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(1) ANbide by the terms of the statement; and <br />V('1 lationyo#. heemployed,red, n s�rRil of his her cow fiction f r a <br />la er than five rk <br />calein ar dagys I er such conwiciori <br />tec Notif ohnwrtiTceQQ�eeev'ts1urb �oyuranloyles gwritin po?fL to4{ic�a)lo cfrordaguc � eaiplto gee <br />Wosi 10 <br />asphhraIn <br />�mggis l nmp P DC V 21rNoe4 ceo shads lnnc�uop th,ve�enplf��a'pod <br />number`s�of each a ected grant; <br />Tak'n one. ooqf the. followi act i ns, withi 30 lend r <br />respect�tgrany�employeeiwhousa�Orconv�iot,Tgra, (d)(p1�, wi <br />�1A IToakiinnguap ro n to �� isor}eeI action amijist such h fain <br />req piir�mentsp0hereehaobilitart�pon,arc� oa i/3, as amended; or <br />8tl Require such emplQy_eh}litatpo ioC'�pata to facoor] iAr' UR <br />useasi aneor e <br />orrotherr apfiropnateeagency e, or o a nal h, Raw en orcemen , <br />(g) Making a good faith effort to continue to maintain a drug- free <br />workplace through implementation of paragraphs (a), (b), (c), (d), <br />(e), and (f). <br />Check l-�there are workplace on file that are not identified <br />ere. <br />on ceal <br />for eYL) least en� hJF� Fo mp�r�6'p/ .. plTbe ��a aswande9pF�eap glanclon <br />Check IT if the <br />State has elected to complete OJP Form <br />GRANTEES WHO ARE INDIVIDUALS) <br />A le eirpdr� b eC uwFrrtegyWj'rkplaactoFN of 1988, and <br />depneN aig taF a', Sectwhs u�% 55 and gr7.�f2�- <br />Asa o dition of tthe gr nt.l ertify that I will not an a e in <br />h use l o Rap onlroflaedu sub tanoe inn'conoi ion nag �aocts sy wo �h <br />t�e grant, ancp <br />The rantep mu insertf in tl�e epoace hnrovided �.elow t�e de B. If convinced oof a criminal dru offense resulting fro <br />s'1 fofr tYse �er orm nce o wor ne connec ion wi tae violation occurrin urrng the conduc� of any rant activity, FIJI <br />peo is gra report the cor icon, in wr ing, within 10 calendar da s of the <br />conviction, to: De artment c Justice, Office of Justice Programs, <br />cc el of Performance (Street address, city, country, state, zip D C 20531ntrol �esk, 633 Indiana Avenue, N.W., Washington, <br />As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications. <br />1. Grantee Name and Address <br />Frank Fajardo <br />60 Civic Center Dr. <br />Santa Ana, CA 92702 <br />2. Application Number and/or Project Name - 3. Grantee IRS/Vendor Number <br />Druq Enforcement Administration <br />4. Typed Name and Title of Authorized Representative <br />David Valentin, Chief of Police, Santa Ana Police Department <br />5. Signature <br />1 1777::!5s a' <br />6. Date <br />