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Home My WebLink AboutFEMA Griggs GulfFEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0151 PROJECT WORKSHEET I Expires April 30, 2001 PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this form is estimated to average 30 minutes. The burden estimate includes the time for reviewing Instructions, searching existing data sources, gathering and maintaining the needed data, and completing and submitting the forms. You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right :.omer of the forms. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Wbrmation Collections Management Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472, 'aperwork Reduction Protect (3067-0151). NOTE: Do not send Your completed form to this address. --�D�GLARAS I9 N NO. _NY !PRO TOH 003 ECT NO. IFIPS NO. D23-3218fl-00 DATE 8/29!2005 CATEGORY C DAMAGED FACILITY WORK COMPLETE AS OF: Roads 7/13/2005 0% APPLICANT (COUNTY Town of Harford Cortland .00ATION IN LATITUDE LONGITUDE 3riggs Gulf Road 42.41523 IW 76.18593 DAMAGE DESCRIPTION AND DIMENSIONS During the declared incident period from April 2, 2005 to April 4, 2005 the Town of Harford experienced severe flooding and substantial rainfall 'hat damaged shoulders and roads townwide. A number of sections of shoulder totalling 650' along Griggs Gulf Road were completely washed 3ut 4' wide and 4.5' deep on average. SCOPE OF WORK Repair damaged shoulder sections along Griggs Gulf Road. Install 650' of large stone, 3'W x 4.5'H rip rap. Baddill with granular material to -estore shoulder and fill spaces in between riprap. Does the scope of work change the pre -disaster conditions at the site? N Special Considerations issues included? Y Hazard Mitigation proposal included? N Is there insurance coverage on this facility:' N PROJECT COST ITEM CODE DESCRIPTION UNIT QUANTITY UNIT PRICE 9002 Work to be done 3250 SLOPE PROTECTION RIP RAP 3040 BACKFILL (GRANULAR) - 4 - ENTER FEMA COST CODES a- - - ENTER FEMA COST CODES <- t- t- ENTER FEMA COST CODES <- c_ <- <- ENTER FEMA COST CODES <- c <- c. ENTER FEMA COST CODES ENTER FEMA COST CODES ENTER FEMA COST CODES PREPARED BY: Soon O PAL HuA h M/u , FEMA PO FEMA Form 90-91, SEP 98 '+ 0 $ - CY $ 325.00 $ 60.00 CY $ 48.10 $ 16.00 COST $19,504.00 $769.60 TOTAL COST $20,269.60 :TITLE: Town Supervisor Rav Marsh REPLACES ALL PREVIOUS EDITIONS. FEDERAL EMERGENCY MANAGEMENT AGENCY SPECIAL CONSIDERATIONS QUESTIONS APPLICANT'S NAME 2, FIFS NUMBER 3. DATE Town of Warford 023-3216 6/29/2005 4. PROJECT NUMBER 5. LOCATIO FEMA TOH 003 Gdps Gulf Road 1589 Form must be filled out—for each praJect. 1. Does the damaged facility or item of work have Insurance andtor is it an insurable risk? (e.g.. braIWRO, 0i*Pmen4 vehk =s. ems) yes No Unsure COMMENTS: x 2. is the damaged facility located within a floodplain or coastal high hazard area, or does k have an impact on a floodptatn or wetland? Yes No Unsure COMMENTS: I x 3. Is the damaged faaily or item of work located within or adjacent to a Coastal Barrer Resource System Unit or an Otherwise Protected Area? yesINo I Unsure COMMENTS: x I! 4. Va the proposed facility repatrslreoonstructien change the pre -disaster cOndifiM7 (e.g.. hloWnt, materrar, focatfarr, cepeaty, use orfuncBon) Yes No Unsure COMMENTS: X 5. Does the appkArIt have a hazard mitigation proposal or would the aPP'ir-wt like technical assistance for a hazard m tigaW" propesel? YesI No I Unsure I COMMENTS: JI x 3. Is the damaged faaRy on the National Register of Historic Places or the state hlstorie listing? Is It older than 50 years? Are there more, similar buildings near the site? Yes No Unsure COMMENTS: x 1. Are there any pristine or undisturbed areas on, or near, the project site? Are there large tracts of forestland? yes NoI Unsure COMMENTS: x 3. Are there any hazardous materials at or adjacent to the damaged facility andlor dam of work? YesI No I Unsure COMMENTS: x 9 Are there arty other environmentally or conlroversiai Issues assodated with the damaged (ad anNar item of work? YesNo Unsure COMMENTS: Subject bank and shouters are along Griggs Gulf Creels. I x FEMA Form 90-120, NOV 96 FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0151 PROJECT WORKSHEET Expires April 30, 2001 PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this form is estimated to average 30 minutes. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and submitting the forms. You are not required to respond to this collection of information unless a valid OM6 control number is displayed in the upper right comer of the forms. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472, Paperwork Reduction Proiect (3067-0151). NOTE: Do not send your completed form to this address. DECLARATION NO. (PROJECT NO. IFIPS NO. DATE CATEGORY FEMA- 1589 -NY f TON 002 I 023-32160-00 6/29/2005 1 C DAMAGED FACILITY WORK COMPLETE AS OF: Gabion Basket Wall 7/13/2005 0 APPLICANT lCortland COUNTY Town of Harford LOCATION Griggs Gulf Road LATITUDE LONGITUDE N 42.41637 W 76.19337 DAMAGE DESCRIPTION AND DIMENSIONS During the declared incident period from April 2, 2005 to April 4, 2005 the Town of Harford experienced severe flooding and substantial rainfall That caused washouts and shoulder damage townwide. Along Griggs Gulf Road, in Griggs Gulf Creek, a 100' long gabion basket and wood slope protection wall was damaged. The gabion baskets were two baskets high (Teach), totaling 6' high with a width of 3'. SCOPE OF WORK Applicant will utilize force account labor, materials and equipment to remove the gabion baskets and restore embankment by installing two courses of large, heavy (3'x 3') rip rap along the entire 100' embankment. This is considered a good construction practice. Does the scope of work change the pre -disaster conditions at the site? _ Y Special Considerations issues included? Y Hazard Mitigation proposal included? N Is there insurance coverage on this facility? N PROJECT COST ITEM CODE DESCRIPTION UNIT QUANTITY I 9G02 Work to be done 0 I $ 4101 GABION BASKET REMOVAL CY $ 66,70 $ 3250 SLOPE PROTECTION RIP RAP Cy $ 66.70 $ <- < < ENTER FEMA COST CODES ENTER FEMA COST CODES ENTER FEMA COST CODES G ENTER FEMA COST CODES { ENTER FEMA COST CODES <_ <_ <- <- ENTER FEMA COST CODES ENTER FEMA COST CODES ENTER FEMA COST CODES I PREPARED BY: Scott Linder, SEMO PAL Hugh Murphy, FEMA PO UNIT PRICE 5.00 60.00 TOTAL COST TITLE: Town 13upervisor Ray Marsh COST $333.50 $4,002.00 $4,335.50 in FEMA Form 90-91, SEP 98 REPLACES ALL PREVIOUS EDITIONS. J FEDERAL EMERGENCY MANAGEMENT AGENCY SPECIAL CONSIDERATIONS QUESTIONS 1, APPLICANTS NAME 2, FIPS NUMBER 3. DATE Town of Harford 023-32160-001612912005 4. PROJECT NUMBER 5, LOCATION FEMA TOH 002 GriUc s Gulf Road 1589 Form must be filled out—for each project. t. Does the damaged facility OF item of work have insurance and/or is it an insurable risk? (e, g, buildings, equipment, vehicles, etc.) YesINo I Unsure I COMMENTS: x 2. Is the damaged facility located within a fioodpiain or coastal high hazard area, or does it have an impact on a floodplain or wetland? YesJ No Unsure COMMENTS: !I X 3, Is the damaged facility or item of work located within or adjacent to a Coastal Barrier Resource System Unit or an Dtherwisa protected Area? Yes No Unsure COMMENTS: X 4. Wi€1 the proposed facility repairs/recomtruction change the pre -disaster condition? (eg., f 4o rint, material, bcation, capacity, use orfunclion) Yes I No Unsure COMMENTS: Site will be changed from gabion baskets to riprap, X II 5. Does the applicant have a hazard mitigation proposal or would the applicant tike technicat assistance for a hazard mitigation proposal? YesII No Unsure COMMENTS: X I[ III 6, Is the damaged facility on the National Register of Histoffo Places or the state historic listing? is it otdor than 50 years? Are there more, similar buildings near the site? Yes No Unsure` COMMENTS: X !J 7. Are there any pristine or undisturbed areas on, or near, the project site? Are there large tracts of forestland? Yes No Unsure COMMENTS: x 3. Are there any hazardous materials at or adjacent to the damaged facility andfor item of work? Yes No Unsuref COMMENTS: x 1 9. Are there any other environmentally or controversial Issues associated with the damaged facility and/or item of work? Ye is s No Unsure COMMENTS: The subject embankment is on Griggs Gulf Creek. FEMA Form 90-120, NOV 98 APPLICANT PROJECT OR SITE NO, Town of Harford PAGE OF TOH 002 CALCULATIONS OF WORK TO BE DONE SCOPE OF WORK DETAILED ON THIS ESTIMATE SHEET: FEMA Remove gabion baskets 1DO'L x 3'W x VH and install twn courses of large (3'W x 3'D) oprap. 1589 0 0��Q' p�� DESCRIPTION P J� GO P G 'IV 40 � Site 9 4101 GABION BASKET REMOVAL 100 3 6 66.7 CYJ Site 1 3250 SLOPE PROTECTION RIP RAP j $ 5.00 $ 333.33 100 3 6 66.71 CY j $ 60.00 1 $ 4,000.00 0 �<_ <_ <- <- ENTER FEMA COST CODES 0 <_ <• <- <- ENTER FEMA COST CODES 0 <- <_ <_ <_ ENTER FEMA COST CODES f 0 <_ <-,c- <- ENTER FEMA COST CODES 0 <- <- <- <_ ENTER FEMA COST CODES I 0 a <_ <. <- ENTER FEMA COST CODES 44� 0 �< <- <- <- ENTER FEMA COST CODES f 0 <- <- c_ <_ ENTER FEMA COST CODES 0 <_ <. <- <- ENTER FEMA COST CODES I ENTER FEMA COST CODES 0 j<- <- <. <- ENTER FEMA COST CODES III 0 I'<- <- <- <_ ENTER FEMA COST CODES 0 c_ <_ <. <- ENTER FEMA COST CODES l 1 ! ENTER FEMA COST CODES � r 0 <- <_ <_ <- ENTER FEMA COST CODES <- ENTER FEMA COST CODES USER MAY INPUT OWN DATA HERE USER MAY INPUT OWN DATA HE 1 RE USER MAY INPUT OWN DATA HERE USER MAY INPUT OWN DATA HERE GRAND TOTAL: $ 4,333.33 APPLICANT PROJECTOR SITE NO, PAGE OF Town of Harford TOH 002 Hazard Mitigation Calculation Worksheet SCOPE OF WORK DETAILED ON THIS ESTIMATE SHEET: FEMA Instal; 100' of large stone, 21W x 4'FI rip rap. Backfill with granular malarial to repair shoulder and fill spaces in dpfap. DESCRIPTION Site 1 3250 'SLOPE PROTECTION RIP RAP Site 1 3040 (BACKFILL {GRANUL M 0 ENTER FEMA COST CODES 0 <- <. <- a ENTER FEMA COST CODES 0 <- <- <- <- ENTER FEMA COST CODES 0<. <- <_ <- ENTER FEMA COST CODES 0 I<. < <_ <_ ENTER FEMA COST CODES 0 <- ENTER FEMA COST CODES <- ENTER FEMA COST CODES 0 II< �- <- ENTER FEMA COST CODES 0 II4 < <_ <_ ENTER FEMA COST CODES 0 {<- 4 c- <_ ENTER FEMA COST CODES 0 <- <_ <_ e- ENTER FEMA COST CODES 0 �< <- < c_ ENTER FEMA COST CODES 0 r<_ <. <_ <_ ENTER FEMA COST CODES 0 IG < <- <- ENTER FEMA COST CODES 0<. <. <_ <- ENTER FEMA COST CODES 0<- < <- <- ENTER FEMA COST CODES USER MAY INPUT OWN DATA HERE USER MAY INPUT OWN DATA HERE USER MAY INPUT OWN DATA HERE USER MAY INPUT OWN DATA HERE 100 100 I 1589 2 I 3 22.2 Cy 1$ 66.00 $ 4,000.00 355.56 GRAND TOTAL: $ 4,355.56 Federal Emergency Management Agency JHAZARD MITIGATION PROPOSAL (HMP) 1589 APPLICANT PROJECT NUMBER CATEGORY Town of Harford TOH 002 C SCOPE OF MITIGATION WORK: FEMA COST CODE 4100 3250 3040 PREPARED BY: MATERIAL AND/OR DESCRIPTION <- <- <- <- ENTER FEMA COST CODES ROCK AND WIRE BASKETS (GABIONS) SLOPE PROTECTION RIP RAP BACKFILL (GRANULAR) <- <- <_ <_ ENTER FEMA COST CODES <- <- <- <. ENTER FEMA COST CODES <- <- <- <- ENTER FEMA COST CODES <_ <_ <_ <_ ENTER FEMA COST CODES < < < <- ENTER FEMA COST CODES <- <_ <- - ENTER FEMA COST CODES <- <- <- K- ENTER FEMA COST CODES <_ <- <. <_ ENTER FEMA COST CODES <- <- — ENTER FEMA COST CODES Ray Marsh ESTIMATE OF WORK QUANTITY UNITS UNIT PRICE -88.9 CY $ 120 $ 44.4 CY $ 60 $ 22.2 I CY $ 16 $ 1 II DATE 6/29/2005 r COST (10,668) 2,664 355 NET TOTAL COST -> (IN ADDITION TO PROJECT WORKSHEET TOTAL) $ (7,649) TITLE: Town Supervisor HAZARD MITIGATION ACTIVITY Category C, D, E, F and G Projects Only: IZI Check here if effective mitigation is feasible on this project: Check here if mitigation will be performed on any site in this project: ED Codes and Standards 0 Good Construction Practices FE Mitigation Policy 15% IE List BIC (Attach BIC analysis) Other Category C, D,E, F and G Project Only: Please enter the percentage of the project or the estimated amount for HM: %1 � $� -$7,64$.801 Check here if you wish to attach a Hazard Mitigation Proposal: FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0151 PROJECT WORKSHEET I Expires April 30, 2001 PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this form is estimated to average 30 minutes. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and submitting the forms. You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right comer of the forms. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472, Paperwork Reduction Project (3067-0151). NOTE: Do not send your completed form to this address. DECLAFEMA- X15$9 TION NO -NY PRO TOH Q0ECT � IFIPS N O. 023-32160-00 DATE 711412005 (CATEGORY C DAMAGED FACILITY WORK COMPLETE AS OF: Griggs Gulf Road Culvert #1 7/14/2005 0% APPLICANT COUNTY Town of Harford Cortland LOCATION(LATITUDE ]LONGITUDE Griggs Gulf Road !N 42.41884 IW 76.18057 DAMAGE DESCRIPTION AND DIMENSIONS During the declared incident period from April 2, 2005 to April 4, 2005 the Town of Harford experienced severe flooding and substantial rainfall That damaged culverts and embankments throughout the town. A 5'x8' squash culvert on Griggs Gulf Road was destroyed and riprap around the upside and downstream sides were washed away. The squash culvert was located in a 10'W x 201 x 5'D space between two concrete abutments that measured 201 x 1'W x 5'D each. The abutments are 1' below the road. SCOPE OF WORK Utilizing force account labor, equipment, stock materials and purchased materials the Applicant will restore the culvert to its' pre -disaster condition and then mitigate. Excavate the site 1 UW x 6'D x 20% in between two 201 x 5'D x 1'W abutments, furnish and install a 72"CMP that is the approximate equivalent of 5'H x 8'W, which is the size of the pipe that was damaged. Rip rap on both sides upstream and downstream 101 each by 6'D x 4'W. Cover with granular surface course. A hazard mitigation proposal is attached to upgrade to a 96" squash pipe (112" x 75") and remove and demolish the abutments. Does the scope of work change the pre -disaster conditions at the site? N i Special Considerations issues included? Y Hazard Mitigation proposal included? Y Is there insurance coverage on this facility? N PROJECT COST ITEM CODE DESCRIPTION UNIT QUANTITY UNIT PRICE 9002 Work to be done 0 $ <- <- <- <- ENTER FEMA COST CODES 3361 CMP 72" (FURNISH AND INSTALL) LF 3251 SLOPE PROTECTION RIP RAP (DUMPED) CY 3010 AGGREGATE SURFACE COURSE TON ENTER FEMA COST CODES ENTER FEMA COST CODES ENTER FEMA COST CODES ENTER FEMA COST CODES <- <_ <_ <_ ENTER FEMA COST CODES ENTER FEMA COST CODES PREPARED BY: Scott Linder, SEMO PAL Hugh Murphy, FEMA PO COST $ 40.00 $ 198.00 $7,920.00 $ 35.60 $ 44.00 $1,566.40 $ 4.90 $ 19.00 $93.10 TOTAL COST (TITLE: Town Supervisor Ray Marsh FEMA Form 90-91, SEP 98 REPLACES ALL PREVIOUS EDITIONS. $9,579.50 2. is the damaged facility located within a floodplain or coastal high hazard area, or does it have an impact on a floodplain or wetland? Yes No Unsure COMMENTS: X 3, Is the damaged facility or item of work located within or adjacent to a Coastal Barrier Resource System Unit or an Otherwise Protected Area? Yes i No I Unsure COMMENTS: 1 X 4. VMIi the proposed facility repairstreconstruction change the pre4isaster condition? (e.g.. tbofprfnt, material, 100800n, capacity, use or functton) Yes I No E Unsure COMMENTS: Site will be mitigated by removing abutments and upgrading Culvert sizes. X Ij 5. Does the applicant have a hazard mitigation proposal or would the applicant like technical assistance for a hazard mitigation proposal? Yes j No I Unsure COMMENTS: Mitigation proposal attached. x 6.15 the damaged facility on tate National Register of Historic Places or the state historic listing? Is 4 older than 50 years? Are there more, similar buildings near the site? Yes No Unsure+ COMMENTS: x 7. Are there any pristine or undisturbed areas on, or hear, the project site? Are there large tracts of forestland? Yes i No I Unsure COMMENTS: is B. Are there any hazardous materials at or adjacent to the damaged facility and/or item of work? YesI No Unsure COMMENTS: I` X 9. Are there any other environmentally or controversial issues associated with the damaged facility andlor item of work? Yes j No Unsure COMMENTS: Site is in Griggs Gulf Creek. X II FEMA Form 90-120, NOV 98 FEDERAL EMERGENCY MANAGEMENT AGENCY SPECIAL CONSIDERATIONS QUESTIONS 1, APPLICANTS NAME 2. PIPS NUMBER DATE Town of Harford 7/14/2005 023-32160-0013. 4. PROJECT NUMBER 5. LOCATION FEMA TOH 004 Griggs Gulf Road 15$0 Form must he filled out --for each project. t. Does the damaged facility or item of work have insurance and/or is it an insurable risk? (e. g., hufidings, equipment, vehicles, etc.) Yes No Unsure COMMENTS: I X 1 2. is the damaged facility located within a floodplain or coastal high hazard area, or does it have an impact on a floodplain or wetland? Yes No Unsure COMMENTS: X 3, Is the damaged facility or item of work located within or adjacent to a Coastal Barrier Resource System Unit or an Otherwise Protected Area? Yes i No I Unsure COMMENTS: 1 X 4. VMIi the proposed facility repairstreconstruction change the pre4isaster condition? (e.g.. tbofprfnt, material, 100800n, capacity, use or functton) Yes I No E Unsure COMMENTS: Site will be mitigated by removing abutments and upgrading Culvert sizes. X Ij 5. Does the applicant have a hazard mitigation proposal or would the applicant like technical assistance for a hazard mitigation proposal? Yes j No I Unsure COMMENTS: Mitigation proposal attached. x 6.15 the damaged facility on tate National Register of Historic Places or the state historic listing? Is 4 older than 50 years? Are there more, similar buildings near the site? Yes No Unsure+ COMMENTS: x 7. Are there any pristine or undisturbed areas on, or hear, the project site? Are there large tracts of forestland? Yes i No I Unsure COMMENTS: is B. Are there any hazardous materials at or adjacent to the damaged facility and/or item of work? YesI No Unsure COMMENTS: I` X 9. Are there any other environmentally or controversial issues associated with the damaged facility andlor item of work? Yes j No Unsure COMMENTS: Site is in Griggs Gulf Creek. X II FEMA Form 90-120, NOV 98 r +.;TOWN OF UARFORD HIS HWA` 13EPAThNZ' 271 Route 38 1 i . I Mord M918, N.Y. 13835 t 807-844.9176 Road Nwne: r ., .. EquiPMOnt Hours, /j Y, n I aa C �p� ft eor�'/Mato, al a � F fro re ��w' ! �` ♦ ti. . s V t� Man How per hwr Number of Hous 5,6 $`41 Total �r0 ro Pace/UnK I"r000 % OD TOTAL ESTIMATED COST FOR REPAIRS Total d 2r ao A k. t Total -J 00 0,0 .f-,0 dc", Datf,, 7/2642005 FEDERAL EMERGENCY MANAGEMENT AGENCY Project Completion and Certification Report (PA) Disaster #: 1589 P.A. ID: 023-32160-00 Applicant: HARFORD (TOWN OF) PW# VSN PKG# INF Cat Work Projected Approved PW Done By Compl. Date Amt. % Actual Date Amt, Claimed Comments Camel, Completed by Applicant 1227 0 58 N C at fncn C SITE NUMBER: 1NAME:�� 4C 10/19/2046 $4,335.50 Ob/o ' cQ[05 � R FACILI TY GASION BASKET WALL LOCATION GRIGGS GULF ROAD SCOPE OF WORK APPLICANT WILL UTILIZE FORCE ACCOUNT LABOR, MATERIALS AND EQUIPMENT TO REMOVE THE GABION BASKETS AND RESTORE EMBANKMENT BY INSTALLING TWO COURSES OF LARGE, HEAVY (3'X 3') RIP RAP ALONG THE ENTIRE 100' EMBANKMENT, THIS 1S CONSIDERED A GOOD CONSTRUCTION PRATICE. Total for 1 PW $4,335.50 Subgrantee Admin: Grand Total: $4,465.56 Page 1 of 11 07/26/2005 FEDERAL EMERGENCY MANAGEMENT AGENCY Project Completion and Certification Report (PA) Disaster #: 7589 ID; 023-32160-00 Applicant: HARFORD (TOWN OF) CERTIFICATION :REBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF WORK AND COSTS CLAIMED ARE ELIGIBLE IN ACCORDANCE WITH THE kNT CONDITIONS, ALL WORK CLAIMED HAS BEEN COMPLETED, AND ALL 3TS CLAIMED HAVE BEEN PAID IN FULL. N ED: , f 9za//' ea-ot�'y DATE. APPLICANT'S AUTHORIZED REPRESENT / ATiVE Page 2 of 2 I CERTIFY THAT ALL FUNDS WERE EXPENDED IN ACCORDANCE WITH THE PROVISIONS OF THE FEMA -STATE AGREEMENT AND I RECOMMEND AN APPROVED AMOUNT OF $ DATE: GOVERNOR'S AUTHORIZED REPRESENTATIVE Q e: 0.7 2712005 FEDERAL, EMERGENCY MANAGEMENT AGENCY Project Completion and Certification Report (P.4) Disaster #:1589 P.A. ID: 023-32160-00 Applicant: HARFORD (TOWN OF) PW# VSN PKG# INF Cat Work Projected Approved PW % Actual Date Amt. Claimed Comments Done By Compl. Date Amt. Compl. Completed by Applicant of Jncn 1225 0 63 N C 10119/2006 $15,783.50 0% C fa'l � $1 , Rip, Jp SITE NUMBER: 1 FACILITY NAME : GRIGGS GULF ROAD CULVERT # 1 LOCATION GRIGGS GULF ROAD SCOPE OF WORK UTILIZING FORCE ACCOUNT LABOR, EQUIPMENT AND STOCK AND PURCHASED MATERIALS THE APPLICANT WILL RESTORE THE CULVERT TO ITS' PRE -DISASTER CONDITION. EXCAVATE THE SITE 10' W X 6'D X 20'L BETWEEN THE TWO (2) 20' L X 5' D X 1' W ABUTMENTS, FURNISH AND INSTALL A 72" CMP THAT IS THE APPROXIMATE EQUIVALENT OF 5'H X 8'W SQUASH PIPE, WHICH IS THE SIZE OF THE PIPE THAT WAS DAMAGED. RIP RAP ON BOTH SIDES UPSTREAM AND DOWNSTREAM 10'L EACH BY 6'D X 4'W. COVER WITH GRANULAR SURFACE COURSE. A HAZARD MITIGATION PROPOSAL IS ATTACHED TO UPGRADE TO A 96" SQUASH PIPE (112" X 75") AND REMOVE AND DEMOLISH THE ABUTMENTS, Total for 1 PW $15,783.50 Subgrantee Admin: $473.51 Grand Total: $16,257,01 Page 1 of 11 901") TOWN OF HARFORD HIGHWAY DEPARTMMNT 271 Route 38 Harford MUls, N.Y. 13835 607-844-9170 EquipnWt Hours- Total- C'A l000 �4 cy/) Quento, twwateriai 0 i ManH04r S pff h0j Number of Hours T 00 1600 6 -lode TOTAL ESTIMATED COST FOR REPAIRS Price/Unit /eS 'cr /S 70P le La /}).. tv 0 Federal Emergency Management Agency E -Grants Page I of 16 NAW 5kio Navigation My Roles Preferences HelpLog b� Out Logged in as: RONALD HEPLER [ Session Expires in 30 mins 1 H0FA0 Reports Administration Information i Version: 202.00.00 Server: mwegual ] Subgrant Application (aw) ...Application Status Preparer Information Contact Information Proiect Description Damage Facilities Special Considerations ••-Witiclation Cost Estimate Insurance Information Comments and Attachments Submit Application Bundle Reference # (Amendment #) JDate Awarded Subgrant Application - FEMA Form 90.97 FEDERAL EMERGENCY MANAGEMENT AGENCY PROJECT WORKSHEET DISASTER PROJECT PAID NO. NO. FEMA 14129 I - DRI NY 3216001 00160- APPLICANT: HARFORD (TOWN OF) DAMAGED FACILITY: DATE CATEGORY 10-01-2013 C WORK COMPLETE AS OF; 10-01-2013: 50 % Site 1 of 13 COUNTY: Cortland Griggs Gulf Road -Site 1 LOCATION: Current Version: GPS Coordinates 42.41908, -76.1805 DAMAGE DESCRIPTION AND DIMENSIONS: Current Version: LATITUDE: LONGITUDE: 42.41908 -76.1805 During the incident period of June 26 to July 4, 2013, severe storms and flooding caused damage to public infrastructure in New York State, On July 12, 2013, a major disaster declaration was declared for 16 counties including Cortland County. — In the Town of Harford on Griggs Gulf Road, at location 42.41908,-76.18050, flash flood waters caused water to overtop a CMP crossover culvert 5 feet high by 6 feet wide by 30 feet long. The water washed out an area 10 feet long by 8 feet wide by 2 feet deep over the culvert inlet and damaged the road shoulder 4 feet wide by 200 feet long by 1 foot deep. (36 cy total). The flow also scoured the road and damaged 300 feet long by 18 feet wide of road surface. SCOPE OF WORK: Current Version: WORK COMPLETED Site 1 — The Town of Hanford Highway Department utilized 3 hours of straight time force account labor and 3 hours of force account equipment to make the repairs to Site -1. The Town also utilized 12 cubic yards of bank run gravel and 24 cubic yards of crusher run gravel from stock to complete the repairs for a total of 36 cubic yards. The town filled the washed out area over the culvert, 10 feet long by 8 feet by 2 feet deep and the road shoulder 4 feet wide by 200 feet long by 1 foot deep (36 cubic yards total) and graded the shoulder and roadbed. See photos Site 1 —Views I, 2, and 3 for completed work. Cost to repair Site 1 LaborAWringe Eq ui ment Shane Merriman 1 hour $28.95 ST= $28.95 Excavator 1 hours X $65/hr = $65.00 Dan Courtney 1 hour X $24.09 ST = $24.09 Loader 1 hours X $50/hr = $50.00 Steve Perry 1 hour X $21.51 ST = $21.51 Dump Truck 1 hours X $60/hr = $60.00 Materials Total $74.55 Total $ 175.00 Bank Run 12 cy X $1.75/cy = $21.00 Crusher Run 24 cy X $13.50/cy = $324.00 Total $345.00 Total Site 1 Cost = https://i,source.fema.net/emmie/sfgOgl Load.do?vo.reviewld=&topTile=internlalCommon... 10/15/2013 1" ederal Emergency Management Agency E -Grants Page 2 of 16 $594.55 RECORD RETENTION: Complete records and cost documents for all approved work must be maintained for at least 3 years from the date the last project was completed or from the date final Payment was received, whichever is later. Applicant is responsible for retention of all documentation associated with this project. SUPPORTING DOCUMENTATION: 100% of the documentation to support this project has been reviewed and verified by the Applicant and Project Specialist for eligibility and correctness. Ail Supporting documentation has been returned to and retained by the applicant. PROCUREMENT: The applicant is required to adhere to State Government Procurement rules and regulations and maintain adequate records to support the basis for all purchasing of goods and materials and contracting services for projects approved under the Public Assistance program, as stated in 44 CFR 13.36. The applicant has advised they have/will follow their normal procurement procedures. PERMITS: The PA Project Specialist has advised the Applicant that it is their responsibility to obtain all applicable local, state and federal permits prior to any construction or debris disposal activity referenced on this project, Applicant has also been advised that the lack of obtaining and maintaining these documents may jeopardize funding. jects are subject to an insurance review as s INSURANCE: The applicant is aware that all protated in 44 C.F.R. Sections 206.252 and 206.253.If applicable an insurance determination will be made either as anticipated proceeds or actual proceeds in accordance with the applicant's insurance policy that may affect the total amount of the project. DIRECT ADMINISTRATIVE COSTS:The subgrantee is not requesting Direct Administrative Costs (DAC) that are directly chargeable to this specific project. Associated eligible work is related administration of the PA project only and in accordance with 44 CFR 13.22. These costs are treated -onsistently and uniformly as direct costs in all federal awards and other subgrantee activities and are not included in any approved indirect cost rates. Iroject was reviewed for 406 Hazard Mitigation and determination is made that mitigation is not easible. Site 2 of 13 DAMAGED FACILITY: COUNTY: Cortland Burvee Road- Site 2 LOCATION: LATITUDE: LONGITUDE: Current Version: 42.45663 -76.1765 GPS Coordinates 42.45663, -76.1765 DAMAGE DESCRIPTION AND DIMENSIONS: Current Version: During the incident period of June 26 to July 4, 2013, severe storms and flooding caused damage to public infrastructure in New York State. On July 12, 2013, a major disaster declaration was declared for 16 counties including Cortland County, Site 2 — In the Town of Harford on Bur vee Road at location 42.45663,-76.17650, flash flood waters damaged a 24 inch diameter by 40 foot long CMP crossover culvert. The water overtopped the damaged culvert and scoured the gravel road over a 1000 linear feet 20 feet wide in many areas at varying depths washing away 144 cubic yards of road surface. SCOPE OF WORK: Current Version: Work Completed Site 2 — The Town of Harford Highway Department utilized 36 overtime hours of force account labor and 36 hours of force account equipment to make the repairs to site 2. The town also utilized 144 cubic yards of item 4 gravel and 24 cubic yards of crusher run gravel from stock to complete the repairs. The damaged 24 inch by 40 feet long CMP crossover culvert was replaced by a 30 inch diameter by 40 feet long poly pipe at the time the repairs were made. See attached Hazard Mitigation proposal for Site 2. The road scour 20 feet wide by 1000 feet long, was repaired by adding the 144 cubic yards of Item 4 and grading. See photos Site 2 —Views 1, 2, 3, and 4 for completed work. Cost to repair Site 2 Labor Wringe Equipment Shane Merriman 12 hours X $28.95 OT = $347.40 Excavator 12 hours X $65/hr = https://isource.fema.net/enitnie/sf9O91 Load.do?vo.reviewld=&topTile=internalCoimmon... 10/15/2013 I vuu,at Emergency Management Agency E -Grants $780.00 Dan Courtney $600.00 Steve Perry $720.00 12 hours X $27.13 OT = $325.56 Loader 12 hours X $24.22 OT = $290.64 Materials Total $963.60 Total $ 2100.00 CMP culvert 10 gauge $25.73 per foot X 40 feet = $1029.20 Crusher Run 24 cy X $13.50/cy = $324.00 Item 4 - 144cy=198 ton X $5,25/ton= $1039.50 Total Materials $2392.70 Page 3 of 16 12 hours X $50/hr = Dump Truck 12 hours X $60/hr = $5456,30 Total Site Cost = Total Site 2 cost is to repair to pre -disaster condition . Note: This cost will be used to calculate HMF cost comparison, The HMP work to install a 30 inch by 40 ft long poly culvert has been completed. The applicant did not install a new CMP culvert. RECORD RETENTION: Complete records and cost documents for all approved work must be 'maintained for at least 3 years from the date the last project was completed or from the date final )ayment was received, whichever is later. Applicant is responsible for retention of all documentatioi associated with this project. 3UPPORTING DOCUMENTATION: 100%of the documentation to support this project has been eviewed and verified by the Applicant and Project Specialist for eligibility and correctness. All supporting documentation has been returned to and retained by the applicant. 'ROCUREMENT: The applicant is required to adhere to State Government Procurement rules and egulations and maintain adequate records to support the basis for all purchasing of goods and iaterials and contracting services for projects approved under the Public Assistance program, as tated in 44 CFR 13.36. The applicant has advised they have/will follow their normal procurement rooedures. 'ERMITS: The PA Project Specialist has advised the Applicant that it is their responsibility to obtain II applicable local, state and federal permits prior to any construction or debris disposal activity ,ferenoed on this project. Applicant has also been advised that the lack of obtaining and iaintaining these documents may jeopardize funding. JSURANCE: The applicant is aware that all projects are subject to an insurance review as stated in 4 C.F.R. Sections 206.252 and 206.253.If applicable an insurance determination will be made ther as anticipated proceeds or actual proceeds in accordance with the applicant's insurance )licy that may affect the total amount of the project. he subgrantee is not requesting Direct Administrative Costs (DAC) that are directly chargeable to is specific project. Associated eligible work is related administration of the PA project only and in :cordance with 44 CFR 13.22. These costs are treated consistently and uniformly as direct costs in I federal awards and other subgrantee activities and are not included in any approved indirect cost tes. 3plicant is submitting 406 Hazard Mitigation with project. Site 3 of 13 DAMAGED FACILITY: I COUNTY: Cortland Burvee Road -Site 3 LOCATION: LATITUDE: I LONGITUDE: Current Version: 42.45834 -76.1765 GPS C000rdinates 42.45834, -76.1765 DAMAGE DESCRIPTION AND DIMENSIONS: Current Version: During the incident period of June 26 to July 4, 2013, severe storms and flooding caused damage to public infrastructure in New York State. On July 12, 2013, a major disaster declaration was declared for 16 counties including Cortland County. Site 3 — In the Town of Harford on Burvee Road at location 42.45834,-76.17850, flash flood waters plugged and damaged a 30 inch diameter by 60 feet long CMP crossover culvert. The culvert was overtopped causing a washout on the outlet side exposing the pipe leaving a cavity over the pipe and on the roadbed of 10 feet wide by 65 feet long by 3 feet deep,(72 cubic yards) SCOPE OF WORK: Current Version: https://isource.fema.net/enmic/sf9091 Load.do?vo.reviewld=&topTile=internalCommon... 10/15/2013 • ,u,,i at zmergency Management Agency E -Grants Page 4of16 Work Completed Site 3 — The Town of Harford Highway Department utilized 24 hours of straight time force account labor and 24 hours of force account equipment to make partial repairs to Site 3. The town utilized 72 cubic yards of cobble stone to fill the washed out areas 10 feet wide by 65 feet long by 3 feet deep (72 cubic yards). The material was dumped and graded to make the repairs. Note: the road and shoulder were repaired, but the damaged culvert will be replaced in the work to be completed section of this subgrant application. A Hazard Mitigation Proposal is also attached for Site 3. Cost to repair Site 3 Labor/wfringe nt Shane Merriman 8 hour X $28.95 ST = $231.60 $480.00 Dump AutogCarme$ hours X $60lhr = Dan Courtney 8 hour X $24,09 ST = $192.72 Dump Western 8hours X $65/hr = $520.00 Steve Perry 8 hour X $21.51 ST = $172.08 Grader $464.00 8 hours X $58/hr = Materials Total $596.40 Total $ 1464.00 Cobble stone 72 Cy X $1.25/ cy = $90.00 $215040 Total $90,00 Total Site 3 Cost = Work to be Completed Site 3 - In the Town of Harford on Burvee Road at location 42.45834,-76.17850, flash flood waters Augged and damaged a 30 inch diameter by 60 feet long CMP crossover culvert which will be -epiaced with a new CMP culvert. The work to be completed will be estimated using f FEMA Cost odes. Note: See HMP attached for replacement with a Poly culvert. RECORD RETENTION: Complete records and cost documents for all approved work must be naintained for at least 3 years from the date the last project was completed or from the date final aayment was received, whichever is later. Applicant is responsible for retention of all documentation associated with this project. ;UPPORTING DOCUMENTATION: 100% of the documentation to support this project has been eviewed and verified by the Applicant and Project Specialist for eligibility and correctness. All supporting documentation has been returned to and retained by the applicant. 'ROCUREMENT: The applicant is required to adhere to State Government Procurement rules and ?gulations and maintain adequate records to support the basis for all purchasing of goods and iaterials and contracting services for projects approved under the Public Assistance program, as tated in 44 CFR 13.36. The applicant has advised they havelwill follow their normal procurement rocedures. 'ERMITS: The PA Project Specialist has advised the Applicant that it is their responsibility to obtain II applicable local, state and federal permits prior to any construction or debris disposal activity :ferenced on this project. Applicant has also been advised that the lack of obtaining and iaintaining these documents may jeopardize funding. VSURANCE: The applicant is aware that all projects are subject to an insurance review as stated in 4 C.F.R. Sections 206.252 and 206,253.If applicable an insurance determination will be made ither as anticipated proceeds or actual proceeds in accordance with the applicant's insurance olicy that may affect the total amount of the project. he subgrantee is not requesting Direct Administrative Costs (DAG) that are directly chargeable to its specific project. Associated eligible work is related administration of the PA project only and in ccordance with 44 CFR 13.22, These costs are treated consistently and uniformly as direct costs in II federal awards and other subgrantee activities and are not included in any approved indirect cost ates. pplicant is submitting 406 Hazard Mitigation with project. Site 4 of 13 DAMAGED FACILITY: COUNTY: Cortland Burne Road -Site 4 LOCATION: Current Version: GPS Coordinates 42.45821, -76.1784 DAMAGE DESCRIPTION AND DIMENSIONS: Current Version: LATITUDE: LONGITUDE: 42.45821 -76.1784 During the incident period of June 26 to July 4, 2013, severe storms and flooding caused https://isource.fema.net/emmic/sf909l Load. do?vo. reviewld=&topTile=intemalCommon... 10/15/2013 -u%'ia1 F-mergency Management Agency E -Grants Page 5 of 16 damage to public infrastructure in New York State. On July 12 2013, a major disaster declaration was declared for 16 counties including Cortland County. Site 4 — In the Town of Harford on Burvee Road at 10cation42.45821,-76,1784 heavy water flow in a long. long. de ditch completely plugged and exposed a field driveway culvert 12 inch diameter by 20 feet SCOPE OF WORK: Current Version: Work to be Completed Site 4 — In the Town of Harford on Survee Road at location42.45821,-76.1784, heavy water flow in a roadside ditch long. The damaged culvert will be replaced and estimated with FEcompletely plugged and exposed a field driveway culvert 12 inch diameter by 20 feet attached for replacement with a 12 inch dia. Poly culvert. MA Cost Codes. See HMP Furnish and install new culvert CMP 12in.dia. By 20 ft. long FEMA Cost Code 3351 $40.00/ft. X 20 ft. = $800.00 RECORD RETENTION: Complete records and cost documents for all approved maintained for at least 3 years from the date the last project was completed or from he date final payment was received, whichever is later. Applicant is responsible for retention of all documentation associated with this project. SUPPORTING DOCUMENTATION: 100% of the documentation to support this project has been reviewed and verified by the Applicant and Project Specialist for eligibility and correctness. All supporting documentation has been returned to and retained by the applicant. PROCUREMENT: The applicant is required to adhere to State Government Procurement rules and regulations and maintain adequate records to support the basis for all purchasing of goods and materials and contracting services for projects approved under the Public Assistance program, as stated in 44 CFR 13.36. The applicant has advised they have/will follow their normal procurement procedures. PERMITS: The PA Project Specialist has advised the Applicant that it is their responsibility to obtain all applicable local, state and federal permits prior to any construction or debris disposal activity referenced on this project. Applicant has also been advised that the lack of obtaining and maintaining these documents may jeopardize funding. INSURANCE: The applicant is aware that all projects are subject to an insurance review as stated in 44 G.F.R. Sections 206.252 and 206,253.1f applicable an insurance determination will be made either as anticipated proceeds or actual proceeds in accordance with the applicant's insurance policy that may affect the total amount of the project. The subgrantee is not requesting Direct Administrative Costs (DAC) that are directly chargeable to this specific project. Associated eligible work is related administration of the PA project only and in accordance with 44 CFR 13.22. These costs are treated consistently and uniformly as direct costs in all federal awards and other subgrantee activities and are not included in any approved indirect cost rates. Applicant is submitting 406 Hazard Mitigation with project. Site 5 of 13 DAMAGED FACILITY: I 1 Scuit Hill Road -Site 5 COUNTY: Cortland LOCATION: LATITUDE: LONGITUDE: Current Version: 42.46851 -76.16528 Gps Coordinates 42.46851, -76.16528 DAMAGE DESCRIPTION AND DIMENSIONS: Current Version: During the incident period of June 26 to July 4, 2013, severe storms and flooding caused damage to public infrastructure in New York State- On July 12, 2013, a major disaster declaration was declared for 16 counties including Cortland County, Site 5 — In the Town of Harford on Scutt Hill Road at location 42.46851,-76,16528, flash flood waters inundated a 15 inch diameter by 60 feet long CMP crossover pipe. The pipe was completely plugged and damaged beyond repair. SCOPE OF WORK: Current Version: https://isource.fema.net/emmie/sf9o9l Load.do?vo.reviewld=&topTile=intemalCommon... 10/15/2013 r euerat Emergency Management Agency E -Grants Page 6 of 16 Work to be Completed Site 5 — In the Town of Harford on Scutt Hill Road at location 42.46851,-76.16528, flash flood waters inundated a 15 inch diameter by 60 feet long CMP crossover pipe. The pipe was completely plugged and damaged beyond repair. The culvert will be replaced and estimated using FEMA Cost Codes. See HMP attached for replacement with an 18 inch dia. Poly culvert. Furnish and install new culvert CMP 15 in. dia. By 60 ft. long FEMA Cost Code 3352 $44.001ft. X 60 ft. = $2640 RECORD RETENTION: Complete records and cost documents for all approved work must be maintained for at least 3 years from the date the last project was completed or from the date final Payment was received, whichever is later. Applicant is responsible for retention of all documentation associated with this project. SUPPORTING DOCUMENTATION: 100 % of the documentation to support this project has been 'eviewed and verified by the Applicant and Project Specialist for eligibility and correctness. All Supporting documentation has been returned to and retained by the applicant. 3ROCUREMENT: The applicant is required to adhere to State Government Procurement rules and egulations and maintain adequate records to support the basis for all purchasing of goods and naterials and contracting services for projects approved under the Public Assistance program, as stated in 44 CFR 13.36. The applicant has advised they havelwill follow their normal procurement procedures. 'ERMITS: The PA Project Specialist has advised the Applicant that it is their responsibility to obtain Il applicable local, state and federal permits prior to any construction or debris disposal activity :ferenoed on this project. Applicant has also been advised that the lack of obtaining and iaintaining these documents may jeopardize funding, JSURANCE: The applicant is aware that all projects are subject to an insurance review as stated in 4 C.F.R. Sections 206.252 and 206.253.lf applicable an insurance determination will be made ther as anticipated proceeds or actual proceeds in accordance with the applicant's insurance �licy that may affect the total amount of the project. pplicant is submitting 406 Hazard Mitigation with project ie subgrantee is not requesting Direct Administrative Costs (DAC) that are directly chargeable to is specific project. Associated eligible work is related administration of the PA project only and in :cordance with 44 CFR 13.22_ These costs are treated consistently and uniformly as direct costs in I federal awards and other subgrantee activities and are not included in any approved indirect cost tes. 4ZARD MITIGATION: HMP Attached. DAMAGED FACILITY: Scutt Hill Road - Site 6 LOCATION: Current Version: Site 6 of 13 COUNTY: Cortland Gps Coordinates 42.46675, -76.46914 DAMAGE DESCRIPTION AND DIMENSIONS: Current Version: LATITUDE: LONGITUDE: 42.46914 -76.16386 42.46675 -76.17382 During the incident period of June 26 to July 4, 2013, severe storms and flooding caused damage to public infrastructure in New York State. On July 12, 2013, a major disaster declaration was declared for 16 counties including Cortland County_ Site 6 — In the Town of Harford on Scutt Hill Road at beginning at location 42.46914,-76.16388 and ending at location 42.46675,-76.17382, flash flood waters overtopped and damaged a crossover culvert 18 inch in diameter by 40 feet long, causing high velocity water to scour the seasonal gravel roadbed 18 feet wide by 2800 feet long. SCOPE OF WORK: Current Version: Work Completed Site 6 - The Town of Harford Highway Department utilized 9 hours of overtime force account labor and 9 hours of force account equipment to make partial repairs to Site 6. The town used a grader and loader to repair the 18 feet wide by 2800 feet long scoured roadbed. No materials were added to make the partial repairs. The damaged culvert was not replaced at this time and will be replaced in the work to be completed section of this subgrant application. A Hazard Mitigation Proposal is also attached for Site 6. Cost to repair Site 6 https:Hisource.fema.net/emmie/sf9091 Load .do?vo.reviewld=&topTi1c=internal Common... 10/15/2013 Federal Emergency Management Agency E -Grants Page 7 of 16 Labor Iwfringe Equipment Shane Merriman 3 hour X $28.95 OT = $86.85 Pickup 3 hours X $20/hr = $60.00 Dan Courtney 3 hour X $27.13 OT = $81.39 Loader 3hours X $50/hr = $150.00 Steve Perry 3 hour X $24.22 OT = $72.66 Grader 3 hours X $58/hr = $174.00 Total $240.90 Total $ 384.00 Materials -no materials used $624.90 Total Site 6 Cost = Work to be Completed Site 6 — In the Town of Harford on Scutt Hill Road at beginning at location 42.46914,-76.16388 and ending at location 42.46675,-76.17382, flash flood waters overtopped and damaged a crossover culvert 18 inch in diameter by 40 feet long, causing high velocity water to scour the seasonal gravel roadbed 18 feet wide by 2800 feet long. The roadbed was repaired but the culvert was damaged and will be replaced and estimated using FEMA Cost Codes. See HMP attached for replacement with a 24 in. dia. Poly pipe. Furnish and install new culvert CMP 24 in. dia. By 40 ft. long FEMA Cost Code 3354 $65.00& X 40 ft. = $2600 RECORD RETENTION: Complete records and cost documents for all approved work must be maintained for at least 3 years from the date the last project was completed or from the date final payment was received, whichever is later. Applicant is responsible for retention of all documentation associated with this project. SUPPORTING DOCUMENTATION: 100 % of the documentation to support this project has been reviewed and verified by the Applicant and Project Specialist for eligibility and correctness. All supporting documentation has been returned to and retained by the applicant. PROCUREMENT: The applicant is required to adhere to State Government Procurement rules and regulations and maintain adequate records to support the basis for all purchasing of goods and materials and contracting services for projects approved under the Public Assistance program, as stated in 44 CFR 13.36. The applicant has advised they have/will follow their normal procurement procedures. PERMITS: The PA Project Specialist has advised the Applicant that it is their responsibility to obtain all applicable local, state and federal permits prior to any construction or debris disposal activity referenced on this project. Applicant has also been advised that the lack of obtaining and maintaining these documents may jeopardize funding. INSURANCE: The applicant is aware that all projects are subject to an insurance review as stated in 44 C.F.R. Sections 206.252 and 206,253.If applicable an insurance determination will be made either as anticipated proceeds or actual proceeds in accordance with the applicant's insurance policy that may affect the total amount of the project. The subgrantee is not requesting Direct Administrative Costs (DAC) that are directly chargeable to this specific project. Associated eligible work is related administration of the PA project only and in accordance with 44 CFR 13.22. These costs are treated consistently and uniformly as direct costs in all federal awards and other subgrantee activities and are not included in any approved indirect cost rates. Applicant is submitting 406 Hazard Mitigation with project. Site 7 of 13 DAMAGED FACILITY: COUNTY: Cortland Bleck Road -Site 7 LOCATION: Current Version: GPS Coordinates 42.46636, -76.17400 DAMAGE DESCRIPTION AND DIMENSIONS: Current Version: LATITUDE: LONGITUDE: 42.46636 -76.174 During the incident period of June 26 to July 4, 2013, severe storms and flooding caused damage to public infrastructure in New York State. On July 12, 2013, a major disaster declaration was declared for 16 counties including Cortland County. Site 7 – In the Town of Harford on Bleck Road at location 42.46636,-76.17400, flash flood waters filled in a roadside ditch 6 feet wide by 200 feet by 2 foot deep.(88.9 cubic yards) SCOPE OF WORK: https:Hisource.fema.net/emmie/sf909l Load.do?vo.reviewId=&topTile—internalCommon... 10/15/2013 Federal Emergency Management Agency E -Grants Page 8 of 16 Current Version: Site 7 — The Town of Harford Highway Department utilized 1 hour of straight time force account labor and I hour of force account equipment to make repairs to Site 7. The town utilized a grader to clean and shape the road side ditch 6 feet wide by 200 feet long by 2 feet deep. This is equal to 88.9 cubic yards of material moved in place. Cost to repair Site 7 Laborlwfringe Equipment Steve Perry 1 hour X $21.51 ST = $21.51 Grader hours X $58/hr = $58.00 Total $21.51 Total $ 58.00 Materials -no materials used $79.51 Total Site 7 Cost = RECORD RETENTION: Complete records and cost documents for all approved work must be maintained for at least 3 years from the date the last project was completed or from the date final payment was received, whichever is later. Applicant is responsible for retention of all documentation associated with this project. SUPPORTING DOCUMENTATION: 100% of the documentation to support this project has been reviewed and verified by the Applicant and Project Specialist for eligibility and correctness. All supporting documentation has been returned to and retained by the applicant. PROCUREMENT: The applicant is required to adhere to State Government Procurement rules and regulations and maintain adequate records to support the basis for all purchasing of goods and materials and contracting services for projects approved under the Public Assistance program, as stated in 44 CFR 13.36. The applicant has advised they have/will follow their normal procurement procedures. PERMITS: The PA Project Specialist has advised the Applicant that it is their responsibility to obtain all applicable local, state and federal permits prior to any construction or debris disposal activity referenced on this project. Applicant has also been advised that the lack of obtaining and maintaining these documents may jeopardize funding. INSURANCE: The applicant is aware that all projects are subject to an insurance review as stated in 44 C.F.R. Sections 206.252 and 206.253.If applicable art insurance determination will be made either as anticipated proceeds or actual proceeds in accordance with the applicant's insurance policy that may affect the total amount of the project. The subgrantee is not requesting Direct Administrative Costs (DAC) that are directly chargeable to this specific project. Associated eligible work is related administration of the PA project only and in accordance with 44 CFR 13.22, These costs are treated consistently and uniformly as direct costs in all federal awards and other subgrantee activities and are not included in any approved indirect cost rates. Project was reviewed for 406 Hazard Mitigation and determination is made that mitigation is not feasible. Site 8of13 DAMAGED FACILITY: COUNTY: Cortland Bleck Road - Site 8 LOCATION: Current Version: GPS Coordinates 42.46739, -76.17415 DAMAGE DESCRIPTION AND DIMENSIONS: Current Version: LATITUDE: LONGITUDE: 42.46739 -76.17415 During the incident period of June 26 to July 4, 2013, severe storms and flooding caused damage to public infrastructure in New York State. On July 12, 2013, a major disaster declaration was declared for 16 counties including Cortland County. Site 8 — In the Town of Harford on Bleck Road at location 42.46739, -76.17415, flash flood waters inundated a CMP crossover culvert 5 feet in diameter by60 feet long. The inlet side was filled in with gravel 8 feet wide by 20 feet long by 4 feet deep. (24 cubic yards) SCOPE OF WORK: Current Version: Work Completed Site 8 — The Town of Harford Highway Department utilized 6 hours of straight time force account https://isource.fema.net/emmie/sf'9091 Load. do?vo.reviewId=&topTile—internalCotnmon... 10/15/2013 Federal Emergency Management Agency E -Grants Page 9 of 16 labor and 6 hours of force account equipment to make repairs to Site 8. The inlet side of the crossover culvert filled in with gravel 8 feet wide by 20 feet long by 4 feet deep (24 cubic yards) was cleaned out using an excavator and (2) dump trucks. The gravel was hauled to the temporary storage Site 12 at location 42.45132, -76.18877 on Hilsinger Road. A signed authorization by Richard Tillotson is attached to this subgrant application for temporary storage of gravel. The area has been verified as a Zone x flood zone as shown on attached Firmette for Site 12. Laborlwfringe Equipment Shane Merriman 2 hours X $28.95 ST = $57.90 Dump Auto Car 2 hours X $60/hr = $120.00 Dan Courtney 2 hours X $24.09 ST = $48.18 Dump Western 2 hours X $651hr = $130.00 Steve Perry 2 hours X $21.51 ST = $43.02 Excavator 2 hours X $65/hr = $130.00 Total $149.00 Total $480.00 Materials -no matertais used Total Site 8 Cost = $629.00 RECORD RETENTION: Complete records and cost documents for all approved work must be maintained for at least 3 years from the date the last project was completed or from the date final payment was received, whichever is later. Applicant is responsible for retention of all documentation associated with this project. SUPPORTING DOCUMENTATION: 100%of the documentation to support this project has been reviewed and verified by the Applicant and Project Specialist for eligibility and correctness. All supporting documentation has been returned to and retained by the applicant. PROCUREMENT: The applicant is required to adhere to State Government Procurement rules and regulations and maintain adequate records to support the basis for all purchasing of goods and materials and contracting services for projects approved under the Public Assistance program, as stated in 44 CFR 13,36. The applicant has advised they havetwill follow their normal procurement procedures. PERMITS: The PA Project Specialist has advised the Applicant that it is their responsibility to obtain all applicable local, state and federal permits prior to any construction or debris disposal activity referenced on this project, Applicant has also been advised that the lack of obtaining and maintaining these documents may jeopardize funding. INSURANCE: The applicant is aware that all projects are subject to an insurance review as stated in 44 C.F.R. Sections 206.252 and 206.253.lf applicable an insurance determination will be made either as anticipated proceeds or actual proceeds in accordance with the applicant's insurance policy that may affect the total amount of the project. The subgrantee is not requesting Direct Administrative Costs (DAC) that are directly chargeable to this specific project. Associated eligible work is related administration of the PA project only and in accordance with 44 CFR 13.22. These costs are treated consistently and uniformly as direct costs in all federal awards and other subgrantee activities and are not included in any approved indirect cost rates. No mitigation opportunities have been identified. This project worksheet is for emergency work only; therefore mitigation is not eligible. DAMAGED FACILITY: Bleck Road - Site 9 LOCATION: Current Version: Site 9of13 COUNTY: Cortland GPS Coordinates 42.46863, -76.17343 DAMAGE DESCRIPTION AND DIMENSIONS: Current Version: LATITUDE: LONGITUDE: 42.46863 -76.17343 During the incident period of June 26 to July 4, 2013, severe storms and flooding caused damage to public infrastructure in New York State. On July 12, 2013, a major disaster declaration was declared for 16 counties including Cortland County. Site 9 — In the Town of Harford on Bleck Road at location 42.46863, -76.17343, a crossover culvert CMP squash pipe 12 feet wide by 10 feet high was inundated by flash flood waters in an unnamed tributary of the East Branch of Owego Creek. The inlet side of the culvert filled in with gravel 8 feet wide by 60 feet long by 4.5 feet deep. (80 cubic yards). The outlet side of the culvert filled in with gravel 10 feet wide by 60 feet long by 2 feet deep. (56 cubic yards) SCOPE OF WORK: https://isource.fema.net/emmie/sf9091 Load. do?vo.reviewId=&topTile=internal Common... 10/15/2013 Federal Emergency Management Agency E -Grants Current Version: Page 10 of 16 Work Completed Site 9 - The Town of Harford Highway Department utilized 9 hours of straight time force account labor and 9 hours of force account equipment to make repairs to Site 9. The inlet side of the crossover culvert filled in with gravel 8 feet wide by 60 feet long by 4.5 feet deep (80 cubic yards. The outlet side of the culvert filled in with gravel 10 feet wide by 60 feet long by2 feet deep (56 cubic yards). The gravel was cleaned out using an excavator and (2) dump trucks. The gravel was hauled to the temporary storage Site 12 at location 42.45132, -76.18877 on Hilsinger Road. A signed authorization by Richard Tillotson is attached to this subgrant application for temporary storage of gravel. The area has been verified as a Zone x flood zone as shown on attached Firmette for Site 12. Labor/wfringe Shane Merriman 3 hours X $28.95 ST = $86.85 $180.00 Dan Courtney 3 hours X $24.09 ST = $72.27 $195.00 Steve Perry 3 hours X $21.51 ST = $64.53 $195.00 Total $223.65 Total $570.00 Materials -no materials used Equipment Dump Auto Car 3 hours X $601hr = Dump Western 3 hours X $65/hr = Excavator 3 hours X $65/hr = Total Site 9 Cost = $793.65 RECORD RETENTION: Complete records and cost documents for all approved work must be maintained for at least 3 years from the date the last project was completed or from the date final payment was received, whichever is later. Applicant is responsible for retention of all documentation associated with this project. SUPPORTING DOCUMENTATION: 100% of the documentation to support this project has been reviewed and verified by the Applicant and Project Specialist for eligibility and correctness. All supporting documentation has been returned to and retained by the applicant. PROCUREMENT: The applicant is required to adhere to State Government Procurement rules and regulations and maintain adequate records to support the basis for all purchasing of goods and materials and contracting services for projects approved under the Public Assistance program, as stated in 44 CFR 13.36. The applicant has advised they have/will follow their normal procurement procedures. PERMITS: The PA Project Specialist has advised the Applicant that it is their responsibility to obtain all applicable local, state and federal permits prior to any construction or debris disposal activity referenced on this project. Applicant has also been advised that the lack of obtaining and maintaining these documents may jeopardize funding. INSURANCE: The applicant is aware that all projects are subject to an insurance review as stated in 44 C.F.R. Sections 206.252 and 206.253Jf applicable an insurance determination will be made either as anticipated proceeds or actual proceeds in accordance with the applicant's insurance policy that may affect the total amount of the project. The subgrantee is not requesting Direct Administrative Costs (DAC) that are directly chargeable to this specific project. Associated eligible work is related administration of the PA project only and in accordance with 44 CFR 13.22. These costs are treated consistently and uniformly as direct costs in all federal awards and other subgrantee activities and are not included in any approved indirect cost rates. Project was reviewed for 406 Hazard Mitigation and determination is made that mitigation is not feasible. Site 10 of 13 DAMAGED FACILITY: COUNTY: Cortland Bleck Road -Site 10 LOCATION: Current Version: GPS Coordinates 42.47032, -76.17258 DAMAGE DESCRIPTION AND DIMENSIONS: Current Version: LATITUDE: LONGITUDE: 42.47032 -76.17258 During the incident period of June 26 to July 4, 2013, severe storms and flooding caused damage to public infrastructure in New York State. On July 12, 2013, a major disaster declaration was declared for 16 counties including Cortland County. Site 10 — In the Town of Harford on Bleck Road at location 42.47032, -76.17258, a poly crossover culvert 48 inches in diameter by 40 feet long was inundated with flash flood waters. The culvert https://isource.ferna.net/emmie/sf9091 Load.do?vo.reviewld=&topTile=internalCommon... 10/15/2013 Federal Emergency Management Agency E -Grants Page 11 of 16 overtopped filling in the outlet with gravel 15 feet wide by 100 feet long by 3 feet deep (167 cubic yards). The water continued down the roadway washing away 565 feet of road shoulder 4 feet wide by 1 feet deep. (84 cubic yards) The flow also damaged the oil and stone road surface in two areas. A 20 feet by 30 feet section and 10 feet by 150 area. (total of 233.3 square yards) SCOPE OF WORK: Current Version: Work Completed Site 10 - - The Town of Harford Highway Department utilized 17 hours of straight time force account labor and 17 hours of force account equipment to make repairs to Site 10. The outlet side of the culvert filled in with gravel 15 feet wide by 100 feet long by 3 feet deep (167 cubic yards). The gravel was cleaned out using an excavator and (2) dump trucks. The gravel was hauled to the temporary storage Site 12 at location 42.45132, -76.18877 on Hilsinger Road. A signed authorization by Richard Tillotson is attached to this subgrant application for temporary storage of gravel. The area has been verified as a Zone x flood zone as shown on attached Firmette for Site 12. The road shoulder 4 feet wide by 565 feet long by 1 foot deep (84 cubic yards) was filled with 36 yards of cobble stone and 48 cubic yards of bank run and graded. The two sections of oil and stone surface roadbed 20 feet by 30 feet and 10 feet by 150, (233.3 square yards) were repaired with a dump truck and a spreader box. There was a total of 186.64 gallons of oil and 9.332 tons of 1A stone was used in a two layer process. The calculations for this application are as follows: Labor/wfringe Shane Merriman $360.00 Dan Courtney $325.00 Steve Perry $58.00 = $325.00 6 hours X $28.95 ST = $173.70 6 hours X $24.09 ST = $144.54 5 hours X $21.51 ST = $107.55 $3.301hr = $3.30 Total $425.79 Total $1071.30 Materials Cobble Stone 36cy X $1.251cy = $45.00 Bank Run 48cy x $1.751cy = $84.00 Equipment Dump Auto Car 6 hours X $60/hr = Dump Western 5 hours X $65/hr = Grader 1 hours X $581hr = Excavator 5 hours x $65/hr Spreader Box 1 hour x Oil .4 gal/sq. yd. Stone 40lbslsq. yd. Area 20 ft by 30 ft plus 150 ft by 10 ft equals 2100 sq ft divided by 9 equals 233.3 sq yds Oil 233.3 sq yds x .4 gal x 2 coats equals 184.64 gal 186.64 gal x $1.960/gal equals $365.81 Stone 1A- 233.3 sq yd x40 lbs/gal x2 coats equals 18,664 lbs divided by 2000lbsltn equals 9.332 ton 9.332 ton x $11.25/ton equals $104.99 The stone was from stock and the oil was delivered at the site by Vestal Asphault during the application process. Material Total = $599.80 Total Site 10 Cost = $2096.89 RECORD RETENTION: Complete records and cost documents for all approved work must be maintained for at least 3 years from the date the last project was completed or from the date final payment was received, whichever is later. Applicant is responsible for retention of all documentation associated with this project. SUPPORTING DOCUMENTATION: 100% of the documentation to support this project has been reviewed and verified by the Applicant and Project Specialist for eligibility and correctness. All supporting documentation has been returned to and retained by the applicant. PROCUREMENT: The applicant is required to adhere to State Government Procurement rules and regulations and maintain adequate records to support the basis for all purchasing of goods and materials and contracting services for projects approved under the Public Assistance program, as stated in 44 CFR 13.36. The applicant has advised they have/will follow their normal procurement procedures. PERMITS: The PA Project Specialist has advised the Applicant that it is their responsibility to obtain all applicable local, state and federal permits prior to any construction or debris disposal activity referenced on this project. Applicant has also been advised that the lack of obtaining and maintaining these documents may jeopardize funding. INSURANCE: The applicant is aware that all projects are subject to an insurance review as stated in 44 C.F.R. Sections 206.252 and 206.253.If applicable an insurance determination will be made either as anticipated proceeds or actual proceeds in accordance with the applicant's insurance policy that may affect the total amount of the project. The subgrantee is not requesting Direct Administrative Costs (DAC) that are directly chargeable to https://isource.fema.netiemmie/sf9O9I Load.do?vo.ireviewId=&topTile=intemalConunon... 10/15/2013 Federal Emergency Management Agency E -Grants Page 12 of 16 this specific project. Associated eligible work is related administration of the PA project only and in accordance with 44 CFR 13.22, These costs are treated consistently and uniformly as direct costs in all federal awards and other subgrantee activities and are not included in any approved indirect cost rates. Project was reviewed for 406 Hazard Mitigation and determination is made that mitigation is not feasible, Site 11 of 13 DAMAGED FACILITY: COUNTY: Cortland Kells Road -Site 11 LOCATION: Current Version_ GPS Coordinates 42.47247, -76.17309 DAMAGE DESCRIPTION AND DIMENSIONS: Current Version: LATITUDE: LONGITUDE: 42.47247 -76.17309 During the incident period of June 26 to July 4, 2013, severe storms and flooding caused damage to public infrastructure in New York State. On July 12, 2013, a major disaster declaration was declared for 16 counties including Cortland County. Site 11 — In the Town of Harford on Kells road, a crossover poly culvert 18 inches in diameter by 40 feet long at location 42.47247, -76.17309, overtopped filling the culvert outlet area with gravel 3 feet wide by 30 feet long by 1 foot deep (3.3 cubic yards). The heavy water flow then scoured the 16 feet wide gravel roadbed for a distance of 2894 feet ending at location 42.46557, -76.17841. SCOPE OF WORK: Current Version: Work Completed Site 11 - The Town of Harford Highway Department utilized 15 hours of straight time force account labor and 15 hours of force account equipment to make repairs to Site 11. The outlet side of the crossover culvert filled in 3 feet wide by30 feet long by 1 foot deep (3.3 cubic yards) was cleaned out with an excavator and deposited on the roadbed. The 16 feet wide by 2894 feet long scoured gravel roadbed was repaired by grading. No additional material was required. Labor/wfringe Equipment Shane Merriman 5 hours X $28.95 ST = $144.75 Pick up Truck 5 hours X $20/hr = $100.00 Dan Courtney 5 hours X $24.09 ST = $120.45 Grader 5 hours X $58/hr = $290.00 Steve Perry 5 hours X $21.51 ST = $107.55 Excavator 5 hours X $65/hr = $325.00 Total $372.75 Total $715.00 Materials -no materials used Total Site 11 Cost = $1087.75 RECORD RETENTION: Complete records and cost documents for all approved work must be maintained for at least 3 years from the date the last project was completed or from the date final payment was received, whichever is later. Applicant is responsible for retention of all documentation associated with this project. SUPPORTING DOCUMENTATION: 100% of the documentation to support this project has been reviewed and verified by the Applicant and Project Specialist for eligibility and correctness. All supporting documentation has been returned to and retained by the applicant. PROCUREMENT: The applicant is required to adhere to State Government Procurement rules and regulations and maintain adequate records to support the basis for all purchasing of goods and materials and contracting services for projects approved under the Public Assistance program, as stated in 44 CFR 13.36. The applicant has advised they have/will follow their normal procurement procedures. PERMITS: The PA Project Specialist has advised the Applicant that it is their responsibility to obtain all applicable local, state and federal permits prior to any construction or debris disposal activity referenced on this project. Applicant has also been advised that the lack of obtaining and maintaining these documents may jeopardize funding, INSURANCE: The applicant is aware that all projects are subject to an insurance review as stated in 44 C.F,R. Sections 206.252 and 206.253.If applicable an insurance determination will be made either as anticipated proceeds or actual proceeds in accordance with the applicant's insurance policy that may affect the total amount of the project. The subgrantee is not requesting Direct Administrative Costs (DAC) that are directly chargeable to this specific project. Associated eligible work is related administration of the PA project only and in https://isource.fema.net/emmie/sf9091 Load.do?vo.reviewld=&topTile=internalCommon... 10/15/2013 Federal Emergency Management Agency E -Grants Page 13 of 16 accordance with 44 CFR 13.22. These costs are treated consistently and uniformly as direct costs in all federal awards and other subgrantee activities and are not included in any approved indirect cost rates. Project was reviewed for 406 Hazard Mitigation and determination is made that mitigation is not feasible. DAMAGED FACILITY: Hilsinger Road -Site 12 LOCATION: Current Version: Site 12 of 13 COUNTY: Cortland GPS Coordinates 42.45132, -76.18877 DAMAGE DESCRIPTION AND DIMENSIONS: Current Version: LATITUDE: LONGITUDE: 42.45132 -76.18877 During the incident period of June 26 to July 4, 2013, severe storms and flooding caused damage to public infrastructure in New York State. On July 12, 2013, a major disaster declaration was declared for 16 counties including Cortland County. Site 12 — In the Town of Harford on Hilsinger Road at location 42.45132, -76.18877 a temporary gravel storage location is located on Richard Tillotson property. SCOPE OF WORK: — Current Version: Site 12 — No work performed. This is the temporary gravel storage location at 42.45132, -76.18877 on Hilsinger Road. A signed authorization by Richard Tillotson is attached to this subgrant application for temporary storage of gravel. The area has been verified as a Zone x flood zone as shown on attached Firmette for Site 12. Site 13 of 13 DAMAGED FACILITY: COUNTY: Cortland Hilsinger Road -Site 13 LOCATION: Current Version: GPS Coordinates 42.45792, -76.19169 DAMAGE DESCRIPTION AND DIMENSIONS: Current Version: LATITUDE: LONGITUDE: 42.45792 1-76.19169 During the incident period of June 26 to July 4, 2013, severe storms and flooding caused damage to public infrastructure in New York State. On July 12, 2013, a major disaster declaration was declared for 16 counties including Cortland County. Site 13 — In the Town of Harford on Hilsinger Road at location 42.45792, -76.19169, heavy rains scoured the gravel road surface 16 feet wide by 300 feet long. SCOPE OF WORK: Current Version: Work Completed Site 13 - The Town of Harford Highway Department utilized 1 hour of straight time force account labor and 1 hour of force account equipment to make repairs to Site 13. A grader was used to repair the scoured gravel roadbed 16 feet wide by 300 feet long. No material was added. Cost to repair Site 13 Labor Iwfringe Equipment Steve Perry 1 hour X $21.51 ST = $21.51 Grader Ihours X $581hr = $58.00 Total $21.51 Total $ 58.00 Materials -no materials used $79.51 Total Site 13 Cost = RECORD RETENTION: Complete records and cost documents for all approved work must be maintained for at least 3 years from the date the last project was completed or from the date final payment was received, whichever is later. Applicant is responsible for retention of all documentation bttpsJ/isource.fema.net/emmie/sf9091 Load.do?vo.reviewId=&topTile=internal Common... 10/15/2013 Federal Emergency Management Agency E -Grants associated with this project Page 14 of 16 SUPPORTING DOCUMENTATION: 100% of the documentation to support this project has been reviewed and verified by the Applicant and Project Specialist for eligibility and correctness. All supporting documentation has been returned to and retained by the applicant. PROCUREMENT: The applicant is required to adhere to State Government Procurement rules and regulations and maintain adequate records to support the basis for all purchasing of goods and materials and contracting services for projects approved underthe Public Assistance program, as stated in 44 CFR 13.36. The applicant has advised they havelwill follow their normal procurement procedures. PERMITS: The PA Project Specialist has advised the Applicant that it is their responsibility to obtain all applicable local, state and federal permits prior to any construction or debris disposal activity referenced on this project. Applicant has also been advised that the lack of obtaining and maintaining these documents may jeopardize funding. INSURANCE: The applicant is aware that all projects are subject to an insurance review as stated in 44 C.F.R. Sections 206.252 and 206.253.If applicable an insurance determination will be made either as anticipated proceeds or actual proceeds in accordance with the applicant's insurance policy that may affect the total amount of the project. The subgrantee is not requesting Direct Administrative Costs (DAC) that are directly chargeable to this specific project. Associated eligible work is related administration of the PA project only and in accordance with 44 CFR 13.22. These costs are treated consistently and uniformly as direct costs in all federal awards and other subgrantee activities and are not included in any approved indirect cost rates Project was reviewed for 406 Hazard Mitigation and determination is made that mitigation is not feasible. Does the Scope of Work change the pre -disaster conditions at the site? Special Considerations included? Yes No Yes No Hazard Mitigation proposal included? Yes No Is there insurance coverage on this facility? Yes No PROJECT COST ITEM CODE NARRATIVE QUANTITYIUNIT UNIT COST I PRICE 1 0000 Work Completed -Site 1 OILS $ 0.00 $ 0.00 2 9007 ,Labor 1/LS $74-551 $ 74.55 3 9008 Equipment 1/LS $ 175.001 $ 175.00 4 9009 Material 1 /LS $ 345.001 $ 345.00 5 0000 Work Completed -Site 2 OILS $ 0.00 $ 0.00 6 9007 Labor 1/LS $ 963.60 $ 963.60 7 9008 Equipment 1/LS $ $ 2,100.00 2,100.00 8 9009 Material 1/LS $ $ 2,392.70 2,392.70 9 0000 Work Completed -Site 3 OILS $0.00 $0.00 10 9007 Labor 1/LS $ 596.40 $ 596.40 11 9008 Equipment 1/LS $ $ 1,464.00 1,464.00 12 9009 Material 1/LS $ 90.o0 $ 90.Qp 13 0000 Work to be CompletedI -Site 3 OILS $ 0.00 $ 0.00 1 IIII 14 3355 CMP 30" (Furnish and Install) 60/LF $ 74.00 $ 4,440.00 15 0000 Work to be Completed OILS $ 0.00 $ 0.00 https://isource.fema.net/emmic/sf9o91 Load.do?vo.reviewld=&topTile=internalCommon... 10/15/2013 Federal Emergency Management Agency E -Grants PREPARED BY RICHARD MUSA APPLICANT REP. Shane Merriman Page 15 of 16 l l 20/LF $ 40.00 $ 800.00 OILS 60/LF OILS 40/LF OILS 1 /LS 11LS OILS 1/LS 11LS OILS 1/LS 1 /LS OILS 1/LS 11LS 1 /LS OILS 11LS 11LS [illi"] OILS 1 /LS 11LS TITLE FEMA Project Specialist TITLE Highway Superintendent $ 0.00 $ 0.00 -Site 4 16 3351 CMP 12" (Furnish and $ 65.00 $ 2,600.00 Install) J f 17 0000 Work to be Completed $ 58.00 $ 58.00 -Site 5 18 3352 CMP 15" (Furnish and $ 480.00 $ 480.00 Install) 19 0000 Work to be Completed $ 570.00 $ 570.00 -Site 6 20 3354 CMP 24" (Furnish and 1,071.30 $ 1,071.30 Install) 21 0000 Work Completed -Site I $ 372.75 7 22 9007 Labor 23 9008 Equipment 24 0000 Work Completed -Site 8 25 9007 Labor 26 9008 Equipment 27 0000 Work Completed -Site 9 28 9007 Labor 29 9008 Equipment 30 0000 Work Completed -Site 10 31 9007 Labor 32 9008 Equipment 33 9009 Material 34 0000 Work Completed -Site 11 35 9007 Labor 36 9008 1 Equipment Work Completed - Site 37 0000 12 - No Cost Gravel Storage Temp. Location 38 0000 Work Completed -Site 13 39 9007 Labor 40 9008 Equipment PREPARED BY RICHARD MUSA APPLICANT REP. Shane Merriman Page 15 of 16 l l 20/LF $ 40.00 $ 800.00 OILS 60/LF OILS 40/LF OILS 1 /LS 11LS OILS 1/LS 11LS OILS 1/LS 1 /LS OILS 1/LS 11LS 1 /LS OILS 11LS 11LS [illi"] OILS 1 /LS 11LS TITLE FEMA Project Specialist TITLE Highway Superintendent $ 0.00 $ 0.00 $ 44.00 $ 2,640.00 $ 0.00 $ 0.00 $ 65.00 $ 2,600.00 $ 0.00 $ 0.00 $ 21.51 $21.511 $ 58.00 $ 58.00 $ 0.00 $ 0.00 $ 149.00 $ 149.00 $ 480.00 $ 480.00 $ 0.00 $ 0.00 $ 223.65 $ 223.651 $ 570.00 $ 570.00 $ 0.00 $ 0.00 $ 425.79 $ 425.79 1,071.30 $ 1,071.30 $ 599.80 $ 599.80 $ 0.00 $ 0.00 $ 372.75 $ 372.75 $ 715.00 $ 715.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 21.51 $ 21.51 $ 58.00 $ 58.00 TOTAL $ COST 23,447.56 SIGNATURE SIGNATURE https:Hisource.fema.net/emmie/sf909l Load.do?vo.reviewld=&topTile=internal Common... 10/15/2013 Y lyes TOWN OF HARFORD HIGHWAY DEPARTMENT III Route 33 Harfard M, N.Y 13333 607-844-9176 V Eqr i Hours: 3 ` f_ � _.�... T � y..J.. twrmateftl Pdoee/Unit Number of Hour TOTAL ESTIMATED COST FOR REPAIR$ '"00 TOW'q OF HARFORD IUGHWAY DEPARTMNT 271 Route 38 Harford Mme, N.Y. 13834 607.844-917o Raw fft1w Qf�olo-f Goin lq". Min H , W_g Lau* Hours: c ro JA Ali Num or of Hours Tow ro jf-06 TOTAL ESTIMATED COST FOR REPAIR, 660 271�L 00 ?(.701,? aX7 dk ;dcelum Woo Tata, AWU da:e &A*4V v APOD Num or of Hours Tow ro jf-06 TOTAL ESTIMATED COST FOR REPAIR, 660 271�L 00 ?(.701,? aX7 dk