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FEDERAL EMERGENCY MANAGEMENT AGENCY
<br /> CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND
<br /> OTHER RESPONSIBILITY 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 attest. Applicants
<br /> should also review the instructions for certification included in the regulations before completing this form. Signature on this
<br /> form provides for compliance with certification requirements under 44 CFR Part 18, "New Restrictions on Lobbying; and 28 CFR
<br /> Part 17, "Government-wide Debarment and suspension (Nonprocurement)and Government-wide Requirements for Drug-Free
<br /> Workplace(Grants)." The certifications shall be treated as a material representation of fact upon which reliance will be placed
<br /> when the Federal Emergency Management Agency(FEMA)determines to award the covered transaction,grant,or cooperative
<br /> agreement.
<br /> 1. LOBBYING (b) Have not within a three-year period preceding this application been
<br /> convicted of ar had a civilian judgment rendered against them for
<br /> A. As required by section 1352,Title 31 of the U.S.Code,and commission of fraud or a criminal offense in connection with
<br /> implemented at 44 CFR Part 18,for persons entering into a grant obtaining,attempting to obtain,or perform a public(Federal,State,
<br /> or cooperative agreement over$100,000,as defined at 44 CFR or local)transaction or contract under a public transaction;violation
<br /> Part 18,the applicant certifies that: of Federal or State antitrust statutes or commission of embezzlement,
<br /> theft,forgery,bribery,falsification or destruction of records,
<br /> (a) No Federal appropriated funds have been paid or will be paid, making false statements,or receiving stolen property;
<br /> by or on behalf of the undersigned,to any person for influencing or
<br /> attempting to influence an officer or employee of any agency,a (c) Are not presently indicted for or otherwise criminally or civilly
<br /> Member of Congress,an officer or employee of congress,or an charged by a governmental entity(Federal,State,or local)with
<br /> employee of a Member of Congress in connection with the making commission of any of the offenses enumerated in paragraph(1)(b)
<br /> of any Federal grant,the entering into of any cooperative agreement, of this certification;and
<br /> and the extension,continuation,renewal,amendment,or modification
<br /> of any Federal grant or cooperative agreement; (d) Have not within a three-year period preceding this application
<br /> had one or more public transactions(Federal,State,or local)
<br /> (b) If any other funds than Federal appropriated funds have been terminated for cause or default;and
<br /> paid or will be paid to any person for influencing or attempting to
<br /> influence an officer or employee of any agency,a Member of B. Where the applicant is unable to certify to any of the statements
<br /> Congress,an officer or an employee of Congress,or employee in this certification, he or shall shall attached an explanation to this
<br /> of a member of Congress in connection with this Federal grant or application.
<br /> cooperative agreement,the undersigned shall complete and submit
<br /> Standard Form LLL,"Disclosure of Lobbying Activities,"in 3. DRUG-FREE WORKPLACE
<br /> accordance with its instructions; (GRANTEES OTHER THAN INDIVIDUALS)
<br /> (c) The undersigned shall require that the language of this certification As required by the Drug-Free Workplace Act of 1988,and
<br /> be included in the award documents for all subawards at all tiers implemented at 44 CFR Part 17,Subpart F,for grantees,as defined
<br /> (including subgrants,contracts under grants and cooperative at 44 CFR Part 17,Sections 17.615 and 17.620:
<br /> agreements,and subcontract(s)and that all subrecipients shall
<br /> certify and disclose accordingly. A. The applicant certifies that it will continue to privide a drug-
<br /> free workplace by:
<br /> []Standard Form LLL,"Disclosure of Lobbying Activities"attached.
<br /> (This form must be attached to certification if nonappropriated funds (a) Publishing a statement notifying employees that the unlawful
<br /> are to be used to influence activities.) manufacture,distribution,dispensing, possession,or use of a
<br /> controlled substance is prohibited in the grantee's workplace and
<br /> 2. DEBARMENT, SUSPENSION,AND OTHER specifying the actions tht will be taken against employees for
<br /> RESPONSIBILITY MATTERS violation of such prohibition;
<br /> (DIRECT RECIPIENT)
<br /> (b) Establishing an on-going drug free awareness program to
<br /> As required by Executive Order 12549,Debarment and Suspension, inform empoyees about:
<br /> and implemented at 44 CFR Part 67,for prospective participants in
<br /> primary covered transactions,as defined at 44 CFR Part 17, (1) The dangers of drug abuse in the workplace;
<br /> Section 17.510-A. The applicant certifies that it and its principals: (2) The grantee's policy of maintaining a drug-free workplace;
<br /> (3) Any available drug counseling,rehabilitation,and
<br /> (a) Are not presently debarred,suspended,proposed for debarment, employee assistance programs;and
<br /> declared ineligible,sentenced to a denial of Federal benefits by a State (4) the penalties that may be imposed upon employees for
<br /> or Federal court,or voluntarily excluded from covered transactions by drug abuse violations occurring in the workplace;
<br /> any Federal department or agency;
<br /> FEMA Form 20-16C,JUN 94
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