HomeMy WebLinkAbout20B - AA - OTS FUNDINGREQUEST FOR
COUNCIL ACTION
CITY COUNCIL MEETING DATE:
OCTOBER 20, 2015
TITLE:
AGREEMENT WITH OFFICE OF TRAFFIC
SAFETY FOR BICYCLE SAFETY
EDUCATION AND OUTREACH
PROGRAM GRANT FUNDING
(PROJECT 166866)
(STRATEGIC PLAN NO. 1, 3B)
r �
I
CITY MANAGER
RECOMMENDED ACTION
CLERK OF COUNCIL USE ONLY:
APPROVED
❑
As Recommended
❑
As Amended
❑
Ordinance on 151 Reading
❑
Ordinance on 2n0 Reading
❑
Implementing Resolution
❑
Set Public Hearing For
CONTINUED TO
FILE NUMBER
1. Approve an appropriation adjustment to recognize Office of Traffic Safety Public Education on
Bicycle Safety grant funds in the amount of $100,000 in the OTS -PWA Traffic Safety Grants
revenue account, and appropriate the same to the OTS- Bicycle Safety PWA expenditure
account.
2. Authorize the City Manager and Clerk of the Council to execute an agreement with the State
of California Office of Traffic Safety, subject to nonsubstantive changes approved by the City
Manager and City Attorney, for Bicycle Safety Education and Outreach Program grant funding
in an amount not to exceed $100,000, for a one -year period from October 1, 2015, through
September 30, 2016.
DISCUSSION
The Santa Ana Public Works Agency has been awarded a $100,000 Bicycle Safety Education
and Outreach Program grant from the State of California Office of Traffic Safety (OTS). These
funds will be used to address bicycle safety through a series of bicycle safety education
workshops and events. The goal of the program is to reduce the number of deaths and injuries in
traffic collisions involving bicycles.
The education and outreach campaign would be bilingual (English and Spanish) and is intended
to reach youth, adults, and seniors. It will include bicycle safety skills classes taught by League
of American Bicyclists Certified Instructors, nighttime bicycle light and helmet distribution events,
and a train - the - trainer seminar to certify cycling instructors.
20B -1
Agreement with Office of Traffic Safety for Bicycle Safety
Education and Outreach Program Grant Funding
October 20, 2015
Page 2
STRATEGIC PLAN ALIGNMENT
Approval of this item supports the City's effort to meet Goal #1 for Community Safety; Objective
#3 (promote fiscal accountability to ensure financial responsibility at all levels of the organization);
Strategy B (promote ongoing efforts to obtain grant funding for activities that will assist in
preventing and reducing criminal activity and traffic collisions).
ENVIRONMENTAL IMPACT
There is no environmental impact associated with this action.
FISCAL IMPACT
Grant funds will be accepted into the OTS -PWA Traffic Safety Grants revenue fund (Account No.
16517002 - 52001) and appropriated into the OTS- Bicycle Safety PWA expenditure fund (Account
No. 16517611- 66220, Project No. 166866) for expenditure in Fiscal Year 2015/16.
Public Works Agency
FM /EWG /CW
Exhibits: 1. Agreement
APPROVED AS TO FUNDS AND ACCOUNTS:
Francisco Gutierrez �)2
Executive Director
Finance & Management Services Agency
20B -2
State of California — Office of Traffic Safety
GRANT AGREEMENT - Page t
OTS -3R I Rev. 4A5)
GRANT NUMBER
PS1621
1. GRANTTITLE
BICYCLE SAFETY EDUCATION AND OUTREACH PROGRAM
2. NAME OF AGENCY
4. GRANT PERIOD
CITY OF SANTA ANA
From: 1011115
3. AGENCY UNIT TO ADMINISTER GRANT
PUBLIC WORKS AGENCY
To: 9/30/16
5. GRANT DESCRIPTION
The City of Santa Ana will implement a bicycle safety program and will conduct ten adult bicycle education classes
within the city. At least three of these classes will be taught in Spanish. To ensure the longevity of the program, one
League Cycling Instructor Certification Seminar will be conducted in September 2016 to train the trainer. Team Firefly
will be organized to meet for ten Operation Firefly street distributions at undisclosed locations throughout Santa Ana
where nighttime bicycle ridership is expected to be high and where the city has seen a history of incidents involving
bicyclists at night. Operation Firefly is an educational and bicycle light and helmet distribution program where
approximately 150 light sets and/or helmets will be distributed per event.
6. FEDERAL FUNDS ALLOCATED UNDER THIS AGREEMENT SHALL NOT EXCEED: $ 100,000.00
7. TERMS AND CONDITIONS: The parties agree to comply with the terms and conditions of the following which are by this
reference made a part of the Agreement:
• Schedule A (OTS -38b) - Problem Statement, Goals and • Exhibit A- Certifications and Assurances
Objectives and Method of Procedure • Exhibit B* - OTS Grant Program Manual
• Schedule B (OTS -38d) - Detailed Budget Estimate and
Sub - Budget Estimate (if applicable)
• Schedule B -1 (OTS -38f) - Budget Narrative and Sub- S
Budget Narrative (if applicable)
*Items shown with an asterisk ( *), are hereby incorporated by reference and made a part of this en as r
These documents can he viewed at the OTS home web page under Grants: www.ots.ca.s;DV.
We, the officials named below, hereby swear under penalty of perjury under the laws of the S f C Iii �a that we are duly
authorized to legally bind the Grant recipient to the above described Grant terms and condit
IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.
8. APPROVAL SIGNATURES
A. GRANTDIRECTOR B. AUTHORIZING OFFICIAL OF AGENCY
NANIE: Cory Wilkerson PHONE: 714 -647 -5643 NANIE: Fred Mousavipour PHONE:
TITLE: Active Transportation TITLE: Executive Director - Public
FAX: 714- 647 -5616 FA`
Coordinator Works Agency
ADDRESS: 20 Civic Center Plaza M43 ADDRESS: 20 Civic Center Plaza M43
Santa Ana, CA 92702 Santa Ana, CA 92702
E-MAIL: cilkerson a santa- ana.org E- rotalL: fmousavipour@santa- ana -org
(Signalure) (Date) (Signature) (Dare)
C. FISGM.OR AC'C'OUNTING OFFICIAL D. OFFICE AUTHORIZED To RECEIVE PAYMENTS
NAME: Francisco Gutierrez PHONE: 714 -647 -5420 NAME: City of Santa Ana
liar: Executive Director - ADDRESS: Finance & Management Services Agency M -87
Finance & Management FAN: 714- 647 -5414
Services 20 Civic Center Plaza
ADDRESS: 20 Civic Center Plaza M -17 Santa Ana, CA 92702
Santa Ana, CA 92702
9. DUNS NUMBER
E-MAIL: futierrez(q?santa- ana.org DUNStt: 083153247
REMMRrD 20 Civic Center Plaza, 81' Floor
ADDRESS A
zI1, Santa Ana, CA 92702 -4058
(Signature) (D<ve)
F_VA Wrr
SCHEDULE A
GRANT DESCRIPTION
GRANT No. PS1621
PAGE I
1. PROBLEM STATEMENT
With a population of just under 330,000, the City of Santa Ana is one of the thirteen highest population cities in
the State. The City is approximately 27.1 square miles in size. Santa Ana has a large volume of motor vehicle
traffic, with the arterials carrying 30,000 to 40,000 vehicles per day. There are also four freeways that converge
within the city and a total of 450 miles of streets.
Relative income and vehicle ownership levels within the City are significantly lower than statewide averages.
The City population's median age is the youngest of the seven largest cities in Orange County and the
residential density is one of the highest in the State. Transit ridership in Santa Ana is the highest in the County
with several of the busiest OCTA bus lines serving the City. As a result of climate and demographics, bicycle
dependent population is relatively high when compared to other communities in the County or the State. Also, a
significant portion of the adult bicyclists may not speak English or understand the rules of the road.
In 2011 and 2012, the City of Santa Ana ranked 3`d highest of similar -sized cities for bicycle - involved
collisions, falling just behind San Francisco and Long Beach. In addition, collisions involving bicyclists riding
at night increased from 40 in 2012, to 43 in 2013. Finally, bicycle - involved collisions remained steady with 222
in 2012, and 223 in 2013.
2. PERFORMANCE MEASURES
A. Goals:
1) To maintain the number of bicyclists killed in the City of Santa Ana from the 2013 base year total of 0
by September 30, 2016,
2) To reduce the number of bicyclists injured in the City of Santa Ana by 10% from the 2013 base year
total of 203 to 183 by September 30, 2016.
3) To maintain the number of bicyclists killed in nighttime collisions in the City of Santa Ana from the
2013 base year total of 0 by September 30, 2016.
4) To reduce the number of bicyclists injured in nighttime collisions in the City of Santa Ana by 10% from
the 2013 base year total of 43 to 39 by September 30, 2016.
B. Objectives:
1) To conduct 10 bicycle classroom workshops/skill trainings with an effort to reach 120 members of the
community.
OTS -38b (Rev. 4115)
SCHEDULE A
GRANT DESCRIPTION
GRANT No. PS1621
PAGE 2
2) To conduct 1 train - the - trainer workshop /League Cycling Instructor Certification Seminar with an effort
to reach 12 members of the community.
3) To conduct 10 helmet and light distribution events with an effort to reach 1,500 members of the
community.
3. METHOD OF PROCEDURE
A. Phase 1 - Program Preparation, Training and Implementation (15' Quarter of Grant Year)
• Identify personnel and project responsibilities.
• Execute professional services contract with community partners and sub - contractors.
• Set up accounting system for project expenses and reporting responsibilities for Quarterly Progress
Reports.
• Prepare marketing/outreach strategy and materials.
• Purchase program safety equipment and materials.
Media Requirements
• Issue a press release announcing the kick -off of the grant by November 15. The kick -off press
releases and media advisories, alerts, and materials must be emailed to the OTS Public Information
Officer at pio(diots.ca.eov, and copied to your OTS Coordinator, for approval 14 days prior to the
issuance date of the release.
B. Phase 2 - Program Operations (Throughout Grant Year
Conduct ten (10) bilingual Traffic Skills 101 classes.
Organize a League Cycling Instructor Certification Seminar with an effort to certify 12 to 15
participants.
Distribute 1,500 helmets and lights (head- lights /tail - lights) at ten (10) Team Firefly events.
Media Requirements
• Send all grant - related activity press releases, media advisories, alerts and general public materials to
the OTS Public Information Officer (PIO) at iiooLiots.ca.Qov, with a copy to your OTS Coordinator.
a) If an OTS template -based press release is used, the OTS PIO and Coordinator should be copied
when the release is distributed to the press. If an OTS template is not used, or is substantially
OTS -38b (Rev. 4/15)
r1-
SCHEDULE A
GRANT DESCRIPTION
GRANT No. PS1621
PAGE 3
changed, a draft press release shall be sent to the OTS PIO for approval. Optimum lead time
would be 10 -20 days prior to the release date to ensure adequate tum- around time,
b) Press releases reporting the results of grant activities such as enforcement operations are exempt
from the recommended advance approval process, but still should be copied to the OTS PIO and
Coordinator when the release is distributed to the press.
c) Activities such as warrant service operations and court stings that could be compromised by
advanced publicity are exempt from pre- publicity, but are encouraged to offer embargoed media
coverage and to report the results.
• Use the following standard language in all press, media, and printed materials: Funding for this
program was provided by a grant from the California Office of Traffic Safety, through the National
Highway Traffic Safety Administration.
• Email the OTS PIO at pio�dots.ca.aov and copy your OTS Coordinator at least 30 days in advance, a
short description of any significant grant - related traffic safety event or program so OTS has sufficient
notice to arrange for attendance and/or participation in the event.
• Submit a draft or rough -cut of all printed or recorded material (brochures, posters, scripts, artwork,
trailer graphics, etc.) to the OTS PIO at pioAots.ca.aov and copy your OTS Coordinator for approval
14 days prior to the production or duplication.
• Include the OTS logo, space permitting, on grant - funded print materials; consult your OTS
Coordinator for specifics.
C. Phase 3 — Data Collection & Renortina (Throughout Grant Year)
• Agencies are required to collect and report quarterly, appropriate data that supports the progress of
goals and objectives.
• Statistical data relating to the grant goals and objectives will be collected, analyzed, and incorporated
in Quarterly Performance Reports (QPRs). QPRs for the quarter ending September 30 will include
year -to -date comparisons of goals and objectives. If required, a separate quarterly data reporting
form will be completed each quarter and submitted as part of the QPR.
• Reports will compare actual grant accomplishments with the planned accomplishments. They will
include information concerning changes made by the Grant Director in planning and guiding the
grant efforts.
• Reports shall be completed and submitted in accordance with OTS requirements as specified in the
Grant Program Manual.
OTS -38b (Rev. 4/15)
rI-
SCHEDULE A
GRANT DESCRIPTION
GRANT No. PS1621
PAGE 4
4. METHOD OF EVALUATION
Using the data compiled during the grant, the Grant Director will complete the "Final Evaluation" section in
the fourth/final Quarterly Performance Report (QPR). The Final Evaluation should provide a brief summary
of the grant's accomplishments, challenges and significant activities. This narrative should also include
whether goals and objectives were met, exceeded, or an explanation of why objectives were not completed.
S. ADMINISTRATIVE SUPPORT
This program has full support of the City of Santa Ana. Every effort will be made to continue the activities
after the grant conclusion.
075- 38b(Rev,4 /15)
20B -7
SCHEDULE
DETAILED BUDGET ESTIMATE
GRANT NO. PS 1621
SUB BUDGET: Education & Outreach
FUND NUMBER
CATALOG
NUMBER (CFDA)
FUND DESCRIPTION
TOTAL
AMOUNT
402PS
20.600
State and Community Highway Safety
100,000.00
Positions and Salaries
Full -Time
None
Overtime
None
$
$
COST CATEGORY
FISCAL YEAR ESTIMATES
1011115 thru 9/30/16
TOTAL COST
TO GRANT
A. PERSONNEL COSTS
CFDA
FY -I
Positions and Salaries
Full -Time
None
Overtime
None
$
$
$
$
Category Sub -Total
$
$
B. TRAVEL EXPENSE
In -State
Out -of -State
$
$
$
$
Category Sub -Total
$
$
C. CONTRACTUAL SERVICES
None
$
$
Category Sub -Total
$
$
D. EQUIPMENT
None
$
Category Sub -Total
$
$
E. OTHER DIRECT COSTS
Bicycle Helmets
Bicycle Safety Equipment
Education and Outreach
20.600
20.600
20.600
$ 30,000.00
$ 22,500.00
$ 47,500.00
$ 30,000.00
$ 22,500.00
$ 47,500.00
Category Sub -Total
$ 100,000.00
$ 100,000.00
F. INDIRECT COSTS
None
$
$
Category Sub -Total
$ -
$ _
GRANT TOTAL
$ 100,000.00 1
$ 100,000.00
OTS -38d (Rev. 4,115)
206-8
SCHEDULE B -1
GRANT NO.
SUB BUDGET: PS1621
BUDGET NARRATIVE Page I
PERSONNEL COSTS
None
TRAVEL EXPENSE
None
CONTRACTUAL SERVICES
None
EQUIPMENT
None
OTHER DIRECT COSTS
1,500 Bicycle Helmet(s) - helmets to be distributed during bicycle rodeos and other bicycle safety- related
events.
Bicycle Safety Equipment — safety equipment such as bicycle headlights /taillights, reflectors, and reflective
arm and leg bands to be distributed during bicycle rodeos and other bicycle safety- related events.
Education and Outreach — will provide instructional services to teach Traffic Skills 101 courses and coach
a seminar, develop and produce all marketing/outreach materials, procure and distribute bicycle helmets and
satiety equipment, and organize team volunteers for Operation Firefly events.
INDIRECT COSTS
None
PROGRAM INCOME
There will be no program income generated from this grant.
OTS -38f (Rev. 4/15)
rl- •
SCHEDULE B
DETAILED BUDGET ESTIMATE
GRANT NO. PS 1621
FUND NUMBER
CATALOG
FUND DESCRIPTION
TOTAL
A. PERSONNEL COSTS
NUMBER(CFDA)
FY -I
AMOUNT
402PS
20.600
State and Community Highway Safety
100,000.00
COST CATEGORY
FISCAL YEAR ESTIMATES
1011115 thru 9/30/16
TOTAL COST
TO GRANT
A. PERSONNEL COSTS
CFDA
FY -I
Positions and Salaries
Full -Time
None
Overtime
None
Category Sub -Total
$
$
B. TRAVEL EXPENSE
In -State
Out -of -State
$
$ _
Category Sub -Total
$ _
$ _
C. CONTRACTUAL SERVICES
Education and Outreach Services
20.600
$ 100,000.00
$ 100,000.00
$
Cate o Sub -Total
$ 100,000.00
$ 100,000.00
D. EQUIPMENT
None
$
Category Sub -Total
$
$
E. OTHER DIRECT COSTS
None
$
Category Sub -Total
1
$
1
1$
F. INDIRECT COSTS
None
Category Sub -Total
$
$ _
GRANT TOTALI
Is
100,000.00
ED 100,000.00
OTS -38d (Rev. 4/15) P�6 1l
SCHEDULE B -1
GRANT No. PS 1621
BUDGET NARRATIVE Page 1
PERSONNEL COSTS
None
TRAVEL EXPENSE
None
CONTRACTUAL SERVICES
Education and Outreach Services — a local community organization will provide instructional services,
develop and produce all marketing materials, procure and distribute bicycle safety equipment, and organize
distribution and training events.
EQUIPMENT
None
OTHER DIRECT COSTS
None
INDIRECT COSTS
None
PROGRAM INCOME
There will be no program income generated From this grant.
OTS -38f (Rev. 4/15)
20B -11
EXHIBIT A
CERTIFICATIONS AND ASSURANCES
Page 1
Failure to comply with applicable Federal statutes, regulations, and directives may subject Grantee Agency
officials to civil or criminal penalties and/or place the State in a high risk grantee status in accordance with 49
CFR § 18.12.
The officials named on the grant agreement, certify by way of signature on the grant agreement signature page,
that the Grantee Agency complies with all applicable Federal statutes, regulations, and directives and State
rules, guidelines, policies and laws in effect with respect to the periods for which it receives grant funding.
Applicable provisions include, but are not limited to, the following:
• 23 U.S.C. Chapter 4— Highway Safety Act of 1966, as amended
49 CFR Part 18— Uniform Administrative Requirements for Grants and Cooperative Agreements to
State and Local Governments
• 23 CFR Part 1200 — Uniform Procedures for State Highway Safety Grant Programs
NONDISCRIMINATION
The Grantee Agency will comply with all Federal statutes and implementing regulations relating to
nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (Pub. L. 88-
352), which prohibits discrimination on the basis of race, color or national origin (and 49 CFR Part 21); (b)
Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681 -1683 and 1685- 1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29
U.S.C. 794), and the Americans with Disabilities Act of 1990 (Pub. L. 101 -336), as amended (42 U.S.C. 12101,
et seq.), which prohibits discrimination on the basis of disabilities (and 49 CFR Part 27); (d) the Age
Discrimination Act of 1975, as amended (42 U.S.C. 6101 - 6107), which prohibits discrimination on the basis of
age; (e) the Civil Rights Restoration Act of 1987 (Pub. L. 100 -259), which requires Federal -aid recipients and
all sub - recipients to prevent discrimination and ensure nondiscrimination in all of their programs and activities;
(f) the Drug Abuse Office and Treatment Act of 1972 (Pub. L. 92 -255), as amended, relating to
nondiscrimination on the basis of drug abuse; (g) the comprehensive Alcohol Abuse and Alcoholism
Prevention, Treatment and Rehabilitation Act of 1970 (Pub. L. 91 -616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or alcoholism; (h) Sections 523 and 527 of the Public Health
Service Act of 1912, as amended (42 U.S.C. 290dd -3 and 290ee -3), relating to confidentiality of alcohol and
drug abuse patient records; (i) Title VIII of the Civil Rights Act of 1968, as amended (42 U.S.C. 3601, et seq.),
relating to nondiscrimination in the sale, rental or financing of housing; 0) any other nondiscrimination
provisions in the specific statute(s) under which application for Federal assistance is being made; and (k) the
requirements of any other nondiscrimination statute(s) which may apply to the application.
Certifications and Assurances (Rev. 6/15)
20B -12
EXHIBIT A
CERTIFICATIONS AND ASSURANCES
Page 2
BUY AMERICA ACT
The Grantee Agency will comply with the provisions of the Buy America Act (49 U.S.C. 53230)), which
contains the following requirements:
Only steel, iron and manufactured products produced in the United States may be purchased with Federal funds
unless the Secretary of Transportation determines that such domestic purchases would be inconsistent with the
public interest, that such materials are not reasonably available and of a satisfactory quality, or that inclusion of
domestic materials will increase the cost of the overall project contract by more than 25 percent. Clear
justification for the purchase of non - domestic items must be in the form of a waiver request submitted to and
approved by the Secretary of Transportation.
POLITICAL ACTIVITY (HATCH ACT)
The Grantee Agency will comply with provisions of the Hatch Act (5 U.S.C. 1501 -1508) which limits the
political activities of employees whose principal employment activities are funded in whole or in part with
Federal funds.
CERTIFICATION REGARDING FEDERAL LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
person for influencing 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 connection with
the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the
entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or
modification of any Federal contract, grant, loan, or cooperative agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing 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 connection with this Federal
contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -
LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award documents for
all sub -award at all tiers (including subcontracts, sub - grants, and contracts under grant, loans, and
cooperative agreements) and that all sub - recipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by section 1352, title 3l, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each
such failure.
Certifications and Assurances (Rev. 6/I5)
20B -13
EXHIBIT A
CERTIFICATIONS AND ASSURANCES
Page 3
CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
Instructions for Primary Certification
1. By signing and submitting this grant agreement, the Grantee Agency Official is providing the certification
set out below.
The inability of a person to provide the certification required below will not necessarily result in denial of
participation in this covered transaction. The prospective participant shall submit an explanation of why it
cannot provide the certification set out below. The certification or explanation will be considered in
connection with the department or agency's determination whether to enter into this transaction. However,
failure of the Grantee Agency Official to furnish a certification or an explanation shall disqualify such
person from participation in this transaction.
3. The certification in this clause is a material representation of fact upon which reliance was placed when the
department or agency determined to enter into this transaction. If it is later determined that the Grantee
Agency Official knowingly rendered an erroneous certification, in addition to other remedies available to
the Federal Government, the department or agency may terminate this transaction for cause or default.
4. The Grant Agency Official shall provide immediate written notice to the department or agency to which this
grant agreement is submitted if at any time the Grantee Agency Official learns its certification was
erroneous when submitted or has become erroneous by reason of changed circumstances.
5. The terms cohered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant,
person, primary covered transaction, principal, grant agreement, and voluntarily excluded, as used in this
clause, have the meaning set out in the Definitions and coverage sections of 49 CFR Part 29. You may
contact the department or agency to which this grant agreement is being submitted for assistance in
obtaining a copy of those regulations.
6. The Grantee Agency Official agrees by submitting this grant agreement 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 proposed for debarment under 48 CFR Part 9, subpart 9.4, debarred, suspended, declared ineligible,
or voluntarily excluded from participation in this covered transaction, unless authorized by the department
or agency entering into this transaction.
7. The Grantee Agency Official further agrees by submitting this grant agreement that it will include the clause
titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier
Covered Transaction," provided by the department or agency entering into this covered transaction, without
modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.
8. 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 proposed for debarment under 48 CFR Part 9, subpart 9.4, debarred,
suspended, ineligible, or voluntarily excluded fi-om the covered transaction, unless it knows that the
certification is erroneous. A participant may decide the method and frequency by which it determines the
Certifications And Assurances (Rev. 6/15)
20B -14
EXHIBIT A
CERTIFICATIONS AND ASSURANCES
Page 4
eligibility of its principals. Each participant may, but is not required to, check the list of Parties Excluded
from Federal Procurement and Non - procurement Programs.
9. Nothing contained in the foregoing shall be construed to require establishment of a system of records in
order to render in good faith the certification required 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.
10. Except for transactions authorized under paragraph 6 of these instructions, if a participant in a covered
transaction knowingly enters into a lower tier covered transaction with a person who is proposed for
debarment under 48 CFR Part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from
participation in this transaction, in addition to other remedies available to the Federal Government, the
department or agency may terminate this transaction for cause or default.
Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered
Transactions
(1) The Grantee Agency Official certifies to the best of its knowledge and belief, that its principals:
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded
by any Federal department or agency;
(b) Have not within a three -year period preceding this grant agreement been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection 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 record, 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 application/grant agreement had one or more public
transactions (Federal, State, or local) terminated for cause or default.
(2) Where the Grantee Agency Official is unable to certify to any of the Statements in this certification, such
prospective participant shall attach an explanation to this grant agreement.
instructions for Lower Tier Certification
L By signing and submitting this grant agreement, the prospective 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 certification, in addition to other remedies available to the Federal government, the
Certifications and Assurances (Rev. 6/15)
20B -15
EXHIBIT A
CERTIFICATIONS AND ASSURANCES
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
grant agreement 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 transaction, debarred, suspended, ineligible, lower tier covered transaction, participant,
person, prirnmy covered transaction, principal, grant agreement, and voluntarily excluded, as used in this
clause, have the meanings set out in the Definition and Coverage sections of 49 CFR Part 29. You may
contact the person to whom this grant agreement is submitted for assistance in obtaining a copy of those
regulations.
5. The prospective lower tier participant agrees by submitting this grant agreement 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 proposed for debarment under 48 CFR Part 9, subpart 9.4, debarred, 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 grant agreement 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. (See below)
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 proposed for debarment under 48 CFR Part 9, subpart 9.4, 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, but is not required to, check the List of Parties Excluded
from Federal Procurement and Non - procurement Programs.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in
order to render in good faith the certification required 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 proposed for
debarment under 48 CFR Part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily 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.
Certifications and Assurances (Rev. 6/I5)
20B -16
EXHIBIT A
CERTIFICATIONS AND ASSURANCES
Page 6
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion —Lower Tier
Covered Transactions:
The prospective lower tier participant certifies, by submission of this grant agreement, that neither it nor its
principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from participation in this transaction by any Federal department or agency.
2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification,
such prospective participant shall attach an explanation to this grant agreement.
Certifications and Assurances (Rev. 6 /15)
20B -17
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