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Form 5-NIIYIS Compliance <br />CMS Coanpliance Information <br />I o be eligible to receive FY 20f 0 F ederal preparedness funding assistance, applicants must meet NIMS compliance <br />requirements. State, Territory, Tribal, and local governments are considered to be in full NIMS compliance if they have <br />adopted and/or implemented the FY05, FYOb, FY07, FY08 and FY09 compliance activities. Adoption and/or <br />implementation has been self=certified each year by the Governor's oflice for each State and Territory, which includes <br />Iribal and local governments Ohio Revised Code 5502.28(c} designates NIMS and its incident response management <br />component, the Incident Command System (ICS), as the primary response/recovery framework for all jurisdictions in the <br />state <br />Iherefore, the Applicant's Director, Chief Executive, or designee must review and certify below that these FY05, FY06, <br />FY07, FYO$ and FY09 NIMS requirements have in fact been implemented to the "good faith effort" standard within the <br />agency of jurisdiction by all disciplines receiving direct benefit as a result of FY05, FY06, FY07, FY08 and F Y09 <br />expenditures and likely to receive direct benefit as a result of'I'Y2010 SHSP expend'ihues. Evidence of compliance with <br />these requirements must be made available, upon request, to Ohio EMA Failure to do so may result in suspended or <br />terminated funding <br />Please check one: <br />^ The Applicant is one of the 1'7 state agencies, commissions, divisions, or departments, or is a jurisdiction over <br />5,000 population (based on the 2000 U.S. Census) required to complete a National Incident Management System <br />Compliance Assistance Support Tool (NIMSCASI~ The Applicant's NIMSCAST is complete and any open <br />corrective action plans are being addressed. <br />^ The Applicant is not requited to complete a National Incident Management System Compliance Assistance <br />Support Iool (NIMSCAST) The Applicant has established a training program that ensures the requisite <br />NICvIS/ICS training for personnel with a role in emergency response or incident management The Applicant also <br />has established-the necessary policies and procedures to execute any responsibilities assigned in a state or local <br />emergency operations plan. <br />the Applicant hereby certifies that the tasks necessary to. address implementation of NIMS requirements in <br />accordance with FX091VIhI5 guidance have been accomplished, and as such the. Applicant has satisfied the NIMS <br />compliance conditions that are a prerequisite to receipt of FY2010 grant funds.. <br />Grant Signatory (signature) Date <br />Please refer to the Ohio NIMS Implementation Guidance is available at http•//ema Ohio gov/NimsGuidance.asnx.for <br />additional detail regarding NIMS compliance [equirements. <br />Page 36 <br />