Orange County NC Website
CERTIFICATIONS REGARDING (A) DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY 35 <br />MATTERS; (B) DRUGFREE WORKPLACE REQUIREMENTS; AND (C) LOBBYING <br />A- -'icants should refer to the regulations cited below to determine which certifications(s) apply to their grant, and review the instructions included in the <br />r', tions. Signing this form complies with certification requirements under "Government-wide Debarment and Suspension (Non-procurement)", <br />"Government-wide Requirements for Drug-Free Workplace (Grants)" in 45 CFR Part 1229, and `2iew Restrictions on Lobbying" in 45 CFR Part 1230. <br />The certification(s) shall be treated as a material representation of fact upon which reliance will be placed when the Corporation determines to award the <br />covered transaction, grant, or cooperative agreement. <br />A. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBLITTIJS <br />As required by Executive Order 12549, Debarment and Suspension, and implemented at 45 CFR Part 1229, for prospective participants in primary covered transactions, as <br />defined at 45 CFR Part 1229, Sections 1229.105 and 1229.110 - <br />1. The applicant certifies that it and its principals: <br />(a) Are not presently deban~ed, suspended, proposed for debarment, declared ine]igrble, or voluntarily excluded from covered transactions by any Federal department or <br />agency; <br />tb) Have not, within a 3-year period preceding this application, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal <br />offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; <br />violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false <br />statements, or receiving stolen property; <br />(c) Are not presently indicted for or otherwise criminally or civilly charged by a Federal, State or local government entity with corrmrission of any of the offenses <br />. enumerated in paragraph 1(b) of this certification; <br />(d) Have not, within a 3-year period preceding this application, had one or more public transactions (Federal, State or local) terminated for cause or default. <br />2. Where ffie applicant is unable to certify to any of the statements in this certification, he or she shall attach an explanation to this application. <br />B. DRUGFREE WORIO'LAN (GRANTEES OTHER THAN INDIVIDUALS) <br />As required by the Drug-Free Workplace Act of 1988, and implemented at 45 CFR Part 1229, Subpart F, for grantees, as defined at 45 CFR Part 1229, Sections 1229.605 <br />and 1229.610 - <br />1. The applicant certifies that it will or will continue to provide adrub-free workplace, and will - <br />(a) Publish a statement notifyir-g employees that unlawful manufactim, distnbution, dispensing, possession or use of a controlled sub-stance is prohibited in the <br />grantee's workplace and specifying the actions that will be taken against employees for violation of such prolnbition; <br />(b) Establish an on-going ding-free awareness program to inform employees about - <br />(1) The dangers of drug abuse in the workplace; <br />(2) The grantee's policy ofmaintaining adrug-free workplace; <br />( ~3) Any available drug counseling, rehabilitation, and employee assistance programs; and <br />~" (4) The penalties that may be imposed upon employees far drug abuse violations occurring in the workplace. <br />(c) Require that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph' 1(a); <br />(d) Notify the employee in the statement required by subparagraph 1(a) that, as a condition of employment under the grant, employee will - <br />(1) Abide by the terms of the statement; and <br />(2) Notify the employer in writing of any conviction for a violation of a criminal drug statute which occurred in the workplace, no later flrau 5 calendar days after <br />such conviction; . <br />(e) Notify the cognizant Corporation Grants Officer within 10 calendar days after receiving notice of such conviction under subparagraph (d)(2) from the employee, or <br />otherwise receiving actual notice. The notice shall include the title of the employee's position and the identification number(s) of the affected grant; <br />(f) Take one of the following actions, within 30 calendar days of receiving notice with respect to any employee who is so convicted - <br />(1) Take appropriate persomrel action against such an employee up to and including termination consistent with the requirements of the Rehabilitation Act of 1973, <br />as amended; or <br />(2) Require such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State or local <br />health, law enforcement, or other appropriate agency; <br />(S) Make a good faith effort to continue to maintain adrug-free workplace through implementation of paragraphs 1(a) through 1(f). <br />C. LOBBYING <br />As required by Section 1352, Title 31 of the U.S. Code, and implemented at 45 CFR Part 1230, for organizations entering into a grant or cooperative agreement over <br />$100,000, as defined at 45 CFR Part 1230, Sections 1230.105 and 1230.110, the applicant certifies that: <br />1. No Federal appropriated funds have been paid or will be paid, by of on behalf of the undersigned, to any person for influencing ar attempting to influence an officer or <br />employce 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 awarding of any <br />Federal contract, the making of any Federal grant, the malting of any Federal loan, the entering into of any cooperative agreement, or the extension, continuation, <br />renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. <br />2. If any funds other than 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 <br />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 <br />cooperative agreement, the undersigned shall complete and submit Standard Form-I I.L, "Disclose Form to Report Lobbying," in accardaace with its instnrctions. <br />3. The undersigned shall require that the language of tlris certification be included in the award documents for all subcontracts at all tiers (including subcontracts, sub- <br />grants, and contracts under grants, loans, and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly. <br />As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certification(s). (A copy of the governing body's <br />an' ~tion for me to sign this certification as official representative is on file in the applicant's office) <br />Ora,ie County Government Board of Commissioners Marearet Brown. Chair <br />Applicant Organization Printed Name and Title of Authorized Representative <br />-April 1, 2003 <br />Signature of Authorized Certifying Official Date <br />