R-06-03-23-14E4 - 3/23/2006RESOLUTION NO. R -06-03-23-14E4
WHEREAS, the Texas Forest Service has grant funds available
through the Urban Forestry Partnership Grant Program, and
WHEREAS, the City Council wishes to enter into an Urban Forestry
Partnership Grant Program Agreement for the available grant funds for
the continued funding of an Arborist, and
WHEREAS, said grant requires a 5096- match from the City, Now
Therefore
BE IT RESOLVED BY THE COUNCIL OF THE CITY OF ROUND ROCK, TEXAS,
That the Mayor is hereby authorized and directed to execute on
behalf of the City an Urban Forestry Partnership Grant Program
Agreement, a copy of same being attached hereto as Exhibit "A" and
incorporated herein for all purposes, and the match required from the
City is hereby approved.
The City Council hereby finds and declares that written notice of
the date, hour, place and subject of the meeting at which this
Resolution was adopted was posted and that such meeting was open to the
public as required by law at all times during which this Resolution and
the subject matter hereof were discussed, considered and formally acted
upon, all as required by the Open Meetings Act, Chapter 551, Texas
Government Code, as amended.
RESOLVED this 23rd day of March, 2006.
ST: .
WELL, yor
City of Round •ock, Texas
CHRISTINE R. MARTINEZ, City Secre
@PPDesktop\ODMA/WORLDOX/O:/
DOX/RESOLUTI/R60323E4.WPD/sc
Federal Program
CFDA Number: 10.664
Period: 10-01-05 to 9-30-06
Grant Number: 05-08-04
Grant Amount: $8,202
Local Match: $8,202
Urban Forestry Partnership Grant Program
A Cooperative Program Between the Texas Forest Service
And the USDA Forest Service
GRANT AGREEMENT
This Grant Agreement is hereby entered into by and between the
Texas Forest Service (TFS), a Member of The Texas A&M University System
and an agency of the State of Texas, and the City of Round Rock, Texas,
hereafter referred to as 'Grantee.'
Article 1. This agreement represents the entire agreement between the
parties. Any modification of purpose, final product, grant award, or
matching contribution must be requested in writing and approved by the
TFS. Grantee must raise the entire balance of funds necessary to complete
the budget as proposed, from non-federal sources. All funds must be used
for the purposes stated below.
Purpose: To continue the professional arborist position, responsible
for conducting the NeighborWoods tree planting program and for
developing a street tree pruning cycle. The position would also help
conduct educational programs, enforce the tree ordinance, and improve
the city tree nursery. Grant and local funds will pay fo the salary and
benefit costs for the position.
Article 2. The $8,202 grant will be paid on a reimbursement basis upon
submission of approved cost records AND a project final report. Interim
reports detailing partial project accomplishments and costs will be
accepted for partial payment. The amount paid will equal 50% of the
approved project costs, not to exceed either the grant amount or the out-
of-pocket expenses. The Grantee shall be responsible for a minimum match
of $8,202, in eligible cash purchases or in-kind contributions.
Article 3. The Grantee shall be responsible for providing proof -of -
payment records for all purchases and in-kind contributions. These include
source documentation such as invoices, cancelled checks, paid receipts,
payroll or time and attendance records, contract documents, and valuation
letters for third -party in-kind contributions. Cost records must be
retained for three years following conclusion of the project.
Article 4. The Grantee must provide the TFS with an official resolution
passed by its governing body that authorizes its representative to execute
any agreements associated with this grant and commits the organization to
the matching contribution as proposed in the grant application and listed
above.
a
EXHIBIT
-2 -
Article 5. Applicable federal cost principles (attached OMB A-87 for
local governments, OMB A-21 for higher education institutions, or OMB A-
122 for nonprofit groups), administrative requirements (attached 7 CFR
Part 3016 or 7 CFR Parts 3015/3019), and the Grantee's application will be
followed in determining reasonableness, allowability, and allocation of
costs. Grantee's procurement procedures must conform to standards defined
in these documents and Grantees receiving $300,000 or more in federal
funds must comply with federal Single Audit Act requirements, as detailed
in circular OMB A-133.
Article 6. The terms of this agreement shall be governed by the laws of
the State of Texas. In addition, the Grantee agrees to comply with all
applicable federal laws, as specified in the attached Assurances for Non -
Construction Programs. Grantee must certify that they have not been
debarred from this or any other federal program, must comply with federal
drug-free workplace requirements, and must comply with restrictions on
lobbying Congress.
Article 7. The Grantee shall submit a final project performance report, a
financial summary with supporting documentation, and a copy of any product
developed through the grant within 60 days of project completion, or by
November 30, 2006, at the latest. (If required, a copy of the Single Audit
report covering the grant period must also be submitted.)
Article 8. The State Forester and the Comptroller General of the United
States, or any of their authorized representatives, shall have the right
of access to any pertinent books, documents, papers, or other records of
the Grantee which are pertinent to the grant in order to make audits,
examinations, excerpts, and transcripts.
Article 9. (For tree planting projects only.) The Grantee must provide
the TFS with a resolution or letter from the governing body of the entity
that owns the property where the trees are to be planted. This document
must grant permission to the Grantee to install this planting and commit
to providing reasonable protection for the trees.
Article 10. (For tree planting projects only.) Exhibit A (Tree Planting
Maintenance Specifications), attached hereto and incorporated for all
purposes, must be followed and will be used by the TFS to measure
performance by the Grantee. Trees must be maintained for three full years
following planting. The Grantee must replace any dead trees within the
period of this Agreement if the number of live trees falls below 90% of
the original number planted and included in project cost reports.
Article 11. If a Grantee materially fails to comply with any term of this
award, as stated above, the TFS may temporarily withhold cash payments
pending correction of the deficiency by Grantee, disallow all or part of
the cost of the activity or action not in compliance, wholly or partly
suspend or terminate the current award for the Grantee, withhold further
awards for the program, demand repayment of the grant, or take other
legally available remedies.
-3 -
Article 12. The Grantee may terminate this entire Agreement, without
cause, prior to the expiration of the grant period, upon thirty (30) days
written notice. Upon cancellation of this Agreement and release or return
of the unexpended grant funds, the Grantee is fully released of all
obligations under this Agreement.
Article 13. The Grantee agrees to hold the Texas Forest Service (TFS)
harmless from any injury to person or property occurring in connection
with project operations by Grantee, its agents, or employees, to the
extent allowed by law.
Article 14. If any part of this Agreement shall be deemed to be or shall,
in fact, be invalid, inoperative, or unenforceable as applied, such
circumstance shall not have the effect of rendering any other provision of
this Agreement invalid, inoperative, or unenforceable to any extent
whatever.
Acceptance: We accept this grant subject to the terms and provisions
stated above.
Grantee:
Grantor:
Signature
Title
Organization
Date
James B. Hull
State Forester
Texas Forest Service
Date
DATE: March 16, 2006
SUBJECT: City Council Meeting - March 23, 2006
ITEM: *14.E.4. Consider a resolution authorizing the Mayor to execute an Urban
Forestry Partnership Grant Program Agreement with the Texas Forest
Service to continue to fund an arborist position.
Department: Parks and Recreation
Staff Person: Rick Atkins, Director
Emsud Horozovic, Forestry Manager
Justification:
The arborist will continue to implement and develop numerous programs such as: Neighbor
Woods (street trees planting in neighborhoods), street tree routine maintenance, and educational
programs in our schools. Additionally the arborist will continue to lend support by assuming some
duties currently performed by the Forestry Manager.
Funding:
Cost: $53,000
Source of funds: Texas Forest Service and General Fund
Background Information:
The City of Round Rock Parks and Recreation Department has received several grants from the
Texas Forest Service over the years. This is a third and last year Texas Forest Service is funding
an Arborist position. This Service has been extremely valuable to PARD and we would like to
continue the program.
Public Comment: N/A
EXECUTED
DOCUMENT
FOLLOWS
TEXAS
FOREST ="SERVICE
The Texas A&M University System
5.941
April 3, 2006
Emsud Horozovic, Urban Forester
City of Round Rock PARD
301 W. Bagdad, Suite 250
Round Rock, TX 78664
Re: Partnership Graft No. 05-08-04
Dear rozovic:
Please find enclosed a copy of the executed Grant Agreement for your community forestry
Partnership grant. The official starting date for the project is October 1, 2005, and the ending date is
September 30, 2006. If you have any questions regarding project implementation or TFS technical
guidelines, please contact your local forester. He or she is responsible for insuring that the project is
completed according to the Grant Agreement and all technical guidelines. We also encourage you to
conduct a "check presentation ceremony" at an appropriate time to recognize the program's
participants. It is important to involve government leaders that help make this work possible by
showing them the impact of the program.
Once the work is completed, you will need to submit a report detailing the project
accomplishments and its costs, as detailed in the Documentation Guidelines already provided to you.
This report is due within 60 days of project completion, or November 30, 2006, at the latest. This
grant will be paid on a reimbursement basis, upon review of the cost report and equal to 50% of the
project's total costs, not to exceed the total amount of the grant.
If you have any administrative questions about this project contact me at (979) 458-6650.
/pds
Enclosure
cc: Jim Carse
Sincerely,
Peter D. Smith
Grants Administrator
Forest Resource Development & Sustainable Forestry
John B. Connally Building * 301 Tarrow, Suite 364 * College Station, Texas 77840-7896
TEL 979/458-6650 * FAX 979/458-6655
http://texasforestservice.tamu.edu
f
Federal Program
CFDA Number: 10.664
Period: 10-01-05 to 9-30-06
Grant Number: 05-08-04
Grant Amount: $8,202
Local Match: $8,202
Urban Forestry Partnership Grant Program
A Cooperative Program Between the Texas Forest Service
And the USDA Forest Service
GRANT AGREEMENT
This Grant Agreement is hereby entered into by and between the
Texas Forest Service (TFS), a Member of The Texas A&M University System
and an agency of the State of Texas, and the City of Round Rock, Texas,
hereafter referred to as 'Grantee.'
Article 1. This agreement represents the entire agreement between the
parties. Any modification of purpose, final product, grant award, or
matching contribution must be requested in writing and approved by the
TFS. Grantee must raise the entire balance of funds necessary to complete
the budget as proposed, from non-federal sources. All funds must be used
for the purposes stated below.
Purpose: To continue the professional arborist position, responsible
for conducting the NeighborWoods tree planting program and for
developing a street tree pruning cycle. The position would also help
conduct educational programs, enforce the tree ordinance, and improve
the city tree nursery. Grant and local funds will pay fo the salary and
benefit costs for the position.
Article 2. The $8,202 grant will be paid on a reimbursement basis upon
submission of approved cost records AND a project final report. Interim
reports detailing partial project accomplishments and costs will be
accepted for partial payment. The amount paid will equal 50% of the
approved project costs, not to exceed either the grant amount or the out-
of-pocket expenses. The Grantee shall be responsible for a minimum match
of $8,202, in eligible cash purchases or in-kind contributions.
Article 3. The Grantee shall be responsible for providing proof -of -
payment records for all purchases and in-kind contributions. These include
source documentation such as invoices, cancelled checks, paid receipts,
payroll or time and attendance records, contract documents, and valuation
letters for third -party in-kind contributions. Cost records must be
retained for three years following conclusion of the project.
Article 4. The Grantee must provide the TFS with an official resolution
passed by its governing body that authorizes its representative to execute
any agreements associated with this grant and commits the organization to
the matching contribution as proposed in the grant application and listed
above.
R -o4 -o3 -2.3 -146 &{
-2 -
Article 5. Applicable federal cost principles (attached OMB A-87 for
local governments, OMB A-21 for higher education institutions, or OMB A-
122 for nonprofit groups), administrative requirements (attached 7 CFR
Part 3016 or 7 CFR Parts 3015/3019), and the Grantee's application will be
followed in determining reasonableness, allowability, and allocation of
costs. Grantee's procurement procedures must conform to standards defined
in these documents and Grantees receiving $300,000 or more in federal
funds must comply with federal Single Audit Act requirements, as detailed
in circular OMB A-133.
Article 6. The terms of this agreement shall be governed by the laws of
the State of Texas. In addition, the Grantee agrees to comply with all
applicable federal laws, as specified in the attached Assurances for Non -
Construction Programs. Grantee must certify that they have not been
debarred from this or any other federal program, must comply with federal
drug-free workplace requirements, and must comply with restrictions on
lobbying Congress.
Article 7. The Grantee shall submit a final project performance report, a
financial summary with supporting documentation, and a copy of any product
developed through the grant within 60 days of project completion, or by
November 30, 2006, at the latest. (If required, a copy of the Single Audit
report covering the grant period must also be submitted.)
Article 8. The State Forester and the Comptroller General of the United
States, or any of their authorized representatives, shall have the right
of access to any pertinent books, documents, papers, or other records of
the Grantee which are pertinent to the grant in order to make audits,
examinations, excerpts, and transcripts.
Article 9. (For tree planting projects only.) The Grantee must provide
the TFS with a resolution or letter from the governing body of the entity
that owns the property where the trees are to be planted. This document
must grant permission to the Grantee to install this planting and commit
to providing reasonable protection for the trees.
Article 10. (For tree planting projects only.) Exhibit A (Tree Planting
Maintenance Specifications), attached hereto and incorporated for all
purposes, must be followed and will be used by the TFS to measure
performance by the Grantee. Trees must be maintained for three full years
following planting. The Grantee must replace any dead trees within the
period of this Agreement if the number of live trees falls below 90% of
the original number planted and included in project cost reports.
Article 11. If a Grantee materially fails to comply with any term of this
award, as stated above, the TFS may temporarily withhold cash payments
pending correction of the deficiency by Grantee, disallow all or part of
the cost of the activity or action not in compliance, wholly or partly
suspend or terminate the current award for the Grantee, withhold further
awards for the program, demand repayment of the grant, or take other
legally available remedies.
-3 -
Article 12. The Grantee may terminate this entire Agreement, without
cause, prior to the expiration of the grant period, upon thirty (30) days
written notice. Upon cancellation of this Agreement and release or return
of the unexpended grant funds, the Grantee is fully released of all
obligations under this Agreement.
Article 13. The Grantee agrees to hold the Texas Forest Service (TFS)
harmless from any injury to person or property occurring in connection
with project operations by Grantee, its agents, or employees, to the
extent allowed by law.
Article 14. If any part of this Agreement shall be deemed to be or shall,
in fact, be invalid, inoperative, or unenforceable as applied, such
circumstance shall not have the effect of rendering any other provision of
this Agreement invalid, inoperative, or unenforceable to any extent
whatever.
Acceptance: We accept this grant subject to the terms and provisions
stated above.
Grantee:
Grantor:
itle
a1 i co r eo1 C 1
Organization
-2D3—O
ate
411.
James 'ull
State Forester
exas Forest Service
Date
OMB Approval No. 0348-0040
ASSURANCES - NON -CONSTRUCTION PROGRAMS
'iblic reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing
.(structions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET.
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
NOTE: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the
awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such
is the case, you will be notified.
As the duly authorized representative of the applicant, I certify that the applicant:
1.
Has the legal authority to apply for Federal assistance
and the institutional, managerial and financial capability
(including funds sufficient to pay the non -Federal share
of project cost) to ensure proper planning, management
and completion of the project described in this
application.
Will give the awarding agency, the Comptroller General
of the United States and, if appropriate, the State,
through any authorized representative, access to and
the right to examine all records, books, papers, or
documents related to the award; and will establish a
proper accounting system in accordance with generally
accepted accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from
using their positions for a purpose that constitutes or
presents the appearance of personal or organizational
conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable
time frame after receipt of approval of the awarding
agency.
5. Will comply with the Intergovernmental Personnel Act of
1970 (42 U.S.C. §§4728-4763) relating to prescribed
standards for merit systems for programs funded under
one of the 19 statutes or regulations specified in
Appendix A of OPM's Standards for a Merit System of
Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all Federal statutes relating to
nondiscrimination. These include but are not limited to:
(a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race, color
or national origin; (b) Title IX of the Education
Amendments of 1972, as amended (20 U.S.C. §§1681-
1683, and 1685-1686), which prohibits discrimination on
the basis of sex; (c) Section 504 of the Rehabilitation
trrevious Edition Usable
Act of 1973, as amended (29 U.S.C. §794), which
prohibits discrimination on the basis of handicaps; (d)
the Age Discrimination Act of 1975, as amended (42
U.S.C. §§6101-6107), which prohibits discrimination
on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended,
relating to nondiscrimination on the basis of drug
abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970 (P.L. 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) §§523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee
3), as amended, relating to confidentiality of alcohol
and drug abuse patient records; (h) Title VIII of the
Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as
amended, relating to nondiscrimination in the sale,
rental or financing of housing; (1) any other
nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is being
made; and, (j) the requirements of any other
nondiscrimination statute(s) which may apply to the
application.
7. Will comply, or has already complied, with the
requirements of Titles II and III of the Uniform
Relocation Assistance and Real Property Acquisition
Policies Act of 1970 (P.L. 91-646) which provide for
fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal or
federally -assisted programs. These requirements apply
to all interests in real property acquired for project
purposes regardless of Federal participation in
purchases.
8. Will comply, as applicaple, with provisions of the
Hatch Act (5\.U.S, §§1501-108 and 7324-7328)
which limit the pojA a1 activities 44 mployees whose
principal employ 'ent �rtiwil;es: are- d in whole or
in part with Federal funds. ' .
Authorized for Local Reproduction
Standard Form 4248 (Rev. 7-97)
Prescribed by OMB Circular A-102
9. Will comply, as applicable, with the provisions of the Davis -
Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act
(40 U.S.C. §276c and 18 U.S.C. §874), and the Contract
Work Hours and Safety Standards Act (40 U.S.C. §§327-
333), regarding labor standards for federally -assisted
construction subagreements.
10. Will comply, if applicable, with flood insurance purchase
requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires
recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of
insurable construction and acquisition is $10,000 or more.
11. Will comply with environmental standards which may be
prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National
Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating
facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in
floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management
program developed under the Coastal Zone Management
Act of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity of
Federal actions to State (Clean Air) Implementation Plans
under Section 176(c) of the Clean Air Act of 1955, as
amended (42 U.S.C. §§7401 et seq.); (g) protection of
underground sources of drinking water under the Safe
Drinking Water Act of 1974, as amended (P.L. 93-523);
and, (h) protection of endangered species under the
Endangered Species Act of 1973, as amended (P.L. 93-
205).
SIGNATURE OF AUT •RIZ RTIFYI
APPLIC ,ANIZATI•N
C I i y OF PoUAJD EOCk,
12. Will comply with the Wild and Scenic Rivers Act of
1968 (16 U.S.C. §§1271 et seq.) related to protecting
components or potential components of the nationa
wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance
with Section 106 of the National Historic Preservation
Act of 1966, as amended (16 U.S.C. §470), EO 11593
(identification and protection of historic properties), and
the Archaeological and Historic Preservation Act of
1974 (16 U.S.C. §§469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of
human subjects involved in research, development, and
related activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of
1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 et
seq.) pertaining to the care, handling, and treatment of
warm blooded animals held for research, teaching, or
other activities supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning
Prevention Act (42 U.S.C. §§4801 et seq.) which
prohibits the use of lead-based paint in construction or
rehabilitation of residence structures.
17. Will cause to be performed the required financial and
compliance audits in accordance with the Single Audit
Act Amendments of 1996 and OMB Circular No. A-133,
"Audits of States, Local Govemments, and Non -Prof
Organizations."
18. Will comply with all applicable requirements of all other
Federal laws, executive orders, regulations, and policies
governing this program.
TITLE
DATE SUBMITTED
September 2, 2005
Standard Form 424B (Rev. 7-97) Back
Certifications Regarding Lobbying; Debarment, Suspension and Other
Responsibility Matters; and Drug -Free Workplace Requirements
Applicants should refer to the regulations cited below to determine the certification to which they are required to attest.
Applicants should also review the instructions for certification included in the regulations before completing this form. Signature
of this form provides for compliance with the certification requirements under 7 CFR 3018, "New Restrictions on Lobbying,"
and 7 CFR 3017, "Governmentwide Debarment and Suspension (Nonprocurement) and Governmentwide Requirements for
Drug -Free Workplace (Grants)." The certifications shall be treated as a material representation of fact upon which reliance will
be placed when the USDA Forest Service determines to award the covered transaction, grant, or cooperative agreement.
1. Lobbying
As required by Section 1352, Title 31, of the U.S. Code, and implemented at 7 CFR 3018, for persons entering into a grant or
cooperative agreement over $100,000 as defined at 7 CFR 3018.105 and 3018.110, the applicant certifies that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee 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 making of any Federal grant, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or
cooperative agreement;
(2) [f 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 agency, a Member of Congress, an officer or employee of Congress or an employee of
a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and
submit Standard Form -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions;
(3)The undersigned shall require that the language of this certification be included in the award documents for all subawards at
all tiers (including subgrants, contracts under grants and cooperative agreements, and subcontracts) and that all subrecipients
shall certify and disclose accordingly.
2. Debarment, Suspension, and Other Responsibility Matters
As required by Executive Order 12549, Debarment and Suspension, and implemented at 7 CFR 3017, for prospective
participants in primary covered transactions, as defined at 7 CFR 3017, Sections 3017.105 and 3017.110--
1. The applicant certifies that it and its principals:
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered
transactions by any Federal department or agency;
(b) Have not within a three-year period preceding this application been convicted of or had a civil judgment rendered against
them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public
(Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or
receiving stolen property;
(c)Are not presently indicted for or otherwise criminally or civilly charged by a Government entity (Federal, State, or local) with
commission of any offenses enumerated in paragraph (lxb) of this certification; and
2. Where the applicant is unable to certify to any of the statements in this certification, he or she stall attach an explanation to
this application.
%
3. Drug Free Workplace (Grantees Other Than Individuals)
As required by the Drug -Free Workplace Act of 1988, and implemented at 7 CFR 3017, Subpart F, Section 3017.600 Purpose
for grantees, as defined at 7 CFR 3017, Section 3017.605 and 3017.610-
A. The applicant certifies that it will or will continue to provide a drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a
controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for
violation of such prohibition;
(b) Establishing an ongoing drug-free awareness program to inform employees about --
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace;
(c)Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement
required by paragraph (a);
(d) Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant, the
employee will --
(1) Abide by the terms of the statement; and
(2) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the
workplace no later that five calendar days after such conviction;
(e) Notifying the agency, in writing, within 10 calendar days after receiving notice under subparagraph (d)(2) from an employee
or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including
position title, to every grant officer on whose grant activity the convicted employee was working, unless the Federal agency has
designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant;
(f) Taking one of the following actions, within 30 calendar days of receiving notice under subparagraph (d)(2), with respect to
any employee who is so convicted -
(1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the
requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved
for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency;
(g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c),
(d), (e), and (f).
B. The grantee may insert in the space provided below the site(s) for the performance of work done in connection with the
specific grant
Place of Performance (Street address, city, county, state, zip code)
C>> OF kou,iD Ecxx
Check Q if there are workplaces on file that are not identified here.
As the duty authorized representative of the applicant, 1 hereby certify that the applicant will comply with the above
certifications.
Name of Applicant
ROL)ftJD nock
Organizat on Name
PR/Award Number and/or Project Name
11N�/.E m i4Xw�u mRyGR
rint Norized
3-31-O(v
R-04• 03-Z3-JyEy