Orange County NC Website
Applicant Name <br />ProgramlAClivity Recelving Federal Grant Funding <br />Acting on behalf of the above named Applicant as its Authorized Official, I make the following certifications and agreements to <br />the Department of I-]ousing and Urban Development (1-IUD) regarding the sites listed below: <br />I certify that the above named Applicant will or will continue <br />to provide adrug-flee workplace by: <br />a. Publishing a statement notifying employees that the un- <br />lawful manufacture, distribution, dispensing, possession, or use <br />of a controlled substance is prohibited in the Applicant's work- <br />place and specifying the actions that will be taken against <br />employees for violation of such prohibition. <br />b. Establishing an on-going drug-flee awareness program to <br />inform employees --- <br />(1) The dangers of drug abuse in the workplace; <br />(2) The Applicant's policy of maintaining adrug-flee <br />workplace; <br />(3) Any available drug counseling, rehabilimtion, and <br />employee assistance programs; and <br />(4) The penalties that may be imposed upon employees <br />for drug abuse violations occurring in the workplace. <br />c. Making it a requirement that each employee to be engaged <br />in the performance of the grant be given a copy of the statement <br />required by paragraph a.; <br />d, Notifying the employee in the statement required by para- <br />graph a. that, as a condition of employment under the grant, the <br />employee will --- <br />(1) Abide by the terms of the statement; and <br />(2) Notify the employer in writing of his or her convic- <br />tion for a violation of a criminal drug statute occurring in the <br />workplace no later than five calendar days after such conviction; <br />e. Notifying the agency in writing, within ten calendar days <br />after receiving notice under subparagraph d.(2) flora an em- <br />ployee or otherwise receiving actual notice of such conviction. <br />Employers of convicted employees must provide notice, includ- <br />ing position title, to every grant officer or other designee on <br />whose grant activity the convicted employee was working, <br />unless the Federalageney has designated a central point for the <br />receipt of such notices. Notice shall include the identification <br />number(s) of each affected grant; <br />f: Taking one of the following actions, within 30 calendar <br />days of receiving notice under subparagraph d. (2), with respect <br />to any employee who is so convicted --- <br />(1) Taking appropriate personnel action against such an <br />employee, up to and including termination, consistent with the <br />requirements of the Rehabilitation Act of 1973, as amended; or <br />(2) Requiring such employee to participate satisfacto- <br />rily in a drug abuse assistance or rehabilitation program ap- <br />proved for such purposes by a Federal, State, or local health, law <br />enforcement, or other appropriate agency; <br />g. Making a good faith effort to continue to maintain adrug- <br />free workplace through implementation of paragraphs a. thru f. <br />2. Sites fur Wark Performance., The Applicant shall list (on sepnrate pages) the site(s) for the performance of work done in connection with the <br />FIUD funding of the program/activity shown above: Place of Performance shall include the street address, city, county, State, and zip code. <br />Identify each sheet with the Applicant name and address and the program/activity receiving grant funding.) <br />Check here^ if there are workplaces on file that are not identifed on the attached shee(s. <br />t hereby certify that all the information stated herein, as welt as any information provided in the accompaniment herewith, is true and accurate <br />Warning: HUDwill prosecute false claims and statements. Convic(ion may result in criminal and/or civil penalties <br />(18 U.S C 1001.1010.1012; 31 U.S.C 3729.3802) <br />Signature <br />ua~e <br />form HUD-50070 (3/g8) <br />ref Handbooks 74171.747513.7485.1& 3 <br />