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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 /> Form Provided by the U.S. DEPARTMENT OF JUSTICE, OFFICE OF JUSTICE PROGRAMS, <br /> OFFICE OF THE COMPTROLLER <br /> CERTIFICATIONS REGARDING LOBBYING ; DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY <br /> MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS <br /> Applicants should refer to the regulations cited below to determine the certification to which they are required to <br /> attest. Applicants should also review the instructions for certification included in the regulations before completing this <br /> form. Signature of this form provides for compliance with certification requirements under 28 CFR Part 69, "New <br /> Restrictions on Lobbying" and 28 CFR Part 67, `Government-wide Debarment and Suspension (Non-procurement) and <br /> Government-wide Requirements for Drug-Free Workplace (Grants)'. The certifications shall be treated as a material <br /> representation of fact upon which reliance will be placed when the Department of Justice determines to award the <br /> covered transaction, grant, or cooperative agreement. <br /> 1 . LOBBYING (b) Have not within a three-year period preceding this application <br /> been convicted of or had a civil judgement rendered against them for <br /> As required by Section 1352, Title 31 of the U.S. Code, and implemented at 28 commission of obtaining, attempt)g to obtain, or performing d or a criminal offense <br />in connection <br /> public (Federal, State, <br /> CFR Part 69, for persons entering into a grant or cooperative agreement over or locaq transaction or contract under a public transaction; violation of <br /> $100,000, as defined at 28 CFR Part 69, the applicant certifies that: Federal or State antitrust statutes or commission of embezzlement, <br /> theft forgery, bribery, falsification or destruction of records, making <br /> (a) No federal appropriated funds have been paid or will be paid by or on behalf false statements, or receiving stolen property; <br /> of the undersigned to any person for influencing or attempting to influence an <br /> officer or employee of any agency, a member of Congress, an officer or employee (c) Are not presently indicted for or otherwise criminally or civilly <br /> of Congress, or an employee of a Member of Congress in connection with the charged by a governmental entity (Federal, State, or local) with <br /> making of any federal grant, the entering into of any cooperative agreement, and commission of any of the offenses enumerated in paragraph (1) (b) of <br /> the extension, continuation, renewal, amendment, or modification of any federal this certification; and <br /> grant or cooperative agreement; <br /> (d) Have not within a three-year period preceding this application <br /> (b) If any funds other than federal appropriated funds have been paid or will be had one or more public transactions (Federal, State, or local) <br /> paid to any person influencing or attempting to influence an officer or employee of terminated! for cause or default; and <br /> any agency, a member of Congress, an officer or an employee of Congress, a an <br /> employee of a member of Congress In connection with this federal grant or B. Where the applicant is unable to certify to any of the statements in <br /> cooperative agreement, the undersigned shall complete and submit Standard this certification, he or she shall attach an explanation to this <br /> Form - LLL, -Disclosure of Lobbying Activities", in accordance with its instructions; application. <br /> (c) The undersigned shall require that the language of this certification be <br /> included in the award documents for all subawards at all Hers (including subgrants, 3. DRUG-FREE WORKPLACE <br /> contracts under grants and cooperative agreements, and subcontracts) and that all (GRANTEES OTHER THAN INDIVIDUALS) <br /> subrecipients shall certify and disclose accordingly. <br /> As required by the Drug-Free Workplace Act of 1988, and <br /> 2. DEBARMENT, SUSPENSION, AND OTHER implemented at 28 CFR Part 67, Subpart F, for grantees, as defined <br /> RESPONSIBILITY MATTERS at 26 CFR Part 67 Sections 67.615 and 67.62G. <br /> (DIRECT RECIPIENT) A. The applicant certifies that it will or will continue to provide a drug- <br /> As required by Executive Order 12549, Debarment and Suspension, and free workplace by: <br /> implemented at 2B CFR Part 67, for prospective participants in primary covered (a) Publishing a statement notifying employees that the unlawful <br /> transactions, as defined at 28 CFR Part 67, Section 67.510 - manufacture, distribution, dispensing, possession, or use of a <br /> A. The controlled substance is prohibited in the grantee's workplace and <br /> applicant certifies that it and its principals: specifying the actions that will be taken against employees for <br /> (a) Are not presently debarred, suspended proposed for debarment, declared violation of such prohibition; <br /> ineligible, sentenced to a denial of federal benefits by a State or Federal court, or (b) Establishing an on-going drug-free awareness program to inform <br /> voluntarily excluded from covered transactions by any federal department or employees about- <br /> agency; <br /> (1) The dangers of drug abuse in the workplace; <br /> (2) The grantee's policy of maintaining a drug-free workplace; <br /> (3) Any available drug counseling, rehabilitation, and employee <br /> assistance programs; and <br /> (4) The penalties that may be imposed upon employees for drug <br /> abuse violations occurring in the workplace; <br /> FDLE JAG Grant Appllcstlon Package Lobbying Debarment Suspension and Drug-Free Workplace Certification <br /> Page 1 <br />