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Exhibit C <br />page 2 of 2 <br />The grantee certifies that it will or will continue to provide a drug-free workplace by: <br />a) Publishing a statement notifying emcioyess that the unlawful manufacture, distribution. <br />dispensing, possession, or use of a controlled substance is prohibited in the grantee's <br />workplace and specifying the actions that will be taken against employees for violation of <br />such prohibition: <br />b) Establishing an ongoing drug-free awareness program to inform employees about — <br />11 The dangers of drug abuse in the workplace: 2) The grantee's policy of maintaining <br />a drug-free workplace: 31 Any available drug counseling, rehabilitation, and empioyee <br />assistance programs: and 41 The penalties that may be imposed upon employees for <br />drug abuse violations occurring in the workplace: <br />c) Making it a requiremem that each employee to be engaged In the performance of the grant <br />be given a copy of the statement required by paragraph (a): <br />d) Notifying the employee in the statement required by paragraph (a) that, as a condition of <br />employment under the gram. the employee will — <br />1) Abide by the tams of the statement: and 21 Notify the employer in writing of his or <br />her conviction for a violation of a criminal drug statute occurring in the workplace no <br />later than five calendar days after such conviction: <br />e) Notifying the agency in writing, within tan calendar days after receiving notice under <br />paragraph (d)(2) from an employee or otherwise receiving actual notice of such conviction. <br />Employers of convicted employaes must provide notice, including position title, to every <br />gram officer or other designee on whose gram activity the convicted employee was <br />working, unless the Federal agency has designated a central point for the receipt of such <br />notices. Notice shall include the identification number(al of each affected gram <br />f) Taking one of the following actions, within 30 calendar days of receiving notice under <br />paragraph (d)(2), with respect to any employee who is to convicted: <br />11 Taking appropriate personnel action against such an employee, up to and including <br />to.. motion. consistent with the requirements of the Rehabilitation Act of 1973, as <br />amended: or 21 Requiring such employee to participate satisfactorily in a drug abuse <br />assistance or rehabilitation program approved for such purposes by a Federal, State, or <br />local health, law enforcement, or other appropriate agency: <br />g) Making a good faith effort to continue to maintain a drug-free workplace through <br />implementation of paragraphs lei, (b), (c). (d), lei and Ifl. <br />The grantee may insert in the space orovided below the site(s) for the performance of work done in <br />connection with the spudic gram fuse attachments if neededl: <br />Place of Performance (Street address. city, county, state, zip code) <br />Check_ if there are workplaces on file the are not idsmified here. <br />.—>NOTE-. Sections 76.430(cl and fdl(21 and 76.035(a)(1) and (bl provide that a Federal agency <br />may designate a central recmot point for STATE-WIDE AND STATE AGENCY -WIDE certifications, <br />and for notification of criminal drug convictions. For HHS. the central receipt point is Division of <br />Grants Management and Overnight. Office of Management and Acquisition. HHS, Room 517-D. <br />200 Independence Ave. S.W.. Washington, D.C. 20201 <br />Signature Dap <br />Title Organization <br />