HomeMy WebLinkAboutResolution No. 2016-C22 STATE OF CALIFORNIA
CALIFORNIA GOVERNOR'S OFFICE OF EMERGENCY SERVICES Cal OES ID No:
CAL OES 130
DESIGNATION OF APPLICANT'S AGENT RESOLUTION NO.2016-C22
Hazard Mitigation Grant Program and Pre-Disaster Mitigation Program
BE IT RESOLVED BY THE City Council OF THE City of Azusa
(Governing Body) (Name of Applicant)
THAT City Manager
(Title of Authorized Agent)
is hereby authorized to execute for and on behalf of the City of Azusa ,a public entity
(Name of Applicant)
established under the laws of the State of California,this application and to file it with the California Governor's Office of Emergency Service.
for the purpose of obtaining certain federal financial assistance under Public Law 93-288 as amended by the Robert T.Stafford Disaster Relief
and Emergency Assistance Act of 1988,and/or state financial assistance under the California Disaster Assistance Act
THAT the City of Azusa ,a public entity established under the laws of the State of California,
(Name of Applicant)
hereby authorizes its agent(s)to provide to the California Governor's Office of Emergency Service for all matters pertaining to such state
disaster assistance the assurances and agreements required.
Please check the appropriate box below:
bd.This is a universal resolution and is effective for all open and futures Disasters/Grants up to three(3)years following the date of approval
below.
OThis is a Disaster/Grant specific resolution and is effective for only Disaster/Grant name/number(s)
Passed and approved this 7 day of March 2016
/ ev. ii. i4_.‘
Joseph Romero Rocha, Mayor
(Name and Title of Governing Body Representative)
(Name and Title of Governing Body Representative)
• CERTIFICATION
I, Jeffrey L. Cornejo,Jr. ,duly appointed and City Clerk of
(Name) (Title)
City of Azusa ,do hereby certify that the above is a true and correct copy of a
(Name of Applicant)
Resolution passed and approved by the City Council of the City of Azusa
(Governing Body) (Name of Applicant)
on the 7th day of March ,2016.
(Signature) // t (Title)
Cal OES 130(Rev.7t13) tt// Page 1 «tt////
STATE OF CALIFORNIA
CALIFORNIA GOVERNORS OFFICE OF EMERGENCY SERVICE
CAL OES 130-INSTRUCTIONS
Cal OES Form 130
Instructions
A new Designation of Applicant's Agent Resolution is required if the previously submitted document is older than three(3)
years from the last date of Board/Council approval.
When completing the Cal OES Form 130,Applicants should fill in the blanks on page 1. The blanks are to be filled in as follows:
Resolution Section:
Governing Body: This is the individual or group responsible for appointing and approving the Authorized
Agents. Examples include: Board of Directors,City Council,Board of Supervisors,etc.
Name of Applicant: This is the official name of the non-profit,agency,city,county or special district that has applied for the grant.
Examples include: City of Sacramento;Sacramento County;or Los Angeles Unified School District.
Authorized Agent: These are the individuals that are authorized by the Governing Body to engage with the Federal Emergency
Management Agency and the California Governor's Office of Emergency Service regarding grants applied for by the Applicant.There
are two ways of completing this section:
1. Titles Only: If the Governing Body so chooses,the titles of the Authorized Agents should be entered here,not their
names.This allows the document to remain valid if an Authorized Agent leaves the position and is replaced by another
individual. If"Titles Only"is the chosen method,this document must be accompanied by a cover letter naming the
Authorized Agents by name and title.This cover letter can be completed by any authorized person within the agency
(e.g.;City Clerk,the Authorized Agent,Secretary to the Director)and does not require the Governing Body's
signature.
2. Names and Titles: If the Governing Body so chooses,the names and titles of the Authorized Agents should be listed.A
new Cal OES Form 130 will be required if any of the Authorized Agents are replaced,leave the position listed on the
document or their title changes.
Governing Body Representative: These are the names and titles of the approving board members.Examples
include: Chairman of the Board,Superintendent,etc. The names and titles cannot be one of the designated Authorized Agents.
Certification Section;
Name and Title:This is the individual that was in attendance and recorded the Resolution creation and approval.
Examples include: City Clerk,Secretary to the Board of Directors,County Clerk,etc.This person cannot
be one of the designated Authorized Agents to eliminate"Self Certification"
Cal OES 130(Rev.7/13) Page 2