HomeMy WebLinkAboutC2005-345 - 7/19/2005 - ApprovedEXECUTIVE OFFICE OFTHE PRESID~
OI~ICI~ OF NATIONAL DRUG ~N~ ~
Chief Pete Alvar~ Jr.
Corpua Christi Police Department
32 ! John Sm'lain Stree~
Corgu~ Chrh~ TX 78403
We ar~ plmaed to iaform ~nm tlmt ~m Awaxd, Grant Number gI5PHNP517Z, ~ b~m
in the amouat of $145,740.00. 'rh~ award to the Cm'pu~ Chri~ Polk~ D~pmtmma will rapport
Texa~ Comal Corridor Initiative initiative(s) a~ the Houa~n High Int~fity Drug
Area (HIDTA).
The original and one copy oftl~ Award with Special Co~litiom ~ em:lo~d. Ir'you ~ this
a~m'd, ~ign both the Awa.,'d ~nd Special Condi~ ~ nmn'n a co~y to the l~T~ti,.~al lrIT~A
fi,aeL: ~-a C_.a_ in M~-.-~. Keep the original ~py of the Cnam Award and Special C. ondiliom
~' your file.
If you have any qumtions pextaining t~ this grant aw~t, pl~ase feel free t~ c~ntact Phuo~
De3ear at 202-395-6739.
Sinc~'~ly,
A~ant Deputy DL,'~tor
Offit~ of State ~md Loc~ ~
Encknur~
ONI~'P
/.OO5-345
07/19/0~
M200~-226
Executive Office of the IN'ed(lent
AWARD
321JotmSm'tnMS'm:ct
4. Awird Nlmlbe~.
ISPHIqPSI 7Z
01/01R15 ~ 12/31/05
01/01/05 ~o 12/31/05
I,ac R~ IRS/Vendor No.
6. I:)n~: ~ 7. Acl/on
2. S~cipient Nmne and Ad~'c~
12.
10. Amount ofT~is Awmd
11. Total Awmd
Pruviom Awm~i )db. Amf.
S145,740.00
Special ~
TI~ abo~ Orsnt is ~ subje~ m such conditions or limiimiom ns sr~ set
foflh on the nlmched 5 i~m-(s).
13. Sinhm~ry Au~or~ ~r Gmnl: Public Lnw 1(~ ~.7
14. Ty~__ Nftn~ 8nd Title of ~ 15.
ONDCP OfFicial
Joseph D. Keefi:
Ol~c~ ofNn~cEml DruJ Cot~tml Policy
I I ' l, ,. t =' ~ I i I ','.~ i
Typed Nsn~ ~-.~ T't~le of'AuR~'iz~ Rn~imt
Ol~icinl
I~. ,s,e,~n~r~ Clnss/ficntion Code 19. HIDTA AWARD
HIDTA.
Inactive: 'rexnn Conslnl ~ lnitinfiw
Awnrd Amount:
Awn~l Pcnod:
Atlnc. tma~ to Award 15PHNPS17Z Pn~2of6
Christi ~
Mr. Slan Fm~e
$145,740.0~
1/I/2(IO5 I~ 12/31/2005
ONDCP
AIl mqm~ f~r pm/mem and inquifim should be smin~m:l m:
The Nalional HIDTA Asnin~nn~ Cen~
11200 N-W 20th St~
S~s: IO0
Miat~ FL 331'/2
Plgn:: 305=715-7600
as set ~ in the ONDCP Guidelin~t
c. thl: audit mlui~mln~ of OMB Cilxmlar A- ! 33,
d. th~ cost l~h-=¥k_ c~rlninod in OMB Ckcular A=87, and
OtT-~:e of N~tional Drug Control Policy Athtchmcnt to Award # 15PHNPS17Z Pag~ 3 of 6
be FDIC ins[zr~. It is deniable thtt the bank be a member of I~ Fedm'al Rmm've ~tstem.
must be intcn~ bearir~__
F. xcept for inln'~ mn~d on ndvm~t~____ of funds exnnpt toxin' tl~ In~t~,~,~l Coepentk~ Act (31
ILS C. 0501 et seq.) and the Indian ,%lf-~ Act (23 U.S.C. 450), Ipanmm and _ ~ ~
(21 CFR SecUre 1403.21i)
Finam~! S~s R~port~ (OMB Sa~d~t Fcs'm 269) will be required qua.m-ly dining ~ awm'd ix~iod nna
the end oflhe award. These forms shah be ftxtd to Phutn~ l)t~ear at 202-39~-S17~.
Off~ of Natkmal Drag Ccm1~ Policy Attnchment to Awntd # 15PHNP517Z Pa~ 4 of 6
Offi~ of Nalional Drug Cxmtrol Ptiicy A~ to Award # 15PHNP517Z Pa~ 5 of 6
750 17th ~ NW, We/tinglon DC 20503.
Aaa: Weedy Batten, Room 541. Phone: 202-395=6792, Fax: 202-395-5176.
¢~Tme of Nsti4:mal Drug Cattrol Po~cy A.~:-~.,,~nt to Award # I5'PHNPJlTZ PnS~ 6 of 6
15. The ~c. ipient ri&tens Io ~ui.,tete nnd le:ep on file, as apl~opria~ Immi?ntkm and Nntm'nli~ntien
Service Eml~:~neat gJi~'bflity Verifx:ation Ferrn 0-9). This fu~,u is robe reed by n:~ of x%dmd fimd~
to veri~ tl~ peraom me di~'bte to wodc in the United S't~m~
eoal]k-t of intere~ or p4s'senal pin.
~PI~NT ACCEPTANCE OF SPECIAL CONDITIONS
Typ~ Name
ChieE o[ Pol~.¢e
(Sigatu~)
_Ptzloe (;~ t4) t '~ ~
Adnmt~ All~ I 2JNX).~O 2,000.00
I:~" ,._. k~i '%., .,.,4~nd~gt -- I I,DO0.O0 ~OO~OO
W,,mlJI
14,10~.JI,
c - - -~mpmm
I.~ I II
IMqdll & mmll
'~
()FIqCE OF NATIONAl. DRUG CONTROL POLICY
I.'Y 0S HIDTA S'FATE AND LOCAL INITIAT1VIiS
IN.N'I'RU('I'IONS ~ )R APPLICANTS
Fo .~bsm[ a grant applicali~m fi~' FY' ~ HIDTA State arsd L~cal Iniliativ~ F-'ulldln~: Ih~ following form mmsbo .i_~,,.d and
· .Application for FawlprnJ A.~istano:. ~1~-424.
· Btalg. e~ Information N~-Conitrutaion Progrtr~. SF-424A, Page 2.
{Parc I will r~ be milmM.)
· Bud~ I~fornmfion C~n~ruetion IM:~rmm. SF-424C.
· Ceflirlcali~m rk. gardin! l.,*bying: Suiqx~%k,n ami otht.~' Re~'ixm.~bility M~.ter~ Dru~-lare~ Wtak.plac~ R,q.,b%~,dt]t; ~
fX.~t Status. ut'ti No.fl-Dt.~'rtmi[mti~m Statuk-s art] ImpJemt~ntiflg
· Dl,~'he~urt ofLobbyins Activit~s.
· Pm~:M.,.c of E~kJcv~t~lme of Iflformmit~n
i:a.h ,,! ~he~. d~.'mnenl~ hu,,~, hr'on ,'ompk'tcd ha.,o:d u[xm infim~mlhm ~hmilk.'d for the F'Y (15 Initialivm. Ifl~a taJ'm:melkm i~
m~-,wr~., ]. t~,nlJCl IiX. Natkma} I-UlTrA A[~lmX'c ('cnt~'r rot r~w forms.
]'lx~: ,h,.'u,enl~ mtm Ix. cm~kqed a,~.l ~irnt-d in fi~eir ~-nlir~l), and n.qurncd with original stgaatnnm alTt.,.~ be~ the awm'd ~
.'an I~ ,mliumd
Nalkma,I HJ[ITA A~t, iilam.-e ('erect
112(I) NW_--~'.~] .~-ll: lill
Miami. lq. ~3172-
t .~J~ ) 715-7~}
APPLICATION FOR
FEDERAL ASSISTANCE
1. TYPE OF
Z. DAI~. RECEIVED BY--S~'ATE
A,i:~ k:mt~r, P,, ~ pll.lUon
ADDFIF,c,S-, n, ,'fr. ,mm~ ~,,'~, u~7~p(,~
4. DATE RECENED BY FEDERAL AGENCY
e. EMPLOYE~ ID~.NllF'ICATIO~I NUMBER (EgO
TYPE OF AJ=PUCATION
X_ New _ Co~tlnua/k)n_ Revtslon
A Ir~meAwmJ 13. D~crmme.Aamn:l
C ~rtc~me D,.~lcm D. Decmm~ D~don
~ ~Vy) ...........
16, ESlliATED ~:
a. FederaJ
c. State
d. Local
e. Otter
f. Program Income
g. TOTAL
review
TO THE BEST OF MY KNOWt. E[X]E AND BELIEF, ALL DATAIIN THI~ APPUCA'r1cg61:JflEA~PUCATtOM ~ ~ AJ~) CQI~IEC'r. 11~
DOGUMENT HA,B BEEN DULY AXrTHOFU~I:n BY THE GOgT=R/~IQ BOOY OF TI.~ APPUCANT AI~ l~i AJq)UCANT WILL COMPLY ~
~ ATTACIfJ) A~I.q:L4,NI~.~ f THE A~IB'I'ANCE I~ AW.ildqlDED.
INSTRUCTIONS FOR ~ S1r424
P]~blk' rCl~,,rh,qi bunion for Ihi,; culk',.lion of infix-mature i~ cslimaled to ,vera~ 45 minulr~ per maiaoa~ '~m,--,,,~o~. ~ far
in~u [~.'I,,n~. ~'~ching existing data .~wrcex. gmherin~ und main~inin~ Ihe dm. ne~:kM, ~ compteVlng ~d mvtoming t~ coUea~oo
[nlorld~h..n ~,'ml ct mmem.,, ~.gm'ding Ihe hmdcn c.,4im~lt, of un.',' olhcr aspect of tiffs coIlecl~ of b~fu~umL~on, bwAudJ~ ~ Em'
[c, lut.~ng 'Ins ~rden [o t~.. ¢ )f~c~., ,,r M,,r~c~.n, .',~ Bud~'t. P~r~,,~ Re~km Pmj~ (0:34&0043), Wml~ ~X~
Iq.EASE I)O NOT RETI.'RN YOIJR ('OMPI.ETFA) FORM TO THE OFFICE OF MANAG~ AND BLIDGWr; 8E2qD IT
TO THE S, DDRE~; PROVIDED BY THE SPON~)RING AGENCY.
ht.m: F:r~. Ilcm:
I ~'ll ]' xpl.mal, m)
Dina .~pph.,.'mmfl .~ubmtlzuxf [o r"t'~.kTdl Agent') tOT SKIIC if
upphc'..~]c ~ & ~plJc~nl'~, c~mU'~] nu,~mr (if up~lk'~:de).
3. ,Rf--,t,. u.,z' ~,My li"applk'ahk.).
I..,:gm mi: of ~plic~at. rmme of primm'y, ur~ni/,,~,~d
uml..~-hk'h will undemke the ~ssisu~nce ~.'dx ity. tump~:te
a, klru,,.,, (ti th.' applicant. ~ nm~ ~ telel'~m' numlx~ of
ll~' [x.r,,on lo ~.'tmlZl tm rn~lt'~, relmed h) Ihb, ap~lic'alkm.
t, I'.'nk.i crnplo)~x Idemificalit,n Numh..r (EIN} u,, m,,,igned by
Its.' Inlcrnal Revrnue
7 Enlr, ~1~ apDft~d~c ~ILL']' in IhL' ~ C ]~X~x Mod
('lxx.~ ~plHx~riilc box and en~.-r
q ~L~.~ n) prm'idcd:
· "Ne'~ ' nle'dn'~ · new a.~birk:~ .'lwa~J
"( '(mlilKW~m' melnb uny clmnge in Ihe [:eck'rnl
f ~,mmcm',~ fimmciaJ (k54igmJon (~- omlingent
hah[lily fnm~ ~n exi~ing ~blignlim~
"rex,,mn' mc~ns aa) cl-~., in ih:
(;o~t, rn~em's financial (~lj~sfion C~ c~)ntingenl
habihly from ~n exJ.,qing obligjlJorL
N=~- ,,fF, xk'r~ ~-nc> from ~:h ~s~ixlum.x. [~ being
r~xim.,~,led ,~ith Ibis ~tik'mi~m.
If) U~. 11~' Cumlog .)f F'eak~l I)orm...stk. AssJ:,mm'e number
m.I Ii[It. t,I I~.. p~ogmm um'k.r which a~ismrmt, is
I I .En~, u hrwfde~:riptiw I[LE' ol'pro~.tl. If mor~ Ihan
lwogr. Lm i, involved, y~m .d~NJId aplx'?KI un explanation on
12.
13.
14.
15.
lb.
17.
18.
l.ls~ only th~ ~ paUtical eadt~ afltm~cl (e.g., Siam,
counti~ cit~).
appli~de. If the ~ctioa will n~alt in a dollm chm~ m n
exi~n$ aw~M. indm only tho anmmt of the ~ ~
1:5.
Al~ic~t~ ~ c~nt~ tl~ ~Bm SIz~ Poim ~CcxX~ct
(SPOC) for Fedm,~ F..u~ca~ ~ 12372 to ,b~,~im
wt~:t]-~- d= .+q,Uc~do~ h mb,~ect to th~ Sm~
ir~rsovcmmcn~J review ~
CaL~mrm or de~. i~Am ddim:p~t ,,,~i~ dialiowm~
Tobe signed bythe authorizodt~.~a,_c ' "ye M'th0
~plic~.-,;.. A copy of Ibc go~ __h~_ 's autl~rizadon fi~
)~u to ~gn lifts application as official ,,~, v ' 'irc mwt
~e on fit~ in LI'E 8pp.lJclnt'l offtc~. (C~rM~ l:~zJfa-d
INSTRUCTIONS FOR THE SF-424A
I'ulqk' r,.-p~ing I:nm.k'n fin' Ihi~ colP.~cli,n dj inform·it· i*, c~in,aed W ·vcra? 180 mi·ua· por lZSpotm~ !~ ~ for
,e~ .,.'wing inn, rte,,om,. ~carchin.~ cxistin~ data .,~ n~',.~ ~.athering and mai·Iai·in8 the cLlla needed, and
,v~ ,cwmg Ih·. oil·ti,tm of infin'malkm. ~'ml c.mnk, nts regarding Lhc In·lc· cstimat~ or any otb~ upc~t of rids col]oc:fl~l of
inh.r,m,o~. ,r~.'luding ,~uggeni~m~. I'~w rc'd~.'mg dfi*, burden to Ihe t'H'f'&-e of Mana4~umma and Bm'l~---~.
Pr~qo.'t H)348-*~t4L Wa.~ingtom I)C
PI.EASE I)O NOT RETLrRN YOUR COMPI.ETED FORM TO THE OFFICK OF MANAGEMKNT AND BI,~GRT,
Nl-~ D I'r (rT 'l~lE AE)DRES.',; PROVIDED BY 'THE SPONSORING AGl~ICY.
Th,. G'wni p. ck.'signed ~o Il'mi applk'ation can ~. mack: for
lurid, fr, ,m om. ~n' m~w~ grunt progran~. In rwcparing thc
budgcL ;*dhgn' [o any cni~tin~ F..n:k'm] 8runhn' aScnc)
gmdclim, s. ~'hLch Im.~.xibe hdv, ·nd Whelhef budge,od
am,,unL', n~ulJ hc ~Tun'ul¢ly ,.how· fit diff,..rt, nl funclim~
ch' uq. I,x tries w,hin the [re,sram. Fur ~.',.nk. i'~',.~gran'~.
.,.ho~.n by funclitai or ~,'fivity. For o~her lW~q~an~n, gmrdor
agone,c, may ,tXlUi~ · breagch~wn iv/ruin, k· ~w ~'tivity.
.*,k'vm~n .'LB.C '.md D ~houkl inclu~ b~dget e.,aimatc~ for
Ihe who,lc pfoj~x"t except when al~lying Gn' -~i,tanct.
~h~ch ~,.quim, ~ auth~'i/atipn in a.nual ~n' oLher
luudmg i~n-k~l incrcnt, m,.. In Ihe laUer ca:~... ~%'tiom A.
H.t ~l D sh~ld I'n~xidc the hutlge~ for Ih· ~l budget
i*cr,,J, umall.x a year) and .~.%'litm E ~,h~ndd i'n~sent the
,ccd fen ~xlcr..d aaa, si·nc· in the suha.n4~'nt inalge~
I~:nc<ls MI applications ~.mld c~mtain a breakdown by
IlK: ,,h~t. ct cla~. cm~gn-k~, shown in Linc*. ·- k L~f Scx.'lion
B.
Un· 1-4, ~ (c) thFomlh (S)
F,r new applicat~ kayo odium· (c~ and (d) blank. For
cz'h linc entry in CcOnm~ ti) a,-~ Co), mm' in Column (o),
~pp~'t Ibc pt~ for d~ first fupel~_w perlod (tmmlly a
)'cm').
emi,r.~ea ··duma of fuada w~.~. will m ~
ut ~ e~ ~ ~/~,~n~~ff~
~xe ~ ~ b~ ~ h ~ (~) ~ (~ ~
~off~ ~~~
n~a) in ~ ...... ~ ~ ~ ~ ~ ~ in
Col~n (~) ~ (~.
.*'~xtiom .~. Bodl~ Smm~ry 1~ I-4 calum tm) and
tb)
I'~N .tl~'d~:mion pea'taimng to · *,ingle i'm.,.~r.,m requiring
I~lgel .,m~mmn by malt,pt· fa·ct,cmn tn* activitk'~, cnler
Iht ru.u'm, ot eu,:h activit) ,w fum.'tion on cnch line in
(.'t,lum (·). itnd eltra' thc cmak~ nund~r in c. lumn (b).
I:~n al~iCalion peri·in,n! lo multipl~ pn~.ram~ whe~
· mc ,H die pnwams requite a brealuiown by function m'
ucn~x fly. ~l~- thc cal~ug ~ Ii,lc on ,:ach linc in
colurun ia) anti the n~:~x:x:live ~nlal*4{ num~n- tm each line
in ~ ,dm,u cb).
]';tN .q:],~licatkm perm]runs to mit,pie pnvp'a,L~ ~'ncre
,w .ww'r pro~rnrra require at I~x. nJu.'h,wn by fum.',itm ,m
mq,~ d). preps~: · ~.'peraic dZ'el Gw ,.'~ch i~x)grmn
.:q.iring Ihe bn..~tkdown. Additional sheclm .d~uld he um.'d
'&'h~-n one I~.~1'I{1 doe'A mn I~l*X~x'J~lt.' attL'qunlt' ~l~L~.'t' fi.W ..,11
Ih~.';,kck,wn of daxl requin.'d H(nvc*x'er. when rmh-u than
In tlz co4umn Izadinlp (I) t~,,-_*h (4), ntw th~ dtim of
thc mmc ~ f~ md a~dviti~ abown on lim
1-4, cokmm tn), Scc~m A. When addtfioaal atmm ~
in thc total mquitemm~ for fimd~ (bo*~ Pedmll md nOd-
FedemJ) by object c'--* ~
I.ha 6a.l- Show tie to.th of Lia~ fa to fih in ea:h
line 6j Sh.a ~he u,m,unl .r imliro:t c~,~.
Lira. &k- EnK'r Ihs: tolnl uf urmmnl~,
t:~N .dl dl')plicaliom, fig ne~, lq'ants ,md ¢LlnllnUatl~'l tir-dnt~
IIX, ,oral anl~i[]l in column (5). l.in¢ ~. ,d~mld he LIX'
~.ame a.,. Iix' to~al m'mmm .',~ n in '4e~i.n A. c.lunm
I.in.. 5. I 0~ .~pplenk. ntal granU, um.l chang,..-, t. l~ranL,,, the
h~l dnk~fll of the imTea,~. ~w ~'t'r t-,~t, u,, sh~,v,n in
t olmnn, I )-14 .. Linc 6L ~;.l~uld hc the mn..' lc. IIX. sum or
IlK' :m~,ulll~- in %tli.n A. ¢olu,nn
I.fme '7. ['~nlt~ ;M.' e~limah.'cl unamn! of imon,,', d un3
t ,q'x tied ti, he generalcd In~m Ihb. pn~je,ct. I.~, m~ -'~_M or
~.ubll"~l Ibis un~mnL Show ut~ler the pnr~rmn mzrr~li','e
HUl¢lncnl the i~alllre ',tnt] .~u.rce of imams... TM.. c:qinmted
~rnoum ,~'prt~r~n ino~rne ma.~ bs.' ¢on.<kk'~rcd by the
h.'tk'ral t.,rlAIOl a$cm.'y in ~k'ltwnlJnlng
fix'
C. lunm (b) Emer the conlrib~tion Io he made by
;he q,plicam.
Colm,m (0 Enter Ibe urmmnl ,f the Slate'a cash
and in-kind ct,ntribufi~m if the applicam is m~ a
~me or S~,,' a~:ocy. At~lica. nt~ which an: a
Slalc .~' Stole ag~nek~ r~uld leave this c~lunm
Cnhmm (d) Enlcr thc nmoum of c~h m~l in-kind
cumributio~ tn he nm:lc ~m all other soun.'c:s.
Cohmm (c) Ente~ ~ of colunm (bL(cL and (d).
Lira. 12. Enle~ tt~ ~ for cm:h of column (bN{e). The
&rm~um m colurrm (c) r, houkl be equal to the ammmt on
lam.. 5. column (O ~'cfion A.
~ 13 p~.-~- d~ ~noum ol'c~h n~dot by qua'tot from
the grmzlt~' llur~T during d~ i'u~ ~.
I~me 14 ~ Ih~ mnz~unt ofeesh fram sdl ~x'r sore
m~Med by quar~.~' durin$ ih,,. £u~ ~.
l.h~ 15 - Fmtrr tim h~tal~ of amounts on Lines 13 and 14.
I J~ 1~-I~- '--En~'r in Column (a) It~ same gram IX'Oll'am
Lilies shown in Column (a), Section A. A ~ by
fum.'tion or activity i~ nol neccssm'7. ~ n~w applicaliom
and c~mLioum.ioo grant ~p~licmiom, ealer in ~ ~
o,lumm llmaunt] of F-~:d~rll br~k ~ will be __r~.....'..~_ ~ to
funding period (usually in )~m~). TI~ mcOee need mat be
If ,norc than fi~n' linc~ ~re ~ Io list tl~ pro. mu ttti~
.~hmit ~lditional ~hedui~s u nece~af7.
Serlio, F. Omer a,,d~e~ b,f~ d--
IJme 21 - U~' fbi. spec~ to explain ~ ~ ir=tivtl:lu~l
din:~t object clma corn calga~ ;ee tkm may aypem' to be ,~1,
l. Jue 2~- Emir tt~ types of indlz~t mm ~
I'~'determine~:L fl n~] or fixed ) dmt will be i~ effec:t dm'lng
the fimding lm'iod, fl~e eafimat~d amomt of ttm ba~ m
ASSURANCES - NON.CONTRUCTION PROGRAMS
PI.FASE DO NOT REI'I.,rRN YOUR COMPI.ETED FORM TO THE OFFICE O~' M~q.'kG]I:M]GqT AND
.NENI) I1 TO THE ADDRESS PROVIDED BY THE SPONSORING AGI~ICY.
'N(~"I'E; ('enair ,)f tlx'~: u.,~urancc~ n~.x mu Ix. al~lic'a~lc to )orr proj~'t or pm[ram, if you have qumtiom, please .c~enct the
i:wunling n~.cm.>. Furtl~-r. ,.x-rluin F~'derul-:lw'arding ugcnc'k.'~, ma.,, rt.'quirt: applicants to certify Io a&:Utlonnl ~ If lush
.~s f~' d-ly u~h~J?~d r~ree~'nlaLi~ ~ orl~: up~lk..ml! I c.~tJfy tirol the
lira, fhc ~..~..,I aull~wit.~ to uppt.~ fc~ f'n.'tk'ral .',~.,d~lance
.md I1'~ in~li[utional, nmnngcriul 'and finam'inl
~opatn'hly oncludin8 lund~ .nu~ci~m h~ pn.~ the ram-
Itxk.~al ~ of p~x)jt-n.'t cxw,.I} Io cnsurc
I,lunning, nla'aa~mem und com,pk~ti~,m ~l'll~'
,k .':,a. f ib~ in Ihii applical.itm.
Will give tht. awan.tin.e agency. [b~ C~,mplmlkn'
~ N.m. ral of I. Tnhed Si,men. nnd if al:q~n~lw'iulc.
iI~,.u~h an~ aulhor~/.t"d ~'p~.'ticntnli,.'t'. ~.'c":~ Io and
sl~: .8ta lu examim., ull rt~nd. ~ndu~. palx.'r.
,I,~cu~'n~ related m Ih,.. mr,'m-al' uno v, ill e,,au~liah n
pr,'q'~r e~'c-tmtin~. ~,y~¢m in nc~nda~x. ,~ith
gem.rally n~x'e~ a. couming ,anmlnn.b, ,w ag:my
Will ~tabhsh safcguard~ Io pr~d]ibil, cmphLvcc~ I~)m
.-mN their positiore~ fin' a purf,,at Ihal com. titute~
I' e.~..nt,, dw appemumc ot' ~r~mal ~r tWLtuniz~iotm]
· ~ml'l~'1 (~r mte~-,~., or ix..f~.mal gain.
Will mil'~,, and oomph:to the v,~n-k w~thsn th,: 7.
.~pohc:able time frnm~: nfk-r n.x'cilX of alLT, n~ al
.,win ding ng:cncy
Will ,.'omp4y with Iht, Imc~.auvt. rnn~.,mal Pt, r~mm.I
.x~.'l ,,f 1970 {42 U. U. C. 4728 4763~ rclaling
iwcw~'rihcd ,aandnrdn for rn~rit ~,.v~tem~. fi~- pr~xurn~
iumh.'d uno~.'r o~.' of th~. nim-leen
~.8utaaom, .,,Oa.'if~nl in Al~cndix A
~;lan~mda I'~n' a Mt'rit S.x ~.,m ~d'Pcr~nm.'l
~.dm,m~,lrulion (5 C'. F. R. 9{10. Subt~nrt I:1.
Will c'orn,p~ with nil I~'d~.n-al :~l;~ttm:'~ reluling
h, , ,} Titlr VI of thc Civil Righl~ Acz or 1964 (P.L.
~8=?,52) which pruhibiu, dia.ximinmitm tm thc ~ of
~a.x.. c~lor or naliorml orig~n; (bi Title IX of the
Echx'ation Amendmenla of 1972. a~ amended (20 U.
S C 1681. 16R3. and 1685-1686L which pn~bits
dm.'siminmiua on the hemis of,-'~; (c) ~n.'ti~m 504 of
th~ Rehabilitm~on Act of 1973..'~ an'a.-m~,l (29 U. S.
¢'. 794). which prohihi~ dia.Timinati~m on Ihe hanis of
handica0~ (d) th~ Agt. Di~.'riminalinn Acl of 1975. as
-'~mm~led (42 U. S. C. 6101-61(}7). which pmhib~
di~:riminmion on the basis ora?; {e} the I"J~'ug Ab~lRC
Act of 1970 (P. L1 91-616), m ~.
:d~l~i~m; ~,) 523 ~d 52'7
.~v~ Ac~ ~ 19~2 (42 U. $. ~ ~ ~3 m~d 290 ra-
Cial ~of I~ (42U S~ ~1 m~m
u~ ~Jch ~1~ ~ ~
~~~s) ~~ym ~
Will~y,~~~~
~~I~.LgI~~
Will ~,~y, m ~ ~~
~ ~t (5 U. S.C. I~1-1~
~ich li~ ~ ~ ~
~in~~~
Dux r.-J),acon Att t-10 U. S. C'. 27{'m lo 2'7etd - 7}. the
(',,~..land/~.'t (40 !.;. S. C. 276,.' nnd la L' S ('. 1474}.
;JIl~ I[1~ COqlI'~L'I. Wtll~ HoOI~ ami Snf~:l.~ SLuiK.~U'~
· ~:t t-lO U. g. C. 327-333). n.'gurding lah,' ~,lundurd~
lot IL'dcruU.', ,~.~isK."d c'on.<'~'u~:l.i~m ~b usn.~.m~.'nl.<.
~0. Wdl comp4.~, il'applicahh:, with fhxx]
purr hed.' rt'qt~'emenl.~ of ,~.~cti~,n 1(12~ a ) of Iht,
l~isu~cr Pn~-ction A~.'I of 1977, <P.L. ,~3-".L.1~ which
:L'qulr~, r~-il~ems in a ~.p.x'inl fl(xs.I ha/urd ure;i
i,arll, ipalc :n ~ progrum and I,, Imr,'lm.,,~'
m~,m ano: il'th~ I.t~l ~.',~1 of in.,an'a, bk. ~.~tm.,aructi(,n and
,~;quu61k~n ~ $ I0.(}00 [~'
· I. ~.Vill ,.'~nply with envmmm~mal ~nndartL,, whk'h
I~. pr~scribt-d punamm Io Ihe following: I-! im;lilulion
.,l'c,vis~mmcn~a] quahty conlnd tneesm't'~, unck~
%ulJ,,nal .Enviroarm. nlal P~)li~.. Ac~ of 1969 (P.L
· .40, and E,u.'cuti%-e Order IEOi 1151.1: Ib~ m~ificulJ(m
,~l'x J,daling fnciliLit'~ pur~uanl lo EO 117~,8.
i~xt%lhm .ff we~.lnnds f~tr~uant to ]~) 11990; (d~
~ ,'nlualitm ,f fkx~d hn~rd.~ in fl;~'xJpla.in.,, in
;~.~.',~c~ wh.h FA) I 1~8~: (el as~ur.,ncv
, tm.,as~-nc.~ wkh Iht. ~lq,,ov-'d Slalc nmnagt, m~zm
i,n~g~am ck'~clo~.'d under ;la: ('oe.~al Z~m~
Mzma~en]tm At1 of 1972 ( 16 U.S.C. 14.;I cl ~..'~q.}; (f)
· ,mh~rmh) of Fedend ~.lior~ h, Stule (Clem' Air~
Irn~lcn~.mlat..km ~ undt-r ~c'~lb.m 17h Icl d'llw
( 'hr.',; Air Acl. of 1955. m, rimer,, _le~_ t42 I.'.S.(' 7401 el.
,Irinkin~ ~ter und~ the snrc Drinking Waan- A,.-1 of
, '/'/-L a~ ,,,ret, fl..a_ ;P.L. ~3-523~: and (hi I'~l~lkm of
,.ndan~.'~"d ..~e~__~z~ under the F. ndnng,:n.'d Slx't'k'~ Att
,,r io73. e. nmended. ~P.I.
12. Will cu,,~y with the Wild and ~ Rlv~l A~t of
1968 (16 U.S.C. 1271 et S~l.) teared to fn'mectln[
wild s~d scenic ri~m sysan~.
13. Will assis! Ihe nwa~lin8 ageocy in ass~
cumplis~:~ with satire 106 of the Nal~mal ~
Pn.~rvmioa Act of 1966, ~ ~ (16 U.S.C. ·
470}. EO 11593 (klcmificMion and ~ of
histodc prop~k:s) and ~1~ Archsi~o~k:al and
Hi.,aotic Prcsm-vn~ion Act of 1074 (16 U.S.C. 469)-I
c~ S~l.).
14. Will comply with P.L. 93-348 msm'dinl iht
of hunmn ~aJhjec~ invoivod in n:nmn:~ ~
m~iJmncc.
15. Will c~y wKh the La~ Animal Welfl~ A~.
of 19~6 (P.L 89-544. as an~nd~t, 7 u..q.c. 2131
w~., bkx)ded ..imals ~ for rtsc~clt, kmc. htn& or
16. Will co~y with ih= [~J-B~md
I~v~(Jon Act (42 ~.S.C. 4801 0(mo,.) ~
17.
Aetof 1984 or OMB ~ No. A-133, Andi~ of
Institmions of Higher Lem'nin& and othor
I rncdt miom.
18. Will cesnply with all appilcalde nsquiremeats of all
SIGNATI
~,,~E OF AUTHOFIITFn CERTIFYING OFFICIAL
APPliCANT ORG~N~T~
INSTRUCTION FOR THE SF 424-C
PLEASE DO NOT R~TURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGI~gl]2qT AND BIJ'D~gr,
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGI~TCT.
~:al,mn u.- Ir this ii an ~licution fin' u -New" prujcn:t.
t-nk,] Iht' IOta] t~limu~cl cma of earh rd' thr itcrm, Ibacd
liner I Ihro~Eh lb(-,, applicable)under
~ 'l.A ~;SIFICATIONS.'
II Ihr~ al~C~i~m enlaJl.,, · change h~ an cxu, liflg uwtm:L
,~nk.t ih.. cliLzibk' amounU. ,nn,mvod undcr ~.. previuua
a]war, I f,, ~ ib.'ma ur~l,~" C¢~;T Cq..ASSIFICA'FI¢)N'
(ol,,m h. If this ii an al~licalion Iiw · -Ncw-
,..mcr [Im[ port~m oflhe co~a. of each iiem in Ctdunm ..,
~hic'h u. nm all,~wnble fro' Fedetnd A.u~tancc. Contact the
rx'derel agency for mainlance in d~erminin8 the
:tllov, abJlity of fl~e~il'lc cn~13.
filM- tq~:ali, m enlaih · chang;: w an cnisling uward.
cnk'r [~' adju~nem I + tn- t-)] to ~. pre& iou~,ly apl~,ved
t¥~AI~, ¢ fn,m co]~lmn ~. I ll:[~.~.qcxl in Ihia upplk-mitm.
Colmnn .:. 'lT~ i~ ~.' n~l ~f limt I [hmugh If, in columra
'a" .ad 'h"
[.ia 2 - F..nkn' c,aimm~d ~[tc ~ rigM0,) or,ay
acqu[~ili,n trims flhi~ include~ pan.'htm:, k.ne~, und/~
lam:
nafi:iy equ~pmenL es:. m be treed at the ~un'lt~, if mah
IAne 12 - Total of imm I tluuu~h 11.
l.ine 13 - Eau'r ealimmed orn~htl~ ~a~. (Ck~mdt tl~
Federal agtn~.-y for tl~' Inm:amla~ of d~ e~lztlm:l
o~ma~etion ~ to u~)
I.ine 14- Ealer the tolal oflin~ 12~ 13.
line 15- Enler es~tr~ pm~mm Inc~nm robe e~nnd
Line 16 - Subtra~ line 15 from Uno 14.
I.im. 3 - I'~nh.n' ,..,,t i ma ted ~.a~ rt'lak~l tu rrhs.'ulk,n alvi,-n7
.r~]~tam.'c. repl:,ccqrn:nl butting, and mlc~-alhm paymt, nt~
[~ d,~plm ed I'~: ntm~, ami bu.~im:~'s. ;.~.'.
linc 17 - This bl~:k If for the ceq~m6on of the laedenl
sha~. Multiply the to~l allowa~: ~ ca~ fxom Ih~_
16. column ~c- by the ~ In~g~m~ ~ (this may
be up lo IflO ptn~-~.m: con~lt ~ ~ fm ~
~n~ ~) a~ e~ ~ ~ ~ ~ 17.
ASSURANCi~ - CONSTRUCTION PRO4~RAM~
I~ublh n..l~ing Ixtrdcn for [hi~ colk.%'tkm ~d' information is ¢~limaled tn av,.-ra~e 15 rrdnules ]~r ~ ~ firrm ~
;t'~ k'x, inr in,,tn,,'lion,~. ~rdr~'hin~t cxi.~ing dam ~ ~tn'~.'~.~ guthcring and n~.nla, inin~ the data needed., and complel~[ smd
. ~.~ u.v, iur IIx' c,,llectitm of inforn~ll~m..%nd c~,mmcnls rc'.gmding the bun:kal e~ate or any otb~ n~ oftb~ ~ of
· M'~,'mal u~n. in,. lading. ~.uggx'~ion,,. fiw r~'ing Ibis hurden. Io Ihe ~fl-~ce of Mmmsetzmm am:l Ballet, Pa~ Redm~ae
Ih'oik~.'t ~I.L'44~'~-41~M2). Washington. I)C 20503
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFIC~ Olr MANAGE:M~qT AND BUDORT,
NOTE: t 'erlai~ of tix'~,, u~;surum.%,, nm.~ m~ ~' applicable ~u ~ua' IXX~ject or pra~. if you have que~ ~ ~
~' .~,w-',,ding Agu~.~.. Further. evnnin F~.'dend u.~-~islunee a~'ttrding agencies amy rt.'quire ap~ lo ~ to nddflJonal
,r,~un,m'~'s. If sm:h is the case. ?m will Ix: m~4iF~d.
duly uull~rizk'd r~pre~,enmli,.e of tim a1~plic~nt [ cerlify the the applicant:
Hm, [he lei:al au~x~.x m [q3pl~, for [q.'dcrul
.,nd ~he in~.ilmional, managerial and financial
· ,~hility ~ including fund~, ~ffick. m h~ pa.~
l~.xk.,ra~ dun~ of pm.~.%'; ccem~) h, en~ure proper
idanning. ,mnagement and eompkqi~m of rix' pn~jk%q
~.'rl'lx.'d Jn dl~ ul~i~zatk~n.
Will give It~ awmdJng u~eney. Ifc C'~mq,i. ndk:r
( k.-m. ral ~rl'the Unilt'd Sla~. and if uppmpr~e, tl~
~ml't. b'-ffOOL~ any aulht,ri~d rt'pre~nlali ~ e. m."~e.,~ to
;,~11he ri~.ln, to examine all n.x~ e:ls. I~,,t,s. pap~r~ or
,h,..-um~nu re,ed to Iix. ~i~,,nce: and ~ ill e~ablis~
., pr,~'r -'- cuumia~ .,.~ ~m m u,.-ccm, lamx. with
Will no~ diq~e ot'. n,dif.~ iix. u.~. of. ,,r dmng~.
~crn~ ~1 ~tk. ri:al pnqx. rly lille. ~' ~,~.'r imert~ in
· ,e unO fa dities ~ ith~ l~rmis~en -',nd inqrucliorai
m,rn t~.' -~w~:lin~ ut~t'nc~,. Will re..'~ml Ih~ I~.xleml
,mc~c~ m ~he lille ~ff~t'nl i~Olx, ny in uceordum:e wilh
· ,winding agency dm.x'm.e~, and will inclu~..
: .,~t. rmnl in Ihe tille ol'real pr~q'~rly a.'quirtxl in whole
· ,~ in pnrl v. flh F'ederul mn~slam.'e funds h~ u.,~urv
,h.~,~minau~m during Ihe u.~..l'ul life or ihe
Will cc~np~ with [~ n.'quiren~..nts of iix.
:,wmt.fmB agcney wilh r~gurd.,~ Io IIX' drafting, n:~ Jew
and approval of c~mslruclk,n Hues ual
Will pnwide and main~n c~mpt.'U.'nl 'and 'ak'qu~c
cngm~.Ting .,4.q'~"vJskm al. I1'~ con~lructkm
~.'nsur¢ II'ml the c~m~pk'h, work c~rnfi~'m~, v, ith thy
.,iq,o~d plan~ and sp~.'ificm.i~ns and wall I'urni~h
pn~e~.,, n:lXn'ls 'and sm'h ~her infornmtum ~,, muy ·
~eqmmd b: ~ s.~s~ua~ awardin~ ugcm-.~
Will iail~e and ~..~mp~¢ IIw ~tn'k u,'ilhin Iht.
..ppi, ',.:aMc lime fram,., after n.x'cipt or a~lWU~ al ~d' [he
:,winding a~'ncy
? Will eslahli~h ~ufet~uard- Io prohibh em.ld~L~t't~
,,'~mr their Hmlkms f,~' a imr'p,,~ Ihul c~m.,,lilule.~ or
iwe~.,m [Iw dppcarunee ~tff~,nal ~. twgan]/nti,tmaJ
..'t~.fll]lC! of mh:rc."~l_ ,.,r R."r~mal gain.
,i Will ,,.xm~p~3, wilh Iht' ]nk.~ov;.rnm,..nla,
%et ,,f lg?,'l I42 U.S.('. 4"/LM~-4?~3J rel,,,in~
I0.
tss ,1~ .x~mpl.x. tn' ha.,, already c(m~plk'd, w~lh Iht
~xtmff~nis o~"Fillc~i II and III id'tN., t Inilln'm
Reh,cali~m Assistunc~ and r~ul Properly Acqui.41ion
1',4)~ ~e~ A~, of 1971) (P.L. ql-6-t6) ~'hk'h pn,vitk~ for
lu~r and ~uilabb: trcmm~m of i~rr~rt,, disl~latxxl or
x~ h~...e ix-,,q~.,rly i~ acquired ~ u n:sul! ,f rx'deml and
k-~k, rally a-.shied pmgnm~,. Tl~.,~e n.'Xluir~mcnls apply
~,. mil imen si in n.~a] pr~ffx~y ~'quh't~J For pnJ. jt~-I
purp~, r~gardle~ ,ff IAxk'ral pmqicipulitm in
pu£t b~,~,.
Wdi .-umpl.~ wilh I. ht. i~ne, iom, oflhc Halch Ac! J5
~ ~ ~'. 151~1-I~ -',nd 7324-7321,1) shk'h limil I1~
, mid,~,m~m Jmi,,il~..s un., fumk'd in ~ h,k ,~ in pm1
~ ~th I~.'&-r.il funds.
~ Will ,:Oml~.V. as apgl~.able, wifl~ Ihe prm ishm~, ~,l'll~.
I ~.~ i.,-Bm.',,n Afl 140 U.S.C. 2'76a Io 2?fia 71. I~'
~ '~..lm~l t~'t (40 I.L~;.C. 27hc -,nd I~ U..'4.¢'. 14741.
"'h~, onu'~.'~ Work Nmr~ and ~l'el) Stun, lards A~.'~ ~40
! .~ C. 327-333~regarding laNwstandards lin'
Ic~.'r~dl.~ ~,;.~isled c~mslruction ~,ubagxt.~m~..nls.
· 4. Will comply wilh Iht. I'h~l insurance imrcha.~
~,.'qusr~rra.~l~ of Stn.-liun IO2(aJ of Iht Fh~nt Did, ncr
I'nxt'cliun Act of It~73 [P.L. 93 23.4) ~'hk:h n.n. lUitCS
,.~..ip~m~ in a s'ptn:iul flc~',d hazanl mt.-, Io participale
m thc In~,am and I, purcha~, fl0~ in.~uram'c iftl~
,,tal ~x~s~ of inm-abk, ctm.,ilruclicm anti at'quishi~m i~
$10.~ltn' mo~
n Will comity with ~mv,nernental mndanls whiVn may
In.. pr,.~:rih., pl.~a~anl Io Iht. fidlowing: Iai in.,,'tilulion
.d'¢nvirtn~mmtal quahly contrul mca~urcs under the
Nal,,nml em'inmm~ntal policy A~t of 1969 IPJ- 91-
~V01 aad Ex~:uliw Order (EO~ 11514: ih) mnificalion
,,l's i~ting f~-'ilhies pursuam Io ~) 117314: i c)
lb.
17.
18.
19.
SIGI',~.~E OF AUTHORIZED CERTIFYING OFFICIAL.
c/t/log'
¢) ~ C ~.-~il;'~AT1 ~i. 'CONTROL POLICY
('Ek~II~CA'FIONS REGARDING LOBBYING, DEBARMENT, SUSI~,NSlON AND OTRKR
RESPONSIBII.ITY MA~FERS: DRUG-FREE WORKPLACE REQUI~Rq~O~]T~;
DEBT STATUS, AND NONDIS('RIMINATION STATUS AND IMPI.I~.MI~]TI_NG RI~ULATION~
Gen~nd Requirements
I h,.' I-'1~¥ of N-d~mal Drug ('~mlml h)lk'.~ (()N[I('P)i~
n.Nu,cd t,. o/~ui, from all al'~licunC,' ccllJl'k'ulion.~
rc.eard,ng IcN:kwnl tk'bt .,aulus. ck,~nanncm uno M.t~[X.l~ion. ttnd
~ ,lint. trt~: w~nkplace. Aisle:ams n.%lUe~ting. [m,nit~ greatcr
than ~. I~IO.OtR} in ~,mi~ lund~ mu.,d ul,~)o.'ni~ tcganling
h,~nj,g a. liwli~, and ma.,, ix.. required It) ,mhsml a
I h,,.'l,,.ur,' ol Lo4~byinF ^eli ~ ilk.'%- ~ Slarklu~d I:(~, I.I .I.).
In,.limmm.d upphcnm.~ un.' rcquircd It, certfly ihul I1~:~ will
~..~,ltl[[)~~. ~,llh Ih~ nc~tli.~fim~nali,n .~due'~ .',~
~mplc,~mt mg re/: ulatiore,
.A,f~l,,'anl, ,d~mld refer It~ the rcgulmion~ cit,.%t tx:low Io
~lennlm.. ibc c~rldicaion~, ,) which Iht) an.. required to
,..~ rlifi~-',li,,n inch~l in t~.' n:~ulal, km~ I'~:lbrr ¢oml'~eling
Ihs,, h,m %ignaJurc of tht. fin'm pro~ idt~ fin k'o,n~lia~'c
· ,h ~ rrlilS,:athm requiren~.,ms untk.'r 21 L'I"R IXU'l 1405.
"Nt'w R~.,,trk'liolts on I.x~.xing- and 21 CI:R pun 1414.
(;,.'x'r; ,Umnll widx, Oehnnncnl ttnd Su,,Ix-~sitm.
~N, ,n pnx'u~cm~mL Ccrhficalitm Rrg-,uding Federal ~'bl
S~alu: ,t)MB Cil,'ulm' ^- 129). unt] CcrliF~.'-ti:m Rcgarding
tlw N,,nd~,.,.'riminalion S~tm.~ a~l In~rn~..mmg
R,..'gul;dlOpe,. T~.' ct.xtifu.'ations ~aall be treated a'~ a mm,..xini
n.'prc-.t.ntmlon ol Ibc1 UlX~n whk'h reliance ~ill Ix, pi--cd
v.~,..i, ih,: ~ Ifg~.'e ..ff Natknml Dru.u Cunlml P,Ik'.x ~k~xmincs
IL..IM, ,Il d II)~ C~W,'FKN] CLIS, t~It'TUliN,3.' ~.ft:lTk.'nl
I. I.OBBYING
,%- rcqaJrcd by ~'ctkm 1352. Tilic 31 .fl~' ti S. ('t~'. a~
m]pk',wnl~ In ?l ~ ~ I~. for ~ns cnlc~ng i~
CFR tilln I~. ]~ ~l~um ~x~if~ I~:
Mcm~ Of( 'tm~ in c~mmxlion ~ ith I~ ~ing tzf
[¢~ ~, ~'~t. t~ ~i~'a~n ~,~ any Fc~
I~:n ~ m ~ill ~qng ~d to any ~
c][]~.~ tH C~ ~ ~ e~loyk~' ,flu
{ .m~[~ in ,~m~ion with this ~1 (;~nt
ami ~t[~it S~ ~n -[J.l.. "Di~'h~'
(c) The undcr~ila.d ~aH require tlat tie leluale of [hi.
t..~:rtifv.--al km be i~cluded in the awwd
subawn'ds at ail tiers ('mclaJ~g mbgmm, c~m~c~
suhc~mtra.'ts) / ~ .n ~
2. DERARMI~TT, ~ &=NJ) ~
RE~I~I~II.IT~ ~L~'l'rl~ (1)IilCT ~
,~ r~quL~d by ~v~ On:~'
Sus~gnsion / imp~mem~ ~ 21 ~ Pm 1404,
A. "rl~ flppliclm c~niflm thlllf it lnd b tEIm::~/l:
Where the ,,+¥&am is umble to certify to any of ttm
{m~m~ in d-d~ :~-flflc{flm. H~ a- dm a-n m{tmm:h m
2.
(a). PubUddn$ a saucn~t r~tifyiag employ~m ~ m,,
tm~wful mufm, dil~lmtkm, ~ ~
or u~e ora contmllod m is ~ in tho
lala:n aF~Jlu~ cr~[oy~en for ~ o~mr.h probib~k~l;
lb) F. rdLh4ishing an on-going drug fR:e awatcness pn~ram to
infim employe~ i
'1'1~.' dan~.cr~ ,f drug uhu~: in thc
TIw al,lflicem", IXdk'y of mmntaining u tlru~ free
v,..rkplace:
^n.~ a~ ailabl., drug o,un.~ling, n:habihl:u,m..',nd
'Fix. [x.~lfie~ that ma)' be impu~.d utx~n cmoIoyee~ for
dlu_~ uhm, e v,~lation ~,.x'm'fing in [he
(d' MMdn~: it u r,.~.luiremenl that each empl.)x.v lo he
c..,!ag,.xt in ti,: perfimnam:e .fda., grant Ix' gixcn a
ol the ,.rah-rix. hi rrquJn.'d by i'lmi~11]fll
0.'. N.,~,~ ,ng rix emlflO~ec in dx' statemenl rcquir,.'d b.~
1~, a~-apt~ (u, dm. u.~ n condili~m ,£ enq~k,.x ~m. nl um. kn'
t~ .~';*m. ~he cn~l,)x~: ~ ill
I I, AhMt' hy the Ic'rne~ ol the slatcmenl: und
N,,~it,. tht. c.~'floy~..r in wriling ~ff hi.~ o~ I~.'r ,:.nvk-li~m
I~q a x ~olafion ofu trim,frei drug ~,mtut¢ ~x.'curr,nl~ in the
~ ,rkplace m, laler than fi~' cultn~ar du? al'k'f ~'h
k,qlX icdon:
N,,til'.x m~. tM u$em:~, m vcrilin$, within I0 culendar
da?,, after n:x tiring m~tia: uncka' subparagraph (dX2)
t~,~,u an emph~yee tn' oth~.rwi~e receivin.e m'lual make
ol ,,uch cun~ ~cliom,. Empk~yers or ctmx k.qrd emphLyoes
mura i~'ovide nolk~ ir~:ludio$ I~'ndl.itm lilk., t~,: The
A,,,i~da.r~e Centre'. IMOI Ntwthvn.,,,a 53'" Tema.'e. suite
_-ql). Miami. I"lorkla 33166. Niece droll im'ludc thc
~.k'nfil'n:al~oo nundx-r elf c. ach alTccted grant:
{~, 'I ~mg on~ of Ihe folk,win$ ~.li~,r~ within .MI cuk. ndar
'd~.'~ ,l'rtn~ivmI netk'c unck'r ~ubpmagraph td}~2 ). with
n..:.~.~. ~ to an,, emplu.,,ec who i~, ~ c'~m~, icled-
Taking appn~e ix. rs, mnel m.%m against such un
cmph,.~ee, up to and im'luding lerminati;m, co~islenl
~ Hh Ibe n.'qu~remenu, of the Relmhilimlion/%'1 of
Requinn~ ,,u,:h emph~)ec Io pm%.ipale .ati~fm tueily in
u .tru~ abuse a.~,,tancv or relmbililati~m pr,grum
aPlwOSed fin' such ~ b) a Federal State. L~' h~.'al
h,t ahh. b.w c,fonatmcnt, o.r t~hca' apfnopriute :tgc~.~:
Making · So, nj £ailh cff~n'l Io CtmlinUe t~ nmintuin u
thug hoe wt~kplace Ihn,ugh in~plen'n, nlali~,n o1'
IX, agnqd~, {~:. {b}. {eL ~dl. {eL uml II'L
1 I~ appl~c~ nm) ~n~cn in Il&' ~,a.x, ina~ ~..'d
h..Ioa I1~' silt'{,,) E~' the perfin'mam'e ~,f '*-rk dt,ne
~r conm. cfion with tM' Hx.n.'ific c~xq-n..raliw
L%'ck il' th,:rc arc ~tn'kl~t't.s r,n file thru art. mst
ia.milhM hen...
'11~.' re~lation~ Imavide dm a reciplem that la a State may
ck't't of m~k,, tree ct.'rtiFwafio~ in each Federal ritual year.
A r,py u-t' which d~aukl be inclu,~ with each a0pikafiee
i'm' ¢ }NDCP Funding.
DRUG FREI?, WORIL'PLACIr. (~ W~O
ARE INDIVIDUALS)
,~ rcquircd by the Drug Free Workldace Act of 1988, md
~molemcnl~d at 21 CFR Part 1404 Sabgml. F.
A. as a coz~difio~ of the coopemive Ml'emeaL I ~
thai I will no~ cn?~? in ~ tmlawfal mamffactt~,
dislfibution, diqx'mins, pessemioe, or ,,=- of a
B. I f convicted of n criminal drag off~mse ~sultln[ fm-m a
violatkn~ c~curring dm'ing the cuod,,,-~, of Itny grnnt
10 calendar days of th~ convic~m, m:. TI~ ~
Ceraer. 8401 Northwest 53~ Tm'tam, ~ ~ ~
Florida 33166.
4. CE~TIYlCATION R,~G&RD]NG
DE'BT STATUS (OMB CireMm- A-I~
The Apldicam ~rfifm to the bern ot'i~. Imowled~
he. lief, ~ it is n~ delinqmnt in the repayment
fecietll debc
CERTlYICATION REGARDING Tmz
NONDISCRIM~L~TI~ ~TAT~J'I~ AND
LMPI.~ EEGULAIION8
Thr applicant c,a tifi,~ dm it will ,.u,~y with the foUow~
nondbcriminazioa ~lame~ and their i . k .~' -
n:$ulafioa~ (a) title Vl of the Ch, il ri~d~ A~t og i'964 (42
U.S.C. 20~0D ct ~eq.) which lm:n4dm
,n'igin. be exclucied fn)m pmicipaflon la, be dealed the
any pro,ram or acLi,dly for whlda tim Naplic~ _t?~_ ~_~nM
IL'demi financial m~i~,~nce; Co) Section ~4. if the
rchabilimioe Act of 1973. aa amended (29 U.8.C. 794),
whh:h pruhibit~ diacrimimfion on lie ~ of handicap in
prnlrer~ and activifiea n~vinl ~ fimm:ial
ar, si~aance: (c) title IX of the Educa6ea Arm~
I ~T2. m aa amended ~20 U.S.C. 1981 et ~l.) wtfida
,listTiminalion tm Ihe ~ o{' ~ex in edoc:~tioa ~ and
a.'tivitics reccivimt federal finm~-'ial m~m~e; md id) the
~.gr Di~.Timimaion Act of 1975, ~ ~ (42 U3.C.
~101 el seq.) which i~ohib~ di~iminalioa on Ibe bmia oi'
a~ in programs and activitin ~ fe6eral fmm:Jal
into ,~'ctmnl ~s a factor necear,~ fiat' the normal
,w -,-hievemem of any ~utory objective of the lmajeet or
activity r, hall m~t violale thit ~
^. Ih~ ,IL,i` .lul I~K'i/L d n.'p~..~c'm~i vu ~)I' Ibc al~lic.'ml. I hereby c~.~il'.~ 1ho1. I~' lt~tk3nl, will
Ap~l~at~n Number and/or ProJect Name:
(hln~"~ IR.~cnd~ Num['~': ~~~
T~ Name a~ T~le ~ ~ R~e~:
D~SCLOSURE OF LOBBYING ACTIVITIES
( omp~ele flla futm to,4-a.~-- ~-dv'~e~ i:~r~ai Io3] U.KC.
If rz~edq mtl~ la Na. 4 b Sehe~erd~
and eddre~ of Prfe~
ONDCP
& Feds1; ~,e~n N~brr. If Immm
HIDTA
Nooe None
II. Atone d F'a~im (dlid~ d dm %~1.,,.1:
I:L
lilraded Ia lie~ I I:
Nogle
(,-~--"k C," "--- Ibnd ia p ~.'4 ] J.-,~ ! i~emr/)
IL letonmdee reqem~ duwlk tkk fore k nikeda-d by dtk 31
U..~LC. ~m,e~ 1'i~t 1'lab cimbaal~ d iokiJTiql m"li~lks ia · milerbl
Fede~l t '.,~ ( kdT:.
/
/i-lJJ.
NO.:
Ho ;ton HIDTA
15311 Vatttage ParkwayW~ Sui~ # 286
Houston, TX 77032
Phot~-. (281) 372-5855
F.a,,, (281) 372-5865
Houston FIIITI'A DixectxWs Olde
ATrN: Ms. ~ M. Wilson
1.~11 Vantage ~y W., S~" # 2116
Hommn, TX