HomeMy WebLinkAboutCounty of San Diego; 2020-12-30;DocuSign Envelope ID: 9BB3A1B4-9D39-4236-9368-7E67A0A678E3
SAN DIEGO COUNTY FIRE
IN COOPERATION WITH CAL FIRE
-2249 lainacha Road I Ei Cajon CA 92019
5510 Overland Avenue Suite 250, San Diego I CA 92122-1239
e".777.17-*
/RE
.s4\010. c ou:41,
TONY MECHAM FIRE CHIEF
HERMAN REMICK
DIRECTOR, FIRE PROTECTION DISTRICT
RATIFICATION OF AMENDMENT NO.1 TO EXTEND FIRE AGENCY MUTUAL AID AGREEMENT FOR COVID-19 VACCINE
ADMINISTRATION
This Ratification of Amendment No. 1 to the Fire Agency Mutual Aid Agreement for COVID-19 Vaccine
Administration is made between the County of San Diego (County) and the City of Carlsbad Fire Department (Fire
Agency).The parties to this Amendment may be referred to herein collectively as the "parties n or individually as a "party".
The parties entered into a Mutual Aid Agreement (MM) effective December 30, 2020 to provide assistance under the
Emergency Management Mutual Aid Plan for COVID-19 Vaccination assistance. The parties agree to this Amendment to
the MAA as follows:
•1) Section 14 of the MAA is hereby amended to read in its entirety as follows:
'This Agreement shall remain in force until September 30, 2021, unless sooner terminated
pursuant to Section 15.'
2)All other provisions of the MAA remain in full force and effect.
3)This Amendment is entered into on the date the last party signs this Amendment, but is effective as of April
30, 2021.
4)This Amendment may be executed in any number of separate counterparts, each of which shall be deemed
„,-,an original but all of which when taken together shall constitute one and the same instrument. The parties
agree that signatures transmitted electronically via pdf attachment shall be binding as if they were original
signatures.
Providir)g 4gency
By
Name: Scott Chadwick
Title: Director of Emergency Services
Agency: City of Carlsbad
Date:
Approved as to Form:
By iti/1466 :i ifaYVell'6e-4,,,_
Name: Celia A. Brewer
Title: City Attorney
Agency: City of Carlsbad Fire Department
Date: jirkiz.„<„ -7/
Requesting Jurisdiction
By AttStNA.
Name: Jason Malneritch
Title: Deputy Chief
County: San Diego County Fire
Date: 5/28/2021
SAN DIEGO COUNTY FIRE
IN COOPERATION WITH CAL FIRE
.1249 larnacha Road 1E1 Cajon I CA 92019
5510 Overland Avenue 1 Suite 250, San Diego CA 92123-1239
vAirw.sdcoun_tyfire._otE
Cie-79',51t5dica•
TONY MECHAM
FIRE CHIEF
HERMAN REMICK
DIRECTOR FIRE PROTECTION OiSTRiCT
FIRE AGENCY MUTUAL AID AGREEMENT FOR COVID-19 VACCINE ADMINISTRATION
Parties
This Fire Agency Mutual Aid Agreement for COVID-19 Vaccine Administration, including
any exhibits attached hereto (Agreement), is made between the County of San Diego (County)
and the fire agency identified on page 4 of this Agreement (Fire Agency). The parties to this
Agreement may be referred to herein collectively as the "parties" or individually as a 'party".
Recitals
WHEREAS, the County is combatting a global pandemic from Coronavirus Disease 2019
(COVID-19); and
WHEREAS, the Centers for Disease Control and Prevention (CDC) and California
Department of Public Health (CDPH) expect the pandemic outbreak to get worse before it
stabilizes; and
WHEREAS, the County's Public Health Officer has declared a local health emergency and
County and Fire Agency have each proclaimed a local emergency due to the COVID-19
pandemic; and
WHEREAS, on March 4, 2020, the State of California proclaimed a State of Emergency
as a result of the COVID-19 pandemic. COVID-19 is widespread in our community and requires
ongoing guidance from federal, State, and local Governments, as well as Public Health Officials.
The County of San Diego is working closely with regional partners to implement its Test, Trace,
and Treat (T3) Strategy to monitor the local situation, perform testing and disease investigation
activities, and provide support services to those impacted by the disease. A component under the
13 Strategy includes delivery and administration of COVID-19 vaccine; and
WHEREAS, County and Fire Agency are collaborative partners in ensuring the needs of
residents are met through the delivery of essential services. Vaccine administration is one such
essential service and Fire Agency is willing to provide mutual aid in the form of vaccine
administration; and
WHEREAS, subject to availability, Fire Agency will provide healthcare staff authorized to
administer vaccination services as well as other support staffing in conjunction with the County
and other municipal and private actors in order to safely, effectively, and timely administer COVID-
19 vaccinations as deemed necessary by the Public Health Officer, or designee; and
WHEREAS, the Agreement shall consist of this document, Exhibit A Scope of Work,
Exhibit B Information Privacy and Security Provisions, Exhibit C Payment Schedule, and Exhibit
D Federal Emergency Management Agency (FEMA) Provisions.
THEREFORE, in consideration of the foregoing recitals and the mutual covenants and
promises set forth below, and for other good and valuable consideration, receipt of which is nereby
acknowledged, the parties hereto agree as follows:
TERMS and CONDITIONS
1.Scope of Work. Fire Agency shall perform the work described in the "Scope of Work"
attached as Exhibit A to this Agreement_
2.Compensation: The Payment Schedule, and/or budget are set forth in Exhibit C. County will
pay Fire Agency the agreed upon price, pursuant to Exhibit C for the work specified in Exhibit
A, Scope of Work.
3.Indemnity and Insurance:
3.1. Claims Arising from Sole Acts or Omissions of a Party: Each party to this Agreement
hereby agrees to defend and indemnify the other party to this Agreement, its agents,
officers and employees, from any claim, action or proceeding against the other party,
arising solely out of its own acts or omissions in the performance of this Agreement. At
each party's sole discretion, each party may participate at its own expense in the defense
of any claim, action or proceeding, but such participation shall not relieve any party of any
obligation imposed by this Agreement. The parties shall notify each other promptly of any
claim, action or proceeding and cooperate fully in the defense.
3.2. Claims Arising from Concurrent Acts or Omissions: The parties hereby agree to
defend themselves from any claim, action or proceeding arising out of the concurrent acts
or omissions of the parties. In such cases, the parties agree to retain their own legal
counsel, bear their own defense costs, and waive their right to seek reimbursement of
such costs, except as provided in paragraph 3.3 below.
3.3, Joint Defense and Reimbursement and Reallocation: Notwithstanding paragraph 3.2
above, in cases where the parties agree in writing to a joint defense, the parties may
appoint joint defense counsel to defend the claim, action or proceeding arising out of the
concurrent acts or omissions of parties. Joint defense counsel shall be selected by mutual
agreement of parties. The parties agree to share the costs of such joint defense and any
agreed settlement in equal amounts, except as follows: parties further agree that no party
may bind another to a settlement agreement without the written consent of all parties.
Where a trial verdict or arbitration award, in a joint defense case, allocates or determines
the comparative fault of the parties, parties may seek reimbursement and/or reallocation
of defense costs, judgments and awards, consistent with such comparative fault.
3.4 Insurance: Each party shall obtain at its own cost and expense, and keep in force and
effect during the term of this Agreement, including all extensions, policies of insurance or
programs of self-insurance with policy limits in sufficient amounts to cover any and all
potential liabilities of such party hereunder. Policy limits shall in no way limit either party's
indemnification obligations.
4.Conformance with Rules and Regulations: The parties shall be in conformity with all
applicable federal, State, County, and local laws, rules, and regulations, and Executive
Orders, current and hereinafter enacted, including facility and professional licensing and/or
certification laws and keep in effect any and all licenses, permits, notices and certificates as
are required. The parties shall further comply with all laws applicable to wages and hours of
employment, occupational safety, and to fire safety, health and sanitation.
5 Confidentiality: Fire Agency shall protect the privacy and security of County information that
Fire Agency may create, receive, access, store, transmit, and/or destroy under this
Agreement. In addition, Fire Agency shall be in compliance with privacy and security
2
requirements as set forth in Exhibit B, as applicable. Exhibit B is attached and incorporated
by reference.
6. Governing Law: This Agreement shall be governed, interpreted, construed. and enforced in
accordance with the laws of the State of California.
7_ Federal and Federal Emergency Management Agency (FEMA) Provisions: The parties
agree that the vaccination services shall be provided in conformance with applicable federal
iaw and FEMA provisions as set forth in the attached Exhibit D. Exhibit D is attached and
incorporated by reference,
8.Third Party Beneficiaries Excluded: This Agreement is intended solely for the benefit of the
parties hereto Any benefit to any third party is incidental and does not confer on any third
party to this Agreement any rights whatsoever regarding the performance of this Agreement.
Any attempt to enforce provisions of this Agreement by third parties is specifically prohibited
9.Amendments to Agreement: Any party may propose amendments to this Agreement by
providing written notice of such amendments to the other party. This Agreement may only be
amended by a written amendment signed by both parties.
10.Severability: If any terms or provisions of this Agreement or the application thereof to any
person or circumstance shall, to any extent, be held invalid or unenforceable, the remainder
of this Agreement, or the application of such term and provision to persons or circumstances
other than those as to which it is held invalid or unenforceable, shall not be affected thereby
and every other term and provision of this Agreement shall be valid and enforced to the
maximum extent permitted by law.
11.Full Agreement: This Agreement and Exhibits A, B, C and D represent the full and entire
agreement between the parties with respect to the Project and supersedes any prior wrttten
or oral agreements with respect to the Project that may have existed.
12.Scope of Agreement: This Agreement only applies to the Project described herein and does
not set forth any additional current or future obligations or agreements between the parties,
except that the parties may by written amendment amend the scope of this Agreement.
13.Live Well San Diego Vision: The County of San Diego, Health and Human Service Agency
(HHSA), supports the Live Well San Diego vision of Building Better Health, Living Safely, and
Thriving. Live Well San Diego, developed by the County of San Diego, is a comprehensive,
innovative regional vision that combines the efforts of partners inside and outside County
government to help all residents be healthy, safe, and thriving. All HHSA partners and
contractors. to the extent feasible, are expected to advance this vision. Building Better Health
focuses on improving the health of residents and supporting healthy choices. Living Safely
seeks to ensure residents are protected from crime and abuse, neighborhoods are safe, and
communities are resilient to disasters and emergencies. Thriving focuses on promoting a
region in which residents can enjoy the highest quality of life.
13.1. Information about the Live Well San Diego can be found on the County's website and a
website dedicated to the vision.
http://wwvv.sdcounty.ca.00v/hhsa/programsisdilive well san diego/index.html and
http://www.LiveWelISD.oro
14.Term: This Agreement shall become effective on 12/30/2020 and be in force until April 30,
2021 and may be extended on a month to month basis upon agreement of the parties.
15.Termination for Convenience The parties may, by written notice stating the extent and
effective date, terminate this Agreement for convenience in whole or in part, at any time
16.Counterparts: This Agreement may be executed in any number of separate counterparts, each
of which shall be deemed an original but all of which when taken together shall constitute one
and the same instrument.
17.Administration of Agreement: Each party identifies the individual identified on the signature
page to serve as the authorized administrative representative for that party. Any party may
change its administrative representative by notifying the other party in writing of such change.
Any such change will become effective upon the receipt of such notice by the other party to
this Agreement. Notice of the authorized representative shall be sent to each party as follows:
County
Geoffrey Pemberton
Deputy Chief, North Operations
San Diego County Fire
619-590-3101
Geoff.Pemberton@fire,ca.gov
Fire Agency
Mike, C aid 61%00 CI
Elf 4.. CiAitc-
Cihl 04 Coe lc bad Virt boar-talon+
cr51
roictAm-et. ea softwood e CAyitjca. v
County of San Diego
Dated: ca/V By.
Geoffrey Pemberton
Deput Chief North Operations
SarA3igo County Fire
Agency Name
Dated: k c•-&-E.2-1 By:
Name:
Title:
'Sbrr 644t.I., lex
extV tift P.1"43
4
EXHIBIT A — SCOPE OF WORK
1. Target Population and Geographic Service Area
1 Fire Agency shall administer vaccines to persons as prioritized by the County at mutually
agreed and designated events andior locations within the San Diego County region.
2 General Requirements for Service Delivery
2.1. Fire Agency shall only use providers authorized by the state to administer COVID vaccine,
Providers authorized to administer vaccine include paramedics or other individuals that
the State may authorize in the future either through order, waiver or other decree or who
may be authorized through the proper delegated authority of someone authorized to do
so, so long as appropriately supervised.
2.2. Fire Agency shall maintain records on all licenses and certifications of staff administering
vaccines, as required.
2.3. Fire Agency shall provide primary and secondary points of contact to the County, including
emergency contact information and protocols, as requested by County.
2.4. Fire Agency shall adhere to protocols and procedures for vaccine administration as
identified by the County and State.
2.5. Fire Agency shall ensure individuals authorized to administer COVID vaccines have
completed all required training for the COVID vaccines as designated by the County.
3, Specific Requirements for Service Delivery
3.1, Vaccination Administration and Handling.
3.1.1, County will supply Fire Agency with all vaccinations and related supplies including
Personal Protective Equipment (PPE) for the performance of this work.
3.1,2. Fire Agency shall adhere to the storage and handling requirements in
accordance with vaccine package inserts and in accordance with CDC
Vaccine Storage and Handling Toolkit and maintain the cold chain integrity
of the vaccine at all stages of delivery and administration.
3.1.3. Fire Agency shall transfer or dispose of unused vaccine in accordance with CDC
Vaccine Storage and Handling Guidelines..
3.1.4. Fire Agency shall remove laionazard waste in accordance with California Department
of Public Health requirements.
3.1.5. Fire Agency shall administer licensed vaccines that may be available under an
emergency authorization according to accepted practice following the priority
recommendations from the Advisory Committee on Immunization Practices (ACIP)
and under the County's tier framework Fire Agency shall adhere to ACIP
recommended immunization schedule, dosage, and contraindications unless there
are exceptions based on medical judgment or state law.
3.1.6. Fire Agency shall follow ACIP recommendation to provide a 15-minute observation
time for persons receiving vaccine and 30 minutes for persons receiving vaccination
that have a history of an immediate allergic reaction of any severity to a vaccine or
injectable therapy andfor persons with a history of anaphylaxis due to any cause,
3.1.7. Fire Agency shall document the vaccines administered necessary to meet reporting
requirements for the California Department of Public Health (CDPH), CDC and any
other agencies as required for COVID-19 vaccine administration including the
County of San Diego. Fire Agency shall, coordinate with County to use SDIR for
documentation and reporting of immunization information.
3.1.8. Fire Agency shall report vaccinations administered information to County on
patients who have been vaccinated. The reporting shall comply with the
5
requirements as noted by the County for immunization reporting through electronic
means. Results shall be reported within 24 hours of administration consistent with
State and local reporting requirements
3.1.9. Fire Agency shall advise all patients that they have a right to decline to have their
immunization record shared with other health care providers, agencies, or schools
in the California Immunization Registry Fire Agency shall provide County with all
signed declination forms. These forms shall be delivered to County no later than
one week following vaccination administration date by fax at (619) 692-6619. by
mail, or by batch delivery in person to:
County of San Diego, Health and Human Services Agency,
Public Health Services. Epidemiology and Immunization Services Branch
3851 Rosecrans Street, Mai!stop P573, Suite YO4
San Diego, CA 92110
3.2. Fire Agency shall not charge the patient any surcharge, premiums or added costs.
3,3. Fire Agency shall make reasonable best efforts to ensure vaccines are only given to
patients in the applicable phased groups, understanding that the eagerness for consumers
to get the vaccine. creates an environment in which consumers may misrepresent their
status in a particular group. County is responsible tor identifying the patients who are to
receive vaccination at any vaccination site or event covered under this Agreement and
County understands and agrees that Fire Agency will not refuse to vaccinate any individual
who can provide proof of invitation for vaccination or other agreed upon documentation
that they are a patient in the applicable phased group. Further, County acknowledges that
Fire Agency will utilize the CDPI-i
(httbs://www.cdph. ca.gov/Proorams/CID/DCDC/Pages/COVID-19/Vaccine-
Prioritization.aspx) and other relevant CDC guidance to take reasonable measures to
ensure all vaccines prepared for administration are utilized arid not wasted, such that, at
the end of any vaccine event or day of a vaccine event, Fire Agency may administer
vaccine doses that might otherwise be wasted to patients who were not invited to the event
by County and who may be outside of the applicable phased group
6
EXHIBIT B — INFORMATION PRIVACY AND SECURITY PROVISIONS
1. Recitals. This Article is intended to protect the privacy and security of County information that Fire
Agency may create, receive, access, store, transmit, and/or destroy under this Agreement. In
addition to the below responsibilities, Fire Agency shall be in compliance with the following rules,
regulations, and agreements, as applicable:
1.1. Health Insurance Portability and Accountability Act, specifically, Public Law 104-191, the
Health Information Technology for Economic and Clinical Health Act, Public Law 111-005,
42USC section 17921 at seq., and 45CFR Parts 160 and 164, collectively referred to as
"HIPAA;"
1.2. County agreements with the State of California, collectively referred to as "State Agreements"
and posted on the County's website at: wvvw.cosdcompliance,m, including:
1.2.1. For Eligibility Operations contracts, the Medi-Cal Eligibility Data System Privacy and
Security Agreement Between the California Department of Social Services and the
County;
1.2.2. For Mental Health contracts, the Medi-Cal Behavioral Health Services Performance
Agreement between the California Department of Health Care Services (DHCS) and
the County;
1.2.3. For Substance Use Disorder contracts, the San Diego County Alcohol and Drug
Program Administrator Agreement between DHCS and the County;
1.2.4. For Aging and Independence Services contracts, the Standard Agreement between the
County and the California Department of Aging;
1.2.5. For Whole Person Wellness contracts, the Agreement for Whole Person Care Pilot
Program for San Diego County with OHCS; and
1.2.6. For Public Health Services contracts, the Standard Agreement between the County and
the California Department of Public Health.
1.3, Title 42 Code of Federal Regulations, Chapter 1, Subchapter A, Part 2.
2 Definitions. Terms used, but not otherwise defined, in this Article shall have the same meaning as
defined by HIPAA.
2.1 "Breach" of Protected Health Information (PHI) shall have the same meaning given to the term
"breach" under HIPAA and "breach" of Personal Information (PI)/Personally Identifiable
Information (PII) shall have the same meaning as given to it under the State Agreements.
2.2. "Business Associate," when applicable, shall mean Fire Agency.
2.3. "County PHI" shall have the same meaning as PHI under HIPAA, specific to PHI under this
Agreement.
2.4. "County P1/PIE" shall have the same meaning as PI/P11 under the State Agreements, specific to
PI/PII under this Agreement,
2.5, "Covered Entity," when applicable, shall mean the County.
2.6. "Security incident" shall have the same meaning as defined by the State Agreements
3. Responsibilities of Fire Agency,
3.1. Use and Disclosure of County PHI/PUPII, Fire Agency shall use the minimum County PHI/PI/P11
required to accomplish the requirements of this Agreement or as required by Law. Fire Agency
may not use or disclose County PHI/Pl/PI I in a manner that would violate HIPAA or the State
Agreements if done by the County.
3.2. Safeguards. Fire Agency shall ensure sufficient administrative, physical, and technical controls
are in place to prevent use or disclosure of County PHI/PI/PH,
3.3. Mitigation. Fire Agency shall mitigate, to the extent practicable, any harmful effects caused by
violation of the requirements of this Article, as directed by the County.
3.4. Subcontractors. Fire Agency shall ensure that any agent, including a subcontractor, to whom
it provides County PHI/PI/PI!, imposes the same conditions on such agents that apply to Fire
Agency under this Article.
3.5. Cooperation with County.
3.5.1. Fire Agency shall provide access to County PHI/PI/PI!, as well as internal practices and
records related to County PHI/PI/PI!, at the written request of County within ten (10)
calendar days.
3.5.2, Fire Agency will assist County regarding individual's access, copy, amendment,
accounting of disclosure, and other such requests for County PHI/PI/PH in the time and
manner designated by County.
3.6. Breach Reporting. Fire Agency shall report breaches and suspected security incidents to
County, to include:
3.6.1. Initial Report.
3.6.1.1. Fire Agency shall email County Contracting Officer's Representative (COR)
and HHSA Privacy Officer immediately upon the discovery of a suspected
security incident that involves data provided to County by the Social Security
Administration, as per the State Agreements.
3.6.1.2. Fire Agency shall email COR and HHSA Privacy Officer immediately of
breaches and suspected privacy incidents involving 500 or more individuals.
3.6.1.3. Fire Agency shall additionally submit an online County "Privacy Incident
Report" through the online portal at www.cosdcompliance.org within one (1)
business day for all breaches and suspected security incidents.
3.6.2. Investigation Report. Fire Agency shall immediately investigate such suspected
security incident or breach and provide the County a complete report of the
investigation within seven (7) working days using County's "Privacy Incident Report"
online form.
3.6,3. Notification. Fire Agency will comply with County's request to notify individuals and/or
media and shall pay any costs of such notifications, as well as any costs associated
with the breach. County shall approve the time, manner and content of any such
notifications before notifications are made..
3.7. Designation of Individuals. Fire Agency shall designate a Privacy Official and a Security Official
to oversee its privacy and security requirements herein.
3.8. Termination. Upon termination of the Agreement for any reason, Fire Agency shall return or
destroy all County PHI/PO/PI, except County PHI/PII/PI necessary for Fire Agency to continue
its proper management and administration or to carry out its legal responsibilities, as mutually
agreed upon by the Parties. If the Parties mutually agree that return or destruction of County
PHI/PH/PI is infeasible, Fire Agency shall extend the protections of this Article to such County
PHI/PII/PI for so long as Fire Agency maintains such County PHI/PII/PI
8
EXHIBIT C — PAYMENT SCHEDULE
1 Term. Fire Agency shall be compensated during the Initial Term pursuant to Table A. below,
including any Option(s) period, if exercised.
2. Reimbursement Rates. Fire Agency shall be compensated no more than the stated California
Fire Assistance Agreement (CFAA) rate listed for Vaccine Administration in Table A.
2.1. In the event Fire Agency receives additional sources of funds from a third party, Fire
Agency shall work with the County to credit the County's costs on vaccination services,
Table A.
Service Description Reimbursement Rate Administration Rate
Vaccine Administration Published CFAA Approved Rate Published Administrative Rate
3.invoices.
3.1. Fire Agency shall invoice the County monthly and submit appropriate documentation as
requested by the County.
3.2. invoices must also include Fire Agency's National Provider ID number, date of service,
location of service, description of service(s), number of vaccinations, vaccination fee and
all required documentation that supports reimbursement costs incurred in the billing cycle
for venue/site logistics.
3.3. Invoice approval is subject to County's review. Invoices without complete and proper
documentation may be subject to a delay in payment.
3.4. Invoices shall be submitted via e-mail to: James (Mike) Weissenburger
James.Weissenburgerasdcounty.ca.gov
4.Invoice Certification.
4.1. Invoice shall contain the following certification:
I certify that the above deliverables and/or services were delivered and/or performed
specifically for this Agreement in accordance with the terms and conditions set forth herein. I
further certify, under penalty of perjury under the laws of the State of California, that no
employee or entity providing services under the terms and conditions of this Agreement
is currently listed as debarred, excluded, suspended, or ineligible on the Federal
System for Award Management (SAM: http://SAM.gov), the Federal Health and Human
Services Office of Inspector General List of Excluded Individuals/Entities (LEIE.
http://exclusionsmig.hhs.gov), or the State of California iViedi-Cal Suspended and
ineligible list (wvvw.medi-cal.ca.gov).
Printed Name & Signature Date Signed Telephone & Fax Number
9
EXHIBIT D — FEDERAL AND FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA)
PROVISIONS
Fire Agency shall, as a condition of this contract, and for the duration of the contract and any
extension of the contract or surviving conditions contained therein as required by the County,
be in compliance with the following stipulated conditions and applicable federal provisions:
1.Access to Records:
1.1. Fire Agency agrees to provide the County, the State of California, the federal agency
Secretary or Administrator, the Comptroller General of the United States, or any of their
authorized representatives access to any books, documents, papers, and records of the
Owner which are directly pertinent to this Occupancy Agreement for the purposes of
making audits, examinations, excerpts, and transcriptions
1.2. Fire Agency agrees to permit any of the foregoing parties to reproduce by any means
whatsoever or to copy excerpts and transcriptions as reasonably needed.
1.3 Fire Agency agrees to provide the federal agency Secretary or Administrator or his
authorized representatives access to construction or other work sites pertaining to the
work being completed under the Agreement.
1.4 In compliance with the Disaster Recovery Act of 2018, County and Fire Agency
acknowledge and agree that no language in this Agreement is intended to prohibit audits
or internal reviews by the federal agency Secretary or Administrator or the Comptroller
General of the United States.
2.Department of Homeland Security Seal. Logo, Flag: Fire Agency shall not use the DHS seal(s),
logos, crests, or reproductions of flags or likenesses of OHS agency officials without specific
FEMA pre-approval.
3.Compliance with Federal Law, Regulations, and Executive Orders: This is an acknowledgement
that federal financial assistance may be used to fund all or a portion of the Agreement. Fire
Agency will comply with all applicable Federal law, regulations, executive orders, federal
agency policies, procedures, and directives
4.No Obligation by Federal Government: The Federal Government is not a party to this
Agreement and is not subject to any obligations or liabilities to the County. Fire Agency, or any
other party pertaining to any matter resulting from the Agreement.
5, Program Fraud and False or Fraudulent Statements or Related Acts Fire Agency
acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False Claims and
Statements) applies to Fire Agency's actions pertaining to this Agreement.
6. Single Audit: Fire Agency shall comply with the Single Audit requirements of 2 CFR Part
200.501, et seq.
California Governor's Office of Emergency Services (Cal OES} - Fire and RCS= flivisioa
2020 SALARY SURVEY / ADMINISTRATIVE RATE
for
AGREEMENT FOR LOCAL GOVERNMENT FIRE AND EMERGENCY ASSISTANCE TO
THE STATE OF CALIFORNIA AND FEDERAL FIRE AGENCIES
(California Fire .Assistance Agreement)
Please complete the salary survey information sheet. A2 fields on this form that pertain to your agency are required, or may be returned due to lack of
information. Return your completed survey as soon as possible to:
Cal OES FireandReseueDivision
36S0 Schriever Ave Mather, Ca Morals 95655
-or-
cfaareirnbursement@caloes.ca.eov
(Cal OES will verity receipt ofyour mailed salary survey by replying "received")
Agency 3-Letter MACS ID.: CBD
Agency / Department Name: City of Carlsbad Fire Department
Chiefs Name: Mike Calderwood
Chiefs Email Address*: rnichael.calderwood.darlsbadca.gov
Department Email Address: Jennifer.marinov@carlsbadca.gov
Physical Address, City, State, Zip: 2560 Orion Way
Mailing Address, City, State, Zip: Carlsbad, CA 92010
Telephone Number: 760-931-2141
FAX Number 760-929-0258
Federally Recognized Tribe? Yes I No:MI Federal Fire Dept.? Yest] No: MI I Dept of Defense? Yes:0 Noliii Volunteer Fire Dept.? Yes:0 DI MI
•Email !s for the Individual responsible far reviewing and processing the salary survey, administrative rate. and Invoices,
All information provided on this form is subject to audit by Cal OES, CAL FIRE, and the Federal Fire Agencies signatory to the California Fire
Assistance Agreement.
Please provide the hourly Salary Rate, or Base Rate for each classification used by your agency that is reflected in the chart below,
Insirarrions for Comaleiine the 2020 Cal OES Satan, Surrea I Instructions for Comaktinz ridmi fistrolive Rate Calculations
Classification Title Base Rates (Si)
as of 05/01/2020
Salary Rate or Base Rate
(Si) as of: June 24, 2020
Above B/C with 11/1
MOU/MOA for above for Straight Time (OD_
MOU/MOAJGBR
Portal-to-Portal
Chief $27.14 /per hour 107.10 /per hour Yes: • No: ME Yes: No:0
Deputy Chief $27.14 /per hour 0.00 /per hour Yes:- a No: ME Yes: No: L1
1
Division Chief $27.14 /per hour 89.69 /per hour Yes: • No: II Yes:I No:0
Yes: No:0
Yes: LE No: [3
Assistant Chief $27.14 /per hour 96.63 /per hour Yes: No: INI
Battalion Chief $27.14 /per hour 53.33 /per hour
Co. Officer/Capt./Lt. $22.58 /per hour 39.74 /per hour
Yes: IN No:
App. Officer/Engineer $22.58 /per hour 35.32 /per hour
Yes: f No:0
Firefighter/FF-PMedic $22.58 /per hour 32.60 /per hour
Yes: WE No: •
Administrative Rate** (due by July 1st): 0.16576 i Enter as Decimal
Agency Federal Taxpayer I.D. Number or Federal Employee ID. Number: 95-6004793
Agency Data Universal Numbering System (DUNS) Number: 073333932
FISCal Supplier I.D. Number: . 0000421397
NOTE: These rates are not effective until the date they arc received by Cal OES.
"If your agency has an administrative rate on file, you are required to update and complete an administrative rake calculation sheet
(Page 2) by July 1,2020. After that date, the rate wilt default to the de minimis of 10%.
What is reported on this form constitutes direct salary costs fur employees.
As an authorized representative of my agency/dept., I certify to the best of my knowledge and belief, and under penalty of perjury that this information is correct. Furthermore, my signature below represents acceptance by my agency/dept., as a cooperator, to comply with the authorities, teems and conditions of the CFAA. I also agree to comply with all cooperator agency internal accounting and expense reimbursement standards,
Michael Calderwood
CI,2 9 620 ?CI
Date A*'I, 2020
Mat Wane
Cal ORS Ore and Rescue &vista"- 2020,SalatyStrevey /Adeline:teethe Rate
California Governor's Office of Emergency Services (Cal OES) - Fire and Rescue Division
2020 SALARY SURVEY / ADMINISTRATIVE RATE
for
AGREEMENT FOR LOCAL GOVERNMENT FIRE AND EMERGENCY ASSISTANCE TO
THE STATE OF CALIFORNIA AND FEDERAL EIRE AGENCIES
(California Fire Assistance Agreement)
Agency 3-LetterMACSI.D.: CBD Agency/Dept Name: City of Carlsbad Fire Department
FY 18 19 , Data for use in 2020 Fire Agreements
Year
Administrative Rate(Include ONLY allowable costs and use whole numbers
PROGRAM INDIRECT DIRECT TOTAL
Emergency Medical Services 361,080 25,624 386,704
General Administration 1,722,708
1,722,708
Information Technology 517,336
517,336
Logistics / Procurement / Supply / Minor Fire Equipment _ 515,945
515,945
Public Information Office 0
o
Telecommunications 112,549
112,549
Arson Investigation
0 o
Community Education
0 o
Facilities
241,565 241,565
Fire Comm. Center /Dispatch / Comm. & Control Center
674,982 674,982
Fire Hazard Reduction Program
87,718 87,718
Fleet
941,266 941,266
Hazardous Materials Response Program
169,709 169,709
Mapping
4,617 4,617
Operations
15,982,774 15,982,774
Prevention
1,138,839 1,138,839
Training
153,969 153,969
Urban Search and Rescue
63,055 63,055
GRAND TOTALS _ 3,229,618 19,484,118 22,713,736
ADMINISTRATIVE RATE (INDIRECT COST/DIRECT COST): 0.16576
As an authorized representative of my agency/dept., I certify to the best of my knowledge end belief, and under penalty of perjury that the
administrative rate is correct and is established in accordance with the negotiated California Fire Assistance Agreement using the Imp:talons for
Coyipleting Administrative Rate Calculations and !CRP Delnitions. Furthermore, my signature below represents acceptance by my agency/dept.„ as a cooperator, to comply with the authorities, terms and conditions of the CFAA.
Michael Calderwood
lc,20!,10 /—
PPM Armee
Cal OES Rae and Rereve &Wean -2020 Vary&tneyi Adwailstragee Rate
Date
May I, 2020
Agency/Dept. 3-LetterMACS ID PrintAgency/DiparfttantNarna
Michael Calderwood
Print Name /Worked R Cal OES Fire am' Rescue Diviston-AfftfthmentA, Non-Suppres.rean Perronne Daft
May 2020
California Governor's Office of Emergency Services (Cal OES) - Fire and Rescue Division
ATTACHMENT A. NON-SUPPRESSION PERSONNEL
For
2020 SALARY SURVEY if ADMINISTRATIVE RATE
AGREEMENT FOR LOCAL GOVERNMENT FIRE AND EMERGENCY ASSISTANCE TO
THE STATE OF CALIFORNIA AND FEDERAL FIRE AGENCIES
(California Fire Assistance Agreement)
Please complete this attachment for all NON-SUPPRESSION PERSONNEL and return to:
Cal OES - Fire and Rescue Division
3650 Schriever Ave Mather, California 95655
-or-
efaareimOursement@,catoes.ca.eov
(Cal OES will verb receipt ofyour emoiled salary survey by replying 'received')
A.Please provide the hourly Salary Rate for each non-suppression classification for Suppression Personnel. Instructions for
calculating the Salary Rate are provided in the instructions for Completing the 2020 Cal Oa Salary Survey.
B.If "MOU/M0A/OBR or equivalent for Portal-to-Portal" is checked "Yes", a complete copy of the relevant document(s) must
be submitted with the salary survey for review. Failure to submit will prevent the classification(s) from being considered for
portal-to-portal reimbursement. Please review the salary survey instructions regarding the MOU/MOAJOBR or equivalent
for tuneline requirements.
CLASSIFICATION TITLE
13
Salary Rate (Straight Time) as
of June 24, 2020
MOU/MOA/GBR or
equiv. for Portal-to-Portal
Fire Marshal 75.38 /per Hour Yes 41 No:0
Assistant Fire Marshal 57.91 /per Hour Yesal No:0
Fire Prevention Specialist 1 37.26 /per Hour Yes:II No: II
Fire Prevention Specialist 11 41.58 /per Hour Yes0 Nolp
Assistant Director of Emergency Services 77.27 /per Hour Yes:10 Noll
NThZ31-
/perilous Yes:0
/per Hour Yes:El N0:0
/per Hour Yes: 111 No:0
/per Hour Yes:0 No:0
/per Hour Yes:0 No:0
/per Hour Yes:0 No:0
/per Hour Yes:0 No:0
/per Hour Yes:0 No:0
/per Hour Yes: No:0
/per Hour , Yes:0 No:0
Yes:0 No:0
/per Howl
/per Hour Yes:0 No:0
more space is required,please use another copy oft is form.)
NOTE: These rates are not effective until the date they are received by Cal OES,
THE RATES REPORTED ON THIS FORM CONSTITUTE DIRECT SALARY COSTS FOR EMPLOYEES AND ARE NOT CONTINGENT UPON THE CFAA FOR REIMBURSEMENT.
As an authorized representative of my agency/dept., I certify to the best of my knowledge and belief, and under penalty of perjury that this information is correct. Furthermore, my signature below represents acceptance by my agency/dept., as a cooperator, to comply with the authorities, terms and conditions of the CFAA. I also agree to comply with all cooperator agency internal accounting and expense reimbursement standards.
CBD City of Carlsbad Fire Department