HomeMy WebLinkAbout2025-173A TRUE COPY
CERTIFICATION ON LAST -AGE
RYAN L. BUTLER, CLERK
Criminal Justice Grants
LOBBYING, DEBARMENT, AND DRUG
FREE WORKPLACE CERTIFICATION
Email completed form to: CJgrants@fdle.state.fl.us
Instructions: Before completing this form, applicants should refer to the regulations cited below to determine which
certifications are required. Using this form, applicants may certify their compliance with the following requirements:
28 CFR Part 69, "New Restrictions on Lobbying;" 28 CFR Part 67, "Government -wide Debarment and Suspensions
(Non -procurement);" and 28 CFR 83, "Government -wide Requirements for Drug Free Workplace (Grants)," as
applicable. The certifications attested to on this form shall be treated as a material representation of fact and will
be relied upon as such when Criminal Justice Grants makes award determinations for a covered transaction,
grant, or cooperative agreement.
1. Lobbying
As required by Section 1352, Title 31 of the U.S. Code, and implemented at 28 CFR Part 69, for persons
entering into a grant or cooperative agreement over $100,000, as defined at 28 CFR Part 69, the applicant
certifies that:
a) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, 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
the making of any federal grant, the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any federal grant or cooperative agreement.
b) If any funds other than federal appropriated funds have been paid or will be paid 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 grant or cooperative agreement, the undersigned shall
complete and submit Standard Form LLL — "Disclosure of Lobbying Activities", in accordance with its
instructions.
c) The undersigned shall require that the language of this certification be included in the award documents for
all subawards at all tiers (including subgrants, contracts under grants and cooperative agreements, and
subcontracts) and that all subrecipients shall certify and disclose accordingly.
2. Debarment, Suspension and Other Responsibility Matters
As required by Executive Order 12549, Debarment and Suspension, and implemented at 28 CFR Part 67 -
a) The applicant certifies that it and its principals:
i. Are not presently debarred, suspended, proposed for debarment, declared ineligible, sentenced to
a denial of federal benefits by a State or Federal court, or voluntarily excluded from covered
transactions by any federal department or agency;
ii. Have not within a three-year period preceding this application been convicted of or had a civil
judgement rendered against them for commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft forgery, bribery, falsification or destruction
of records, making false statements, or receiving stolen property;
iii. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity
(Federal, State, or local) with commission of any of the offenses enumerated in paragraph (a)(ii) of
this certification; and
iv. Have not within a three-year period preceding this application had one or more public transactions
(Federal, State or local) terminated for cause or default.
b) Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach an
explanation to this application.
3. Drug Free Workplace
As required by the Drug -Free Workplace Act of 1988, and implemented at 28 CFR Part 67, Subpart F, as defined
at 28 CFR Part 67 Sections 67.615 and 67.620 —
a) The applicant certifies that it will or will continue to provide a drug-free workplace by:
UGJG-001 Page 1 of 2
Lobbying, Debarment, and Drug Free Workplace Certification rev. 07/25
STATE OF FLORIDA
INDIAN RIVER COUNTY
THIS IS TO CERTIFY THAT THIS IS A TRUE AND CORRECT
COPY OF THE ORIGINAL ON FILE IN THIS OFFICE.
RYAN L BUTLER, CLERK
BY D.C.
Criminal Justice GrantsDATE
LOBBYING, DEBARMENT, AND DRUG
FREE WORKPLACE CERTIFICATION
Email completed form to: CJgrants@fdle.state.fl.us
i. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing,
possession, or use of a controlled substance is prohibited in the subgrantee's workplace and
specifying the actions that will be taken against employees for violation of such prohibition;
ii. Establishing an on-going drug-free awareness program to inform employees about —
1) The dangers of drug abuse in the workplace;
2) The subgrantee's policy of maintaining a drug-free workplace;
3) Any available drug counseling, rehabilitation, and employee assistance programs; and
4) The penalties that may be imposed upon employees for drug abuse violations occurring in
the workplace.
iii. Making it a requirement that each employee to be engaged in the performance of the grant be
given a copy of the statement required by paragraph (i);
iv. Notifying the employee in the statement required by paragraph (i) that, as a condition of
employment under the grant, the employee will —
1) Abide by the terms of this statement; and
2) Notify the employer in writing of his or her conviction for a violation of criminal drug statute
occurring in the workplace no later than five (5) calendar days after the conviction.
V. Notifying the agency, in writing, within ten (10) calendar days after receiving notice under
subparagraph (iv)(2) from an employee or otherwise receiving actual notice of such conviction.
Employers of convicted employees must provide notice including position title to: Florida
Department of Law Enforcement, Bureau of Criminal Justice Grants, P.O. Box 1489, Tallahassee,
FL 32302-1489. Notice shall include the identification number(s) of each affected grant.
vi. Taking one of the following actions within thirty (30) calendar days of receiving notice under
subparagraph (iv)(2), with respect to any employee who is convicted —
1) Taking appropriate personnel action against such an employee, up to and including
termination, consistent with the requirements of the Rehabilitation Act of 1973, as
amended; or
2) Requiring such employee to participate in a drug abuse assistance or rehabilitation
program approved for such purposes by a Federal, State, or local health, law
enforcement, or other appropriate agency.
vii. Making a good faith effort to continue to maintain a drug-free workplace through implementation of
paragraphs (i) through (vi).
b) The subgrantee may insert in the space provided below the site(s) for the performance or work done in
connection with
As the duly authorized representative of the applicant, I hereby certify that applicant will comply with the following
certifications:
11 Certification Regarding Lobbying (required for applications over $100,000)
2✓ Certification Regarding Debarment, Suspension and Other Responsibility Matters (required for all
applicants)
E] Certification Regarding Drug -Free Workplace (required for state agency applications)
Recipient: Indian River County
Printed Name: Joseph E. Flescher Title: Chairman
Signature: Date: 08/25/2025
Applica Number:
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Lobbying, Debarment, and Drug Free Workplace Certification rev. 07/25