HomeMy WebLinkAbout145-10 RESOLUTIONRESOLUTION NO. 145-10
A RESOLUTION AUTHORIZING ACCEPTANCE OF AN ARKANSAS
DEPARTMENT OF FINANCE AND ADMINISTRATION GRANT FOR
ENFORCEMENT OF UNDERAGE DRINKING LAWS IN THE AMOUNT OF
$32,000.00 AND APPROVING A BUDGET ADJUSTMENT
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
FAYETTEVILLE, ARKANSAS:
Section 1. That the City Council of the City of Fayetteville, Arkansas hereby authorizes
acceptance of an Arkansas Department of Finance and Administration grant for enforcement of
underage drinking laws in the amount of $32,000.00.
Section 2. That the City Council of the City of Fayetteville, Arkansas hereby approves a
budget adjustment, a copy of which is attached as Exhibit "A."
PASSED and APPROVED this 3rd day of August, 2010.
APPROVED:
B
ATTEST:
By:
SONDRA E. SMITH, City Clerk/Treasurer
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FAYEULLE
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City of Fayetteville, Arkansas
Budget Adjustment Form
Budget Year
2009
Department: Police
Division: Police
Program:
Police/Animal Projects
Date Requested
7/15/2010
Adjustment Number
Project or Item Added/Increased:
Overtime, crime prevention supplies and travel and
training
Project or Item Deleted/Reduced:
None
Justification of this Increase:
These expenses are covered by the non-matching 2010-
2011 Underage Drinking Prevention Grant.
Justification of this Decrease:
Account Name
Increase Budget
Account Number
Amount
Personnel Services - Contra
Crime Prevent/Investigate
1010 2920 5120 00
1010 2920 5201 00
Travel & Training
1010 2920 5304 00
P oject Number
29,400 04(06' S' ( '/
1,100 0 go rvU/
Account Name
Decrease Budget
Account Number
1,500 02"bi" fool
Amount
Project Number
State Grants - Operational
1010
0001 4302 01
32,000 0206 .") C)/
Division Head
Budget D. or
Date
74-/f=Ta
Date
epartnent Director
Finance Direc r
Chief c! Sta
a or
Date
—7—.Z5- 2,010
Date
Date
�O
ate
Type:
V.090403
Budget & Research Use Only
A E
Requested By
General Ledger Date
Posted to General Ledger
Posted to Project Accounting
Initial
Date
Initial Date
G Tabor
Submitted By
City of Fayetteville Staff Review Form
City Council Agenda Items
and
Contracts, Leases or Agreements
8/3/2010
City Council Meeting Date
Agenda Items Only
Patrol
Division
Action Required:
Police
Department
Approval of the non-matching grant award for Enforcing Underage Drinking Laws Grant and budget adjustment in the
amount of $32,000.00.
32, 000.00
Cost of this request
1010-2920-5120.00
Account Number
08068- 2010 '
Project Number
Budgeted Item
Category / Project Budget
$
Underage Drinking Prevention Grant
Program Category / Project Name
Grant
Funds Used to Date Program / Project Category Name
General
Remaining Balance Fund Name
Budget Adjustment Attached
X
xiltof,--
Depa •- - ' irector
orney
Finance and Internal Services Director
7-(c-K1
Date
Date
7- 26-)olo
Date
Date
Previous Ordinance or Resolution #
Original Contract Date:
Original Contract Number:
Received in City 07-16-10P03:35 RCVD
Clerk's Office
Received in
Mayor's Office
f42
Comments:
Revised January 15, 2009
THE CITY OF FAYETTEVILLE, ARKANSAS
DEPARTMENT CORRESPONDENCE
ARKANSAS
www.accessfayettevi l le.org
CITY COUNCIL AGENDA MEMO
To: Mayor Lioneld Jordan and Members of the City Council
From: Greg Tabor, Chief of eireloor
Date: July 16, 2010
Subject: Enforcing Underage Drinking Laws Grant
PROPOSAL:
The Office of Intergovernmental Services Division of the Arkansas Department of Finance and
Administration has awarded a grant in the amount of $32,000.00 to the Fayetteville Police Department to
enforce underage drinking laws. The Fayetteville Police Department will use these funds to offset the
expenditure of a number of details to monitor and inspect alcohol permitted outlets in the enforcement of
underage drinking laws throughout the year. This will include overtime, crime prevention supplies and training.
This is a reimbursement grant with no matching funds required.
RECOMMENDATION:
Staff recommends approval the non-matching grant award for Enforcing Underage Drinking Laws and a
budget adjustment in the amount of $32,000.
BUDGET IMPACT:
None
RESOLUTION NO.
A RESOLUTION AUTHORIZING ACCEPTANCE OF AN ARKANSAS
DEPARTMENT OF FINANCE AND ADMINISTRATION GRANT FOR
ENFORCEMENT OF UNDERAGE DRINKING LAWS IN THE AMOUNT OF
$32,000.00 AND APPROVING A BUDGET ADJUSTMENT
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
FAYETTEVILLE, ARKANSAS:
Section 1. That the City Council of the City of Fayetteville, Arkansas hereby authorizes
acceptance of an Arkansas Department of Finance and Administration grant for enforcement of
underage drinking laws in the amount of $32,000.00.
Section 2. That the City Council of the City of Fayetteville, Arkansas hereby approves a
budget adjustment, a copy of which is attached as Exhibit "A."
PASSED and APPROVED this 3rd day of August, 2010.
APPROVED: ATTEST:
By: By:
LIONELD JORDAN, Mayor SONDRA E. SMITH, City Clerk/Treasurer
July 2, 2010
STATE OF ARKANSAS OFFICE OF INTERGOVERNMENTAL SERVICES
Department of Finance
and Administration
1515 West Seventh Street, Suite 400
Post Office Box 8031
Little Rock, Arkansas 72203-8031
Phone: (501) 682-1074
Fax: (501) 682-5206
http://www.arkansas.gov/dfa/igs
Notification of Award
FY 2011 Enforcing the Underage Drinking Laws Grant
EUUI, #2008-All-FX-0002-IG08-08-10
Dear: Ms. Judea Cohea
The Arkansas Department of Finance and Administration, Office of Intergovernmental Services
(DFA -IGS) is pleased to announce that your application for a mini -grant has been approved in the
amount of $32,000. The award period will run from July 15, 2010 to Mav 15, 2011.
➢ Adjustments were made to your original budget as follows: Adjusted/Disallowed cost: (1)
ABC hearings travel $1,000 (2) Reduction of cost to EUDL national conference by $2000,
limit 1 officer. Thus the final amount of your award is $32,000.
➢ Remember our office must receive and approve samples of all advertisement, whether
media/newspaper/billboards etc.
Award Acceptance
Receipt of the award is contingent on the following:
a. All Attachments must be signed (in blue ink) by your Authorized Official (agency head)
and returned to DFA -IGS by July 9.
1) Attachment 1 (acknowledgement and acceptance)
2) Attachment 2 (approved itemized budget)
3) Contact information for your designated Agent who will manage the mini -grant
and for at least one additional alternate contact must also be provided in
Attachment 1.
4) Attachment 3 (certifications regarding lobbying)
5) Attachment 4 (certification regarding debarment)
6) Attachment 5 (assurances)
7) Attachment 6 (contract and grant disclosure/certification form)
Acceptance of the award indicates the Authorized Official's:
a. Acknowledgement that the requirements for this award and all Attachments are
understood and accepted.
b. Agreement with the terms and conditions contained.
c. Acceptance of and agreement to comply with federal and state laws and requirements
governing the EUDL grant. [Office of Justice Programs Financial Guide may be
accessed via the internet at [http://www.ojp.usdoi.2ov/financiakuide/index.htm ]
d. Understanding that all project related costs are reimbursements only. Actual cost must
be paid by grantee prior to requesting reimbursement. No expenses will be prepaid by
DFA/IGS.
e. Acknowledgement that food and beverages are allowable for conferences, meetings or
training sessions it there are participants, if the event is a work related event, if the cost
of the food/beverages is reasonable and the event is not related directly to amusement
and/or social events and provide a speaker/program at a lunch or dinner per OJJDP
Financial Guide, Part III Chapter 7, Food and Beverage Section.
f. Acknowledges that travel/lodging/meals must be paid by the subreciepient and
submitted to DFA/IGS for reimbursement with proper documentation.
g. Understand that budget modification requests must be approved by this office before
the subgrantee spends money on modified line item.
h. Understand that all advertising/media is restricted to the funded project according to
the approve budget and must not include any elected officials. All subreciepients MUST
submit a sample of all advertising/media information to the office of DFA/IGS for
approval prior to print or public announcement.
1. A bilingual effort for media/public service announcement campaigns should be
conducted in areas where there is a high Hispanic population.
j. Per OJJDP Financial Guide, Part III Chapter 7, Publication Section states "all
materials publicizing or resulting from award activities shall contain an
acknowledgement of the awarding agency assistance. An acknowledgement of support
shall be made through the use of the following or comparable footnote: "This project
was supported by the EUDL award number, awarded by OJJDP, Office of Justice
Programs.
k. Understand that hold conditions apply to all line items with unspecified travel, admin,
activities (presentations), parades, etc. A hold means no funds can be spent from that
particular line item until specific details are submitted to our office about each event.
1. Understand that travel to national conference is limited to one officer.
m. Understand that consultant rates are limited to $450 for an 8 -hour day. Per OJJDP
Financial Guide, Part III Chapter 15, Consultant Rates section states "when the rate
exceeds $450 for an 8 -hour day, or $56.25 per (excluding travel and subsistence costs), a
written PRIOR APPROVAL is required from the awarding agency. Prior approval
requests require additional justification. An 8 -hour day may include preparation,
evaluation and travel time in addition to the time required for actual performance."
Reporting Requirements
Reimbursement requests are due monthly no later than the 5th of the month and a final
reimbursement request is due no later than June 5, 2011. Quarterly progress reports are due by:
October 5, 2010; January 5, 2011; April 6, 2011; and June 5, 2011.
Failure to submit these reports by the deadline may result in a cancellation of this award or only
partial reimbursement. A report is required even if no activities were performed within the
reporting period.
Reimbursement will be issued only for the specific items and services indicated in the approved
budget. To ensure full reimbursement, detailed receipts must be attached to the reimbursement
request. To receive reimbursement for promotional items, copies or samples must prior approval
before expenditure and documentation must be submitted with the reimbursement request. One
original (signed in blue ink) and an electronic version of the monthly and quarterly reports must be
submitted.
Mail original report to:
Parunta Brown
DFA Office of Intergovernmental Services
1515 West 7th Street, Suite 400
PO Box 8031
Little Rock, Arkansas 72201-8031
Submit electronic copy to parunta.brm'n (a),dfa.arkansas.jiov
DFA -IGS Acknowledgement
Monthly reimbursement and Quarterly progress report forms will be provided to mini -grant recipient
upon DFA -IGS receipt of Attachments 1 through 5.
Terms and Conditions
a) The Mini -grant Recipient shall not discriminate against any participant in the
performance of this award because of race, creed, color, disability, national origin,
sex, religion or marital status.
b) Expenditures will be reimbursed in accordance with the approved budget.
c) Reimbursement Invoices will be submitted by the Sth of each month for expenditures
made in the previous month.
d) Final request for reimbursement will be submitted by June 5, 2011.
e) Quarterly Progress Reports will be submitted by the 56 or 6th day of the following
month after the quarter's end: October 5, 2010; January 5, 2011; April 6, 2011; and
June 5, 2011.
f) Minors will be compensated at a rate of pay no higher than $10.00 per hour.*
g)
Officers will be compensated at a rate of pay no higher than $35.00 per hour for OT.
Officers will not be compensated for court time.*
h) Compensation for mileage will be reimbursed at $.42 cents a mile (or highest rate
approved by the State).*
*Items reimbursed only if they are in the approved budget.
DFA -IGS Contact
Should you have any questions or concerns throughout your grant period, please contact Parunta
Brown at: (501) 682-3766 or by email at narunta.brown(a/dfa.arkansas.2ov.
Congratulations once again on your award.
Sincere
Doris Smith
Assistant Administrator
DFA Office of Intergovernmental Services
Mail completed documents (Attachments 1 through 5) to:
Parunta Brown
DFA Office of Intergovernmental Services
1515 West 7th Street, Suite 400
PO Box 8031
Little Rock, Arkansas 72201-8031
Attachment 1
Grantee Acknowledgement of EUDL Grant Requirements
and Restrictions
I, Lioneld Jordan , agency head for City of Fayetteville
acknowledge the specific requirements outlined in the Notification of Award.
I will ensure the timely submission of all reports and will ensure the reimbursement requests are
submitted only for qualified expenses and for only the approved amounts as outlined in the
Approved Budget.
Contact Information: 100 A. West Rock Street, Fayetteville, AR 72701
Lioneld Jordan
Mayor
Agency He d- Printed Name Title
Sire
Authorized Agent/Award Manager contact information:
Name: Rick Crisman
Phone: 479-575-8341
Va///)
Title: Corporal, COP Division
Other: rcrisman@ci.fayetteville.ar.us
Alternate Person contact information: (at least one required)
Name: Greg Tabor Title: Chief of Police
Phone: 479-587-3500
Other: gtabor@ci.fayetteville.ar.us
Name: Judy Cohea Title• Support Services Manager
Phone: 479 587-3581
Other: jcohea@ci.fayetteville.ar.us
Individual Line Item (amounts)
$240.00
$240.00
$240.00
$240.00
$240.00
$240.00
$240.00
$240.00
$1,920.00
ARKANSAS DEPARTMENT OF FINANCE AND ADMINISTRATION
OFFICE OF INTERGOVERNMENTAL SERVICES
ENFORCING UNDERAGE DRINKING LAWS
MINI -GRANT BUDGET SPREADSHEET
Cops -N -Shops
<List line item>
6 officers x 7 hrs x $35.00
6 officers x 7 hrs x $35.00
6 officers x 7 hrs x $35.00
6 officers x 7 hrs x $35.00
6 officers x 7 hrs x $35.00
6 officers x 7 hrs x $35.00
6 officers x 7 hrs x $35.00
6 officers x 7 hrs x $35.00
TOTAL CATEGORY AMOUNT
Individual Line Item (amounts)
$1,470.00
$1,470.00
$1,470.00
$1,470.00
$1,470.00
$1,470.00
$1,470.00
$1,470.00
$11,760.00
Bar Patrol
<List line item>
6 officers x 5 officers x $35.00
6 officers x 5 officers x $35.00
6 officers x 5 officers x $35.00
6 officers x 5 officers x $35.00
6 officers x 5 officers x $35.00
6 officers x 5 officers x $35.00
TOTAL CATEGORY AMOUNT
Individual Line Item (amounts)
$1,050.00
$1,050.00
$1,050.00
$1,050.00
$1,050.00
$1,050.00
$6,300.00
Compliance Checks
(2 officers x 3 hrs x $35.00) + (1 minor x 3 hrs x $10.00)
(2 officers x 3 hrs x $35.00) + (1 minor x 3 hrs x $10.00)
(2 officers x 3 hrs x $35.00) + (1 minor x 3 hrs x $10.00)
(2 officers x 3 hrs x $35.00) + (1 minor x 3 hrs x $10.00)
(2 officers x 3 hrs x $35.00) + (1 minor x 3 hrs x $10.00)
(2 officers x 3 hrs x $35.00) + (1 minor x 3 hrs x $10.00)
(2 officers x 3 hrs x $35.00) + (1 minor x 3 hrs x $10.00)
(2 officers x 3 hrs x $35.00) + (1 minor x 3 hrs x $10.00)
TOTAL CATEGORY AMOUNT
(Shoulder Taps
<List line item>
(2 officers x 3hrs x$35.00) + (1 minor x 3hrs X $10.00)
(2 officers x 3hrs x$35.00) + (1 minor x 3hrs X $10.00)
(2 officers x 3hrs x$35.00) + (1 minor x 3hrs X $10.00)
(2 officers x 3hrs x$35.00) + (1 minor x 3hrs X $10.00)
(2 officers x 3hrs x$35.00) + (1 minor x 3hrs X $10.00)
(2 officers.x 3hrs x$35.00) + (1 minor x 3hrs X $10.00)
TOTAL CATEGORY AMOUNT
Individual Line Item (amounts)
$240.00
$240.00
$240.00
$240.00
$240.00
$240.00
$1,440.00
Bikes, Blues, BBQ
<List line item>
4 officers x 8hrs x $35.00 (Bar Patrol)
4 officers x 8hrs x $35.00 (Bar Patrol)
<List line item>
<List line item>
<List line item>
TOTAL CATEGORY AMOUNT
Individual Line Item (amounts)
$1,120.00
$1,120.00
$0.00
$0.00
$0.00
$2,240.00
U of A Football Games
<List line item>
4 officers x 5hrs x $35.00 (pre -game Cops -N -Shop)
6 officers x 5hrs x $35.00 (post game bar patrol)
4 officers x 5hrs x $35.00 (pre -game Cops -N -Shop)
6 officers x 5hrs x $35.00 (post game bar patrol)
<List line item>
TOTAL CATEGORY AMOUNT
Individual Line Item (amounts)
$700.00
$1,050.00
$700.00
$1,050.00
$0.00
$3,500.00
Fake ID Training for Merchants & Officers
<List line item>
2 officersx 2 hrs x $35.00
2 officersx 2 hrs x $35.00
2 officersx 2 hrs x $35.00
2 officersx 2 hrs x $35.00
2 officersx 2 hrs x $35.00
2 officersx 2 hrs x $35.00
2 officersx 2 hrs x $35.00
2 officersx 2 hrs x $35.00
2 officersx 2 hrs x $35.00
2 officersx 2 hrs x $35.00
TOTAL CATEGORY AMOUNT
Individual Line Item (amounts)
$140.00
$140.00
$140.00
$140.00
$140.00
$140.00
$140.00
$140.00
$140.00
$140.00
$1,400.00
U of A / High School Underage Drinking Presentations
<List line item>
2 officers x 2hrs x $35.00
2 officers x 2hrs x $35.00
2 officers x 2hrs x $35.00
2 officers x 2hrs x $35.00
2 officers x 2hrs x $35.00
2 officers x 2hrs x $35.00
TOTAL CATEGORY AMOUNT
Individual Line Item (amounts)
$140.00
$140.00
$140.00
$140.00
$140.00
$140.00
$840.00
Advertising & Training
<List line item>
Materials for Program in Entertainment District
Training (National EUDL Conference) 1 officer
<List line item>
<List line item>
<List line item>
TOTAL CATEGORY AMOUNT
Individual Line Item (amounts)
$1,100.00
$1,500.00
$0.00
$0.00
$0.00
$2,600.00
TOTAL OF ALL CATEGORY AMOUNTS $32,000.00
Lioneld Jordan
AGENC DEAD-PRINTE E
SIG ATURE
Mayor
TITLE
U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
OFFICE OF THE COMPTROLLER
CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND
OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS
Applicants should refer to the regulations cited below to determine the certification to which they are required to
attest. Applicants should also review the instructions for certification included in the regulations before completing this
form. Signature of this form provides for compliance with certification requirements under 28 CFR Part 69, "New
Restrictions on Lobbying" and 28 CFR Part 67, "Government -wide Debarment and Suspension (Nonpro-curement) and
Government -wide Requirements for Drug -Free Workplace (Grants)." The certifications shall be treated as a material
representation of fact upon which reliance will be placed when the Department of Justice determines to award the
covered transaction, grant, or cooperative agreement.
1. LOBBYING
As required by Section 1352, Title 31 of the U.S. Code, and
implemented at 28 CFR Part 69, for persons entering into a
grant or cooperative agreement over $100,000, as defined at
28 CFR Part 69, the applicant certifies that:
(a) No Federal appropriated funds have been paid or will be
paid, by or on behalf of the undersigned, to any person for in-
fluencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in con-
nection with the making of any Federal grant, the entering into
of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal grant or
cooperative agreement;
(b) If any funds other than Federal appropriated funds have
been paid or will be paid to any person for influencing or at-
tempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with this
Federal grant or cooperative agreement, the undersigned shall
complete and submit Standard Form - LLL, "Disclosure of
Lobbying Activities," in accordance with its instructions;
(c) The undersigned shall require that the language of this cer-
tification be included in the award documents for all subawards
at all tiers (including subgrants, contracts under grants and
cooperative agreements, and subcontracts) and that all sub -
recipients shall certify and disclose accordingly.
2. DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS
(DIRECT RECIPIENT)
As required by Executive Order 12549, Debarment and
Suspension, and implemented at 28 CFR Part 67, for prospec-
tive participants in primary covered transactions, as defined at
28 CFR Part 67, Section 67.510—
A. The applicant certifies that it and its principals:
(a) Are not presently debarred, suspended, proposed for debar-
ment, declared ineligible, sentenced to a denial of Federal
benefits by a State or Federal court, or voluntarily excluded
from covered transactions by any Federal department
or agency;
(b) Have not within a three-year period preceding this applica-
tion been convicted of or had a civil judgment rendered against
them for commission of fraud or a criminal offense in connec-
tion with obtaining, attempting to obtain, or performing a
public (Federal, State, or local) transaction or contract under a
public transaction; violation of Federal or State antitrust statutes
or commission of embezzlement, theft, forgery,
bribery, falsification or destruction of records, making false
statements, or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or
civilly charged by a governmental entity (Federal, State, or
local) with commission of any of the offenses enumerated in
paragraph (1)(b) of this certification; and
(d) Have not within a three-year period preceding this applica-
tion had one or more public transactions (Federal, State, or
local) terminated for cause or default; and
B. Where the applicant is unable to certify to any of the
statements in this certification, he or she shall attach an
explanation to this application.
3. DRUG-FREE WORKPLACE
(GRANTEES OTHER THAN INDIVIDUALS)
As required by the Drug -Free Workplace Act of 1988, and
implemented at 28 CFR Part 67, Subpart F, for grantees, as
defined at 28 CFR Part 67 Sections 67.615 and 67.620—
A. The applicant certifies that it will or will continue to provide
a drug-free workplace by:
(a) Publishing a statement notifying employees that the
unlawful manufacture, distribution, dispensing, possession, or
use of a controlled substance is prohibited in the grantee's
workplace and specifying the actions that will be taken against
employees for violation of such prohibition;
(b) Establishing an on-going drug-free awareness program to
inform employees about—
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance programs; and
(4) The penalties that may be imposed upon employees for
drug abuse violations occurring in the workplace;
(c) Making it a requirement that each employee to be engaged
in the performance of the grant be given a copy of the state-
ment required by paragraph (a);
(d) Notifying the employee in the statement required by para-
graph (a) that, as a condition of employment under the grant,
the employee will—
OJP FORM 4061/6 (3-91) REPLACES OJP FORMS 4061/2, 4061/3 AND 4061/4 WHICH ARE OBSOLETE.
(1) Abide by the terms of the statement; and
(2) Notify the employer in writing of his or her conviction for a
violation of a criminal drug statute occurring in the workplace
no later than five calendar days after such conviction;
Check ❑ if there are workplaces on file that are not indentified
(e) Notifying the agency, in writing, within 10 calendar days here.
after receiving notice under subparagraph (d)(2) from an Section 67, 630 of the regulations provides that a grantee that
employee or otherwise receiving actual notice of such convic-tion. is a State may elect to make one certification in each Federal
Employers of convicted employees must provide notice, including fiscal year. A copy of which should be included with each ap-
position title, to: Department of Justice, Office of plication for Department of Justice funding. States and State
Justice Programs, ATTN: Control Desk, 633 Indiana Avenue, agencies may elect to use OJP Form 4061/7.
N.W., Washington, D.C. 20531. Notice shall include the iden-
tification number(s) of each affected grant; Check ❑ if the State has elected to complete OJP Form
(f) Taking one of the following actions, within 30 calendar 4061/7.
days of receiving notice under subparagraph (d)(2), with
respect to any employee who is so convicted— DRUG-FREE WORKPLACE
(1) Taking appropriate personnel action against such an (GRANTEES WHO ARE INDIVIDUALS)
employee, up to and including termination, consistent with the As required by the Drug -Free Workplace Act of 1988, and
requirements of the Rehabilitation Act of 1973, as amended; or implemented at 28 CFR Part 67, Subpart F, for grantees, as
(2) Requiring such employee to participate satisfactorily in a defined at 28 CFR Part 67; Sections 67.615 and 67.620—
drug abuse assistance or rehabilitation program approved for A. As a condition of the grant, I certify that 1 will not engage
such purposes by a Federal, State, or local health, law enforce- in the unlawful manufacture, distribution, dispensing, posses-
ment, or other appropriate agency; sion, or use of a controlled substance in conducting any
(g) Making a good faith effort to continue to maintain a drug- activity with the grant; and
free workplace through implementation of paragraphs (a), (b), B. If convicted of a criminal drug offense resulting from a
(c), (d), (e), and (f). violation occurring during the conduct of any grant activity, I
B. The grantee may insert in the space provided below the will report the conviction, in writing, within 10 calendar days
site(s) for the performance of work done in connection with of the conviction, to: Department of Justice, Office of Justice
the specific grant: Programs, ATTN: Control Desk, 633 Indiana Avenue, N.W.,
Washington, D.C. 20531.
Place of Performance (Street address, city, county, state, zip
code)
As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications.
1. Grantee Name and Address:
City of Fayetteville, 100 A West Rock Street, Fayetteville, AR 72701
2. Application Number and/or Project Name 3. Grantee IRS/Vendor Number
Enforce Underage Drinking Laws 71-6018462
4. Typed Name and Title of Authorized Representative
Lioneld Jordan. Mayor f3 - 4 - (C)
5. Signature 6. Date
`.
'U.S. Government Printing Office: 1996 - 405-037/40014
OJP FORM 4061/1 (REV. 2/89) Previous editions are obsolete
U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
OFFICE OF THE COMPTROLLER
r `L
Certification Regarding
Debarment, Suspension, Ineligibility and Voluntary Exclusion
Lower Tier Covered Transactions
(Sub-Recipient)
This certification is required by the regulatioons implementing Executive Order 12549, Debarment and
Suspension, 28 CFR Part 67, Section 67.510, Participants' responsibilities. The regulations were published as
Part VII of the May 26, 1988 Federal Register (pages 1.9160-19211).
(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON REVERSE)
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its
principals are presently debarred, suspended, proposed-for debarment, declared ineligible, or voluntarily
excluded from participation in this transaction by any Federal department of agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in this
certificaiton, such prospective participant shall attach an explanation to this proposal.
Lioneld Jordan, Mayor
Name and Titl, of Authorized Representative
4
S D
s.: . ur- ate
City of Fayetteville
Name of Organization
100 A West Rock St., Fayetteville, AR 72701
Address of Organization
OJP FORM 4061/1 (REV. 2/89) Previous editions are obsolete
Instructions for Certification
1. By signing and submitting this proposal, the prosective lower tier participant is providing the
certification set out below.
2. The certification in this clause is a material representation of fact upon which reliance was placed
when this transaction was entered into. If it is later determined that the prospective lower tier participant
knowingly rendered an erroneous certificaiton, in addition to other remedies available to the Federal
Government, the department or agency with which this transaction originated may pursue available
remedies, including suspension and/or debarment.
3. The prospective lower tier participant shall provide immediate written notice to the person to which
this proposal is submitted if at any time the prospective lower tier participant learns that its certification was
erroneous when submitted or has become erroneous by reason of changed circumstances.
4. The terms "covered transction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposes," and "voluntarily
excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of
rules implementing Executive Order 12549.
5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed
covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with
a person who is debared, suspended, declared ineligible, or voluntarily excluded from participation in this
covered transaction, unless authorized by the department or agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will include
the clause titled, "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion —
Lower Tier Covered Transaction," without modification in all lower tier covered transactions and in all
solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective participant in a
lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the
covered transaction, unless it knows that the certification is erroneous. A participant may decide the
method and frequency by which it determines the eligibility of its principals. Each participant may check the
Nonprocurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of
reports in order to render in good faith the certification requred by this clause. The knowledge and
information of a participant is not required to exceed that which is normally possessed by a prudent person
in the ordinary course of business dealings.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters. into a lower tier covered transaction with a person who is suspended,
debarred, ineligible, or voluntary excluded from participation in this transaction, in addition to other
remedies available to the Federal Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or debarment.
ASSURANCES
The Applicant hereby assures and certifies compliance with all Federal statutes, regulations, policies, guidelines, and requirements, including OMB
Circulars No. A-21, A-87, A-110, A-122, A-133; E.O. 12372 and Uniform Administrative Requirements for Grants and Cooperative Agreements -
28 CFR, Part 66, Common Rule, that govern the application, acceptance and use of Federal funds for this federally assisted project. Also the
Applicant assures and certifies that:
1. It possesses legal authority to apply for the grant; that a
resolution, motion or similar action has been duly adopted or
passed as an official act of the applicant's governing body,
authorizing the filing of the application, including all
understandings and assurance contained therein, and directing
and authorizing the person identified as the official
representative of the applicant to act in connection with the
application and to provide such additional information as may
be. required.
2. It ensures that individuals with limited English proficiency
(LEP) will be provided access to its program and activities.
3. It will comply with requirements of the provisions of the
Uniform Relocation Assistance and Real Property Acquisitions
Act of 1970 (P.L. 91-646) which provides for fair and equitable
treatment of persons displaced as a result of Federal and
federally - assisted programs.
4. It will comply with provisions of Federal law which limit certain
political activities of employees of a State or local unit of
government whose principal employment is in connection with
an activity financed in whole or part by Federal grants or
subgrants. (5 USC 1501, et. seq.)
5. It will comply with the minimum wage and maximum hours
provision of the Federal and State Fair Labor Standards Act if
applicable.
6. It will establish safeguards to prohibit employees from using
their positions for a purpose that is or gives the appearance of
being motivated by a desire for private gain for themselves or
others, particularly those with whom they have family, business,
or other ties.
7. It will give the Department of Finance and Administration, or
the Comptroller General, through any authorized representative,
access to and the right to examine all records, books, papers, or
documents related to the subgrant.
8. It will comply with all requirements imposed by the Federal
sponsoring agency or the Department of Finance and
Administration concerning special requirements of law, program
requirements, and other administrative requirements.
9. It will ensure that the facilities under its ownership, lease or
supervision which shall be utilized in the accomplishment of the
project are not listed on the Environmental Protection Agency's
(EPA) list of Violating Facilities and that it will notify the
Department of Finance and Administration and the Federal
grantor agency of the reciept of any communication from the
Director of the EPA Office of Federal Activities indicating that a
facility to be used in the project is under consideration for listing
by the EPA.
10. It will comply with the flood insurance purchase requirements of
Section 102 (a) of the Flood Disaster Protection Act of 1973,
Public Law 93-234, 87 Stat. 975, approved December 31, 1976,
Section 102 (a) requires, on and after March 2, 1975, the
purchase of flood insurance in communities where such
insurance is available as a condition for the reciept of any
Federal financial assistance for construction or acquisition
purposes for use in any area that has been identified by the
Secretary of the Department of Housing and Urban
Development as an area having special flood hazards. The
phrase "Federal financial assistance" includes any form of loan,
grant, guaranty, insurance payment, rebate, subsidy, disaster
assistance loan or grant, or any other fore of direct or indirect
Federal assistance.
11. It will assist the Federal grantor agency in its compliance with
Section 106 of the National Historic Preservation Act of 1966 as
amended (16 USC 470), Executive Order 11593, and the
Archeological and Historical Preservation Act of 1966 (16 USC
569 a-1 et seq.) by (a) consulting with the State Historic
Preservation Officer on the conduct of investigations, as
necessary, to identify properties listed in or eligible for inclusion
in the National Register of Historic Places that are subject to
adverse effects (see 36 CFR Part 800.8) by the activity, and
notifying the Federal grantor agency of the existence of any such
properties, and by (b) complying with all requirements
established by the Federal grantor agency to avoid or mitigate
adverse effects upon such properties.
12. It will comply, and assure the compliance of all its subgrantees
and contractors, with the applicable provisions of Title 1 of the
Omnibus Crime Control and Safe Streets Act of 1968, as
amended, the Juvenile Justice and Delinquency Prevention Act,
or the Victims of Crime Act, as appropriate; the provisions of
the current edition of the Office of Justice Programs Financial
and Administrative Guide for Grants, M7100.1; and all other
applicable Federal laws, orders, circulars, or regulations.
13. It will comply with the provisions of 28 CFR applicable to
grants and cooperative agreements including Part 18,
Administrative Review Procedure; Part 20 Criminal Justice
Information Systems; Part 22 Confidentiality of Identifiable
Research and Statistical Information; Part 23, Criminal
Intelligence Systems Operating Policies; Part 30
Intergovernmental Review of Department of Justice Programs
and Activities; Part 42, Nondiscrimination/Equal Employment
Opportunity Policies and Procedures; Part 61, Procedures for
Implementing the National Environmental Policy Act; Part 63,
Floodplain Management and Wetland Protection Procedures;
and Federal laws or regulations applicable to Federal Assistance
Programs.
1
14. It will comply, and all its contractors, with the
nondiscrimination requirements of the Omnibus Crime Control
and Safe Streets Act of 1968, as amended, 42 USC 3789 (d), or
Victims of Crime Act (as appropriate); Title VI of the Civil
Rights of 1964, as amended; Section 504 of the Rehabilitation
Act of 1973, as amended; Subtitle A, Title 11 of the Americans
with Disabilities Act (ADA) (1990); Title IX of the Education
Amendments of 1972; the Age Discrimination Act of 1975;
Department of Justice Non -Discrimination Regulations, 28 CFR
Part 42, Subparts C, D, E, and G; and Department of Justice
regulations on disability discrimination, 28 CFR Part 35 and Part
39.
15. In the event a Federal or State court or Federal or State
administrative agency makes a finding of discrimination after a
due process hearing on the grounds of race, color, religion,
national origin, sex, or disability against a recipient of funds,
the recipient will forward a copy of the finding to the
Department of Finance and Administration, Office of
Intergovernmental Services.
16. It will provide an Equal Employment Opportunity Program if
required to maintain one, where the application is for $500,000
or more.
17. It will comply with the provisions of the Coastal Barrier
Resources Act (P.L. 97-348) dated October 19, 1982 (16 USC
3501 et seq.) which prohibits the expenditure of most new
Federal funds within the units of the Coastal Barrier Resources
System.
18. Will comply, as applicable, with provisions of the Hatch Act (5
USC 1501-1508 and 7324-7328) which limits the political
activities of employees whose principal employment activities
are funded in whole or in part with Federal funds.
19. Will cause to be performed the required financial and
compliance audits in accordance with the Single Audit Act
Amendments of 1996 and OMB Circular No. A-133, "Audits of
States, Local Governments, and Non -Profit Organizations" and
Department of Finance and Administration audit requirements.
20. It will have complete and well -organized books, records and
other original documentation relating .to any and all subgrant
expenditures, reimbursement or payment claims, reciept of
funds, personnel employed, services rendered, individuals
served, and all other records pertinent to the subgrant award.
Furthermore, its bookkeeping shall be adequate to track the
receipt and expenditure of all organizational funds, separately.
It shall also maintain a functioning internal control structure
which includes accounting and service delivery procedures that
segregate subgrant funds from other organization funds and
services.
Signature of Authorized Official
21. It will provide for fund accounting, auditing, monitoring and
evaluation procedures, as necessary to keep such records as the
Department of Finance and Administration shall prescribe, to
assure fiscal control, proper fund management and effective
disbursement of funds received under the subgrant award.
22. No income eligibility standard will be imposed on individuals
receiving assistance or services supported with funds
appropriated or designated to carry out the subgrant project.
23. Subgrant funds made available under this subaward will not be
used as direct payment of cash or any other monetary transaction
with any victim or dependent of a victim for any purpose.
24. It will not, and all its subgrantees and contractors will not, hire
illegal aliens.
25. That the address or location of any shelter -facility assisted under
the subgrant project will not be made public, except with the
written authorization of the person or persons responsible for the
operation of such shelter.
26. It will comply with the Department of Finance and
Administration, Office of Intergovernmental Services, Subgrant
Administration Guide (June 2002, as amended, or its successor).
27. It will comply, and assure the compliance of all its subgrantees
and contractors, with the disclosure required by Governor's
Executive Order 98-04 and acknowledges that disclosure is a
condition of the subgrant award and that the Department of
Finance and Administration cannot enter into any such subgrant
award for which disclosure is not made.
Failure to make any disclosure required by Governor's
Executive Order 98-04, or any violation of any rule, regulation,
or policy adopted pursuant to that Order, shall be a material
breach of the terms of a subgrant award. Any subgrantee who
fails to make the required disclosure or who violates any rule,
regulation, or policy shall be subject to all legal remedies
available to the Department of Finance and Administration.
28. Public Law 103227, Part C Environmental Tobacco Smoke, also
known as the Pro Children Act of 1994, requires that smoking
not be permitted in any portion of any indoor routinely owned or
leased or contracted for by an entity and used routinely or
regularly for provision of health, day care, education, or library
services to children under the age of 18, if the services are.
funded by Federal programs either directly or through State or
Local governments, by Federal grant, contract, loan, or loan
guarantee. The law does not apply to children's services
provided in private residences, facilities funded solely by
Medicare or Medicaid funds, and portions of facilities used for
inpatient drug or alcohol treatment. Failure to comply with the
provisions of the law may result in the imposition of a civil
monetary penalty of up to $1,000 per day and/or the imposition
of an administrative compliance order on the responsible entity.
2
CONTRACT AND GRANT DISCLOSURE AND CERTIFICATION FORM
Failure to complete all of the following information may result in a delay in obtaining a contract, lease, purchase agreement, orant award with any Arkansas State Agency.
SUBCONTRACTOR: SUBCONTRACTOR NAME:
❑ Yes x❑No
TAXPAYER ID NAME: City of Fayetteville
IS THIS FOR:
El Goods?
❑ Services?E] Both?
YOUR LAST NAME: Jordan
FIRST NAME: Lioneld
M.I.:
ADDRESS: 113 W. Mountain St., Fayetteville, AR 72701
CITY:
Fayetteville
STATE: AR
ZIP CODE: 72701
COUNTRY: United States
AS A CONDITION OF OBTAINING, EXTENDING, AMENDING, OR RENEWING A CONTRACT, LEASE, PURCHASE AGREEMENT,
OR GRANT AWARD WITH ANY ARKANSAS STATE AGENCY, THE FOLLOWING INFORMATION MUST BE DISCLOSED:
FOR INDIVIDUALS*
Indicate below if: you, your spouse or the brother, sister, parent, or child of you or your spouse is a current or former: member of the General Assembly, Constitutional Officer, State Board or Commission
Member, or State Employee:
Position Held
Mark (q)
Name of Position of Job Held
[senator, representative, name of
board/ commission, data entry, etc.]
For How Long?
What is the person(s) name and how are they related to you?
[i.e., Jane Q. Public, spouse, John Q. Public, Jr., child, etc.]
Current
Former
From
MMM
To
MMMT
Person's Name(S)
Relation
General Assembly
❑
0
4
Constitutional Officer
0
0
State Board or Commission
Member
❑
❑
State Employee
0
0
® None of the above applies
Indicate below if any of the following persons, current or former, hold any position of control or hold any ownership interest of 10% or greater in the entity: member of the General Assembly, Constitutional
Officer, State Board or Commission Member, State Employee, or the spouse, brother, s'ster, parent, or child of a member of the General Assembly, Constitutional Officer, State Board or Commission
Member, or State Employee. Position of control means the power to direct the purchasing policies or influence the management of the entity.
Position Held
Mark (�
Name of Position of Job Held
[senator, representative, name of
board/commission, data entry, etc.]
For How Lon g'
What is the person(s) name and what is his/her % of ownership interest and/or
what is his/her position of control?
Current
Former
From
MMM
ToOwnership
MMM(
Person's Name(s)
Position of
Interest (%) Control
General Assembly
0
0
4
Constitutional Officer
❑
❑
State Board or Commission
Member
0
0
State Employee
0
0
12 None of the above applies
Contract and Grant Disclosure and Certification Form
Failure to make anv disclosure required by Governor's Executive Order 98-04, or anv violation of any rule, regulation, or policy adopted pursuant to
that Order, shall be a material breach of the terms of this contract. Any contractor, whether an individual or entity, who fails to make the required
disclosure or who violates anv rule, regulation, or policy shall be subject to all legal remedies available to the aaencv
As an additional condition of obtaining, extending, amending, or renewing a contract with a state agency I agree as follows:
1. Prior to entering into any agreement with any subcontractor, prior or subsequent to the contract date, I will require the subcontractor to complete a
CONTRACT AND GRANT DISCLOSURE AND CERTIFICATION FORM. Subcontractor shall mean any person or entity with whom I enter an agreement
whereby I assign or otherwise delegate to the person or entity, for consideration, all, or any part, of the performance required of me under the terms
of my contract with the state agency.
2. I will include the following language as a part of any agreement with a subcontractor:
Failure to make any disclosure required by Governor's Executive Order 98-04, or any violation of any rule, regulation, or policy adopted
pursuant to that Order, shall be a material breach of the terms of this subcontract. The party who fails to make the required disclosure or who
violates any rule, regulation, or policy shall be subject to all legal remedies available to the contractor.
3. No later than ten (10) days after entering into any agreement with a subcontractor, whether prior or subsequent to the contract date, I will mail a
copy of the CONTRACT AND GRANT DISCLOSURE AND CERTIFICATION FORM completed by the subcontractor and a statement containing the dollar
amount of the subcontract to the state agency.
I certify under penalty of perjury, to the best of my knowledge and belief, all of the above information is true and correct and
that I agree to th = subcontrac. or disclosure conditions stated herein.
Signature
Vendor Contact Person Dreg Tabor
Title Mayor
Title Chief of Police
Date 7 f/7 c
Phone No(479) 587-3500
Agency use only
Agency Agency Agency Contact Contract
Number Name Contact Person Phone No. or Grant No.