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CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER
<br />RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS
<br />
<br />Applicants should refer to the regulations cited below to determine the certification to which they are required to attest. Applicants should also
<br />review the instructions for certification included in the regulations before completing this form. Signature of this form provides for compliance
<br />with certification requirements under 34 CFR Part 82, "New Restrictions on Lobbying" and 34 CFR Part 85, "Government-wide Debarment and
<br />Suspension (Nonprocurament) and Government-wide Requirements for Drug-Free Workplace (Grants)." The certifications shall be treated as
<br />a material representation of fact upon which reliance will be placed when the Department of Energy determines to award the covered
<br />
<br />transaction, grant, or cooperative agreement.
<br />
<br />1. LOBBYING
<br />
<br />The undersigned certifies, to the best of his or her knowledge and
<br />belief, that:
<br />
<br />(1) No Federal appropriated funds have been paid or will be paid by
<br /> or on behalf of the undersigned, to any person for influencing or
<br /> attempting to influence an officer or employee of any agency, a
<br /> Member of Congress, an officer or employee of Congress, or an
<br /> employee of a Member of Congress in connection with the
<br /> awarding of any Federal contract, the making of any Federal
<br /> grant, the making of any Federal loan, the entering into of any
<br /> cooperative agreement, and the extension, continuation, renewal,
<br /> amendment, or modification of any Federal contract, grant, loan,
<br /> or cooperative grant.
<br />
<br />(2) If any funds other than Federal appropriated funds ha~ been paid
<br /> or will be paid to any person for influencing or attempting to
<br /> influence an officer or employee of any agency, a Member of
<br /> Congress. an officer of employee of Congress, or an employee of
<br /> a Member of Congress in connection with this Federal contract.
<br /> grant, loan, or cooperative agreement, the undersigned shall
<br /> complete and Submit'Standard Form-LLL, 'Disclosure Form to
<br /> Report Lobbyingi' in accordance with its instructions.
<br />
<br />(3) The undersigned shall require that the language, of this
<br /> certification be incl~ided in the award documents for all subawards
<br /> at ali tiers (including subcontracts, subgrants, and contracts under
<br /> grants, loans, and cooperative agreements) and that all
<br /> subrecipients shall certify and disclose accordingly. . .....
<br />
<br />This certification is a material representation ~f' fact upon '~Which
<br />reliance was placed when this transaction was made or entered into.
<br />Submission of this certification is a prerequisite for making or entedng
<br />into this transaction imposed by section 1352, title 31, U,S. Code. Any
<br />person who fai}s to file the required certification shall be subject to a
<br />civil penalty of not less than $1o,000 for each such failura.
<br />
<br />(c)
<br />
<br />(d)
<br />
<br />2. DEBARMENT, SUSPENSION, AND OTHER RE-
<br />SPONSIBILITY MATTERS
<br />
<br />(1) The prospective primary participant certifies to the best of its
<br /> knowieqge and belief, that it and its principals:
<br />
<br />(a)
<br />
<br />Are not presently debarred, suspended, proposed for
<br />debarment, declared ineligible, or voluntarily excluded from
<br />covered transactions by any Federal department or agency;
<br />
<br />(b)
<br />
<br />Have not within a throe*year period receding this proposal
<br />been convicted of or had a civil judgment rendered against
<br />them for commission of fraud or a criminal offense in
<br />connection with obtaining, attempting to obtain, or performing
<br />a public (Federal, State, or local) transaction under a public
<br />transaction; violation of Federal or State antitrust statutes or
<br />commission of embezzlement, theft, forgery, bribery,
<br />falsification or destruction of records, making false
<br />statements, or receiving stolen property.
<br />
<br />Are not presently indicted for or otherwise chminatly or
<br />civilly charged by a government entity (Federal. State or
<br />local) with commission of any of the offenses enumerated
<br />in paragraph (t)(b) of this certification; and
<br />
<br />Have not within a three-year pedod preceding this
<br />application/proposal had one or more public transactions
<br />(Federal, State or local) terminated for cause or default.
<br />
<br />(2) Where the prospective primary participant is unable to certify to
<br />any of the statements in this certification, such prospective
<br />participant shall attach an explanation to this proposal.
<br />
<br />3. DRUG-FREE WORKPLACE
<br />
<br />This certification is required by the Drug-Frae Workplace Act of
<br />lg88 (Pub. L. 100-690, Title V, Subtitle D) and is implemented
<br />through additions to the Debarment and Suspension regulations,
<br />published in the Federal Reqister on January 31, 1989, and May --
<br />25, 1990.
<br />
<br />ALTERNATE I
<br />(GRANTEES OTHER THAN INDIVIDUALS)
<br />
<br />(1) The grantee cert~es that it will or will continue to provide a
<br /> drug-free workplace by::
<br />
<br />(a)
<br />
<br />Publishing a statement notifying employees that the
<br />unlawful manufacture, distribution, dispensing, possession,
<br />or use of a controlled substance is prohibited in the
<br />grantee's workplace end specifying the actions that will be'
<br />taken against employees for violation of such prohibition;
<br />
<br />(b) Establishing an ongoing drug*free awareness program to
<br /> inform employees about:
<br />
<br />(1) The dangers of drug abuse in the workplace;
<br />
<br />(2) The grantee's poifcy of maintaining a drug-free
<br /> workplace;
<br />
<br />(3) Any available drug counseling, rehabilitation, and
<br /> employee assistance programs; and
<br />
<br />(4) the penalties that may be imposed upon ~ployees for
<br /> drug abuse violations occurring in the workplac?;
<br />
<br />(c)
<br />
<br />Making it a requirement that each employee to be engaged
<br />in the performance of the grant be given a copy of the
<br />statement required by paragraph d(a);
<br />
<br />(d)
<br />
<br />Notifying the employee in the statement required by
<br />paragraph (a) that, as a condition of employment under the
<br />grant, the employee witl:
<br />
<br />(1) Abide by the terms of the statement; and
<br />
<br />(2) Notify the employer in writing of his or her conviction
<br /> for a violation of a criminal drug state occurring in the
<br /> work-place not later than five calendar days after such
<br /> conviction.
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<br />FA-CERTS (3/g7) ~
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