Agency Acknowledgement & Agreement

The undersigned, representing (organization/city)* hereby acknowledges receipt of the item(s) of equipment listed below and certifies that at the time of initial inspection this equipment was in good working order. This equipment was purchased with federal Homeland Security Grant Program (HSGP) funds through the Governor's Office of Homeland Security, as approved by the Nevada County HSGP Approval Authority. The procurement procedures used to purchase this equipment conform to applicable federal laws and standards. As federally funded equipment, it is understood that this equipment must be made available for mutual aid, as requested.

By accepting this equipment (organization/city) * agrees to maintain accountability of all items, mark or tag all individual items or sets and control purposes, maintain or repair any items and ensure all Code of Federal Regulations (CFR) required record keeping. ID tag numbers, location of storage, and physical condition will be reported to Nevada County OES at the time of purchase, and at least once every two years thereafter.

Items lost or destroyed within the Grant Performance Period checked below must be replaced solely by the city or organization originally signing for the equipment at its own expense. All items, regardless of cost, procured under this or any federal grant programs will be maintained and controlled for the useful life of the items, and any sale, disposal, or planned destruction of said items will be done only upon receipt of written approval of the U.S. Department of Homeland Security of its delegated representative.