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(1) Abide by the terms of the statement; and
<br />(2) Notify the employer In writing of his or her conviction for a
<br />violation of a criminal drug statute occurring in the workplace
<br />no later than five calendar days after such conviction;
<br />(e) Nniifying the agency, in writing, within 16 calendar days
<br />after receiving notice under subparagraph (d)(2) from an
<br />employee er nth prood, mcaiving dollar noun. of such comic -fan.
<br />Employers of convicted employees must provide notice, including
<br />position title, to: Department Of Justice, Oflics of
<br />Justico Pmgrams, ATTN: Control Desk, 6,13 Indiana Avenue,
<br />N.W., Worthington, D.C. 20531. Notice shall Include the loan -
<br />tifemAc n number(.) of each affected grant;
<br />If) Taking one of the following actions. within 30 eafendar
<br />day. of rsneivbtg notice under subparagraph (d)(2), with
<br />respect to any employee who is so ronva ed-
<br />(1) Taking appropriate personnel action against auah an
<br />enslaved, up to and including tcrmi arum, consistent with the
<br />requirements of the Robabilimarm Act Of 1973, as amended; or
<br />(2) P.quiring.uch employoe to participate satisfactorily in a
<br />drug abuse aacistaned or mbahllitafion program appmend far
<br />such purposes by a Federal, State, or Ideal tough. 1. incurred.
<br />melt, or other appropriate agency;
<br />(g) Making a good truth effort to continue ht maintain a drug
<br />free workplace through Implementation .l paragraphs (e), (b),
<br />(r), (d). 10). and (t).
<br />S.Tho grantee may insert In the space pevil i d below the
<br />stta(e) for the performance of work done In connection with
<br />the specific y.at'
<br />Piece of Performance (Street declared, cry, county, state, sip
<br />code)
<br />SAPD Integrated Law Enforcement Solution RFP
<br />RFP Exhibits
<br />Check ❑ 11 there are workplaces on file that are not indeatified
<br />hare.
<br />Section 67.030 of the regulations provides that a gramee that
<br />m
<br />is a State may elect to make one certification is each Federal
<br />fiscal year. A copy of which should be Included with each ap-
<br />plication for Department of Justico funding. States and State
<br />ege bilge may elect to use OJP Form 406117.
<br />Chock O if the State has olerlad to complete ON Form
<br />4061P.
<br />0RUG-FREE WOH KPLACE
<br />(GRANTEES WHO ARE INDIVIDUALS)
<br />As required by me Drug -Rem Workplace Act of 1909, and
<br />Implemented at 23 CFR Part 67, Subpart R tar grantees, Oa
<br />do6ned at 20 CFR Part 67; Sections 6].615 and 67.620 -
<br />A. As a condition of the grant, I noddy that I will not engage
<br />In the nniawlbi manufaolcm, dlainbutlon, deposited, poses-
<br />start. a, ar use of a c artrolletl s i a mm. in conducting any
<br />activity with the grant; and
<br />S. If convicted of a criminal drug cannro resulting from a
<br />violation occurring during the conduct of any grunt activity, I
<br />will report ilia conviction, In writing, within 10.$ends, days
<br />Of the conviction, to: Department of dostica, Office of Jostfre
<br />Programs, ATl'N', Central East, 633 Indian. Avenue, N.W.
<br />Washington, D.C. 20531.
<br />As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above cartlficallara
<br />I. GmNee Name and Address:
<br />2. Application Number and /or Protect Name 3. Grants. IRSIVeame, Number
<br />4. Typed Name and Title of Authorizad Rapresenedive
<br />5. Signature
<br />19C -158
<br />S. Dare
<br />EXHIBITS PAGE 4
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