Form FEMA Form 089-10 FEMA Form 089-10 Narrative Statement

DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY

URBAN SEARCH RESCUE RESPONSE SYSTEM
NARRATIVE STATEMENT
Paperwork Burden Disclosure Notice
Public reporting burden for this form is estimated to be 4 hours per response. The burden estimate includes the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
submitting the form. You are not required to respond to this collection of information unless it displays a valid OMB Number.
Send comments regarding the accuracy of this burden estimate and any suggestions for reducing the burden to: Collections
and Research Branch, Department of Homeland Security, Federal Emergency Management Agency, 1800 South
Bell Street, Arlington, VA 20590-3305, Paperwork Reduction Project (1660-0073). Note: Do not send your completed
form to this address.
APPLICATION TABLE OF CONTENTS
SECTION NAME

TAB

Table Of Contents
Checklist
Sample Cover Letter
Preparer & Contact Information
SF 424 - Application
SF 424 A - Budget
SF 424 B - Assurances/Certifications
SF LLL Lobbying Activities Form
Purpose of Cooperative Agreement
Administration & Management
Training
Equipment
Storage & Maintenance
Budget Summary
Appendix 1 - Position Descriptions
Appendix 2 - Form for Additional
Budget Clarification Information

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

APPLICATION CHECKLIST
DUE DATE
DONE

ITEM

NOTES

SF 424 (Application)
(SF 424 A (Budget Form)
Budget Narrative (Four Program Category Spreadsheets)
Assurances & Certifications
SF 424 B
SF LLL (If Lobbying)
Latest Single Audit Information Attacked (if current audit is in progress,
please provide estimated date of completion in "Notes" column)
Single Audit Corrective Plan (If findings)
Request for authorization of pre-award costs (If training or meetings
prior to start of Cooperative Agreement)
Indirect Cost Rate Agreement approved by cognizant government
agency (If charging indirect costs)
Rolling/Floating transportation specifications (if applicable)
Position Descriptions (Attach or fill in Appendix I - Tab 14)
Form for additional Budget Clarification Information (Attach or fill in
Appendix 2 - Tab 15)
FEMA Form 089-10

Page 1 of 36

SAMPLE COVER LETTER FOR COOPERATIVE AGREEMENT APPLICATION

Month XX, 20XX
US Department of Homeland Security
Federal Emergency Management Agency
Grants Management Branch
Attn: Ms. Sylvia A. Carroll
Tech World, Room 411
500 C Sgreet, SW
Washington, DC 20472
Dear Ms. Carroll:
Enclosed is the US&R application of Your Sponsoring Agency Name for the year 20XX
Department of Homeland Security/FEMA, Urban Search & Rescue Cooperative Agreement
for a total of $xxx,xxx.
We are including an original application package and one copy of each:
1. Application for Federal Assistance, SF 424
2. Budget Information - Non Construction Programs FEMA form SF 424A
3. Budget Narrative
4. Summary Sheet for Assurances and Certifications, SF 424 B
5. SF LLL
6. Single Audit Report for 20XX
7. Indirect Cost Rate Authorization
Please call "Your Point of Contact" at (XXX) XXX-XXXX or email at [email protected] or
"Alternate Point of Contact" (XXX) XXX-XXXX or email at [email protected] for any other
information that you man need.
Sincerely,

Your Agency Head
Title
Agency

FEMA Form 089-10

Page 2 of 36

PREPARER AND CONTACT INFORMATION
PREPARER INFORMATION
PREFIX
FIRST NAME
MIDDLE NAME
LAST NAME
TITLE
AGENCY/ORGANIZATION
ADDRESS 1
ADDRESS 2
CITY
STATE
ZIP CODE
PHONE
FAX
E-MAIL
CONTACT INFORMATION
PREFIX
FIRST NAME
MIDDLE
LAST NAME
TITLE
AGENCY/ORGANIZATION
ADDRESS 1
ADDRESS 2
CITY
STATE
ZIP CODE
PHONE
FAX
E-MAIL
FEMA Form 089-10

Page 3 of 36

APPLICANT INFORMATION
TASK FORCE
ORGANIZATION NAME
EMPLOYER IDENTIFICATION NUMBER
DUNS NUMBER
ADDRESS 1
ADDRESS 2
CITY
COUNTY
STATE
ZIP CODE
COUNTRY
AUTHORIZED REPRESENTATIVE FIRST NAME.
AUTHORIZED REPRESENTATIVE MIDDLE NAME.
AUTHORIZED REPRESENTATIVE LAST NAME.
AUTHORIZED REPRESENTATIVE TITLE
AUTHORIZED REPRESENTATIVE PHONE NUMBER
APPLICANT IDENTIFIER (If Applicable)
STATE APPLICANT IDENTIFIER (If applicable)
ORGANIZATIONAL UNIT
DEPARTMENT
DIVISION
MADE AVAILABLE FOR EO 12372 (Answer Y or N)
DATE REVIEWED (If applicable)
"Y" FOR NOT COVERED, "N" FOR NOT SELECTED

FEMA Form 089-10

Page 4 of 36

PURPOSE OF AGREEMENT

The purpose of this Readiness Cooperative Agreement is to continue the development and maintenance of
National Urban Search and Rescue (US&R) Response System resources to e prepared for mission response
and to provide qualified personnel in support of Emergency Support Function-9 (ESF-9) activities under the
National Incident Management System (NIMS) and the National Response Plan (NRP).
Our Task Force agrees to manage the continued development and maintenance of this National US&R
Response System resource. We will be prepared to provide qualified, competent US&R personnel in support
of ESF-9 activities under the National Response Framework. Specifically, the FY2009 Statement of Work and
the accompanying budget narrative provides our plan to accomplish our objectives identified by DHS/FEMA.
This work plan identifies the key areas that our Task Force will focus its continued readiness efforts. These
key areas are administrative and program management, training, support, equipment cache preparedness,
maintenance and storage. These key areas are detailed in the Statement of Work. This Cooperative
Agreement will allow our Task Force to maintain a high standard and condition of operational readiness. It is
the intent of our Task Force to comply with the US&R Response System FY 2009 Statement of Work throughout
the duration of this agreement.
While portions of the FY2009 Statement of Work are included in the budget narrative, we acknowledge compliance
with the FY2009 Statement of Work in its entirety.

FEMA Form 089-10

Page 5 of 36

ADMINISTRATION AND MANAGEMENT
Task Force General Comments
TF-1 will accomplish the goals set forth in the DHS-FEMA statement of work, guidance, and directives provided by the Urban Search & Rescue
Program office. The costs for the Administration & Management portion of the budget/narrative will be addressed in this section and will cover costs for
a maximum amount of time of 12 months, and the costs will occur within the 16 month period of performance. The cost details will be provided in the
object classes within this Program category.
TF-1 Administrative/Management personnel are responsible for the day-to-day operations of
the Task Force and will be responsible to ensure that all management, administration, and operational requirements are accomplished. Out Task Force
will attempt to maintain the preparedness of the Task Force under this Readiness Cooperative Agreement, in order to provide critical emergency response
services as one of the 28 teams for the National Urban Search and Rescue Response System under the Activation Cooperative Agreement. Funding for
any deployments will be handled under the Activation Cooperative Agreement.
Total Administration & Management Cost

$

PERSONNEL SALARIES & FRINGE BENEFITS SECTION
Notes For Personnel Salaries and Fringe Benefits Section
The Task Force will provide sufficient staff for management and administration of the US&R Task Force day-to-day activities to accomplish required
supervisory, administrative, training and logistical duties. Specifically, program management, grants management, financial management, administrative
support, training coordination and instruction, logistics management and property accountability. This shall include, but is not limited to, funding personnel
salaries relating to Task Force development and management, record keeping, inventory and maintenance of the US&R Equipment Caches,
correspondence with Task Force members and parties who support Task Force activities, along with similar management ad administrative tasks.
Provide the staffs' salary, benefits, and also note any cost of living increases (percentage and amount) below what will be paid under the Cooperative
Agreement. There is drop-down menu for the staff positions, and any additional staff not noted can be added. If a staff position is part-time, please
provide the hours and hourly rate in the Personnel box below to clarify the time to be allotted, e.g., one day a week, 40 hours a month at a rate of $45.00
per hour, etc. If overtime hours are listed, please not them as a separate line item blow. Put the total amount under salary. Note the hourly rate in the
clarification box.
Staff Position

Full/Part
Time

Name

Overtime
Hours

Salary Dates
(Current)

Salary Dates
(Prior)

Fringe Benefits

Salary

Totals

TOTALS
Personnel Salaries
The area below is for any additional notes the Task Force may need to add for clarifying the paid staff positions. If the position is part-time list the hours
and the hourly rate. Also, there is a separate area (Appendix) for the position descriptions for each staff position listed, or position descriptions may be
added as an attachment.

Cost Basis (please check the appropriate boxes)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 6 of 36

Fringe Benefits (if applicable)
The area below is to state the total percentage (e.g., 23%) for the Fringe Benefits (if applicable) and list the items (e.g., health, dental, workers' comp) that
are included.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:

TRAVEL
Notes For Travel Section
Attend DHS/FEMA-sponsored or DHS/FEMA-approved US&R meetings, conferences, and training sessions, to include Task Force Leader meetings, the
12 standing US&R Work Groups, Operations Group, Ad Hoc Work Groups and Sub Groups, Incident Support Team (IST) training/meetings, workshops,
or others as directed by the US&R Program Office as they relate to the National US&R Response System. Other activities include on-site peer
Operational Readiness Evaluation (ORE) of other Task Forces, quality assurance oversight of FEMA-sanctioned training courses, training with other
Task Forces, grants management training, and research and development for equipment, as directed by the US&R Program Office. Based on approval
by the US&R Program Office and available funding, Task Forces can use funds to cover travel for product research and development efforts; thereby
keeping apprised of cutting edge technology for equipment used within the system.
There are also miscellaneous meetings that are required due to the dynamic program. Costs can be provided in detail or by trip costs, and a detail of the
costs should be listed in the comments sections, that will show how you arrived at the trip total. The costs listed below are estimates due to travel
locations that are unknown at the time of application. It is at this time when costs are generally based on historical data. There are drop down menus
for some of the meetings, and you can add others that are in line with the state of work. The drop down menu in the section below includes all events,
allowing you the flexibility to account for your travel costs in this section Admin/Management Program Category or the Training Program Category. The
Task Force is authorized to reallocate fund between Admin/Management travel and Training travel without requesting a budget change authorization.
However, this change must be reflected in your Performance Report and note the reason(s) for the change.
Event Title

No. of Personnel

No. of Trips (approx).

Cost Per Person

Total Cost

TOTAL
Travel
Briefly describe breakdown of travel Cost Per Person. Provide examples of "other authorized travel" if selected above.

Cost Basis (please check the appropriate box)
Union Agreements

City/County/Organization Negotiated Agreements

Historical Data

Bids/Quotes

Costs are in Comparison w/ other TFs for Similar Tasks or Items

Other

If other, list here:
FEMA Form 089-10

Page 7 of 36

EQUIPMENT
Notes For Equipment Section
Purchase of office furniture and equipment specifically for administrative purposes are allowable under this Cooperative Agreement. This shall include,
but is not limited to, laptops and desktop computers, cellular telephones/wireless PDAs, printers, scanners, copy machines, desks, book shelves, etc.
The costs noted in this area are for the purchase of equipment and not service agreements, which should be included under contractual or other.
Rolling or floating transportation will require specifications as part of the application and should be listed under the Equipment Program Category. The
general definition of "Equipment" out of the FCFR is: "Equipment" means an article of non-expendable, tangible personal property having a useful life
of more than one year and an acquisition cost that equals or exceeds the lesser of the capitalization level established by the governmental unit for
financial statement purposes, or $5000.
These are the items our Task Force anticipates requiring for the FY2009 Cooperative Agreement for the equipment object class under the Administration/
Management Program Category. However, due to the the dynamic program, the requirements for these items (within the amount approved at time of
award for this object class) may change. Any changes to listed item swill be reflected in the Performance Reports, with the reason for the change noted
ad the Task Force will not e required to submit a budget change if items are on the approved cache lists, authorized by program guidance or directives.
Item Description

Cache #

Unit Cost

No. of Units

Totals

TOTAL
Equipment
Describe any additional supporting information for equipment costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 8 of 36

SUPPLIES
Notes For Supplies Section
In the below area, provide an approximate listing of the supplies necessary for the administration/management of this cooperative agreement. Supply
items/costs that should be listed are items to support the administration/management of the Task Force and other than what the equipment definition
states as follows: The general definition of "Equipment" out of the CFR is: "Equipment" means an article of non-expendable, tangible personal property
;having a useful life of more than one year and an acquisition cost that equals or exceeds the lesser of the capitalization level established by the
governmental unit for financial statement purposes, or $5000. However, due to the dynamic program, the requirements for these items (within the
amount approved at time of award for the object class) may change. Any changes to the listed items will be reflected in the Performance Reports,
including the reason for the change(s) noted.
These are the items we anticipate requiring for the FY2009 Cooperative Agreement. However, due to the dynamic program, requirement of these items
may change and any changes will be reflected in the Performance Reports, with the reason for the changed noted.
Item Description

Cache #

Unit Cost

No. of Units

Total Cost

TOTAL
Supplies
Describe any additional supporting information for supply costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 9 of 36

CONTRACTUAL
Notes For Contractual Section
In the area below, list any contractual costs for medical exams, services, rentals, etc. The Task Force Medical Screening will take place in accordance
with Program Directive 2005-008 or a more current revised directive issued by the US&R Program Office.
Quantity

Service

Unit Cost

Total Cost

TOTAL
Contractual
Describe any additional supporting information for contractual costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 10 of 36

OTHER
Notes For Other Section
This area will cover any miscellaneous items that are not covered in the other object classes and are allowable under the Statement of Work.
Quantity

Item

Unit Cost

Total Cost

TOTAL
Other
Describe any additional supporting information for other costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:

INDIRECT COSTS
Notes For Indirect Costs Section
Indirect Costs can only be listed if there is an Indirect Cost Rate Agreement that has been approved by a cognizant Federal Agency. A copy of the Indirect
Cost Rate Agreement should accompany the application. The Indirect Cost Rate Agreement you provide should state what category or categories the
Indirect Costs are based on, e.e., equipment, salaries, all expenses, etc. The information provided below should list the description of the cost category
for the base, the amount on which it's based, the percentage, and the total. The rate or amount approved at time of award will prevail through the term
of the Cooperative Agrement.
Item/Category

Item Description

Base Amount

Percentage

Total Cost

TOTAL
Indirect Costs
Describe any additional supporting information for indirect costs below. Please advise who is the Cognizant Federal Agency and the date of approval..

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 11 of 36

TRAINING
Task Force General Comments
TF-1. The training portion of this
This Program Category covers the costs for the training portion of the Readiness Cooperative Agreement for
this budget/narrative will cover costs for a maximum amount of time of 12 months, and will be accomplished within the 16 month period of performance.
TF-1 intends to maintain a deployable Task Force and will provide the required training to insure mission readiness, safety, and management
of the Task Force. The training will be accomplished in accordance with the Urban Search & Rescue Program Office statement of work, program
guidance, directives, and will also include training to meet the NIMS compliance requirements. The training cost details will be provided in the below
object classes under this Program Category. Our Task Force will attempt to maintain the preparedness of the Task Force under this Readiness
Cooperative Agreement; in order to provide critical emergency response services as one of the 28 teams for the National Urban Search and Rescue
Response System. Funding for any deployments will be handled under the Activation Cooperative Agreement. The below list of training and costs
covers what is anticipated for this Readiness Cooperative Agreement.
Total Administration & Management Cost

$

PERSONNEL SALARIES & FRINGE BENEFITS SECTION
Notes For Personnel Salaries and Fringe Benefits Section
The Task Force can use this category to account for the salaries of Task Force Members attending US&R-related, US&R-required, and local training as
well as salaries for the training coordinator. This includes, but is not limited to, functional training, mobilization training, local training for the program,
grants management training, training with other task forces, research and development for equipment, and other DHS/FEMA approved training events,
or training related to the requirements of the US&R program, as approved by the Program Manager/Grants Assistance Officer. This may also include
backfill expenses for the individual(s) attending training. If specific costs are unknown, give estimated salary hours and average salary rate. If specific
dates are unknown, provide estimated time frame (e.g., 1 day per week/month, etc.). If overtime hours are listed, please note them as a separate line
item below. Put the total amount under salary. Note the hourly rate in the clarification box.
Staff Position

Training Event
Description

Full/Part
Time

Overtime
Hours

Date
Salary Changed

Fringe Benefits
(If Applicable)

Salary

Totals

TOTALS
Personnel Salaries
The area below is to provide additional notes the Task Force may need to add for clarifying the range of salary rates used to develop the average hourly
cost.

Cost Basis (please check the appropriate boxes)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 12 of 36

Fringe Benefits (if applicable)
The area below is to state the total percentage (e.g., 23%) for the Fringe Benefits (if applicable) and list the items (e.g., health, dental, workers' comp) that
are included.

Cost Basis (please check the appropriate box)
Union Agreements

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Bids/Quotes

Historical Data
Other

If other, list here:

TRAVEL
Notes For Travel Section
Attend DHS/FEMA-sponsored or DHS/FEMA-approved US&R meetings, conferences, and training sessions, to include Task Force Leader meetings, the
12 standing US&R Work Groups, Operations Group, Ad Hoc Work Groups and Sub Groups, Incident Support Team (IST) training/meetings, workshops,
or others as directed by the US&R Program Office as they relate to the National US&R Response System. Other activities include on-site peer
Operational Readiness Evaluation (ORE) of other Task Forces, quality assurance oversight of FEMA-sanctioned training courses, training with other
Task Forces, grants management training, and research and development for equipment, as directed by the US&R Program Office. Based on approval
by the US&R Program Office and available funding, Task Forces can use funds to cover travel for product research and development efforts; thereby
keeping apprised of cutting edge technology for equipment used within the system.
There are also miscellaneous meetings that are required due to the dynamic program. Costs can be provided in detail or by trip costs, and a detail of the
costs should be listed in the comments sections, that will show how you arrived at the trip total. The costs listed below are estimates due to travel
locations that are unknown at the time of application. It is at this time when costs are generally based on historical data. There are drop down menus
for some of the meetings, and you can add others that are in line with the state of work. The drop down menu in the section below includes all events,
allowing you the flexibility to account for your travel costs in this section Admin/Management Program Category or the Training Program Category. The
Task Force is authorized to reallocate fund between Admin/Management travel and Training travel without requesting a budget change authorization.
However, this change must be reflected in your Performance Report and note the reason(s) for the change.
Event Title

No. of Personnel

Cost Per Person

Lump Sum

TOTAL
Travel
Briefly describe breakdown of travel Cost Per Person. Provide examples of "other authorized travel" if selected above.

Cost Basis (please check the appropriate box)
Union Agreements

City/County/Organization Negotiated Agreements

Historical Data

Bids/Quotes

Costs are in Comparison w/ other TFs for Similar Tasks or Items

Other

If other, list here:
FEMA Form 089-10

Page 13 of 36

EQUIPMENT
Notes For Equipment Section
Purchase of equipment specifically for training, to include props, training materials, training facility expenses, etc. are allowable under this Cooperative
Agreement. The costs noted in this area are for the purchase of equipment and not service agreements, which should be included under contractual
or other. Rolling or floating transportation, if allowable, will require specifications/approval as part of the application. The general definition of "Equipment"
out of the CFR is: "Equipment" means an article of non-expendable, tangible personal property having a useful life of more than one year and an
acquisition cost that equals or exceeds the lesser of the capitalization level established by the governmental unit for financial statement purposes, or
$5000.
These are the items our Task Force anticipates requiring for the FY2009 Cooperative Agreement for the equipment object class under the Administration/
Management Program Category. However, due to the the dynamic program, the requirements for these items (within the amount approved at time of
award for this object class) may change. Any changes to listed item swill be reflected in the Performance Reports, with the reason for the change noted
ad the Task Force will not e required to submit a budget change if items are on the approved cache lists, authorized by program guidance or directives.
Item Description

Item #

Cache #

Unit Cost

No. of Units

Total Cost

TOTAL
Equipment
Describe any additional supporting information for equipment costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 14 of 36

SUPPLIES
Notes For Supplies Section
In the below area, provide an approximate listing of the supplies necessary for the administration/management of this cooperative agreement. Supply
items/costs that should be listed are items to support the administration/management of the Task Force and other than what the equipment definition
states as follows: The general definition of "Equipment" out of the CFR is: "Equipment" means an article of non-expendable, tangible personal property
;having a useful life of more than one year and an acquisition cost that equals or exceeds the lesser of the capitalization level established by the
governmental unit for financial statement purposes, or $5000.
These are the items our Task Force anticipates requiring for the FY2009 Cooperative Agreement. However, due to the dynamic program, the requirements
for these items may change and any changes will be reflected in the Performance Reports, including the reason for the change(s) noted. A budget change
is not required to be submitted if the costs in this category remain the same and items are allowable under the SOW, Directives Guidance and Cache
List.
Item

Cache #

Unit Cost

No. of Units

Total Cost

TOTALS
Supplies
Describe any additional supporting information for supply costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 15 of 36

CONTRACTUAL
Notes For Contractual Section
In the area below, list any contractual costs for medical exams, services, rentals, etc., as it pertains to training.
Quantity

Service

Unit Cost

Total Cost

TOTAL
Contractual
Describe any additional supporting information for contractual costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 16 of 36

OTHER
Notes For Other Section
This area will cover any miscellaneous items that are training-related and allowable under the State of Work but not covered in the other object classes.
Quantity

Item

Unit Cost

Total Cost

TOTAL
Other
Describe any additional supporting information for other costs below.

Cost Basis (please check the appropriate box)
Union Agreements

City/County/Organization Negotiated Agreements

Historical Data

Bids/Quotes

Costs are in Comparison w/ other TFs for Similar Tasks or Items

Other

If other, list here:

INDIRECT COSTS
Notes For Indirect Costs Section
Indirect Costs can only be provided if there is an Indirect Cost Rate Agreement that has been approved by a cognizant Federal Agency. A copy of the
Indirect Cost Rate Agreement should accompany the application. The Indirect Cost Rate Agreement you provide should state what category or categories
the Indirect Costs are based on, i.e., equipment, salaries, all expenses, etc. The information provided below should list the description of the cost category
for the base, the amount on which it's based, the percentage, and the total. The rate or amount approved at time of award will prevail through the term
of the Cooperative Agrement.
Item/Category

Item Description

Base Amount

Percentage

Total Cost

TOTAL
Indirect Costs
Describe any additional supporting information for indirect costs below. Please advise who is the Cognizant Federal Agency and the date of approval.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 17 of 36

EQUIPMENT
Task Force General Comments
This program Category covers the costs for the equipment portion of the Readiness Cooperative Agreement for
TF-1. The period of
performance covers a 16-month period to accomplish the work in this area.
TF-1 intends to maintain a deployable Task Force and will
provide the required equipment to insure mission readiness, safety, and management of the Task Force. The equipment will be purchased in
accordance with the requirements of the Urban Search & Rescue Program Office statement of work, program guidance, and directives. The equipment
and supporting cost details will be provided in the below object classes under this Program Category. Our Task Force will attempt to maintain the
preparedness of the Task Force under this Readiness Cooperative Agreement, in order to provide critical emergency response services as one of the
28 teams for the National Urban Search and Rescue Response System.
The below list of equipment and costs covers what is anticipated for this Readiness Cooperative Agreement. Due to the dynamic program, training
scheduling and requirement changes, some of the equipment listed may require revisions. Any changes will be noted within the Performance Reports,
and will include the change and the reason for the change. It will not require a budget adjustment as long as the change is within the Program
Category total as noted at time of award, and is an approved equipment requirement within the statement of work, program guidance, and directives.
Total Equipment Cost

$

PERSONNEL SALARIES & FRINGE BENEFITS SECTION
Notes For Personnel Salaries and Fringe Benefits Section
The Task Fo4ce can use this category to account for the salaries of Task Force Members who perform duties related to maintenance of US&R equipment
and vehicles. This may also include backfill expenses for individual(s) who are working with the cache. If specific costs are unknown, give estimated
salary hours and average salary rate. If specific dates are unknown, provide estimated time frame (e.g., 1 day per week, month, etc.). If overtime hours
are listed, please note them as a separate item below. Put the total amount under salary. Note the hourly rate in the clarification box.
Staff Position

Full/Part Time

Overtime Hours Date Salary Charged

Fringe Benefits (if applicable

Salary

Totals

TOTALS
Personnel Salaries
The area below is to provide additional notes the Task Force may need to add for clarifying the range of salary rates used to develop the average hourly
costs.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 18 of 36

Fringe Benefits (if applicable)
The area below is to state the total percentage (e.g., 23%) for the Fringe Benefits (if applicable) and list the items (e.g., health, dental, workers' comp) that
are included.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:

TRAVEL
Notes For Travel Section
The Task Force can use this category to account for the salaries of Task Force Members who perform duties related to maintenance of US&R equipment
and vehicles. This may also include backfill expenses for individual(s) who are working with the cache. If specific costs are unknown, give estimated
salary hours and average salary rate. If specific dates are unknown, provide estimated time frame (e.g., 1 day per week/month, etc.). If overtime hours
are listed, please not them on a separate item below. Put the total amount under salary. Note the hourly rate in the clarification box.
Event Title

No. of Personnel

Cost Per Person

No. of Trips (approx).

Total Cost

TOTAL
Travel
Briefly describe breakdown of travel Cost Per Person. Provide examples of "other authorized travel" if selected above.

Cost Basis (please check the appropriate box)
Union Agreements

City/County/Organization Negotiated Agreements

Historical Data

Bids/Quotes

Costs are in Comparison w/ other TFs for Similar Tasks or Items

Other

If other, list here:
FEMA Form 089-10

Page 19 of 36

EQUIPMENT
Notes For Equipment Section
Your agency is authorized to purchase equipment as listed in the approved DHS/Fema Task Force Equipment Cache List, dated August 2003 or any
subsequently approved DHS/FEMA US&R Equipment list. Task Force personnel are reminded and directed not to exceed quantity and/or cost caps as
listed on the cache list. Task Force must follow department procurement regulations, which are in accordance with 44 CFR Part 13 or 2 CFR 215 to
ensure reasonable prices are obtained. The US&R Program Office and the Grants Office Assistance Officer must provide written approval for any other
equipment not identified on approved cache list(s), in program guidance, or specifications. Those Task Forces who maintain an IST Medical Cache are to
include the appropriate amount below for replacement of equipment and pharmaceuticals.
However, due to the dynamic program, the requirements for these items (within the amount approved at time of award for this object class) may change.
Any changes to listed items will be reflected in the Performance Reports, noting the reason for the change and the Task Force will not be required to submit
a budget change if items are on the approved cache lists, noted in the state of work, or authorized by program guidance or directives. Rolling or floating
equipment requires the specifications to be submitted to the Program Office/Grants Assistance Officer for prior approval. The general definition of
"Equipment" out of the CFR is: "Equipment" means an article of nonexpendable, tangible personal property having a useful life of more than one year and
an acquisition cost that equals or exceeds the lesser of the capitalization level established by the governmental unit for financial statement purposes, or
$5,000.
List below those items your Task Force anticipates requiring for the FY2009 Cooperative Agreement for the equipment object class under the Equipment
Program Category.
Item Description

Item #

Cache #

Unit Cost

No. of Units

Total Cost

TOTAL
Equipment
Describe any additional supporting information for equipment costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 20 of 36

SUPPLIES
Notes For Supplies Section
In the area below, provide an approximate listing of necessary supplies. Supply items/costs that should be listed are items other than what the equipment
definition states as follows: The general definition of "Equipment" out of the CFR is: "Equipment" means an article of nonexpendable, tangible personal
property having a useful life of more than one year and an acquisition cost that equals or exceeds the lesser of the capitalization level established by
the governmental unit for financial statement purposes, or $5000. However, due to the dynamic program, the requirements for these items (within the
amount approved at time of award for this object class) may change. Any changes to the listed items will be reflected in the Performance Reports,
including the reason for the change(s) noted.
List below those items your Task Force anticipates requiring for the FY2009 Cooperative Agreement for the equipment object class under the Equipment
Program Category. A budget change is not required to be submitted for approval if the costs in the object class remain as approved at time of award and
the items are allowable in accordance with the statement of work, program guidance and directives.
Cache #

Item

Unit Cost

No. of Units

Total Cost

TOTALS
Supplies
Describe any additional supporting information for supply costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 21 of 36

CONTRACTUAL
Notes For Contractual Section
In the area below, list any supporting information for the contractual costs of services, rentals, etc. for equipment.
Quantity

Service

Unit Cost

Total Cost

TOTAL
Contractual
Describe any additional supporting information for contractual costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 22 of 36

OTHER
Notes For Other Section
This area will cover any miscellaneous items that are equipment-related and allowable under the Statement of Work but not covered i the other object
classes.
Quantity

Item

Unit Cost

Total Cost

TOTAL
Other
Describe any additional supporting information for other costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:

INDIRECT COSTS
Notes For Indirect Costs Section
Indirect Costs can only be provided if there is an Indirect Cost Rate Agreement that has been approved by a cognizant Federal Agency. A copy of the
Indirect Cost Rate Agreement should accompany the application. The Indirect Cost Agreement that you provide should state what category or categories
the Indirect Costs are based on, i.e., equipment, salaries, all expenses, etc. The information provided below should list the description of the cost
category for the base, the amount on which it's based, the percentage, and the total. This rate or amount approved at time of award will prevail through
the term of the Cooperative Agreement
Item/Category

Item Description

Base Amount

Percentage

Total Cost

TOTAL
Indirect Costs
Describe any additional supporting information for indirect costs below. Please advise who is the Cognizant Federal Agency and the date of approval..

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 23 of 36

STORAGE & MAINTENANCE
Task Force General Comments
This program Category covers the costs for the storage/maintenance portion of the Readiness Cooperative Agreement for
TF-1. The costs
for the Storage/Maintenance portion of this budget/narrative will be addressed in this section and will cover costs for a maximum amount of time of 12
months for any warehouse lease or maintenance costs for the equipment/vehicles, and the costs will occur within the 16 month period of performance.
TF-1. intends to provide the required storage and maintenance for the equipment to insure mission readiness, safety, and management of the
Task Force. The storage and maintenance will be in accordance with the requirements of the Urban Search & Rescue Program Office statement of work,
program guidance and directives,. The supporting cost details will be provided in the below object classes under this Program Category.
Our Task Force will attempt to maintain the preparedness of the Task Force under this Readiness Cooperative Agreement, in order to provide critical
emergency response services as one of the 28 teams for the National Urban Search and Rescue Response System. The below list of costs covers what
is anticipated for this Readiness Cooperative Agreement. Minor renovations are allowed for the warehouse and they will not change the footprint of the
facility.
Total Equipment Cost

$

PERSONNEL SALARIES & FRINGE BENEFITS SECTION
Notes For Personnel Salaries and Fringe Benefits Section
The Task Force can use this category to account for the salaries of Task Force Members who perform duties related to storage & maintenance. This may
also include backfill expenses for individual(s) who are working with related projects. If specific costs are unknown, give estimated salary hours and
average salary rate. If specific dates are unknown, provide estimated time frame (e.g, 1 day per week/month, etc.). If overtime hours are listed, please
note them as a separate line item below. Put the total amount under salary. Note the hourly rate in the clarification box.
Staff Position

Full/Part Time

Overtime Hours Date Salary Charged

Fringe Benefits (if applicable

Salary

Totals

TOTALS
Personnel Salaries
The area below is to provide additional notes the Task Force may need to add for clarifying the range of salary rates used to develop the average hourly
costs.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 24 of 36

Fringe Benefits (if applicable)
The area below is to state the total percentage (e.g., 23%) for the Fringe Benefits (if applicable) and list the items (e.g., health, dental, workers' comp) that
are included.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:

TRAVEL
Notes For Travel Section
This section can be used for those travel items related to storage, maintenance and/or equipment (e.g,, mileage, etc.) allowable within the scope of the
Statement of Work. Please note: These expenses can be reflected within the Administrative/Management travel category instead. Costs can be
provided in detail or by trip costs, and a detail of the costs should be listed in the comments sections, that will show how you arrived at the trip total. The
costs listed below are estimates due to travel locations that are unknown at the time of application. It is at this time when costs are generally based on
historical data. There are drop down menus for some of the meetings, and you can add others that are in line within the Statement of Work.
Event Title

No. of Personnel

Cost Per Person

No. of Trips

Total Cost

TOTAL
Travel
Briefly describe breakdown of travel Cost Per Person. Provide examples of "other authorized travel" if selected above.

Cost Basis (please check the appropriate box)
Union Agreements

City/County/Organization Negotiated Agreements

Historical Data

Bids/Quotes

Costs are in Comparison w/ other TFs for Similar Tasks or Items

Other

If other, list here:
FEMA Form 089-10

Page 25 of 36

EQUIPMENT
Notes For Equipment Section
This section may be used to reflect expenses related purchasing, maintenance and repair of equipment and vehicles, as approved by DHS/FEMA and
within the scope of the Statement of Work. Your Task Force is authorized to purchase equipment as listed in the approved DHS/FEMA Task Force
Equipment Cache List, dated August 2003 or any subsequently approved DHS/FEMA US&$ Equipment list. Task Force personnel are reminded and
directed not to exceed quantity and/or cost caps as listed on the cache list. Task Force must follow department procurement regulations, which are in
accordance with 44 CFR Part 13 or 2 CFR 215 to ensure reasonable prices are obtained. The US&R Program Office and the Grants Office Assistance
Officer must provide written approval for any other equipment not identified on approved cache list(s). Those Task Forces who maintain an IST
Medical Cache are to include the appropriate amount below for replacement of equipment and pharmaceuticals. Please note: These expenses can
be reflected within the Equipment category instead.
Item Description

Item #

Cache #

Unit Cost

No. of Units

Total Cost

TOTAL
Equipment
Describe any additional supporting information for equipment costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:

FEMA Form 089-10

Page 26 of 36

SUPPLIES
Notes For Supplies Section
In the area below provide an approximate listing of necessary supplies. Supply items/costs that should be listed are items other than what the equipment
definition states as follows: The general definition of "Equipment" out of the CFR is: "Equipment" means an article of non-expendable, tangible personal
property having a useful life of more than one year and an acquisition cost that equals or exceeds the lesser of the capitalization level established by the
governmental unit for financial statement purposes, or $5000.
Cache #

Item

Unit Cost

No. of Units

Total Cost

TOTAL
Supplies
Describe any additional supporting information for supply costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 27 of 36

CONTRACTUAL
Notes For Contractual Section
In the area below, list any supporting information for the contractual costs of services, rentals, etc., as it pertains to the maintenance and/or lease of
storage facilities and associated US&R equipment and supplies. Under the quantity for leases, please include the square footage of the warehouse.
This section can also include costs for planning, engineering and other costs for development, maintenance, minor construction, upgrades, minor
renovations and modifications, etc. of the existing warehouse/training facilities that do not change the footprint of the structures. Any costs for upgrades
to existing warehouse facilities associated with this funding must be included and be approved by the Program Office and Grants Assistance Officer.
This Cooperative Agreement may not be used for funding new capital construction.
Service

Prior
Coverage Dates

Lease
Begin Date

Lease
End Date

Quantity

Unit Cost

Total Cost

TOTALS
Contractual
Describe any additional supporting information for contractual costs below. Include square footage and cost per foot for any facility leases included above.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 28 of 36

OTHER
Notes For Other Section
This area will cover any miscellaneous items that are storage & maintenance-related and allowable under the Statement of Work but not covered in the
other object classes, including minor construction costs.
Quantity

Item

Unit Cost

Total Cost

TOTAL
Other
Describe any additional supporting information for other costs below.

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:

INDIRECT COSTS
Notes For Indirect Costs Section
Indirect Costs can only be provided if there is an Indirect Cost Rate Agreement that has been approved by a cognizant Federal Agency. A copy of the
Indirect Cost Rate Agreement should accompany the application. The Indirect Cost Agreement that you provide should state what category or categories
the Indirect Costs are based on, i.e., equipment, salaries, all expenses, etc. The information provided below should list the description of the cost
category for the base, the amount on which it's based, the percentage, and the total. This rate or amount approved at time of award will prevail through
the term of the Cooperative Agreement
Item/Category

Item Description

Base Amount

Percentage

Total Cost

TOTAL
Indirect Costs
Describe any additional supporting information for indirect costs below. Please advise who is the Cognizant Federal Agency and the date of approval..

Cost Basis (please check the appropriate box)
Union Agreements
Bids/Quotes

City/County/Organization Negotiated Agreements
Costs are in Comparison w/ other TFs for Similar Tasks or Items

Historical Data
Other

If other, list here:
FEMA Form 089-10

Page 29 of 36

BUDGET SUMMARY
This summary will be populated based on figures entered into other sections of this narrative.

ACTIVITY

COST

OBJECT CLASS

COST

Administration & Management
Training
Equipment
Storage & Maintenance

Personnel
Fringe Benefits
Travel
Equipment
Supplies
Other
Indirect Charges

ACTIVITY SUM
OBJECT CLASS SUM
TOTAL

FEMA Form 089-10

Page 30 of 36

APPENDIX 1 - POSITION DESCRIPTIONS
Please fill in position descriptions below, or attach pre-typed descriptions.
1. Administrative Specialist. Name:
Describe Administrative Specialist functions here.

2. Financial Grants Manager. Name:
Describe Financial Grants Manager functions here.

3. Grant Manager. Name:
Describe Grant Manager functions here.

4. Logistics Coordinator. Name:
Describe Logistics Coordinator functions here.

5. Logistics Manager. Name:
Describe Logistics Manager functions here.

1. Program Manager. Name:
Describe Program Manager functions here.

FEMA Form 089-10

Page 31 of 36

APPENDIX 1 - POSITION DESCRIPTIONS - continued
Please fill in position descriptions below, or attach pre-typed descriptions.
7. Training Coordinator. Name:
Describe Training Coordinator functions here.

8. Training Manager. Name:
Describe Training Manager functions here.

Other (Please list position and name):
Describe position functions here.

Other (Please list position and name):
Describe position functions here.

Other (Please list position and name):
Describe position functions here.

Other (Please list position and name):
Describe position functions here.

FEMA Form 089-10

Page 32 of 36

APPENDIX 2 - BUDGET CLARIFICATION (additional space, if needed)
Please use the blocks below to clarify any items you weren't able to fit into the other portions of the narrative.
ADMINISTRATIVE MANAGEMENT
Personnel Salaries:

Fringe Benefits:

Travel:

Equipment:

Supplies:

Contractual:

Oher

Indirect Charges

FEMA Form 089-10

Page 33 of 36

APPENDIX 2 - BUDGET CLARIFICATION (additional space, if needed) - continued
Please use the blocks below to clarify any items you weren't able to fit into the other portions of the narrative.
TRAINING
Personnel Salaries:

Fringe Benefits:

Travel:

Equipment:

Supplies:

Contractual:

Oher

Indirect Charges

FEMA Form 089-10

Page 34 of 36

APPENDIX 2 - BUDGET CLARIFICATION (additional space, if needed) - continued
Please use the blocks below to clarify any items you weren't able to fit into the other portions of the narrative.
EQUIPMENT
Personnel Salaries:

Fringe Benefits:

Travel:

Equipment:

Supplies:

Contractual:

Oher

Indirect Charges

FEMA Form 089-10

Page 35 of 36

APPENDIX 2 - BUDGET CLARIFICATION (additional space, if needed) - continued
Please use the blocks below to clarify any items you weren't able to fit into the other portions of the narrative.
STORAGE AND MAINTENANCE
Personnel Salaries:

Fringe Benefits:

Travel:

Equipment:

Supplies:

Contractual:

Oher

Indirect Charges

FEMA Form 089-10

Page 36 of 36