KRAF Agreement of Service
KansasBoard of EmergencyMedicalServices
_
900 S.W. Jackson,Suite 1031, Topeka,Kansas 66612
(785) 296-7296FAX: (785) 296-6212
KRAFGrant ProgramCY2019AgreementofService
Completeandreturnoriginaldocuments,andretainacopyforyourrecords
AsagranteeunderthetermsoftheKansasBoardofEmergencyMedicalServicesRevolvingandAssistanceFund(KRAF)GrantProgramthe undersignedherebyagrees toabide bythefollowingrequirements:
1.Awardsshallnotbetransferable.Anyfundsdisbursedpursuanttoanawardshallbeproperlyusedandaccountedforatalltimes.Granteeistoberesponsibleforthepreparationandmaintenanceofproperaccountingrecordswhichshallbemaintainedforaperiodofnotlessthanfive(5)yearsandwhichshallbesubjecttoandavailableforinspectionbytheExecutiveDirector,StateInspector,orhisagentforstateauditinspections.
Byapplyingforandacceptingtheawardedproperty,therecipientacknowledgestheirresponsibilityforaperiodoffiveyears ofreceiptto:
1.Ensuretheequipmentand/ormaterialsareavailableforannual inspectionbyaKBEMSrepresentative;and
2.Ensuretheequipmentand/ormaterialsaremaintainedinoperationalorderandmaintainedaccountabilityand maintenanceofequipmentand/ormaterials.
Forthepurposesofthisrequirement,propertyfallsintothreecategories:Equipment: Itemscostingabove $300.
Materials:Durableitemscostingfrom$50. -$300.Supplies:ExpendableitemsOR items costingunder$100.
IntheeventthatanEMSServicesurrenderstheirServicepermitwithin4 yearsoftheawardoftheequipmentand/ormaterials,theownershipofthesame,revertstotheBoardofEMS.Ifthe owner/operatorwhohas contractedfortheequipmentand/ormaterials has beenabsorbedunderanotherPermittedEMSServiceanddesirestheequipment,anewcontractmustbemadewithreceivingpartytoinitiateaformaltransferofequipmenttothenewowner/operator.Thenewowner/operator,uponreceiptoftheequipmentassumescontractualresponsibilitiesasidentifiedabovewiththeoptiontopurchasethepropertyata20%annualdepreciationcosts,basedon thereceiveddateofthe property.
Ifmatchingfundswereinvolved,theywillbeconsideredaswell,ata20%annualdepreciation.
2.GranteemustcomplywithallconditionsasnotedonAwardLetter.Shouldanyauditrevealthatfundswereusedforitem(s)notawardedfunding, the granteeshallbeheldresponsibleforrepayment.
3.Equipment,whichisawardedfunding,istobepurchasednew/used/refurbished,beoperational,andalldocumentationmustbesubmittedduringtheapplicationprocess.Ifthegranteewishestopurchaseanitemthatisnotnew,arequestforamodificationmustbesubmittedinwritingwithinten(10)calendardaysafterthe deadline.“Used/Refurbished”mustbeshown onthequote.
4.Grantfunds are forpurchaseditemsonly.Leasedequipment is noteligibleforreimbursement.A loan(forthe match)onKRAF awardedequipmentis notallowed.
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KRAFGrant ProgramCY2019AgreementofService
5.Nofundsshallbe provided forconstructioncosts;vehicles;fireapparatusand/orequipment;dailyoperationalcostssuchasexpensesforelectricity,gasolineortires;extendedwarrantiesorserviceagreements.
6.Ownershipofanyequipmentpurchased,inwholeorinpart,withtheuseofstatemoniesshallbeinthename oflicensedambulanceserviceto whichfundingwasawarded, orin the name ofthelocaljurisdictioninwhichtheorganizationislocated.Theequipmentpurchasedinwholeorinpartwiththeuseofstatemoniesshallbeusedbythe granteeand shallremain foruse withinthegrantee’sjurisdiction.
7.Thegranteeshallcomplywithallplans,policies,proceduresandguidelinesadoptedbytheKansasBoardofEmergencyMedicalServices, astheymayapply.
8.Thegranteeshallnotdiscriminate in the provisionofitsservices orin the conductofitsbusiness oraffairson thebasisofrace,color,creed,religion,sex,disability, ornationalorigin.
9.AllpartiesinvolvedintheproductionofanycomponentofafundedprojectshouldbeawarethattheKBEMSreservestherighttoreproduce anysuchprojectsforstate-wideuse.
VERIFICATION
I,astheOperator,affirmthatthegranteeagreestoabidebyallitemslistedintheAgreementforServices,andbysigningbelowatteststothisfact.Anyfraudulentsubmissionsforpayment(ormisrepresentationsofanykind)maybeconsideredsufficientcauseforgrantrevocation,repaymentandpossibleprosecutionofboththe GranteeandtheOperator,whosenameappearsbelow.
NameofGrantee(Agency)Nameand TitleofOperator / Print: Signature:
DaytimePhoneNo.
E-mailaddress(ifavailable)
SignatureofServiceDirector / Print: Signature:
FederalIdentification Number(FIN)
GrantNumber(KBEMSonly)
DateExecuted(KBEMSonly)
NOTE:Yourgrantawardmayhaveacondition.Thisconditionmustbemetinordertoreceivegrantfunds.