|
CERTIFICATIONS REGARDING LOBBYING;.DEBARAIEN~f, SUSPENSION AND OTHER
<br /> RESPONSIBILITY. MATTERS; AND DRUG-FREE ",VOKI. OLACE REQUIREMENTS
<br />
<br />Aosilcants should refer to the re~iations cited below to determine the cenLfzation to which they are re~O~ed to attest. A.ppiicants should
<br />a.~o revtew the instructions for cen'~cation included in me regulations before comoieimg this form. Signature of this form provides for
<br />
<br /> soenmon ~onorocurement) and Government-~de Requirements for Dru~-Free Workplace (Grant%~." The
<br />cemvcanons shall be treated as a mateNai representation of fact upon which reliance will be placed when the Depar'n'nem ofEnerW
<br />dete..,'mmes to award the covered transaction, gram, or cooperative
<br />
<br />1. LOBBYING
<br />
<br />The tmde."si~ed certifies, io the best ofiss or her lmowleO, e and belief·
<br />
<br />No Federal appropriated funds have been paid or v-ill be paid. by
<br />or on behalf of the undm-signed, to any person for influencinv or
<br />anemptmg to iMluence an officer or e:nployee of any agenc.~, a
<br />Me=bet of ConFess. an officer or employee ct' Conm'ess. or an
<br />employee~ of a Member of Cenm-ess in comaecfio~ whh' the
<br />awarding of any Federal cona-a~:. ~.~ maiden of any Federal ~am.
<br />.'he '-'~'~ng of any Federal loan. =e mte.,-mg ~nto of any cooperative
<br />a.~'. cement and the extension, centmuation, rr'aewa.ljamendment.
<br />or modification of my Fede~ teac'act, grant, loan. or cooperative
<br />
<br />(c) .~e not p::esendy indicted for or otherwise criminally or civilly
<br /> · charged by a goverammt ~o.ry (Federal. State or locall with
<br /> commission of any of the offenses enume:-ated in poco_m-apb
<br /> (1)ih) of thls certification: and
<br />
<br />id} .Have act widxin a three-year period prece~':g '~is
<br /> appiicatio='prcposal bad one or more public =aamctions
<br /> C Fed.e.~. S ate or local1 te.--'--mated for cause or defaui:.
<br />
<br />(2) V,%~-~ ~e pro~ec~','e prim.ax?' participant iF unable to ce.":L, to any
<br /> of the smtemems m this ce,~ificanon, tach prospective pa:':mipant
<br /> ~imll ar'tach an explanation to this proposal.
<br />
<br />(2) If any lim~ than Federal appr~riar~d f',m~ have berm paid or will
<br /> be paid to any per~n for influ~..<'mg or artempti,g to kahence an
<br /> office.- or employee of any a.g~cy, a Member of ConD'ess. an
<br /> officer or employee of Conures~. or an e"mplovee cfa Member of
<br /> Con_re'ess in conn~don wit~ :ils Federal cone-act..ma.at, loan. or
<br /> coop,-.--"ative .agreement. the tmd~'i~ed shall complete and subnut
<br /> Stamia:d Fon:n-LLL "Disclo~-_--e Form to Report Lobbvinu." in
<br /> accordance with its instructions. ' -
<br />
<br />Toe undemi~ed shall require ~ the lan~e of this certification
<br />be included in the award docu::::ears for all subawards at all tiers
<br />(including subcontracts, sub_z-ams, and contracts under arants.
<br />loans, and cooperative a~eem~rs } and that all ~brecipien~ shall
<br />cer:ilS/and disclose accordingiy.
<br />
<br />This certification is a material representation of f~t u~n which
<br />reliance was placed when this tran~ction was made or mtemd rotc.
<br />Sub~. '.ssion offs cm'~cation is a p,"~uisite for maldn~, or entermu
<br />rotc tins a'ansaaien imposed by sec=on 1352. dr, lc 31. U.S.'Code.
<br />person who fails te file the required Ce.":ificauon sl~ll be subject to
<br />civil penally of not less than $10.000 and not more than $100.000 for
<br />each such failure.
<br />
<br />3. DRUG-FREE WORkTLACE
<br />
<br />TNs ce.mr]cation is ~quired by the Dy, ag-Free Workplace Act of 1938
<br />(Pub. L. 100-690. Title V. Subtitle D') and is impiemented
<br />ackti:ions to the Debarm~t md Su~ms,on ,'e~larions. published in
<br />Fed..~_! Re~re;- on January 3 I. 1989. and May 25. 1990.
<br />
<br />,4.L TER. M4 TEI
<br />(Ga~4.YTEES OTHER TI-L4.¥ I),'DIIqDU..ILS)
<br />
<br />( 1 } The ._~.ntee c~'~'ies that it will or will continue :o provide a ti-ag-
<br /> ~:ee workplace by:
<br />
<br /> la) Pablishing a statement notiS:'ing e.T...ptoyees that the unlawful
<br /> manufacture, dismbu,~on, dispensing, possession, or use of a
<br /> coho'oiled suhsta, CC is proixibited in the _~-'-amee's work, lace
<br /> md %peci~.-i=g the actions u~t will be taken against employees
<br /> for violation of such proi~ibition:
<br />
<br /> Ibl Est~lisking an ongoing a-ag. Dee awareness pm.~am :o
<br /> ire'cfm employees about:
<br />
<br />2. DEBAR. MENT, SUSPENSION, AND OTHER RE-
<br /> SPONSIBILrl'W 3LATTERS
<br />
<br />The pm~e~tive primary parncipant cer:..ifies to the best of irs
<br />.tmowledge and belief, that it and its prmcipais:
<br />
<br />(a) ..M'e not presently deba.-red., mspendeck proposed for
<br /> debare::ent, declared i.neligJble, or voluntanlv excluded fi-om
<br /> covered ~ansactions by any Fede.-al department or agency;
<br />
<br />lb} Have not within a du'ee-year l:~iod r~:edmt this proposal been
<br /> convicted of or l:md a civil ju .c[grnent render"~ aminst them for
<br /> commission of fi-.aud or a ~ offense in c~nne~tion with
<br /> obtaining anempting to obtain, or pcrforminv a punic
<br /> { FecL°ral. State. or locaD ~'xn~-,¢t/on under a public ~'ansaction:
<br /> 'dolafien of Federal or State ~tia,ast statutes or commission of
<br /> embezzl.em, ent. theft, for~.e?,,, bribery, falsification
<br /> ' - . or
<br /> desw,ction of r~ords, n",~.d~t false statements, or receiving
<br />
<br />Tne clingers of &-ag abuse in the workplace:
<br />
<br />The .z-~:ee's policy, ofmai~mining a drug-free '.vote. mince:
<br />
<br />Any available drug counseling, reimbilitation, and
<br />employee assistance pro.ams: and
<br />
<br />The penalties that may be imposed upon employees for
<br />drug abuse violations occurring in the workplace:
<br />
<br />Ma. lcing it a requirem=t that each employee to be engaged in
<br />the perfor=ance of the _~'ant be given a copy of the statement
<br />required by para=..2-'aph
<br />
<br />No60ing ~e .en:..ploye~ m the statement required by para,apb
<br />{a) that. as a condition of employment under the ~a.nt. the
<br />e.mpioyee wilh
<br />
<br />Abide by the te,,":r..s of 'he s:atement: and
<br />
<br />
<br />
|