ŠĻą”±į>ž’ 79ž’’’456’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ģ„Įq` ųæ'™bjbjqPqP ¼@::ż)’’’’’’¤       D`„5č±č±č±€h²,”²läCŚŲ µ"µ(JµJµJµ·n ø$/øŽŁŁŁŁŁŁŁ$ēŪhOŽr“Ł T¾?·^·T¾T¾“Ł  JµJµõÉŁ^Į^Į^ĮT¾” Jµ JµŽŁ^ĮT¾ŽŁ^Į^ĮŗvĻ¬  ¶ŅJµµ €)DåāÅč±č¾D"ŅJŅŅ¼ߣ0ŚlŅJĮŽ,Į"ĮŽ”¶ŅĮŽ ¶ŅCød§¹ž^Į„ŗĢq»ćCøCøCø“Ł“ŁNĮCøCøCøŚT¾T¾T¾T¾äCäCäCnč±äCäCäCč±L D Ģ\      ’’’’  Workforce Investment Field Instruction (WIFI) No. 03-04 DATE: February 23, 2005 TO: Maryland Workforce Investment Grant Recipients SUBJECT: Extension of Local Workforce Investment Act Five-Year Plans REFERENCES: Public Law 105-220 – Workforce Investment Act 20 CFR 652 – Workforce Investment Act; Interim Final Rule BACKGROUND INFORMATION: The Workforce Investment Act (WIA) requires that each Local Workforce Investment Board (LWIB) submit a five-year local plan to the Department of Labor, Licensing and Regulation (DLLR) in accordance with Section 118 of the law and section 661.345 of the regulations. Current local five-year plans are due to expire on June 30, 2005. The U.S. Department of Labor has instructed States to begin working on a new Strategic Five-Year Plan for Title I of the Workforce Investment Act and the Wagner-Peyser Act; however, only two years of this plan must be submitted to DOL prior to the start of the new program year. Recognizing that pending WIA Reauthorization legislation will significantly impact the way local workforce development systems operate, the Governor’s Workforce Investment Board has approved a streamlined local plan development process. ACTION TO BE TAKEN: This WIFI provides guidance to Local Workforce Investment Boards regarding the submission of a two-year extension to existing local five-year plans. As outlined in Section 118(c) of the Act and 661.345 of the Regulations, LWIBs must provide an opportunity for public comment on and input into the development of the plan prior to its submission to the State. LWIBs must publish the availability of the local Workforce Investment plan extension by March 31, 2005. An informational copy should be submitted to DLLR at the time of publication. Draft plans are due to DLLR by May 2, 2005. The final local plan extension must be submitted to DLLR no later than June 1, 2005. CONTACT: Susan Gallagher (410) 767-2005 or Patricia Crawford (410) 767-2822 EFFECTIVE DATE: February 23 2005 Bernard L. Antkowiak Assistant Secretary WORKFORCE INVESTMENT ACT Planning Guidelines for Extending Local Five-Year Plans I. INTRODUCTION All Local Workforce Investment Boards (LWIBs) must submit an extension to their local Five-Year plans, which currently expire June 30, 2005. This extension will become the basis for the grant agreement between the local Workforce Investment Area and the Department of Labor, Licensing and Regulation (DLLR). Responses are required for each subsection, unless instructions specifically ask for updates or statements of assurance only. II. WIA PLAN EXTENSION FORMAT The following format, including the designated numbering and lettering of Sections, must be used by the LWIB in the development of the plan. A. SIGNATURE SHEETS – 1. WIA Notice of Grant Award - This form is to be signed by the appropriate representative of the LWIB. Both the draft and the final submissions of the plan must have original signatures. (See pp 13-14 for Forms and Instructions) 2. Statement of Concurrence - This form is to be signed by the appropriate chief local elected official(s) (CLEOs) and the LWIB chairperson. The draft plan needs the original signature of the LWIB chairperson. The final document must have the original signatures of both the LWIB chairperson and the CLEOs. (See pp 15-16 for Forms and Instructions) Certifications Regarding Debarment, Drug Free Workplace, and Lobbying - Each of these forms are to be signed by the appropriate representative of the LWIB. (See pp 17-20 for Forms) III. GENERAL NARRATIVE This section is comprised of numerous subsections in which descriptions of program activities and administrative procedures are provided. A. WIA ORGANIZATION Identify the grant recipient and the entity that will administer the WIA program. Provide a mailing address, email address, a telephone number and the name of a contact person for the grant recipient and the administrative entity (if different). B. TITLE I OPERATIONAL AREAS 1. Collaborative Local Labor Market Plan - Describe your local economic environment, including areas of significant growth or decline, labor force characteristics and current industry needs. What strategies will be implemented to meet the demands of the local labor market, particularly industries and occupations that are high growth and high demand. 2. Local Area Governance (LWIB) (a) Describe how the LWIB will coordinate the following Title I activities/functions with local elected officials: (1.) Developing the local workforce investment plan and conducting oversight of the One-Stop system, youth activities and employment and training activities; (2.) Selecting One-Stop operators with the agreement of the chief elected official; (3.) Selecting eligible youth service providers based on the recommendations of the Youth Council and identifying eligible providers of adult and dislocated worker intensive and training services; (4.) Developing a budget for the purpose of carrying out the duties of the local board; (5.) Negotiating and reaching agreement on local performance measures; (6.) Assisting the Governor in developing the Statewide Employment Statistics System under the Wagner- Peyser Act; (7.) Coordinating workforce investment activities with economic development strategies and developing employer linkages. 3. Local Board Staffing Describe the current LWIB staffing plan. {Reference WIFI 9-99} 4. Youth Council Describe how the Youth Council will interact with the LWIB to carry out the functions outlined in the Act: Coordinating youth activities in a local area b. Developing portions of the local plan related to eligible youth c. Recommending eligible youth service providers d. Conducting oversight, monitoring and corrective action of the local area’s youth programs. 5. One-Stop System for Service Delivery List the One-Stop Centers in your local area, including address, phone and fax numbers. Indicate the One-Stop Operator for each site and whether it is a comprehensive or satellite center. Describe any changes in the management, operation, or delivery of services in your One-Stop Centers. This should include a description of how services are currently provided by each of the required and optional One-Stop partners, and particularly the integration of Wagner-Peyser and WIA services. Describe how the needs of dislocated workers, displaced homemakers, low-income individuals such as migrants and seasonal farmworkers, public assistance recipients, women, minorities, individuals training for non-traditional employment, veterans and individuals with multiple barriers to employment (including older individuals, people with limited English-speaking ability, and people with disabilities) are being met. Describe the role, if any, of local faith or community-based organizations in your workforce development system. Provide a copy of each Memorandum of Understanding (MOU) between the Board and the One-Stop partners at each Center as an attachment to the plan extension. Also provide a copy of the current Consortia Agreement if a consortia of 3 or more partners is serving as the One-Stop Operator. {Separate instructions will be forthcoming on the development of MOUs, resource sharing and cost allocation plans.} 6. Services a. Adults and Dislocated Workers (1) Describe the services provided to adults and dislocated workers in your area. (2) Describe your supportive service policy for adults and dislocated workers in accordance with the definition at sections 101 (46) and 134 (e) (2) of the WIA Act. (3) Describe your needs-related payment policy for adults and dislocated workers as defined in section 134 (e) (4) Describe the Individual Training Account policy used in the local area and include a copy as an attachment to the plan. The description should include information such as selection process, dollar limits, duration, etc. Describe the local priority of service policy developed by the LWIB for providing Intensive and Training Services to Adult Participants under WIA Title I. The local policy will need to explain clearly whether there is a constant policy enforced during the entire WIA program period or a policy containing thresholds & triggers of funding obligations and expenditures for policy implementation. The local policy must include a description of how the LWIB has implemented the Veterans’ Priority Provisions of the “Jobs for Veterans Act” (PL 107-288). Also explain priority given to public assistance or other low-income individuals and criteria developed for use of other funds, serving specific population groups, and other appropriate factors unique to the local area. {Reference WIFI 4-99} Describe the local policy for defining "self sufficiency" and "inability to retain employment" (663.230). Employed individuals may qualify for intensive services or retraining services if it can be established that the services are needed to retain employment that leads to "self sufficiency". For employed Adult participants, minimally, the local self-sufficiency policy criteria will need to require employment paying a wage at least equal to the lower living standard income level. For employed Dislocated Workers, the local dislocated worker self-sufficiency policy may define eligibility based on current wages equal to or below a percentage of their prior layoff wage. {Reference WIFI No. 2-99} (7) Identify the staff contact person (and an alternate) who will work with the State Dislocated Worker Unit to plan and provide Rapid Response services in the local area. b. Youth Update the local area’s strategy for providing comprehensive services to eligible youth and meeting WIA’s requirements regarding youth program design. USDOL/ETA’s new vision for serving youth focuses on four major areas: Youth served in alternative education programs must receive a high quality education; Investments of WIA youth resources must be demand-driven, helping youth acquire the skills needed to be successful in a 21st century economy; Investments should be prioritized to serve youth most in need, including out-of-school youth (and those at risk), youth in foster care or aging out of foster care, offenders, children of incarcerated parents, homeless youth, and migrant and seasonal farmworker youth; Youth programs must be performance-based and outcome focused. Please describe local strategies that will support this vision and indicate whether a significant portion of your total participants served in Program Year 2003 fell into these targeted groups. Identify the sixth youth eligibility criteria to be used by the local area, if any (664.210) Identify and provide (if any), a justification for your WIA determined additional barrier as identified by the local board in accordance with Section 129 (c) (5) of the WIA law. 7. Customer Flow System Describe the customer flow process used in the local area (eligibility determination, assessment, movement through core to intensive to training services, priority of service, individualized training plans, case management and follow-up). Performance Management Describe what tools and strategies will be developed to ensure meeting annually negotiated performance standards. 9. Sunshine Provision Describe the process used to involve the public in the development of the local plan. LWIBs must publish the availability of the draft plan extension no later than March 31, 2005. IV. ADMINISTRATIVE PROVISIONS PARTICIPANT ELIGIBILITY PROCESS Please describe any changes in the local policy or procedures regarding Youth, Adult, and Dislocated Worker participant eligibility, as it relates to WIA. {Reference WIFI No. 2-99} OVERSIGHT AND MONITORING Describe the local Workforce Investment Area’s procedures for conducting oversight and monitoring of its WIA activities and those of its subrecipients and contractors. The monitoring plan shall address the monitoring scope and frequency and shall include the following: A requirement that all subrecipient agreements and contracts be monitored at least annually; Procedures for determining that expenditures have been made against the cost categories and within the cost limitations specified in the Act and WIA regulations; Procedures for determining compliance with other provisions of the Act and regulations and other applicable laws and regulations; Provisions for the recording of findings made by the recipients’ monitor(s), the forwarding of such findings to the subrecipient or contractor for response and the recording of all corrective actions; Provisions of technical assistance as necessary and appropriate; and Specific local policies developed by the WIB for oversight of the One-Stop system, youth activities and employment and training activities under Title I of WIA. GRIEVANCE PROCEDURES/COMPLAINT PROCESSING PROCEDURES Describe the Workforce Investment Area’s procedures for handling grievances and complaints from participants and other interested parties affected by the local Workforce Investment system, including One-Stop partners and service providers. Provide a separate description for the following categories of complaints: Complaints alleging discrimination on the ground of race, color, religion, sex, national origin, age, disability, political affiliation or belief, and for beneficiaries only, citizenship or participation in any WIA Title I – financially assisted program or activity; Complaints and grievances not alleging illegal forms of discrimination. This includes grievances from individuals alleging labor standards violations. 2. The local area grievance procedures should also include the remedies that may be imposed for a violation of any requirement under WIA Title I, limited to: Suspension or termination of payments under the title; Prohibition of placement of a participant with an employer that has violated any requirement under WIA Title I; Where applicable, reinstatement of an employee, payment of lost wages and benefits, and reestablishment of other relevant terms, conditions, and privileges of employment; and Where appropriate, other equitable relief. 3. Include a copy of the current Grievance Procedures/Complaint Process Procedures as an attachment to the plan extension. NONDISCRIMINATION AND EQUAL OPPORTUNITY PROVISIONS Reasonable Accommodation With regard to aid, benefits, services, training, and employment, include a statement of assurance that you will provide reasonable accommodation to qualified individuals with disabilities unless providing the accommodation would cause undue hardship. Communication – Individuals with Disabilities Describe what steps you will take to ensure that communications with individuals with disabilities, including individuals with visual or hearing impairments, are as effective as communications with others. Notice and Communication – Languages Other Than English Describe what steps you will take to meet the language needs of limited-English-speaking individuals who seek services or information. E. PROCUREMENT AND CONTRACTING PROCEDURES Describe any changes to your procurement system. Include a statement of assurance that procedures will conform to the standards in DOL regulations 29 CFR Part 97 Uniform Administrative Requirements For Grants and Cooperative Agreements to States and Local Governments, or 29 CFR Part 95 Uniform Administrative Requirements for Grants and Cooperative Agreements with Institutions of Higher Education, Hospitals and Other Non-Profit Organizations. Provide a statement of assurance or other documentation to demonstrate that the acquisition, management and disposition of property adhere to the Property Management Procedures taken from DOL regulations 29 CFR Part 97 and 29 CFR Part 95. Include a statement of assurance that the LWIB has adopted procedures to avoid conflicts of interest or the appearance of such conflicts in the exercise of their responsibilities, particularly those related to the awarding of contracts. F. FISCAL CONTROLS Describe any changes in the LWIB or fiscal agent’s accounting procedures, including the procedures used in preparing reports to the State. In addition to the requirement that all financial transactions be conducted in compliance with GAAP, your fiscal management system must include the following in your accounting procedures. The fiscal system must be adequate to track: (1) Obligations (2) Expenditures (3) Assets The fiscal system must permit the tracking of: Program income (2) Stand-in costs Profits The system must be adequate to prepare financial reports required by the State. 2. Identify the key staff who will be working with WIA funds. 3. Describe how the LWIB’s (or fiscal agent's) financial system will permit tracing of funds to a level adequate to establish that funds have not been used in violation of WIA standards or DOL regulations. 4. Describe changes in any of the following areas: a. Fiscal reporting system Obligation control system c. ITA payment system d. Chart of account system e. Accounts payable system f. Staff payroll system g. Participant payroll system h. Participant stipend payment system 5. Provide a statement of assurance that all financial transactions will be conducted and records maintained in accordance with General Accepted Accounting Procedures (GAAP). Describe the LWIB’s (or fiscal agent’s) cash management system, providing assurance that no excess cash will be kept on hand, and that procedures are in place to monitor cash. Describe your cost allocation procedures including: Identification of different cost pools Procedures for distribution of staff costs between cost categories. Procedures used for distribution of funds from each cost pool. Description of funds included in each cost pool. Description of cost allocation plans for One-Stop Centers. 8. Audits - Include the following standard statement: All governmental and non-profit organizations must follow the audit requirements of OMB Circular A-133. An annual financial and compliance audit will be conducted and submitted to the Department of Labor, Licensing, and Regulation, Office of Employment Training within thirty (30) days after the completion of the audit report, but no later than nine (9) months after the end of the audit period. Furthermore, the LWIB or fiscal agent insures that all required subrecipient audits and all subrecipient audit resolution procedures are completed. Debt Collection Describe any changes in the LWIB or fiscal agent’s procedure for collecting debts involving WIA funds. LOCAL WORKFORCE INVESTMENT BOARD (LWIB) – CHIEF LOCAL ELECTED OFFICIAL (CLEO) WORKING AGREEMENTS Include as an attachment, the agreement between the LWIB and the CLEO that clearly delineates each partner’s roles and responsibilities. The specific issues that must be addressed in this agreement are outlined in WIFI 8-99. RESPONSIBILITIES OF THE ONE-STOP SERVICE DELIVERY SYSTEM Describe the process to be used by the LWIB to meet its responsibilities related to One-Stop operations as outlined in WIFI No. 7-99. Responsibilities of the Local Workforce Investment Boards for the One-Stop Service Delivery System, including: Selecting One-Stop operator(s) and the selection method to be utilized; Defining the role of the One-Stop operator; Determining the number and type of One-Stop Centers in the local system; Defining the minimum requirements for each Center; Setting performance standards including a customer satisfaction index; Reviewing and evaluating performance of the One-Stop system and One-Stop operator(s); and Negotiating Memorandums of Understanding (MOUs) with One-Stop partners relative to operation of the One-Stop delivery system in the local area. CONTINUOUS IMPROVEMENT / CONSUMER REPORT Describe any changes in the process used to ensure the continuous improvement of eligible providers of services, and the extent to which such providers meet the employment needs of local employers and participants. Also, describe any changes to the consumer report system. V. SUBMISSION PROCEDURES A. SUBMISSION OF DRAFT PLAN EXTENSION The LWIB must make copies of the proposed local plan available to the public through such means as public hearings and local news media prior to submitting their plan. The general public must have 30 days from the date that the plan is made available to the public to submit comments to the LWIB. The LWIB must include any such comments that represent disagreement with the plan in their plan submission. The LWIB must submit both a written and electronic copy of the draft plan extension by May 2, 2005 to: Sharon Harris ( HYPERLINK mailto:sharris@dllr.state.md.us sharris@dllr.state.md.us) Maryland Department of Labor, Licensing and Regulation Division of Workforce Development 1100 N. Eutaw Street, Room 616 Baltimore, MD 21201 Original signatures are required on the WIA Notice of Grant Award and the Statement of Concurrence (LWIB Chair only). B. SUBMISSION OF FINAL PLAN EXTENSION The LWIB must submit two signed copies of the final plan extension to DLLR by June 1, 2005. Your submission should include the following: Cover Page with Name of Document and the Local Area Narrative (number pages and use minimum size 12 font) List of Attachments Attachments: WIA Notice of Grant Award (signed by LWIB representative) Statement of Concurrence (signed by LWIB Chair and CLEO) Certification Debarment/Suspension (signed by LWIB rep.) Drug Free Workplace Certification (signed by LWIB rep.) Certification Regarding Lobbying (signed by LWIB rep.) Memoranda of Understanding (see page 4) ITA Policy (see page 5) Grievance/Complaint Procedure (see page 7) LWIB/CLEO Agreement (see page 11) Public Comments and Responses (see pages 7, 11) An electronic copy is also requested. Documents should be addressed to Sharon Harris at the address noted above. REVIEW OF THE PLANS The Governor will approve or disapprove each plan in accordance with Section 118 of the Workforce Investment Board and Part 661.350 of the WIA Federal Regulations. Prior to the Governor’s action on the plans, staff from DLLR/Division of Workforce Development and the Governor’s Workforce Investment Board will review the plans to certify that they are consistent with the WIA Law and Regulations. If inconsistencies are identified, the LWIB will receive notification by May 16, 2005 and asked to make recommended changes in the plan. DEPARTMENT OF LABOR, LICENSING, AND REGULATION WORKFORCE INVESTMENT ACT (WIA) PROGRAM NOTICE OF GRANT AWARD GRANTEE (Name and Address):GRANT NUMBER: GRANT ACTION: Initial Grant Request _ Modification Grant Request Grant Request # __________ As indicated in the Grant Action section above the Grantee hereby requests from the Department of Labor, Licensing, and Regulation (the State Grantor), funds to operate a Workforce Investment Act (WIA) Title program, or modification to of the current WIA Program Grant Agreement. The Grantee agrees to adhere to all of the requirements of the five-year local plan. The Grantee agrees to comply with all of the conditions of the WIA law (PL 105-220), and regulations. The Grantee agrees to operate the WIA program in accordance with the terms of the WIA Program Grant Agreement. It is understood and agreed that neither the State of Maryland nor the State Grantor, nor any of their officials, agents, or employees shall be liable in any action of tort, contract, or otherwise, for any actions of the Grantee, or Local Workforce Investment Board, arising out of this Grant Agreement. WITNESSED BY:CERTIFIED FOR THE GRANTEE BY: SignatureSignature Typed Name and Title of RepresentativeDate Signed by Representative (This Section for State Grantor Use Only) STATE GRANTOR : Division of Workforce Development (DWD) Department of Labor, Licensing and Regulation 1100 North Eutaw Street Baltimore, Maryland 21201 GRANT PERIOD: This grant covers the period fromto  ADMIN ADULT YOUTH DISLOCATED WORKER  ____Initial Funds $ $ $ $ $ Increase Funds $ $ $ $ $ Decrease Funds $ $ $ $ $ Total Funds $ $ $ $ $ No Change to Funds $ $ $ $ $ EFFECTIVE DATE:  WITNESSED BY  APPROVED FOR THE STATE GRANTOR BY: Bernard L. Antkowiak, Assistant Secretary, DWD Approved as to form and legal sufficiency by the Office of the Attorney General on December 16, 1999Date Signed INSTRUCTIONS FOR COMPLETING THE GRANT AGREEMENT SIGNATURE SHEET GRANTEE (Name and Address): Enter the name and address of the administrative agency requesting approval of the grant application. GRANT NUMBER: The initial grant number will be assigned and entered by the State Grantor. The Grantee should enter the assigned grant number for all modification requests OET has decided for administrative ease to consolidate all funding streams into one grant. In order to distinguish the separate funding streams, each funding source will be assigned the grant number followed by a letter. The administrative funds will be assigned the grant number followed by the letter A. The adult funds will be assigned the grant number followed by the letter B. The youth funds will be assigned the grant number followed by the letter C and the dislocated worker funds will be the grant number followed by the letter D. GRANT ACTION: Check the appropriate box and enter the modification request number, if appropriate. CERTIFIED FOR THE GRANTEEE BY: The authorized representative of the Grantee must sign the grant request. Enter the typed name and title of the representative and enter the date on which the signature sheet was signed. WITNESSED BY: The individual who witnessed the authorized signature must sign on this line. THE REST OF THIS FORM WILL BE COMPLETED BY THE STATE GRANTOR. PLEASE DO NOT WRITE BELOW THE DOTTED LINE. STATEMENT OF CONCURRENCE WITH THE ACT Workforce Investment Area: Contact Person for Plan:  This is to certify that the membership for the Local Workforce Investment Board (LWIB) for the (1) Workforce Investment Area is in compliance with Section 117 of the Workforce Investment Act. The LWIB developed the local area plan in partnership with the appropriate chief elected officials. The local area plan is consistent with Section 118 of the Workforce Investment Act, the State plan and local area plan instructions developed by the Governor. Both the LWIB and the chief elected official(s) have approved the local area plan. Said local area plan is submitted to the Maryland Department of Labor Licensing and Regulation jointly by the LWIB and the chief elected official(s). (2)  Signature and typed names of the LWIB Chairperson(s)Date The chief elected official(s) also appoints (3) ___________________ as the Grant Recipient and authorizes (where appropriate) the Grant Recipient to sign agreements. As discussed in WIFI NO. 8-99, a copy of the LWIB/CLEO Working Agreement must be included as part of Section IV of this plan - Administrative Provisions. (4)          STATEMENT OF CONCURRENCE WITH THE ACT INSTRUCTIONS FOR COMPLETING THE FORM: Identification Block: Enter the name of the Workforce Investment Area in the identification block at the top of the form. Also indicate the name, title, telephone number and e-mail address for the individual that should be contacted regarding any questions on the plan. (1) Insert the name of the local workforce investment area. (2) Type the name(s) of the LWIB Chairperson(s) under his/her signature. Indicate the date signed in the date block. (3) Insert the name of the grant recipient entity. (4) Type the name of the Chief Elected Official(s) under his/her signature. Indicate the date signed in the date block. (a) Single County Local Workforce Investment Areas – The County Executive or Chairperson of the County Commissioners must sign the form. (b) Single City Local Workforce Investment Areas – The Mayor must sign the form. (c) Consortium of Counties – The individuals (s) identified in the WIA Local Elected Official Agreement as the Local Workforce Investment Area signatory (s) must sign and date the form. Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.510, Participants' responsibilities. The regulations were published as Part VII of the May 26, 1988 Federal Register (pages 19160-19211). (BEFORE SIGNING CERTIFICATION, READ ATTACHED INSTRUCTIONS WHICH ARE AN INTEGRAL PART OF THE CERTIFICATION) (1) The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three-year period preceding this proposal been convicted of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and (d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. (2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Name and Title of Authorized Representative _____________________________________________________________________ Signature Date Drug Free Workplace Requirements Certification Alternate I. (Grantees Other Than Individuals) Pursuant to the Drug-Free Workplace Act of 1988, and its implementing regulations codified at 29 CFR 98, Subpart F, I, (Insert Name of Signatory) , the undersigned, in representation of the Maryland Department of Labor, Licensing and Regulation, the grantee, attest and certify that the grantee will provide a drug-free workplace by: 1. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; 2. Establishing an ongoing drug-free awareness program to inform employees about: (a) The dangers of drug abuse in the workplace; (b) The grantee's policy of maintaining a drug-free workplace; (c) Any available drug counseling, rehabilitation, and employee assistance programs; and (d) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; 3. Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (1); 4. Notifying the employee in the statement required by paragraph (1) that, as a condition of employment under the grant, the employee will: (a) Abide by the terms of the statement; and (b) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction; 5. Notifying the agency in writing ten calendar days after receiving notice under subparagraph (4) (b) from an employee or otherwise receiving actual notice of such conviction. We will provide such notice of convicted employees, including position title, to every grant officer on whose grant activity the convicted employee was working. The notice shall include the identification number(s) of each affected grant. 6. Taking one of the following actions, within 30 calendar days of receiving notice under subparagraph (4) (b), with respect to any employee who is so convicted: (a) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973 as amended; or (b) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; 7. Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (1), (2), (3), (4), (5) and (6). 8. Notwithstanding it is not required to provide the workplace addresses under the grant, as of today the specific sites are known and we have decided to provide the specific addresses with the understanding that if any of the identified places change during the performance of the grant, we will inform the agency of the changes. The following are the sites for the performance of work done in connection with the specific grant including street address, city, county, state, and zip code:    Check ( ) if there are workplaces on file that are not identified here. Check ( ) if an additional page was required for the listing of the workplaces. I declare, under penalty of perjury under the laws of the United States, and under the penalties set forth by the Drug-Free Workplace Act of 1988, that this certification is true and correct. (Insert Name and Title of Signatory) I (insert name of signatory), certify that I am the (signatory's title), the grantee; that I who sign this Drug-Free Workplace Certification on behalf of the grantee, do so by the authority given by (indicate legal authority), and such signing is within the scope of my powers. Authorized Signature Executed on: Certification Regarding Lobbying CERTIFICATION FOR GRANTSAND COOPERATE AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying, in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all* subawards at all tiers (including subcontracts, subgrants and contract under grants, loans, and cooperative agreements) and that all* subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Grantee/Contractor Organization Program/Title Name of Certifying Official Signature Date *Note: In these instances, "All," in the Final Rule is expected to be clarified to show that it applies to covered grant transactions over $100,000 (per OMB).     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