ion of tnyenironn1tntal quality control m1a1urt1 under tht Joiational Enyenironmtntal Policy Act or IHI (PL 91 middot1901 and EHcutivt Order CEO 11514 (b notircat ion of yeniolaUn1 facilit iu pursuant 0 EO 11138 lei pnitection of wetlands punuanl deg EO 11990 tdl eval111ition of nood haurdt in noodplainl in accordanct with EO 11981 ltlaHWampnet of ptojtct con1 istucy with the approyentd Statt manatmtnt pro1ram dtvtloptd under the Cr111tal Zone ~ana1emtnt Act of 1912 (16 C SC U 1451 et Hq) CO conlormity of Ffftf9I actions lo Stale Claar Airl lmpltmentatioA Plam under Secion 1714cl of tht Clear Air Act of lt55 U amended (42 CSC t 740lttwq l(ampl pr0Ktiontl~aowa1 olclrinkinf water udtr lhl Wo Oriakinl W1ter Act ol 1174 u amtrMW CPL ts-5Ul u4 (bl proampocUoa of olMlanrer-4 1pecit1 undtr tbt Endanprtd Sptcitt Act or 1rrs u -- CPL IS-2061
12 WUI umply with iht W~t IDll ScetUc Riven Act of IHI nl USC II 1111 ot seqI rtlaLH to proKdnf coipoataU or pewntlal eempooaau of lM natioaaJ wild and ICtnic riven 1yawm
~llfttdegJf-r(~
oWif GrIZ~~
Dep t nviron11en tal Prot ection BWSC
13 fl ill a11i1t lht bullmiddotard in1 bull1bullncy in a11ur in1 coinpliuice with Sction 106 of the lationalr Hisioric PAMrvation Act or It u amended (1 1 l SC 470) EO 11593 (ident ification nd pnttction of h iuoric proptrtiu) and the ArchaHIOfuI and Hilloric Prt1trvation Act of 197fll6CSC 469amiddotlttseqI shy
14 Will comply with P L 933415 re1ard in1 the prMKlictn of human 1ubjocta inyenolvtd in rHtarch aklp1n1nt and rt lattd actMUu suppontd by this 1wani of auiatance
15 Will comply with tht Laboralory Animal W11C1tt Act of 1966 IPL 89middot544 a1 amtndtd 7 1 SC 21Jl 1t wqI per1ainin1 to tht can handlinc ancl lnatmeat tf warm blood1d animalbull hold ror rtsarCh teachin1 or other acUYitiu wpporllCI by this awani elauistana
11 Will ro111ply with tht Le1d-Bued Paint Pobonln1 pnuon Act 142 CSC H 410l tt Nq ) which prohibits thbull Ult or Ind ba1td pa inl i n conauuctlon or rth1bllltation o( roaidenct
11 VRill CHM t bt performed amphe required flnaticial aflll cembulllibullnct aviill in acconlaact witb tha 5Ucte Audit Act of 1914
tt Will -ply with alt applicUle requinmtntaof all other federal ia oucuu nrulabonlc policin pftlftint this prorram
IlWwlite$iuHt-fOlllMIJl~ NIC( WUllllionCCo60
Certific3tion Regarding Debarment Suspension and Other Responsibility Matters
The pros~ivbull participant cenllits to the best of its knowledge and belief that it and its principals
a) Ara net presently debarred susoended prooostd for d1blrment decared ineliQible or vclumariy exdudalt trorn cov1rtd transacuons by any Feat~ department or 1g1ncybull
b) Have ro wi1hin a LVH year oeriod pmedlng this prol)Oul been convicted ct or toad a cM jud9ement ttndarte aQtinslt IJlm tor comnvssion ol traud or a cnillMi cllense in coMacuon with orasnin anemptLnQ to obtain or parlonninljl a PIJbfic (Federal Statbull or local) transaction ot contrac underbull iillic transaction violation ol Feotlll or State aruruc salUlH or commmion ol emoeiament tntft torgery bribtty lalsiflcalion or d11tn1cuon ol ~s makin lalst sattments or rrIMng sOlenpropttty
(CJ NI nCll pretenlly irdCed falt Ot - cMmlffy Ot civly ~-Id by I q anlily (Fshy_ Stlll or lccal) wih commillion ol any of lhl oftenus enumtratld W paragraph (1)~1 ot Oil
(d) ~~W~i=e=~or~~~J~ had one 0t men~ I und~ tt11 e fl6al ClltmlN on tNI cenbtion rMY et roundl for rtjteJon d ttil PfODOl9 or termination ot me award 1n IOdlion una1t 11 use sec 1001 a ta111 atamert may ruur in 1 ltnt ot up
middot 10 510000 OI imprisonmllI fOt up to fllrl or both shy
Daniel Gr11nb1um Com1issiontl
-0 I am unable to certify 10 the above saltmtntS My txplanauon is aracttd
I I I I
Itbullbullimiddotmiddotr~Ibulll
rrfIfibulli
u SIA1U l lll0Ubull llii~h~Jfltgt A-i C~ w-sGTO oiilO __
2xi ~SEPA PROCUREMENT SYSTEM CERTIFICATION - -middot- IO J1 l
AllICANTSNAM( ASSIS1ANCl uucATION NuMatll ept Environmental ProtectionBWSC
V001726-0l-6 1111CAHTS A00111lSS
One Winter Street 5th floor Botton Ha 02108
HCllON I - INSTRUCTIONS
I I I I
iiJill 1t-1 Irrbull fltllr ISbull
The aoolicani must comoleie end submit copy of th1S form with Heh 1pplic111on lor EPA A1usi1nce 11 tnbull 1pphc1n1 hes cenlfbulltd its procurement 1ys11m 10 EPA w11h1n 1n1 oas1 ~ yHfl 11nd 11111ys11m hH not been 1uo1t1n11111v r1v1sed complete Pin A in S1c11on IL thin s1Gn end Cite tne form It tne 1v111m nas not bun c1n1fied w11n Ult 0-112 veers comolbulltbull Pin 8 then sion ind dllt lht form
HCTION II - CEATlflCATION
A 1eHirm1n11the1pphcan1 n11 w11h1n the Piii 2 yurs cenif1ed10EPA th1111s orocurem1n1 MOHTHIYlAI 1y11em comolis w11n 40CFP Pen 331nd1n111t1e 1ys1em mH11 thbull reQu1remen11 in 40
FR p n Tn f h Ii n I 11 I n
B BHed upon my ev11u111on of tne bullPohcants procurement sys11m I u 1uthonzed rtoresen1111ve of 111bull applicant Chtcll one of tht lollowingJ
LJ 1 CERTIFY lhlt tlMI apptican11 procurement IYltbullm will rnH1111 of the reQuiremenll of 40 CFA Pin 33 before undertaking 1ny procuremam 1e1ion witn EPA 1111stance
CRTI1I CAII0 10R CXH1Jc18 I GRgtJn S LOgtH8 ))lp OOP R)IJV JC lJ~
Tbbull undbullrbulligDbull6 certifiebull to the bebullt of b bull or her bowlbull49bull uad belief that
(1) bullo Pederamp appropriated fwidJI bampTbull b41bullD or will be pLid by or OD babalf of tbe udeniqned to LDJ pbullrbullo11 tor infl11uci119 or attoap ti119 to i11Clue11ce u officer or aaployee of any a9uay a Weaber of Co119rbullbullbull u officer or -ploy of Co119rbullbullbull or u aaployee of a gttaab4ir of CoD9reH iD coanection witb the awu4ing Of ampZIJ 7ederal CODtract tbe aakin9 ltgtf ampllJ 1e0araJ VdegUt the aal i n9 or uiy rederal lou tba enteri D9 iDto of uy COOJgt9iratiwe a9reect ampAd tbe ute11iaio11 co11tiDuatio11 rellewampl aauDut o r aodificatio11 of uy 7ederal co11tract 9ruit loampJl or cooperathmiddote a9reellt
(2 J If ampllJ fa4a otller thu 1bull4bullral appropriat ~ habullbull beaD paid or will N paid to uy pe=aoa for lltl-ciJa9 or atteaptiD9 to iaflaeacbull u oficer or aplOJbullbull of u7 atuor a bull--ltoer of CODZbullaa or u employee of a bullmMr of CDaigraaa ia couectioa wit~ thia Jederal ooatract qzaat lou or tibullbull agreoae11t tbbull va4eraiped alaa11 complete ud sUait ltaaampamprt hrashytLL tgti tdoaure Jon to aaport Lo~iia9bull ia acoortuce Titll ita iDatructiona
CJ) Tbbull undenipbulld aball require that Ubull lupava of Uia certificatioa ba iacluded ia tte bullbullaz4 of docaauta for ampll bullubawazdbull at all tiara (bclu4iD9 amicoatracta robqruta aad coDtract1 oder 9r uta loau ud cooperatibull agrebulluta) ampad tUt middot amp11 bullubr ecipi bullDt a allampll cbullrtty ud 41aclobullbullmiddot acoor4i1a9ly
Thia certificrtioll ibull a uteria l r epr eHDtamptioa ot fact apoa which r a liuce wu placed wbea thia tranaactioa wu aamp4a or utered into Bubaiaaioa ot thi a ctirtificatioa ia a prereqdaite for bullakin9 or bull DteriDq into thia trusaction iapose-4 b1 leotioa 1352 Title 31 u1 eode by peraoa who taila to til e Ue reqaired certiication aball be subject to a ciTil peulty ot DOt lua thaa s10ooo ~4 raquoot aorbull thampll t100ooo for eacll such failure
Da niel S Gre~nbaum Commiuionn nnn DD l ITLK or AVnOlllED UPllllJrDnn
if~or lou~~arrmn ~efri ~
- barcode 580527
- barcodetext SDMS Doc ID 580527
![Page 11: MEMO REGARDING REQUEST TO INITIATE PROCESSING A … · Ac)r••••nt or bendaent of an Exietinc; ACJr••••nt . To : Deborah Haretedt, Grant• speciali•t. Grant• Inforaation](https://reader033.vdocument.in/reader033/viewer/2022060408/5f0fe4a97e708231d44668d9/html5/thumbnails/11.jpg)
IlWwlite$iuHt-fOlllMIJl~ NIC( WUllllionCCo60
Certific3tion Regarding Debarment Suspension and Other Responsibility Matters
The pros~ivbull participant cenllits to the best of its knowledge and belief that it and its principals
a) Ara net presently debarred susoended prooostd for d1blrment decared ineliQible or vclumariy exdudalt trorn cov1rtd transacuons by any Feat~ department or 1g1ncybull
b) Have ro wi1hin a LVH year oeriod pmedlng this prol)Oul been convicted ct or toad a cM jud9ement ttndarte aQtinslt IJlm tor comnvssion ol traud or a cnillMi cllense in coMacuon with orasnin anemptLnQ to obtain or parlonninljl a PIJbfic (Federal Statbull or local) transaction ot contrac underbull iillic transaction violation ol Feotlll or State aruruc salUlH or commmion ol emoeiament tntft torgery bribtty lalsiflcalion or d11tn1cuon ol ~s makin lalst sattments or rrIMng sOlenpropttty
(CJ NI nCll pretenlly irdCed falt Ot - cMmlffy Ot civly ~-Id by I q anlily (Fshy_ Stlll or lccal) wih commillion ol any of lhl oftenus enumtratld W paragraph (1)~1 ot Oil
(d) ~~W~i=e=~or~~~J~ had one 0t men~ I und~ tt11 e fl6al ClltmlN on tNI cenbtion rMY et roundl for rtjteJon d ttil PfODOl9 or termination ot me award 1n IOdlion una1t 11 use sec 1001 a ta111 atamert may ruur in 1 ltnt ot up
middot 10 510000 OI imprisonmllI fOt up to fllrl or both shy
Daniel Gr11nb1um Com1issiontl
-0 I am unable to certify 10 the above saltmtntS My txplanauon is aracttd
I I I I
Itbullbullimiddotmiddotr~Ibulll
rrfIfibulli
u SIA1U l lll0Ubull llii~h~Jfltgt A-i C~ w-sGTO oiilO __
2xi ~SEPA PROCUREMENT SYSTEM CERTIFICATION - -middot- IO J1 l
AllICANTSNAM( ASSIS1ANCl uucATION NuMatll ept Environmental ProtectionBWSC
V001726-0l-6 1111CAHTS A00111lSS
One Winter Street 5th floor Botton Ha 02108
HCllON I - INSTRUCTIONS
I I I I
iiJill 1t-1 Irrbull fltllr ISbull
The aoolicani must comoleie end submit copy of th1S form with Heh 1pplic111on lor EPA A1usi1nce 11 tnbull 1pphc1n1 hes cenlfbulltd its procurement 1ys11m 10 EPA w11h1n 1n1 oas1 ~ yHfl 11nd 11111ys11m hH not been 1uo1t1n11111v r1v1sed complete Pin A in S1c11on IL thin s1Gn end Cite tne form It tne 1v111m nas not bun c1n1fied w11n Ult 0-112 veers comolbulltbull Pin 8 then sion ind dllt lht form
HCTION II - CEATlflCATION
A 1eHirm1n11the1pphcan1 n11 w11h1n the Piii 2 yurs cenif1ed10EPA th1111s orocurem1n1 MOHTHIYlAI 1y11em comolis w11n 40CFP Pen 331nd1n111t1e 1ys1em mH11 thbull reQu1remen11 in 40
FR p n Tn f h Ii n I 11 I n
B BHed upon my ev11u111on of tne bullPohcants procurement sys11m I u 1uthonzed rtoresen1111ve of 111bull applicant Chtcll one of tht lollowingJ
LJ 1 CERTIFY lhlt tlMI apptican11 procurement IYltbullm will rnH1111 of the reQuiremenll of 40 CFA Pin 33 before undertaking 1ny procuremam 1e1ion witn EPA 1111stance
CRTI1I CAII0 10R CXH1Jc18 I GRgtJn S LOgtH8 ))lp OOP R)IJV JC lJ~
Tbbull undbullrbulligDbull6 certifiebull to the bebullt of b bull or her bowlbull49bull uad belief that
(1) bullo Pederamp appropriated fwidJI bampTbull b41bullD or will be pLid by or OD babalf of tbe udeniqned to LDJ pbullrbullo11 tor infl11uci119 or attoap ti119 to i11Clue11ce u officer or aaployee of any a9uay a Weaber of Co119rbullbullbull u officer or -ploy of Co119rbullbullbull or u aaployee of a gttaab4ir of CoD9reH iD coanection witb the awu4ing Of ampZIJ 7ederal CODtract tbe aakin9 ltgtf ampllJ 1e0araJ VdegUt the aal i n9 or uiy rederal lou tba enteri D9 iDto of uy COOJgt9iratiwe a9reect ampAd tbe ute11iaio11 co11tiDuatio11 rellewampl aauDut o r aodificatio11 of uy 7ederal co11tract 9ruit loampJl or cooperathmiddote a9reellt
(2 J If ampllJ fa4a otller thu 1bull4bullral appropriat ~ habullbull beaD paid or will N paid to uy pe=aoa for lltl-ciJa9 or atteaptiD9 to iaflaeacbull u oficer or aplOJbullbull of u7 atuor a bull--ltoer of CODZbullaa or u employee of a bullmMr of CDaigraaa ia couectioa wit~ thia Jederal ooatract qzaat lou or tibullbull agreoae11t tbbull va4eraiped alaa11 complete ud sUait ltaaampamprt hrashytLL tgti tdoaure Jon to aaport Lo~iia9bull ia acoortuce Titll ita iDatructiona
CJ) Tbbull undenipbulld aball require that Ubull lupava of Uia certificatioa ba iacluded ia tte bullbullaz4 of docaauta for ampll bullubawazdbull at all tiara (bclu4iD9 amicoatracta robqruta aad coDtract1 oder 9r uta loau ud cooperatibull agrebulluta) ampad tUt middot amp11 bullubr ecipi bullDt a allampll cbullrtty ud 41aclobullbullmiddot acoor4i1a9ly
Thia certificrtioll ibull a uteria l r epr eHDtamptioa ot fact apoa which r a liuce wu placed wbea thia tranaactioa wu aamp4a or utered into Bubaiaaioa ot thi a ctirtificatioa ia a prereqdaite for bullakin9 or bull DteriDq into thia trusaction iapose-4 b1 leotioa 1352 Title 31 u1 eode by peraoa who taila to til e Ue reqaired certiication aball be subject to a ciTil peulty ot DOt lua thaa s10ooo ~4 raquoot aorbull thampll t100ooo for eacll such failure
Da niel S Gre~nbaum Commiuionn nnn DD l ITLK or AVnOlllED UPllllJrDnn
if~or lou~~arrmn ~efri ~
- barcode 580527
- barcodetext SDMS Doc ID 580527
![Page 12: MEMO REGARDING REQUEST TO INITIATE PROCESSING A … · Ac)r••••nt or bendaent of an Exietinc; ACJr••••nt . To : Deborah Haretedt, Grant• speciali•t. Grant• Inforaation](https://reader033.vdocument.in/reader033/viewer/2022060408/5f0fe4a97e708231d44668d9/html5/thumbnails/12.jpg)
u SIA1U l lll0Ubull llii~h~Jfltgt A-i C~ w-sGTO oiilO __
2xi ~SEPA PROCUREMENT SYSTEM CERTIFICATION - -middot- IO J1 l
AllICANTSNAM( ASSIS1ANCl uucATION NuMatll ept Environmental ProtectionBWSC
V001726-0l-6 1111CAHTS A00111lSS
One Winter Street 5th floor Botton Ha 02108
HCllON I - INSTRUCTIONS
I I I I
iiJill 1t-1 Irrbull fltllr ISbull
The aoolicani must comoleie end submit copy of th1S form with Heh 1pplic111on lor EPA A1usi1nce 11 tnbull 1pphc1n1 hes cenlfbulltd its procurement 1ys11m 10 EPA w11h1n 1n1 oas1 ~ yHfl 11nd 11111ys11m hH not been 1uo1t1n11111v r1v1sed complete Pin A in S1c11on IL thin s1Gn end Cite tne form It tne 1v111m nas not bun c1n1fied w11n Ult 0-112 veers comolbulltbull Pin 8 then sion ind dllt lht form
HCTION II - CEATlflCATION
A 1eHirm1n11the1pphcan1 n11 w11h1n the Piii 2 yurs cenif1ed10EPA th1111s orocurem1n1 MOHTHIYlAI 1y11em comolis w11n 40CFP Pen 331nd1n111t1e 1ys1em mH11 thbull reQu1remen11 in 40
FR p n Tn f h Ii n I 11 I n
B BHed upon my ev11u111on of tne bullPohcants procurement sys11m I u 1uthonzed rtoresen1111ve of 111bull applicant Chtcll one of tht lollowingJ
LJ 1 CERTIFY lhlt tlMI apptican11 procurement IYltbullm will rnH1111 of the reQuiremenll of 40 CFA Pin 33 before undertaking 1ny procuremam 1e1ion witn EPA 1111stance
CRTI1I CAII0 10R CXH1Jc18 I GRgtJn S LOgtH8 ))lp OOP R)IJV JC lJ~
Tbbull undbullrbulligDbull6 certifiebull to the bebullt of b bull or her bowlbull49bull uad belief that
(1) bullo Pederamp appropriated fwidJI bampTbull b41bullD or will be pLid by or OD babalf of tbe udeniqned to LDJ pbullrbullo11 tor infl11uci119 or attoap ti119 to i11Clue11ce u officer or aaployee of any a9uay a Weaber of Co119rbullbullbull u officer or -ploy of Co119rbullbullbull or u aaployee of a gttaab4ir of CoD9reH iD coanection witb the awu4ing Of ampZIJ 7ederal CODtract tbe aakin9 ltgtf ampllJ 1e0araJ VdegUt the aal i n9 or uiy rederal lou tba enteri D9 iDto of uy COOJgt9iratiwe a9reect ampAd tbe ute11iaio11 co11tiDuatio11 rellewampl aauDut o r aodificatio11 of uy 7ederal co11tract 9ruit loampJl or cooperathmiddote a9reellt
(2 J If ampllJ fa4a otller thu 1bull4bullral appropriat ~ habullbull beaD paid or will N paid to uy pe=aoa for lltl-ciJa9 or atteaptiD9 to iaflaeacbull u oficer or aplOJbullbull of u7 atuor a bull--ltoer of CODZbullaa or u employee of a bullmMr of CDaigraaa ia couectioa wit~ thia Jederal ooatract qzaat lou or tibullbull agreoae11t tbbull va4eraiped alaa11 complete ud sUait ltaaampamprt hrashytLL tgti tdoaure Jon to aaport Lo~iia9bull ia acoortuce Titll ita iDatructiona
CJ) Tbbull undenipbulld aball require that Ubull lupava of Uia certificatioa ba iacluded ia tte bullbullaz4 of docaauta for ampll bullubawazdbull at all tiara (bclu4iD9 amicoatracta robqruta aad coDtract1 oder 9r uta loau ud cooperatibull agrebulluta) ampad tUt middot amp11 bullubr ecipi bullDt a allampll cbullrtty ud 41aclobullbullmiddot acoor4i1a9ly
Thia certificrtioll ibull a uteria l r epr eHDtamptioa ot fact apoa which r a liuce wu placed wbea thia tranaactioa wu aamp4a or utered into Bubaiaaioa ot thi a ctirtificatioa ia a prereqdaite for bullakin9 or bull DteriDq into thia trusaction iapose-4 b1 leotioa 1352 Title 31 u1 eode by peraoa who taila to til e Ue reqaired certiication aball be subject to a ciTil peulty ot DOt lua thaa s10ooo ~4 raquoot aorbull thampll t100ooo for eacll such failure
Da niel S Gre~nbaum Commiuionn nnn DD l ITLK or AVnOlllED UPllllJrDnn
if~or lou~~arrmn ~efri ~
- barcode 580527
- barcodetext SDMS Doc ID 580527
![Page 13: MEMO REGARDING REQUEST TO INITIATE PROCESSING A … · Ac)r••••nt or bendaent of an Exietinc; ACJr••••nt . To : Deborah Haretedt, Grant• speciali•t. Grant• Inforaation](https://reader033.vdocument.in/reader033/viewer/2022060408/5f0fe4a97e708231d44668d9/html5/thumbnails/13.jpg)
CRTI1I CAII0 10R CXH1Jc18 I GRgtJn S LOgtH8 ))lp OOP R)IJV JC lJ~
Tbbull undbullrbulligDbull6 certifiebull to the bebullt of b bull or her bowlbull49bull uad belief that
(1) bullo Pederamp appropriated fwidJI bampTbull b41bullD or will be pLid by or OD babalf of tbe udeniqned to LDJ pbullrbullo11 tor infl11uci119 or attoap ti119 to i11Clue11ce u officer or aaployee of any a9uay a Weaber of Co119rbullbullbull u officer or -ploy of Co119rbullbullbull or u aaployee of a gttaab4ir of CoD9reH iD coanection witb the awu4ing Of ampZIJ 7ederal CODtract tbe aakin9 ltgtf ampllJ 1e0araJ VdegUt the aal i n9 or uiy rederal lou tba enteri D9 iDto of uy COOJgt9iratiwe a9reect ampAd tbe ute11iaio11 co11tiDuatio11 rellewampl aauDut o r aodificatio11 of uy 7ederal co11tract 9ruit loampJl or cooperathmiddote a9reellt
(2 J If ampllJ fa4a otller thu 1bull4bullral appropriat ~ habullbull beaD paid or will N paid to uy pe=aoa for lltl-ciJa9 or atteaptiD9 to iaflaeacbull u oficer or aplOJbullbull of u7 atuor a bull--ltoer of CODZbullaa or u employee of a bullmMr of CDaigraaa ia couectioa wit~ thia Jederal ooatract qzaat lou or tibullbull agreoae11t tbbull va4eraiped alaa11 complete ud sUait ltaaampamprt hrashytLL tgti tdoaure Jon to aaport Lo~iia9bull ia acoortuce Titll ita iDatructiona
CJ) Tbbull undenipbulld aball require that Ubull lupava of Uia certificatioa ba iacluded ia tte bullbullaz4 of docaauta for ampll bullubawazdbull at all tiara (bclu4iD9 amicoatracta robqruta aad coDtract1 oder 9r uta loau ud cooperatibull agrebulluta) ampad tUt middot amp11 bullubr ecipi bullDt a allampll cbullrtty ud 41aclobullbullmiddot acoor4i1a9ly
Thia certificrtioll ibull a uteria l r epr eHDtamptioa ot fact apoa which r a liuce wu placed wbea thia tranaactioa wu aamp4a or utered into Bubaiaaioa ot thi a ctirtificatioa ia a prereqdaite for bullakin9 or bull DteriDq into thia trusaction iapose-4 b1 leotioa 1352 Title 31 u1 eode by peraoa who taila to til e Ue reqaired certiication aball be subject to a ciTil peulty ot DOt lua thaa s10ooo ~4 raquoot aorbull thampll t100ooo for eacll such failure
Da niel S Gre~nbaum Commiuionn nnn DD l ITLK or AVnOlllED UPllllJrDnn
if~or lou~~arrmn ~efri ~
- barcode 580527
- barcodetext SDMS Doc ID 580527