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<br />u.s. Department of Justice
<br />Office of Community Oriented Policing Services
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<br />Certifications
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<br />ReganIng ~; Debannent, Snspensicll'" OIlIer RespolIsibily MaIlers; Drug-Free VVorlqDce
<br />ReqtdremenIs Coanlination wIIh AfLded Agencies; N.....SUpIUnting; and ReIentioI..
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<br />Although the Department of Justice has made every effort to simplify the application process. other provisions of Federal law
<br />require us to seek your certification regarding certain matters. Applicants should read the regulations cited below and the
<br />instructions for certification included in the regulations to tmderstand the requirements and whether they apply to a particular
<br />applicant. Signature of this fonn provides for compliance with certification requirements under 28 CFR Part 69, "New
<br />Restrictions on lobbying," and 28 CFR Part 67, "Government-wide Debannent and Suspension (Nonproc:urement) and
<br />Government-wide Requirements for Drog-Free Workplace (Grants),':.and the coordination and non-supplanting requirements
<br />of the Public Safety Partnership and Community Policing Act of 1994. The certifications shall be treated as a material represen-
<br />tation of fact upon which reliance will be placed when the Department of Justice determines to award the covered grant.
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<br />1. Lobbying
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<br />As required by Section 1352, TItle 31 of the US. Code, and imple-
<br />mented at 28 CFR Part 69, for persons entering into a grant or coop-
<br />erative agreement over 5100,000, as defined at 28 CFR Part 69, the
<br />applicant certifies that:
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<br />A. No Federal appropriated funds have been paid or will be
<br />paid. by or on behalf of the Wldersigned, to any person for influ-
<br />encing or attempting to influence an officer or employee of any
<br />agency, a Member of Congress, an officer or employee of
<br />Congress, or an employee of a Member of Congress in connection
<br />with the making of any Federal grant; the entering into of any
<br />cooperative agreement; and the extension, continuation, renewal,
<br />amendment or modification of any Federal grant or cooperative
<br />agreement;
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<br />B. If any funds other than Federal appropriated funds have been
<br />paid or will be paid to any person for influencing or attempting
<br />to influence an officer or employee of any agency, a Member of
<br />Congress, an officer or employee of Congress, or an employee of
<br />a Member of Congress in connection with this Federal grant" or
<br />cooperative agreement, the Wldersigned shall complete and sub-
<br />mit Standard Form - LLL, ''Disclosure of Lobbying Activities," in
<br />accordanC2 with its instIUctions;
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<br />C. The Wldersigned shall require that the language of this certifi-
<br />cation be included in the award documents for all subawards at
<br />all tiers (including subgrants. contracts Wlder grants and coopera-
<br />tive agreements, and subcontracts) and that all sub-recipients
<br />shall certify and disclose accordingly.
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<br />2. Debannent, Suspension and Other Responsibility Matters
<br />COirect Recipient>
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<br />As required by Executive Order 12549, Debarment and Suspension,
<br />and implemented at 28 CFR Part 67, for prospective participants in
<br />primary covered transactions, as defined at 28 CFR Part 67, Section
<br />67.510 -
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<br />A. The applicant certifies that it and its principals:
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<br />(i) Are not presently debarred. suspended, proposed for
<br />debarment, declared ineligible, sentenced to a denial of
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<br />Federal benefits by a state or Federal court, or volWltarily
<br />excluded from covered transactions by any Federal depart-
<br />ment or agency;
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<br />(ii) Have not within a three-year period preceding this appli-
<br />cation been convicted of or had a civil judgment rendered
<br />against them for commission of fraud or a aiminal offense in
<br />connection with obtaining, attempting to obtain, or perlorm-
<br />ing public (Federal, state or local) transaction or contract Wl~er
<br />a public transaction; violation of Federal or stale antitrust
<br />statutes or commission of embezzlement, theft, lorgery,
<br />bribery, falsification or destruction of records, making false
<br />statements, or receiving stolen property;
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<br />(iii) Are not presently indicted for or otherwise aiminally or
<br />civilly charged by a governmental entity (Federal, state or
<br />local) with commission of any of the offenses enumerated in
<br />paragraph (A)(ii) of this certification; and
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<br />(iv) Have not within a three-year period preceding this appli-
<br />cation had one or more public transactions (Federal, state or
<br />local) terminated for cause or default; and
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<br />B. Where the applicant is unable to certify to any of the state-
<br />ments in this certification, he or she shall attach an explanation to
<br />this application.
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<br />3. Drug-Free W orkplac:e (Grantees Other Than Individuals)
<br />
<br />As required by the Drug-Free Workplace Act of 1988, and imple-
<br />mented at 28 CFR Part 67, Subpart F, for grantees. as defined at 28
<br />CFR Part 67, Sections 67.615 and 67.620-
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<br />A. The applicant certifies that it will, or will continue to, provide
<br />a drug-free workplace by:
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<br />(i) Publishing a statement notifying employees that the
<br />unlawful manufacture, distribution, dispensing, possession or
<br />use 01 a controlIed substance is prohibited in the grantee's
<br />workplace and specifying the actions that will be taken against
<br />employees for violation of such prohibition;
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<br />(ii) Establishing an on-going drug-free awareness program to
<br />inform employees about-
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