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HomeMy Public PortalAbout110_031_gohs 2015 grant_Redacted ,EpNOW:34 O . Governor's Office of Highway Safety 7 Martin Luther King Jr Drive•Suite 643 •Atlanta,Georgia 30334 Telephone:404.656.6996 or 888.420.0767•Facsimile: 404.651.9107 www.gahighwaysafety.org Nathan Deal Harris Blackwood GOVERNOR DIRECTOR January 20,2015 Chief Robert Bryson Tybee Island Police Department P.O.Box 1340 Tybee Island, GA 31328 Dear Chief Robert Bryson: Congratulations! On behalf of GOHS Director Han-is Blackwood, I want to announce that your agency has been selected to apply for a$10,000 Small Agency Incentive Grant from the Governor's Office of Highway Safety. Your agency was selected because of the continued support of GOHS initiatives,online enforcement reporting, and participation in the Traffic Enforcement Networks. There will be a mandatory grant training meeting on Wednesday,March 25,2015 at 9:30am at the Georgia Public Safety Training Center in the Computer Training Room. The class is designed to train the Project Director and Financial Officer to manage the grant;which includes responsibility for submitting claims and reports for the grant. We will have GOHS staff on hand at this training to assist your representative(s)with creating and completing the grant application in the eGOHS system. In order to be approved for the grant,your representative(s)must attend this meeting. Each grant will have a Project Director(PD)to initiate and submit the application; as well as create/initiate and submit Monthly Activity Reports,claims,and amendments. The Fiscal Officer/Financial Officer(FO)will be able to create claims,edit budget and financial information. The Agency Authorized Official (AO)is the highest level in the agency/jurisdiction(i.e. Mayor, Commissioner,Executive Director, etc.) and oversees the grant,gives approval for the Grant Terms and Conditions as well as Special Conditions. Your representative(s)must have the names of these persons(PD,FO, &AO)with their contact information which will be entered into the application. In order to make this process easier for the participants and to get as much information as possible entered into the application,we need your representative(s)to bring the following information that will be used on the application: An Equal Opportunity Employer • Please decide what you want to buy and have your budget developed and with you. You can purchase anything that can be purchased with Federal Highway Safety Funds such as Alco sensors,radars,lasers,in car cameras, flashlights,reflective vests, etc. You cannot purchase weapons,tasers,handcuffs,handcuff keys,uniforms, etc. A list of Allowable/Non-Allowable Items(Incentive Grant column)is attached. If you have questions about a particular item, please feel free to contact me. • We will need the Georgia Legislative and Congressional Districts by local government and by county. The list is attached. • Have your agency's Federal Employer ID number and DUNS number with you. • Have your agency's Audit Period and the amount of federal funds that the jurisdiction receives(entire city or county-not just PD or SO) • We will need three years(2012,2013, and 2014) of enforcement data for your agency for number of DUI Arrests, Speeding Citations, Safety Belt violations,All Other Traffic Violations,Traffic Crashes Investigated,and Number of Check Points Conducted. • All agencies awarded federal funds through GOHS are required to receive reimbursement payments electronically. Required information is attached. Claims for reimbursement will be withheld if grantee fails to submit the Vendor Management Fonn(VMF). Please bring banking account information to complete the form. Please contact Kate Steeves by Friday,February 20,2015 to register in www.eGOHS.org (Electronic Grants for the Office of Highway Safety). This will be extremely important and will help make the training easier. Her information is Icsteevesl@gohs.ga.gov or 404-463-8978. If you should have any questions,please feel free to contact Scarlett Woods at swoods @gohs.ga.gov or 404-656-6996. Again,congratulations and thank you for your continued support and participation. Sincerely, Roger Hayes GOHS Division Director Law Enforcement Services An Equal Opportunity Employer GEORGIA COUNTIES BY 2012 LEGISLATIVE & CONGRESSIONAL DISTRICT County Name House Districts Senate Districts Congressional Districts Appling 156, 178 19 12 Atkinson 176 7 8 Bacon 169 7 1 Baker 154 12 2 Baldwin 145 25 10 Banks 28 50 9 Barrow 114, 116, 117 47 10 Bartow 14, 15, 16 14, 52 11 Ben Hill 155 7 8 Berrien 170 7 8 Bibb 140, 141, 142, 18, 25, 26 2, 8 143, 144 Bleckley 144 20 8 Brantley 178 3 1 Brooks 175 8 8 Bryan 160, 164, 166 1 1 Bulloch 158, 159, 160 4 12 Burke 126 23 12 Butts 110, 129 25 10 Calhoun 151 12 2 Camden 174, 180 3 1 Candler 158 4 12 Carroll 18, 68, 69, 70 28, 30 3 Catoosa 2, 3 53 14 Charlton 174, 180 3, 7 1 Chatham 161, 162, 163 1, 2 1 164, 165, 166 Chattahoochee 138 15 2 Chattooga 12 52, 53 14 Cherokee 20, 21, 22, 23, 46 14, 21, 56 11 Clarke 117, 118, 119 46, 47 9, 10 Clay 151 12 2 Clayton 60, 63, 74, 75, 34, 44 5, 13 76, 77, 78 Clinch 174 8 1 Cobb 34, 35, 36, 37, 38, 6, 14, 32, 33 6, 11, 13 39, 40, 41, 42, 43, j 37, 38 44, 45, 46, 53, 61 Coffee 155, 169 7 12 Based on Congressl2(Adopted August 2011),Housel2re(Adopted 2012)and Senatel2(Adopted August 2011) These districts apply in the Fall 2012 election. Report prepared by Legislative Congressional Reapportionment Office County Name House Districts Senate Districts Congressional Districts Colquitt 171, 172 11 8 Columbia 33, 121, 122, 123 23, 24 10, 12 Cook 170 8 8 Coweta 70, 71, 72, 132 28 3 Crawford 140 18 2 Crisp 148 13 2 Dade 1 53 14 Dawson 7, 9 51 9 Decatur 171, 173 11 2 DeKalb --- 79, 80, 81, 82, 83, 84, 10, 40; 41, 42-,- - 4, 5, 6 - 85, 86, 87, 88, 89, 43, 44, 55 90, 91, 92, 93, 94 Dodge 149 13 8 Dooly 139 13 2 Dougherty 151, 153, 154 12 2 Douglas 61, 62, 65, 66, 67, 68 30, 35 13 Early 151 11 2 Echols 174 8 1 Effingham 159, 161 4 1, 12 Elbert 33 24 9 Emanuel 158 4, 23 12 Evans 157 4 12 Fannin 7 51 9 Fayette 63, 64, 71, 72, 73 16, 34 3, 13 Floyd 12, 13, 14 52 14 Forsyth 9, 22, 24, 25, 26 27, 51 7, 9 Franklin 32 50 9 Fulton 22, 25, 40, 45, 47, 48, 6, 21, 28, 32, 35 5, 6, 11, 13 49, 50, 51, 52, 53,5 58 6, 57, 58, 54, 36, 38, 39, 40, 55, 5- 7, 8, 59, 60, 48, 56 61, 62, 63, 64, 65, 80, 95 Gilmer 7 51 9 Glascock 128 23 10 Glynn 167, 179 3 1 Gordon 5, 11 52, 54 14 Grady 173 11 2 Greene 120 25 10 Gwinnett 81, 93, 94, 95, 96, 97, 5, 9,.40, 41, 45, 4, 7, 10 98, 99. 100, 101. 102 48, 55 103, 104, 105, 106, 107, 108, 114 Based on Cangressl2(Adopted August 2011),Housel2re(Adopted 2012)and Senatel2(Adopted August 2011) These districts apply in the Fall 2012 election. Report prepared by Legislative Congressional Reapportionment Office County Name House Districts Senate Districts Congressional Districts Habersham 10, 28 50 9 Hall 27, 29, 30, 103 49, 50 9 Hancock 128 26 10 Haralson 16, 18 31 14 Harris 133, 134, 137 29 3 Hart 32 24 9 Heard 69 28 3 Henry 73, 76, 78, 90, 109 10, 17 3, 10, 13 110, 111, 130 Houston 140, 144, 146, 147, 148 - 18,-20, 26 8 Irwin 155 7 8 Jackson 31, 117 47, 50 9 Jasper 129 25 10 Jeff Davis 149, 156, 169 19 12 Jefferson 127, 128 23 10 Jenkins 158 i 23 12 Johnson 128, 150 23 10 Jones 129, 144 25, 26 8 Lamar 130, 131 16 3 Lanier 176 8 8 Laurens 144, 149, 150 20 12 Lee 152 13 2 Liberty 164, 168 1, 19 1 Lincoln 33 24 10 Long 167 19 1 Lowndes 174, 175, 176, 177 8 1, 8 Lumpkin 9 51 9 Macon 139 15 2 Madison 32, 33 1 47 9 Marion 138 15 2 McDuffie 121, 128 23 10 McIntosh 167 3 1 Meriwether 132, 137 29 3 Miller 154 11 2 Mitchell 171 11, 12 2 Monroe 129, 140, 141 18 8 Montgomery 156 19 12 Morgan 112 25 10 Murray 5, 6, 11 54 14 Muscogee 133, 134, 135, 136, 137 15, 29 2, 3 Based on Congressl2(Adopted August 2011),Housel2re(Adopted 2012)and Senatel2(Adopted August 2011) These districts apply in the Fall 2012 election. Report prepared by Legislative Congressional Reapportionment Office County Name House Districts Senate Districts Congressional Districts Newton 109, 110, 112, 113 17, 43 4, 10 Oconee 117, 119 46 10 Oglethorpe 120 24 10 Paulding 17, 19, 66, 67 30, 31 14 Peach 139, 140 18 2 Pickens 11 51, 54 9, 14 Pierce 178 7 1 Pike 131 16 3 Polk 16 31 14 Pulaski - 148 20 - -- 8 - Putnam 120, 145 25 10 Quitman 151 12 2 Rabun 8 50 9 Randolph 151 12 2 Richmond 123, 124, 125, 126, 127 22, 23 12 Rockdale 90, 91, 92, 109, 113, 114 17, 43 4 Schley 138 15 2 Screven 159 23 • 12 Seminole 154 11 2 Spalding 73, 130 16 3 Stephens 28 50 9 Stewart 151 12 2 Sumter 138, 152 12, 13 2 Talbot 137 15 2 Taliaferro 120 24 10 Tattnall 157 4, 19 12 Taylor 139 15 2 Telfair 149 19 8 Terrell 151 12 2 Thomas 172, 173, 175 8, 11 8 Tift 155, 170, 172 7, 13 8 Toombs 156 19 12 Towns 8 50 9 Treutlen 150 19 12 Troup 69, 132, 133 28, 29 3 Turner 155 13 8 Twiggs 144 26 8 Union 8 51 9 Upson 131 18 3 Walker 1, 2 53 14 Walton 114, 115 25, 46 10 Based on Congressl2(AdoptedAugust 2011),Housel2re(Adopted 2012)and Senatel2(Adopted August 2011) These districts apply in the Fall 2012 election. Report prepared by Legislative Congressional Reapportionment Office County Name House Districts Senate Districts Congressional Districts Ware 174, 176, 180 7 1 Warren 128 23 10 Washington 128 26 10 Wayne 157, 178 19 1 Webster 151 12 2 Wheeler 149 19 12 White 8, 10,27 51 9 Whitfield 2, 4, 6 54 14 Wilcox 148 13 8 Wilkes 33, 120 24 10 ., Wilkinson 144 26 8 Worth 152 13 8 Based on Congressl2(AdoptedAugust 2011),Housel2re(Adopted 2012)and Senatel2(Adopted August 2011) These districts apply in the Fall 2012 election. Report prepared by Legislative Congressional Reapportionment Office GOHS Equipment list- Allowable/Non-allowable Items Law Enforcement Grants TEN Incentive Item HEAT Agency network grant alco-sensors yes yes yes yes ammunition no no no no ball caps must contain GOHS logo no yes yes preapprove batons no no no no binoculars no no no no Blue lights yes yes yes yes Body Worn Cameras- Full-time Traffic Unit Only yes no no yes bulletproof vests no no no no cage for patrol car yes no no no child safety seats yes yes yes yes citation holders yes yes yes yes computer programs (crash reporting,drawing,etc) yes yes yes yes computer scanner yes yes yes yes computers, laptops yes yes yes yes console for patrol car yes no no no copy paper/toner/ink yes yes yes, yes criminal and traffic law book yes yes yes yes drug ID bible no no no no duty gear bags w/logo yes yes yes yes DVD/VHS yes yes yes yes fingerprint scanners no no no no fire extinguishers no no no no first aid kits no no no no first class air accomodations no no no no flashlights yes yes yes - yes flashlight wands, cones yes yes yes yes fuel, oil, tires,brakes yes yes yes no gas masks no no no no generator yes yes yes yes golf cart (s.i.d.n.e., DUI goggles) yes yes yes yes golf shirts- must contain GOHS logo no yes yes preapprove GPS tracker(pursuit equip) no no no no handcuff keys no no no no handcuffs no no no no in car camera yes yes yes yes in car radio yes no no no Intox 9000 yes yes yes yes jackets no no no no K-9, training, equipment, vet bill, etc no no no no latex gloves no no no no lease/purchase of equipment yes yes yes yes led pen lights yes yes yes yes license plate readers no no no no mace no no no no mainframe computers no no no no medtox test kits, drug test kits no no no no meeting room/meals for network meeting yes yes yes yes motor vehicles yes no no no Notary permit and seal no no no no nylon or leather flashlight holders no no no no office furniture no no no no overtime no no no no PAS flashlights yes yes yes yes plaques no yes yes no police form holders (not citation holders) yes yes yes yes portable radios yes yes yes yes power inverters yes yes yes yes Projector yes yes yes yes push bumpers no no no no radar yes yes yes yes rain gear, hat protectors no no no no rear seat insert for patrol car yes no no no rescue tools no no no no riot helmets no no no no seat organizers no no no no shotgun, shotgun rack no no no no stamps/envelops no no no no stop sticks no no no no survival spanish training no no no no teddy bears no no no no telephone service, basic yes no no no tint meters yes yes yes yes traffic cones - - _ , yes yes yes - -yes-- traffic gloves yes yes yes yes traffic glow sticks (flares) no no no no traffic ticket tracking software yes yes yes yes traffic vests yes yes yes yes trailer (bat trailer, DUI goggles golf cart, etc) yes yes yes yes trunk organizers yes yes yes yes t-shirts- must contain GOHS logo no yes yes preapprove uniforms no no no no utility key chain no no no no vehicle tags yes yes no weapon mount light no no no no window barrier for patrol car yes no no no revised 1/21/15 ( oe .eo4 VENDOR MANAGEMENT FORM (PeopleSoft Financial System) a%TA I The initiating Agency will submit this form to the Vendor Management Group for verification and approval.Agency must titre complete section 5 of the form to obtain approval. SECTION 1—VENDOR IDENTIFICATION (COMPLETE ALL APPLICABLE FIELDS) VENDOR NUMBER: FEI/SSN/EMP ID NUMBER: VENDOR NAME: PAYMENT ALT NAME:(IF CHECK IS TO BE PAYABLE IN A DIFFERENT NAME) ADDRESS: ADDRESS CONT: CITY: STATE: ZIP CODE: COUNTRY: PHONE NUMBER: FAX NUMBER: EMAIL: SECTION 2—BANK ACCOUNT INFORMATION (ATTACH COPY OF VOIDED CHECK) ROUTING# BANK ACCOUNT# CI Check here if General Bank Account can be used by ALL State of Georgia agencies making payments 0 Check here if this account can only be used for a SPECIFIC purpose (Indicate specific purpose for which this account can be used) I authorize the State of Georgia to deposit payment for goods or services received into the provided bank account by the Automated Clearing House(ACH). I further acknowledge that this agreement is to remain in full effect until such time as changes to the bank account information are submitted in writing by the vendor or individual named above. I understand it is the sole responsibility of the vendor or individual to notify the State of Georgia of any changes to the bank account information. (Vendor Printed Name) (Vendor Signature) (Date) SECTION 3—SPECIFY TYPE OF ACTION(CHECK ALL THAT APPLY) O New Vendor Q Employee El 1099 Code O Classification Change OAdd address O FEI/TIN Change" El Name Change" CI Change of Address:Address# IO Right of Way Purchase O Vendor Deactivation O Fleet Anywhere Vendor C Other(provide details in Section 4) O Bank Account Add O Bank Account Change O Bank Account Delete Documentation for Vendor Name/TIN changes must include at least one of the following: IRS documentation(tax documents,FR issuance letter,etc); Confirmation from Secretary of State's office of legal name change OR a newly completed W-9 form provided by the vendor. SIC CODES(CHECK ALL THAT APPLY) O Small Business I= Women Owned =Minority Business Enterprise O African American C Asian American p GA Based Business 0 Minority Business Certified p Hispanic-Latino O Native American O Pacific Islander SECTION 4—ADDITIONAL COMMENTS SECTION 5—STATE OF GEORGIA AGENCY CONTACT INFORMATION(OFFICE USE ONLY) Requestor Name: Janice Crawford Agency BU#:46600 Date: Emall: jcrawford @gohs.ga.gov Phone:(404) 651-8460 Fax#: (678) 717-6759 T 4 x VENDOR MANAGEMENT FORM (PeopleSoft Financial System) The initiating Agency will submit this form to the Vendor Management G roue for verification and approval.Agency must ' ,n complete section 5 of the form to obtain approval. SECTION 1—VENDOR IDENTIFICATION(COMPLETE ALL APPLICABLE FIELDS) VENDOR NUMBER: FEI/SSN/EMP ID NUMBER: _ _ - VENDOR NAME: PAYMENT ALT NAME: IF CHECK IS TO BE PAYABLE IN A DIFFERENT NAME) ADDRESS: ADDRESS CO NT: I CITY: STATE: ZIP CODE: COUNTRY: • PHONE NUMBER: FAX NUMBER: EMAIL: SECTION 2—BANK ACCOUNT INFORMATION (ATTACH COPY OF VOIDED CRECJ$)_ ROUTING# BANK ACCOUNT# I1 Check here if General Bank Account can be used by ALL State of Georgia agencies making payments 0 Check here if this account can only be used for a SPECIFIC purpose (Indicate specific purpose for which this account can be used) I authorize the State of Georgia to deposit payment for goods or services received into the provided bank account by the Automated Clearing House(ACH). I further acknowledge that this agreement is to remain in full effect until such time as changes to the bank account information are submitted in writing by the vendor or individual named above. I understand it is the sole responsibility of the vendor or individual to notify the State of Georgia of any changes to the bank account information. (Vendor Printed Name) (Vendor Signature) (Date) SECTION 3—SPECIFY TYPE OF ACTION(CHECK ALL THAT APPLY) New Vendor © Employee J 1 1099 Code Classification Change Q Add address FEI/TIN Change** ❑ Name Change** 0 Change of Address:Address If iJ Right of Way Purchase CI Vendor Deactivation li Fleet Anywhere Vendor 1=1 Other(provide details in Section 4) 0 Bank Account Add El Bank Account Change © Bank Account Delete Documentation for Vendor Name/TIN changes must include at least one of the following: IRS documentation(tax documents,FEI issuance letter,etc); Confirmation from Secretary of State's office of legal name change OR a newly completed W-9 form provided by the vendor. SIC CODES(CHECK ALL THAT APPLY) Small Business O Women Owned Q Minority Business Enterprise C] African American = Asian American GA Based Business O Minority Business Certified p Hispanic-Latino Q Native American I=1 Pacific Islander SECTION 4—ADDITIONAL COMMENTS SECTION 5—STATE OF GEORGIA AGENCY CONTACT INFORMATION(OFFICE USE ONLY) Requester Name: Janice Crawford Agency BU#:46600 Date: Email: jrawford@gohs.ga.gov Phone:(404) 651-8460 Fax#: (678) 717-6759