1994-042-RES WHEREAS, the Office of the Governor of the State of Texas Criminal Justice Division, is offering grant
RESOLUTION NO. 94-042
WHEREAS, the Office of the Governor of the State of Texas, through its
Criminal Justice Division, is offering grant assistance in the amount of $26,547 for the
purpose of funding a full time police officer as a coordinator for the Police Athletic
League; and,
WHEREAS, the Police Athletic League is a juvenile crime prevention program
aimed at reducing juvenile crime, illegal drug use and criminal gang activity; and,
WHEREAS, the City Council of the City of Paris deems it to be in the best
interest of the citizens of Paris to seek such assistance for said project; and,
WHEREAS the City Council of the City of Paris is desirous of processing a grant
application for the Police Athletic League in the amount of $26,547, at a total cost of
$35,399, with $26,547.00 to be provided by grant and $8,852.00 to be provided by the
City of Paris in the form of local matching funds and in kind services; NOW,
THEREFORE,
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PARIS:
1. That an application be made to the Office of the Governor of the State of
Texas, Criminal Justice Division for a grant to provide funding of a full time police
officer as coordinator for the Police Athletic League in the amount of $26,547.00 with
the City of Paris providing $8,852.00 in kind services and funds.
2. That Michael E. Malone, City Manager of the City of Paris, be, and he is
hereby appointed as the Authorized Official of said project and the execution of the
application for said grant in the form attached hereto as Exhibit A on the 14th day of
March, 1994, is hereby ratified.
3. That Karl Louis, be, and he is hereby appointed as Project Director and is
hereby authorized to execute and deliver on behalf of the City of Paris all reports,
communications, assurances and documents necessary for the completion of said project.
4. That W. E. Anderson, Director of Finance, be, and he is hereby authorized
and directed to serve as the Financial Officer for said project and to receive and distribute
funds for purposes of funding a full time police officer as a coordinator for the Police
Athletic League.
PASSED AND ADOPTED this 5th day of May, 1994.
~
Gorge Fisher, Mayor
ATTEST:
.
APPuc~nON FOR ~TATE OR f"EDEAAL ASSISTANCE
OrneE "HE GOVERNOR, CRIULNAL JUSTIce Dlvl~
3. a. Dill. Submt:\&d
Harch 14 1994
4. a. Dill ~.e.tved by SlaJQ..'CO(;
b. :."plan I idenllll"r
b. SIll. ,4pp1lc.alK>tlI~nl1flcr
5. Awlic.&nllnlM:ll~
L ~ Nam.:
! c.. Or pIlItz.l ion aJ Un h
Paris Police Department
Ci
b. AOcn1S (~1Yf Gt"M! O! iJ. 0 Sox. U:'f. ~1Irr.y. ,1.t.. uld:f' code)
P. O. Box 9037
Paris, TX 75461-9037
6. $111' Pay.. I~ir.::alion Nur,';~'
! d. Name &nd lel&pnono num~r ollhll P'lfWl10 be conlllCled on mall o:'S
InvoMng 1M ~~Iie.r.ion (~I~...1 code).
Karl Louis, Chief of.Po1ice
(903) 784-6688
I" i)'?f c: Appii:-a.,t {&fl:S: t"l, a;>p~,;':' ~:6! /.": tJor) @]
A. Salt "i. In~~p'/I~'~,: S:!\.'I:>: Oid::
;. C:lunl1 SIAl. c"nll'Ol:QC In~l.'l.ilton c: ~I~N! l.6n\lr,~
C. 1JU.'\tO;lll J. ~nva" Univtn::y
~. iewnailip ~ :-.dJ..... ';'tiW
t. ~Ia,..!a.. 'l'leIY'lOJr.1
F. ~1"'~Jn~t 1.1,. Nonploln()rpl~ll~n
0.. S~.t:aJ D:.!Tl:'l N. C:l.r (.pIlCI!y):.. "_'. ..
8. iype 01 ~bl\::i:
J New ~ ::.on:J~uA:on J ~8VI~lon
I r. RavisIC>l'l. chfoCK &::r--:~&:e tlcx;~).
;J Inc:t&Se AlIo'1TO :l OIh&r (LY&cifYl
Ll DE<r...u AWL'd
a In::rtue l>Jralon
U DecrN.sf O~c~,
G. N&r.\. 01 GrMID! ~I'\C)':
Otft:::e of lhe Governor. Crimil'lll J~ti:5 D~on
P. O. B0112428
A:J~i:'i. '!'eus 7o;~1
'0. Ca:a!og 01 Fe.otrrJ :.or.'l~li, ,I"ss:Slan~ Nu.-ntler
Oleci< One (1~~:&1 ~.i,'\ci:i~ ~~:JI::e$ orJy):
;) ~6.~:.-JI1".r;'e J..~;e6 ;. ~.ib~i:-':i ?Ii\'in:iorl J..:.
J '6.S7S-Vicl~ cl Crim. J.:.
a 1!.S7Q- iew N&':::t.i=- Co~ ~/':lOr;.'ll
:l '6.~ Hi h l'l~~~~.V Ci'v:: 7ralfdr;irl Prooram
,2. Tale 01 Proj~:::
, 1. Are.as of ProJ€oCI A.::iv~ie5 (Cities, Countie3. $isllS, st:.)
City of Paris
Lamar County
Paris, Texas 75460
Police Ath1e~ic League
13, ~~d Prcj+G: ___..__
S1a~ Dale: i Ending Dlle
11-1-94 I 10-31-95
H. ~~~1J\l klwI (421 tundl cn~ e. Chtd\ on8 priomy 0110/:
- U C.J. ;>larInin; -Ul.awErl~T;IrlIr\P -I'
0: \f~1 Crime ~ OruP' )0 Gan;. 0 V~rnl
b. Ch~ One:
Xl JUVlln~.
o NontJVtnlle
15. Reqmleod FU~:!III~:
, 6. II S??IltI1lon $l.Ibj&c:: 10 revigw bof cale .HC,^~' Drtitr , 2:i72 ;lroces!?
Submit to Ark-Tex
.
1. Fede.'~ Clrard I s .00
F~ (CJDl i 26 547
..._.........,.........................J__.__..___......
i
b. SIll. Oranl i S
FuJ'ldt (CJD) I
---..---.--..-.-r.-..................................-......----............
c. Cesh Malc:n I $ 8 85 2 .00
I '
---------
I
d.1n.lOnd I s
I
(VOCA Only) !
..........--................... . ................ ,. ......... ................ .........................
---...................r..................................--.....-...-........-.....
I
I
I
I
I
o YES, Ihla appJie&1lon wu made avalla,!)le to the iuas He-.tlew and Com~rt
System (TAACS)l:>r rWlni on
.00
(Oale)
:3 NO. 0 Pr~ram Is no! c::lYef'8tl by E. O. , ~2
:J Pro~ram l\a.s 1'\0( bun ~tCt.c by =lle lor review
35,399
.00
17. la the appanl Cltlnqu.nI on any 1.:>>ral ~bt?
=> YES II or..' .!'\ad! an .xpla.tWlon
:) NO
.. TOT AI.
.00
11. To Iht bN\ 01"'1 knowltept and btlItl. aD data in \111 appllC&\lon II \N' and c:orttoet. 1ht documenl has been duly al.llhor.:td by mt govtlming
body of the appMcanl L"ICllht &:lPlica.nl wi" CIOtI'Iply....h IlIt ~ IlUlIt"Ic:t"!It ,""tanCl " IWlrOtd.
t I -'-
L T yp.O Nam. of ~horl1td OlflCl6l b. T IlIt : to j Mphon. Numbtt
Michael E. Malone City Hanager ! (903)785-7511
- ---.................-.......--.----.-..-..--.-. ....-.----.-..---;.... .-..-
d. Slpturt ollulhoti: ~ Ollleal i', 011. SiQ"""
i 3-14-94
,
FXHIBIT A .
F"JECT APPROVAL INFORMATlf
CJU-3
11fID-L
Does this assistance request require' state. local,
regional, or other priority rating?
1J Yes ~ No
Name of Governing Body
Priority Rating
il~m 2...
Does this assistance request require state, or local
advisory, educational, or health clearance?
a Yes 0 No
Name of Agency or Boaro
(Anach Documentation)
llmn.l
Does this assistance request require TRACS review?
. J'. Yas 0 No
(Attach Comments)
Item 4,
Does this assistance request require state, local,
regional, or other planning approval?
~ Yes U' No
Name of Approving Agency
Date
l1atn.i
Is th~ proposed project covered by an approved
comprehensive plan?
~ Yes Q No
Check One: U State
o Local
o Regional
Location of Plan
~
Will the assistance requested serve a federal
installation?
~ Yas 0 No
Nama of Federal Installation
-...- .-.-.....--. .-. --
Federal POp'Jlation Benefiting from Project
item 7~
Will the ,assistance required be on federal land or
installation?
o Yes Xl No
Name of Federal Installation
Location of Federal Land
Percent of Project
11e.m.a
Will the assistance requested have an impact or
effect on the environment?
o Yes l] No
See instructions for additional information tc ~e
provided.
l1am.i
Will the assistance requested cause the displace-
ment of individuals, families, businesses or farms?
U Yes ~ No
Number of: Individuals
Families
Businesses
Farms
..
-.-- --
l1am..1.O.. .
Is there other related assistance on this project
previous, pending, or anticipated?
Ii Yas 0 No
See instructions for additional information to be
provided.
l1m.1t
Is the project in a designated flood hazard area?
U Yes ~ No
See instructions for additional information to be
provided.
C'U-4
BUDGET INFORMATION
Section A-Budget Summary
L S
1 c
n h Budget Categories
.
. d
u
I
.
(' )
CJD/Federal
Funds
(2)
(3)
(4)
Cash Match
In-Kind Match
Total
2. A. Personnel (Fringe Benefits)
6,531.00
2,179.00
8,710.00
1. A. Personnel (Salaries)
$ $
20,016.00 6,673.00
;. G. Indirect Costs
~'/i'.lrp ';-/.I/';.-/,,:"}/. "/"/.- .. /'
'~l ~~~"A: '1/?.,-.,;; f" '1//~, ..~A
~'~;!{:(f t~:/f,:~~' {;f.;';<~_,f~',~.'~
.11.:1'fit,~:!/"N'I),fl;:';'( ,:'._..~).~_~, '
f:}',.:' ,r~~ I"".(~. ~''',~' f ~/~., ~~ ; .1
.i~:.,)'~';.;' ~;';';I..:(}~..;.': ,'/" /.' ~
3. B. Contractual
( C. Travel
s. o. Equipment
6. E. Reserved for Future Usa
7. F. Supplies & Direct
OperatIng Expenses
8. Total Direct Charges
(Sum oj ,.7)
10. Totals
(5 \tTI 0: &-9)
$ $
26,547.00
,1. Program Income
Section B-CS8h Match
Ent.r ..paratt1v Noh .ource of matching tunds and the smoums.
TOlal mus1aore8 wlth line 10, Column 2 sbovflsnd IIne'S c. on oec& CJJ,',
Source Amount I Source I Amount
Proiram Income I I
(anlt)' 11.1 be ~'11d) I
City of Paris $8,852.00 il
I.
I
,
CJU':'
Office of the Governor
I Criminal Justice Division
- ~ .
SCHEDULE A
~
1 O' ct S I
. Ire a anes (' ) (2) (3}
%01 CJD/Federal
Title or Position' . T1me2 Funds Cash Match iOT AL~
(A) P. A. L. Coordinator 1100 $20 016.00 IS 6 673.00 S 26.689 00
(B) I I
(C)
(0) I
'{E) I
(F)
(G)
(H) I
(Q
(J)
(K) .-
(L) I
Overtime ,
. .
TOTAL Direct Salaries $20,016.00 $ 6.673.00 $ 26,689.00
2. Fringe Benefits
FICA
Retirement
Insurance
Other (explain) Workers Com .
%or
$ Rate
7.657c $ 1 548.00
@8 167c 1 651.00
$ 517.00
551. 00
$ 2 065.00
2 202.00
@
TOTAL Fringe Benefits
$ 6,531.00
S 2,179.00
$ 8,710.00
TOTAL PERSONNEL BUDGET
$ 26,547.00
$ 8,852.00
$ 35,399.00
l. Include only one posttlon ptr lint. Attteh a de,eMptlon of the dutlw or r..ponalblll1ln of wch positIon.
l Express as a percent ot lotal time. ("0 hour. per week)
~. Should reflect employee's gross ulary anrlbutabl.1o the project
~JU'b
Office of the Governor
Criminal Justice Division
-=
~
, T~
SCHEDULE B
(' ) (2) , (3) ,
CJD/Federal
DescriptIon of Service Funds Cash Match TOTAL
(A) N/A $ $ $
(B) I
(C) I I
-
(0) I
(E) I
(F) ,0' I
(G) I
(H) I
(Q
TOT Al PROFESSIONAL AND $ 0 $ 0 $ 0
CONTRACTUAL SERVICES
REQUIRED N'ARRATIVE: Briefly describe any anticipated contractual arrangement and work products
expected. Describe basis for arriving at the cost of each line item. Professional services (such as consultants,
trainers, counselors, evaluators, etc.) should be described by type of service, number of hcurs, rate per hour,
and travel costs, if any.
amee OT me Governor
Criminal Justice Division
liJ u- I
~
-
-
,...
SCHEDULE C
IB&E.
1. Local Travel
(1 ) (2) (3),
Miles Traveled CJD/Federal
Title or Position Annuallyl $Rate Funds Cash Match TOTAL
:
(A) N/A $ $ S
(8) I
(C) I
(0)
(E)
(F) I
(G) .'
(H)
LOCAL TRAVEL TOTAL $ 0 $ 0 $ 0
2. In-State Travel (Specify clearly and use continuation pages if necessary)
CJD/Federal
Purpose Destination Funds Cash Match TOTAL
$ $ $
IN..sTATE TRAVEL TOTAL $ $ $
3. Out-at-State Travel (Specify clearly and use continuation pages if necessary)
CJDIFederal
PurDose Destination ... _.1_ Cash -. . . TOTAL
rUl IU:J
$ $ $
OUT -oF..ST A TE TOTAL $ $ $
.
I $
I
ITOTAL TRAVEL BUDGET
I$
I $
Office of the Governor
Criminal Justice Division
t;11').~
L
,:r 1"
--
SCHEDULE C (Continued)
REQUIRED NARRATIVE: Briefly describe the applicant's travel policy (Le. mileage rates and per diem
rates). Specify purposes for each item of travel. Break out costs 01 each in-state and each out-af-stats
trip to separately show the specific costs of transportation and of per diem. .
.
.
. .'
There will be no. travel expense by the P .A.L. Coordinator.
l
NOTE: "personal~ owned vehicles are to be used. transportation costs should be shown on Schedule C; ~ agency or loa sed
vehicles are to be used. the vehicle operation/maintenance costs shoukJ be shown on Schedule F. .Supplies and
Direct Operating Expenses: Tuition for training oourses should be listed as supplies in Schedule F.
vJLJ'~
Ottlce of the Governor
CrIminal Justice Division
--
=
..... -
SCHEDULE D
(1 ) (2) (3) 0
CJO'/Federal
Equipment Name or DescrIption and Quantity Funds Cash Match TOTAL
Do Not List Brand Names "
(A) S $ 1$
(5) I
(C) I
(0)
,(E) I I I
f (F) I ! I
I
(G) .' I
(H)
(I)
(J)
(K) I .~
(L) I
(M)
(N)
(0)
(P)
(Q) I
TOTAL EQUIPMENT PURCHASES $ 0 $ 0 $ 0
REQUIRED NARRATIVE: Describe the basis for arriving at the cos1 o1sach line item.
_. .L
SCHEDULE E
Schedule E 18 currently applicable to regional Juvenile detention facilities only.
Contact CJD for detail. r~8rdlng theae constructIon projects.
vJU' I V
Office of the Governor
Criminal Justice Division
. ..."'-_.....
-:
~
P'
SCHEDULE F
(1) (2) (3)
Directly Charged Supplies and CJD/Federal I
I
,
Other OperatIng Expenses Funds Cash Match TOTAL I
i
I
Is I
I
S I
I (A) N/A S I
I
- I I
I
.!B} I
tIC) I \ I
!
-
,(0)
I(E} I
I
(F)
(G)
(H) I I
TOT AL SUPPLIES AND DIRECT $ S $
. . 0 0 0
OPERATING EXPENSES
REQUIRED NARRATIVE: Describe the basis for arriving at the cost of each line item.
\,;JU.' ,
Office of the Governor
Criminal Justice Division
I" T........
SCHEDULE G
-"
lliD1~
, (' ) I (2) (3)
Indirect Costs CJD!Federal Cash Match TOTAL
(A) Indirect Costs Pee Approved Cost Allocation Plan $ N/A $ I $ 0
(B) Indirect Cos1S Per CJD Computation Table $ N/A $ 0
REQUIRED NARRA nVE: If Method (A) is used, specify the rate and attach a copy of the document by
which the current cost aHoca1ion plan was approved.
NOTE: Indlr.ct COlli art authorlz.d In an amount not to .xc..ci thl computation table In the CJO Flnlnclallnd Administrative
Requlr.m.nt. MCtlon of the grant applleltlon kit, or II luthorlzed per the applicant'. co.t allocation plan.
CJD.15
,
DESIGNATION OF GRANT OFFICIALS
CJD rules require that three persons be designated to the positions of Authorized Official, Project Director,
and Ananclal Officer for the purposes of administering a grant. The Project Director and the Financial
Officer may not be the same person but, under extenuating circumstances, one person may otherwise flIl
two positions. In accordance with the criteria and definition of responslb'lItles set forth in the Flnanclal
and Administrative Requirements section of the CJ~ Grant Application and Administration Guidelines
governing 'submlsslon of this application, the following desIgnations are made:
APPLICANT:
City of Paris Police Department
PROJECT TlilE:
POtICE ATHLETIC LEAGUE
@ Ms. Karl Louis
Project Director (Type or Print)
~Ms. W. E. A1)der!=;on
Financial Officer (Type or Print)
Chief. Police Department
Title and Agen..."1
811 Bonham Street
Business Address (Street or P. O. Box)
Dirp-rtor of Fin~n~p
Tttle and Agency
I
p () 'Rox Q017
Buslness Address (Street 0( P. O. Sox)
Paris
City
903/784-6688
. Telephone Number
Texas
Zip
75460
Paris Tp-x~~
City Zip
903/785-7511
i e1ephone Number
7S4nl-9017
@ Ms. Hicl1aal E. }1a1onc
Authorized OffICial (Type or Print)
City Manager
Tide and Agency .
P. O. Box Q017
Business Address (Street 0( P. O. Box)
Paris
Chy
903/785-7511
Telephone Number
"7546l=W7
2jp
-,
CERTIFICA nON
I certify that the programs proposed in this application meet all the requirements of the Texas Narcotics
Control Program, that all the information. presented is correct, and that the applicant will comply with the
provisions of the Texas Narcotics Control Program and all other federal and state laws, regulations, and
guidelines. By appropriate language incorporated in each grant, subgrant, or other document under which
funds are to be disbursed, the undersigned shall assure that the applicable conditions above apply to all
recipients of assistance.
Authorized Official
3 11~ 94
Date
City of Paris
Grantee
DB-94-B04-07432
Grant #
60
EQUAL EMPLOYMENT OPPORTIJNIIT PROGRA1\1 CERTmCATION
I, Michael E. Halone , certify that
This agency employs fewer than 50 people; therefore, the
required to file an equal opportunity program
in accordance with 28 CFR 42.30 1 ~., Subpart E.
is not
(Criminal Justice A2ency)
or
This agency employs 50 or more people and bas received or applied to the Criminal Justice Division,
Office of the Governor for total funds in excess of S25,000; therefore, the City of J:ari ~
bas fonnulated (Criminal Justice Agency)
an equal employment opportunity program in accordance with 28 CFR 42.30 1 ~., Subpart E and
that it is on file in the office of
W. E. Anderson
City Hall (name)
135 1st Street S.E. .
(address)
Paris, TX 75460
for review or audit by an official oCthe Criminal Justice Division, Office oCthe Governor as required
by relevant laws and regulations.
Director of Fin~nrp/Personne1
.
(title)
PROJECf TITLE: POLICE ATHLETIC LEAGUE
Authorized Official (sipature)
Project Director (si~ature)
.J!.1!i.Jj
Date
J! JJj ..E.!J
Date
City of Paris
Grantee
DB-94-B04-07432
Grant #
61
SINGLE AUDIT ACT CERTIFIED ASSURANCE
The grantee hereby assures compliance by itself and its applicable subrecipients (contractors) with the
Single Audit Act of 1984, PL98-502 (ACT) and, panicularly, with the requirements of OMB Circular A-
128 (copy enclosed) as follows (check one):
1.
Grant funds of SI00,OOO or over -
An annual audit by an independent auditor made in accordance with the
requirements of OMB Circular A-128.
2.
x
Grant funds of S25,OOO to Sloo,OOO -
An annual audit made in accordance with OMB Circular A-128 or in
accordance with federal laws and regulations governing the program.
3.
Grant funds of less than S25,000 -
Exempt from the Act but governed by audit requirements prescribed by
state or local law or regulation.
Authorized Official (signature)
Financial Officer (signature)
3/14/94
---
Date
3 /141 94
---
Date
City of Paris
Grantee Organization
DB-94-B04-07432
Grant Number
If items 1 or 2 above are checked, the grantee should, within 60 days following the date of the grant
award, furnish the following information:
1. The identity of the organization conducting the audit.
2. Approximate time audit will be conducted.
3. Audit coverage to be provided.
62
I
I
I.
U.S. DEPARTMENT OF JUSTICE
OFflCE OF JUSTICE PROGRAMS
OFflCE OF THE COMPTROLLER
Certification Regarding
Debannent, Suspension, Ineligibility and Voluntary Exclusion
Lower Tier Covered Transactions
(Sub- Recipient)
This certification is required by the regulltions implementing Executive Order 12549, Debarment and Suspension,
28 CFR Part 67, Seetion 67.510, Participants' re!pOllJibilities. The regulations were published as Part vn of the
May 26, 1988 Federal Rtgintr (pages 19160-19211).
(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON REVERSE)
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals
are pre.scntly debamd, IUSpCnded, proposed for debarment, declared ineligible, or voluntarily excluded from
participation in this trwaetion by any Federal department or agency.
(2) Where the prospective lower tier participant is ule to certify to any of the stl.t.ements in this certification, such
prospective participant shall attach an explanation to this proposal.
Name and Title of Authorized Representative
Michael E. Malone
City l1anager
Signature
Date
3-14-94
Name of Organiution
City of Paris, Paris, Texas
Address of OrganilJ.tion
135 First Street S.E.
Paris,
Texas
75460
(e) notifying the agency within ten days after receiving notice under subparagraph (d)(2)from an employ
or otherwise receiving actual notice of such conviction;
(t) taking one of the following actions with respect to any employee who is so convicted;
(1) taking appropriate personnel action against such an employee, up to and including
termination; or
(2) requiring such employee to participate satisfactorily in a drug abuse assistance or
rehabilitation program approved for such purposes by a federal, state, or local health,
law enforcemen~ or other appropriate agency;
(g) making a good faith effort to continue to maintain a drug-free workplace through
implementation of paragraphs (a), (b), (c), (d), (e), and (0.
II. The grantee shall insert in the space provided below the site(s) for the performance of work done in
connection with the specific grant.
Place of PerformaDC(:
Police Athletic League Building
(Organiution)
138 Lamar Avenue
Street address
Michael E. Malone
Name of Person
Paris
City
Lamar
County
Texas
State
75460
-
Zip Code
City Manager
Title
Signature
.1-'11:.1 jj
Dlte
City of Paris
Organiution
65
CERTIFICATION REGARDING LOBBYl~G
Prior to the release of federal funds by the Criminal Iustice Division (CID), the Authorized Official for
grantees which receive S 100,000 or more must complete and return the attached Certification Regarding
Lobb~ing, including the CID grant number to which the certification applies. (Note: The grant number is set
fonh on the Statement of Grant Award.)
!
CERTIFICATION REGARDING LOBBYING
Each person shall file the most current edition of this certification and disclosure form, if applicable, \IIith each
submission that initiates agency consideration of such person for an award of a federal contract, grant, or
cooperative agreement ofSlOO,OOO or more; or federal loan ofS150,OOO or more.
This certification is a material representation of fact upon which reliance \I!'aS placed when this transaction was
made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by section 1592, title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than S10,000 and not more than SI00,ooO for each
such failure.
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) no federal appropriated funds have been paid or will be paid 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
\IIith the awarding of any federal contract, the making of any federal grant, the making of
any federal loan, the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any federal contract, grant, loan,
or cooperative agreement;
(2) if any non-federal funds have been paid or will be paid 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
this federal contract, grant, loan, or cooperative agreement, the undersigned shall check
here _ and complete and submit Standard Form # _ "Disclosure Fonn to Report
Lobbying", in accordance with its instructions;
(3) the undersigned shall require that the language of this certification be included in the award
documents for all sub-awards at all tiers and that all sub-recipients shall certify accordingly.
3-14-94
Date
Signature of Authorized Official
DB-94-B04-07432
. Grant Number
City of Paris
Grantee
66