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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 (Nonprocurement) 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 />transaction, grant, or cooperative agreement. <br /> <br />LOBBYING <br /> <br />The undersigned certifies, to the best of his or her knowledge and <br />belief, that: <br /> <br />(1) <br /> <br />No Federat 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 />(c) <br /> <br />Are not presently indicted for or otherwise criminally or <br />civilly charged by a government entity (Federal. State or <br />local) with commission of any of the offenses enumerated <br />in paragraph (I)(b) of this certification; and <br /> <br />(d) <br /> <br />Have not within a three-year period 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 pdmary 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 />(2) If any funds other than Federal appropriated funds have 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 Lobbying,' in accordance with its instructions. <br /> <br />(3) The undersigned shall require that the language of this <br /> certification be included in the award documents for all subawards <br /> at all 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 of 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 entering <br />into this transaction imposed by section 1352, title 31, U.S. Code. Any <br />person who fails to file the required certification shall be subject to a <br />civil penalty of no'c less than $10,000 for each such failure. <br /> <br />This certification is required by the Drug-Free Workplace Act of <br />1988 (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 />AL TERNA TEI <br />(GRANTEES OTHER THAN INDIVIDUALS) <br /> <br />(1) The grantee certifies 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 and 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. DEBARMENT, SUSPENSION, AND OTHER RE- <br />SPONSIBILITY MATTERS <br /> <br />(1) The prospective pdmary participant certifies to the best of its <br /> knowledge 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 three-year pedod 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, bdbery, <br />falsification or destruction of records, making false <br />statements, or receiving stolen property. <br /> <br />(c) <br /> <br />(d) <br /> <br />(2) The grantee's policy 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 employees for <br /> drug abuse violations occurring in the workplace; <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 />Notifying the employee in the statement required by <br />paragraph (a) that, as a condition Of employment under the <br />grant, the employee will: <br /> <br />(1) Abide by the terms of the statement; and <br /> <br />(2) Notify the employer in wdting 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. <br /> <br />~)- I 9 FA-CERTS (3197) <br /> <br /> <br />