69-10 - Agreement

Panel Review Page 6 of 6 FEDERAL EMERGENCY MANAGEMENT AGENCY OBLIGATING DOCUMENT FOR AWARD/AMENDMENT 11a. AGREEMENT NO. 2. AMENDMENT 3. RECIPIENT NO. 4.TYPEOF 5. CONTROL NO. EMW-2009-FO-11636 NO 22-6002396 ACTION W468977N i) AWARD 6. RECIPIENT NAME AND —_—_7. ISSUING OFFICE AND ADDRESS 8. PAYMENT OFFICE AND ADDRESS ADDRESS Grant Programs Directorate FEMA, Financial Services Branch West Orange Fire Department 500 C Street, S.W. 500 C Street, S.W., Room 723 415 Valley Road Washington DC, 20528-7000 Washington DC, 20472 West Orange POC: Sylvia Carroll New Jersey, 07052-5226 9. NAME OF RECIPIENT PHONE NO. 10. NAME OF PROJECT COORDINATOR PHONE NO. PROJECT OFFICER 9737318962 Tom Harrington 1-866-274-0960 Alicia Skinner 11, EFFECTIVE DATE OF 12. METHOD OF 13. ASSISTANCE ARRANGEMENT 14, PERFORMANCE PERIOD THIS ACTION PAYMENT Cost Sharing From:05-MAR- 5.04 MAR11 05-MAR-10 SF-270 10 oan Budget Period From O1-OCT- T5:39.SEP-10 15. DESCRIPTION OF ACTION a. (Indicate funding data for awards or financial changes) PROGRAM NAME CFDA NO. ACCOUNTING DATA PRIOR AMOUNT CURRENT CUMMULATIVE ACRONYM (ACCS CODE) TOTAL AWARDED THIS TOTAL AWARD NON- XXXK-KAK-AKAXXK-XXXKK- AWARD ACTION FEDERAL XXXX-XXXX-K + OR (-) COMMITMENT AFG 97.044 2010-M9-3120GF-25000000- $0.00 $47,483.00 $47,483.00 $5,275.00 4101-D TOTALS $0.00 $47,483.00 $47,483.00 $5,275.00 b. To describe changes other than funding data or financial changes, attach schedule and check here. N/A 16a. FOR NON-DISASTER PROGRAMS: RECIPIENT IS REQUIRED TO SIGN AND RETURN THREE (3) COPIES OF THIS DOCUMENT TO FEMA (See Block 7 for address) Assistance to Firefighters Grant recipients are not required to sign and return copies of this document. However, recipients should print and keep a copy of this document for their records. 16b. FOR DISASTER PROGRAMS: RECIPIENT IS NOT REQUIRED TO SIGN This assistance is subject to terms and conditions attached to this award notice or by incorporated reference in program legislation cited above. 17. RECIPIENT SIGNATORY OFFICIAL (Name and Title) DATE N/A NIA 18. FEMA SIGNATORY OFFICIAL (Name and Title) DATE Sylvia Carroll 02-MAR-10 Go Back https://eservices. fema.gov/FemaFireGrant/firegrant/jsp/fire_admin/awards/spec/view_awar... 3/12/2010