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<br />CJD Gran. Application - Page 14
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<br />CERTIFICATIONS
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<br />1. The applicant certifies that ft will provide a drug.free workplace by:
<br />B. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of
<br />a controlled substance Is prohibited In the grantee's workplace and specifying the actions that will be taken against
<br />employees for violation of such prohibition.
<br />b. Establish a drug-free awareness program to Inform employees about:
<br />I. the dangers of drug abuse In the workplace;
<br />Ii. the applicanfs policy of maintaining e drug.free workplace;
<br />IU. any available drug counseling, rehabilitation, and employee assistance programs; and
<br />Iv. the penalties that may be Imposed upon employees for drug abuse violations.
<br />c. Making ft a requirement that each employee to be engaged In the performance of the grant be given a copy of the
<br />statement required by paragraph (a).
<br />d. Notifying the employee In the statement required by paragraph (a) that, as a condition of employment under the grant, the
<br />employee will:
<br />I. abide by the terms of the statement, and
<br />U. notify the employer of any criminal drug statute conviction for a violation occurring In the workplace not later than five
<br />days after such conviction.
<br />e. Notifying the agency within ten days after receiving notice under subparagraph (d)(i1) from an employee or otherwise
<br />receiving actual notice of such conviction. '
<br />f. Taking one of the following actions with respect to any employee who Is so convicted:
<br />I. Taking appropriate personnel action against such an employee, up to and Including termination; or
<br />n. Requiring such employee to participate satisfactorily In a drug abuse assistance or rehabilitation program approved for
<br />such pUlposes by a federal, state, or local haalth, law enforcement, or other appropriate agency.
<br />g. Making a good tafth effort to continue to maintain a drug-free workplace through the Implementation of paragraphs (a), (b),
<br />(c), (d), (e), and (f).
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<br />If application Is In excess of $1 00,000, I certify to the best of my knowledge and belief to the following:
<br />1. No federal appropriated funds have been paid or will be paid to any person for Influenclng or attempting to Influance an officer
<br />or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of
<br />Congress In connection with the awarding of any federal contract, the making of any federal grant, the making of any federal
<br />loan, the entering into of any cooperative agreement. and the extension, continuation, renewal, amendment, or modification of
<br />any federal contract, grant, loan, or cooperative agreement.
<br />D Check here If any non-federal funds have been paid or will be paid to any person for Influencing or attempting to
<br />Influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an
<br />employee of a member of Congress In connection with this federal contract, grant, loan, or cooperative agreement. You
<br />must also notify the Criminal Justice Division (CJD) or your local council of govemments for the 'Disclosure Form to
<br />Report Lobbying'.
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<br />2. The undersigned shall require that the language of this certlflcation be Included In the award documents for all sub-awards at
<br />all tiers and that all sub-reclplents shall certify accordingly.
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<br />AUDIT CERTIFICATION (SELECT THE APPROPRIATE CHOICE)
<br />I certify: <
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<br />The applicant agency currently expends combined federal funding of $300,000 or more and, therefore, is
<br />required to submit an annual single audit by an Independent auditor made In accordance wfth the Single Audit
<br />Act Amendments of 1 gga and OMB Circular A.133.
<br />The applicant agency currentiy expends combined federal funding of less than $300,000 and, therefore, Is
<br />exempt from the Single Audft Act and cannot charge audft costs to a CJD grant. I understand, however, that
<br />CJD may require a Iimfted scope audft as deflned In OMB Circular A-133.
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<br />EQUAL EMPLOYMENT OPPORTUNITY PLAN (EEOP) CERTIFICATION (SELECT THE APPROPRIATE CHOICE)
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<br />Definitions:
<br />TVDe I EntllY
<br />EducatlonaVmedicaVnon-profit inslitutionlNative American Tribe - certification required (select appropriate choice below);
<br />EEOP NOT required.
<br />Tvoe II EntllY
<br />All other recipients receiving more than $25,000, but not more the $500,000 - certification required (select the appropriate
<br />choice below); organizations must maintain EEOP on flle for possible audit W the organization has more the 50
<br />employees.
<br />Tvoe III EntllY
<br />For profit entities and state and local govemments receiving $500,000 or more - certification required (select the
<br />appropriate choice below); the organization must submit an EEOP to the Office for Civil Rights (OCR) for approval.
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<br />Issue Date: October 2002
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