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1 CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER <br /> RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS <br /> Applicants should refer to the regulations cited below to determine the certification to which they are <br /> required to attest. Applicants should also review the instructions for certification included in the <br /> regulations before completing this form. Acceptance of this form provides for compliance with certification <br /> requirements under 28 CFR Part 69, "New Restrictions on Lobbying,"2 CFR Part 2867, "DOJ <br /> Implementation of OMB Guidance of Nonprocurement Debarment and Suspension," and 28 CFR Part 83, <br /> "Government-wide Debarment and Suspension," and Government-wide Requirements for Drug-Free <br /> Workplace(Grants)."The certifications shall be treated as a material representation of fact upon which <br /> reliance will be placed when the Department of Justice determines to award the covered transaction, <br /> 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 <br /> 69, for persons entering into a grant or cooperative agreement over$100,000, as defined at 28 CFR Part <br /> 69, the applicant certifies that: <br /> (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to <br /> any person for influencing or attempting to influence an officer or employee of any agency, a Member of <br /> Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection <br /> with the making of any Federal grant, the entering into of any cooperative agreement, and the extension, <br /> continuation, renewal, 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 <br /> 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 this <br /> Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form - <br /> LLL, "Disclosure of Lobbying Activities," in accordance with its instructions; <br /> (c)The undersigned shall require that the language of this certification be included in the award <br /> documents for all subawards at all tiers (including subgrants, contracts under grants and cooperative <br /> agreements, and subcontracts) and that all sub-recipients shall certify and disclose accordingly. <br /> 2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS (DIRECT RECIPIENT) <br /> As required by Executive Order 12549, Debarment and Suspension, and implemented at 2 CFR Part <br /> 2867, for prospective participants in primary covered transactions, as defined at 2 CFR Section <br /> 2867.20(a): <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 <br /> denial of Federal benefits by a State or Federal court, or voluntarily excluded from covered transactions <br /> by any Federal department or agency; <br /> (b) Have not within a three-year period preceding this application been convicted of or had a civil <br /> judgment rendered against them for commission of fraud or a criminal offense in connection with <br /> obtaining, attempting to obtain, or performing a public(Federal, State, or local) transaction or contract <br /> under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, <br /> theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen <br /> property; <br /> (c)Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity <br /> (Federal, State, or local)with commission of any of theoffenses enumerated in paragraph (1)(b)of this <br /> certification; and <br /> (d) Have not within a three-year period preceding this application had one or more public transactions <br /> (Federal, State, or local) terminated for cause or default. <br /> 30 <br />