Attachment A
State of CalifornIA
GOVERNOR’S OFFICE OF EMERGENCY SERVICES Cal OES ID No:059-00000
Cal OES 130
DESIGNATION OFAPPLICANT'SAGENT RESOLUTION FOR NON-STATEAGENCIES
BE IT RESOLVED BY THE Board of SupervisorsOF THE County of Orange
(GoverningBody) (NameofApplicant)
THAT Deputy Director, OC Public Works, OC Operations and Maintenance,OR
(TitleofAuthorizedAgent)
Manager, OC Public Works, City Contracts,OR
(TitleofAuthorizedAgent)
Emergency Management/FEMA Coordinator, OC Public Works,
(TitleofAuthorizedAgent)
ishereby authorizedtoexecute for andonbehalfof the County of Orange, apublic entity
(NameofApplicant)
established under the lawsof the Stateof California, this applicationandtofile it with theCalifornia Governor’s Office of Emergency Services for thepurpose of obtaining certainfederalfinancial assistanceunderPublic Law93-288as amendedby theRobert T.Stafford DisasterRelief andEmergency Assistance Act of 1988, and/or statefinancial assistanceunder the CaliforniaDisaster AssistanceAct.
THAT the County of Orange , apublic entity established under thelawsofthe State of California,
(NameofApplicant)
hereby authorizes its agent(s) to provide tothe Governor’s Office of Emergency Servicesfor all matters pertaining to such state disaster assistance theassurances and agreements required.
Please check the appropriate box below:
This is a universal resolution and is effective for all open and future disasters up to three (3) years following the date of approval below.
This is a disaster specific resolution and is effective for only disaster number(s) ______
Passed andapprovedthis day of ,20
Michelle Steel, Chairman, Board of Supervisors,
(NameandTitle ofGoverningBodyRepresentative)
Andrew Do, Vice Chair, Board of Supervisors,
(NameandTitle ofGoverningBodyRepresentative)
Todd Spitzer, Supervisor,
(NameandTitle ofGoverningBodyRepresentative)
Shawn Nelson, Supervisor,
(NameandTitle ofGoverningBodyRepresentative)
Lisa Bartlett, Supervisor,
(NameandTitle ofGoverningBodyRepresentative)
CERTIFICATION
I,Robin Stieler,duly appointedand Clerk of the Boardof
(Name)(Title)
County of Orange,do hereby certify that the above isa trueandcorrect copyofa
(NameofApplicant)
Resolution passedand approved by the Board of Supervisorsof the County of Orange
(GoverningBody)(NameofApplicant)
on the day of , 20.
(Signature) (Title)
Cal OES 130 (Rev.9/13) Page 1
State of CalifornIA
GOVERNOR’S OFFICE OF EMERGENCY SERVICES
Cal OES 130 - Instructions
Cal OES Form 130 Instructions
A Designation of Applicant’s Agent Resolution for Non-State Agencies is required of all Applicants to be eligible to receive funding. A new resolution must be submitted if a previously submitted Resolution is older than three (3) years from the last date of approval, is invalid or has not been submitted.
WhencompletingtheCal OESForm130,Applicantsshould fill intheblanksonpage1. Theblanksaretobe filled inasfollows:
Resolution Section:
Governing Body: Thisisthe groupresponsibleforappointingandapprovingtheAuthorized Agents.
Examplesinclude: BoardofDirectors,CityCouncil,BoardofSupervisors, Board of Education, etc.
Name of Applicant: The public entity established under the laws of the State of California. Examples include: School District, Office of Education, City, County or Non-profit agencythat hasapplied forthegrant, such as: CityofSan Diego, SacramentoCounty, Burbank Unified School District, Napa County Office of Education, University Southern California.
Authorized Agent: Thesearetheindividuals that areauthorizedbytheGoverningBodytoengagewith the Federal Emergency Management Agency andthe Governor’s Office of Emergency ServicesregardinggrantsappliedforbytheApplicant. Therearetwowaysofcompletingthissection:
1. Titles Only: IftheGoverningBodysochooses,the titlesoftheAuthorizedAgentswouldbe enteredhere,nottheirnames.Thisallowsthedocumenttoremainvalid (for 3 years)ifanAuthorizedAgent leavesthepositionandisreplacedbyanotherindividual in the same title. If “Titles Only”isthechosenmethod,this documentmustbeaccompaniedbya cover letter namingtheAuthorizedAgentsbyname and title. Thiscover letter canbe completedbyanyauthorizedpersonwithintheagencyanddoesnotrequirethe Governing Body’ssignature.
2. Namesand Titles: IftheGoverningBodysochooses,thenamesand titles oftheAuthorizedAgents wouldbelisted.AnewCal OESForm130 will be required ifanyofthe AuthorizedAgentsare replaced, leave theposition listed onthedocument or their title changes.
Governing BodyRepresentative: Thesearethenamesand titles oftheapprovingBoardMembers.
Examples include: ChairmanoftheBoard,Director,Superintendent, etc. The names and titles cannotbe one of thedesignated Authorized Agents, and a minimum of two or more approving board members need to be listed.
CertificationSection:
Name and Title: Thisistheindividual that wasinattendanceandrecordedtheResolutioncreationandapproval.
Examples include: CityClerk,SecretarytotheBoardofDirectors,CountyClerk, etc. Thispersoncannotbeoneofthe designated AuthorizedAgents or Approving Board Member (if a person holds two positions such as City Manager and Secretary to the Board and the City Manager is to be listed as an Authorized Agent, then the same person holding the Secretary position would sign the document as Secretary to the Board (not City Manager) to eliminate “SelfCertification.”
Cal OES 130 (Rev.9/13) Page 2
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