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CERTIFICATION REGARDING LOBBYING ; DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITIY <br /> MATTERS ; AND DRUG-FREE WORKPLACE REQUIREMENTS <br /> Florida Department of Law Enforcement <br /> Edward B me Memorial Justice Assistance Grant Program <br /> (c) Making tt a requirement Mat each employee to De 7h (a) ; <br /> e performanceof the grant be given a copy of the statement required by (a) ;(d) Notifying the employee in the statement required by a) that, <br /> as acondition of employment under the grant, the employee(1 ) Abide by the terms of the statement; and <br /> (2) Notify the employer in writing of his or her conviction on of a Check here If there are workplaces on file that are not identified <br /> criminal drug statute occurring in the workplace no later tentlar days here. <br /> after the conviction; <br /> Section 67,630 of the regulations provides that a grantee that is a <br /> (e) Notifying the agency, in writing, within 10 calendar days after receiving notice State may elect to make one certification in each Federal fiscal year. <br /> under subparagraph (d) (2) from an employee or otherwise receiving actual notice A copy of which should be included with each application for <br /> of such conviction. Employers of convicted employees must provide notice Department of Justice funding. States and State agencies may elect <br /> including position its, to: Department of Justice, Office of Justice Programs, to use OJP Form 41 <br /> ATTN: Control Desk, 633 Indiana Avenue, N.W., Washington, D.C. 20531 . Notice <br /> shall include the idenflfication numbers) of each affected grant; Check here _ If the State has elected to complete OJP Form <br /> 4061/7. <br /> (ITaking one of the following actions, within 30 calendar days of receiving notice <br /> under subparagraph (d) (2), with respect to any employee who is so convicted- <br /> (1) Taking appropriate personnel action against such an employee, up to and DRUG-FREE WORKPLACE <br /> including termination, consistent with the requirements of the Rehabilitation Act of (GRANTEES WHO ARE INDIVIDUALS) <br /> 1973, as amended; or <br /> (2) Requiring such employee to participate satisfactorily in a tlru abuse As required by the Drug-Free Workplace Am of 1988, and <br /> Y 9 implemented at 28 CFR Part 67, Subpart F, for grantees, as defined <br /> assistance or rehabilitation program approved for such purposes by a Federal, at 28 CFR Part 67; Sections 67.615 and 67.620- <br /> State, or local health, law enforcement, or other appropriate agency; <br /> (g) Making a good faitheffort to continue tomaintain a dru -free wor lace A. As a condi ion of the grant, I certify that I will not engage in the <br /> 9 kP unlawful manufacture, distribution, dispensing, possession, or use of <br /> through implementation of paragraphs (a), (b), (c), (d), (a), and (q. a controlled substance in conducting any activity with the grant; and <br /> B. The grantee may insert in the space provided below the sites) for the B. If convicted of a criminal drug offense resulting from a violation <br /> performance of work done in connection with the specific grant: occurring during the conduct of any grant activity, I will report the <br /> Place of Performance (Street address, city, county, state, zip code) conviction, in wilting, within 10 calendar days of the conviction, to: <br /> Department of Justice, Office of Justice Programs, ATTN: Control <br /> Desk, 633 Indiana Avenue, N.W., Washington, D.C. 20531 . <br /> As the duly authorized representative of the applicant, I hereby certify that the applicant will Comply with the above <br /> certifications. <br /> 1 . Grantee Name and Address : Indian River County Board of Commissioners <br /> 1640 25th Street , Vero Beach , FL 32960 <br /> 2. Project Name: Indian River County Planning <br /> 3. Typed Name and Title of Authorized Representative: Gary C . wheeler , Chairperson <br /> 4. Signature : 5 . Date :_ (rite �l V <br /> FDLE JAG Grant Application Package Lobbying Debarment Suspension and Drug-Free Workplace Certification <br /> Page 2 <br />