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.............. .................................................... CJD Grant Application - Page 14 <br />% <br /> <br /> CERTIFICATIONS <br /> 1. The applicant certifies that it will provide a drug-free workplace by: <br /> a. 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 applicent's poticy of maintaining a drug-free workptace; <br /> iii. any available drug counseling, rehabilitation, and employee assistance programs; and <br /> iv. the penalties that may be imposed upon employees for drug abt~se violations. <br /> c. Making it 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 /> 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 /> ii. notify the employer of any criminal drug stsfuts conviction for a violation occurring in the workptace not later than five <br /> days after such conviction. <br /> e. Notifying the agency within ten days after receiving notice under subparagraph (d)(ii) 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 /> ii. Requiring such employee to participats satisfactorily in a drug abuse assistance or rehabilitation program appr°ved f°r <br /> such purposes by a federal, state, or local health, law enforcement, or other appropriate agency. <br /> g. Making a good faith effort to continue to maintain a drug-free workplace through the implementation of paragraphs (a), (b), <br /> (c), (d), (e), and (0. <br /> If application is in excess of $'100,000, 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 influencing or attempting to influence 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 /> [~] 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 governments for the "Disclosure Form to <br /> Report Lobbying'. <br /> <br /> 2. The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at <br /> all tiers and that alt sub-recipients shall certify accordingly. <br /> <br /> AUDIT CERTIFICATION (SELECT THE APPROPRIATE CHOICE) I certify: <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 with the Single Audit <br /> Act Amendments of 1996 and OMB Circular A-133. <br /> ] The applicant agency currently expends combined federal funding of less than $300,000 and, therefore, is <br /> exempt from the Single Audit Act and cannot charge audit costs to a CJD grant. I understand, however, that <br /> CJD may require a limited scope audit as defined in OMB Circular A-133. <br /> <br /> EQUAL EMPLOYMENT OPPORTUNITY PLAN (EEOP) CERTIFICATION (SELECT THE APPROPRIATE CHOICE) <br /> Definitions: <br /> <br /> Tvoe I Entity <br /> Educational/medical/non-profit institution/Native American Tribe - certification required (select appropriate choice below}; <br /> EEOP NOT required. <br /> <br /> Tyoe II Entitl/ <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 file for possible audit if the organization has more the 50 <br /> employees. <br /> Type III Entity <br /> For profit entities and state and local governments receiving $500,000 or more - certification requ[rad (select the <br /> appropriate choice below); the organization must submit an EEOP to the Office for Civil Rights (OCR) for approval. <br /> <br /> Issue Date: October 2002 <br /> <br /> <br />