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<br /> 6bßD
<br /> "G.B. Departm.ent of Justice ~
<br /> Office of Community Oriented Policing Services
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<br /> Cerlifi cati 0 ns
<br /> Regarding Lobbying; Debanßent; SuspèÎ1Sion ànd Other Responsibifdy Matters; Diu§ffèe WòriqJI3œ
<br /> Requirements; Coordination with Affected Agencies; and Non-Supplanting.
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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 /> uire us to seek your certification regarding certain matters. Applicants should read the regulations cited below and the
<br /> IUctiOns for certification included in the regulations to understand the requirements and whether they apply to a particular
<br /> ayylicant Signature of this form provides for compliance with certification requirements under 28 CPR Part 69, "New
<br /> Restrictions on Lobbying" and 28 CFR Part 67, "Government-wide Debarment and SuspeI1Sion (Nonprocurement) and
<br /> Government-wide Requirements for Drug-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 deternúnes to award the covered grant
<br /> 1. Lobbying
<br /> (i) Are not presently debarred, suspended, proposed for
<br /> As required by Section 1352, TItle 31 of the US. Code, and imple- debannent, declared ineligible, sentenced to a denial of
<br /> mented at 28 CFR Part 69, for persons entering into a grant or coop- Federal b€nefits by a State or Federal court, or voluntarily
<br /> erative agreement over 5100,000, as defined at 28 CFR Part 69, the excluded from covered transactions by any Federal depart-
<br /> applicant certifies that: ment or agency;
<br /> A. No Federal appropriated funds have been paid or will b€ (ü) Have not within a three-year period preceding this appli-
<br /> paid, by or on b€half of the undersigned, to any person for influ- cation been convicted of or had a civil judgment rendered
<br /> endng or attempting to influence an officer or employee of any against them for commission of fraud or a crimina1 offense in
<br /> agency, a Memb€r of Congress, an officer or employee of connection with obtaining, attempting to obtain, or perform-
<br /> Congress, or an employee of a Memb€r of Congress in connection ing public Œederal, State, or local) transaction or contract
<br /> with the making of any Federal grant, the entering into of any under a public transaction; violation of Federal or State
<br /> cooperative agreement, and the extension, continuation, renewal, antitrust statutes or commission of embezzlement, theft,
<br /> amendment, or modification of any Federal grant or cooperative forgery, bn"bery, falsification or destruction of records, making
<br /> agreement; false statements, or receiving stolen property;
<br /> B. If any funds other than Federal appropriated funds have been (ill) Are not presently indicted for or otherwise aiminally or
<br /> paid or 'Will b€ paid to any person for influencing or attempting civilly charged by a governmental entity (Federal, State, or
<br /> to influence an officer or employee of any agency, a Memb€r of . local) with comnússion of any of the offeI1S€S enumerated in
<br /> Congress, an officer or employee of Congress, or an employee of paragraph (A)(ii) of this certification; and
<br /> a Member of Congress in connection V\;th this Federal grant or
<br /> cooperative agreement, the undersigned shall complete and sub- (iv) Have not within a three-year period preceding this appli-
<br /> mit Standard Form - LLL, "Disclosure of Lobbying Activities," in cation had one or more public transactions (Federal, State, or
<br /> accordance with its instructions; local) terminated for cause or default; and
<br /> C. The undersigned shall require that the language of this certifi- B. Where the applicant is l1I1able to certify to any of the state-
<br /> cation be included in the award documents for all subawards at ments in this certification, he or she shall attach an explanation to
<br /> all tiers (including subgrants, contracts under grants and coopera- this application.
<br /> tive agreements, and subcontracts) and that all sub-recipients
<br /> shall certify and disclose accordingly. 3. Drug-Free Workplace (Grantees Other Than Individuals)
<br /> 2. Debarment, Suspension, and Other Responsibility Matters As required by the Drug-Free Workplace Act of 1988, and imple-
<br /> (Direct Recipient) mented at 28 CFR Part 67, Subpart F, for grantees, as defined at 28
<br /> CFR Part 67, Sections 67.615 and 67.620 -
<br /> As required by Executive Order 12549, Debarment and Suspension,
<br /> and implemented at 28 CFR Part 67, for prospective participants in A. The applicant certifies that it will or will continue to provide a
<br /> primary covered transactions, as defined at 28 CFR Part 67, Section drug-free workplace by:
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<br /> (i) Publisrung a statement notifying employees that the
<br /> A. The applicant certifies that it and its principals: unlawful manufacture, distribution, dispensing, possession, or
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