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COM 0472.000 2002-2004
Jattl Os y,~ Harry Kim ~Li%cJ William Takaba Mayor Director rs Nancy E. Crawford ar,T' ~.ow~'e~ Deputy Director ~ OF'MA C®u~~~ ~avvaii Finance Department 25 Aupuni Street, Room 118 • Hilo, Hawaii 96720 (808)961-8234 • Fax 808 961-8248 ~ ~ G N A ~ °v January 22, 2004 , ~ , ~ ..-r';;-~ N Honorable James Arakaki, Chairperson and a Members of the County Council Hawaii County Council 25 Aupuni Street Hilo, Hawaii 96720 Re: Hawaii Island Meth Initiative -COPS Grant The Hawaii Island Meth Initiative is a joint effort of U.S. Senator Daniel K. Inouye, the Hawaii Community Foundation, and the County of Hawaii. This cooperative effort is in response to the overwhelming concern of the community to the devastating effect that ICE or crystal methamphetamine is having on our children, our families, and our communities. This initiative is the result of years of community planning, community mobilization, and the commitment of resource providers to work together to heal our Island. In February of 2003, US Senator Danie! K. Inouye successfully earmarked $3.9 million dollars for the Hawaii County Meth Initiative. These monies were put into the budget of the U.S. Department of Justice and assigned to the Community Oriented Policing Services (COPS) agency. The Hawaii Community Foundation (HCF) was designated by Senator Inouye as the recipient of the COPS grant. This was based on three factors: 1) Grant managerial experience with large, complex, federal grants; 2) A history of commitment to community programs and social services; and 3) A reputation for integrity and fiscal responsibility managing multiple funding projects. HCF has worked closely with the Office of the Mayor and with the Hawaii Island community to implement this Hawaii Island Meth Initiative. The monies were focused on three primary areas: Enforcement, Treatment, and Prevention. The goal was to improve our community capacity to effectively address the problems posed by ICE. This meant addressing-:gap areas-and prioritizing funding issues based on areas of greatest need. It also meant trying to equitably distribute these monies to the three primary areas. The recommendations from the Meth Summit, input from multiple community meetings, and statistics and data indicating areas of greatest concern were important in establishing funding priorities. Res. o~~_~¢ Rif. T®: Il ~.l $ Rif. C~sate r ai Honorable James Arakaki, Chairperson Page 2 January 22, 200 Three county agencies were identified as being able to effectively utilize these resources to immediately impact the ICE problem: The Hawaii County Police Department (HCPD), The Office of the Prosecuting Attorney (OPA), and The Hawaii County Resource Center (HCRC), that is under the County's Department of Research and Development. HCPD and the OPA were critical components in the area of Enforcement and the HCRC was identified as being an important component in the area of Prevention. The respective county agencies and HCF have been working closely together for many months to ensure that the scope of work and the budget requests conform to the requirements of the COPS grant. The breakdown of the Hawaii Island Meth Initiative are as follows: Enforcement - $900,000; Treatment - $1,500,000; Prevention - $1,500,000. The HCPD and OPA budgets are included in the enforcement areas along with the costs for the establishment of a juvenile drug court. The treatment budget includes monies for the establishment of an adolescent residential treatment program and for a treatment fund for service providers to expand treatment options for Island residents. The prevention budget includes monies for the community and service providers to conduct prevention and education activities focusing on our youth and our families Island-wide. The Hawaii Island Meth Initiative funding is for a period of one year. U.S. Senator Inouye has included a second year of funding for this initiative that has been approved by the US Senate and is awaiting final budget approval from the U.S. Congress and the President. It is anticipated that the second year of funding will not be less than $2 million dollars for Island of Hawaii. The Office of the Mayor will continue working closely with the HCF, U.S. Senator Daniel K. Inouye, the County Council, our State Legislators, the Governor's Office, and the Community to ensure that our Island continues to receive support in its effort to combat the adverse effects of ICE. This initiative is just another small step in that effort. Hopefully, as we continue to work closely together, we will be able to make a difference in the lives of our children and our families. Enclosed are 3 separate resolutions authorizing the Mayor to enter into an agreement with the Hawaii Community Foundation for the Hawaii Island Meth Initiative -COPS Grants for the Hawaii County Police Department, the Office of the Prosecuting Attorney, and the Department of Research and Development. Also enclosed is a bill for an ordinance amending the Operating Budget by appropriating the Hawaii Island Meth Initiative -COPS Grant funds awarded to each of the aforementioned Departments by the -HCF. Honorable James Arakaki, Chairperson Page 3 January 22, 2004 If there are any questions, please do not hesitate to call Mr. Billy Kenoi of the Mayor's Office. , William Takaba Director of Finance APPROVED: 6~~~ Harry Kim Mayor Enc. cc: Billy Kenoi, Police, Prosecuting Attorney, R & D GRANT` SUMMARY (Su lenient to 8-52, Re oast for C®uncil Action) T e of Grant A ro riation bein re uested: ew or an additional a ro riation ® New (for this fiscal year period). Olt ? Additional appropriation (to an existing grant); Is a draft agreement attached? Has the original grant notification been transmitted to Yes ? No Council? ? Yes ? No Name of Grant Program: Community Oriented Policing Services Grantor: U.S. Department of Justice -through the Ilawai`i Community Foundation County Grantee Department or Agency: Police, Prosecutors, and Research & Development County Grantee Contact Person: Billy Kenoi Phone Number: x8316 Amount of Grant: $827,392 Grant Period (Commencement & Completion): March 8, 2004 -March 7, 2005 Purpose of Grant: Improve the community's capacity to effectively address the problems posed by ICE. This goal will be focused on three primary areas: Enforcement, Treatment, and Prevention. County Match required?: ? Yes ®No If yes, Matching Amount? Budgeted in account# In-kind? Explain: Explanation: County's personnel requirements: Amount of new position(s)? Qty: Permanent: ? Temporary: Duration: Full-time: ? Part-time: Time Element: Qty: Contractual: ? Explain: Explanation: Additional Comments about Grant: Part of the Ilawai`i Island Meth Initiative - Attached is Billy Kenoi's letter requesting council action on these grant awards. In anticipation of extra funding from IICF, Prosecutor's appropriation is $16,733 more than its award amount. B-52 Grant Summary Form J~tv of ~°!!a~ o.• . t Harry Kim Dixie Kaetsu Mayor a; ; • Managing Director t~'_. 8t~ - Na M; OTC TE OR°NA~pI Peter. L. Hendricks COUNTY OF HAWAII Deputy Managing Director 25 Aupuni Street, Room 215 • Hilo, Hawaii 96720-4252 • (808) 961-8211 • Fax (808) 961-6553 KONA: 75-5706 Kuakini Highway, Suite 103 • Kailua-Kona, Hawaii 96740 (808) 329-5226 • Fax (808) 326-5663 January 21, 2004 TO: Bill Takaba, Finance Director FROM: Billy Kenoi, Mayor's Office RE: C.O.P.S. / H.C.F. -Hawaii Island Meth Initiative The Hawaii Island Meth Initiative is a joint effort of U.S. Senator Daniel K. Inouye, the Hawaii Community Foundation, and the County of Hawaii. This cooperative effort is in response to the overwhelming concern of the community to the devastating effect that ICE or crystal methamphetamine is having on our children, our families, and our communities. This initiative is the result of years of community planning, community mobilization, and the commitment of resource providers to work together to heal our Island. In February of 2003, US Senator Daniel K. Inouye successfully earmarked $3.9 million dollars for the Hawaii County Meth Initiative. These monies were put into the budget of the US Department of Justice and assigned to the Community Oriented Policing Services (COPS) agency. The Hawaii Community Foundation (HCF) was designated by Senator Inouye as the recipient of the COPS grant. This was based on three factors: 1) Grant managerial experience with large, complex, federal grants; 2) A history of commitment to community programs and social services; and 3) A reputation for integrity and fiscal responsibility managing multiple funding projects. HCF has worked closely with the Office of the Mayor and with the Hawaii Island community to implement this Hawaii Island Meth Initiative. The monies were focused on three primary areas: Enforcement, Treatment, and Prevention. The goal was to improve our community capacity to effectively address the problems posed by ICE. This meant addressing gap areas and prioritizing funding issues based on areas of greatest need. It also meant trying to equitably distribute these monies to the three primary areas. The recommendations from the Meth Summit, input from multiple community meetings, and statistics and data indicating areas of greatest concern were important in establishing funding priorities. Three county agencies were identified as being able to effectively utilize these resources to immediately impact the ICE problem: The Hawaii County Police Department (HPD), The Office of the Prosecuting Attorney (OPA), and The Hawaii County Resource Center (HCRC). HPD and the OPA were critical components in the area of enforcement and the HCRC was identified as being an important component in the area of Prevention. The respective county agencies and HCIm have been working closely together for many months to ensure that the scope of work and the budget requests conform to the requirements of the COPS grant. The Breakdown of the Hawaii Island Meth Initiative are as follows: enforcement - $900,000; Treatment - $1,500,000; Prevention - $1,500,000. The HPD and OPA budgets are included in the enforcement areas along with the costs for the establishment of a juvenile drug court. The treatment- budget includes monies for the establishment of an adolescent residential treatment program and for a treatment fund for service providers to expand treatment options for Island residents. The prevention budget includes monies for the community and service providers to conduct prevention and education activities focusing on our youth and our families Island-wide. The Hawaii Island Meth Initiative funding is for a period of one year. US Senator Inouye has included a second year of funding for this initiative that has been approved by the US Senate and is awaiting final budget approval from the US Congress and the President. It is anticipated that the second year of funding will not be less than $2 million dollars for Hawaii Island. The Office of the Mayor will continue working closely with the HCF, US Senator Daniel K. Inouye, the County Council, our State Legislators, the Governor's Office, and the Community to ensure that our Island continues to receive support in its effort to combat the adverse effects of ICE. This initiative is just another small step in that effort. Hopefully, as we continue to work closely together, we will be able to make a difference in the lives of our children and our families. Please initiate the paperwork for the County to accept and appropriate these funds. HAWAII POLICE DEPARTMENT HAWAII COMMUNITY FOUNDATION GRANT SCOPE OF WORK : DESCRIPTION OF PROTECT PROJECT Addressing the Crystal 1Vlethanaphetanune "ICE" Problem in Hawaii County AWARD 5525,912 PROBLEM STATEMENT: It is well documented that a large and growing drug demand exists in the County of Hawaii. Crystal Methamphetamine continues to lead as the drug of choice for many users. A highly addictive drug, Crystal Methamphetamine has provided suppliers and distributors with a large and profitable market. The increased supply and demand for crystal methamphetamine or "ice," in the County of Hawaii is a continuous threat to the safety and welfare of the general public, therefore, a primary law enforcement concern. We continue to see a rise in the number of narcotic related arrests, especially for the possession and distribution of "ice." Arise in the number of organized groups involved in the trafficking of narcotics is also evident. There are documented accounts or incidents that have taken place, whereby crimes of violence have occurred due to the involvement of narcotics. The local media, elected officials and members of the public have repeatedly stated that the abuse of crystal methamphetamine or "ice" on the Big Island has reached epidemic levels. The Mayor of the County of Hawaii, Harry Kim, has publicly declared "war" on "ice." With the noticeable increase in availability of crystal methamphetamine ("ice") on the island of Hawaii, a concentrated effort in addressing the trafficking of narcotics through airports is vital to the success of confronting the "ice" epidemic. Through information gathered and past investigations, we have determined that the majority of "ice" and other hard drugs are being smuggled through the airports by means of passengers or parcel services. As a result, The Hawaii Police Department has established two Ice task force units, one in East Hawaii and one in West Hawaii along with two dedicated telephone lines ("Ice" Hotline) for use by the public for reporting of crystal methamphetamine possession and or distribution. The three man Ice Task Force unit's primary goal is to identify, dismantle, disrupt, arrest, and prosecute street, mid and upper level drug trafficking organizations and organized crime groups involved in methamphetamine distribution, methamphetamine manufacturing, and money laundering. Our efforts have disrupted the activities of several organizations in the County of Hawaii and have led other organizations to alter their operations. Feedback from community groups indicates that enforcement efforts mitigated their concern of blatant drug activity occumng in their neighborhood. In addition to our enforcement program, in response to numerous requests from the community, school officials and businesses, task force personnel continue to maintain a drug prevention and educational program. During 2003, the Hawaii Police Department during Joint Task Force Operations recovered 16.67 pounds of Crystal Methamphetamine, conducted 631 methamphetamine related investigations and arrested 394 individuals. The results of these types of investigations were achieved only through additional manpower and federal support with a primary focus on crystal methamphetamine. ~5. ~ ~5- ~ `I' HAWAII COMlO~IUNITY FOUNDATION GRANT Addressing the Crystal 1Vlethamphetamine "ICE" Problem in Ilawai'i County Page 2 Pit®GRAIdI DETAILS Funds obtained through the Hawai' i Community Foundation Grant will be utilized for salaries and wages for additional personnel to supplement the two established "ICE Task Force" Units, creating a "Keahole Airport Drug Smuggling" Unit, and two utility vehicles for use by these units. ICE TASK FORCE UNTI' PERSONNEL -Creating four additional Police Officer III positions that will be assigned to the established ICE Task Force Units in East and West Hawaii. Each unit will obtain two of these positions to supplement their current compliment of (1) Police Detective and (2) Police Officer IIIs. The additional personnel assigned to each of the established "ICE Task Force" Units will be instrumental in dealing with the increase in established dealers of crystal methamphetamine. These additional personnel will allow these units to expand their current operations that have proven successful in dismantling, disrupting, arresting, and prosecuting street mid and upper level drug trafficking organizations and organized crime groups involved in methamphetamine distribution, methamphetamine manufacturing, and money laundering. KEAHOLE AIRPORT DRUG SMUGGLING UNIT - Establishing a specialized "Airport Smuggling Detail" comprised of a Police Detective/Sergeant and two (2) Police Officer III positions that will be assigned to the Area II Vice Section in West Hawaii, under the command of the Vice Lieutenant. This specialized unit will be responsible for interdicting "ice" as well as other hard drugs that are being smuggled through the Keahole International Airport from source cities such as Los Angeles, San Francisco, San Diego, and Las Vegas. The unit will also be assisting in investigating arriving flights from source countries such as Japan, Philippines, Canada, and Mexico as well as monitoring private aircrafts arriving from different areas. In addition to the arrival and departure of flights, this smuggling unit will also be monitoring the various parcel services and freight companies located at the airport and other locations in the West Hawaii area. In conjunction with investigating narcotics interdiction cases, the unit will also work with the Ice Task Force and Vice Section of both East and West Hawaii in furthering narcotics investigations throughout the County of Hawaii. It is anticipated that with this combined effort in addressing the smuggling aspect of drug interdiction, there will be a decrease in the availability of "ice" and other hard drugs on the Island of Hawaii. VEHICLES -Purchasing two utility vehicles for use by the established "ICE Task Force" Units in East and West Hawaii during search warrant raids and daily operations. Very often, the rural roads, which are commonplace on the Big Island creates logistical problems when too many police vehicles have to be utilized. The vehicles will be equipped with storage containers/lockers for securing evidence as well as "raid" kits and other tools that may be needed during the execution of search warrants. Vehicles will also be available to transport members of the departments Special Response Team Tactical Unit, that assist in executing search warrants during high risk situations as it relates to the violence associated with crystal methamphetamine use. IIA~VAII COMMUNITY FOUNDATION GRANT Addressing the Crystal Methamphetamine "ICE" Problem in Ilawai i County Page 3 GOALS The Ice Task Force Unit's primary goal is to identify, dismantle, disrupt, arrest, and prosecute street, mid and upper level drug trafficking organizations and organized crime groups involved in methamphetamine distribution, methamphetamine manufacturing, and money laundering. The Keahole Airport Smuggling Unit's primary goals are to identify, arrest, and prosecute individuals who attempt to smuggle crystal methamphetamine and other narcotics into and out of the County of Hawaii. O)~JECTIVES ICE TASK FORCE 1. Maintain two Ice Task Force Units in operation in East & West Hawaii, consisting of personnel from the Hawaii County Police Department. 2. Meet Monthly to coordinate joint operations and training, as well as other enforcement efforts and to share information. 3. Seize a minimum of 2.2 pounds of crystal methamphetamine. 4. Make a minimum of 400 methamphetamine related arrests. 5. Seize assets for forfeiture, as applicable. 6. Monitor and follow up on tips received on the "Ice" Hotline. KEAHOLE AIRPORT SMUGGLING UNIT' S 1. Maintain a narcotics smuggling unit consisting of one Police Detective/Sergeant and two Police Officer III positions. 2. Meet monthly to coordinate joint operations and training, as well as other enforcement efforts and to share information. 3. Increase the number of airport interdiction cases by 15 percent. 4. Seize assets for forfeiture, as applicable. IIAWAII COMMUNITY FOUNDATION GRANT Addressing the Crystal Methamphetamine "ICE" Problem in Ilawai i County Page 4 ACTIVITIES ICE TASK FORCE 1. Investigative efforts will be directed towards the identification and arrest of individuals possessing and or distributing crystal methamphetamine. 2. In furtherance of the task force concept, the Hawaii Police Department's Ice Task Force will participate and assist in interagency investigations involving crystal methamphetamine. 3. Ice task force personnel will attend monthly meetings in order to share current information and to coordinate joint operations as well as other enforcement efforts. 4. Training of personnel is an essential component to the Ice task force. Training will include attending conferences and workshops on topics that will be instrumental in increasing the attendee's knowledge and work performance. Training will also familiarize the Ice task force officers with current and up-to-date trends of various crystal methamphetamine concerns and investigative techniques. KEAHOLE AIItPORT SMUGGLING UNIT 1. Investigative efforts will be directed towards the identification and arrest of individuals smuggling crystal methamphetamine and other narcotics into and out of the County of Hawaii. 2. Participate and assist in inter-agency investigations involving crystal methamphetamine. 3. Smuggling Detail personnel will attend monthly meetings in order to share current information and to coordinate joint operations as well as other enforcement efforts. 4. Training of personnel is recognized as an essential component for these types of investigations; therefore, training will include attending conferences and workshops on topics that will be instrumental in increasing the attendee's knowledge and work performance. Training will also familiarize officers with current and up-to-date trends of various crystal methamphetamine concerns and investigative techniques BUDGET DETAILS (Refer to Attachment 1) 1. Two (2) Police Officer III positions Area I ICE Task Force $128,739 (Approximate cost is $64,369 per position) (Cost includes salaries/wages, auto allowance, and fringe benefits). 2. Two (2) Police Officer III positions Area II ICE Task Force $128,739 (Approximate cost is $64,369 per position) (Cost includes salaries/wages, auto allowance, and fringe benefits). HAWAII COMMUNITY FOUNDATION GRANT Adeiressing the Crystal Methamphetamine "ICE" Problem in Havvai i County Page 5 3. One (1) Police Detective/Sergeant, Keahole Airport Unit $ 73,195 (Approximate cost is $73,195 per position) (Cost includes salaries/wages, auto allowance, and fringe benefits). 4. Two (2) Police Officer III positions Keahole Airport Unit $128,739 (Approximate cost is $64,369 per position) (Cost includes salaries/wages, auto allowance, and fringe benefits). 5. Eight (8) Passenger Van for Area I ICE Task Force $ 31,500 6. Four-door SUV for Area II ICE Task Force $ 35,000 TOTAL $525,912 TIMELINE The additional positions being funded through this program for the Ice Task Force, will be in operation by June 1, 2004 and the positions for the Keahole Airport Smuggling Unit will be in operation by August 1, 2004. The Lieutenant assigned to each of the Vice Sections in Area I and II, shall record monthly data, and oversee efforts and methods used to achieve the goals and objectives, and arrive at conclusions as to the success/failure or need for alterations. PERFORMANCE INDICATORS 1. The number of persons arrested for narcotics offenses involving possession, distribution and smuggling of crystal methamphetamine; 2. The quantity and value of crystal methamphetamine seized; 3. The type, amount and value of assets seized for forfeiture; 4. The number of officers trained and types /dates of training received; 5. The dates of monthly Ice task force meetings attended; SUMMARY REPORTING The Hawaii Police Department to submit quarterly reports to the Hawaii Community Foundation containing statistical data relating to Performance Indicators. HAiNAII POLICE ®EPARTIUIENT 4~A11VAll COIIAIVIUNITY FOUN®ATION GRANT Attachment 1 Salaries & Wac,~es for Detective/Sergeant 51 744 Retirement a~ 7%_x $51,744. _ _ _ $ _ 3,622 Medicare Tax a~ 1.45% x $51,744 $ 750 _ _ _ _ Work Comp ~ 4.28% x $51,744 $ 2_,215_ Unemployment ~ .25% x $51,744 $ 129_ Medica! Famil $420 X 12 Months Y~ - 5,040 Dental_(Family) $50 x 12 Months $ 600 Vision (Family) $8 x 12 Months $ 96 Life Ins $4 x 12 Months _ 48 SOLD $85 x 12 Months $ 1,020 Car ABlowance $450 x 12 Months I $ 5,400 Car Insurance ; $ 1,960 Uniform &_Equipment , $ 571 Total $ 73,195 Salaries & Wades for Police OfFicer III $ 43,932 Retirement car 7% x $43,932.___.. _ - _ _ $ ___.______3,075 Medicare Tax 1_.45% x $43,932 _637 _ _ Work Comp a~ 4.28% x $43,932 _ 1_$ _ _1__,880 Unemployment a~_.25% x $43,932 _ _ 110 Medical (Family) $420 X 12 Months ~ _ 5,040 _ _ - _ Dental (Family) $50 x 12 Months $ 600 _ Visoon (Fami~i $8 x 12 Months $ _ 96 _ _ _ _ _ _ Life Ins $4 x 12 Months $ 48 _ _ _ _ SOCD $85 x 12 Months ' $ 1,020 Car Allowance $450 x 12 Months $ 5,400 Car Insurance ; $ 1,960 Uniform & Equipment ~ 571- . _ - _ Total $ 64,369 - _ - For 2 PO III Positions $ 128,739 _ _ _ _ - _ - _ _ - i - - - _ _ _ . t - - _ HAdNAII P®LICE ®~PAIZTIVIE~IT O~A10WAll COIlAIVIUIVITY I°~UNDATI®N (~I~AIVT Attachment 1 _ ~U®C~T ~I~EAI4D®Vi4f~ - (2) PO III Positions Area I Ice Task Force @ $64,398 per officer (Cost includes salaries/wages, auto allowance, and fringe benefits) I $ 128,739 (2) PO IlI Positions Area I Ice Task Force @ $64,398 per officer (Cost includes salaries/wages, auto allowance, and fringe benefits) $ 128,739 (1) Police Det/Sgt, Keahole Airport Unit @ $73,244 (Cost includes salaries/wages, auto allowance, and fringe benefits) $ 73,195 _ _ (2) PO III Positions Keahole Airport Unit @ $64,398 per officer (Cost includes salaries/wages, auto allowance, and fringe benefits) , $ 128,739 - _ Eight (8) Passenger Van for Area I ICE Task Force $ 31,500 - - - Four-door SUV for Area II ICE Task Force $ 35,000 - TOTAL, ~ $ 525,912 ~~„I 808521628 t-516 P.02 F-185 Jan-21-04 04:50am From°HAWAII C0: ~N1TY FOUHOATIOH Several provisions of federal saw and policy apply to ap grant progrstri~ Vlk (the Offset of Communrty Glriematd - iayg Services) need to secure your assurance the the appGcana w.ili comply with these provisions. 1f you would ffikc further infoatnaeiort a ut any of these assurances, okras eontar.r your scare's CQpS Grant Paograrat Specialist at {800f) 421-6770. . $y the applicant's authorized represeneative's signature, yht applicar4 assures That it will comply gsritia all legal sad a rive rc9uirrrrytrtts that govrtro the applicant {oz acctpeance and use of Federal grant funds, ]n particular, rise applicant as ores us tha~- 1.1c has been lcg3lly and offieiaQy authorized by the appropriate 'Y'iaest civil rights requirements arc forard 1 the taon- gavern'vag body {for e~tantiple, nyayar or city council) to apply For this tiistriminatiory provisions of the Omnibus airrye Coastrol and grate aryl that the pe4sost~ sigrtit?g t}ae application and these Safc Strc+rrs Act of 1968, as arryerded (4Z S.G S 3789(d~); 7'ttk asataranees ore its behalf ;re authonacd eo do so and to act on its VT of rho Gve~ ltiglsrs Act of 19b4, as area [42 U.S.G S - behalf with respect to ray issues that may ar'sse during processing of 20bpr1j; the lydiayx CiviD Risiaxs Ad (2S 1307-1303); ehis appl'acacion. Section 504 of she Rehabilitaciast Act of 1 73, as ameadcd (2'3 I,IS.C. 3 794); ~n}e ll, 5ubtide A of rhtt a'4 rssr+ns arith 2. It will coanp}y with the pravisitatys of Federal saw w}yich liaYaie certain dl7isabilitics Act (Atilt) (42 l,]$.C. S 12107, setg); she Age politicyl activiaies of grantee employees whose principal eratploynaera 1:133rrisninatior ACr of 1975 (42 i.t.5.0- S 6] 1, et seq.); and is ;a eonne,Ctior with an ac tiviry Granted in whole oa in par[ with this 1Departnc~rx of juseiee Noss-Discriarairym - Rcgulscions gran~.'1'itese restrictitam sac set forth in 5 U.S.G § 1501, ca seq. contained in'1;tlt 28, Parrs 35 and 42 {sub its C, D, E and G) of the Code o! l+edeaal Rcgtrhtioras. 3. It wall comply wish the rrtityimum v~age end maximum houa~ provisions of the Federal }'air labtsr Standards Act, if applicablC• R. In the event that any court Or adrraiayisera ' e agcnry makes s landing of duaairsination on growrds of ~ra , co)DS, religion, 4. ]t will establish safeguar.ls, if it has not doryt sa already, eo prohibit raponal origin, gender, disabs7ity or age alg st else appJicara sleet enaployces from rasing their po3iaiotss for a purpose that i; err gives a dot process hearing, ie agrees to fosward copy of else i°arsding the appearance of being, err otivatetJ my a desire far private gain for to aiye i7fF'fce of t„yYti Rights, OFFice of Jtas a progtatns, 810 7th theasselvrs or others, parties}arty these with whorry they have Isma~y, Serest, AIW, Washington, I]tC. 20531. bg5iryesS Qr'other ht5. Grantees shat }saws 50 or anon employ and grarsts ovcs . la sill give she X7tpartraent of berries or the Comptra8er General $500,40Ki (or over $1,000,800 art grants aver r eighteen-myonth access eo and the right to e,<arnirae records and dowmer[s related to period}, nature submit art acceptable Equal ployaaycrtt she grant- pppoatvnity Pier ("dP' or FLOP siao form (f graraec is reiluirtel 6o submit are FTOP veyder 28 CFBZ 42,302), that its ' G. la will comply with al) aequireat?ertea imposed by the Depastmenc of approved by she Olfzee of justice Progsaarys, !3fliet: for Cival Justsre as s condicon or adrrairisrrattve requirerraent of the grans, Rights within 60 days of the awtard Saart Clan Poe giatatb tartlet including bvt nor limited to: the requiremctaBS of OMB Circulars A- $500,040, but aver $25 000, err for grattaces 'ti+ fewer r2aaa 5Q 57,11-21, A-122, At the )Federal Acgtrisit}on Rcguhtioras; as applicable empkyyees, the grantee trust submit zen 1EE Cestif cation, (governing east pairaripies); OI1f$ Crarctelars 11-102 or 11.110, as (Gaaneees of }ass chary $25,01)0 ass not sWbj x to rite ESOP applicabk (F1rsPforrm Adminastraaeive R,equiaemertxs for (master and requiretnt:ac_) Coapeaative Agreentenxs)} C:aR3B Cianxhr A-133 (gpvemuag aadics~; the applicable previsions of the Omraalxus Camas Control and Safe 9- Pursuana ao T?epatetnetet of Josses ,Stride ' s {June t 8, 2042 ; Streets Act of 19fi8, as amended; the current edition of the COPS Federal Reglseer (volume 67, Number 117, gee 41455-4t472u, f Grant Monitoring Standards and Guidelines, and wish aA other order 7it}e V] of the Cival flights r?ce of 19 , it wiD erysura applicable progaaaee acquirements, }aws, orders, regulations, oa rttearyingfui access to its prograryss sad act;vi es by persons with circulars. liryaieed ~Yrgliah profic;ency. , 7, if applicable, ;t wily, to abr. extent practicagyde and consistent with 10. ]twain ensure that ray facilities under its rership, Icase ad applicable law, sack, recruia aril hint qualitxd anembers of racial and supesvisipn which shall be utalited sat the act ayp5ahrnerrt of the ethrtir ryirioriry groups-arid qualilaed women say order to further project are flat Israel on the d:nvera~+arxse»rs1 orettitart Agcryry's tffectave law crforeemcna by irertasing their ranks w;th;rt the sworn (EPA) !is[ of V;odaeerag Facilities and that i< w rodfy es if t. posimors in the agency, ~ advised by the 131'R that a facility [0 1?e used ' this ga•artt is uryder considcradan for such listing by the ]?PA. [ 8. It wi}I nor, ors the ground ~:.F race, rotor, zeligsor, rtati®ryal origin, ' , genies,disability Ua age, unlawfully exclude any person from ]1, ]f the applitatatb stare has estab}ished a ievr and comment pareitipatioa sae, drny she btrtafrts of or employment to any person, prtxcduse ursdcr l+xecutivt Order 12372 anti 2s selected this or subject any person to disctvt>jnation its enraneeeion vdth any program for review, it has made this apfalicaei avaiiiabk far - s or artivities funded in whole or;a part with federal loads- review by cite state Sutgle Point of Coryxaee. ; ) t • ~ ~ Jan-21-04 04:50pm From-HAWAII COt~'!!'~ITY FOUNDATION 8085216288 T-516 P.03 F-185 - r - agency-Awned, rented of ptnonallyowne hielCa +rtere:asc~i plheer 3e47e(1AM, Ae'vet, sic sl AACa[>,c,.xn+. a+at. pr 1oca1 fnncis (or s miniatia,m of oaAr (tall +esl btu~;o:-e c,rclr 13. It will not use COPS funds to supplant (rcphat:e) start, loyal, or folJowinv catparsainn of the ~tant pta;iod. $~resu of IsadiaA Af(air~ funds that oahetsoise would be stasdr available for the pnrposcs of this grrnt, as sppGeable_ Fslse tt9temcaat8 ne claims naa3c in ten tiati avaeb e:q>ms grants (nduc6iaa~es~(rCrariw~3~,rremenor} rs~s~ rrsnah in 6t1cs, ianl)a75rAnane+at, dislaarmtete ftermeA ~ ie:i~titag ire itderal grAnes tar eC+ntractx, and/urt 3ray oe Cr rt'tYac+tly svaiFsble 6y laue 1 certify that the assursi~t:cs pro`idcd arc rruc and accurate to ehc best oC m;t knciwled~. l:lecti+An~ nr efthcr sclcc dntas of ne~v nftACials will not rcliere elae grsntec e+adey esf its obligstinns nndcr tlAis grsna _ Q9/05l2003 SA~~atuel' eaf 13~~ etuittve: (Or OffacAal wath Date 3ar seit only> sp ~~Z~t3,PEl ~~a a3 "Ematurr of ent .xrcuei~Y (4w dffieaal with f}atr Yniantial A+adaority, a5 a}aplitzble) u aed' Morslr 2Q 2t?03 e03t73I909 Jan-21-04 04:51pm From-HAWAII COIF"~~ITY FOUNDATION 8085216286 T-516 P.04/15 F-185 ~~tlE)~~ ~egartiif]g Lobtayifl~ D~~ar~nt, Sasspe~3on aftd IDl<h~r Re.as~i114~1 !Vl~1~t -~r~ VV ~s:l Rwequar~ra~ents C.axor~raati~n viv~h A~~~ Agef~cl~; ~l~r]-Sa~ppl~l~»gF and 68~t ~?leheuk+h tlae 1'7epartsnent bf Justice has made every effPrB tea simplify ehe 3plaliratio~n pr~occ~ other praviseons o fedasal L• w seggart vs to sect: your certificxri:>n Kgardirag crraain matters. tSppiicants sboulrl te?sd the tt};ulaeions Cited br3owr and the irist bons for eerefitarion intltadcd in the rcgcrlauons rq uradctstand the rec}uirctnr»es and whether they apply to p particular applir_atst_ S" of this fara» pttrvidles fe+r eor»pliancr wieh errtifitation rrytaieernenta stt>•,1cr 2g CTTt $aart b9,'•Wrw Resttictigna tan l.obbyireg," arnd 28 tt I'ati 67, "Ciovt:rnrnent•wide Y?e: barnunt and Suslacasiort (A7onfstocurrment) and Go.•crnanrrrt-+bide Requ:srynentS foa I -FSec ~rkplast (Grants}," and the cun+c#imtioia a»d eaon•s~tsyipl~ounp ree}uirrmrtats of the Fublif Ssfctg 3~rtriership and torrsr» ty Fanlicitag ~cE of ']'be tcrtificatians shall be trcatni as a stasteYial rrpra4cattatiott of fact upon which reliaraee will tar Placed when t Deyiar~raeua of justice dctcrrraincai ra award the cc+vese+ll;rant 1. l.ubbying (st) ¢lavr ntat vit~tin s rkree-yrar period steealir;~ tlsas applicati~ been een1itted of of had a Civil jud t sestdtncd agahaat tlacm As rec}trirrd by Section 1352,'1'ide 31 taf tltr Ll.& Cock, and for cgrtarnissiora of fraud ar a criminal o feusr ha cotaaaer~tion aarlde smplcmentsd ae CY;]t Part 4?, for petsorr§ cner:srag Intca a gs:<nt or obttining, attempting tq obtain, or pert a lie {fcdasal, cgopKralive agternarnt o+ret `j100,00D, as definnl at 28 CF1R fart 69, state or k~cat) 4taaSactigtt or Cotatract to a 17+pbliC tsansacyitart; c}SC apy,Gcant ccrtifus tint: vitalatlori ref ftdCral or state antitrust sta ter or coormus3s'grt of A. i'Jn federal apprapristad funds havt been paid or wi11 be paid, by rat~abevleT,te»t, theft, fargcr9, brs'ber}S f "Sr..ttiaa or dtstructior, of on bthsJf oC ehe untiessigracd, 3o any person got. irtfluesatirg of of rccgsds, rtaaking false statrmcnts, or ' ins stolen propettp; anrmptirrg to itrflurr~tc an gfficcr w cnraployea of any agency, a pacmbrt of Congress, officer Or erraplayce of Corrgress, err an (tit, ~.xe not presently indicted Cot oa ctwi5r Ctsta]itxally or tm}+lo;•tr of a mrmlirr of Cangrexs in cpnnrCLtOp with the making civilly ehatg,ed by a ga+•rmmcntal gariiy ftderil, stare of ]gcaf) oC any federal grant; the cnttring into of anp enoperstive agrecmrn~ +vith <OtYrmission of any of the gffe errvarcrated in paragraph grad the exteris:iori, Continuatiytt, rerllw~l, amendrnen8 or mgdificatio» (1)(u7 of this trrtification; and of any federal grant or try»pssativc agrrezaaent; (n) Na+-r rage within a thrcc•year pc ' prt~seditag dais }i )f any funds other tean federal apprYSptsaeCd funds have beers paid application bird one os morn public tsa ns {Icd+etal, sbte or of will br paid to spy pcrsgtt for i»Auentirag ur atternptirag to loran terminated for cause cat d~ul~ a d ]nllumtc an ofi'iccr qr s.-r»171+Zyitt Gif any agent}, a rttetnber of Ccmtirrss, an offers or er»pi~rte oC Congress, oa ari emplsyee of a B` CVlicrc ehe applicant is aarasble eq eexti m asay of the sncmber of Castgsess v. con»cction with dais frd¢a~B grant or statemcitrs ixa this etrtifiratioa, ]ie oa shalB attae}r ao cooperative agrremrnt, thr undctsigracd shall eornpleee and suUmit explanation t+m this application. Staridaad Form - 1J..L, "I]isclosrare of I.9tabvirag Activities," i» acrurdance with its ipsrructivras; 3. Drug-Free 1Workplace (Gi~nt+ets Cttfr °I'ban Indietidtsals) C. '7?ie u»draaigned shall require drat the lau~3~e of this certiftratia3n its sr9pired bj the I?tng-Jsree i0(114rkrlst Ace o$ 1988, atyd be ~itludcd in the award dgrutt'atnrs for aA subawards a: all tier; implcrrirnted at 2$ CFR Part 67, $u F, ffgs grzute+ts, as (ndudirag ssrb},fra»ts, cr.~ouaets usader gsarrts asad Cooperative altfiratd ae 28 CFIe Part t+7, Seetioas 67. IS Arad 57.62® - agretmenes,and subccsutmcts~ apd that all sub;rrapiencs shall certify 4. ~'hc applicant eerofies that ft will, or contirnte tea, prooid~e an+l disclose geeot~cJinBlk a dr4rg-fret workplace by: 2. Debarment, 5ucpens,on and Odaet Responsibalr'ay T4atters (L?i~ttct ~ Pablrshr»g a statemene notafyang trta tBaae t]re amlavvfvl Itecipicut) manufacttrre, dissn'butiq», disp~e»sing, n qr rase of x ro»trolled subseaner is prohitrirt:d ata granta:t's workplace As required by Executive Order 12549, Debarment a»d Saaspcnsioti, and spccifvirag the acsions alaar will be takr:q agair76t empla+yees and implemrnred at 28 C1'R hart 67, Fat prospective participa»ts Ae far +~iolaeian of such pro~liilaitign; fatimary ccavcred tranRa<tiAns, as defined at 26 CFYt. Batt 67, Sectioia 67.510 • (nj ratablishing an orr•kai»y, dtq~•free wariness psogranr tq inform errafrfr~ee~ abMat - r1 7hr applicant crrtifics that it and ieR priptipalsti (a) 7ht dsngers oI dswg abuse in ehe workplace; Art neat prrcrntly d~barrrd, suspended, proposed for drtrarment, ctcclarcd ineligsblt, stpte-»ced m a dcrrrr! of fcdrtal bcnetits by a rraee (b) The grattrce's policy of main a drug-fret: svorkplaec; ur federal coarrt, or ovtu»tarily txCtuded frrim rovtted trarisastions try any fedora! department or age»t:}; Jan-21-04 04:51 pm From°HAYdAII C0~"~"!ITY FOUNDATION 8085216286 T-516 P.05/15 F-185 t~~ t.~.._.._....._..._, -...r...,--.........-g. shoat .rioFAtid>ns occotri»E ill Bhc woa..,,,acc; B. 7lae grantee a»ay insert av the 5gaee lbel~.v tau sitt:(5) far the ~rforttartce of ev®sk t4t2ste . cctiara s (auk AiaDc?rtg~it a reyuisernent tLat xac]a cuaplny~ec to be mgagcd to t}rc sls~t~ grsmt~ the prrfcuaraartce of eLe Brant be given a copy of the xtaterattsat Plaec of prrfotanastcc (sBrcet nddsessy ~ tamngys, ~y required by T+at'+S~F~ n: cq>de) a (iv) lvotifyi»g the cmpl~+; to in the statement c[<juired by gaaragragrb (i) shag, as a condition of erIItployrnaat uadsr the gra»t, she empleyee w1l - Chuck C7 if tltrse art worklalacec oat dale ~e .re saog idcntsfxd hmr~ (a} 1lbide by the scams of tltt: 6taterseera6 and Section b7_d3Q of ghe regetladoras pr ghat a tee_ chat is .state ~raap =Watt go raaalte o»e etro tacao in cads (b) Notify eht: om~per in evmtirag of his or Lac e®erviCtion feu a federal ~c.l yrsr, a copy of w9tie$a tha+als~ be ' wilt violation of a csirasi:.al drug statute vccurri»g in the workplace rach appGcatuan for Dejrartment of Jnstir fvtx9" States na Dates than frve ealerrdar days aFtec such cppviG4iMt; an8 sgaHe aged tv vSt C?1p m ~]/7. Chec6; ~i if tltC start liras [9eCetd toe ojP ~n (v) T7otifyiag ehc age-rate, en waitsng, wjg¢dp ]0 calendar dayR afteQ .8067/7. receiving notice v»clea sulaparageaph Ctv}(b) fi~vara aat ennplayKC or cadacr~visc rcceR,rirtg acaual codce of Sorch conviction. Harap}oyeis 4. Cn<ardirtat'aurs of ea~nvictect cmplcsyecs rraust paovidc notice, mrltxlvag gtQgiuon tick, to: CC3PS t~f5ce, t 7tH! ~Tesmrnat Ave_, NW, lt~shi»,gto», LyC The public .Safety partners]aijt aead airy l;taliortg Act 2053tL 1Votice slam] invade the idrrttilaca®an »tamtser(s} of each of ] 49~ tegnsres apgtGca»es rP sestitj that sleets has been affesred grant; aplartaF+aiate eoacdi~tion with all aSstts3es tlrgt ~ be affected by the apaplicagg'e gsatat Apr (vt) Taking Qnc of the foAcrwirag actin»s, v~chi» 30 calendar daps of ,effected agents ~Y inelastic; aaaea~ -the ~F#ice of receiving Haste unties subparagraph (nr)(ka), wide respect to sate the Uniaed States :ettoricsy, state or total _ osectatora, oe ury~tlayee wLo hs so ccMavicgcd - corrcctignal agereeie.-'the stfspl'scstat certi t8~t t&tere Dtas been appropriate ea>msdarnatron wish aS a age»eiest Takisag anp'ropaaatc pcrsonrael aeon against such era . cmplapcr, cap to ars~t inclvdaag terarptaagpyA, corte6ste»a with the rctpairemtnra of slat RekiabdiC~tisatt r1[e of ]973, s13 amended; Ur (b) Requtrirag swtla u~tplay~e to pmsticip®te sa+~fa~ctor7y i» s drarg abuse assistanec or rehabitirdtiett program approved €or assets pwrpt~srs by a Federal, state or:local health. law tnforeern~t oa otlret apprapeiatc agency; - GrarttecNsuraeartdAdd~xss: Saws-~~- Cammumity Fouadaiton, 1164 Bishop St, Ste C10, I~ono3ulu, HI 9681: Appli~st?onNo..ndJarF'rojsctNama~ Methsmn etazu~ Prr~'Leo];ir~rteceflltSAYettdtxNttmbe~ Noxi r~~it ~Or artizs]:ioat TypcdNarracitrtd75tleof$ cc~erva Kel.v n 3$. `Y'alltet:a President & ~0 Signattre: ~ Bate; ®9 ~5 /2(103 r9s tJtr duy Qrthoi}aed reprrexerrlcruve of rdaegewemdxg> boely, i'taea°at~ crrtF,~ rlse~/Qert harr~'sag` late do obov~ axa~ft= ce~aias. Fler~pvsx ~saew o„~ia7nis aatidB rant vciiee+e 8ke ` ~'2ts ~a?sas ~ altar . 73rpedNtttaeear?d'l,"kafGove]Facectttiwe: Ha YCimm Mayor, Ctatarity v$ Fla di1 3ignattre: ~ I)atc: 9 / 8 / 0 3 8085216286 T-516 P.08115 F-185 Jan-21-04 04:52pm Fram-HAWAII C01~' ''TY F011NDATION ;,~;,~_.z;,~ f f@ ~ ~ °ttt'~ 'F~ "C~3 71'his dasclos~tre foxari shall to cx~rrtpleted by the rep4rtar?g entaty, whether saahav~aadee or pri a l~ede~a3 recipi- ent, at ~e ~xtit-sation or receipt Qf a covered Federal actio~rt, or a material change to a previ~z filing, pe=rsazant to title 31 U.S.C. section 13§2e 7"he filang cif a forrtt as required for each payartertt or agree ~ !o areak~ pay- rtrtent to any tobby'rng ti-nntiy for influendng or attearapting to influena:e ~ officer or e?aa~apl of Gray agt:ncy, a Mennber of Congress, an offaCCer' or employee of Congress, oa- an employee- of a Iv9em$~t of ~ ~ rrogre~s i~ c~a>4- ne~nn wath a covered federal ac#ion. Complete MITI items that apply fox'~th the iraitieB anal ma$erial change report. Refer to the itraplerrtentvng guadance published dxy tlhe Qf~ce o¢ Managemert$ and budget for additional inforaraataon. i. Identify the type of c+over~ed federal actiofl for wvhiclt lob• Bred Federal actaort (iterra )f knavery a t$De feali Catalog hying ~vaty Ss and / or has lxeYa seceired eo iritauerece the out- of fiedetal I)c~ant~tic Rssistarece (C'FD.f~ n her far grants, crnrae of a coffered Federal ,ictiore. c+~operative agneeanes~~ loans artd 9oan tset73itts~ts. 8. ):stray the xraost ~prapriate Federal id anaxraber 2. Iderttsfy the status of the ~Vo®eaed Federal action ava~bie Sir tl~ ~deral action Sdesrt~iedatevn 2 (eg., Request for g''roposal (fBfP) neamtaer; lravi tSorY four $id (dFB) 3. ]dentify the appropriates classiticatian ~ this report. u thSs is a follow.ael7 report eaersetl by a material change to the irefor- nt.zmbea; grant ~aeruica7.encerttent PaszYrel7er; ~ratsa~. get3rel~ or . matbon previously regxrgted, antes the year and quarter ir'a loan award nuanber; tl~ application/ sara4rril nrterrber which eAe change occurred. );Wray the date cf the?ast lxevi- fined by the Pedal agea~cy~. Ineluc4e es. e-g9 "'RFF Duel subrreittesd L7119D~Oi. Y ~ l'Y d'~ S erataey tar this cbnr- Federal action. 9. >:or a covered F~esal action why fees bee~e era the ftr)1 nay, addr€~s ;city, state and ~p rode t?f the award or Daan maerxtitrraeast by the ~der~a4 sy, ea+,Ber t8~e reporting entity, Include tart I)asEaict number, if Federal amoeant of tip award /]can ca~eaXaa t far the)xaart:e kncwn_ t~eedc the appropr5ate dass~i~tiQn of the tepartiabg edatsty:deret=fied aua Steams 4 ar S. entity~tleai designates of it asp ur esspects to be a prams or sub- iQ (a) ~rtter rtes tug r~rree, addsr~s, city, sta and Tip cede of awerct re®piens. Identify thr ties ref the Subawardee, eg,,, the this Dobbyutg en#ry engage+d by the repo registrant idettta- first subawarde+e of the prune is the 3st tier: Stxbawara~ fiecl Sn )fetal 4 to influx the covered Fed cation. include but are rent litaeited to sutseontrac~,, subgrants and ' oontra~ct awards under graarts. (b) ~rster the feel] natxae(s) of the irtciividual( pea~formireg ser- vices, ~r^+d iYtclude full address if differeett 1U (a„3. )raetex 5. If the orgaatiaataore filirsg the; repoa-t in Stem 9 edsecks Last Name FarSt Alaaase', artd MSdcile lraitiaJ 7). "Satbawardee; 'them enter the ferl3 nar»e, adcia~.~ city, stave and zip code of she priime feeieral recpiertt. Include- 17.3~e certifying alfi 5hal) sign and dale the fanrt,.psiQtt Coregessaoreal I)istrac~I, if ktaawae. has/leer naart~, Atle rmd ta~~phon+e nvxrbea. 6. br'iter flee name of the Federal ag~e>1ey making the aroused or Public rrporli>rZ bserdear J6r t3ris aWlaYiws of . is estinwte~ le Dean [cTreT,rtitme?nt. ]nc[tade at least one o;garrixatiesrsal IeVel ~'tnitrutrs per rerperrse, irYltadirrg tatrfe~ _ ,q ~,ttrucriart~ below agency rv~sate, i¢ knawrs. For exarreple ; Depar4atent of se~rhi>{g existrng data sokrtw~, $athrrtng aesd irrai~J ' paz~ the data ~fal, acrd c~'mplePir?$ and rraRNevirrg 13at calle~tian . ~d mrst - Tracaspo;-tatiorl. Uavied Staffs ('oasR Guazd. corrals reger7'dmg the herrdtn e~tnerats or arryothrr enf dtis a+lln °f anfo7lrratreha, anrhrding 57tg,$~Sirtat7S~r' redtrrf9ig thrF derr, 8o t7ts ~ 7. Enter the Federal progr-atre name or desmptaon for the cov- Mano~rrrnt acrd Skud~rt, Faprrwark,Raductio~i Fmj f03g8-0Q4b). Wi~sit+~gtary d~.C 2t153t) f . a' Jan-21-04 04:52pm From-HAWAII COQ`"`'TY FOUNDATION 8085216286 T-516 P.OT/15 F-185 • ~ ~ Appwveal ~ OI~IH , Comple4e Y3vs farm to disclose ]c~b3~ying aelivities peila-sua~t to 3] US.C-13,52 (See reverse far iristructioaas anc3 paablic burden disclosure) , 1. Type of Federal Ar9iora: b 2. Statns ®4 ~FaeAeaal As'4iora: a 3. Httpoat Tye a. C+ontrart a. bid/offfdtr/application a_ iatitYal f~° b. grant b. initial award b. ueateriai aaage c_ cooperative agreement s. post-award d. loan ForMairriad ge[3rrdv~: e. Joan guarantee year f. loan faisuranre tortes: Date of last por4 9. Naasee and Address of lieparting Entity: 5..1$ $Z¢goriing Eaat#ty $n No. ! is $mba arose, l~ata~g ~ Prime ®Satbawardee Nassae atad Address ®f l'rim~ 7ier~,____~ ijk'rgoavre: Hawai' i Co>ffitutaity Fouxadatiom 116+ Bishop St~'eet, Su3t:a 800 Honolulu, iatawsi r i 96813 Congressidmal District (n~ber), if known: _ Corsgressional I>histrict (rtexmber), if kre rc 6. Federal Deyaaatanent/fAgea~cy: 7. Federal Pa"ogrd~t IVanae/Dtscriptioat: CF®ANum~r, if applicaabl~ t3. Pedeaal Ac~tiun Nnaa~elaer; of kndDSe*n: 9. rehwascl Amoan#, ~ known: 10. a. Name and Address of Labb7ing registrant 1Q Is. lnaiieidmals lE'd~arssaiiag 5grtrares (if indivadread,.lcsC a»'nse,~'rt'st name,l?dl): {including ae9dfrd~s if diffe7~t94 frro No.lDa) (last name. nazate, MI): la.lpegormation segaeSled tlumn~}l? this fmrm as anthamized by. S8gY1~tZire: f 7it1e 31 U.S.r~ SecF~on 7352 'lam disr]esst~e cf 2obbyirag aetirrimes is a EtL1te?79a1 arFre-scast,~oaa of ffaet upnn vrhSeYs reliasee>' sues placed ~ the leer a~svC whc$, t!>i, tr+nsactiaat Frirtt Name: ~ lvin A . Ta data vas made ar Battered iedt~ "This da`scla~seue is zey,uired p~r- soeant to 33 iJ.S.~ 9352, ~t1is iaeffnrmatid3tt wi21 ~e mptetted tes 7"ttle- President ~ CEO the Cangxess sea1C ~aenteal]y 2rea3 will be available foe ptablie inspecti~ Arey ~ wlym fsily to $ile tier re,quirrd alisrldm swe ;.teall tee s®bjrct to a civil geetaat7 e>f aeot less at+aaq X10,000 Telephone No.: 808-537-6333 bate: OS 20 3 aced nal awsC ttean $200,006 fur eaete suele faile~ere. ~edera] Use r>~tly: Authariaed !m Lotad Reproductioa9, 5 lord Forna - LLL Jan-21-04 04:53pm From-HAWAII C01~" `'TY FOUNDATION 8085216286 T-516 P.09/15 F-185 ~ C~i~7iFlCA7l~N tJ~ Cl~A?Mtli' Oi= Cl..AN~7ES~1~`~ i:3Ft~9~ i~+?~t? ~°CZi~i~S °fhis section expla:ns the requirements for cleanup of a clarsc9estir~ drtag is story discovered while irmplernenting a CAPS P~lethamphetarnine gr~stt. It re ~ to certify what cleana~p strategy yvu plan on tatiiizing. Speoal~y, It rega;lests #on regarding (i) the ape of training loc~ti-law ar>rforcement pe~$onn~6 revs; ~ whether Gli:~4 contractors, DF.~0 equivalent conY~ctors or other quailed conirars ~ or local personne! viii perform the cleart~rp and disposal o$ hazardoass chemical west ;and (3) . whether vehicles anchor storage units funded--under the grant program vuiil , used to transport and/or stare hazardous cf'temical waste. '~'i~te astable cleanups elegies app dISCUS$e~ In IYtora detail In the ~r1v1r'Canrrletlta! dlsseSStrlent, which yOt1 ilav~ viewed and agreed to abide tsy. Irt order to ensure protection of human heait!°a and tae environment in inraple enting a Cf7PS Il~ettiamphetarrrir~ gran#, applicants must agree to ~e proper trairaing of law enfarcemerrt persnnr~ei, She use of gsaafifjed contractors arlddor toctll personra~l for the cleanup end disposal of ha~ar~us waste; and-the adherence to Federal, and iota! regulatory requirements for the Cleanup of h~ardous rrtical waste, inciud g thbe transport and storage of such waste. the training aff !aw enforcerrlent personne! must meet the requirements of Occupational Safety and ~dealth AdminiSt~tion (OSHA) regarding hazardou waste environments (~9 CFR Part 19'If3.'12® and part- `12~t9) and the ~nvirtrnx~ntal iareatection Agency's (SpA) Resaurce Conservation and f3ecovery Act (RCI~A) reguia#ic~ s pertaining tv the geraeratloro, stodge, transport, and dispo~l of hazardous tee CFR marts 2t~1 et seq.), as well gas any St~ta or local requir~nts. In addition t4 ensuring the proper training csf laonr enfarrertaent personnel, the environmentally sound cleanup of clandestine fataoratories is accomplisha~d rough ~e util""ization of qualified caratractor~ car local pers~nei who perfs~rptY the duties a "generatC~r'° of ha~arclous waste, as defrneel by EP1a in its regsplations cod'>ftie at ~ C~i~t Farts ~G67, at seq 9 2 . ' fibs Drug ~nforcarnent Administration {p~,q) underta8ces cleanup caf clandestine d laboratories rhroughoart the counta~ foy trairoirlg agents under QSt1A standards and b utilising qualified compactors ~snder the o-tazardous l~Vaste C9eana~p and 3posal Dontr3icts { v?o~pc). Pending funding avaliability,l]EA's servides are availatal~ to ill latw enfforcemeplt agennoies engaging !n rise cleaniop of clandestrine faborataries at no cost to the law en>'orcemera~ agencies. As with- the applicant°s law enfmrreriaent personnel, the quaiifred contractor personneP must ~ trained under the requirements listed above and are resQonslble for aatilizing permute treatpnerot, storage and cisposal facalitias that meet ttte abssve fisted requirepriessts. ~ Althoaogh grantees sander the CCDPS fUlethamphetarnine grant rcoeast demonstrate h their clandestine drug lataoratory deanup:program provides ffor-the protection off htatnan h aith-and the ea~vironrnent, they are: not required tv either send-their personnel specifficslly to the trainitxi program or to use only D~ disposal contractors; l<iowever, if ncoes choose -not use these existing DF.A reso~rrces, #hay must ddmonsttata (fiat tfiey have equivalent training aid disposal resoure~s in place to indude contraeltor oversight plans and procedures, ortha# the alning -and disposal resources in place meet applicable Federal, State and-local laws and regariicsns. Docurreent must be r+avleen+ed, coraapleted and aeteerraed with proposal leit ~ Jan-21-04 04:53pm From-HAWAII COf~" '"TY FOUPIDATION 8085216286 T-516 P.10/15 F-185 An applicant's cleanup r.... ~azardr~us eheraticai waste must aiso c.. aty vmith P,~'s Comprehensive Er~vironmentat Response GampensatiOrt and t_iaiaility 6~~t (~~lri~?) (4~ CFA Part 3og) and the U.S. pepartanent of Tcansportatior~'s ragutations g®v n~ng ttte labeling arlc! Yransportatiori of hazarrious waste (Parts X49 C1R1~ Para 10t3. et s st. end Pars :54-39g). e ~ c~.ie A. Claaodestia~e Drug Laboratory Clew»aap Program 7°rainare~ o! Lam ressneaat iPcrsoranel Sc that th® COPS 4ffce rrtay ensure that your clae~destine r~nag laboratsary ci anup program edequateiy provides for the- protectiaet oP human health and the east onan~nt in regard to file training of law enforcement personnel, please certify as to one ! ~e following: that aao .art of this grant involves I certify tha8.k~ the cleamd}ti of adaprdestine dt~sg daborcttories: IG '13- ~3 Signature of A ro~~.t C~rgaxaixaC~dn Date Typed NsrnE ofiExecutive~'yp~ Title of ecutiv® ATc proii•it Or ~Tonprof t ~rg~x nation i~ Signature vernersent executive 1'3ate ~aarx i~im ~a or Typed Narras of Government executive 'Typed Titte cif CaQVemment ~c~ five pocgm~llt iYlatSB be treviswec9, composted aa~d returned with 6sa'~gsosdl kit ~ Jan-21-04 04:53pm From°HA4~A11 C0~'~"'ITY FOUNDATION 8085216286 T-516 P. 11/15 F-185 I certify rhea I have: IJ.~4-t yuivalertt rraiasing in place for racy laa~ era,~r~.~ment persv el regaarding ryae•clearaup ofcdandestine drug laborer®ries and treat tt raaeets the rsaaraan requfremenas set forth ire applicable p'ederal, Stare and local laws arad regredcttitsns: Signature of Lavv enforcement Executive fete • Typed Name of Laver Enforcement ~xecutiv~Typed Ti#Ie og Laver i=nforeemerl i.:xe~c~tiwe Signature of Government 1=xecutive pats Typed Name of Government Eacecutiv® 'Typed Title of G®vernmerlt Ex utnve I certify that I leave traaPaing in pdcace for racy law enforcement persosanel regarding t e cleanup of clandestine drub laboratoazes ar:d tlsar rt saseets the tratnirrg regsairernerats set forth i alrpdicezble p`ederal, Stale ~xratf local laws grad regulations: Signature of Leww Enfarcement Sxecutiva [gate 'Typed Name of Lavr ~forcerrient ExecutiveTyped Titie Qf Lavtit i=nforcernen# iExecutive Signature of Government Executive Bate TyFred Name of Gcavernrn®nt Executive Types9 Title cf Government Ex utive r' ~acutnent encast tre r~vlevved, cvmp8eted an4 r~t~arr~ect with ~Ore+pa~sel kit 3 Jan-21-04 04:53pm from-HAWAII CO{i~!?'"'TY FOUNDATION 8065216266 T-516 P.12/15 t=-185 C:l~sttteS#i~c I.lt'~. abor~4ory (:lea~nuta P'ro~ram _ I~BSposa Ha~~rei us So that the G®PS (~fti~ice may ensure that your c6andestirae drug laboratory ear+up program adequately provides f®r the prot~cti~n of t~umaa~ health and tt~~ err ~ron?ner~ in regard to the disposal of haaardous waste, please certify as to one of the f lov+rarrg: I certify that I will only utilize D~1 ca`lsp~sal a®trtraators for the eleamep and dls}~s 1 hazardoaes waste assocaared with claradesairae drdlg laboratories: 1i:,I 3 -l~~3 Signature of _ Executive ®ate AToasproiEif: Urgan~zatioaa Pre~ideat & ~G~o Typ Na Hof E?cecutiveTyped Title o tsxe ve ottp of irk rgan~.x~~ian ~oprv~ g~a z~c~.oaa l~-l -tip Si nature a over nment executive i7ate Harms Kia~a Typed Natrae of Government l=acecut(ve Typed Title of s~overnrreent axe ' e I certify that I aa~ill be resting aeon-DE,9 disposal contmctors for tdre cleQmcp arrd dis sal of hazardous waste associatest wft}~ clondesrii>7e drug laboratories, and thaP these coat ctors arse .D,~1-e~rrfvalent and meet all necessary ~uaiificeatiQros for the cdea~rup acrd disposctd hazardores 1v4Sre: Signature of Lang Ehforcemerrt executive !<3ate Typed Nam® of I-av~ Enforcement Execut(veTyped Title of Law Enforcetrrent l=xecutive Signature of Goverr~rrrerrt Executive Ct'ate Typed.Name of Government Executive Typed Title of Government 'eve ~oeum~ent must b~ rovi~wrod, eorntal~4cd ~n~ r~turne~ v~itPr pre~ra~s~9 kBt e; Jan-21-04 04:54pm From-HAWAII C0~""''TY FOUNDATION 8085216288 T-516 P. 13/15 F-185 1 CeD'tJJy roaae 1 weer oe use. on-.f..r.G~Y eCr1tTRCtOP~s QD9a/o8' l®c8d6 g~~~73?, YI~13V eP3J EeanC87t person»ed~i~r the adearru,F+ and disposed ofhaxprdot~s e~casfC cassaciated wash edanetes "nee dt~a~ dcaboralorles, and that the iradividaeads imaotved fo these stctrvities a7reet add necessary tdafecations for She cdeQrraep aratl edisposud ofhex~arrdotas waste, ats set forth ire eappdiewabde p'ederrad, tale aced docad dews trod re,~tdations: Signature of haw enforcement EXeCUtive Data Typed Name of 1.ae+v,DnforcEment ~ceoutiveTyped Title taf ~w Sngor~man ~secutive Signature of Government Lxecut6ve Date fiyped Name of Government executive Typed Title ®f Government axe utie+e Claaac$eatene Y9rug Laboratory Cleanup ;f'ru~rapa Fa~nda»~ for Vehiele au ~toe-~ge ~.lxaats So that the C+DPS Office may ensur® that the vehioles.and storage wntaine s that are funded under youa~ clanelestin® drug laboratory cleanup pr~mrn adequate) provac9e for the protection of hearnan health ~?nd the enviranment in regard to the traaasp and storage of I~~a~ardous chernica! waste, please certify as to one of tfae ft~llowi g: I certify that.lunding rece9vad under this pro~rc~ri fear vehrcdes sand/or st®rage atnits r flee specifac ptcrpose of transporting and/or storing daa~ara'ous chetre6a:ad Este naee~ts the req~earernents set forth in applicable Federal, State aracd docad da~vs and regaclartd®a~. Signature of Lino enforcement ~cecutive Date Typed Name of Ravi enforcement ~ecut;VeTyped Title of L.aw )enforcement Execastive Signature of Government Sxecutiv® Date Typed Name of Govemment Executive Typed Title ®f Governnent lxe utiaee ~ocue~lent vn~aSt be r~vi®~n?ea~, eoenpletec4 avid i'e~urreesCO vwi4ll pr~pass~l kit S Jan-21-04 04:54pm From=HAWAII COl~!!W!TY FAUNDATION BO$5216286 T-516 P.14/15 F-185 Finding of No Sign ant Impact throu~lkout the iruplement~a. . of its Applicant understazads that the 1~nvironnketkBal Assessarkeaalt vvas p~par~d d~ the requirements of the NatioAal I~aZViroa~erktal Policy tact, d2 U.S.C. 4321 seg., and tbat this assessrrient provides btsth the basis for take above listed prote~ive ~e u v~aell as references to severs.l Stat~]tCS, regtalatio~s, and gaaidelines that are paatec~al Y re$~a~1~>Go the implemeufiatioak of these rtkea~sures. Ce~ift~aUaaa I certify that I hate read the attached special cotap?ttiare ar~d agree to abide by k't: Signatwe afa I~ccutive Dec Noaaprafit Orga~.aia~ion Kelvin H. ~eketa President & CBo Typed 1Vaffie of Exec~3ti~ Typed Tide o ~~ve f ~,r-~oaP~'afit Oxgaaiza~ia~at '~onprofii~ Or nisatian r ~ lp/22/03 Si atta~e of ~t Bxeatltii?e Ua~ ICim _ Ma D Co b~ ~ ~ Typed Nine of Gavernmeatt Executive -Typed Tit3e ®£Gawean~eat e Jan-21-04 04:54pm From-HAWAII COPS°""!TY FOUNDATION 8085216286 T-516 P. 15/15 F-185 I certify that fundi>1~ received for vehiedes arpddor storage uniPS tas2deP° rhea ~a~ofect ~ e rFOt awarded for the specafie pterpase of trartspar8ireg aa~d/ar storzaag daa~rdv~s otaemse~ waste asad will root be a~sed for saach actavitaes associated ~itla the clcarea~p ~~'cdancdestine dabo teerie.~ Signature of ~~cecutive ~e#~ ldfonp~of3~t Oxgar~izatic~m ICelvisa H, Talceta ~ PYesideatt & CEO "e of ~xecutove'Typed Title ®f ~ace~uf~ae Jaaap ~ fit Organfzaxion ~c~~apscfil; Ord i~atioa 1/22 03 i nature ernmer9t Executive date ~i~~cry Kim NJ.~y®r, C®ttrity of )Ei~?wai Typed Name of Government executive Typed Title ®f Cov~mt~ent Ex a.atieee ~®ce~ment mast be rmvb~vve~t, c®r»p6etact ~t8~ t~>eeerra~~ wets pr~p~s~t 8ti~ ~ IIAWAII COUNTY DRUG PROSECUTION UNIT -SCOPE OF WORK I. DESCRIPTION OF PROJECT Ice, cocaine, crack, and heroin are just some of the drugs prevalent in Hawaii County. There are numerous stories of lives, families and businesses destroyed by drug addiction. The prevalence of drugs in our community is manifested in the early and prevalent use of drugs by our youth as reflected in the State's Alcohol and Drug Abuse Division survey of students in schools throughout the State. Virtually every measure indicates that students in Hawaii County are at greater risk than other students statewide. Favorable attitudes toward, exposure to, and risky behavior are also highest for Hawaii County students. The Prosecutor's Office participated with government agencies, service providers, businesses and community members to identify and address juvenile justice issues. Through a collaborative process, availability of drugs was identified as a major risk. factor affecting youth in Hawaii County. In addition, a broad spectrum of the Hawaii Island community came together to develop a comprehensive effort to address-the ice problem. The community, service providers and government are committed to tackling the problem with afour-pronged approach education, prevention, enforcement and treatment. The Hawaii County Prosecutor's Office is joining with law enforcement at the County, State and Federal level to further refine efforts to address this plague in the community. While the drug user may best be served by treatment, the community is best served by hard and swift prosecution of individuals and organizations manufacturing and distributing large quantities of ice and other drugs. With increases in police resources directed at the drug problem the need for dedicated prosecution services focused on the drug issue is critical to the balance of justice. The Office of the Prosecuting Attorney will put in place two dedicated and experienced deputy prosecutors to work with the County, State and Federal law enforcement officials in prosecuting individuals and organizations distributing large quantities of ice and other drugs. These deputies will be located in Hilo and Kona and will be available for review of warrants, charging decisions, preliminary hearings, grand jury, trial and appeals. They will apply for cross designation as special assistant U.S. attorneys and participate in the referral and or trial of defendants in the Federal District Court. These attorneys will also expand the Office's role in both the State and Federal forfeiture programs in order to disgorge any drug wealth. II. WORKPLAN A. ACTIVITIES 1. Deputies to work with Drug Task Force on review of warrants and consult on charging decisions. 2. Deputies to meet quarterly with Police and other law enforcement agencies to develop effective law enforcement strategies to handle drug dealers and those organizations profiting from illegal drug activities. 3. Participate in in-service training for Police, law enforcement and prosecutor staff to accomplish strategies developed by law enforcement partnerships. 4. Obtain cross deputization as Special Assistant U.S. Attorneys in assist in more effective multi jurisdictional prosecution. 5. Traditional prosecution of selected drug cases which include grand jury, pre-trial motions, hearings, trials, sentencing and appeals. B. TIMELINE 1. Within one month of receiving funds, memorandum of agreement with Police established. 2. Within three months of receiving funds, deputies will be hired and oriented to project. 3. Within one month of deputies being hired, procedures with Police will be completed. 4. Within six weeks of the first quarterly meeting with Police and law enforcement draft procedures will be written. 5. Procedures to be finalized by second quarterly meeting. C. DELIVERABLES 1. Memorandum of agreement with Police. 2. Quarterly report on number of warrants reviewed, number of conferrals on charging decisions, number of preliminary hearings, number of grand jury appearances, number of trials and number of appeals. 3. Written procedures for prof ect. 4. Record of quarterly meetings with Police and law enforcement. 5. Record of in-service trainings. PROJECT BUDGET CATEGORY AAAOUNT DESCRIPTION JUSTIFICATION 1. EQUIPMENT $ - 2. OTHER COSTS $ - 3. SUPPLIES $ - 4. TRAVEL $ - 5. CONTRACTS/CONSULTANTS $ - 6. PERSONNEL 6.1 Deputy Prosecuting Attorney $ 72,192 Experienced DPA in Hilo 6.2 Deputy Prosecuting Attorney $ 72,192 Experienced DPA in Kona Total Personnel $ 144,384 7. FRINGE BENEFITS 7.1 FICA/Social Security $ 11,045 7.65% of salary 7.2 Health Insurance $ 15,330 $524.78/mo.4/1/04- 6/30/04, $676.70/mo. (estimate) 7/1 /04-3/31-05 7.3 Life Insurance $ 100 7.4 Vacation $ - 7.5 Sick Leave $ - 7.6 Retirement $ 14,947 8.95% of salary 4/1/04- 6/30/04, 10.85% of sal. (estimate) 7/1/04 -3/31/05 7.7 Worker's Comp. $ 6,180 4.28% of salary 7.8 Unemployment Insurance $ 361 .25% of salary Total Fringe Benefits $ 47,963 TOTAL BUDGET $ 192,347 TOTAL FUNDS ALLOCATED $175,614 Additional funding needed $ 16,733 8p85216286 T-516 P.02 F-185 J sn-21-p4 p4 : 50pm From-HAYiA l f )fV I TY FOl1~0AT i 0f~ ~~tl~l~~fy~ Several provisions of dedtral law anal polity app)y to aU ~+nnr programs, VC(t (the Offact of Coanmursiry Urirared P liciAg Services) rlfird rti srcrtre yow assurance that the applicant will comply wick these provisions. )f yon world L°ke furthts irtfactnatit»a a ut ariy pf 4hese asstsrantCS, pkasd tomear.r your state's SOPS Grant Paagrarrt Specialist at {806} <21-b774. . $y the applicanr'a auchorixed) representative's signareare, the applicafle assetrrs tdat it wi)1 ctsrr,ply wins all ]ego] sad a rive reyuirerntnts that govtro the appGtant (or acceptance and use of ftdera) grans fonds 1ri partievht, the app]ecaflt its ns char Ir has brew degally and ofi"seii0y auehPSa2ed by the appropsiatc 7`hese civil rights rtgvererr?ents arc fovatd i the won- goverravag body (for raaptip)e, triayor or City counral} to appl)* for :his aji3Crirtairi2tiota provisions of the; t'Jrrsrtibtss tirite Coflraol acrd gsant apd chat the persons signing the application and chest Sala SrtsetS Act Pf 196$, as arree»dot>t (4Z SSG § 378p(d}}; TatBc aSsuraar-es on ir: behalF afe auchotiatd ra do so aqd to ace on its Vl of the Civi Riglsis Act of 7964, ss uatr (42 U.S.G § beltA)f with resjxtt ea any issues that snag elite dntit5g pao[essiwg of 20044); the ]radia,a Civil Rights Act (25 t1S C. 8307 -1303); this application. 5ettrart 504 of ehe Rehabil•Sratican Act of 173, as araetadcd (29 USC. § 794}, l else lk, Snbti$e A of tta,t: r4 tairaras with 2. ]t w,7] eonrp)y with eltt provisions of fedora) law ev}aich lirwit terrain I?i9abi)isies Ar:e (ADA) (42 #3S.G s 12108, seg.}; the Age pts);eicaD activieies of gnnrtt employees whose principal errip7Pyrraena $>iscrirnsriariaa Art of 79'75 (42 li:s,~ § 61 i, et seq.}; $rtd is in ebnnecrion with am as tivity finanted ist whole of its past with this l~epartmrnt o€ justit:e Non-l~iscairrsisaa " Reguilations gram.'l'dtcse restrictiares a,t set fPrth ba 5 i].S.G ~ 1541, et seq. contained in'lir3t g'2rrs 35 and 42 (s?sb res D, ~ and G} of the Code Pf Fcdezal Regulatiprss. 3. h will comply with the animiwaura wage and rr,aximuan hour3 provisions of the Fedora! )'air ]..abor Srafldards Att, if applicable. A. ]n ehe evrrse char any eesuxt or adrainisraa ' e agency motors a fending of dixtri,ninmeion on gxPwads off ct>loa, religion, 4. ]t will eseabGste safeguards, if ;t has nog dame so already, to prohibit nanional oragirs, gender; disability or age ag - st the app]icane afrtr ertsploye<s frordt using BhcL po3iaians fOr a pua'pose Rhar ,s, os gruel a due process hearing, it agrees Po forward copy of the firadi»g the appearance of being, rr;oeivated by a desire for privaem gain for to the: Offxc of Civt7 Rights, OfFW.t rsf ~us t Frvgrarrss„ 810 7th rhessasdvC•s or others, panic ularly tbtsst with whore they hmve farnrly, Srrt:et, N'itc; Washingrort, I1C. 20531. businrss or•Prher tics $ Grantees Bhat hgvt 54 of mock employ as:d gloats 0vcr . It a+aU give the ]?spasa'taent of justice rsr the CorrspraoDcr General ;500,400 (4t eves $1,000,000 isa greats auto n eig8stea;aa•manth access to and the sight to exarniree recarQS and documents related to pcriPt>), trust subs'rtat ass acceptable ~tlnal playsastnt ehe grant- Opportunity A)an ~`1~OP'~ or ~IEt7P shat faros (f grantee is required eo submit an ~CJP under 2$ GFkt 423021, chat is G, ]t will comply with a!1 rertuirenrerits imposed by tlae Dspartmenc rsf approved by the Office of justice Psggaams, Of6.ees for C'.ttrsl ]ustiee as a condition or administrative requirement of the groat, TtigltZS wiehin 64 days of the aoearr3 stale da pot presets trnda incleiding bee nor limitrd to: ohs requiretrtetets of OIt98 :Circulars A- $500,044, but over $25,000, ar for gaantees 'tls fewres than 50 87, A-21, A-122, or the lctdrral AcegRaisitxPn Regvhttians; as applicab]e employees, the granter must spl7snia ass EE Ceztifarstiara. (&overnetag cost principles}; ORd$ Cira:u)ars R-702 or A•7 ] 8, as (Os~neees of less that: $25,000 are true sub) t eo the ESOP applicable (lJraiform AdmiriastrArsve IZtgasirerrsetats for Casant5 Arad reyuirtmcasa.l Ceaprrativt: Agrecmenxs); ~:tMB Cirev)ar A-733 (g+averB,isag andses}; the applicable provisions of tbt Onaraabus Cairns Contra! and Sale 9. Pursuant ro T}e8artmenr of )oasts guide: ' s Qasae 1&, 2042 ~ Streer$ Art of 1968, as arner,dad; clot cutrrnt edition 4f tbo COIsS Fede~l Register (Yoiurna: 67, Nombet l7?, gel 4ig55-41472)), + r Grant Moriitorir,g Standards and Guidelines and with a)) other under 7it1e V] of ehe Civil 8tights Iiet of 19 , rt wiD ensure i applicable progrun regtaixtments, lawS,:ordess, ra~gulaCaras, or rtseaningful at:ress so its programs and acrieri es by persons with circulars. ]irrtited jrrag)ish proficienclc i r 7. If applicable, it wilt, to ehr. exrtnt pras:ticable and consi5tmt with 10. ]twill ensure char any fatilitits eradtr its ntrship, lease or applicable law, seek, recauit a,•,d hire gtrslifted meflabers of racial afld SnptrvisiCa which Shall be utsiized ist Aha act rrap)ishraesat of the eehrtit: tnvaosity groups and i)ualifxd women ire order to further praeject arc nor Iistet] ow the 1~nviranrsBeAra1 tsrettion Agtraty's effective law enfprernatna by int:reaslmg thcu ranks .vithitF the sworn (~l?A) list of Violatieag Facilities and that it w flotiCy us if r positions in the agrncy, ~ advised by the 13l}A that a facility to lac used i this g~amt is under ~ consideration ter such Gstirag by the LePA. 8. ]twill not, on the ground ~f race, color, religion, nztiona! origin, gender, disability or apt, uritawfuliy exclude any person from 11. 1f rht applitartr's start has arablislaed a r sew and [o,nmenr parrictpabon in, deny the benefits of or employment ro acay person, proaedurt under fixecc,tive Ordet 72372 and as SelCCred rhos tYr subject any person to dist:nrsaipatiastt in connmetion +v;th any program for rrview, it hot made this aplx)ieata avai)able for s or aew,ties funded in whole Pr its part with federal funds` review by ehe trees Single Point of Con~act~ 3 . t • Jan-21-04 04:50pm From-HAWAII C VITY FOUNDATION B085218286 T-516 P.03 F-185 apeney-Awned, rtflted or pepsonally-owned ~tjtaclea inert`3~ ssd ~lP~ets sCt3e~l~.,..~eeo~ ecvci, azc sl en~c~, vin,. ac~.~• or fatal funtls (ar a minimum of t+nr juii 9CS4 budf{~~e e;relr 13. 1t will not use COPS funds to supplant (replace) scale, local, ev fi+Aowing experaranrr A( the ~+rant pe'ait3d. ~ Bureau of lndia» ACjaue (ands that orhrrwrst would bt mode available for eht purposes of this grant, as appGeable_ 1'sfst €tateme»rz os claims »~adt: ist can tit9rt +uirh i_gfi>, grortts (inclutGng ~tx+l+cnti+'~ agsremrnts) r+~3;' resarh irs f»ca, iaprisaanrr+ent, cliSharm~rr from ~ icij+a~tit>~ ir+ j~leral gra»tg t+r toetraces, and/tx'rry or rr srrverdy available by lovie 1 t¢rtify that the assiar:+a~ccA pmvidcd are troe and atcurAtt to the bast qC my ltnr+wlcd~. ]:,kKtie+n~ or »thcr selcc rkstas 4f »4,tiv oftuials will nee rclie+~e eht: granere ea~wey eE its obGgatinr?s under this gr$nr . 49/05/2pC13 SA~'nature tYj l}II3631r~, P ~ ~vti2 ( t~ f~C1a! tidaTj+ Da4c 7+r vnatit fl a•10IcT~1 ,'};nature of ent .,x~rcutiveY,(^t+r Of(iesal with l7atC l'inaf+Cl2l l,L4M0r7r~ ag+pl+eabld:) up rcd~ 14Fa?PCh 20, 2003 e03~31909 Jan-21-04 04:51 pm From-HAWAII ( WtTY FOUNDATION 8085216286 T-516 P.04115 F-185 I~~I~i`~ fte~arding Lobbying; i:9arbal->rr~rlt, 5c>l~p~l~siort ar~d ~1T~ R~porl~s~aatsty Nl~tt -Fri V4~ a~ F2~quir~rnents +Cawrl~n~ly~ At€~ed A~eo~a~i~s; T~mn-~upplarsltir~g°, aeac9 R~f< 1?lrhaulh Flee Department of justice leas made evcYV+ effort ter simplify- tine application darocess, oti?er prxrvi~ons o fiedesal Lew tax tb pock yctut crttificatir~n re~rding crreain materrs. Appiicanes should lead the eepatiaeiotfs Curd bcdayav and t3te lase ctiorts for cerflfiration irrtludcd in the rcgarlauons ro understand Flee tc~crirtmrnes and whceber they apply to a particular applieapt. $ pf Leis fottJt pr~oPvir3es far ccampliance wieh c~rtifitation rrclvierrtrerres under 2$ Clk'St Tram ti9,'7Nrw RcaYrictignis tin l.obbyin];,"'nd 2$ Paas 67, "Cinvextuncne•widc Dcbarr~trnt and Suspcnsitm (Nvngrtoecrrefrtt:ne)'aad GA~•ernment ~aidc Itcquisera~t$ fAr -Free Wosk}~,ce (Grants)," and the er?Dre{llratlodt and racm•suppladbYng rec}e:irrmmts of the Public 5afetp Psrestership and Comresorliey P~DD•aring 1~+CR taf ]994. 7'lac arrtifacatians shall be trcaectii as a rnatrxial ts-prescaafatirrra of fact uptm which rcliaoa:e will be placed vrhett t Drpart~atrrt of ~utxioc drtern»nai to aN+ard the eovr:rcd yrattt. l.abbying (L) Have ntrt wix}rin a tlrreo-lrrar period xtCeclirag this applicatipaa beers eanrieted of os Fred a civil i~ t tauudt:tcd agaiabse tla~ rls rryuirrd by Srctitm 1352,'1 et]e 31 pf the USL Cock, and fax crxturaissitaA of fraud er a rrimirtal o foeyae iga eoppn smplemcrrtad at 28 Cl;}S Pact 69, fear persons entering itattr a grant ar Abtainirtg, attempting t4 obtarx, or perf - a lxtblie (federal, cgopKiadvC agreement aver;l t)U,UOD, as deli®cY1 aP 28 CFR !'art 59, sate or kxaT) eraftsactit>tt at Carrtra[ti o a ~ablit trastsaepo:s; t}tr applicant crrtifses tlrar. violation Af fcdaral Ar state antitrust stn Fes or eommissiota of ,1. I~lo federal apprppriated funel.4 11AVQ been paid or will LK paid, by rmbrzalcrrreaat, tFreft, fvrgcrg, 1bdlierX f '$t~tiort o! destruction or qn bahrJf of ehc un~kssigncd, to spy person fort alflrxtsting or of records, rnal<.ifr~ frlst statements, or irtg stblrn proPctty; attempting rv influrratc an off ccr yr crtspl~syee of any agrYtcy, a rarcmbcr of Congress, an Afficcr Ar employee of Congressr ear an (ur) .arc not prcarntly indicted for oz st+arist crirseirtaliy or tmplu,.•te e+f a member of Conhrress in connC~oft with the making civilly chatgcd bl a go+•rmm«rtal entity federal, state tar loca4 Af any federal grant, ehc t:ntering intA of any t.Aapcrative agrec,ment; wiPh eAmtaiSRion of arty of ehc nf1Fe enugacrsted iry psrxgraph and the extrnriprs, ContinttatiOtt, t€cadwal, aant:ardt7aarat or modi¢i~caeion (1)(v) of 4}ras terta6eaeron• and Af arty fcdcxal grant ar cAnpcratrvs agrcrsraent, (n) l~as•S not within a thacc-year pe pxecedietg ttaia 1~ if an) funds oeher tt,an federal ayrpropsiattd f'trnds Isava barn paid appGeatinn had rme ar more Public tta C'OOrss (fedQal, state or ar will br paiJ to any pexsoxt faeY irafluatacing or attcmptixrg to lots!) ternainatrd for cause ox default; , d influena:c an oftrcer qr r.'rtrFil9yCe of any agrncy, a rrteeAlrCY xrf Con};rrss, an offers yr employee of CAngress, oe air ertaplvyes of a H. Wlrcrc Flee apyrticant is unable to eery ro awry of the member of C:aragress v, cAnnection with this fsdera! gsarat Ar statcrtrrn[s in this eeatifsatiAn, he ors shall attaels ~ cocrgcxative ;rgrremrnt, the unrlczsigned shall complete and submit expluaation tee this application. Standard Farm - Z1.L, "L~iselosurc of 7.obbystrg rlctivitics," in aCCUrdance with its trlRrtuCttUA3: 3. Drug-fir+re i'd/orkplace (Grstttties Qtlt Than 7erdividtnls) C. "lire undersigned shall require cleat the language Af this certi(tt.~tiun As rr9nirecl bg the Drug-IFree WryrJtplac At'i Af ]9$$, and berntludcd in the award dr>cumettes for a4l subawards at all tiers imPlerrrented at 28 CFTL Pare 67, 5u F, fQr gr~rsttes, as (nciudis3g subgrants, cr.,otrattti andcr giants and caogieaative dtfsnrd at 2$ C1t'R Past 67, Sections 67. 15 artd 67.b20 - agreCmCnts, and subccx,tracrs) and that alt sub-accipimts shall ee:rtify A. arc applicant cet¢ifaes that it will, os continue ~ pt~ovide and disdpse aceurtlirtFly a druug-(rte woskplatr by: 2. 13ebarf»e»t, Suspension and Other Rcn~rons79b~ity ;•iatters (Dixtct t7 Publishing a statement rrotifyirng exn levees eh9t Flee unlawful Recipient) manufacture, distn'buaiarr, dispensing, soon of use of a Controlled substance is prohibited ifs gr~eee's wor9cphce r1s required by Exeeutive Order 32549, Drbarmctat and $uspcnsiofr, and spccifyirtg Flee actions that rovill be takcrl against efetployc,es and implrmrneed at ?8 lrYTR Pare 6~, (ur prupeetive ParticipaAes in fOr viodatian of such prolarlriticrn; l7rimary etrvcred [ranza<tinres, as dcftncd at 2S CPR DTart 67, Scetr®n G7.510 • (u) Itstablisiring an on•koirrg drug•free wariness program to infarrrt cxn]r!'r~•cex abfwt - ,1. 'J•hr a f+pGcanr crrrifi~;c that it and its pcaftcipals (a) The dangers Af dacrg abuse in the workplace; Art not presently debarred, ~'uspmded, proposed for drlratrr,ent, declared ineli~blc, sert[e-flt:ed r~ a drnia! of federal benefits by' a Irate (b) The grantee's pal;ey a( mairttai g a drug-free ~vtrrltyrlace; ur federal court, ur .vluntaxily t:xcluded from coveted tranaacaans by any federal dcparrmcnt or agency-, Jan-21-04 04:51pm From-HAIYAII ~ VITY FOUNDATION 8085216286 T-516 P.05/15 F-185 \..J ~.~.......,......e....-~ ~ ....N....~ ~...t....~«...,..... abusc ~Fatitrns oscv:ritsg;n tht workjilatc; B. 7'he gsenree shay iatsert ma the mace 6elt~+w? a!u site{3) fax t@?e lfarfbamanCe ®f wtxk de~tte . coatsoeetioat wedh ~ Clif) lllakJ97~it a regWrerne7a4 that ea[h ~p'l~'Cf Tda bC Cr1~~[Yl 7n g¢~ sp~,f>< ~JR~ the prrfsftsnanee of d,e grant be given s ecspy of the xtataasrnt Place of pcsforaarastsG {street address, ~ ~oattR stsete, self r¢quired by T~'+8'sFb C): code) • (rv) 13otifying tho ¢rszpl~wcr in the statetneet rCquircd b9' Pa~B~f'h that, $s a condition o[ erstiployrnast t~aider the prsrst, [ifs rmpEt~yeC ~ ' Check ®if these are wmrkplascs ort talc ltat ste qqt . idcrtdfigd herb (a) Rb~ by tDae tctsns Qf the 6Tatt;rnrast: and Sectiara 67.4341 of the regvlaeions ps that s tee l~ that is • state :ear ctcct 4+P s+alte a~no c+erti tioo in catlt (b) Noafy the emptoyet 'sat orating of his or her coravittion fqa a federal f5,atal yeas, s COPT mf wlaicDt be ir~tded tviT¢s violamon of a ~^.n~.sal sing stawtc cxcurring in tht: woakplsce sych apjsliration for l~elrsrtttsent mf ]nseit fisax3"us~ Scstes no 6atcr than five cafefldar dayz a~4cr such con~Tiott; arsd state agetss8cs ma'y elect to ease O,I~ m 40tS717. Checl: ® if the state has deCetd tot o)P Torro {v) Notifying the agency,, an writing, witha~ 70 calendar days after 4067/7. receiving notice undet svblwuagraph Cnr){b) ftt>eae an ctatployre ®t . odacra»sc scceavir?g aeaesal aotise of such eonvicaion. ~srsp}oyers q_ CasrardinaTirnt of ecm~iCted errsplsyecs sa~su3t:piovidc notice, indnilissg pnsitavn . titk, to: CUPS Office, 7700OrersnpnT Ave, NW,'{aJashirtgtort, L1C 2Q53Q Notice shall include flee idcatL4Elcmtior8 nvsm The Rsblic.Safccy Aartasership and Crataset wary 7ataliong rice 7xz(s) of cash of 7'la4 eegffi'sres ~,pplicanes to certify etsat t7scre ha. been affccred graatt; apjssYapaatt corsadiraati4ss watl, all agcnsses t}ist snsay be (vt) Taking 4nc of the fQArrwing actions, wiehi» 30 calendar daps of affected by else ag~plicas+R'e gsant pr+aposa8 f 9pp.cx*ed_ rrtcivin~, notice undee svbPa~B~Ph CN)(~). with respect av soy Affected agcneics may vaduode, amassg the: Offite of the United States rlttosikCy, state OY loeal t®as, os csrsgloyce who ~ so ux~vtctctil . eorre:etagnal agetseas~ Tlse appliearst eerci tDtat tlsESC lsas breat appsopsiate ~:d'isaateoo c~stBti aB a ag2roisa {a) 'raking appaopriatc lsessostasel aeti®aa against s+acb aq . employee, vp t® ant artcludhag rerraaiaeaggp, consistent with the sequirsments° mf the Rchaba7itatinta 11st of 1973, ss srneasdeal; or {b) Requ'ariag suds etuplol~ tss particigaaee saticfaceottly in a druK abuse assiswnee or rchahelitation pra~gsazes aplxraved for sase9, favrpascs by a federal, state e?r local health, law enfdreesnent o$ other sspprapriatc agency; CrantccTdaunca~A~ess:H~~$~-`~- Co~u~aa.ty Fousasiaiton, 1164 Bishop St, Ste 4]0, Honolulu, HI 9681_ A~lieation No. arsd/ot g'roject Name: Me thamyhe t BYIIint? Prq ~ ~ ~ ~lendor Nasrtsbe~ PlQn rofit •4]r anizstion TypedNarrKaridTaa3cos,',/ F~ectit'te~ Ke7.v"n H. 7`aketa President ~ CFA Signatsa+e: ls~- _ _ I>~e: 09/05/2403 As sire duly aalknfi~ed rt~aresera8asftie ®f titre g®v®salarg ~R I hweby cera, Jj+ shot ,/area Iri~r~a{g 68ec ~,+at~eartiarg* pa B9it arb~ ja r.~oass. ~lecsaorx o,~raew ca~`itsnds tdi/l lips rdiawe dire goo irag + ~'Jts ~a°gat~ras~ aaat~~ sDsFs graprat 73pedNarneand7"lcos'Gov,tExea~trtivc: HS ~^y I~~:ISIi fd~yQ~, bounty eat I3~ iii Sigraaturc: ~atc. 9 / 8 / 0 3 8085216288 T-516 P.011I15 €-185 Jan-21-04 04:52pm From-HAWAII C ITY FOUNDATION + ~ w ~ a .0 d 0$f8 IaYJ~~t:Bi e'D~"_' 41/ - . 'I7~ais disclosure form shall be coraapleted by the report~istg aratity, whether stsbawardee or Iari ~ Fecl~eral ~pi_ ant, at flee itaitiarion ®s receipt of a Covered Faders] action, stir a materaal cktange to a previsars ptgasuant to tiler? 31 U.S.C section a3S2: The filing of a fotan is re~usred for each paytrtent or a t 4o'raalc~ pay- aYta?nt to any lodsbyirtg enfity for influencing or attern~tisag t® ira#luerace an oifscer ar errapl c+f any agency, a Mernlaer of Coragre~ss, an offaser ar ernplayee of C®rtgr~ nr an ~mp]a~ye~ of a Me~raber of ~ as~ress im con- . raectioas wi8h a covered l+edera3 action. ~®rngslete all itergas that appi'y far both the araitxad acrd ~reaf~erial rharage report. Refer to flee irrap]ementing gat6danstQ ptal~lfsl'te~cl by the Qffice of Managernen8 aced D3udgee for adtliiionalanf©aanation. 1. Identify the type o$ covered l~edtral action for which Iob- es~d Fedeazal actioet (itet7a Tf ktaotvey a the full C_°atalag hying dCtivity is Arad / or has; bcera secured to iraflaaence theout- of 1~ederal I)at'rt~9c A~sfstanc~? (~A) n bar for g,~raa,2s, came of a covered FeKie~,l Faction. coaperatDVe agnc~traesats, ltti.~s atuD loam mutitnre~is. Enter the ma>sg appropa late Federal id ~ attamb~ea 2. Dderatily the states of the ~;evered Federal action avax`lable far the Fedea-al action ident~ed aterxa ~ (eg, 3. Identify the apprnpaiate cPassificadon ~ this repcsrt. If this ~ f ~ ~~'~P) n~~° f $id (lFB) nuasber; grant ararae7autc~rnent rattm'a?res; tar~tsat~, or is a follow.vp repast causer! lay a material change tt, tDae iaafor- loam award raes~aben, tBae application/ coratsol nwnbea oration previous]y repeated, eaYta~ tree year and quarter fn a~ul•aida the change occurra3+d. Entex the date a~ the ]ast paevi- signed Y'Y the ~d+eral ageaxy). Include es, e_g., °'RFP ®Dr-7. oa~sly szabsniet~ed report by tl'ais repot'tixag entity for this amv- ere+d Federal action. 9. Far a coveaed Faders] action where has beear era a~wataaal orlaart cgnaaraatsssent Dry tpttt Federa! ~ e+btea the the fait xaame, address, City, state and .zip code of the Feciesat amotarat ~ flee award/lean c1C~a73ai t fcvrthe pairne reporting entity. lndude Ga,agressa~anal I3lstsid raurnber, 3f entity idt~atified ire iteaxa 4 aa• 5. known t~rls, the apl7roPri:ate dassafatati4n of the reportSng entity'tlaat designates ~if it as, ur expects oo be, d prira~ er sub- I (a) Enter the farll r~rrae, address, airy, and zip cncl~e of award redpient. Identify the ties- of the subaarardee, e.g, the tkae Dobg t'Y the ~ ~ °arae idetatir first subawaz+dee of the prirxae is the lst tier: Subawara3s fled in item ~ 80 influrbne+e the covered Fed aa:9sn~, include but are root .limited to saibcontracts~ subga-ants and contract awards under grants. (b) ]Prater thE~e full raarxae(s} of the~rixadividual( FrerfoactYairag ser- var.~p 2~fa6I ~i I~~E~E d l1$1 ~d L adlll~(aL ~L H'~ ~n~j' 5. If the orgaraizatiaara fading th:: report 3n item 4 checks Last DVarrae, Fia•St TJame, aced Middle Initial- "Saabawardee; 'then enter the faall raarrae, address, city, state and zip cede of the pa assae 7Federal recipient. Dnc2ude ]7. The certifying affic,~] sDia]l signs ar?d date t}ae f~em,.pii¢at Cangre~onal 13;strict, if ks~uam h~/heT n~~ title grad te7epho~ere nut~'aber. _ 6. F.aater tDae name of the Federal agetacy riaaking the award os Fables rcp~rtitag btsrdcra jot t7a~s caldettiert of ' is csama~ pa Doan sonntatitmeatt. ]a ae:Iude at feast oaae organizatiora.~l ]evel 8c ~ mraar~t~s prs P~sparrse, dndudis~g tuaar~r r ~ g r,85~ 1bQlow agency casette, if known, Fas ~earaapla;, Departraaent of savrs~ung rxLsemg date sonasrrs, gaslar?ing and ina8n ~ ing the data azaslai, rind 6prnFEetitrg amd rcr~tuin~ the mTlectybn aj '4m_ Surd ~ - Traraspoi tati4ay United Stites t''oas2 Guard. mrnis rcgnrdirr~ the ba+~'den estimate or array ot]:~x of this csplda~ica~ of inja7lTfatibn, anttu4lrcg sa,$,gestians jot sedurtgig chic den, W thr t~rtr of 7. Enter the Federal program ruame ar descrip4ora for the tov9 J19tenog~irrnl and BaKtget, Aafxrwurk,RcAaection 10345.4~4bJ, F Washingtm, L?.C 2t}530. t • e'' Jan-21-04 04:52pm From-HAWAII l ,VITY FOUNDATION 8085216286 T-516 P.O7/15 F-185 • ~ ~ ~ Ap'pavv~ try Oiv~ , ~nmp)ete this farm to clise)ose ]abbyiaag activities pursuant to 3I U.S.C. 1352 tafa~dea} Yt?Vt?rSe fist ITt$tTUCtIOtaS a.Tt[I plti7)SC $3llt'dt.'7't dIS[J~58AFt'} a 1. Type of Faders) A,ctio~s: b 2. Stataas of ]~eAeaai Actpan; a _ 3_ Htat Try a. contract a. bad jofferlapp)icatiott a_ istatYai ftC b. grant b. initial award b. matetiai stage c_ c~voperative a$ref~men4 c. g~ost-award d. )tsar For Ma?`seal ~e ~?rJy: e. Doan guarantee Year f. loan insuiarace Quarter: Elate of bast port 9. Name and Address o4 Re~rti>ng Entity: 5. ],f Repoatang Ezataty fn Nn. ~l is Smba ardee, Ex,eer ~Pri t7 Subawaadee Name aaasi Address of FYam~ 75er . rjkixoum: Hawai' a, Co~tuAity Foundation 1161} i3ishop Sttceet ~ Suite 800 Honolulu, 4lawai'i 9b813 Congressional District (natxzabe~r), if known: Congsesstiortiai L1;strict fn+ux~ber}, if Jca, n 6. Eederaa Deparelme~nt/Agensy: 7. Federal D'xo~gaaase Name/Dessaiptivat. CFDANuraabt;r, if applicable; t3. Federal Actiost Ntaxs,tser; i!f kvaoovrt: 9. Aavard Aaaeouaat, i.~ kttowaa: 10. a. Name and Addxe~ss of Lobbying I~egistta7St 19.7s. lnaiividnals lf'e7ti'ttrmiitg sea arises (if iaadavfdaeat,.last ncssne,~rst srame,Ml): {including ac)sires~if different fan NaAt?a) (last name, Faa~a"t name, N,iI); 1l.inf~rmztion segmented tltrcrmgPt aBtislorat a9 at?t}~orizeai bg: $Hg3'1at71T@: f Title 31 U-S,C- Section 735 1'#tis d3scDosae2+e of lobbl'i8tg aCtivatiey ig ~ m>atttYal rc~se~entatix~ee of fart ugroaa ero~tir3? Priam Naaaae: g lvir? A . Take to selianco was plaeed trp the der alx~ve rovhen t9~is eraetsasmoga suss mode or etnlered inteD. ~1`elis disCioseare is seyuired pgxr- s.xaest to 37 t7.S.er 1352, his ia~furlII3alSose wall he selwrted to 7It3e- Fr a sidetit & CEO the C~egn:ss semi-apeetua3ly anal will be a~r~at~ble forpubdic iaaspec5~. Any ptzson whm fad to 4`ilr thr tztlaai7+Pt~ disrt~- Te)e hpne Nv.: 808-537-6333 lC?ate: 05 20 3 seat shall Tie satrje,ct tm a rivil petaaity of not less ilaaa~ SaoAOV ~ 09 ~ / grad eao! aaoac than 32t)67,0oay far eac#a smch faiBure. pedera) Use ~?iy: Authorized !Or Local Reproduction, 5 lard Form - LPL 1 ®RGANIZA~I®IV: Hawaii C®unty Res®urce Center SCOPE ®F W®Rt4 1. ®escription of Project WHAT: Hawaii County Resource Center (HCRC) links Hawaii Island communities to Hawaii County government, working to enhance collaborative efforts between grassroots groups and the government, including law enforcement. HCRC empowers individuals, community groups, nonprofit agencies and county departments to develop skills to achieve greater capacity as well as increased funding. HCRC will foster continued dialogue among law enforcement, government and community through facilitated meetings, developing a united front to resolve the ICE problem. WHY: Strong, well-functioning neighborhoods and communities have been shown to be effective in battling drugs and poverty nationwide; law enforcement and treatment are supported at the grassroots levels by prevention and education. HCRC will facilitate collaborative efforts at the neighborhood level island-wide to confront the growing ICE epidemic. WHO: Working closely with the Office of the Mayor, Police Department and the Prosecutor's Office, HCRC is well positioned to build needed bridges between the community and county departments. Also a lied with the Ku°ikahi Mediation Center, HCRC can take its facilitators into subdivisions and neighborhoods barraged with conflicts resulting from the ICE epidemic. The Community Empowerment Project (CEO) was managed through HCRC and used the facilitator model successfully island-wide. HOW: HCRC encourages healthy collaborations and capacity-building through its unique facilitator program. Four well-trained facilitators familiar with the workings of county government will be available to community groups and neighborhoods working to ameliorate problems that have resulted from the ICE epidemic. These facilita#ors can help groups through aproblem-solving process that results in clear objectives and plans of action. While the facilitators use effective meeting skills, demonstrating the `how-to", community members will begin to integrate and use these skills in alt of their interactions. This community based infrastructure empowers individuals to support the efforts of law enforcement and local agencies through education, mentoring and technical assistance. 2. VVorkplan a. ~4ctivities There are four major HCRC activities related to this drug-free effort: ~e~ . (~-I~~-~ 2 1) To train and nurture a group of 4 Community Level Facilitators who will lead local meetings, modeling effective meeting skills to neighborhood groups, community associations, the public and county departments. They will teach communities how to reach their goals through proven methods. They will also act as liaisons and communication links between county government and the public, instructing both parties in more effective interactive skills. 2) To support effective Community Meetings through the facilitator network, empowering grassroots advocates for aDrug-Free island. Facilitators will lead meetings, provide coaching, assist with goal-setting, planning and evaluation. Groups already in existence will be targeted for help in becoming more skillful, and newly forming groups will also be educated. To assist the Hawaii Community Foundation with outreach and logistics for the Meth Initiative Grant informational meetings and provide other support services as needed to support this inititative. 3) To conduct Capacity Building Trainings to teach the public and county departments effective skills in meeting facilitation, problem-solving, conflict management, strategic planning and other related topics. HCRC facilitators and outside trainers will be utilized as appropriate. Educational/informational trainings will be held island-wide in conjunction with Police, Neighborhood Watch groups, sober addicts and Ukiah Mediation Center. 4) To organize, .publicize, review, and oversee the State Mini-grant Fund. HCRC will support local-organizations to develop, implement and evaluate projects that fight the drug epidemic primarily through prevention, education and mentoring efforts in their communities. i~. Timeline: January 2004 ®March 2004: • Data gathering, planning, preliminary actions. • Community mini-grant process developed; first mini-grants are awarded. RFP made public. • Facilitator team training retreat held and community outreach begins. Neighborhood groups needing help are targeted. First community meetings are held. • Capacity-building trainings in facilitation and problem-solving for community groups and the public are scheduled and held. • Trainings/community meetings in collaboration with Mediation Center are developed and scheduled. • Quarterly evaluation of the whole project commences April 2004 ®June 2004: • Community mini-grant awards continue. Site visits and celebrations are scheduled. First evaluations are completed. • Facilitator teams continue work as needed in community, teaching as they demonstrate skills. Facilitators attend quarterly training. • Capacity-building trainings continue with classes in Strategic Planning and Conflict Management. 3 • Continued trainings/ community mee#ings in collaboration with Mediation Center are scheduled. • Quarterly evaluation of project continues. July 2004 _ September 2004 • Monitoring of mini-grants continues, along with final evaluations when needed. COntlnlling Slte VISItS. • Facilitator teams continue work as needed in community, teaching as they demonstrate skills. Community members targeted to become facilitators.. Facilitators attend quarterly training. • Capacity-building trainings continue with classes in Learning How to Work with County Departments. • Continued trainings in collaboration with Ku'ikahi Mediation Center are scheduled. • Quarterly evaluation of the project continues. October 2004 ®ecember 2004 • Facilitator teams continue work as needed in community, still teaching as they demonstrate :skills. Community members take over, coached by facilitators. • Capacity-building trainings continue with classes requested by the community. • Evaluation of the project nears completion. c. ®eliverables 1) 4 trained facilitators available island-wide by the end of February; 4 recorders receiving "on- the job" training by end of March to become skilled community facilitators by end of year 2) 16 Capacity-building Trainings this year at various island-wide locations to provide capacity- building to entire island population 3) 96 Community Meetings this year utilizing HCRC facilitators to model and teach effective facilitation, strategic. planning, problem solving and confiict management skills. In this way facilitators will help community groups to become successful advocates for adrug-free island 4) 50 Mini-grant recipients this year will be supported to develop, implement and evaluate grassroots projects that battle the ICE epidemic th-rough education, prevention and mentoring efforts in their communities 4 3. ~ueJget ORGANIZATIORI: Hawaii County Resource Center CATEGOi2Y ABVIOUIVT ®ESCRIPTBON JUSTII=(CATION 1. EQUIPMENT (Tangible property having a useful life of more than two years and an acquisition cost of $5,000 or more per unit. Must receive approval by COPS federal officer rior to urchase. 1.1 $ 1.2 $ 1.3 $ 2. OTI-IER COSTS (Equipment below $5,000 and have a useful life of less than two years may be listed under "Other Costs". 2.1 Facilitator Training Retreat $ 1022.68 Lodging 6 x $110, Team building, skill- trainers $300, building at the start for Materials/supplies facilitators and staff $62.68 2.2 Ca acit -buildin Trainin s $ 400 4 trainin s x $100 Room rental 3. SUPPLIES (List items by type [training materials and expendable items costing less than $5,000, such as books, manuals, etc.] Generally, supplies include any materials that are expendable or consumed during the course of the ro'ect. 4. TRAVEL (Itemize travel expenses of personnel by purpose, e.g. staff to training, field interviews. Show the basis for the computation, e.g. 100 miles x $.30/mile. 4.1 Facilitator mileage $ 4800 4 facilitators X $100/mo Each facilitator is allowed $100 per month for travel 4.2 Staff mileage $ 2664 2 staff x 300 mi/mo x $.37 5. CONTRACTS/CONSULTANTS (Provide a description of the product or service to be procured by contract and an estimate of the cost, e.g. lease of com uter. 5.1 Facilitators $ 26,400 4 facilitators x $550/mo To run community meetings, develop neighborhood capacity and lead trainin s 5.2 Recorders $ 2400 4 recorders x $50/mo Recorders take notes and are in training to become facilitators 5 6. PERSONNEL (Grant funds -may be used to hire new, additional personnel who will work on this project or who will backfill positions that are vacated if an employee is deployed to work on this ro'ect. 6.1 HCRC Coordinator/Administrator $ 31,621.12 $20.27/hr x 1560 hrs See 'ob descri tion 6 6.2 Outreach S ecialist $ 27,050.40 $17.34/hr x 1560 hrs See 'ob descri tion 6 6.3 Mini-grant Clerk $ 5,922.80 $11.39/hr x 520 hrs See job description pg 6 7. FRINGE BENEFITS (Fringe benefits should be based on known actual costs or an established formula. Fringe benefits are for the personnel listed in budget category 6 and only for the percentage of time devoted to the rant ro'ect: 7.1 FICA/Social Security 7.65% $ 4,941 FICA= 1.45%; soc sec = 6.2% 7.2 Health Insurance $ 8,596 7.3 Life Insurance $4.16 monthly $ 74 7.4 Vacation 72 hours annually $ 2,708 7.5 Sick Leave 90 hours annually $ 3,385 7.6 Retirement 8.95% $ 5,251 7.7 Worker's Comp. 4.28% $ 2,766 7.8 Unemployment Insurance .25% $ 162 7.9 Other $ TOTAL: $ 23,585 TOTAL ~U®GET $125,866 7. I°IZINGE ~EIdEFITS -Detailed Breakdown Coordinator Specialist Mini-Grant 7.1 $2,419 $2,069 $453 7.2* 0 4,298 7.3 37 37 7.4 1,460 1,248 7.5 1,824 1,561 7.6 2,830 2,421 7.7 1,354 1,158 254 7.8 79 68 15 "Health Ins. Coverage (monthly) medical $141.32 (single) $419.78 (family dental 14.80 50.02 vision 3.6'0 7.68 $159.72 $477.48 6 6. PIaRSONIVEL 6.1 HCRC C®®rdinat®r/Adrninistrat®r $20.27/hr x 1560 hrs This position oversees the entire operation of HCRC, providing overall leadership and direction. Plans and recommends strategies to attain goals and desired outcomes. ®irects the HCRC communications network; plans and recommends strategies to develop and implement its functions. Administers and monitors grants, contracts, and program initiatives; oversees project budgets, reports and timeliness; participates in evaluation of projects. Makes arrangements for facilities and other logistical details required for community trainings and meetings. Facilitates and develops collaborations and interagency cooperation. Trains, monitors, and supervises volunteers, staff, and contract workers. Tasks Time required Organize, implement and oversee Community Training - 25% Publicize, intake, monitor, evaluate mini-grants - 20% Manage, monitor, and supervise Facilitators - 15% Collaborate w/ mediation center and county govt - 10% Other related duties - 5% 6.2 HCRC Outreach Specialist $17.34/hr x 1560 hrs This position develops, mobilizes and supports HCRC communication network and facilitates and supports district groups. Leads efforts in outreach to community associations and groups. Networks with grassroots organizations to provide assistance. Provides leadership and direction relating to community capacity building, providing technical assistance and training as needed. Builds bridges to needed resources. Provides outreach and coaching to community regarding mini-grant, oversees review committee; performs evaluation and makes site visits. Tasks Time required Mobilize, coach and support Facilitators - 25% Organize and oversee Community Meetings - 25% Review and evaluate mini-grants - 20% Other related duties - 5% 6.3 Mini-grant Clerk $11.3Jlhr x 520 hrs This position will track, record, process and distribute awards for the mini-grant funds, working under direction of the HCRC Coordinator. 8085216286 T-516 P.02 F°185 Jan-21-04 04:50pm From°HA1~AIl INITY FOUNDATION ~~~lf~l~r~~ several provisions of federal law and polity apply to all grant programs. !Xk (the Office of Coanmrsnity Qr7e®red F licirig StrviceE) need to Secure your assurarree Char the applcant wil] Comply with These provisions. 1f you would L'&e Fnrrher inEoranatitart a ut arap of these assurances, please tontar.t your state's CQp$ Grant Progmnn SprciaJist at (80~ 421-b770. . By the applicant's authorized representative's signa[vre, the applicant assures That it will commply with all legal seed a time re9uiremerits that govtro the applicant for acceptanct and use of ft4era) gronr funds. Iri pareieular, the applicant as ores ear thafi 7_ It has been ]egaily acrd offaeiallp authpri2ed by the appropriate 7txsa civil rights requirertaents arc foetnd i the non- governing body (for exapaple, tta9yor or city council} to apply (or this tjistr'trrairiation provisions pf the Omnibus tielre Contrtal steel gra»t seal that [lee persons signing the applieaeion grid thesC Safe Streets Act of ]9de$, as amt:nded (4a G f 37$9(4)}; Ttle d3suranees or? its behalf are authorized to d0 so ared t® act on its VI of t9ae Civt7 Rights Act of it3f,~4, as am (42 U.S.G § - behalf with respter to any issues ahaa snag arise during processing of 20644); the lndiara rival ]tights AeP (25 LLS 1307-13D.3}; this application. Section 504 of the RcbabiliraRit>n Arc of 1 ~3, as amendet3 (Z+3 t.IS.C. § 794); 'l'ade 11, Subtitlt A of t]ac .4 ericans -with 2. ]t well coneply with the provisitns of federal law which Itrttit certaiat ~?isabilitics Art (A®A) (42 tI.S.C. s 127®1, seq.); the Age political activitie3 of granase employees whpse principal emplpymene Discrimination ACt of 7975 (421.tS.C- S d1 1, et stq.); and is ire connection with an ae tiviry fuearited in whop ear ire part with this Y7epartmenc of Jostles Non-JDiscrim4raa - 1teg,.tlatiores grans. 7-litre resTrietiors set set fprrh in 5 U.$•G § 7501, et seq. coraeained in Tick 28, Parts 35 and 42 (sub r[s C, D, E and G} of the Code pf Fcdeaal ReguFations. 3. It we71 comply with rht rniniriaum wage 9nd maximum hours provisions of the Federal Dais ],.ataor S[aridards AcrT if appliesble. A. 1n the evens tha8 any court or adminisrra ' e agency makes a finding of discrimiriataon on grounds o! ra , cOlba, rcl-agion, 4. 1t will establish 3afegaarJs, if it has opt dome Sa alse2dy, [O prohibit national origin, gender, disability or age sB alas app]icarat afros employees from using they positaoris for a purpose shat is, or gives a duo process hearing. it agrees to fgtward copy O( She ~ndirig the appearance o! being, motivated by a desire for private gain for to the Office of C'r+nl Rights, OfSeee of Jns a Progaarrls, 814 7th themselves tar ethers, particularly sh®se with whorb7 they have fanas7y, Stroct, NSX; Washing[ori, T.t.f,:. 20531. business or~othcr tics. $ Grantees that have 50 or mots employ and grants over . ]t will give the l~epartrnrnt of Justice or the CornptrAller General $500,000 (or eves 31,000,000 its gaareaa eves n eighteen-nTOrith access to aril the light Bo e,.artairx records and docuriaen[s related to perio4}, m+rst subrrtit eta acceptable equal plerysnent flee grant Opport~aniry Plxre ("PLOP' or ~EOP shot farrae (af gsatttee is required to s~bmir son F..I;OP uroder 28 CFR 4Z30Z), rhar is ' 6. ]t will comply with all serluiremettts imposed by the i?epartrnenc of approved by the pfG[e of Justice Progr+ms, Office dot Civsl Justice as a condi>SOn pr adrniraistrauve requirement of nc~ grant, Rig]sts witPtin 60 days of the aarard saaa4 da I~Or ga'antb [1t1del inclutluag bur not liraaited so: the regeeiremettes of 071 Cirevlara A- 9w500,040, buc.over X25,000, or for grantees 'th ftwer tleaaa 50 $7, A-21, A-1 Z2, or the Federal Acelraisitzora Regulations, as appftCable employees, the grantee roust spbsnnt an F.,g Cen;fseaticma. (gavtrrseng cost principles); OA9B Circulars A-102 or A-110, as (Grantees of Jess theta $25 04D are nor subj t To the EEC7P applicable (Uniform Admiriastrative Requirements for Grants and requirernenr.) Cooperative Agre<mcnts}, G~Ir]B Cirrulat A-733 (gavernistg audits}; the applicable provisions pf the Osnretbus Cairsae Control acad. Szfe Pursuant rv Llepar[mera[ of Jos®ce grails ~ s Qrane 18, 2042 d Streets AtT of 7968, as arner~dad; the cvrra:rat edition of the CUPS Federal Register (Volume G7, Number 177, gee 41455-4i47~), ~ GrrriT Monitoring 5mndard. and Guidtlines, and with all other under 7itie V] of the Civel Itigtees Aer 4f 19 , it wiD ensure applicable psagraraa requirements, laws, orders, regulations, pr riaeagiPtgftal access so its prograrras and artful es by persons with dreulars. limited Irrigiish profseiency. i 7. If Applieabk, i[ will, to the extort Practicable and consistent with 14. It wi11 ensure rhar any faeilit9es lender its nership, lease or applicable law, seek, rectllit Arad hire gvaliTrcd members of racial and BulaFrvisi4ri which shall be utsiixed 9ra the see rnplishmena of the rthrtie rsliraority groups and tloralified women in order to further project arc riot lisaed on the $raviroser'lRental oreCtion Agency's effec[3ve law enfprcement bV increasitag their ranks o+ithin the sworn (E]"A) lira of Violatipg Facilities and that it w Woody sae i( a. positions in the agency. ~ advised by the )PA that a faciEiry [o be used i this grans is under ? corisidcration (or such Gating by the LcPA. !twill AOt, on the ground of race, solos, reiigfon, national origin, ` geodes, disability pr age, urilawfuUy exUude any Pcr3on from 17. if the applacant's state has established a r few and comment participation ire, deny rho benaftts of or employment to any prison, proeedare under lbxecveivt Order 12172 and aS Seleeted than or subjecs any person to discntttinatiori in connection with any program for review, it has made this applicati availakale for s or activities funded in whole pr ire part with federal funds. review by the state Single Point of Contact. r • Jan-21-04 04:50am From-HAWAII ( VITY FOUNDATION 8085216288 T-516 P.03 F-iB5 ageney-owned, rtAted oe personaUy-Awned ~th~c}ca ineressa`d OEhera rC+Jep~~,,,,trne eevci, as ai earaeme, wn~. an~~r or local funtls Eor a minimum of cane fttfi >a:si bnu~ce e;*ek! 13. It will not use COPS fundls to supplant (rc(ifaca) scare, Igcal, er fallgwisag eupitatittn A( the ~an9 pt'si~d. Buteay of indiari Aff3ir~ Eunds shat otherwist would bt rnade avulable !ot the pnaposcs of this grant, as appGeabie. i'alst ftytetnentx ear rlaima arcade in con uv,~ aratb e.e~3t:4 gr~rits (indtKlislg; cvtsj're:r7h~'C aksreesacntti) raaa~• rcaah in fines, impa7sasnancnt, Z~IS~atanlfat frta~tta ~ scipssaitsK i» Itdera! gY~9eDtF tas eontraces, ossd/tx a9yy tat cr srrrmrtiy available 6v lax 1 certify that the assurta ~cet. prAVit3ed arc true and accurate to the br.;t of my knowledge. l_letta,ms nc Athcr selct oqn= of nC.v ZaftKiofs will not ecliere ehc granter thaaaty of its gbl'ag~tions under this grsAt _ 49/05/2003 Signature pE •xreutrvt (or ~ffcial wiria Date pr vnaut r~ n~i; n~ ~izata,an ,'gnature taf cnt .xa-cueive (or Offaeia! with Darr Fsnantial ~1t,thatity 85 ai~pliealale) rep reds IIJ~rrh 10. 2003 e03s731909 Jan-21-04 04:51 pm From-NAbYAII f LAITY FOUNDATION 8085216286 T-516 P.O4/15 F-185 Re~arditlg Lobt>Iyirl~ ~4~ar~Tlt, Sa>ISp~e~s8®n and Other Resp~itaility -F:r~ 1~V acs Requeremeflts Coardir~ati~ veiuth A~~c~ A4enci~s; Nil,-Supplarltsalg, arld stet Although Ylre 17epattmenl of justice }Has made ever}. effgrt tae SirrHPL'fy the applicatirm fatoeegs, other gfravssions n federal law s'e'`ie~ tss eo seek your cettilicarion rt:garding crrtain mattrrs. Appiicanrs should toad the tt:gtalatiasns turd brltrw anal t3te 8rist ceions for c®tifietotion intltrdrd an the rcgeelarons to uredct$tand t!x rcquartmrrats and whct}eer tltcy apPl}• to a Particular applieatet_ Sigm of Chits famse ptovidea: for eUrrepGancr with crrt;ftation rrtltr;rrment$ utedet Z8 CT~t Yeart 69, "IJrw l;estrictigtas rsn T.obbyi»~" ared2$ $edr't 67, "C'arevMremena.wide De:barm4ne and Susfeevsicxe (Rlonp;oeuaement) and Cieo~ernmcret-osidr Itcquirrsteertts for -Fsec ee (Grants)," anJ thr e,xeHdireatioir and non•supplatating rryuirrmrnts of the Public Safetp Jksstsaet,},;p and Camrttu 't}y Polacirag ~jct of 194. The tertificatitsns shall be treattti as a steatetial tepte4etDeatirn of fact taleon which reliaoee aril! kHC placed whey t ~Taatat a>f ~mstsoe tieterrtHipee$ rn award the covered grant. i. Lvbbyang (He) klave reset w'it}airi a Ilerrre-yru peeiod meerrsg Chas appdiesti4rs been conrieted of of had a crvr7 jaed t tsttdt:acd agaaist t}e~ AS rrtastirrd by Srctitrrt 1352,'15t1e 37 of the U.~ Caxk, and for cornmi$sian of fraud or a rran,-vtal o ftnse ~ Copryc~p~ ~tajt}, implcmentsd at CFk Part tS9, fttr psraons entering iE94a a grant or obttining, attempting tq obta;n, or perf a ptrblie (fcdtra0, cgoprtras~ve agreemrnt vvsr;190,000, as defines] ae 28 CFR Tease 69, state ~ kxal) trarasaetion aaa contract ® a Ptablis t;satrsae~,psg the applicant certifies tleat vic>latitm of fea8e;ral or state antitrstst sa ter or eosiDga of A. I'Jo fedtt-sl apprc>firiat4d fvvttl4 have been paid or will be Paid, by rttsbtzrlemrnt, theft, fcysgasg, bey'QxrX f 'bcHtaott at dtsuuceivn Pt pn behtJf of the unJtssigncd, to any person for aetlvcricvag or of rccgrds, makirsg false statenxaits, or ing stork„ proPetty; artrmpting tv inOurrtCc an vffaccr w ¢mployea of any agency, a mcrnba:t rHf Congress, :+n offxcr or cnaployre of Cangrc$$r a>r an (ue) ?ue not presently indicted for or crarisc cai,Ytat:ally or errlplthee of a mrmbrr of Conge-ras in cPnnd;~grH wide the mal:iteg Civilly charged by a govrmmental eAtily federal, state oc ltee~el} of an} federal grant, the Sntcring into of any a:OAprritive ygrecmcfHa; with trSmrraission of any of the off;: eaetanacratedsr> Pasagraph and the eztcnriOrs, CGenunuatiOW, rentwal, ammdtneatt or modification (t)(s) of than crrtification; and of any fcdc8al grant or erxepeaarivve agrecarirnr, (n) Hati'e teat within a thrrr-yea pe ' pa:ecedirag tlsia }3. if Grey funds other than fcdSral appropriated funds have becri Pa1d agpliczsiaan had oar or mere pubGe rtioris (fedczol, stars or or will br paiJ Pte any pittsOtt ft?g it7f16aencing or attrrteptiteg to loss!] trrtnireatrJ for causr p~ dtfs~ul[', a d influrnec an oftecer or employee ref any agency, a meu?bes aef Can};rrss, an vfficrt aar erreployes of Congress, or aai c:tHplcysx of a a Whcrc nc~ apgleearlt is uttabk ro eerti to arey of the member of (:ringtess ia, totrncetiasn wide this fcdtra! grates or statcsternts era this erivfication, he oa s shall attaels ass eotepCratlve ;Ssrrernrnt, thr undersagard Shall COmplrrr aced aubr8l46 exPlareaeion 40 this application. Standard Form - LI.L, "]]iselosurc of Ixebiaeirig Activities," in accusdancc with it$ insttsectiPtas, 9. Drag-Frye iY/orkplace (Graa~rees 4th ~ltara )iadyviduals) C. 7~ee eetedrtaigned shall require that the language of this eerti~iCation As rrs}uiretl b} the Drug-I=ces ~Votkplas ACe of l9$8, atHd be included iti the award drx'tamcnts for at3 subawards at all tiers implcmcneed at Z$ CFTC Part 57, Su F, foa gxsatocs, as ~ndudislg subgrants, cunuaets under g;tants and cOC?peiativr defancd at 28 Cp'R Pats d7, Secti~pms 67. 1S and d7.f:20 - agrCCgnents, and subcrn,trsCts) and shat al! sub-iccipirnts shall certify A. '!"lee applicatet cetoftes that it will, or eorttinue tai pravidt anJ disclvsc accorclist}}u a dtug•(rcc workplatc by: 2. 73rbarmdYtl, Suspension and Otlect Reeponsibaliry Tfatters (Diztci n Teukelix6ing a statemrnt notifying 4-rre layees t$at: the ttnlawful Rccipicnt) manufacttue, discn'bution, dispensing, soon oz use of a cgntrollyd subseaner i3 prohibited in ga~tet:'s vrOrkplace AS required by E7tcetrtiYc Order 12549, Debarment and SHHSpensio7H, and spccafying flee actions rhae seri8l be rkcrt agslstst etapp3oYee;s and implemented at 28 CPR Part 67, fur prtxapeCtive participants in for violation of such prolubitir~tt: l7rimary covcrrd tranRat lions, aR do fined at 26 CFIt D'art 67, ScctioaH 6y.519 • (n) I'stablixhing an ongoing ding-free wariness pra~ram t4 inform ctripl'eeycex atxwt - ,1. 'J'hr applicant crrriFict that it and itc principals (a) 7hc dangers of drug abuse in the workplace; (r) Are not prrsently Jcbarrrd, srospended, proposed for drbarrreent, declared ineligible, senu-nrrd rn o drnia! of federal baMCYits by a state (b) The gtanrce's paeiitr of mairttai g a dntg-free tvrerieplare; yr federal coup, yr ovluntari9y exeludrd from coveted tranSaC4bns by any federal department or agency; Jan-21°04 04:51 pm From-HAWAII ( VITY FOUNDATION 8085216286 T-516 P.05/15 F-185 abuse .r'snkatiors occ~zriiasg its the workplace; ~ B. 7'he gr~etee criay insert era the s3,eetee 6eypw the s;tt:(s) frx the lXrftrrAtance of eatazir dprae . eartnretiwra with ¦ (eat) Rlakir}grit a regnireraent that each ernplra}'Ce to be engaged in the spteciex grant tlfc prrform'rlce of tl~e g,'rant be g1Yen a Cnpy of the staaernent Place of pcrfotrtxarecc {street addrt:ss, t:it~ t>~ttys stems, zeg r¢quirtd by paragrepb t7, cods) • {rv) Notifying rho smpl4wcc in the statement rCKluircd by paragra¢tb (i) that, $s a corddition of epasp9oyrnent urades the grrrtt, t?ae orral~loy~er ~ - Check ~ if these art arorBgzlaces aza ftlc 1~t sae riot idcetdited Acre Abiic by flat terms of the 6tatt:mrnt; surd Seciiote b7.b30 of the re~tlatiares pr that a grantee ' shat u a caste aeay elect t4 rrnke orte ct:ra tine iirt catdt (b) Notify the tmpioj~ra in writing of his or her conviction fwr a federal f>RCaI ;ear, a copy of wlticlt ai~tld be ~aduded wit4t violation of a ~^~;~:al drug statvefi weeurriangan the workpbce a~Taeation for Tlepartmtnt of ]aerie fond"ara~ Se~trs nn later than free G7aEYJdar days after such cgnyGt84it; Arad state a}~encoes raaay el4'G4 tt? t9St'. C!J$~ rat 4061/7. ChecB; ~ ii the state hag eleetec! to r OjP Pornm {v) T~otifying the ageraty, in writing, witl`aist 10 calendar dayR after 4a61/7 receiving nutice unties svbparagraPla (rv}{b} frcaen an a~taplaq~ of , otlfetwasc rccervrrag ac-rua] A6tace of Sc9Cla cOnhCtron. lrnrployers 4. G>nrdiraat;eara o! rcmvEeted ea~nplorees reuse prmvidc noe:ice, inclncfing position . tide, t« CUP'S Office, 1100 Vermgnt slue, NW, ~shingto», L1C The Public.Safecp Partrxrshila Arad amity Fnlidttg rlet 20530. Notice sbaU inchtcle the idtrstifacation numbcr(g) of cacti of 7~39~ resingres appL'cartes ep eertifp that there has been affcsred grant; aMampriate toordimtiwn with ap agcntaes that may be (vt) Talxisrg ant of the foA:ruing actions, wichia 30 calendar dept of the applicar~'e gswrat p~r+opoarl appacrv~. rctcivinR nbticr under subparagraph (rv)(ts), with respect to eery ~Y ~OnB tlsc Office of the Uniaed States.tlttaxtrrey, start at !veal osecutors, va ernployeC who is so cex~victed . correctignal agenc'vss- Tlae applicant term that tlaerC !tars been a~mpriate coordination asith aA a agog, {a) 7'akissg appropriate persortsael satins, against sash arq . employee, vp to as1A inclddirg tearrliraaq~l9, corasEsteatt with the regvirement2 of the RchabaTatatitaaa ~cY of 1973, os amended; or {b) Rrqu"arnsg Such cK~eplq~ eo particilaatt' s~atisfactvBa7y Eat f< drug abuse assiswraee or rthab~lieatirm pr4grun a~rovcd fos such purposes by a federal, state rrr lm*.a! health, law a»forcertseat os attest apprapriatt agency; GrantccNaar,car,d,~,d~-css;Hawai'i Gatmttuuity latxsa~daiton, 1164 Bishop St, Ste 00, Honolulu, HI 9681: Application No.arad/ur}°rojextNamr~ Metht3rn~hetRmine_Prg~ecfr~rttceiR,t~?attdortdttrssnnbtr I3da rofit ~O-rganizatt:i®n 7ypcdNatsr:c~rtdTitlcas~,~/c ~ccaxivc: Kelv'n li. ~'alteta President ~ CFA SEgnattse: `~f- I~aee; 09/05/2003 As the asarly arthr»~icd ra~rre5C7816A4ve of she goverrairrg boely, I d1e>•~ err~jy shat 1 sear dvaadra~ aBae ~?anxrarirag sa the ~b~ c~oars E1mciong a~aaew m,~Sciaads resil9 nos rdierc !tae iaag 8~y+ r~'~v ~+8 arerdrr tBaFr gazaa~ TypedNatrsttrtdrkofGovetta+>~°ntExectttive: Ha ry Kim, I~ayQr, County Q$ I38 iii Signatt.trc: ~ I]atc: 9 / 810 3 8085216286 T°516 P.O6/15 F-185 Jan-21-04 O4:52pm Frain-HAWAII C ITY FOUNDATION ' ~ ~ . k - s4/Q ~ 4abRi 1 CAW i YQ - - - z 'his disclosure form sltai]I 1.~e completed by the repc?rtsng entity, whether svbawardee or psi ~ Federa3 recipi- ent, at the irtitiatian or r~eipt of a covered Federal action, as a ptoaterfiail chaatge to a previoes @'ilang, pe~rSeaant tp title 3] U.S.C section ~3~~ The filing of a form is required for each payment ur agree t go make: pay_ meret to any lobbying Entity for inflttencirtg or attexn~tir$g to iazfluence sat offat:~r or e~npB of easy agency, a Member of Congress, art officer or exnpi~syee of Ca~ngress. or an errtployt}e of a Membex of ~ regress itt c~anr necteon with a covered Federal action. Correplete all items-that apply-fox botft the' iatitiaB g ane3 ~naferial fi]tarege report. Refer to the implementing gvedanc+e published by the f~ffiee of Ivdanagexlrtere# seed 13aadget for addetional information. Identify the type of rnvered Federal act;or? for which lob- Bred Federal action (item ] If Ict?owr4, a the full Catalog hying taa;tivity Ss aa~ad/ or has bet's secvxed to influence the ®ut- of Federal DC>a7testie Assistance (~°FUA) her for gtc`ants, corr+e of a t:overed Ft:,tleaal ~tctiaan. sotDperative ag~emesats, lcaa~ aru4 l+~ar? mr~titts. 8. inter t$ae most approprate Federal id ' rteurabes 2. Identify the status of the ~;ova:redFederal action available foT the Federal acYitxe identibiec~ steers 2 (eg., Regaaest f®r Frmp~o~l (RI:P) number; I:nvi close four D3id (!F!}? 3. Identify the appropriate cdass~cazron of this report. If Phis numt~; grant~auancxa~racement pts~relaer; coratt,~et, t~~ or is a follow_up mport caused by a material Shange to the ir?for- Evart aware) number; the application/ caretrnl number mason previously reported. enter the year and quarter ist assi ed the Fedsaral a Whirl: the Change 4CCUrted. X:nter the c$ate of ells last prevaa ~ t'Y $eMY~- ]ric9ude es, egg ''RFf vwl 58]knrts4t@'[I7 rR 11115 ®Fr~]. y e'P° by r'ep~~8 entity for this cnw- eretid Federal ac$on. 9. Fnr a c~ver~d Feaieral action why Baas bc+erl ~a arovanCi orloaaa cotB117sitrnerat by the Federal ry, Ater the thg fa,t]I rtaiale, add taffy, state and ~p code of the Federal arslolrret o$ the award/liners earalrsei t for tB1e prime repcyttirt$ erltiey. lndt~de Cautgress-,orPal L>istrict nurnl~r, H ea~tity sdentsfied $re it~i 4 ar 5. knowrc C?leck the aPl'f°Pria~ Classlfitation of the tag entity-that designates if it is, .~r experts to be, a prime or sub- ] 0. (a} Enter dne full dame, dddl~5s, sty, era and yip cxlde of award recipi~erls. Ideratafy the east oaf the subawardee, e.g., tfae the lob~S entity esegaged try the repo n'gstrartt zderlti- fixst subawar+dee of the Pr's is the 3tt tier: Subawan3s bed in item 4 to ii1$luenre the evened Fed a~oro. inr~ade but sae 71oY litraited to subcosltracts, sasbga ants anti contract a,~a1-ds under gratits_ (b} 1Ep~ater tlae full narree(s) Qf the ire<iividual{ perfornaireg set. vices, and iattitadea full addmss if differt:rtt ]0 (a1. Enter 5. If the orgariiaation filing the: report in item ~ checks Last Name, First Tlarrle, aped Middle Initial I}- "SuDawardee;' cheat enter the futlraarrse: address, city, state and zip code of the prime Federal terlpftzat. Yrlcl~ade 77. The certifying official shall sight and date the frum,.prirnt Congressional 13istaic~, if knnwrt. hisJhernaraa~ title and teltpha~aenlxmber, s b_ Enter tlye natrre of the Feder,~I agency making the award oP Asa~iic reportita~ btardesr for this Bolles of is atimglasl fa lean ~mrxtitmeret. L :dude at least are drgaavi~tional level _ atnazpg>e30 misars#es per rrsParrse, intlrrrfmg tr~s:e fnr r ' g irestrucedaras, b2ksw agency resent, iff known. Fpr example, Departlent Of stsrrClrirrg existn,$ date s~rrt,~s, gatheri»g at»d rnern ' fa7g the dQta neestal pnd evmyfelinrg and revi~4ariar~ the sUllcdiOra of ors. 5tnd mm - Transpo;-tatioly United States Coast Guard. mints regaTdirrg flee brardtra estimate yr a,r3r o2hca~vf this Codlec~'ioar n/ infunnalion,mrludir{g5ugga:SfiatES~r7eait+ritlgdltis `de~e.69thCC~S'~of 7. )inter the F'edera.T program nQune or description for the cov- Nlurrvgcrnenp errs Budgri, Fageravark ReAudeon fryoj (0398.OG~~), 6'Vtdhingttm, L7.G 2053(!. e' f Jan-21-04 04:52pm From-HAWAII C IITY FOUNDATION 8085216286 T-516 P.O7/15 F-185 m a App,oved t'Y ©l~ , Complete this laarn to clasclcase lcabbyang activities p~zasuaatt to 3I U.S•C_ 1352 (asamer,ded~ (See reverse for instructions and pubvc burden dasdt3sure) ' i. Type o¢ Federal Actiomm: b 2. sterns of Peatesaa Ac4ian: a 3. Ripoat ~ a. Contrast a. bid/offer/application a_ iStitial$~" b. grant b. iruioal awarst b. ~aatesia! ante r_ crooperative a~reerrtent c. post-atward d.loaat ForMQferaatf gaOrrlp: e. Doan graaranteF Year: f. loam inseaTastte Qt~rte$: Date of fast post 9. Name and Address og Repcvrting Entity: 5. I! Rep®rting Exstity ire No. is Saba ardee, Entea 3Llt. Prime ~ Subawaadee N~aae aatd address of Primes 7ie~ . if A;amum: liawai' i, community 1•oundation 116+ Bishop Street: ~ 5taite 800 Honolulu, llaws~t4 96813 Congsessiortal District (number). if known: ~ Congressional I3istrict (staaanber?, i# Jcn n: 6. Federal Depaatrasent/Agency: 7. Federal Paro~~art Na~ae/13escriptaQat: CFDA2Vlaaraber, i€ applacable; 8. Federal 11~ctiaza 1+iv~a~ber; if Icnoavsa: 9. Aa~rard .9aaaonaaC, if lcrsowaa: 10. a. Naane and Addxsss ®f Lasl~byiaag l~rgystraaat irk b. lndividuala Perfaxzniaag Services (if iradividaurl,.Dust aarraaae,~t nurrte,lVl)): (including ac$stress if dafferea~t fao No.1C?a) (last naarae, fast name,1v,91): ll.Infosareation requested ~Baroa:gte thi9 form is anthoriard ~ Si~r-tature: f Title 31 U.S.C_ Section 735 9`ltis discloseas+r off lobbying aetiviti@s is ~ D7a~teYial aepn-sent~tix~re of fface upon wbaetn P'rirtt I'~Iarr~e: ~ l.vin A . Take to reliance sues placed b'}' the tier al~v¢ when alms traasaeeeara eves made oa epotered ivato. "this disci®sasa~e is reguiaed pair- s?aant to 33 YS.S.~ 33bz, $3ais infmixaatioaa bvill lee nEpogfed to Tit3e• President & CEO the C~ragres9 sensi-annsaally and will be awail,ble-fob pnblis irasp~t3smtt.Apey~pevsorawl»fa~9t4-fide Sheaegsai8,edr$aFa']o- ~ele hGrreNv.: 808-537-6333 seat Shall are subjcrt to a civil f?entTey of nat less 3haAa ~~A,~ p bate: 05 20 3 and not asosx than ~]04,OO6 f®r reds smc~a failnve. Hederal uSe ~Y= Authorised !ar Lora! }tep7oduniost, 5 deed norm - LLL