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Certifications Page 1 of 3
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<br /> U.S.DEPARTMENT OF JUSTICE
<br /> OFFICE OF JUSTICE PROGRAMS
<br /> OFFICE OF THE CHIEF FINANCIAL OFFICER
<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
<br /> this form. Acceptance of this form provides for compliance with certification requirements under 28 CFR Part 69,
<br /> "New Restrictions on Lobbying,"2 CFR Part 2867, "DOJ Implementation of OMB Guidance on Nonprocurement
<br /> Debarment and Suspension,"and 28 CFR Part 83,"Government-wide Debarment and Suspension,"and
<br /> Government-wide Requirements for Drug-Free Workplace(Grants)."The certifications shall be treated as a
<br /> material representation of fact upon which reliance will be placed when the Department of Justice determines to
<br /> award the covered transaction, grant, or cooperative agreement.
<br /> 1. LOBBYING As required by Section 1352,Title 31 of the U.S. Code, and implemented at 28 CFR Part 69,for
<br /> persons entering into a grant or cooperative agreement over$100,000, as defined at 28 CFR Part 69, the
<br /> applicant certifies that:
<br /> (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
<br /> person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an
<br /> officer or employee of Congress, or an employee of a Member of Congress in connection with the making of any
<br /> Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal,
<br /> amendment,or modification of any Federal grant or cooperative agreement;
<br /> (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing
<br /> or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
<br /> Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative
<br /> agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities,"
<br /> in accordance with its instructions;
<br /> (c)The undersigned shall require that the language of this certification be included in the award documents for all
<br /> subawards at all tiers(including subgrants, contracts under grants and cooperative agreements, and
<br /> subcontracts) and that all sub-recipients shall certify and disclose accordingly.
<br /> 2. DEBARMENT, SUSPENSION,AND OTHER RESPONSIBILITY MATTERS (DIRECT RECIPIENT)
<br /> Pursuant to Executive Order 12549, Debarment and Suspension, implemented at 2 CFR Part 2867, for
<br /> prospective participants in primary covered transactions, as defined at 2 CFR Section 2867.20(a), and other
<br /> requirements: •
<br /> A.The applicant certifies that it and its principals:
<br /> (a)Are not presently debarred, suspended, proposed for debarment, declared ineligible, sentenced to a denial of
<br /> Federal benefits by a State or Federal court, or voluntarily excluded from covered transactions by any Federal
<br /> department or agency;
<br /> (b) Have not within a three-year period preceding this application been convicted of or had a civil judgment
<br /> rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to
<br /> obtain, or performing a public(Federal, State, or local)transaction or contract under a public transaction;violation .
<br /> of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or
<br /> destruction of records, making false statements, or receiving stolen property;
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<br /> httns://mants.oiausdoi.aov/6msexternal/disnlavAssurancesTextAction.st?method=certify... 5/17/2016
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