HomeMy WebLinkAboutCertificationCAG-18-288, Certification
US 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 form.
Signature of this form provides for compliance with certification requirements under 28 CFR Part 69, ''New
Restrictions on Lobbytng" and 28 CFR Part 67, "Government -wide Debarment and Suspension (Nonpro-curement) and
Government -wide Requirements for Drug -Free Workplace (Grants) " The certifications shall be treated as a material
representation of fact upon which reliance will be placed when the Department of Justice determines to award the
covered transaction, grant, or cooperative agreement.
1. LOBBYING
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 -
(a) No Federal appropriated funds have been paid or will be
paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee
of any agency, a Member of Congress, an officer or
employee of Congress, or an employee of a Member of
Congress in connection with the malting of any Federal
grant, the entering into of any cooperative agreement, and
the extension, continuation, renewal, amendment, or
modification of any Federal grant or cooperative agreement,
(b) If any funds other than Federal appropriated funds have
been paid or will be paid to any person for influencing or at-
tempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with this
Federal grant or cooperative agreement, the undersigned shall
complete and submit Standard Form - LLL, "Disclosure of
Lobbying Activities," in accordance with its instructions,
(c) The undersigned shall require that the language of this cer-
tification be included in the award documents for all subawards
at all tiers (including subgrants, contracts under grants and
cooperative agreements, and subcontracts) and that all sub -
recipients shall certify and disclose accordingly.
2. DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS
(DIRECT RECIPIENT)
As required by Executive Order 12549, Debarment and
Suspension, and implemented at 28 CFR art 67, for prospec-
tive participants in primary covered transactions, as defined at
28 CFR Part 67. Section 67 510—
A The applicant certifies that it and its principals.
(a) Are not presently debarred, suspended, proposed for debar-
ment, declared ineligible, sentenced to a denial of Federal
benefits by a State or Federal court, or voluntarily excluded
from covered transactions by any Federal department
or agency,
(b) Have not within a three-year period preceding this applica-
tion been convicted of or had a civil judgment rendered against
them for commission of fraud of a criminal offense in connec-
tion with obtaining, attempting to obtain, or performing a
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,
(c) Are not presently Indicted for or otherwise criminally or
civilly charged by a governmental entity (Federal, State, or
local) with commission of any of the offenses enumerated in
paragraph (1)(b) of this certification, and
(d) Have not within a three-year period preceding this applica-
tion had 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 the
statements in this certification, he or she shall attach
an explanation to this application.
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—
A The applicant certifies that it will or will continue to provide
a drug -free workplace by -
(a) Publishing a statement notifying employees that the
unlawful 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 against
employees for violation of such prohibition,
(b) Establishing an on -going drug -free awareness program to
inform employees about—
(1) The dangers of drug abuse in the workplace,
(2) The grantee's policy of maintaining a drug -free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance programs, and
(4) The penalties that may be imposed upon employees for
drug abuse violations occurring in the workplace;
(c) Making It a requirement that each employee to be engaged
in the performance of the grant be given a copy of the statement
required by paragraph (a),
(d) Notifying the employee in the statement required by para-graph
(a) that, as a condition of employment under the grant,
the employee will—
(1) Abide by the terms of the statement, and
(2) Notify the employer in writing of his or her conviction for a
violation of a criminal drug statute occurring in the workplace
no later than five calendar days after such conviction;
(e) Notifying the agency, in writing, within 10 calendar days
after receiving notice under subparagraph (d)(2) from an
employee or otherwise receiving actual notice of such convic-lion
Employers of convicted employees must provide notice, including
position title, to, Department of Justice, Office of
Justice Programs, ATTN Control Desk, 633 Indiana Avenue,
N.W. Washington, D C 20531 Notice shall include the iden-
Ification number(s) of each affected grant,
(f) Taking one of the following actions, within 30 calendar
days of receiving notice under subparagraph (d)(2), with
respect to any employee who Is so convicted—
SeaTac HIDTA Task Force (Group D-22)
300 Sff, Ave, Suite 1300
Seattle, WA 98104
Check u; iif there are workplaces on file that are not indentified
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 ap-
plication for Department of Justice funding States and Stale
agencies may elect to use OJP Form 406117.
Check 0 if the State has elected to complete OJP Form
406117
(1) Taking appropriate personnel action against such an
employee, up to and including termination, consistent with the
DRUG -FREE WORKPLACE
requirements of the Rehabilitation Act of 1973, as amended, or
(GRANTEES WHO ARE INDIVIDUALS)
(2) Requiring such employee to participate satisfactorily in a
drug abuse assistance or rehabilitation program approved for
As required by the Drug -Free Workplace Act of 1988, and
such purposes by a Federal, Slate, or local health, law enforce-
implemented at 28 CFR Part 67, Subpart F. for grantees, as
defined at 28 CFR Part 67, Sections 67 615 and 67 620—
ment, or other appropriate agency,
(g) Making a good faith effort to continue to maintain a drug-
A As a condition of the grant, I certify that I will not engage
free workplace through implementation of paragraphs (a), (b),
in the unlawful manufacture, distribution, dispensing, posses-
(c), (d), (e), and (f)
sion, or use of a controlled substance in conducting any
activity with the grant; and
B. The grantee may insert in the space provided below the
site(s) for the performance of worts done to connection with
B If convicted of a criminal drug offense resulting from a
the specific grant.
violation occurring during the conduct of any grant activity,
will report the conviction, in writing, within 10 calendar days
Place of Performance (Street address, city, county, state, zip
of the conviction, to- Department of Justice, Office of Justice
code)
Programs, ATTN. Control Desk, 810 Seventh Street NW ,
Washington, DC 20531
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 IRSfVendor Number
DEA SeaTac HIDTA Task Force (Group D-22)
4. Typed Name and Title of Authorized Representative
Kevin Milosevich Chief of Police — Renton Police Department
5 Signature
W
6 Date
7
'U, S Govermmenl Pfining Office: 1996 - 40&037140014