9TO:
FROM:
DATE:
SUBJECT:
BACKGROUND:
GRANTOR:
CITY OF SOUTH MIAMI
OFFICE OF THE CITY MANAGER
INTER-OFFICE MEMORANDUM
The Honorable Mayor & Members of the City Commission
South Miami
.·6d
AI·America City
11111.'
2001
Steven J. Alexander, Interim City Manager
Agenda Item No.: q April 17,2013
A Resolution authorizing the City Manager to accept the grant award in the amount
of $77,910.00 from the South Florida High Intensity Drug Trafficking Areas
(SFLHIDT A) Program.
The SFLHIDTA is a component of a group of federally funded task forces
combating drug use and trafficking throughout the United States. This grant will
support initiatives designed to implement the strategy proposed by the Executive
Board of SFLHIDT A and approved by the Office of National Drug Control Policy
(ONDCP). While SFLHIDTA requires the services of a Deputy Director, this
organization is sponsored by federal grants and does have the financial mechanism
to perform payroll functions. Therefore, SFLHIDT A requires a municipality that is
not participating in the same retirement system with that of the employee to act as a
disbursing agency. The City of South Miami desires to assist and support its
federal law enforcement partners, of which SFLHIDT A is one.
In January 31,2013 the City of South Miami was awarded a grant in the amount of
$77,910.00 from the High Intensity Drug Trafficking Areas (HIDTA) Program
with a grant period from May 1, 2013 to September 30, 2013. The City of South
Miami will disperse the sum of which is Sixty-two Thousand, Eight Hundred and
Four Dollars ($62,804) in salary and Three Thousand, Five Hundred ($3,500.00) in
vehicle compensation to the Deputy Director of South Florida HIDT A, Widell
LLC. The City of South Miami is a political subdivision of the State of Florida,
which agrees to act solely as a financial intermediary and disbursing agent on
behalf of South Florida HIDT A and the Contractor and will be compensated in the
amount of$1,558.00.
South Florida High Intensity Drug Trafficking Areas (SFLHIDTA) Program
GRANT AMOUNT: $77,910.00
GRANT PERIOD:
ATTACHMENTS:
May 1,2013 through September 30,2013
Award Letter
Contract
Application
1 RESOLUTION NO. ----2
3 A Resolution authorizing the City Manager to accept the grant award in the
4 amount of $77,910.00 from the South Florida High Intensity Drug
5 Trafficking Areas (SFLHIDTA) Program.
6
7
8 WHEREAS, the SFHIDT A is a component of a group of federally funded task forces
9 combating drug use and trafficking throughout the United States.
10
11 WHEREAS, this grant will support initiatives designed to implement the strategy
12 proposed by the Executive Board of SFLHIDT A and approved by the Office of National Drug
13 Control Policy (ONDCP); and
14
15 WHEREAS, the SFLHIDT A requires the services of a Deputy Director; and
16
17 WHEREAS, the City of South Miami was awarded a grant in the amount of $162,312.00
18 from the SFLHIDTA Program with a grant period from May 1,2012 to April 30, 2013 to fund
19 the salary of the Deputy Director; and
20
21 WHEREAS, the City of South Miami was awarded a grant in the amount of $77,910.00
22 from the SFLHIDTA Program with a grant period from May 1,2013 to September 30,2013 to
23 fund the salary of the Deputy Director; and
24
25 WHEREAS, the City of South Miami will disperse the sum of which is Sixty-two
26 Thousand, Eight Hundred and Four Dollars ($62,804) in salary and Three Thousand, Five
27 Hundred ($3,500.00) in vehicle compensation to the Deputy Director of South Florida HIDTA,
28 Widell LLC.
29
30 WHEREAS, the City of South Miami is a political subdivision of the State of Florida,
31 which agrees to act solely as a financial intermediary and disbursing agent on behalf of
32 SFLHIDTA and the Contractor and the City will be compensated in the amount of $1 ,558.00.
33
34
35
36 NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND CITY
37 COMMISSION OF THE CITY OF SOUTH MIAMI, FLORIDA THAT:
38
39
40 Section 1: The Mayor and City Commission authorize the City Manager to accept the
41 grant award in the amount of$77,910.00 from the South Florida High Intensity Drug Trafficking
42 Areas (SFLHIDTA) Program.
43
44 Section 2: This resolution shall be effective immediately after the adoption hereof.
45
46
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PASSED AND ADOPTED this __ , day of ___ , 2013.
ATTEST:
CITY CLERK
READ AND APPROVED AS TO FORM
LANGUAGE, LEGALITY AND
EXECUTION THEREOF:
CITY ATTORNEY
2
APPROVED:
MAYOR
Commission Vote:
Mayor Stoddard:
Vice Mayor Liebman:
Commissioner Harris:
Commissioner Newman:
Commissioner Welsh:
City Manager Hector Mirabile
City of South Miami
6130 Sunset Drive
South Miami, FL 33143
Dear Mr. Mirabile:
January 31, 2013
We are pleased to inform you that your request for funding from the High Intensity Drug
Trafficking Areas (HIDTA) Program has been approved, and a grant (Grant Number
G 13MIO005A) has been awarded in the amount of $77 ,910. This grant will support
initiatives designed to implement the Strategy proposed by the Executive Board of the
South Florida HIDTA and approved by the Office of National Drug Control Policy (ONDCP).
The original Grant Agreement, including certain Special Conditions, is enclosed. By accepting
this grant, you assume the administrative and financial responsibilities outlined in the enclosed
Grant Conditions, including the timely submission of all financial and programmatic reports,
the resolution of audit findings, and the maintenance of a minimum level of cash-on-hand.
Should your organization not adhere to these terms and conditions, ONDCP may terminate
the grant for cause or take other administrative action.
If you accept this award, please sign both the Grant Agreement and the Grant Conditions and
return a copy to:
Finance Unit
National HIDTA Assistance Center
11200 NW 20th Street, Suite 100
Miami, FL 33172
(305) 715-7600
Or via email to your respective NHAC accountant.
Please keep the original copy of the Grant Agreement and Grant Conditions for your file.
If you have any questions pertaining to this grant award, please contact Dan Grayson at
(202) 395-6692.
Enclosures
Sincerely,
lA(tv~ad \(, 'iA1-,lie'e)
Michael K. Gottlieb
National HIDTA Director
Executive Office of the President
Office of National Drug Control Policy
1. Recipient Name and Address
City Manager Hector Mirabile
City of South Miami
6130 Sunset Drive
South Miami, FL 33143
1A. RecipientIRSlVendorNo.: 1596000431Al
Subrecipient Name and Address
2A. Subrecipient IRS/Vendor No.:
1 ufS
Grant Agreement
4. Award Number: G13M10005A
5. Grant Period: From 0110112013 to 12/3112014
6. Date: 113112013
8. Supplement Number
9. Previous Award Amount:
7. Action
o Initial
Supplemental
3. Project Title 10. Amount of This Award: $77,910
Management and Coordination 11. Total Award: $77,910
12. Consistent with Public Law 112-175, the Continuing Appropriations Resolution, 2013, this document
provides a total budget and spending ceiling as reflected in Block 10 of the Grant Award document,
which represents funding at the rate of 48% of the fiscal year 2012 funding level. Accordingly, the
sum of all budgets cannot exceed the award amount reflected in Block 10 of the Grant Award
document. The Office of National Drug Control Policy acknowledges that the aforementioned
funding level is below the stated budget requirements; however, additional funding cannot be made
available until enacted through public law.
13. Statutory Authority for Grant: Public Law 112-175
14. Typed Name and Title of Approving Official
Michael K. Gottlieb
National HIDT A Director
16. Signature of Approving ONDCP Official
l~ \ C.A.MUe l(. ~)o~+l \ e T~
18. Accounting Classification Code
DUNS: 24628976
EIN: 1596000431A1
15. Typed Name and Title of Authorized Official
Hector Mirabile
City of South Miami
17. Signature of Authorized Recipient/Date
19.HIDTA AWARD
OND1070DB1314XX OND6113
OND2000000000 OC 410001
Grant G 13MIO005A
Page 2 of5
GRANT CONDITIONS
A. General Provisions
1. This grant is subject to:
•
•
•
•
•
•
•
•
OMB Circular A-87, Cost Principles for State, Local, and Indian Tribal Government; or,
if applicable, OMB Circular A-21, Cost Principles for Educational Institutions;
OMB Circular A-102, Grants and Cooperative Agreements with State and Local
Governments; or, if applicable, OMB Circular A-II 0, Uniform Administrative
Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals
and Other Non-Profit Organizations;
OMB Circular A-133, Audits of States, Local Governments and Non-Profit Institutions;
Government-wide Debarment and Suspension (Non procurement), codified at 21 CFR §
1401 et. seq.;
Government-wide Requirements for Drug-Free Workplace (Grants), codified at 21 CFR §
1401 et. seq.;
New Restrictions on Lobbying, codified at 18 USC § 1903 and 31 USC § 1352;
Nondiscrimination in Federally Assisted Programs and Equal Opportunity Plans
requirements are codified at USC, Title VI (42 USC § 2000d et seq.); and
Immigration and Naturalization Service Employment Eligibility Verification Form (I-9).
2. Audits conducted pursuant to OMB Circular A-133, "Audits of State and Local Governments",
must be submitted no later than 9 months after the close of the grantee's audited fiscal year. A
copy of the audit report and management letter must be sent to:
EOP/ONDCP
Attention: Michael Reles
GSD/RDF (202) 395-6608
Anacostia Naval Annex
Bldg 41 O/Door 123
250 Murray Lane, SW
Washington, DC 20509
or:
mreles@ondcp.eop.gov
Grant G13MIO005A
Page 3 of5
3. Grantees are required to submit Federal Financial Reports (FFR) to the Department of
Health and Human Services, Division of Payment Management (HHS/DPM). Other
reporting requirements are specified in the HIDT A Program Policy and Budget
Guidance.
4. The recipient gives the awarding agency or the Government Accountability Office,
through any authorized representative, access to, and the right to examine, all paper or
electronic records related to the grant.
5. Recipients of HIDTA funds are not agents ofONDCP. Accordingly, the HIDTA, its
fiscal agent(s), HIDTA employees, HIDTA contractors, as well as state, local, and
federal HDTA participants, either on a collective basis or on a personal level, shall not
hold themselves out as being part of, or representing, the Executive Office of the
President or ONDCP.
B. Special Conditions HIDT A Grants
The following special conditions are incorporated into each award document.
1. This grant is awarded for the initiative(s) named above. Variation from the description of
activities approved by ONDCP and/or from the budget attached to this letter must comply with
the reprogramming requirements as set forth in ONDCP's HIDTA Program Policy and Budget
Guidance.
2. This award is subject to the requirements in ONDCP's HIDTA Program Policy and Budget
Guidance.
3. No HIDTA funds shall be used to supplant state or local funds that would otherwise be made
available for the same purposes.
4. The requirements of28 CFR Part 23, which pertain to information collection and management
of criminal intelligence systems, shall apply to any such systems supported by this award.
5. Special accounting and control procedures must govern the use and handling of HIDTA
Program funds for confidential expenditures; i.e. the purchase of infonnation, evidence, and
services for undercover operations. Those procedures are described in Section 6-12 of the
HIDT A Program Policy and Budget Guidance.
6. The grant recipient agrees to account for and use program income in accordance with the
"Common Rule" and the HIDT A Program Policy and Budget Guidance. Asset forfeiture
proceeds generated by the HIDTA-funded initiatives shall not be considered as program income
earned by HIDT A grantees.
Grant G13MIO005A
Page 4 of5
7. Property acquired with these HIDT A grant funds is to be used for activities of the South Florida
HIDTA. If your agency acquires property with these funds and then ceases to participate in the
HIDTA, this equipment must be made available to the HIDTA's Executive Board for use by
other HIDT A participants.
8. All law enforcement entities that receive funds from this grant must report all methamphetamine
laboratory seizure data to the National Clandestine Laboratory DatabaselNational Seizure
System at the El Paso Intelligence Center.
c. Payment Basis
1. A request for Advance or Reimbursement shall be made using the HHS/DPM system
(www.dpm.psc.gov). Copies of invoices or payroll registers must accompany the payment
confirmation number to provide documentation for the reimbursement request. Requests for
advances must be accompanied by details specifying the need for the advance. Documentation of
how the advance was spent must be submitted within 21 days and before another advance or
reimbursement will be approved.
2. The HIDT As, or their respective grantees, must utilize the HIDT A program Financial Management
System's (FMS) Disbursement module each time they submit a disbursement request to the NHAC.
Requests for payment in the DPM system will not be approved unless the required disbursements
have been entered into the FMS. Payments will be made via Electronic Fund Transfer to the award
recipient's bank account. The bank must be FDIC insured. The account must be interest bearing.
3. Except for interest earned on advances of funds exempt under the Intergovernmental Cooperation
Act (31 U.S.C. 6501 et seq.) and the Indian Self-Determination Act (23 U.S.C. 450), grantees and
subgrantees shall promptly, but at least quarterly, remit interest earned on advances to HHS/DPM at
the address provided below. When sUbmitting your checks, please provide a detailed explanation
which should include: reason for check (remittance of interest earned on HIDTA advance
payments), check number, grantee name, grant number, interest period covered, and contact name
and number.
Ms. Janet Fowler
Division of Payment Management
Department of Health and Human Services
Via U.S. Postal Mail:
P.O. Box 6021
Rockville, MD 20852
Via FedEx:
7700 Wisconsin Avenue
10th Floor
Bethesda, MD 20814
Grant G13MIO005A
Page 5 of5
4. The grantee or sub grantee may keep interest amounts up to $100 per year for administrative
purposes.
RECIPIENT ACCEPTANCE OF GRANT CONDITIONS
Signature: Date:
Name: Hector Mirabile
Organization: City of South Miami
I Ca I !'
HIDTA Agency Name Initiative
South Florida City of South Miami Management and Coordination 162,312.00 Administration G13MIO005A
Agency Total: City of South Miami 162,312.00
Total 162,312.00
2/1/2013 2:41:52 PM
Budget iI
2013 -South Florida
Awarded Budget (as approved by ONDCP)
Contractor -Director -Deputy
Vehicle allowance
Total Services
Administrative costs
Total Other
Page 1 of 1
Total Budget
$162,312.00
1 $150,729.00
$8,400.00
$159,129.00
$3,183.00
$3,183.00
$162,312.00
2/1/2013 2:41:52 PM
HIDTA
2013
SF -424 Application
South Florida HIDTA
G13MI0005A
City of South Miami
$162,312.00
Generated On: 10 .. ;013
OFFICE OF NATIONAL DRUG CONTROL POLICY
FY 2013 HIDTA STATE AND LOCAL INITIATIVES
INSTRUCTIONS FOR APPLICANTS
Attached are the following documents for your FY 13 funding application:
• Approved FY 13 Budget to the City of South Miami for the Multiple Initiative(s).
• Application for Federal Assistance, SF-424.
• Budget Information Non-Construction Programs, SF-424A, Page 2. (Page I will not be utilized.)
• Assurances Non-Construction Programs, SF-424B.
• Budget Information Construction Programs, SF-424C.
Certification regarding Lobbying; Debarment, Suspension and other Responsibility Matters; Drug-Free
• Workplace Requirements; Federal Debt Status, and Non-Discrimination Statutes and Implementing Regulations.
• Disclosure of Lobbying Activities.
To submit a grant application for FY 13 HIDT A State and Local Initiative Funding, the following forms must be
signed and returned:
• Application for Federal Assistance, SF-424.
• Budget Information Non-Construction Programs, SF-424A, Page 2. (Page I will not be utilized.)
• Assurances Non-Construction Programs, SF-424B.
• Budget Information Construction Programs, SF-424C.
Certification regarding Lobbying; Debarment, Suspension and other Responsibility Matters; Drug-Free
• Workplace Requirements; Federal Debt Status, and Non-Discrimination Statutes and Implementing Regulations.
• Disclosure of Lobbying Activities.
Each of these documents have been completed based upon information submitted for the FY 13 initiatives. Ifthis
information is incorrect, contact the National HIDT A Assistance Center for new forms.
These documents must be completed and signed in their entirely and returned with original signatures affixed
before the award letter can be initiated.
After completion, the forms should be sent to:
National HIDTA Assistance Center
11200 NW 20th ST, STE 100
Miami, FL 33172
(305) 715-7600
APPUCATlON FOR
FEDEfU\L ASSlSTANCE 2. DATE SUBMITTED 04/10/2013 Applicant Identifier:
1. TYPE OF SUBMISSION 3. DATE RECEIVED BY STATE State Application Identifier
Application Pre-application 4. DATE RECEIVED BY FED AGENCY Federal Identifier G13MIOOO5A
-Construction -Construction
~ Non-Construction -Non-Construction
5. APPLICANT INFORMATION
LEGAL NAME: City of South Miami ORGANIZATIONAL UNIT:
Organizational DUNS: 24628976
ADDRESS (Give city, county, State and Zip Code) Name and telephone number o/person to be contacted on
City of South Miami
matters involving this application (give area code)
6130 Sunset Drive Director Tim Wagner
South Miami, FL 33143
6. EMPLOYER IDENTIFICATION NUMBER (EIN) 7. TYPE OF APPLICANT: (Enter appropriate letters in box)
1596000431A1 A. State H. Independent School District
8. TYPE OF APPLICATION B. County I. State Controlled Institution of Higher
Learning
S New -Continuation -Revision C. Municipal J. Private University
If revision, enter appropriate letter{s) in box{es) DD D. Township K. Indian Tribe
(Specify) E. Interstate L. Individual
A. Increase Award B. Decrease Award
F. Inter-municipal M. Profit Organization
C. Increase Duration D. Decrease Duration G. Special District N. Other
Other (specify) 9. NAME OF FEDERAL AGENCY ONDCP
10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE 11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT
NUMBER (CFDA):
95.001 Management and Coordination
12. AREAS AFFECTED BY PROJECT
(Cities, Counties, States, etc.):
13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF
Start Date Ending Date a. Applicant b. Project
1/1/2013 12131/2014
15. ESTIMATED FUNDING: 16.IS APPLICATION SUBJECT TO REVIEW BY STATE
EXECUTIVE ORDER 12372 PROCESS?
a. Federal $162,312.00
a. YES. This preapplication/application was made
b. Applicant available to the State Executive order 12372
c. State D process for b. Applicant review on:
d. Local Date:
e. Other b. No. D Program is not covered by E.O. 12372
f. Program Income D or program has not been selected by state for
review
g. Total $162,312.00 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT?
Yes If "Yes", attach an explanation [8] No
TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION/PREAPPLICATION ARE TRUE AND CORRECT. THE
DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY
WITH THE ATIACHED ASSURANCES IF THE ASSISTANCE IS AWARDED.
a. Type Name of Authorized Representative b. Title c. Telephone
Steven J. Alexander City Manager
d . Signature of Authorized Representative e. Date Signed
Instructions for the sf424
Public reporting burden for this collection of infonnation is estimated to average 45 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
infornmtion. Send comments regarding the burden estimate or any other aspect of this collection of infonnation, including suggestions for
reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET; SEND IT
TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
This is a standard fonn used by applicants as a required face sheet for pre applications and application submitted for Federal assistance. It
will be used by Federal agencies to obtain applicant certification that States which have established a review and comment procedure in
response to Executive Order 12372 and have selected the program to be included in their process, have been given an opportunity to
review the applicant's submission.
Item: Entry:
1. Self -Explanatory.
2. Data application submitted to Federal Agency (or State if
applicable) & applicant's control number (if applicable).
3. State use only (if applicable).
4. Enter Date Received by Federal Agency, Federal
identification number: if this application is to continue or
revise an existing award, enter present Federal identifier
number. If for a new project, leave blank.
5. Enter a legal name of applicant, name of primary
organizational unit (including division is applicable), which
will undertake the assistance activity, enter the
organization's DUNS number (received from Dun and
Bradstreet), enter the complete address of the applicant
(including country), and name, telephone number, email
and fax of the person to contact on matters related to this
application.
6. Enter employer Identification Number (EIN) as assigned by
the Internal Revenue Service.
7. Enter the appropriate letter in the space provided.
8. Check appropriate box and enter appropriate letter(s) in the
space(s) provided;
• "New" means a new assistance award
• "Continuation" means any change in the Federal
Government's financial obligation or contingent
liability from an existing obligations
• "Revision" means any change in the Federal
Government's financial obligation or contingent
liability from an existing obligation.
9. Name of Federal agency from which assistance is being
requested with this application.
10. Use the Catalog of Federal Domestic Assistance number
and title of the program under which assistance is
requested.
II. Enter a brief descriptive title of project. I f more than one
program is involved, you should append an explanation on
Item: Entry:
a separate sheet. If appropriate (e.g., construction or real
property projects), attach a map showing project location.
For pre application, use a separate sheet to provide a
summary description of this project.
12. List only the largest political entities affected (e.g., State,
counties, cities).
13. Self-Explanatory.
14. List the applicant's Congressional-District and any
District(s) affected by the program or project.
15. Amount requested or to be contributed during the first
funding/budget period by each contributor. Value of in kind
contributions should be included on appropriate lines as
applicable. If the action will result in a dollar change to an
existing award, indicate only the amount of the change. For
decrease, enclose the amounts in parentheses. If both basic
and supplemental amounts are included, show breakdown
on an attached sheet. For multiple program funding, use
totals and show breakdown using same categories as item
15.
16. Applicants should contact the State Single Point of Contact
(SPOC) for Federal Executive Order 12372 to detennine
whether the application is subject to the State
intergovernmental review process.
17. This question applies to the applicant organization, not the
person who signs as the authorized representative.
Categories of debt include delinquent audit disallowances,
loans and taxes.
18. To be signed by the authorized representative of the
applicant. A copy ofthe governing body's authorization for
you to sign this application as official representative must
be on file in the applicant's office. (Certain Federal
agencies may require that this authorization be submitted as
part of the application.
Section C -Non-federal Resources
(a) Grant Program (b) Applicant (c) State (d) Other Resources (e) TOTALS
8. $ $ $ $
9.
10.
II.
12. Total (sum line 8 -11) $ $ $ $
i
SECTION D -FORCASTED CASH NEEDS
Total for 1st Year 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter
13. Federal $162,312.00 $40,578.00 $40,578.00 $40,578.00 $40,578.00
14. Non-Federal
15. TOTAL (sum of 13 and 14) $ $ $ $ $
-------------------------
SECTION E -BUDGET ESTIMATES OF FEDERAL FUNDS NEEDED FOR BALANCE OF THE PROJECT
(b) First (c) Second (d) Third (e) Fourth
16.
17.
18.
19.
20.
SECTION F -OTHER BUDGET INFORMATION
21. Direct Charges 22. Indirect Charges
23. Remarks
INSTRUCTIONS FOR THE SF-424A
Public reporting burden for this collection of information is estimated to average 180 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden to the Office of Management and Budget, Paperwork Reduction
Project (0348-0044), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET,
SEND IT OT THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
General Instruction
This form is designed so that application can be made for
funds from one or more grant programs. In preparing the
budget,adhere to any existing Federal grantor agency
guidelines, which prescribe how and whether budgeted
amounts should be separately shown for different functions
or activities within the program. For some programs,
grantor agencies may require budgets to be separately
shown by function or activity. For other programs, grantor
agencies may require a breakdown by function or activity.
Section A,B,C, and D should include budget estimates for
the whole project except when applying for assistance
which requires Federal authorization in annual or other
funding period increments. In the latter case, Sections A,
B,C, and D should provide the budget for the first budget
period (usually a year) and Section E should present the
need for Federal assistance in the subsequent budget
periods. All applications should contain a breakdown by
the object class categories shown in Lines a-k of Section
B.
Section A. Budget Summary Lines 1-4 column (a) and
(b)
For applications pertaining to a single Federal grant
program (Federal Domestic Assistance Catalog number)
and not requiring a functional or activity breakdown, enter
on Line I under Column (a) the catalog program title and
the catalog number in Column (b).
For application pertaining to a single program requiring
budget amounts by multiple functions or activities, enter
the name of each activity or function on each line in
Column (a), and enter the catalog number in column (b).
For application pertaining to multiple programs where
none of the programs require a breakdown by function or
activity, enter the catalog program title on each line in
column (a) and the respective catalog number on each line
in column (b).
For application pertaining to multiple programs where one
or more programs require a breakdown by function or
activity, prepare a separate sheet for each program
requiring the breakdown. Additional sheets should be used
when one form does not provide adequate space for all
breakdown of data required. However, when more than
one sheet is used, the first page should provide the
summary totals by programs.
Lines 1-4, column (c) through (g)
For new application, leave columns (c) and (d) blank. For
each line entry in Column (a) and (b), enter in Column (e),
(1), and (g) the appropriate amounts offunds needed to
support the project for the first funding period (usually a
year).
For continuing grant program applications, submit these
forms before the end of each funding period as required by
the grantor agency. Enter in column (c) and (d) the
estimated amounts of funds which will remain not
obligated at the end of the grant funding period only if the
Federal grantor agency instructions provide for this.
Otherwise, leave these columns blank. Enter in column (e)
and (1) the amounts offunds needed for the upcoming
period. The amount(s) in column (g) should be the sum of
amounts in Column (e) and (1).
For supplemental grants and changes to existing grants,
do not use column (c) and (d). Enter in Column (e) the
amount of the increase or decrease of Federal funds and
enter in column (1) the amount of the increase of decrease
of non-federal funds. In Column (g) enter the new total
budgeted amount (Federal and non-federal which includes
the total previous authorized budgeted amounts plus or
minus, as appropriate, the amounts shown in column (e)
and (1). The amount(s) in column (g) should not equal the
sum of amounts in column (e) and (1).
Line 5-Show the totals for all columns used.
Section B Budget Categories
In the column headings (I) through (4), enter the titles of
the same programs, functions, and activities shown on line
1-4, column (a), Section A. When additional sheets are
prepared for Section A, provide similar column headings
on each sheet. For each program, function or activity, fill
in the total requirements for funds (both Federal and non-
Federal) by object class categories.
Lines 6a-I-Show the totals of Lines 6a to 6h in each
column.
Line 6j-Show the amount of indirect cost.
Line 6K-Enter the total of amounts on Lines 6i and 6j.
For all applications for new grants and continuation grants
the total amount in column (5), Line 6k, should be the
same as the total amount shown in Section A, column (g),
Line 5. For supplemental grants and changes to grants, the
total amount of the increase or decrease as shown in
column (1)-(4), Line 6k should be the same as the sum of
the amounts in Section A, column (e) and (f) on Line 5.
Line 7-Enter the estimated amount of income, if any
expected to be generated from this project. Do not add or
subtract this amount. Show under the program narrative
statement the nature and source of income. The estimated
amount of program income may be considered by the
federal grantor agency in determining the total amount of
the grant.
Section C. Non-Federal Resources
Lines 8-11 Enter amounts of non-federal resources that
will be used on the grant. If in-kind contributions are
included, provide a brief explanation on a separate sheet.
Column (a) Enter the program titles identical to
column (a), Section A. A breakdown by function
or activity is not necessary.
Column (b) Enter the contribution to be made by
the applicant.
Column (c) Enter the amount of the State's cash
and in-kind contribution if the applicant is not a
State or State agency. Applicants which are a
State or State agencies should leave this column
blank.
Column (d) Enter the amount of cash and in-kind
contribution to be made from all other sources.
Column (e) Enter total of column (b ),( c), and (d).
Line 12-Enter the total for each of column (b )-( e). The
amount in column (e) should be equal to the amount on
Line 5, column (f) section A.
Section D. Forecasted Cash Needs
Line 13 Enter the amount of cash needed by quarter from
the grantor agency during the first year.
Line 14 -Enter the amount of cash from all other sources
needed by quarter during the first year.
Line 15 -Enter the totals of amounts on Lines 13 and 14.
Section E. Budget Estimates of Federal Funds Needed
for Balance of the Project
Lines 16-19-Enter in Column (a) the same grant program
titles shown in Column (a), Section A. A breakdown by
function or activity is not necessary. For new applications
and continuation grant applications, enter in the proper
columns amounts of Federal funds which will be needed to
complete the program or project over the succeeding
funding period (usually in years). This section need not be
completed for revisions (amendments, changes, or
supplements) to funds for the current year of existing
grants.
If more than four lines are needed to list the program titles,
submit additional schedules as necessary.
Line 20-Enter the total for each of the Column (b )-( e).
When additional schedules are prepared for this section,
annotate accordingly and show the overall totals on this
line.
Section F. Other Budget Information
Line 21-Use this space to explain amounts for individual
direct object class cost categories that may appear to be out
of the ordinary or to explain the details as required by the
Federal grantor agency.
Line 22-Enter the types of indirect rate (provisional,
predetermined, final or fixed) that will be in effect during
the funding period, the estimated amount of the base to
which the rate is applied, and the total indirect expense.
Line 23-Provide any other explanations or comments
deemed necessary.
ASSURANCES -NON-CONTRUCTION PROGRAMS
Public reporting burden for this collection of infonnation is estimated to average 15 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of infonnation. Send comments regarding the burden estimate or any other aspect of this collection of
infonnation, including suggestions for reducing this burden, to the Office of Management and budget, Paperwork Reduction
Project (0348-0040), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET,
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
NOTE: Certain of these assurances may not be applicable to your project or program, if you have questions, please contact the
awarding agency. Further, certain Federal-awarding agencies may require applicants to certify to additional assurances. If such
is the case, you will be notified.
As the duly authorized representative of the applicant I certify that the applicant:
1. Has the legal authority to apply for Federal assistance
and the institutional, managerial and financial
capability (including funds sufficient to pay the non-
federal share of project cost) to ensure proper
planning, management and completion of the project
describe in this application.
2. Will give the awarding agency, the Comptroller
General of United States, and if appropriate, the State,
through any authorized representative, access to and
the right to examine all record, books, paper, or
documents related to the award; and will establish a
proper accounting system in accordance with
generally accepted accounting standards or agency
directives.
3. Will establish safeguards to prohibit employees from
using their positions for a purpose that constitutes or
presents the appearance of personal or organizational
conflict of interest, or personal gain.
4. Will initiate and complete the work within the
applicable time frame after receipt of approval of the
awarding agency.
5. Will comply with the Intergovernmental Personnel
Act of 1970 (42 U. U. C. 4728-4763) relating to
prescribed standards for merit systems for programs
funded under one of the nineteen statutes or
regulations specified in Appendix A ofOPM's
Standards for a Merit System of Personnel
Administration (5 C. F. R. 900, Subpart F).
6. Will comply with all Federal statutes relating to
nondiscrimination. These include but are not limited
to: (a) Title VI of the Civil Rights Act of 1964 (P.L.
88-352) which prohibits discrimination on the basis of
race, color or national origin; (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), which prohibits discrimination on the basis of
handicaps; (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 Drug Abuse
Office and Treatment Act of 1972 (P. L. 92-255), as
amended, relating to nondiscrimination on the basis of
drug abuse; (t) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970 (P. L. 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) 523 and 527 of the Public Health
Service Act of 1912 (42 U. S. C. 290 dd-3 and 290 ee-
3), as amended, relating to confidentiality of alcohol
and drug abuse patient records; (h) Title VIII of the
Civil Rights Act of 1968 (42 USC. 3601 et seq), as
amended, relating to nondiscrimination in the sale,
rental or financing of housing; (I) any other
nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is
being made; and (j) the requirements of any other
nondiscrimination statute(s) which may apply to the
application.
7. Will comply, or has already complied, with the
requirements of Titles II and III of the Unifonn
Relocations Assistance and Real Property Acquisition
Policies Act of 1970 (P. L. 91-646) which provide for
fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal or
federally assistance programs. These requirements
apply to all interest in real property acquired for
project purposes regardless of Federal participation in
purchases.
8. Will comply, as applicable, with provisions of the
Hatch Act (5 U. S.C. 1501-1508 and 7324-7328)
which limit the political activities are funded in whole
or in part with Federal Funds.
9. Will comply, as applicable, with the provisions of 12. Will comply with the Wild and Scenic: Rivers Act
the Davis-Bacon Act (40 U. S. C. 276a to 276a-of 1968 (l6U.S.C. 1271 etseq.) related to
7), the Copeland Act (40 U. S. C. 276c and 18 U. S. protecting components or potential components of
C. 874), and the Contract Work Hours and Safety the national wild and scenic rivers system.
Standards Act (40 U. S. C. 327-333), regarding
labor standards for federally assisted construction 13. Will assist the awarding agency in assuring
sub agreements. compliance with section 106 of the National
10. Will comply, if applicable, with flood insurance Historic Preservation Act of 1966, as amended (16
purchase requirements of Section 1 02( a) of the U.S.C. 470), EO 11593 (identification and
Flood Disaster Protection Act of 1973 (P.L. 93-protection of historic properties) and the
234) which requires recipients in a special flood Archaeological and Historic Preservation Act of
hazard area to participate in the program and to 1974 (16 U.S.C. 469a-l et seq.).
purchase flood insurance if the total cost of 14. Will comply with P.L. 93-348 regarding the
insurable construction and acquisition is $10,000 or protection of human subjects involved in research,
more. development, and related activities supported by
11. Will comply with environmental standards which this award of assistance.
may be prescribed pursuant to the following: (a) 15. institution of environmental quality control Will comply with the Laboratory Animal Welfare
measures under the National Environmental Policy Act of 1966 (P.L. 89-544, as amended, 7 U.S.C.
Act of 1969 (P.L. 91-190) and Executive Order 2131 et seq.) pertaining to the care, handling, and
(EO) 11514; (b) notification of violating facilities treatment of warm blooded animals held for
pursuant to EO 11738; (c) protection of wetlands research, teaching, or other activities supported by
pursuant to EO 11990; (d) evaluation of flood this award of assistance.
hazards in floodplains in accordance with EO 16. Will comply with the Lead-Based Paint Poisoning 11988; (e) assurance of project consistency with Prevention Act (42 U.S.c. 4801 et seq.) which the approved State management program developed prohibits the use of lead based paint in construction under the Coastal Zone Management Act of 1972 or rehabilitation of residence structures. (16 U.S.C. 1451 et esq.); (f) conformity of Federal
actions to State (Clear Air) Implementation Plans 17. Will cause to be performed the required financial
under Section 176 (c) if the Clear Air Act of 1955, and compliance audits in accordance with the
as amended (42 U.S.C. 7401 et esq.); (g) protection Single Audit Act of 1984 or OMB Circular No. A-
of underground sources of drinking water under the 133, Audits ofInstitutions of Higher Learning and
Safe Drinking Water Act of 1974, as amended, other Non-profit Institutions.
(P.L. 93-523); and (h) protection of endangered 18. Will comply with all applicable requirements of all
species under the Endangered Species Act of 1973, other Federal laws, executive orders, regulations
as amended, (P.L..93-205). and policies governing this program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL Title
Steven J. Alexander City Manager
APPLICANT ORGANIZATION Date Submitted
City of South Miami
BUDGET INFORMATION -CONTRUCTION PROGRAMS
NOTE: Certain Federal assistance programs require additional computations to arrive at the Federal share of project costs eligible for participation. If such is the case
your will be notified
COST CLASSIFICATION a. Total Cost b. Costs Not Allowable for c. Total Allowable Costs (Column
Participation a-b)
1. Administrative and legal expenses
2. Land, structures, rights of way, appraisals, etc.
3. Relocation expenses and payments
4. Architectural and engineering fees
5. Other architectural and engineering fees
6. Project inspection fees
7. Site work
8. Demolition and removal
9. Construction
10. Equipment
11. Miscellaneous
12. SUBTOTAL (sum oflines 1-11)
13. Contingencies
14. SUBTOTAL
15. Project (program) income
16. TOTAL PROJECT COSTS (subtract # 15 from # 14)
FEDERAL FUNDING
17. Federal assistance requested, calculate as follows Enter eligible costs from line 16c Multiply X ___ %
(Consult Federal agency for Federal percentage share).
Enter resulting Feder&Share.
t"
INSTRUCTION FOR THE SF 424-C
Public reporting burden for this collection of infonnation is estimated to average 180 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of infonnation. Send comments regarding the burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction
Project (0348-0041), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET,
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
This sheet is to be used for the following types of applications: (1) "New" (means a new [previous Un-funded] assistance
award); (2) "Continuation" (means funding in a succeeding budget which stemmed from a prior agreement to fund); and (3)
"Revised" (means any changes in the Federal government's financial obligation or contingent liability from an existing
obligation). If there is no change in the award amount there is no need to complete this fonn. Certain Federal agencies may
require only an explanatory letter to the effect minor (no cost) changes. If you have questions please contact the Federal
agency.
Column a.-If this is an application for a "New" project,
enter the total estimated cost of each of the items listed on
lines 1 through 16 (as applicable) under "COST
CLASSIFICATIONS."
If this application entails a change to an existing award,
enter the eligible amounts approved under the previous
award for the items under" COST CLASSIFICATION'
Column b. If this is an application for a "New" project,
enter that portion of the cost of each item in Column a.
which is not allowable for Federal Assistance. Contact the
Federal agency for assistance in detennining the
allowability of specific costs.
If this application entails a change to an existing award,
enter the adjustment [ + or (-)] to the previously approved
eosts (from column a.) reflected in this application.
Column c. This is the net of line 1 through 16 in columns
"a" and "b".
Line \-Enter estimated amounts needed to cover
administrative expenses. Do not include costs which are
related to the nonna1 functions of government. Allowable
legal costs are generally only those associated with the
purchase of land which is allowable for Federal
participation and certain services in support of construction
of the project.
Line 2 -Enter estimated site and right(s) of way
acquisition costs (this includes purchase, lease, and/or
easements).
Line 3 -Enter estimated cost related to relocation advisory
assistance, replacement housing, and relocation payments
to displaced persons and businesses, etc.
Line 4 -Enter estimate basic engineering fees related to
construction (this includes start-up services and
preparation of project perfonnance work plan).
Line 5 -Enter estimated engineering costs, such as
surveys, tests, soil borings, etc.
Line 6 Enter estimated engineering inspection costs.
Line 7 -Enter estimated costs of site preparation and
restoration which are not included in the basic construction
contract.
Line 9 -Enter estimated cost of the construction contract.
Line \0 -Enter estimated cost of office, shop, laboratory,
safety equipment, etc. to be used at the facility, if such
costs are not included in the construction contract.
Line 11 -Enter estimated miscellaneous costs.
Line 12 -Total of items 1 through 11.
Line 13 -Enter estimated contingency costs. (Consult the
Federal agency for the percentage of the estimated
construction cost to use.)
Line 14 -Enter the total of lines 12 and 13.
Line 15 -Enter estimated program income to be earned
during the grant period, e.g. salvaged materials, etc.
Line 16 -Subtract line 15 from line 14.
Line 17 -This block if for the computation of the Federal
share. Multiply the total allowable project costs from line
16, column "c" by the Federal percentage share (this may
be up to 100 percent; consult Federal agency for Federal
percentage share) and enter the product on line 17.
ASSURANCES -CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. Send comments regarding the burden estate or any other aspect of this collection of
infonnation, including suggestions for reducing this burden, to the office of Management and Budget, Paperwork Reduction
Project (0348-0042), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET,
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
NOTE: Certain of theses assurances may not be applicable to your project or program. If you have questions, please contact
the Awarding Agency. Further, certain Federal assistance awarding agencies may require applicants to certify to additional
assurances. If such is the case, you will be notified.
As the duly authorized representative of the applicant I certify that the applicant:
1. Has the legal authority to apply for Federal assistance,
and the institutional, managerial and financial
capability (including funds sufficient to pay the non-
Federal share of project costs) to ensure proper
planning, management and completion of the project
described in this application.
2. Will give the awarding agency, the Comptroller
General of the United States, and if appropriate, the
State through any authorized representative, access to
and the right to examine all records, books, papers, or
documents related to the assistance; and will establish
a proper accounting system in accordance with
generally accepted accounting standards or agency
directives.
3. Will not dispose of, modify the use of, or change the
tenns of the real property title, or other interest in the
site and facilities without permission and instructions
from the awarding agency. Will record the Federal
interest in the title of real property in accordance with
awarding agency directives and will include a
covenant in the title of real property acquired in whole
or in part with Federal assistance funds to assure non-
discrimination during the useful life of the project.
4. Will comply with the requirements of the assistance
awarding agency with regards to the drafting, review
and approval of construction plans and specifications.
5. Will provide and maintain competent and adequate
engineering supervision at the construction site to
ensure that the complete work conforms with the
approved plans and specifications and will furnish
progress reports and such other infommtion as may e
required by the assistance awarding agency or State.
6. Will initiate and complete the work within the
applicable time frame after receipt of approval of the
awarding agency.
7. Will establish safeguards to prohibit employees from
using their positions for a purpose that constitutes or
present the appearance of personal or organizational
conflict of interest, or personal gain.
8. Will comply with the Intergovernmental Personnel
Act of 1970 (42 U.S.c. 4728-4763) relating to
prescribed standards for merit system for programs
funded under one of the nineteen statutes or
regulations specified in appendix A ofOPM's
Standards for a Merit System of Personnel
Administration (5 C.F.R. 900 Subpart F).
9. Will comply with the Lead-Based Paint Poisoning
Prevention Act (42 U.S.c. 4801 et seq.) which
prohibits the use of lead based paint in construction or
rehabilitation of residence structures.
10. Will comply with all Federal statues relating to non-
discrimination. These include but are not limited to:
(a) Title VI of the Civil Rights Act of 1964 (P.L. 88-
352) which prohibits discrimination on the basis of
race, color or national origin; (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) which prohibits discrimination of the basis of
handicaps; (d) the Age Discrimination Act of 1975, as
amended (42 U .S.c. 610 I -61 07) which prohibits
discrimination on the basis of age; (e) the Drug Abuse
Office and Treatment act of 1972 (P.L. 93-255), as
amended, relating to non-discrimination on the basis
of drug abuse; (f) the comprehensive alcohol Abuse
and alcoholism Prevention, Treatment and
Rehabilitation Act of 1970 (P.L. 91-616), as amended,
relating to nondiscrimination on the basis of alcohol
abuse or alcoholism; (g) 523 and 527 of the Public
Health Service Act of 1912 (42 U.S.C. 290 dd-3
and290 ee-3), as amended, relating to confidentiality
of alcohol and drug abuse patient record; (h) Title VIII
of the Civil Rights Act of 1968 (42 U.S.C. 3601 et
seq. ), as amended, relating to non-discrimination in
the sale, rental or financing of housing; (I) any other
non-discrimination provisions I the specific statute(s)
under which application for Federal assistance is
being made and (j) the requirements on any other non-
discrimination Statute(s) which may apply to the
application.
II. Will comply, or has already complied, with the
requirements of Titles II and III of the Unifonn
Relocation Assistance and real Property Acquisition
Policies Act of 1970 (P.L. 91-646) which provides for
fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal and
federally assisted programs. These requirements apply
to all interest in real property acquired for project
purpose regardless of Federal participation in
purchases
12. Will comply with the provisions of the Hatch Act (5
U.S.c. 1501-1508 and 7324-7328) which limit the
political activities of employees whose principal
e~ployment activities are funded in whole or in part
with Federal funds.
13. Will comply, as applicable, with the provisions of the
Davis-Bacon Act (40 US.c. 276a to 276a-7), the
Copeland Act (40 US.C. 276c and 18 U.S.C. 874),
The contract Work hours and safety Standards Act (40
U. S. C. 327-333) regarding labor standards for
federally assisted construction sub-agreements.
14. Will comply with the flood insurance purchase
requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires
~ecipients in a special flood hazard area to participate
In the program and to purchase flood insurance if the
total cost of insurable construction and acquisition is
$10,000 or more
15. Will comply with environmental standards which may
be prescribe pursuant to the following: (a) institution
of environmental quality control measures under the
National environmental policy Act of 1969 (P.L. 91-
190) and Executive Order (EO) 11514; (b) notification
of violating facilities pursuant to EO 11738; (c)
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
Steven J. Alexander
APPLICANT ORGANIZATION
City of South Miami
protection of wetlands pursuant to EO 11990; (d)
evaluation of flood hazard in floodplains in
accordance with EO 11988; (e) assurance of project
consistency with the approved State management
program developed under the Coastal Zone
Management Act of 1972 (16US.C. 1451 etseq.); (f)
conformity of Federal actions to State (Clean Air)
implementation Plans under Section I 76(c) of the
Clean Air Act of 1955, as amended (42 US.c. 7401 et
seq.); (g) protection of underground sources of
drinking water under the Safe Drinking Water Act of
1974, as amended, (P.L. 93-523); and (h) protection of
endangered species under the Endangered species Act
of 1973, as amended, (P.L. 93-205).
16. Will comply with the wild and scenic rivers act of
1968 (16 U.S.C. 1271 et seq.) related to protecting
components or potential components of the national
wild and scenic rivers system.
17. Will assist the awarding agency in assuring
compliance with section 106 of the National Historic
Preservation Act of 1966, as amended (16 U.S.C.
470), EO 11593 (identification and preservation of
historic properties), and the Archaeological and
Historic Preservation Act of 1974 (16 U.S.C. 469a-1
et seq.).
18. Will cause to be performed the required financial and
compliance audits in accordance with the single Audit
Act of 1984.
19. Will comply with all applicable requirements of all
other Federal laws, Executive Orders, regulations and
policies governing this program.
Title
City Manager
Date Submitted
OFFICE OF NATIONAL DRUG CONTROL POLICY
CERTIFICATIONS REGARDING LOBBYING, DEBARMENT, SUSPENSION AND OTHER
RESPONSIBILITY MATTERS; DRUG-FREE WORKPLACE REQUIREMENTS; FEDERAL
DEBT STATUS, AND NONDISCRIMINATION STATUS AND IMPLEMENTING REGULATIONS
Instructions for the certifications
General Requirements
The Office of National Drug Control Policy (ONDCP) is
required to obtain from all applicants' certifications
regarding federal debt status, debarment and suspension, and
a drug free workplace. Applicants requesting monies greater
than $100,000 in grants funds must also certify regarding
lobbing activities and may be required to submit a
Disclosure of Lobbying Activities" (Standard Form LLL).
Institutional applicants are required to certify that they will
comply with the nondiscrimination statues and
implementing regulations.
Applicants should refer to the regulations cited below to
determine the certifications 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 the form provides for compliance
with certification requirements under 21 CFR part 1405,
"New Restrictions on Lobbying" and 21 CFR part 1414,
Government wide Debarment and Suspension.
(Non procurement), Certification Regarding Federal debt
Status (OMB Circular A-129), and Certification Regarding
the Nondiscrimination Statutes and Implementing
Regulations. The certifications shall be treated as a material
representation of fact upon which reliance will be placed
when the Office of National Drug Control Policy determines
to award the covered cooperative agreement
1. LOBBYING
As required by Section 1352, Title 31 of the U.S. Code, and
implemented in 21 CFR part 1405, for persons entering into
a cooperative agreement over $100,000, as defined at 21
CFR Part 1405, 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 influencing or attempting to influence an officer or
employee of any agency, a member of Congress, and
officer or employee of Congress, or an employee of a
Member of Congress in connection with the making of
any Federal grant, the entering into 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 being paid to any person for
influencing or attempting to influence 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
certification be included in the award document for all
sub-awards at all tiers (including sub-grants, contracts
under grants and cooperative agreements, and
subcontracts) and that all sub-recipients shall certify and
disclose accordingly.
2. DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTER (DIRECT RECIPIENT)
As required by Executive Order 12549, Debarment and
Suspension and implemented at 21 CFR Part 1404, for
prospective participants in primary covered transactions
A. The applicant certifies that it and its principals:
(a) Are not presently debarred, suspended, proposed for
debarment, 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
application been convicted of or and a civil judgment
rendered against them for commission of fraud or a
criminal offense in connection with obtaining,
attempting to obtain or perfonning a public (Federal,
State, or local) transaction or contract under a public
transaction' violation of Federal or State antitrust
statures 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 0 otherwise criminally or
civilly charged by a governmental entity (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 the application.
2. DRUG-FREE WORKPLACE (GRANTEES
OTHER THAN INDIVIDUALS)
As required by the Drug Free Workplace Act of
1988, and implemented at 21 CFR Part 1404
Subpart F.
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
applicant's workplace and specifying the actions that will be
taken against employees for violations of such prohibition;
(b) Establishing an on-going drug free awareness program to
inform employees about
(I) The dangers of drug abuse in the workplace;
(2) The applicant'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 violation occurring in the workplace;
(d) Making it a requirement that each employee to be
engaged in the performance of the grant be given a copy
of the statement required by paragraph (a);
(e) Notifying the employee in the statement required by
paragraph (a) that, as a condition of employment under
the grant, the employee will
(I) 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:
(t) Notifying the agency, in writing, within 10 calendar
days after receiving notice under subparagraph (d)(2)
form an employee or otherwise receiving actual notice
of such convictions. Employers of convicted employees
must provide notice including position title, to: The
Assistance Center, 840 I Northwest 53rd Terrace, suite
200, Miami, Florida 33166. Notice shall include the
identification number of each affected grant;
(g) Taking one of the following actions within 30 calendar
days of receiving notice under subparagraph (d)(2), with
respect to any employee who is so convicted-
(I) Taking appropriate personnel action against such an
employee, up to and including termination, consistent
with the requirements of the Rehabilitation Act of 1973,
as amended; or
(2) Requiring such employee to participate satisfactorily in
a drug abuse assistance or rehabilitation program
approved for such purposes by a Federal State, or local
health, law enforcement, or other appropriate agency;
(h) Making a good faith effort to continue to maintain a
drug free workplace through implementation of
paragraphs (a), (b), (c), (d), (e), and (t).
B. The applicant may insert in the space provided
below the site(s) for the performance of work done
in connection with the specific cooperative
agreement:
Place of Performance (street address, city, country, state,
zip code)
City of South Miami
Check D ifthere are workplaces on file that are not
identified here.
The regulations provide that a recipient that is a State may
elect of make one certification in each Federal fiscal year.
A copy of which should be included with each application
for ONDCP Funding.
DRUG FREE WORKPLACE (RECIPIENTS WHO
ARE INDIVIDUALS)
As required by the Drug Free Workplace Act of 1988, and
implemented at 21 CFR Part 1404 Subpart F.
A. as a condition of the cooperative agreement, I certify
that I will not engage in the unlawful manufacture,
distribution, dispensing, possession, or use of a
controlled substance in conduction any activity with the
grant; and
B. If convicted of a criminal drug offense resulting form a
violation occurring during the conduct of any grant
activity, I will report the conviction in writing, within
10 calendar days of the conviction, to: The Assistance
Center, 8401 Northwest 53rd Terrace, Suite 208, Miami,
Florida 33166.
4. CERTIFICATION REGARDING FEDERAL
DEBT STATUS (OMB Circular A-129)
The Applicant certifies to the best of its knowledge and
belief, that it is not delinquent in the repayment of any
federal debt.
5. CERTIFICATION REGARDING THE
NONDISCRIMINATIN STATUTES AND
IMPLEMENTING REGULATIONS
The applicant certifies that it will comply with the following
nondiscrimination statues and their implementing
regulations: (a) title VI of the Civil right Act of 1964 (42
U.S.c. 2000D et seq.) which provides that no person in the
United States shall, on the ground of race, color, or national
origin, be excluded from participation in, be denied the
benefits of or be otherwise subjected to discrimination under
any program or activity for which the applicant received
federal financial assistance; (b) Section 504 if the
rehabilitation Act of 1973, as amended (29 U.S.C. 794),
which prohibits discrimination on the basis of handicap in
programs and activities receiving federal financial
assistance; (c) title IX of the Education Amendments of
1972m as amended (20 U.S.C. 1981 et seq.) which prohibits
discrimination on the basis of sex in education programs and
activities receiving federal financial assistance; and (d) the
Age Discrimination Act of 1975, and amended (42 U.S.C.
6101 et seq.) which prohibits discrimination on the basis of
age in programs and activities receiving federal financial
assistance, except that actions which reasonably take age
into account as a factor necessary for the normal operation
or achievement of any statutory objective of the project or
activity shall not violate this statute
As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications.
Grantee Name and Address: City of South Miami
6130 Sunset Drive
South Miami, FL 33143
Application Number and/or Project Name: G13MI0005A
Grantee IRSlVendor Number:
Type Name and Title of Authorized
Representative:
5. Signature:
Management and
Coordination
1596000431 A 1
Steven J. Alexander
City Manager
6. Date:
1.
4.
6.
8.
10.
H.
12.
14.
15.
16.
Type of Federal Action:
EJ a. contract
b. grant
c. cooperative agreement
d. loan
e. loan guarantee
f. loan insurance
DISCLOSURE OF LOBBYING ACTIVITIES
Complete this form to disclose activities pursuant to 31 U.S.C. 1352
(See reverse for public burden disclosure)
2. Status of Federal Action 3.
EJ a. bid/offer/application
b. I nitial award
e. post-award
Report Type
EJ a. Initial filing
b. material change
For Material Change only
Year: --Quarter: __
Date of last report:
Name and Address of reporting Entity 5. If reportiug entity in No.4 is Subawardee, Enter name
and address of Prime: o Prime D Subawardee
Tier _ ,ifuknolVn:
City of South Miami
6130 Sunset Drive
South Miami, FL 33143
Congressional District, ifknolVn Congressional District, ifknolVn
Federal Department/Agency: 7. Federal Program NamelDescription:
ONDCP HIDTA
Federal Action Number, if known 9. Award Amount, if known
G13MI0005A $162,312.00
a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if
(if individual, last name, first name, MI) (if individual, last name, first name, MI) different from No. lOa)
last name, first name, MI)
None None
(attach Continuation Sheet (s) SF-LLL-A, if necessary)
Amount of Payment (check all that apply): 13. Type of Payment (check all that apply):
$ N/A actual planned --a. retainer -b. one-time fee --
Form of Payment (check all that apply): --c. commission
--d. contingent fee
-a. cash e. deferrcd --_ b. in-kind; specify: nature f. other; specify: --value
Brief Description of Services Performed or to be Performed and Date(s) of Service, including officer(s), employee(s), or Member(s) contacted, for
Payment indicated in Item H:
HIDT A Related Initiatives
(attach Continuation Sheet (s) SF-LLL-A, if necessary)
Continuation Sheet(s) SF-LLL-A atached: Yes ~ No --
Information requested through this form is authorized by title 31 U.S.c. Signature: section 1352. This disclosure oflobbying activities is a material
representation of fact upon which reliance was placed by the tier above Print Name: Steven J. Alexander when this transaction was made 0 entered into. This disclosure is requested
pursuant to 31 U.S.c. 1352. This information will be reported to the
Congress semi-annually and will be available for public inspection. Any Title: City Manager
person who fails to file the required disclosure shall be subject to a civil
penalty of not less than $10,000 and not more than $100,000 for each such Telephone No.:
failure.
Date:
Federal Use Only: Authorized for local reproduction
Standard Form -LLL