HomeMy WebLinkAboutCOM 0082.057 2004-2006 JNSY'oF ~4?Y
Harry Kim : ~ ~~h4°, Lawrence K. Mahuna
44nror ~ Police Chiej
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Marry S. Kubojiri
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~S~~N~:''MO. P\
4Tf OF~µP~ Deputy Palice Clrrej
County of i~awaii
July 15, 2005 POLICE DEPAIL'I'1dIENT
349 Kapiolani Street Hilo, Hawaai 96720-3998
(808) 935-331 I • Fax (808) 961-8869
TO STACY RIGA, COUNCIL CHAIR AND COUNCIL MEMBERS
VIA DEANNA SAK ,CONTROLLER
_ .
FROM CE K. MAHUNA, POLICE CHIEF
SUBJECT NOTIFICATION OF GRANT AWARD
Compliance with Ordinance No. 01-55, Section 7(1)
Name of Grant Program: Marijuana Eradication
U.S. Department of Justice Drug
Federal or State Grantor: Enforcement Administration
County Grantee Department/Agency: County Police Department
Grant No.: 2005-57
Amount of Grant: $361,788.00
Amount of County Match: $0.00
County Revenue & Expenditures Acct 010-201-5219.31 & 3301.95
Grant Period: January 1, 2005-December 31, 2005
To investigate, eradicate and suppress
marijuana cultivation and to minimize
Purpose of Grant: product availability in the State of Hawaii.
If final report required by grantor? yes
Notification Attached: yes
!~I®,
Ref. T~
Red. ~cste ~
JS pevatlmeyor
\ U. S. Departn. ;rt of Justice
1~ Drug Enforcement Administration
Fnbrcema~
Agreement Number: 2005-57
AGREEMENT
This agreement is entered between the HAWAII COUNTY POLICE DEPARTMENT (HCPD)
hereinafter referred to as HCPD and the DRUG ENFORCEMENT ADMINISTRATION OF THE
UNITED STATES DEPARTMENT OF JUSTICE, hereinafter referred to as DEA, with a reference
to the following:
There is evidence that trafficking in controlled substances exists and that such illegal activity has a
substantial and detrimental effect on [he health and general welfare of the people of the State of
HAWAII. The parties hereto agree that it is to their mutual benefit to cooperate in locating and
eradicating illicit cannabis plants and in the investigation and prosecution of cases before the courts
of the United States and the courts of the State of HAWAII involving controlled substances. The
DEA, pursuant to the authority of 21 USC 873, proposes to provide certain necessary funds and
HCPD is desirous of securing funds.
NOW, therefore, in consideration of the mutual covenants hereinafter contained, the parties hereto
have agreed as follows:
1. HCPD, will, with its own law enforcement personnel and employees, as hereinafter perform
specified, performed the activities and duties described below:
a. Gather and report intelligence data relating to the illicit possession and distribution
of marijuana.
b. Investigate and report instances involving the trafficking in controlled substances.
c. Provide staffing of law enforcement personnel for the eradication of illicit marijuana
located within the State of HAWAII.
d. Arrest and bring to prosecution defendants charged with violation of the controlled
substance laws.
e. Send required samples of eradicated marijuana to the NIDA marijuana Potency
Monitoring Program.
It is understood and agreed by the parties to this agreement that the activities described in
Sub-paragraphs a, b, c, d, and e above shall be provided with the existing personnel and
that the scope of HCPD program with respect to those activities by such personnel,
Letter of Agreement No. 2005-57 Page 2
shall be solely at HCPD discretion, subject to appropriate limitations contained in the budget adopted by
HCPD.
2. DEA will pay to HCPD the amount of THREE HUNDRED SIXTY-ONE THOUSAND SEVEN
HUNDRED EIGHTY EIGHT DOLLARS ($361,788.00) for the period of JANUARY 1, 2005 TO
DECEMBER 31, 2005 to defray the cost relating to the eradication and suppression of illicit marijuana.
It is explicitly understood aid agreed that Federal funds provided to HCPD under this agreement may
not be used to defray costs relating to herbicidal eradication of marijuana without the advance written
consent of DEA.
The Federal funds provided to HCPD are primarily intended for payment of deputies'/officers'
overtime, and salary and overtime of reserve officers while they are actively engaged in the cannabis
eradication process, as well as per diem as appropriate and other direct costs related to the actual
conduct of cannabis eradication, such as rental of equipment and vehicles, fuel for vehicles and
aircraft, and minor repairs and maintenance necessitated by their use to support cannabis eradication.
These Federal funds are not primarily intended for purchase of equipment. Unless specifically
itemized and approved in advance in the operational plan, expenditures for expendable and non-
expendable equipment should not normally exceed 10% of the total Federal funds awarded. All
purchases of property having a useful life of one year or more with an acquisition cost of $300.00 or
more per unit or an aggregate cost of $1,000.00 or more require the advance approval of the
Domestic Cannabis Eradication/Suppression Program (DCE/SP) coordinator, unless specifically
approved in the operational plan.
If DEA approves the purchase ofnon-expendable equipment with an acquisition cost of $5,000.00 or
more per unit for the use of HCPD personnel engaged in cannabis eradication under this Agreement,
DEA may elect to claim ownership of the equipment at the termination of this Agreement. DEA
may also, at its discretion, allow HCPD to retain ownership of the equipment for its future use in
accordance with applicable Federal rules and regu]ations.
Payment by DEA to HCPD will be in accordance with a schedule detemuned by DEA and said
payment will be made pursuant to the execution by HCPD of a Standard Form SF-270, Request for
Advance or Reimbursement, and receipt of same by DEA. However, no funds will be paid by DEA
to a state/county agency under this Agreement until DEA has received to its satisfaction an
accounting of the expenditures of al] funds paid to this state/county agency during the periods of
previous Agreements for this same purpose. These expenditures will be reported on a Standard
Form SF-269, Financial Status Report, and December Monthly Accounting Form.
3. Employees of HCPD shall at no time be considered employees of the United States Government
or the DEA for any purpose, nor will this Agreement establish an agency relationship between
HCPD and the DEA.
4. HCPD shall maintain complete and accurate reports, records and accounts of all
obligations and expenditures of DEA funds under this Agreement in accordance with generally
accepted accounting principle and in accordance with state laws and procedures for expending
and accounting for it's own funds. HCPD shall further maintain its records of all obligations and
expenditures of DEA funds under this Agreement in accordance with all instructions provided by
a~~i,.
i
Letter of Agreement No. 2005-57 Page 3
DEA to facilitate on-site inspection and auditing of such records and accounts.
5. HCPD shall permit and have available for examination and auditing by DEA, the United States,
Department of Justice or the Comptroller General of the United States, or any of their duly
authorized agents and representatives, any and all investigative reports, records, documents,
accounts, invoices, receipts or expenditures relating to this Agreement. In addition, HCPD will
maintain all such foregoing reports and records until all audits and examinations are completed and
resolved, or for a period of three (3) years after termination of this Agreement, whichever sooner.
6. The recipient agrees to comply with the organizational audit requirements of OMB Circular A-
133, "Audits of States, Local Governments, and Non-Profit Organizations." In conjunction with the
beginning date of the award, the audit report period of the state or local government entity to be
audited under the single audit requirement is (01/2005) to (12/2005). The audit report must be
submitted no later than (01/2007) and each audit cycle thereafter covering the entire award period as
originally approved or amended. The management letter must be submitted with the audit report.
Subsequent audits must be submitted no later than thirteen (13) months after the close of the
recipient organization's audited fiscal year. The submission of the audit report shall be as follows:
When the Department of Justice (DOJ) is the cognizant agency, an original and one copy of the audit
report shall be sent to:
DOJ Regional Inspector General for Audit
San Francisco Regional Audit Manager
1200 Bayhill Drive, Suite 201
San Bruno, CA 94066
(415)876-9220
A copy of your audit transmittal letter addressed to the Regional Inspector General, shall be sent to:
Audit Services
Office of the Controller
Office of Justice Programs
810 7"' Street, N.W., Room 5303
Washington, D.C. 20531
When DOJ is not the cognizant agency, an original and one copy of the audit report shall be sent to
the cognizant agency:
~~\''i,
Letter of Agreement No. 2005-57 Page 4
Also, a copy of the audit report shall be sent:
DOJ Regional Inspector General for Audit
San Francisco Regional Audit Manager
1200 Bayhill Drive, Suite 201
San Bruno, CA 94066
(415) 876-9220
A copy of your audit transmittal letter addressed to the Regional Inspector General, shall be sent to:
Audit Services
Office of the Controller
Office of Justice Programs
810 7th Street, N.W., Room 5303
Washington, D.C. 20531
The recipient agrees to submit their corrective action plan with the audit report to the DOJ Regional
Inspector General for Audit, when there are findings/recommendations disclosed in the audit report.
The corrective action plan should include: (1) specific steps taken to comply with the
recommendations; (2) timetable for performance and/or implementation date for each
recommendation; and (3) description of monitoring to be conducted to ensure implementation.
A Department of Justice Order requires the Office of Justice Programs (OJP) to maintain a data base
of all grants made by DOJ components (DOJ Order 2900.8A (June 2Q, 1990) copy attached). To
implement this requirement, OJP requires all DOJ components to submit to it a completed form,
"Grantee Information for Access, a copy of which is attached, for completion by the recipient.
The recipient acknowledges that failure to furnish an acceptable audit as determined by the
cognizant Federal agency may be a basis for denial of future Federal funds and/or refunding of
Federal funds and may be a basis for limiting the recipient to payment by reimbursement on a case
basis.
7. Executive Order 12549
The participant agrees that an authorized officer or employee will execute and return to the DEA
Investigative Support Section (OMS), 2401 Jefferson Davis Highway, Alexandria, Virginia 22301,
the attached OJP Form 4061/6, "Certification Regarding Lobbying; Debarment, Suspension, and
other Responsibility Matters; and Drug Free Workplace Requirements." The participant
acknowledges that this agreement will not take effect and that no Federal funds will be awarded by
DEA until the completed certification is received.
8. Disclosure of Federal Participation
In compliance with Section 623 of Public Law 102-141, the recipient agrees that no amount of this
Award shall be used to finance the acquisition of goods or services (including construction services)
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Letter of Agreement No. 2005-57 Page 5
for the Project unless the recipient:
(a) Specifies in any announcement of the awarding of the contract for the procurement of
the goods and services involved (including construction services) the amount of
Federal funds that will be used to finance the acquisition; and
(b) Expresses the amount announced pursuant to paragraph (a) as a percentage of the total
cost of the planned acquisition.
The above requirements only apply to procurements for goods or services (inciuding construction
services) that have an aggregate value of $500,000 or more.
9. It is further covenant and agreed that HCPD will hold the DEA, its agents and employees and the
United States Government harmless from any and all claims, demands, suits, liabilities and cases of
action, of whatever kind and designation, and wherever located in the State of HAWAII, resulting
from the DCE/SP funded by DEA. The DEA acknowledges that the United States is liable for the
wrongful or negligent acts or omissions of its officers and employees while on duty and acting
within the scope of their employment to the extent permitted by the Federal Tort Claims Act, 28
USC Sections 1346(b), 2671, et seq.
10. HCPD shall comply with Title VI of the Civil Rights Act of 1964, Section 504
of the Rehabilitation Act of 1973, the Americans With Disabilities Act (as incorporated in the Civil
Rights Act of 1991) and all requirements imposed or pursuant to the regulations of the United States
Department of Justice implementing those laws, 28 C.F.R. Part 42, Subparts C, D, and F.
11. Within sixty (60) days after termination of the Agreement, HCPD will prepare a December
Monthly Accounting Form and a SF-269, Financial Status Report, itemizing the breakdown of final
expenditures. The December Accounting form and the SF-269, along with a refund check, payable
to DEA for any unexpended funds which were advanced by DEA, pursuant to this Agreement will
be returned to DEA.
12. Upon submission of the SF-269 and December Accounting Form to the Investigative Support
Section (OMS) for the preceding yeaz, a copy of the general Ledger and the underlying supporting
documentation reflecting the expenditures for equipment in excess of $5,000 and the expenses
associated with the rental or leasing of vehicles or aircraft must be attached.
13. The duration of this Agreement shall be as specified in Paragraph 2. The terms of this
Agreement may be terminated by either party for good cause shown by notice in writing given to the
other party thirty (30) days prior thereof. All obligations that are outstanding on the above
prescribed termination date or on the date of any thirty (30) day notice of termination shall be
liquidated by HCPD within sixty (60) days thereof, in which event DEA will only be liable for
obligations incurred by HCPD during the terms of this Agreement. In no event shall HCPD incur
any new obligations during the period of notice of termination. HCPD shall return to DEA all
unexpended funds forthwith after the sixty (60) days liquidated period.
` J'l
ii
Letter of Agreement No. 2005-57 Page 6
THE AII TY POLICE DEPARTMENT
By:
Title: Police Chief Date:~,~t~1Jg~
DRUG ENFORCEMENT ADMINISTRATION
gy_ Date:
Special Agent in Charge
Los Angeles Field Division
*DEA ACCOUNTING DATA:
DEA/FFS INPUT DATE: BY:
*DIVISIONAL FISCAL CLERK MUST INPUT INTO DEA/FFS
TO BE FILLED OUT BY HEADQUARTERS:
APPROVAL FOR PAYMENT
This is to verify that all of the administrative determinations have been made, that the payment is
legal, proper, correct and approved for payment.
Amount:
Obligation Doc No.
Line No.
Signature
Printed Name /Title
Date Approved
t'
IN WITNESS WHEREOFF, the parties hereto have caused this contract to be executed.
COUNTY OF Hawaii
HA1~'-$cHl4 DIXIE KAETSU
ITS h~A-IL9R Managing D'iretlo~ 7~xc'
APPROVED AS TO FORM AND LEGALITY:
dEP~~~' Corporati n Counse
Gtb",Pti1CJ;~! A. K. -,~,;~~LEZ
STATE OF HAWAII )
SS.
COUNTY OF HAWAII )
On this ~~~Lday of , 2005, before me
personally appeared DIXIE KAETSU, to me personally known, who, being by me duly
sworn, did say that she is the Managing Director of the County of Hawaii, a municipal
corporation of the State of Hawaii; that the seal affixed to the foregoing instrument is
the corporate seal of said County of Hawaii; that the foregoing instrument was
signed and sealed in behalf of the County of Hawaii by authority given to said Mayor
of the County of Hawaii by Section 5-1.3(g) of the County Charter, County of Hawaii
(2000), as amended, and assigned by the Mayor to the Managing Director pursuant
to Section 6-1.3(h) of the County Charter; and said DIXIE KAETSU acknowledged
said instrument to be the free act and deed of said County of Hawaii.
~~L
~ZLF~ " ~2 ~ , 'e-~--T
VI INIA M. TOLENTINO
otary Public, State of Hawaii
My commission expires: 4/22/2009
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S~'ATE OF HAWAII )
) SS.
COl~~TY OF HAWAII )
On this day of , 2005, before me
\
personally appeare~d•HARRY KIM, to me personally known, who, being by me duly
sworn, did say that he is fFm~Mayor of the COUNTY OF HAWAII, a municipal
corporation of the State of Hawa7i; that the seal affixed to the foregoing instrument is the
corporate seal of said County of Hawai • that the foregoing instrument was signed and
sealed in behalf of the County of Hawaii by a~t~ority given to said Mayor of the County
of Hawaii by Section 5-13(g) of the County Charte , County of Hawaii (2000), as
amended, and said HARRY KIM acknowledged said inst ent to be the free act and
deed of said County of Hawaii.
Notary Public, State of Hawaii
My commission expires: \
OMB APPROVAL NO. PAGE OF
0348-004 1 2 PAGES
REQUEST FOR ADVANCE a '•X"°ne°'°°'hb°xe~ 2. BASIS OFREOUEST
OR REIMBURSEMENT TYPE OF ?ADVANCE ?REIMBURSE- I_JCASH
MENT
PAYMENT
REQUESTED b. "X"the applicable box
? FINAL ? PARTIAL ? ACCRUAL
(See instructions on back)
3. FEDERAL SPONSORING AGENCY AND ORGANIZATIONAL ELEMENT 4. FEDERAL GRANT OR OTHER 5. PARTIAL PAYMENT REQUEST
TO WHICH THIS REPORT IS SUBMITTED IDENTIFYING NUMBER ASSIGNED NUMBER FOR THIS REQUEST
DRUG ENFORCEMENT ADMINISTRATION BV FEDERAL AGENCY
2005-57
s EMPLOYER IDENTIFICATION 7. RECIPIENT'S ACCOUNT NUMBER g. PERIOD COVERED BY THIS REQUEST
NUMBER OR IDENTIFYING NUMBER FROM (month, day, year) TO (month, day, year)
99-6000567 N/A JANUARY 1, 2005 DECEMBER 31, 2005
9. RECIPIENT ORGANIZATION 10. PAYEE (Where check is fo be sent ii diNerent than 1(em 9)
Name: Name: HAWAII COUNTY POLICE DEPARTMENT
C/O DEA
Number Number 300 ALA MOANA BLVD., ROOM 3129
and Street: and Street: HONOLULU, HAWAI I
N/A
City, State City, State
and ZIP Code: and ZIP Code:
11. COMPUTATION OF AMOUNT OF REIMBURSEMENTS/ADVANCES REQUESTED
PROGRAMS/FUNCTIONS/ACTIVITIES 7? Original LOA TOTAL
a. Total program (As of date)
outlays to date 361, 788.00 361, 788 .00
b. Less: Cumulative program inwme 0.00
c. Net program outlays (Line a minus
lineb 361 788.00 0.00 0.00 361,780.00
d. Estimated net cash outlays for advance
eriod 0.00
e. Total (Sum o/lines c 8 d) 361, 788.00 0.00 0.00 361, 788.00
f. Non-Federal share of amount on line a 0.00
g. Federal share of amount on linee 361,788.00 361,788.00
h. Federal payments previously requested 0.00
i. Federal share now requested (Line g
minus line h) 361,788.00 0.00 0.00 361,788.00
j. Advances required by 1st month
month, when requested 361, 788.00 361, 708.00
by Federal grantor
2nd month 0.00
agency for use in making
prescheduled advances 3rd month
0.00
12. ALTERNATE COMPUTATION FOR ADVANCES ONLY
a. Estimated Federal cash outla s that will he made Burin eriod covered b the advance
b. Less' Estimated balance of Federal cash on hand as of be innin o! advance eriod
a Amount re nested Line a minus line b N 0.00
AUTHORIZED FOR LOCAL REPRODUCTION (Continued on Reverse) STANDARD FORM 270 (Rev. 7-97)
Prescribed by OMB Circulars A-102 and A-110
'I
13. CERTIFICATION
I certify that to the best of my SIGNAT OR AUTHORIZ CERTIFYING OFFICIAL DATE RWUEGT
knowledge and belief the data on SUBMITTED
the reverse are correct and that all ~~t ~#Y ~ `I ~7n~c
outlays were made in accordance !u .r
with the grant Conditi0ne or Othef TYPED OR PRINTED NAME AND TITLE TELEPHONE (AREA CODE,
agreement and -that payment is NUMBER AND EXTENSION)
due and has not been previously
requested. Lawrence K. MulTUna, Police Chief 808-961-2243
This space for agency use
Public reporting burden for this collection of information is estimated to average 60 minutes per
response, including time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. Send
comments regarding the burden estimate or any o~tier aspect of this collection of informatics,
- including suggestions for red!~cing this burden, to the Office of Management and Budget,
Paperwork Reduction Project (0348-0004), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT
AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
INSTRUCTIONS
Please type or print legibly. Items 1, 3, 5, 9, 10, 11 e, 11 f, 11g, 11 i, 12 and 13 are self-explanatory; specific instructions
for other items are as follows:
Irem Enfry Item Entry
2 Indicate whether request is prepared on cash or accrued activity. If additional columns are needed, use as many
expenditure basis. All requests for advances shall be additional forms as needed and indicate page number in
prepared on a cash basis. space provided in upper right; however, the summary
totals of all programs, functions, or activities should he
4 Enter the Federal grant number, or other identifying shown in the "total' column on the first page.
number assigned by the Federal sponsoring agency. If
the advance or reimbursement is for more than one 1 1 a Enter in 'as of dale," the month, day, and year of the
grant or other agreement, insert N/A; then, show the ending of the accounting period to which this amount
aggregate amounts. On a separate sheet, list each applies. Enter program outlays to date (net of refunds,
grant or agreement number and the Federal share of rebates, and discounts), in the appropriate columns. For
outlays made against the grant or agreement. requests prepared on a cash basis, outlays are the sum
of actual cash disbursements for goods and services, the
6 Enter the employer identification number assigned by the amount of indirect expenses charged, the value of
U.S. Internal Revenue Service, or the FICE (institution) in-kind contributions applied, and the amount of cash
code if requested by the Federal agency. advances and payments made to subcontractors and
subrecipients. For requests prepared on an accrued
7 This space is reserved for an account number or other expenditure basis, outlays are the sum of the actual cash
identifying number that may be assigned by the recipient. disbursements, the amount of indirect expenses
incurred, and the net increase (or decrease) in the
8 Enter the month, day, and year for the beginning and amounts owed by the recipient for goods and other
ending of the period covered in this request. If the property received and for services performed by
request is for an advance or for both an advance and - employees, contracts, subgrantees and other payees.
reimbursement, show the period that the advance will
cover. If the request is for reimbursement, show the 11b Enter the cumulative cash income received to date, if
period for which the reimbursement is requested. requests are prepared on a cash basis. For requests
prepared on an accrued expenditure basis, enter the
Note: The Federal sponsoring agencies have the option of cumulative income earned to date. Under either basis,
requiring recipients to complete items 11 or 12, but not enter only the amount applicable to program income that
both. Item 12 should be used when only a minimum was required to be used for the project or program by the
amount of information is needed to make an advance terms of the grant or other agreement.
and outlay information contained in item 11 can be
obtained in a timely manner from other reports. 11 d Only when making requests for advance payments, enter
the total estimated amount of cash outlays that will be
11 The purpose of the vertical columns (a), (b), and (c) is to made during the period covered by the advance.
provide space for separate cost breakdowns when a
project has been planned and budgeted by program, 13 Complete the certification before submitting this request.
function, or
1~
~ STANDARD FORM 270 (Rev. 7-97) Back
as pe°anm„Hw
11~err1®randlxln
q`
`9FnOiff
Subject Date
Grantee Information for ACCESS
To From
Audit Services Drug Enforcement Administration
Investigative Support Section
I. GRANTEE: Hawaii County Police Department
2. GRANTEE ADDRESS: 349 Kapiolani Street
Hilo, Hawaii 96720
3. GRANT/LOA NO.: DCE/SP Agreement No. 2005-57
4. GRANT PERIOD: January 1, 2005 through Decenber 31, 2005
5. AUDIT REPORT PERIOD: N/A
6. COGNIZANT AGENCY: Department of Justice
7. RECIPIENT TYPE: Ol AGENCY LEVEL: 03
(Code) (Code)
Recipient Type and Agency Level Codes:
Ol -Law Enforcement 02 -State 03 -County 04 -City
8. REASON OR MEMO: (Check as many of the following as apply)
a. New Grantee: [ ] e. Change in Audit Report Period: [ ]
b. New Award: [ X] f. Change in Cognizant Agency: ( ]
c. Change in Grantee Address: [ ] g. Other: [ ]
d. Chang in Aware Report Period: [ ] (Specify)
NO[
E: If submission is for a CHANGE ONLY (8c - 8g) to information previously submitted to Audit
Services, you will only need to complete Item 1 in Items I-6 in addition to your change information.
U.S. DEPARTMENT OF JUSTICE
~ OFFICE OF JUSTICE PROGRAMS
OFFICE OF THE COMPTROLLER
CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND
OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS
Applicants should refer to the regulations cited below to determine the certification to which they are required to
attest. Applicants should also review the instructions for certification included in the regulations before completing this
from. Signature of this form provides for compliance with certification requirements under 28 CFR Part 69, "New
Restrictions on Lobbying" and 28 CFR Part 67, "Government-wide Department and Suspension (Nonprocurement) and
Government-wide Requirements for Drug-Free Workplace (Grants)." The certifications shall be treated as a material
representation of fact upon reliance will be placed when the Department of Justice determines to award the
covered transaction, grant, or cooperative agreement.
1. LOBBYING public (Federal, State, or local) transaction or contract under a
public transaction; violation of Federal or State antitrust
As required by Section 1352, Title 31 of the U.S. Code, and statutes or commission d embezzlement, theft forgery,
implemented at 28 CFR Part 69, for persons entering into a bribery, falsification or destruction of records, making false
ggrant or cooperative agreement over $100,000, as defined at statements, or receiving stolen property;
28 CFR Part 69, the applicant certifies that:
(c) Are not presently indicted for or otherwise criminally or
(a) No Federal appropriate funds have been paid or will be civilly charged by a governmental emity (Federal, State, or
l~aid, by or on behalf of the undersigned, to any person for in- local) with commission of any of the offenses enumerated in
fluencing or attempting to influence an officer or employee of paragraph (1 )(b) of this certification; and
any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in con- (d) Have not within athree-year period preceding this applica-
nechon with the making of any Federal grant, the entering into lion had one or more public transactions (Federal, State, or
of any cooperative agreement, and extension, continuation, local) terminated for cause or default; and
renewal, amendment, or modification of any Federal grant or
cooperative agreement; B. Where the applicant. is unable to certify to any of [he
b If an funds other than Federal a ro rioted funds have statements in this certification, he or she shall attach an
been paYd or will be paid to any perso P For influencing or at- explanation to this application.
tempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or 3. DRUG-FREE WORKPLACE
an employee of a Member of Congress in connection with this (GRANTEES OTHER THAN INDIVIDUALS)
Federal grant or cooperative agreement, the undersigned shall
complete and submit Standard Form - LLL, Disclosure of As required by the Drug Free Workplace Act of 1988, and
Lobbying Activities," in accordance with its instructions; implemented at 28 CFR Part 67, Subpart F, for grantees as
defined at 28 CFR Part 67 Sections 67.615 and 67.6`20-
(c) The undersigned shall require that the language of this cer-
tification be included in the award documents for all subawards A. The applicant certifies that it will or will continue to provide
at all tiers (including subgrants, contracts under grants and a drug-free workplace by:
cooperative agreements, and subcontracts) and that all sub-
recipients shalt certify and disclose accordingly. (a) Publishing a statement notifying employees that the
unlawful manufacture, distribution, dispensing, possession or 4
use oT a controlled substance is prohibited m the grantee's
2. DEBARMENT SUSPENSION, AND OTHER workplace and specifyingg the actions that will be taken against
RESPONSIBILIT`~ MATTERS employees for violation of such prohibition;
(DIRECT RECIPIENT)
As re wired b Executive Order 12549, Debarment and (b Establishing an on-going drug-free awareness program to
q Y in orm employees about-
Suspension, and implemented at 28 CFR Prt 67, for prospec-
tive participants in primarryy covered transactions, as defined at (1) The dangers of drugs abuse in the workplace;
28 CFR Part 67, Section 67.610-
(2) The grantee's policy of maintaining adrug-free workplace;
A. The applicant certifies that it and its principals:
(3) Any available drug counseling, rehabilitation, and employee
(a) Are not presently debarred, suspended, proposed for debar- assistance programs; and
ment declared ineligible, sentenced to a denial of Federal
benefits by a State or Federal court, or voluntarily excluded (4) The penalties that may be imposed upon employees for
from covered transactions by any Federal department drug abuse violations occurring in the workplace;
or agency;
b Have not within athree- ear eriod recedin this a lice- (c) Making it a requirement that each employee to be engaged
lion been convicted of or had a ciPil 'ud ment re ndered a ainst in the performance of the grant be given a copy of the state-
them for commission of fraud or a criminal offense in connec- ment required by paragraph (a);
lion with obtaining, attempting to obtain, or performing a (d) Notifyin the employee in, the statement required by
paragraph ~a) that, as a condition of employment under the
grant, the employee will-
F FORM 4G61/6 (3-91) REPLACES OJF FGRMS 406"tit, 4062/3 AND 400^1/4 WHICH ARE OBSOLETE.
(1) Abide by the terms of the statement; and
(2) Notify the employer in writing of his or her conviction for a
violation of a criminal drug statute occurring in the workplace
no later than five calendar days after such convection;
(e Notifying, the aggency, in writing, within 10 calendar days
after receiving nofce under subparagraph (dl(2) from an Check ? if there are workplace on file that are not identified
employee or otherwise receiving actual notice o such convic- here.
lion. Employers of convicted employees must provide notice
including position title, to: Department of Justice, Office of Section 67, 630 of the regulations provides that a grantee that
Justice Programs, ATTN: Control Desk, 633 Indiana Avenue, is a State may elect to make one certification in each Federal
N.W., Washington, D. C. 20531. Notice shall include the iden- fiscal year. A copy of which should be included with each ap-
tification number(s) of each affected grant; plication for Department of Justice funding. States and State
agencies may elect to use OJP Form 4061
(f) Taking one.of the following actions, within 30 calendar
days of receiving notice under subparagraph (d)(2), with Check ? if the State has elected to complete OJP Form
respect to any employee who is so convicted- 4061/7.
(1) Taking apppropriate personnel action against such an
employee, up to and including termination, consistent with the DRUG-FREE WORKPLACE
requirements of the Rehabilitation Act of 1973, as amended; or (GRANTEES WHO AREINDIVIDUALS)
(2) Requiring such employee to, participate satisfactorily in a As required by the Druq-Free Workplace Act of 1988, and
drug abuse assistance or rehabilitation program approved for implemented at 28 CFR Part 67, Subpart F, for grantees, as
such purposes by a Federal, State, or local health, law enforce- defined at 28 CFR Part 67; Sections 67.615 and 67. 20-
ment, or other appropriate agency;
A. As a condition of the grant.l certify that I will not engage
(g) Making a good faith effort to continue to maintain adrugg- in the unlawful manufacture distribution, dispensing, posses-
ffree work lace through implementation of paragraphs (a), (b), Sion, or use of a controlled substance in conddion any
(c), (d), (e~, and (f), activity with the grant; and
8. The grantee may insert in the space provided below the B. If convinced of a criminal drug offense resulting from a
site(s) for the performance of work done in connection with violation occurring during the conduct of any grant activity, I
the specific grant: will report the, conviction, in writing, within 0 calendar days
of the conviction, to: Department of Justice, Office of Justice
Place of Performance (Street address, city, country, state, zip Programs, ATTN: Control Desk, 633 Indiana Avenue, N.W.,
code) Washington, D.C. 20531.
As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications.
1. Grantee Name and Address:
Hawaii County Folice llepartrnent
349 Kapiolani Street
Hilo, Hawaii 96720
2. Application Number and/or Project Name 3. Grantee IRS/Vendor Number
iX'E/SP Agreement No 2005-57
4. Typed Name and Title of Authorized Representative
Lawrence K. Mahuna, Police Chief
5. Signature 6. Date
MAY 1 1 2005