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HomeMy WebLinkAboutFY17 SHERIFF GCC JAIL GED GRANT AWARD CONTRACTt North Carolina Department of Public Safety Governor's Crime Commission Pat McCrory, Governor Frank L Perry, Secretary November 9, 2016 Sara Fox, Project Director County of New Hanover 230 Government Center Drive Suit 165 Wilmington, NC 28403 Christopher E. Swecker, Chair L. David Huffman, Executive Director SUBJECT: Project Name: 2016 — New Hanover County Sheriffs Office- Jail GED Program Project Number: PROJ011767 Implementing Agency: New Hanover County Sheriffs Office Dear Ms. Fox: Congratulations on receipt of your recent grant award from the Governor's Crime Commission. Attached you will find the Governor's Crime Commission's grant award checklist, your grant award document, and special conditions documents. This grant award does not become effective until it has been signed by the Authorizing Official and Project Director listed above and is returned to the Governor's Crime Commission. The signed grant award must be returned within thirty days of the date the award is mailed. You will be authorized to make expenditures under the grant or receive reimbursement once we have received the original signed grant award. Extensions beyond this thirty day period can only be authorized, in writing, by the Governor's Crime Commission. This grant award is subject to all administrative and financial requirements, including the timely submission of all financial and programmatic reports, resolution of any audit or site -visit findings, and match requirements. Should you not adhere to these requirements, you will be in violation of the terms of this agreement and the award will be subject to termination for cause or other administrative action as appropriate. To assist you, attached is a checklist of what you need to do in order for your Grants Management Specialist to receive your file. Any incomplete items will cause a delay in this process. As always, please contact our office if you have any questions or need additional assistance. Best wishes to you for successful program outcomes! Cordially, L. David Huffman ` Executive Director MAILING ADDRESS:,' OFFICE LOCATION: 4234 Mail Service Center 1201 Front St. Raleigh, NC 27699 -4234 = Raleigh, NC 27609 www.ncgccd.org '�a Telephone: (919) 733 -4564 www.ncdps.gov °`'' Fax: (919) 733 -4625 An Equal Opportunity Employer " S STATE OF NORTH CAROLINA o y0 DEPARTMENT OF PUBLIC SAFETY y�' GOVERNOR'S CRIME COMMISSION y 1201 Front Street, Suite 200 t, Raleigh, NC 27609 Telephone:(919) 733 -4564 Fax:(919) 733 -4625 C http: /tw ,ncgccd.org GRANT AWARD Applicant: County of New Hanover Project Name: 2016 - New Hanover County Sheriffs Office - Jail GED Program Authorizing Official: Chris Coudriet Implementing Agency: New Hanover Sheriffs Department County Manager Address: 230 Government Center Drive Suite 165 Project Director: Sara Fox Wilmington, North Carolina 28403 -1732 Project Number: PROJ011767 Vendor Number: 566000324 Account Manager: Navin Puri Grant Period: 1010112016 - 09/3012017 Budgets Period Personnel Contractual Travel Supplies Equipment Total Year 1 $0.00 $23,328.00 $0.00 $900.00 $0.00 $24,228.00 Grant Budget Source Federal Grant # CFDA # % Funding Federal Award 2016::Byrne Justice Assistance Grants 2016 -DJ -BX -1052 16.738 100% $24,228.00 In accordance with the laws and regulations of the United States and the State Of North Carolina, and on the basis of the grantee's application, the Department of Public Safety hereby awards to the foregoing grantee an award in the amount above. This grant is subject to the conditions listed in the approved grant application as well as all applicable rules, regulations and conditions, as may be described by the Department of Public Safety. Special conditions are attached to this award. This grant shall become effective, as of the start date of the grant period listed, once this original grant award has been properly executed on behalf of the grantee and returned to the Governor's Crime Commission, attention of the Grants Management Director. The grant award must be returned within 30 days of the date the award is mailed from the Governor's Crime Commission. No alterations of any kind may be made on this grant award. Signature of Authorizing Official Date Chris Coudriet, County Manager Name and Title of Authorizing Official Project Director Signature of Project Director Date Sara Fox, Name and Title of Project Director s Crime ,—.P- . Signature of Director l,//)' Date L. David Huffman, Executive Director Name and Title of Director ❑ This award is subject to the attached conditions, which must be signed by both the authorizing official and the project director, and returned along with this Grant Award. No alterations of any kind may be made on this grant award. .5M4o DEPARTMENT OF PUBLIC SAFETY e AWARD CONTINUATION SHEET GOVERNOR'S CRIME COMMISSION 1201 FRONT STREET ' RALEIGH, NORTH CAROLINA 27609 GRANT CRIMINAL JUSTICE SYSTEM IMPROVEMENT COMMITTEE GRANT AWARD SPECIAL CONDITIONS BYRNE JUSTICE ASSISTANCE GRANT FUNDING SUBRECIPIENT: County of New Hanover DUNS NUMBER: 040029563 PROJECT NAME: 2016 - New Hanover County Sheriff's Office - Jail GED Program PROJECT NUMBER: PROJO11767 i.Appiicability of Part 200 Uniform Requirements The Uniform Administrative Requirements, Cost Principles, and Audit Requirements in 2 C.F.R. Part 200, as adopted and supplemented by the Department of Justice (DOJ) in 2 C.F.R. Part 2800 (together, the "Part 200 Uniform Requirements ") apply to this 2016 award from the Office of Justice Programs (OJP) . The Part 200 Uniform Requirements were first adopted by DOJ on December 26, 2014. If this 2016 award supplements funds previously awarded by OJP under the same award number (e.g., funds awarded in 2014 or earlier years), the Part 200 Uniform Requirements to apply with respect to all funds under that award number (regardless of the award date, and regardless of whether derived from the initial award or a supplemental award) that are obligated on or after the acceptance date of this 2016 award. For more information and resources on the Part 200 Uniform Requirements as they relate to OJP awards and subawards ("subgrants "), see the Office of Justice Programs (OJP) website at http:// ojp. gov/ funding /Part200Uni formRequirements.htm. In the event that an award - related question arises from documents or other materials prepared or distributed by OJP that may appear to conflict with, or differ in some way from, the provisions of the Part 200 Uniform Requirements, the recipient is to contact OJP promptly for clarification. 2. Compliance with DOJ Grants Financial Guide The recipient agrees to comply with the Department of Justice Grants Financial Guide as posted on the OJP website (currently, the "2015 DOJ Grants Financial Guide ") , including any updated version that may be posted during the period of performance. 3. Requirement to report potentially duplicative funding if the recipient currently has other active awards of federal funds, or if the recipient receives any other award of federal funds during the period of performance for this award, the recipient promptly must determine whether funds from any of those other federal awards have been, are being, or are to be used (in whole or in part) for one or more of the identical cost items for which funds are provided under this award. I f so, the recipient must promptly notify the DOJ awarding agency (OJP or OVW, as appropriate) in writing of the potential duplication, and, if so requested by DOJ awarding agency, must seek a budget- modification or change -of- project -scope grant adjustment notice (GAN) to eliminate any inappropriate duplication of funding. 4. Requirements related to System for Award Management and Unique Entity Identifiers The recipient must comply with applicable requirements regarding the System for Award Management (SAM), currently accessible at http: / /www.sam.gov. This includes applicable requirements regarding registration with SAM, as well as maintaining the currency of information in SAM. The recipient also must comply with applicable restrictions on subawards ( "subgrants ") to first -tier subrecipients (first -tier "subgrantees ") , including restrictions on subawards to entities that do not acquire and provide (to the recipient) the unique entity identifier required for SAM registration. The details of the recipient's obligations related to SAM and to unique entity identifiers are posted on the OJP web site at Authorizing Official: Qi4 Project Director: Chris Coudriet Sara Fox r° DEPARTMENT OF PUBLIC SAFETY AWARD CONTINUATION SHEET GOVERNOR'S CRIME COMMISSION .s' 1201 FRONT STREET _ 2 RALEIGH, NORTH CAROLINA 27609 GRANT http: / /ojp.gov /funding /Explore /SAM.htm (Award condition: :>yr „tem for Award Management (SAM) and Universal Identifier Requirements), and are incorporated by reference here. This special condition does not apply to an award to an individual who received the award as a natural person (i.e., unrelated to any business or non - profit organization that he or she may own or operate in his or her name) . 5. All subawards ( "subgrants ") must have specific federal authorization The recipient, and any subrecipient ( "subgrantee ") at any tier, must comply with all applicable requirements for authorization of any subaward. This condition applies to agreements that -- for purposes of federal grants administrative requirements -- OJP considers a "subaward" (and therefore does not consider a procurement "contract "). The details of the requirement for authorization of any subaward are posted on the OJP web site at http: / /ojp.gov /funding /Explore /SubawardAut horization.htm (Award condition: Award Condition: All subawards ( "subgrants ") must have specific federal authorization), and are incorporated by reference here. 6. Specific post -award approval required to use a noncompetitive approach in any procurement contract that would exceed $150,000 The recipient, and any subrecipient ( "subgrantee ") at any tier, must comply with all applicable requirements to obtain specific advance approval to use a noncompetitive approach in any procurement contract that would exceed the Simplified Acquisition Threshold (currently, $ 150,000). This condition applies to agreements that -- for purposes of federal grants administrative requirements -- OJP considers a procurement "contract" (and therefore does not consider a subaward) . The details of the requirement for advance approval to use a noncompetitive approach in a procurement contract under an OJP award are posted on the OJP web site at ht tp.,.,ojp.gov/ funding / Explore /NoncompelitiveProcuremen t.htm (Award condition: Specific post -award approval required to use a noncompetitive approach in a procurement contract (if contract would exceed $150,000)), and are incorporated by reference here. 7. Requirements pertaining to prohibited conduct related to trafficking in persons (including reporting requirements and OJP authority to terminate award) The recipient, and any subrecipient ( "subgrantee ") at any tier, must comply with all applicable requirements (including requirements to report allegations) pertaining to prohibited conduct related to the trafficking of persons, whether on the part of recipients, subrecipients ( "subgrantees ") , or individuals defined (for purposes of this condition) as "employees" of the recipient or of any subrecipient. The details of the recipient's obligations related to prohibited conduct related to trafficking in persons are posted on the OJP web site at http: / /ojp.gow funding / Explore/ ProhibitedConduct- Trafficking.htm (Award condition: Prohibited conduct by recipients and subrecipients related to trafficking in persons (including reporting requirements and OJP authority to terminate award)), and are incorporated by reference here. 1. Compliance with applicable rules regarding approval, planning, and reporting of conferences, meetings, trainings, and other events The recipient, and any subrecipient ( "subgrantee ") at any tier, must comply with all applicable laws, regulations, policies, and official DOJ guidance (including specific cost limits, prior approval and reporting requirements, where applicable) governing the use of federal funds for expenses related to conferences (as that term is defined by DOJ), including the provision of food and /or beverages at such conferences, and costs of attendance at such conferences. • Authorizing Official: Project Director: Chris Coudriet Sara Fox s"ST^v, DEPARTMENT OF PUBLIC SAFETY AWARD CONTINUATION SHEET } �a� GOVERNOR'S CRIME COMMISSION �'L 1201 FRONT STREET RALEIGH, NORTH CAROLINA 27609 GRANT .J Information on the pertinent DOJ definition of conferences and the rules applicable to this award appears in the DOJ Grants Financial Guide (currently, as section 3. I 0 of "Post -award Requirements" in the "20 15 DOJ Grants Financial Guide ") . 9. Requirement for data on performance and effectiveness under the award The recipient must collect and maintain data that measure the performance and effectiveness of activities under this award. The data must be provided to OJP in the manner (including within the timeframes) specified by OJP in the program solicitation or other applicable written guidance. Data collection supports compliance with the Government Performance and Results Act (GPRA) and the GPRA Modernization Act, and other applicable laws. 10.0JP Training Guiding Principles Any training or training materials that the recipient -- or any subrecipient ( "subgrantee") at any tier -- develops or delivers with OJP award funds must adhere to the OJP Training Guiding Principles for Grantees and Subgrantees, available at http:;' /ojp.gov/ funding /oj ptrainingguidingprincipl es. .htm. ll.Effect of failure to address audit issues The recipient understands and agrees that the DOJ awarding agency (Governor's Crime Commission(GCC)) may withhold award funds, or may impose other related requirements, if (as determined by the Governor's Crime Commission (GCC)) the recipient does not satisfactorily and promptly address outstanding issues from audits required by the Part 200 Uniform Requirements (or by the terms of this award) , or other outstanding issues that arise in connection with audits, investigations, or reviews of DOJ awards. 12. The recipient agrees to comply with any additional requirements that may be imposed by the Governor's Crime Commission during the period of performance for this award, if the recipient is designated as "high- risk" for purposes of the DOJ high -risk grantee list. 13. Compliance with DOJ regulations pertaining to civil rights and nondiscrimination - 28 C.F.R. Part 42 The recipient, and any subrecipient ( "subgrantee ") at any tier, must comply with all applicable requirements of 28 C.F.R. Part 42, specifically including any applicable requirements in Subpart E of 28 C.F.R. Part 42 that relate to an equal employment opportunity program. 14. Compliance with DOJ regulations pertaining to civil rights and nondiscrimination - 28 C.F.R. Part 38 The recipient, and any subrecipient ( "subgrantee ") at any tier, must comply with all applicable requirements of 28 C.F.R. Part 38, specifically including any applicable requirements regarding written notice to program beneficiaries and prospective program beneficiaries. Part 38 of 28 C.F.R., a DOJ regulation, was amended effective May 4, 2016. Among other things, 28 C.F.R. Part 38 includes rules that prohibit specific forms of discrimination on the basis of religion, a religious belief, a refusal to hold a religious belief, or refusal to attend or participate in a religious practice. Part 38 also sets out rules and requirements that pertain to recipient and subrecipient ( "subgrantee ") organizations that engage in or conduct explicitly religious activities, as well as rules and requirements that pertain to recipients and subrecipients that are faith -based or religious organizations. The text of the regulation now entitled "Partnerships with Faith -Based and Other Neighborhood organizations, ^ is available via the Electronic Code of Federal Regulations (currently accessible at http: / /www.ecfr.gov /cgi- bin /ECFR ?page= browse), Authorizing Official: Q a Project Director: Chris Coudriet Sara Fox »�^ � DZPARTMM OF PUBLIC SAFZTY AWARD CONTINUATION SHEET T' GOVERNOR'S CRIME CODBaSSION 1201 FRONT STREET RALEIGH, NORTH CAROLINA 27609 GRANT by browsing to Title 28- Judicial Administration , Chapter I, Part 38, under a -CFR "current" data. 15. Restrictions on "lobbying" Federal funds may not be used by the recipient, or any subrecipient ( "subgrantee ") at any tier, either directly or indirectly, to support or oppose the enactment, repeal, modification or adoption of any law, regulation, or policy, at any level of government. Should any question arise as to whether a particular use of Federal funds by a recipient (or subrecipient) would or might fall within the scope of this prohibition, the recipient is to contact OJP for guidance, and may not proceed without the express prior written approval of OJP. 16. Compliance with general appropriations -law restrictions on the use of federal funds (FY2016) The recipient, and any subrecipient ("subgrantee ") at any tier, must comply with all applicable restrictions on the use of federal funds set out in federal appropriations statutes. Pertinent restrictions, including from various "general provisions" in the Consolidated Appropriations Act, 2016, are set out at http: / /ojp.gov/ funding / Explore/ FY2016- appropriationsLawRestrictions .htm, and are incorporated by reference here. Should a question arise as to whether a particular use of federal funds by a recipient (or a subrecipient) would or might fall within the scope of an appropriations -law restriction, the recipient is to contact the Governor's Crime Commission (GCC), and may not proceed without the express prior written approval the Governor's Crime Commission (GCC). 17. Reporting Potential Fraud, Waste, and Abuse, and Similar Misconduct The recipient and any subrecipients ( "subgrantees ") must promptly refer to the DOJ Office of the Inspector General (OIG) and the Governor's Crime Commission (GCC)any credible evidence that a principal, employee, agent, subrecipient, contractor, subcontractor, or other person has, in connection with funds under this award -- (1) submitted a claim that violates the False Claims Act; or (2) committed a criminal or civil violation of laws pertaining to fraud, conflict of interest, bribery, gratuity, or similar misconduct. Potential fraud, waste, abuse, or misconduct involving or relating to funds under this award should be reported to the OIG and the Governor's Crime Commission (GCC). by -- (1) mail directed to: Office of the Inspector General, U.S. Department of Justice, Investigations Division, 950 Pennsylvania Avenue, N. W. Room 4706, Washington, DC 20530; Governor's Critrt.. Commission, 1201 Front Street, Raleigh, N.C. 27609. (2) e-mail to: oig.hot linefusdoj.gov; and /or (3) the DOJ OIG hotline: (contact information in English and Spanish) at (800) 869 -4499 (phone) or (202) 616- 9881(fax). Additional information is available from the DOJ OIG website at http: //www.usdoj.gov /oig. 18. Restrictions and certifications regarding non - disclosure agreements and related matters No recipient or subrecipient ( "subgrantee ") under this award, or entity that receives a procurement contract or subcontract with any funds under this award, may require any employee or contractor to sign an internal confidentiality agreement or statement that prohibits or otherwise restricts, or purports to prohibit or restrict, the reporting (in accordance with law) of waste, fraud, or abuse to an investigative or law enforcement representative of a federal department or agency authorized to receive such information. The foregoing is not intended, and shall not be understood by the agency making this award, to contravene requirements applicable to Standard Form 312 (which relates to classified information), Form 4414 (which relates to sensitive compartmented information), or any other form issued by a federal department or agency governing the nondisclosure of classified information. • Authorizing Official: Project Director: Chris Coudriet Sara Fox .f� ^TFo DEPARTMENT OF PUBLIC SAFETY AWARD CONTINUATION SHEET GOVERNOR'S CRIME COMMISSION 1201 FRONT STREET RALEIGH, NORTH CAROLINA 27609 GRANT 1. In accepting this award, the recipient -- a.represents that it neither requires nor has required internal confidentiality agreements or statements from employees or contractors that currently prohibit or otherwise currently restrict (or purport to prohibit or restrict) employees or contractors from reporting waste, fraud, or abuse as described above; and b.certifies that, if it learns or is notified that it is or has been requiring its employees or contractors to execute agreements or statements that prohibit or otherwise restrict (or purport to prohibit or restrict), reporting of waste, fraud, or abuse as described above, it will immediately stop any further obligations of award funds, will provide prompt written notification to the federal agency making this award, and will resume (or permit resumption of) such obligations only if expressly authorized to do so by that agency. 2. If the recipient does or is authorized under this award to make subawards ( "subgrants ") , procurement contracts, or both- - aA t represents that- - (1) it has determined that no other entity that the recipient's application proposes may or will receive award funds (whether through a subaward ("subgrant "), procurement contract, or subcontract under a procurement contract) either requires or has required internal confidentiality agreements or statements from employees or contractors that currently prohibit or otherwise currently restrict (or purport to prohibit or restrict) employees or contractors from reporting waste, fraud, or abuse as described above; and (2) it has made appropriate inquiry, or otherwise has an adequate factual basis, to support this representation; and b. it certifies that, if it learns or is notified that any subrecipient, contractor, or subcontractor entity that receives funds under this award is or has been requiring its employees or contractors to execute agreements or statements that prohibit or otherwise restrict (or purport to prohibit or restrict), reporting of waste, fraud, or abuse as described above, it will immediately stop any further obligations of award funds to or by that entity, will provide prompt written notification to the federal agency making this award, and will resume (or permit resumption of) such obligations only if expressly authorized to do so by that agency. 19. Compliance with 41 U S.C. 4712 (including prohibitions on reprisal; notice to employees) The recipient must comply with, and is subject to, all applicable provisions of 41 U.S.C. 4712, including all applicable provisions that prohibit, under specified circumstances, discrimination against an employee as reprisal for the employee's disclosure of information related to gross mismanagement of a federal grant, a gross waste of federal funds, an abuse of authority relating to a federal grant, a substantial and specific danger to public health or safety, or a violation of law, rule, or regulation related to a federal grant. The recipient also must inform its employees, in writing (and in the predominant native language of the workforce) , of employee rights and remedies under 41 U.S.C. 4712. Should a question arise as to the applicability of the provisions of 41 U.S.C. 4712 to this award, the recipient is to contact the DOJ awarding agency (OJP or OVW, as appropriate) for guidance. 20. Encouragement of policies to ban text messaging while driving Pursuant to Executive Order 13513, "Federal Leadership on Reducing Text Messaging While Driving," 74 Fed. Reg. 51225 (October I, 2009), DOJ encourages recipients and subrecipients ( "subgrantees ") to adopt and enforce policies banning employees from text messaging while driving any vehicle during the course • Authorizing Official:QAaQ Project Director: Chris Coudriet Sara Fox q DEPARTlBi[fl' OF PUBLIC SAFZTY AWARD CONTINUATION SHEET GOVZRNOR'S CRAB CCNMSSION 1901 FROM VMUMT _ 6 _ RALEIGH, NORTS CAROLINA 27609 GRANT of performing work funded by this award, and to establish workplace safety policies and conduct education, awareness, and other outreach to decrease crashes caused by distracted drivers. 21. The recipient agrees to comply with the Governor's Crime Commission's monitoring guidelines, protocols, and procedures, and to cooperate with OJP and OCFO on all grant monitoring requests, including requests related to desk reviews, enhanced programmatic desk reviews, and /or site visits. The recipient agrees to provide to the Governor's Crime Commission (GCC) all documentation necessary to complete monitoring tasks, including documentation related to any subawards made under this award. Further, the recipient agrees to abide by reasonable deadlines set by the Governor's Crime Commission (GCC) for providing the requested documents. Failure to cooperate with the Governor's Crime Commission's (GCC) grant monitoring activities may result in sanctions affecting the recipient's DOJ awards, including, but not limited to: withholdings and /or other restrictions on the recipient's access to grant funds; referral to the office of the Inspector General for audit review; designation of the recipient as a DOJ High Risk grantee; or termination of an award(s). 22. Program income (as defined in the Part 200 Uniform Requirements) must be used in accordance with the provisions of the Part 200 Uniform Requirements. Program income earnings and expenditures both must be reported on the quarterly Federal Financial Report, SF 425. 23. The recipient understands and agrees that it has a responsibility to monitor its subrecipients' compliance with applicable federal civil rights laws. The recipient agrees to submit written Methods of Administration (MOP.) for ensuring subrecipients' compliance to the OJP's Office for Civil Rights at CivilRightsMOA @usdoj.gov within 90 days of receiving the grant award, and to make supporting documentation available for review upon request by OJP or any other authorized persons. The required elements of the MOA are set forth at http: / /wvrv.ojp . usdoj.gov/ funding /other_requirements.htm, under the heading, "Civil Rights Compliance Specific to State Administering Agencies." 24. In order to promote information sharing and enable interoperability among disparate systems across the justice and public safety community, OJP requires the grantee to comply with DOJ's Global Justice Information Sharing Initiative (DOD's Global) guidelines and recommendations for this particular grant. Grantee shall conform to the Global Standards Package (GSP) and all constituent elements, where applicable, as described at: http: / /www. it.ojp.gov /gsp_grantcondition. Grantee shall document planned approaches to information sharing and describe compliance to the GSP and appropriate privacy policy that protects shared information, or provide detailed justification for why an alternative approach is recommended. 25. To avoid duplicating existing networks or IT systems in any initiatives funded by BJA for law enforcement information sharing systems which involve interstate connectivity between jurisdictions, such systems shall employ, to the extent possible, existing networks as the communication backbone to achieve interstate connectivity, unless the grantee can demonstrate to the satisfaction of BJA that this requirement would not be cost effective or would impair the functionality of an existing or proposed IT system. 26. The recipient agrees that any information technology system funded or supported by OJP funds will comply with 28 C.F.R. Part 23, Criminal Intelligence Systems Operating Policies, if OJP determines this regulation to be applicable. Should OJP determine 28 C.F.R. Part 23 to be applicable, OJP may, at its discretion, perform audits of the system, as per the regulation. Should any violation of 28 C.F.R. Part 23 occur, the recipient may be fined as per 42 U.S.C.3789g(c) -(d). Recipient may not satisfy such a fine with federal funds. 27. Grantee agrees to comply with the requirements of 28 C.F.R. Part 46 and all Office of Justice Programs policies and procedures regarding the protection of human research subjects, including obtainment of Institutional Review Board approval, i.f appropriate, and subject informed consent_. 28. Grantee agrees to comply with all confidentiality requirements of 42 U.S.C. section 37899 and 28 C.F.R. Part 22 that are applicable to collection, use, and revelation of data or information. Grantee further agrees, as a condition of grant approval, to submit a Privacy Certificate that is in accord with requirements of Authorizing Official: Project Director: Chri3 Coudriet Sara Fox DEPARTMENT OF PUBLIC SAFETY AWARD CONTINUATION SHEET GOVERNOR'S CRIME COMMISSION 1201 FRONT STREET _ 7 _ �Qf RALEIGH, NORTH CAROLINA 27609 GRANT 28 C.F.R. Part 22 and, in particular, section 22.23. 29. The grantee agrees that within 120 days of award acceptance, each current member of a law enforcement task force funded with these funds who is a task force commander, agency executive, task force officer, or other task force member of equivalent rank, will complete required online (internet- based) task force training. Additionally, all future task force members are required to complete this training once during the life of this award, or once every four years if multiple awards include this requirement. The training is provided free of charge online through BJA's Center for Task Force Integrity and Leadership (www.ctfli.org). This training addresses task force effectiveness as well as other key issues including privacy and civil liberties /rights, task force performance measurement, personnel selection, and task force oversight and accountability. When BJA funding supports a task force, a task force personnel roster should be compiled and maintained, along with course completion certificates, by the grant recipient. Additional information is available regarding this required training and access methods via BJA's web site and the Center for Task Force Integrity and Leadership (www.ctfli.org) . 30. The recipient agrees to participate in BJA- sponsored training events, technical assistance events, or conferences held by BJA or its designees, upon BJA's request. 31. Approval of this award does not indicate approval of any consultant rate in excess of $650 per day. A detailed justification must be submitted to and approved by the Office of Justice Programs (OJP) program office prior to obligation or expenditure of such funds. 32. The grantee agrees to assist BJA in complying with the National Environmental Policy Act (NEPA), the National Historic Preservation Act, and other related federal environmental impact analyses requirements in the use of these grant funds, either directly by the grantee or by a subgrantee. Accordingly, the grantee agrees to first determine if any of the following activities will be funded by the grant, prior to obligating funds for any of these purposes. If it is determined that any of the following activities will be funded by the grant, the grantee agrees to contact BJA. The grantee understands that this special condition applies to its following new activities whether or not they are being specifically funded with these grant funds. That is, as long as the activity is being conducted by the grantee, a subgrantee, or any third party and the activity needs to be undertaken in order to use these grant funds, this special condition must first be met. The activities covered by this special condition are: a. New construction; b. Minor renovation or remodeling of a property located in an environmentally or historically sensitive area, including properties located within a 1 00 -year flood plain , a wetland, or habitat for endangered species, or a property listed on or eligible for listing on the National Register of Historic Places; c. A renovation, lease, or any proposed use of a building or facility that will either (a) result in a change in its basic prior use or (b) significantly change its size; d. Implementation of a new program involving the use of chemicals other than chemicals that are (a) purchased as an incidental component of a funded activity and (b) traditionally used, for example, in office, household, recreational, or education environments ; and e. Implementation of a program relating to clandestine methamphetamine laboratory operations, including the identification, seizure, or closure of clandestine methamphetamine laboratories. The grantee understands and agrees that complying with NEPA may require the preparation of an Environmental Assessment and /or an Environmental Impact Statement, as directed by BJA. The grantee further understands and agrees to the requirements for implementation of a Mitigation Plan, as detailed at http: / /www.ojp.usdoj.gov /BJA /resource /nepa.html, for programs relating to methamphetamine laboratory operations. Application of This Special Condition to Grantee's Existing Programs or Activities: For any of the grantee's or its subgrantees' existing programs or activities that will be funded by these grant funds, the grantee, upon specific request from BJA, agrees to cooperate with BJA in any preparation by BJA of a national or program environmental assessment of that funded program or activity. Authorizing Official: Project Director: Chris oudriet Sara Fox s.f�'`TFd DEPARTMENT OF PUBLIC SAFETY AWARD CONTINUATION SHEET GOVERNOR'S CRIME COMMISSION 1201 FRONT STREET — H RALEIGH, NORTH CAROLINA 27609 GRANT 33. JAG funds may be used to purchase vests for an agency, but they may not be used as the 50% match for purposes of the Bulletproof Vest Partnership (BVP) program. 34. Ballistic- resistant and stab- resistant body armor purchased with JAG funds may be purchased at any threat level, make or model, from any distributor or manufacturer, as long as the vests have been tested and found to comply with applicable National Institute of Justice ballistic or stab standards and are listed on the NIJ Compliant Body Armor Model List (http: / /nij.gov). In addition, ballistic- resistant and stab - resistant body armor purchased must be American -made. The latest NIJ standard information can be found here: http: / /www.nij.gov /topics /technology /body- armor /safety - initiative.htm. 35. The recipient agrees to submit a signed certification that all law enforcement agencies receiving vests purchased with JAG funds have a written "mandatory wear" policy in effect. Fiscal agents and state agencies must keep signed certifications on file for any subrecipients planning to utilize JAG funds for ballistic- resistant and stab- resistant body armor purchases. This policy must be in place for at least all uniformed officers before any JAG funding can be used by the agency for body armor. There are no requirements regarding the nature of the policy other than it be a mandatory wear policy for all uniformed officers while on duty. 36. Recipient understands and agrees that award funds may not be used for items that are listed on the Prohibited Expenditure List at the time of purchase or acquisition, including as the list may be amended from time to time. The Prohibited Expenditure list may be accessed here: 1-ittps: / /www.bja.gov /funding/ JAGCont _rolledPurchaseList_.pdf. 37. Recipient understands and agrees that award funds may not be used for items that are listed on the Controlled Expenditure List at the time of purchase or acquisition, including as the list may be amended from time to time, without explicit written prior approval from BJA. The Controlled Expenditure List, and instructions on how to request approval for purchase or acquisitions may be accessed here: https: / /www.bja.gov/ funding /JAGControlledPurchaseList.pdf. 38. The recipient understands that, pursuant to recommendation 2.1 of Executive Order 13688, law enforcement agencies that acquire controlled equipment through Federal programs must adopt robust and specific written policies and protocols governing General Policing Standards and Specific Controlled Equipment Standards. General Policing Standards includes policies on (a) Community Policing; (b) Constitutional Policing; and (c) Community Input and Impact Considerations. Specific Controlled Equipment Standards includes policies specifically related to (a) Appropriate Use of Controlled Equipment; (b) Supervision of Use; (c) Effectiveness Evaluation; (d) Auditing and Accountability; and (e) Transparency and Notice Considerations. Upon OJP's request, the recipient agrees to provide a copy of the General Policing Standards and Specific Controlled Equipment Standards, and any related policies and protocols. 39. Recipient understands and agrees that the purchase or acquisition of any item on the Controlled Expenditure List at the time of purchase or acquisition, including as the list may be amended from time to time, with award funds by an agency will trigger a requirement that the agency collect and retain (for at least 3 years) certain information about the use of 1) any federally- acquired Controlled Equipment in the agency's inventory, and 2) any other controlled equipment in the same category as the federally - acquired controlled equipment in the agency's inventory, regardless of source; and make that information available to BJA upon request. Details about what information must be collected and retained may be accessed here: https: / /www.whitehouse.gov/ sites / default / files /docs /le_equipment_wg_final_re port_final.pdf. 40. Recipient understands and agrees that failure to comply with conditions related to Prohibited or Controlled Expenditures may result in a prohibition from further Controlled Expenditure approval under this or other federal awards. • Authorizing Official: Qmmrs Project Director: Chris Coudriet Sara Fox �S1A7Ea DEPARTMENT OF PUBLIC SAFETY AWARD CONTINUATION SHEET GOVERNOR'S CRIME COMMISSION 'Y 1201 FRONT STREET _ n _ 7 - RALEIGH, NORTH CAROLINA 27609 GRANT 7 41. Recipient understands and agrees that, notwithstanding 2 CFR § 200.3 13, no equipment listed on the Controlled Expenditure List that is purchased under this award may be transferred or sold to a third party, except as described below: Agencies may transfer or sell any controlled equipment, except riot helmets and riot shields, to a Law Enforcement Agency (LEA) after obtaining prior written approval from BJA. As a condition of that approval, the acquiring LEA will be required to submit information and certifications to BJA as if it was requesting approval to use award fund for the initial purchase of items on the Controlled Expenditure List. Agencies may not transfer or sell any riot helmets or riot shields purchased under this award. Agencies may not transfer or sell any Controlled Equipment purchased under this award to non -LEAs, with the exception of fixed wing aircraft, rotary wing aircraft, and command and control vehicles. Before any such transfer or sale is finalized, the agency must obtain prior written approval from BJA. All law enforcement- related and other sensitive or potentially dangerous components, and all law enforcement insignias and identifying markings must be removed prior to transfer or sale. Recipient further understands and agrees to notify BJA prior to the disposal of any items on the Controlled Expenditure List purchased under this award, and to abide by any applicable laws and regulations in such disposal. 42. BJA strongly encourages the recipient to submit annual (or more frequent) JAG success stories. To submit a success story, sign in to your My BJA account at https: / /www.bja.gov /Login.aspx to access the Success Story Submission form. If you do not yet have a My BJA account, please register at https : / /www.bja.gov /profile.aspx. Once you register, one of the available areas on your My BJA page will be "My Success Stories ". Within this box, you will see an option to add a Success Story. Once reviewed and approved by BJA, all success stories will appear on the new BJA Success Story web page at https://www.bja.gov/SuccessStoryList.aspx. 43. Any law enforcement agency receiving direct or sub - awarded JAG funding must submit quarterly accountability metrics data related to training that officers have received on the use of force, racial and ethnic bias, de- escalation of conflict, and constructive engagement with the public. 44. The recipient agrees that funds received under this award will not be used tc supplant State or local funds, but will be used to increase the amounts of such funds that would, in the absence of Federal funds, be made available for law enforcement activities. 45. Recipient integrity and performance matters: Requirement to report information on certain civil, criminal, and administrative proceedings to SAM and FAPIIS The recipient must comply with any and all applicable requirements regarding reporting of information on civil, criminal, and administrative proceedings connected with (or connected to the performance of) either this OJP award or any other grant, cooperative agreement, or procurement contract from the federal government. under certain circumstances, recipients of OJP awards are required to report information about such proceedings, through the federal System for Award Management (known as "SAM ") , to the designated federal integrity and performance system (currently, "FAPIIS ") . The details of recipient obligations regarding the required reporting (and updating) of information on certain civil, criminal, and administrative proceedings to the federal designated integrity and performance system (currently, "FAPIIS ") within SAM are posted on the OJP web site at http ,ojp.gov /funding /FAPIIS.htm (Award condition: Recipient Integrity and Performance Matters, including Recipient Reporting to FAPIIS), and are • Authorizing Official: Project Director: Chris Coudriet Sara Fox ,SST ^Tt4 DEPARTMENT OF PUBLIC SAFETY AWARD CONTINUATION SHEET *T" GOVERNOR'S CRIME COMMISSION 1201 FRONT STREET _ 10 _ RALEIGH, NORTH CAROLINA 27609 GRANT incorporated by reference here. 46. Recipient acknowledges the final agency decision made by the U.S. Department of Justice that recipient's jurisdiction did not substantially implement the Sex offender Registration and Notification Act (P. L. 109 -248) before the deadline, which determination impacts the funding amount of this award, pursuant to 42 U.S.C. § 16925. In accepting this specific formula award, recipient hereby voluntarily agrees that if it elects to file a judicial appeal of that final agency decision, which was integral in determining this particular funding amount, no such appeal may commence more than 6 months after the date of this award. Authorizing official: Project Director: Chris Coudriet Sara Fox I U.S. DEPARTMENT OF JUSTICE OFFICE OF JUSTICE PROGRAMS OFFICE OF THE COMPTROLLER 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 certification requirements under 28 CFR Part 69, 'New Restrictions on Lobbying' and 28 CFR Part 67, 'Government -wide Debarment and Suspension (Nonpro- curement) and Government -wide 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 Department of Justice 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 28 CFR Part 69, for persons entering Into a grant or cooperative agreement over $100,000, as defined at 28 CFR Part 69, the applicant certifies that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for In- fluencing 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 con- nection 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; (b) If any funds other then Federal appropriated funds have been paid or will be paid to any person for influencing or at- tempting 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 of Lobbying Activities,' In accordance with Its Instructions; (c) The undersigned shall require that the language of this cer- ftfication 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 sub- recipients shall certify and disclose accordingly. 2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS (DIRECT RECIPIENT) As required by Executive Order 12549, Debarment and Suspension, and Implemented at 28 CFR Part 67, for prospec- tive participants in primary covered transactions, as defined at 28 CFR Part 67, Section 67.510 - A. The applicant certifies that it and its principals: (a) Are not presently debarred, suspended, proposed for debar- ment, declared Ineligible, sentenced to a denial of Federal benefits by a State or Federal court, or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three -year period preceding this applica- tion been convicted of or had a civil Judgment rendered against them for commission of fraud or a criminal offense in connec- tion 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 governmental entity (Federal, State, or local) with commission of any of the offenses enumerated In paragraph (1)(b) of this certification; and (d) Have not within a three -year period preceding this applica- tion had one or more public transactions (Federal, State, or local) terminated for cause or default; and B. Whore the applicant Is unable to certify to any of the statements in this certification, he or she shall attach an explanation to this application. 3. DRUG -FREE WORKPLACE (GRANTEES OTHER THAN INDMDUALS) As required by the Drug -Free Workplace Act of 1988, and Implemented at 28 CFR Part 67, Subpart F, for grantees, as defined at 28 CFR Part 67 Sections 67.615 and 67.620 - 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 on -going 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 state- ment required by paragraph (a); (d) Notifying the employee in the statement required by para- graph (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 than 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 convic -tion. Employers of convicted employees must provide notice, including position title, to: Department of Justice, Office of Justice Programs, ATTN: Control Desk, 633 Indiana Avenue, N.W., Washington, D.C. 20531. Notice shall Include the iden- ti icatlon numbers) of each affected grant; (Q 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 enforce. ment, 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 (Q. 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) e� i '� ps Ox cc- �o�t �O u�21nc e.. (Tev`W K Check ❑ If there are workplaces on file that are not Indentified here. Section 67, 630 of the regulations provides that a grantee that m is a State may elect to make one certification in each Federal fiscal year. A copy of which should be included with each ap- plication for Department of Justice funding. States and State agencies may elect to use OJP Form 4081!7. Check ❑ If the State has elected to complete OJP Form 4061/7. DRUG -FREE WORKPLACE (GRANTEES WHO ARE INDIVIDUALS) As required by the Drug -Free Workplace Act of 1988, and Implemented at 28 CFR Part 67, Subpart F. for grantees, as defined at 28 CFR Part 67; Sections 67.615 and 67.620 - A. As a condition of the grant, I certify that I will not engage in the unlawful manufacture, distribution, dispensing, posses- sion, or use of a controlled substance in conducting any activity with the gram; and B. If convicted of a criminal drug offense resulting from a violation occurring during the conduct of any grant activity, I will report the conviction, in writing, within 10 calendar days of the conviction, lo: Department o1 Justice. Office of Justice Programs, ATTN: Control Desk, 810 Seventh Street NW., Washington, DC 20531. As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications. 1. Grantee Name and Address: ok �Y�OJ2r 30 (�oJe�tn C- er•Jew 5u IIoS 2. Application Numb& endlor Project Name 3. Grantee IRS/Vendor Number _�)rbip -CA- N),lLVAber �RoSO��'Iln -I aok�v - New t WVCKU' 4. Typed Name and Title of Authorized Representative C- 5. Signature 6. Date 'LIAQOP *U.S. GOUe PR ,i G1 19%- 405-037140014 DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348 -0046 1. Type of Federal Action: 2. Status of Federal Action: V V 3. Report Type: a. contract b. ®a. bid /offer /application a. initial filing grant b. initial award b. material change c. cooperative agreement c. post -award For Material Change Only: d. loan e. loan guarantee year quarter date of last report f, loan insurance 4. Name and Address of,Reporting Entity: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Name ❑ Prime Subawardee and Address of Prime: Tier ifknown: NL c� Poh�cc NU Aa z'j "- C'c,t�•�y C�o0ec'w't(JV C�T�r S40`,Ds �a'3� a-�o ^j`K'n NC x)(6403 �ctleigh NC 1)-7(099 -4a34 Con ressional District, ifknown: Congressional District, ifknown: 6. Federal Department/Agency: 7. Federal Program Name /Description: a000 NVr\t )Ls4ICC kLssis'iLnc'e- JSCA Gco ProSconn �c� 5 CFDA Number, if applicable: . U0039 8. Federal Action Number, ifknown: 9. Award Amount, ifknown: $ 3A I as 10. a. Name and Address of Lobbying Registrant b. Individuals Performing Services (including address if (ifindividual, last name, first name, Ml): different from No. 10a) (last name, first name, MI): 11. 14amoean r.q . i e.wpn 0Y. lam M ,aM4r.d M "' 31 U. s. C. awm 1352. Trw mwwvre w I&dnro amwem i, a ..Isla aa..awdm m l,d SI nature: ` , 9 m�� � Print Name: (_iSw uwri.,nm .w 0—I er" u.r.m...,Miu1a nu,wal was m.e. a aVar,d M.. TIW 6ad..a. a rayue,d pawanl b 31 U.S.C. 1351. TIn immo.e "a.p.— m m. Cagnu wmianv ey -- a me,eM ra PM= wpaaw. ,vy P—. W. m 5w M np.a.d dadwa. aae a Title: W!,jW ro , dA n Wty of M leaa rat 510,000"M man r>w $/00,000 fm •� —�^ Telephone No�! �i1 --11 6-1 Date: VIZqII fO Federal Use Only: Authorized for Local Reproduction Stantlard Form LLL Rev. 7 -97) N^eU -`� 1nnue� Cotar' n�Jo c-�; ,�au� rs lQ \:i]Q.C� CrIM�N41 `\ ^L�� Ir\C 11A "`c VQri �S4Jl lr rare.. NQ `� "sue} cAnc�S W \ 1 6t Lse A A4 �� UUUF7� c \ do�a/ r,q OLCA:vi -kes . INSTRUCTIONS FOR COMPLETION OF SF -LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the Initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreemenito make payment to any lobbying angry 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 employeeof a Member of Congress in connection with a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and /or has been secured to Influence the outcome of a covered Federal action. 2. Identity the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a followup report caused by a material change to the information previously reported, enter the year am! quarter In which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city. State and zip code of the reporting entity. Include Congressional District, If known. Check the appropriate classification of the reporting entity that designates if it Is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards Include but are not limited to subcontracts, subgrents and contract awards under grants. 5. If the organizationfiling the report in item 4 checks "Subawardee, "then enter the full name, address, city. State and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan oommtment. Include at least one organlzationallevel below agency name, If known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (Item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal identifying number availablefor the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number, grant announcement number, the contract, grant, or loan award number; the appllcatioNproposat control number assigned by the Federal agency). Include prefixes, e.g.,'RFP -DE -90-001 9. For a covered Federal action where mere has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity Identified In item 4 or 5. 10. (a) Enter the full name, address, city. State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the Individual(s) performing services, and include full address If different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI). 11. The certifying official shall sign and date the form, print his/her name, title, and telephone number. According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of Information unless it displays a valid OMB Contro l Number. The valid OMB control number for this Information collection is OMB No. 0348 -0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, 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 Managementand Budget, Paperwork Reduction Project (0346-0046), Washington, DC 20503. CERTIFICATION FORM Compliance with the Equal Employment Opportunity Plan (EEOP) Requirements Please read carefully the Instructions (see below) and then comolete 3eetia a ar.corii— n — v_­_ r Recipient's Name: \ CCU A DUNS Number: - - Address: a3 C) !r Grant Title: N t\L pcc c t cuv,%l Grant Number: ( Award Amount: Name and Title of Contact Person: Tele hone Number: I E -Mail Address: Section A— Declaration Claiming Complete Exemption from the EEOP Requirement Please check all the following bores thai apply: • Recipient has less than fifty employees. ❑ Recipient is an Indian tribe. )(Recipient is a medical institution. • Recipient is a nonprofit organization. ❑ Recipient is an educational institution. at Recipient is receiving an award less than $25,000. 1, h UC �Ir t �� / [responsible official), certify that 7 , .1 :..� [recipient] is not required to prepare an EEOP for the reason(s) checked above, pursuant to 28 C.F.R § 42.302. I further certify that WOu1 IN , . nt,tl er [recipient] will comply with applicable federal civil rights laws hat prohib iscrmunation m employment and in the delivery of s rvices. �Y / t-u 1 i�ct� L"�.t \ -1 '�I� Print or Type Name and Tide Signature Date Section B— Declaration Claiming Exemption from the EEOP Submission Requirement and Certifying That an EEOP Is on File for Review Ifa recipient agency has fifty or more employees and is receiving a single award or subaward of $15,000 or more, but less than 5500,000, then the recipient agency does not have to submit an EEOP to the OCR for review as long as it certifies the following (41 C.F.R. § 41.305): 1, [responsible official], certify that [recipient], which has fifty or more employees and is receiving a single award or subaward for $25,000 or more, but less than $500,000, has formulated an EEOP in accordance with 28 CFR pt. 42, subpt. E. I further certify that within the last twenty-four months, the proper authority has formulated and signed into effect the EEOP and, as required by applicable federal law, it is available for review by the public, employees, the appropriate state planning agency, and the Office for Civil Rights, Office of Justice Programs, U.S. Department of Justice. The EEOP is on file at the following office: [organization], [address]. Print or Type Name and Title Signature Daie Section C— Declaration Stating that an EEOP Utilization Report Has Been Submitted to the Office for Civil Rights for Review Ifa recipient agency has fifty or more employees and is receiving a single award or subaward of $500,000 or more, then the recipient agency must send an ESOP Whiation Report to the OCR for review. I, certify that [responsible octal], which has fifty or more employees and is receiving a single award of $500,00 [recipient], 0 or more, has formulated an ESOP in accordance with 28 CFR pt. 42, subpt. E, and sent it for review on [date] to the Office for Civil Rights, Office of Justice Programs, U.S. Department of Justice. Print or Type Name and Title Signature Dote oMa Annmval Nn I Ill.11idn Fvni,aiinn n,,. n<nilte INSTRUCTIONS Completing the Certification Form Compliance with the Equal Employment Opportunity Plan (EEOP) Requirements The federal regulations implementing the Omnibus Crime Control and Safe Streets Act (Safe Streets Act) of 1968, as amended, require some recipients of financial assistance from the U.S. Department of Justice subject to the statute's administrative provisions to create, keep on file, submit to the Office for Civil Rights (OCR) at the Office of Justice Programs (OJP) for review, and implement an Equal Employment Opportunity Plan (EEOP). See 28 C.F.R. pt. 42, subpt. E. All awards from the Office of Community Oriented Policing Services (COPS) are subject to the EEOP requirements; many awards from OJP, including awards from the Bureau of Justice Assistance (BJA), the Office of Juvenile Justice and Delinquency Prevention (OJJDP), and the Office for Victims of Crime (OVC) are subject to the EEOP requirements; and many awards from the Office on Violence Against Women (OVW) are also subject to the EEOP requirements. If you have any questions as to whether your award from the U.S. Department of Justice is subject to the Safe Streets Act's EEOP requirements, please consult your grant award document, your program manager, or the OCR. Recipients should complete either Section A or Section B or Section C, not all three. Section A The regulations exempt some recipients from all of the EEOP requirements. Your organization may claim an exemption from all of the EEOP requirements if it meets any of the following criteria: it is a nonprofit organization, an educational institution, a medical institution, or an Indian tribe; or it received an award under $25,000; or it has less than fifty employees. To claim the complete exemption from the EEOP requirements, complete Section A. Section B Although the regulations require some recipients to create, maintain on file, and implement an EEOP, the regulations allow some recipients to forego submitting the EEOP to the OCR for review. Recipients that (1) are a unit of state or local government, an agency of state or local government, or a private business; and (2) have fifty or more employees; and (3) have received a single grant award of $25,000 or more, but less than $500,000, may claim the limited exemption from the submission requirement by completing Section B. In completing Section B, the recipient should note that the EEOP on file has been prepared within twenty -four months of the date of the most recent grant award. Section C Recipients that (1) are a unit of state or local government, an agency of state or local government, or a private business, and (2) have fifty or more employees, and (3) have received a single grant award of $500,000 or more, must prepare, maintain on file, submit to the OCR for review, and implement an EEOP. Recipients that have submitted an EEOP Utilization Report (or in the process of submitting one) to the OCR, should complete Section C. Submission Process If a recipient receives multiple awards subject to the Safe Streets Act, the recipient should complete a Certification Form for each grant. Recipients should download the online Certification Form, have the appropriate official sign it, electronically scan the signed document, and then send the signed document to the following e-mail address: EEOPFormsAusdoi.eov. The document must have the following title: EEOP Certification. If you have questions about completing or submitting the Certification Form, please contact the Office for Civil Rights, Office of Justice Programs, 810 7 Street, NW, Washington, DC 20531 (Telephone: (202) 307 -0690 and TTY: (202) 307 - 2027). OMB Approval No. 1121-0340 Expiration Date: 05 /31/14 Public Reporting Burden Statement Paperwork Reduction Act Notice. Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a current valid OMB control number. We try to create forms and instructions that are accurate, can be easily understood, and which impose the least possible burden on you to provide us with information. The estimated minimum average time to complete and file this application is 20 minutes per form. If you have any comments regarding the accuracy of this estimate, or suggestions for making this form simpler, you can write to the Office of Justice Programs, 810 7th Street, N.W., Washington, D.C. 20531. Governor's Crime Commission Grant Award Checklist PLEASE MAKE SURE YOU HAVE COMPLETED ALL OF THE FOLLOWING BEFORE MAILING THE GRANT AWARD BACK TO THE GOVERNOR'S CRIME COMMISSION: • Read Grant Award and Special Conditions carefully as compliance with the standard and special grant conditions are necessary to maintain funding for this project. • Authorizing Official must sign both the Grant Award (grey sheet) and the Special Conditions (all pages). • Project Director must sign both the Grant Award (grey sheet) and the Special Conditions (all pages). • If the name of either the Authorizing Official or the Project Director has changed, do not mark through the pre - printed name. First, the Organizational Administrator must access the project in GEMS and update the name(s) as instructed during the Program Development Workshops and in the 2014 GEMS Project Management Training Guide. Once the information has been updated, then contact the Grant Management Director and request that a new award be issued. Writing on the Grant Award will render it null and void. • Mail the original Grant Award (grey sheet) and Special Conditions back to GCC. • Complete and return the Certification Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug -Free Workplace Requirements (enclosed). • Complete and Return to GCC and the Office for Civil Rights the EEOP Certification Form (enclosed). The address of the Office for Civil Rights is on the form. This form is to be signed by the Authorizing Official of the Applicant Agency. If the Implementing Agency is not a part of the Applicant Agency, then a separate EEOP Certification form must be submitted for the Implementing Agency and signed by the Project Director. • 'New Enclose adopted Whistle Blower Policy (all subrecipients). • Attention! For Non - Governmental Applicant Agencies only: 1. Enclose Board approved Conflict of Interest Policy 2. Enclose State Grant Certification - No Overdue Tax Debt (available on GCC website, www.ncgccd.orq, select Grant Management, then Forms) 3. Enclose grantees web URL (if the agency has one) 4. Enclose brief agency description — NO MORE than 500 characters — (tell what the agency does, not what the grant is for) Once completed, all documents should be mailed to the Governor's Crime Commission, to the attention of Michael Gagner, GCC Assistant Director.