HomeMy WebLinkAboutCertification U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
OFFICE OF THE COMPTROLLER
CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND
OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS
Applicants should refer to the regulations cited below to determine the certification to which they are required to
attest. Applicants should also review the instructions for certification included in the regulations before completing this
from. Signature of this form provides for compliance with certification requirements under 28 CFR Part 69, "New
Restrictions on Lobbying" and 28 CFR Part 67, "Government-wide Department and Suspension (Nonprocurement) and
Government-wide Requirements for Drug-Free Workplace (Grants)." The certifications shall be treated as a material
representation of fact upon reliance will be placed when the Department of Justice determines to award the
covered transaction, grant, or cooperative agreement.
1. LOBBYING public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;
As required by Section 1352, Title 31 of the U.S. Code, and implemented at 28 CFR Part 69, for persons entering into a grant or cooperative agreement over $100,000, as defined at 28 CFR Part 69, the applicant certifies that:
(c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) withcommission of any of the offenses enumerated in paragraph (1)(b) of this certification; and
(a) No Federal appropriate funds have been paid or will be paid,by or on behalf of the undersigned, to any person for influencingor attempting to influence an officer or employee of any agency,a Member of Congress, an officer or employee of Congress, oran employee of a Member of Congress in connection with themaking of any Federal grant, the entering into of anycooperative agreement, and extension, continuation, renewal,amendment, or modification of any Federal grant or cooperativeagreement;
(d) Have not within a three-year period preceding this applicationhad one or more public transactions (Federal, State, or local) terminated for cause or default; and
B. Where the applicant is unable to certify to any of thestatements in this certification, he or she shall attach anexplanation to this application.(b) If any funds other than Federal appropriated funds have beenpaid or will be paid to any person for influencing or attempting toinfluence an officer or employee of any agency, a Member ofCongress, an officer or employee of Congress, or an employee ofa Member of Congress in connection with this Federal grant orcooperative agreement, the undersigned shall complete andsubmit Standard Form - LLL, "Disclosure of LobbyingActivities," in accordance with its instructions;
3. DRUG-FREE WORKPLACE(GRANTEES OTHER THAN INDIVIDUALS)
As required by the Drug-Free Workplace Act of 1988, and implemented at 28 CFR Part 67, Subpart F, for grantees, as defined at 28 CFR Part 67 Sections 67.615 and 67.620-
(c) The undersigned shall require that the language of this cer -tification be included in the award documents for all subawards atall tiers (including subgrants, contracts under grants andcooperative agreements, and subcontracts) and that all sub -recipients shall certify and disclose accordingly.
A. The applicant certifies that it will or will continue to provide adrug-free workplace by:
(a) Publishing a statement notifying employees that theunlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken againstemployees for violation of such prohibition;2. DEBARMENT, SUSPENSION, AND OTHERRESPONSIBILITY MATTERS (DIRECT RECIPIENT)
(b) Establishing an on -going drug-free awareness program toinform employees about-As required by Executive Order 12549, Debarment and Suspension, and implemented at 28 CFR Prt 67, for prospective participants in primary covered transactions, as defined at 28 CFR Part 67, Section 67.510-(1) The dangers of drugs abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free workplace;A. The applicant certifies that it and its principals:(3) Any available drug counseling, rehabilitation, and employeeassistance programs; and(a) Are not presently debarred, suspended, proposed for debar -ment, declared ineligible, sentenced to a denial of Federalbenefits by a State or Federal court, or voluntarily excluded fromcovered transactions by any Federal department or agency;(4) The penalties that may be imposed upon employees for drugabuse violations occurring in the workplace;
(c) Making it a requirement that each employee to be engaged inthe performance of the grant be given a copy of the statementrequired by paragraph (a);(b) Have not within a three-year period preceding this applicationbeen convicted of or had a civil judgment rendered against themfor commission of fraud or a criminal offense in connection withobtaining, attempting to obtain, or performing a (d) Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant,the employee will-
CAG-20-359 Certification
(1) Abide by the terms of the statement; and Seattle Enforcement Group D-22
300 5th Ave, Suite 1300
Seattle, WA 98104
(2) Notify the employer in writing of his or her conviction for aviolation of a criminal drug statute occurring in the workplace nolater than five calendar days after such conviction;
(e) Notifying the agency, in writing, within 10 calendar days afterreceiving notice under subparagraph (d)(2) from an employeeor otherwise receiving actual notice of such conviction.Employers of convicted employees must provide notice, includingposition title, to: Department of Justice, Office of JusticePrograms, ATTN: Control Desk, 633 Indiana Avenue, N.W.,Washington, D.C. 20531. Notice shall include the identificationnumber(s) of each affected grant;
Check if there are workplace on file that are not identified here.
Section 67, 630 of the regulations provides that a grantee that is a State may elect to make one certification in each Federal fiscal year. A copy of which should be included with each application for Department of Justice funding. States and State agencies may elect to use OJP Form 4061/7.
(f) Taking one of the following actions, within 30 calendardays of receiving notice under subparagraph (d)(2), withrespect to any employee who is so convicted-Check if the State has elected to complete OJP Form
4061/7.
(1) Taking appropriate personnel action against such anemployee, up to and including termination, consistent with therequirements of the Rehabilitation Act of 1973, as amended; or DRUG-FREE WORKPLACE(GRANTEES WHO ARE INDIVIDUALS)
(2) Requiring such employee to participate satisfactorily in a drugabuse assistance or rehabilitation program approved for suchpurposes by a Federal, State, or local health, law enforcement,or other appropriate agency;
As required by the Drug -Free Workplace Act of 1988, and implemented at 28 CFR Part 67, Subpart F, for grantees, as defined at 28 CFR Part 67; Sections 67.615 and 67.620-
A. As a condition of the grant, I certify that I will not engage inthe unlawful manufacture, distribution, dispensing, possession,or use of a controlled substance in condition any activity withthe grant; and
(g) Making a good faith effort to continue to maintain a drug- freeworkplace through implementation of paragraphs (a), (b), (c), (d),(e), and (f).
B. The grantee may insert in the space provided below the site(s) for the performance of work done in connection with thespecific grant:
B. If convinced of a criminal drug offense resulting from aviolation occurring during the conduct of any grant activity, I willreport the conviction, in writing, within 10 calendar days of theconviction, to: Department of Justice, Office of Justice Programs,ATTN: Control Desk, 633 Indiana Avenue, N.W., Washington,D.C. 20531.Place of Performance (Street address, city, country, state, zip code)
As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications.
1. Grantee Name and Address:
Renton Police Department
1055 South Grady Way
Renton, WA 98057
2. Application Number and/or Project Name 3. Grantee IRS/Vendor Number
Seattle Enforcement Group D-22
4. Typed Name and Title of Authorized Representative
, - Renton
5. Signature 6. Date
9-22-2020