Document Moscow_doc_426d74ec27

IDAHO TRANSPORTATION DEPARTMENT OFFICE OF HIGHWAY SAFETY MEMORANDUM OF UNDERSTANDING (MOU) Project Number: CFDA Number: V099470,SPT1321 20.205, 20.600 THIS AGREEMENT is made and entered into by and between: CITY OF MOSCOW POLICE DEPARTMENT (Agency name), hereinafter referred to as "Agency" and the Idaho Transportation Department (lTD) Office of Highway Safety, hereinafter referred to as "OHS". IT IS THE PURPOSE OF THIS AGREEMENT for Alive at 25 certified law enforcement instructors to raise awareness of the root causes of needless fatality crashes that plague this age group: poor decision-making, inexperience, risk-taking, drugged/drunk driving, distractions, speed and the failure to wear a seat belt through program presentations. These problems will be addressed in the class, with emphasis being placed on the acronym: Recognize the hazard Understand the defense Act correctly, in time The student will have the skills to determine if they are a defensive driver. Funding will be utilized to address the following identified highway safety problems: • Youthful Drivers ages 15-19 years represent almost 6% of the licensed drivers in Idaho, yet they represent 10.7% of the drivers in motor vehicle-related fatal and serious injury crashes during 2011. In addition, the youthful driver fatal and serious injury crash involvement rate for 2011 indicate they are 2.8 times as likely as all other drivers to be in a crash. (Idaho Traffic Crashes 2011 Report) • In 2011, 28.6% of youthful drivers involved in fatal crashes were impaired. (Idaho Traffic Crashes 2011 Report) • National and international research indicates youthful drivers are more likely to be in single vehicle crashes, make driver errors, speed, carry more passengers than other age groups, drive older and smaller cars, and are less likely to wear seat belts. • In Idaho during 2011, 14.6% of the single vehicle fatal crashes and 12.8% single vehicle rollover fatal crashes involved a driver ages 15-19, indicative of youthful drivers being more likely to make driver errors, speed, carry more passengers than other age groups, drive older and smaller cars, and they are less likely to wear seat belts. (lTD crash data) • Of the 68 teen passenger motor vehicle occupants killed in traffic crashes during the last three years, 62% were not buckled up. Data indicates 13 of 21 youthful passengers and 29 of 47 youthful drivers were not wearing seat belts (lTD crash data). THE GOAL OF THE AGREEMENT is to provide skills for youthful drivers to prevent traffic crashes, be prepared for the unanticipated, and become more aware and responsible as drivers and as passengers in efforts of Toward Zero Deaths, because every young adult life is important. IT IS, THEREFORE, MUTUALLY AGREED THAT: 1. Instructor certification and recertification: Alive at 25 Memorandum of Understanding Page 1 of 7 lclZ.·lZ.Y ---PAGE BREAK--- a. Alive at 25 instructors will complete the Instructor Development Course (IDC) and be certified by the Colorado State Patrol Family Foundation and the National Safety Council (NSC), or designee. b. Alive at 25 instructors must be currently employed by the agency. c. To retain certification, Alive at 25 instructors will teach a minimum of 4 classes per year as the primary instructor, with not more than 6 months passing without instructing a class. The OHS Alive at 25 Program Coordinator (Aa25 PC) or designee will review this annually, and notify the agency of current certified instructors. d. Instructors will attend 16 hours of in-service training over a 2 year period. 2. Reimbursement of certified instructors compensation for paid overtime : a. Agency compensation will be reimbursed up to 1.5 times the primary instructor's normal hourly wage for up to 6 hours, plus agency's contributions to employee benefits for FICA, worker's compensation, state unemployment insurance and PERSI. b. When 20 students have registered for a course, the primary instructor may choose to include a secondary instructor. The secondary instructor's agency will be reimbursed up to 1.5 times the officer's hourly wage for up to 5 hours, plus agency's contributions to employee benefits of FICA, worker's compensation, state unemployment insurance and PERSI. c. Supporting payroll verification will be submitted with the reimbursement claim within 30 days of the class. d. To claim reimbursement for mileage, prior written approval by the Aa25 PC is required. OHS will not reimburse for use of any other vehicles, equipment or supplies used in teaching the Alive at 25 classes. 3. Requirements for conducting Alive at 25 classes: a. Locations shall be approved and set up by the Aa25 PC on the Alive at 25 website. b. Classes shall be held for 4.5 hours to provide adequate time for all required NSC and approved curriculum. c. Classes shall have no more than 30 students attending the class unless the Aa25 PC provides prior written approval. d. The agency shall require the instructor scheduling the class to teach all classes that instructor has scheduled and loaded onto the Alive at 25 website. e. Classes, to be reimbursable, shall have a minimum of 8 students. f. A minimum of 20 or more students shall be registered in order for a second instructor to be reimbursable for teaching the class. g. If the class has less than 8 students, the instructor shall cancel the class unless the Aa25 PC or designee has provided an exemption in writing, and in advance. h. Classes shall not be cancelled unless absolutely necessary. Every effort should be made to find a replacement instructor, if unable to attend. i. If a class is changed or cancelled, the agency's primary instructor shall contact via electronic mail each registered student to ensure the student is placed in another class. j. The agency shall require instructors present a professional image and demeanor at all times. Instructors will not engage in any activities that may offend or harass any student based on race, culture, religion, gender or sexual orientation. k. Classes shall be offered at no charge to the student. Student manuals and certificates are provided by OHS. Alive at 25 Memorandum of Understanding Page 2 of 7 ---PAGE BREAK--- 4. Instructors shall collect and submit student evaluations to OHS with the reimbursement claim. Evaluations shall include the NSC instructor(s) digit number. (Numbers are 6-7 digits.) 5. The has established the following standards applicable to instruction: a. The wearing of police uniforms and or visible duty weapons is highly discouraged. It has been learned through experience that police uniforms create barriers to learning. b. If a uniform is worn, the instructor must have the approval of his/her agency. c. Clothing shall be clean, neat and professional. 6. The website was developed to maintain and establish statistical information on young adult drivers trained: a. Instructors shall utilize the Alive at 25 website to post courses and update the data. b. Classes shall not be loaded on the website for other instructors unless written permission from the Aa25 PC or designee is obtained. c. Students shall utilize the website to register for classes. 7. Instructors are responsible for the care and maintenance of all equipment, course products and videos which have been funded by the OHS and issued by the and NSC to the agency: a. For replacement due to normal wear and tear, the agency shall notify the Aa25 PC. b. The instructor's agency shall reimburse the the current replacement cost for any materials lost, damaged (not including normal wear and use), or stolen due to negligence. Notify the Aa25 PC of the loss or damage. c. For stolen property, the instructor shall complete a police report for the stolen property and submit a copy of the report to the Aa25 PC. 8. Instructor awards shall recognize the highest performing instructors: a. Awards shall be chosen by the Idaho Instructor Trainer Advisory Group {IITAG) and based on student critiques, peer and community nomination, periodic review and evaluations, program involvement and promotion. b. Awards shall be presented at the annual Highway Safety Summit. 9. The agency and instructor shall promote the Alive at 25 Program to youthful drivers, their parents and within local and surrounding communities. Annually a maximum of 3 hours may be claimed for reimbursement of instructor overtime hours involved in promotional activities. 10. Agencies shall encourage all Alive at 25 instructors to increase their traffic safety expertise and outreach in local communities to reduce young adult fatalities, serious injuries and economic losses: a. Encourage attendance at the annual Highway Safety Summit and other workshops or training and fulfill in-service training hours noted in 1. b. Encourage instructor involvement with young adults in local community youth groups and area schools for events, conferences and activities focused on reducing young adult driving and responsibilities as passengers; c. Additional funding may be requested with specific tasks and deliverables developed for the event. 11. The Idaho Instructor Trainer Advisory Group {IITAG) shall provide program guidance to agencies and instructors: a. The IITAG shall consist of three members of Law Enforcement (LE) and the Aa25 PC. b. Meetings meet 3 to 4 times per year. c. Ensure curriculum is followed to and NSC standards. Alive at 25 Memorandum of Understanding Page 3 of 7 ---PAGE BREAK--- d. Periodic review and evaluations of course presentations will be conducted by IITAG members to maintain standards required by the e. Review and recommend instructor reinstatements after a leave of absence. f. Review complaints of classroom instruction and determine whether an instructor evaluation should be performed. g. Review an instructor's evaluation to determine if an instructor should be suspended or decertified. h. Recommend instructor high achievement awards. 12. Evaluation and Reporting: a. Determine baseline data: 1) On the WebCars website, http://apps.itd.idaho.gov/apps/webcars/, click "Alive at 25". Determine data for the prior calendar year, January 1 to December 31, by clicking the year in the box "Select Year or Years". The default is calendar year of statewide data. You will need to uncheck the red box to identify your agency's city and county data by choosing your city and county in the top box. 2) Prepare a Baseline Report, Attachment 3, with the data for youthful drivers. Clearly identify the specific criteria used. 3) What is your agency's Alive at 25 program plans for classes and promotion during the year? 4) Due date for the Baseline Data Report is October 15. b. Evaluate the first 6 months of your agency's Alive at 25 program: 1) Prepare an Interim Report, Attachment 4, and list your accomplishments and challenges during this time period for the Alive at 25 Program. 2) What is your agency's Alive at 25 program plans for classes and promotion during the next 6 months? 3) Print the "Location Statistics Report" from WebCars for statistics on your agency's classes and students during the time period. Submit with your Interim Report. 4) Due date for the Interim Report is April1 each year. c. Evaluate your agency's Alive at 25 program for the year: 1) Prepare an Annual Report of your agency's Alive at 25 Program, Attachment 5. 5) Determine data for the prior calendar year, January 1 to December 31, using the "Year End Summary" of Summary Crash Reports for: 1) 15-19 year old and 2) 20-24 year old young adult driver crash data for the number of fatal, serious injuries and total crashes. 2) How does this compare with the data from the beginning of the year? 3) List your accomplishments and challenges encountered during the year. 4) Print the "Location Statistics Report" from the Alive at 25 website for statistics on your agency's classes and students during the year. 5) List your agency's plans for the program during the next fiscal year. 6) Due date for the Annual Report is October 1 each year. d. Due date for the final reimbursement claim is October 10 each year. 13. Assurances and Other Grant Requirements required by NHTSA for all agencies receiving federal grant funds: a. Certification and Assurances 08/12, Attachment 1. Agency will comply with certification and assurances, as applicable. Alive at 25 Memorandum of Understanding Page 4 of 7 ---PAGE BREAK--- b. Agency authorized personnel will complete and submit the annual Single Audit Certification Letter, Attachment 2. c. Other Grant Requirements: 1} Procurement of equipment and materials: All contracts shall be subject to the requirements governing this MOU, including those for procurement of materials and leasing of equipment. 2} Code of Conduct: No employee, officer, or agent of the agency shall participate in the selection, award or administration of a contract supported by grant funds if a conflict of interest, real or apparent, would be involved. Such a conflict would arise when any of the following have a financial or other interest in the firm selected for award: a) The employee, officer or agent. b) Any member of his or her immediate family. c) His or her partner. d) An organization which employs, or is about to employ any of the above- listed. The agency's officers, employees, or agents shall neither solicit nor accept gratuities, favors or anything of monetary value from contractors, potential contractors, or parties to sub-agreements. The agency guarantees it has not entered into any form of collusion with anyone, involving any form of payment, dependent upon or resulting from the award of this contract or subcontract(s). 3} Conferences, Inspection of Work, Grant Monitoring: Conferences may be held at the request of either party to this MOU. A representative of OHS and/or the U.S. Department of Transportation can visit the site for the purpose of inspection and/or assessment of work being performed at any time. 4) Travel: Grant related local vicinity travel, travel to other parts of the state, and travel outside the state must conform to lTD policies and procedures. Allowable reimbursements cannot be greater than those authorized for state employees, and reimbursements will be made to the agency for grant project travel. lTD policy requires economical and practical modes of travel, as well as moderate dining and lodging. 5) Tax and Compensation Liability: OHS will not incur any liability for worker compensation, FICA, withholding tax, unemployment compensation, or any other payment which is not a part of the grant agreement. 6} Policy Inclusions: In order to receive highway safety grant funds, OHS requires that your agency currently have a Safety Restraint Use policy in effect or implement one prior to completion of the MOU. If requested by OHS, the agency will submit their safety restraint policy to OHS prior to execution of the MOU. 7) Responsibility for Claims and Liability: Your agency shall be required to save and hold harmless OHS, lTD, NHTSA, FHWA and U.S. Department of Transportation from all claims and/or liability due to the negligent acts of your agency or your agency's subcontractor(s), agents, or employee(s). Alive at 25 Memorandum of Understanding Page 5 of7 ---PAGE BREAK--- 8) Failure to comply with any of the terms of this MOU may jeopardize Contractor in receiving future funding from OHS. 9) Eligible organizations agree to indemnify, defend and hold harmless lTD, its officers, agents, employees from and against any and all claims, suits, losses, damages or costs, including reasonable attorney's fees, arising from or by the use of grants. 10) Any dispute, disagreement or question of fact concerning this MOU shall be decided by the OHS Highway Safety Manager. The decision shall be in writing and shall be distributed to the parties concerned. If the agency disagrees with the decision by the OHS Highway Safety Manger, the decision may be appealed to the Director of the Idaho Transportation Department. The appeal must be made in writing within 30 days of the OHS decision, and served by certified mail. 11) Changes and modifications to the MOU will be noted as an attachment and signed by the contracting agent. 12) This MOU, including any attachments, constitute the entire agreement between the parties on the subject matter hereof. There are no understandings, agreements, or representations (oral or written), not specified herein regarding this MOU shall bind either party unless in writing and signed by both parties and all necessary approvals have been obtained. 13) Renewal of the agreement will be automatic on October 1 of each federal fiscal year, through FFY 2014. Award notification of allocated budgets to the contractor will be through electronic mail within 45 days of the beginning of the federal fiscal year. 14) Nothing in this agreement shall be construed as limiting or expanding the statutory or regulatory responsibilities of any involved agency or individual in performing functions granted to them by law; or as requiring either entity to expend any sum in excess of its respective appropriation. Each and every provision of this MOU is subject to the laws and regulations of the State of Idaho and of the United States. 15) Either party may terminate this MOU upon 30 days written notice to the other party. In the event of termination of this MOU, the terminating party shall be liable for the performance rendered prior to the effective date of termination. IN WITNESS WHEREOF, PARTIES HAVE EXECUTED THIS AGREEMENT: City of Moscow, Idaho, Police Department Agency Alive at 25 Memorandum of Understanding High Safety Ma ager Office of Highway Safety Effective Date (by HS ) Page 6 of 7 ---PAGE BREAK--- Agency Contact Information Name Bruce Lovell Title Police Officer Telephone [PHONE REDACTED] Fax [PHONE REDACTED] Email Address [EMAIL REDACTED] Agency Physical Address 118 East 4th Street, Moscow, ID 83843 Warrant Mailing Address City of Moscow, PO Box 9203, ID 83843 Agency or Parent Entity DUNS (Data Universal Number System} 958856338 Parent Entity Name (if applicable) N/A FFV 2013 Calculation for Overtime (OT} Benefits FICA 7.65% PERSI 11.05% State Unemployment Insurance .30% Workers' Comp 3.47% Total 22.47% Alive at 25 Memorandum of Understanding Page 7 of7 ---PAGE BREAK--- CERTIFICATIONS AND ASSURANCES Section 402 Requirements (as amended by Pub. L. 112-141) The Governor is responsible for the administration of the State highway safety program through a State highway safety agency which has adequate powers and is suitably equipped and organized (as evidenced by appropriate oversight procedures governing such areas as procurement, financial administration, and the use, management, and disposition of equipment) to carry out the program (23 USC 402(b) The political subdivisions of this State are authorized, as part of the State highway safety program, to carry out within their jurisdictions local highway safety programs which have been approved by the Governor and are in accordance with the uniform guidelines promulgated by the Secretary of Transportation (23 USC 402(b) At least 40 percent of all Federal funds apportioned to this State under 23 USC 402 for this fiscal year will be expended by or for the benefit of the political subdivision of the State in carrying out local highway safety programs (23 USC 402(b) unless this requirement is waived in writing; This State's highway safety program provides adequate and reasonable access for the safe and convenient movement of physically handicapped persons, including those in wheelchairs, across curbs constructed or replaced on or after July 1, 1976, at all pedestrian crosswalks (23 USC 402(b) The State will implement activities in support of national highway safety goals to reduce motor vehicle related fatalities that also reflect the primary data-related crash factors within the State as identified by the State highway safety planning process, including: • National law enforcement mobilizations and high-visibility law enforcement mobilizations, • Sustained enforcement of statutes addressing impaired driving, occupant protection, and driving in excess of posted speed limits, • An annual statewide safety belt use survey in accordance with criteria established by the Secretary for the measurement of State safety belt use rates to ensure that the measurements are accurate and representative, • Development of statewide data systems to provide timely and effective data analysis to support allocation of highway safety resources, • Coordination of its highway safety plan, data collection, and information systems with the State strategic highway safety plan (as defined in section 148)(a)). (23 USC 402 The State shall actively encourage all relevant law enforcement agencies in the State to follow the guidelines established for vehicular pursuits issued by the International Association of Chiefs of Police that are currently in effect. (23 USC 402(j)). Other Federal Requirements Cash drawdowns will be initiated only when actually needed for disbursement. 49 CFR 18.20 Cash disbursements and balances will be reported in a timely manner as required by NHTSA. 49 CFR 18.21. The same standards of timing and amount, including the reporting of cash disbursement and balances, will be imposed upon any secondary recipient organizations. 49 CFR 18.41. Failure to adhere to these provisions may result in the termination of drawdown privileges. The State has submitted appropriate documentation for review to the single point of contact designated by the Governor to review Federal programs, as required by Executive Order 12372 (Intergovernmental Review of Federal Programs); Equipment acquired under this agreement for use in highway safety program areas shall be used and kept in operation for highway safety purposes by the State; or the State, by formal agreement with appropriate officials of a political subdivision or State agency, shall cause such equipment to be used and kept in operation for highway safety purposes 23 CFR 1200.21 The State will comply with all applicable State procurement procedures and will maintain a financial management system that complies with the minimum requirements of 49 CFR 18.20; Certification and Assurances 08/12, Attachment 1 Page 1 of 6 ---PAGE BREAK--- Federal Funding Accountability and Transparency Act (FFATA) The State will comply with FFATA guidance, OMB Guidance on FFATA Subaward and Executive Compensation Reporting, August 27, 2010, Guidance on FFATA Subaward and Executive Compensation Reporting 08272 010.pdf) by reporting to FSRS.gov for each sub-grant awarded: • Name of the entity receiving the award; • Amount of the award; • Information on the award inclu'ding transaction type, funding agency, the North American Industry Classification System code or Catalog of Federal Domestic Assistance number (where applicable), program source; • Location of the entity receiving the award and the primary location of performance under the award, including the city, State, congressional district, and country;, and an award title descriptive of the purpose of each funding action; • A unique identifier (DUNS); • The names and total compensation of the five most highly compensated officers of the entity if-- of the entity receiving the award and of the parent entity of the recipient, should the entity be owned by another entity; the entity in the preceding fiscal year received- 80 percent or more of its annual gross revenues in Federal awards; and( II) $25,000,000 or more in annual gross revenues from Federal awards; and(ii) the public does not have access to information about the compensation of the senior executives of the entity through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986; • Other relevant information specified by OMB guidance. The State highway safety agency will comply with all Federal statutes and implementing regulations relating to nondiscrimination. These include but are not limited to: Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin (and 49 CFR Part 21); Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. § 794) and the Americans with Disabilities Act of 1990 (42 USC§ 12101, et seq.; PL 101-336), which prohibits discrimination on the basis of disabilities (and 49 CFR Part 27); the Age Discrimination Act of 1975, as amended (42U.S.C. 6101-6107), which prohibits discrimination on the basis of age; the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; the comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970(P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse of alcoholism; 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; Title VIII of the Civil Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; The Civil Rights Restoration Act of 1987, which provides that any portion of a state or local entity receiving federal funds will obligate all programs or activities of that entity to comply with these civil rights laws; and, the requirements of any other nondiscrimination statute(s) which may apply to the application. The Drug-free Workplace Act of 1988(41 U.S.C. 702;): The State will provide a drug-free workplace by: a. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; b. Establishing a drug-free awareness program to inform employees about: 1. The dangers of drug abuse in the workplace. 2. The grantee's policy of maintaining a drug-free workplace. 3. Any available drug counseling, rehabilitation, and employee assistance programs. 4. The penalties that may be imposed upon employees for drug violations occurring in the workplace. c. Making it a requirement that each employee engaged in the performance of the grant be given a copy of the statement required by paragraph Certification and Assurances 08/12, Attachment 1 Page 2 of 6 ---PAGE BREAK--- d. Notifying the employee in the statement required by paragraph that, as a condition of employment under the grant, the employee will - 1. Abide by the terms of the statement. 2. Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction. e. Notifying the agency within ten days after receiving notice under subparagraph from an employee or otherwise receiving actual notice of such conviction. f. Taking one of the following actions, within 30 days of receiving notice under subparagraph with respect to any employee who is so convicted- 1. Taking appropriate personnel action against such an employee, up to and including termination. 2. Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency. g. Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs and above. BUY AMERICA ACT The State will comply with the provisions of the Buy America Act (49 U.S.C. 5323(j)) which contains the following requirements: Only steel, iron and manufactured products produced in the United States may be purchased with Federal funds unless the Secretary of Transportation determines that such domestic purchases would be inconsistent with the public interest; that such materials are not reasonably available and of a satisfactory quality; or that inclusion of domestic materials will increase the cost of the overall project contract by more than 25 percent. Clear justification for the purchase of non-domestic items must be in the form of a waiver request submitted to and approved by the Secretary of Transportation. POLITICAL ACTIVITY (HATCH ACT). The State will comply, as applicable, with provisions of the Hatch Act (5 U.S.C. 1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. CERTIFICATION REGARDING FEDERAL LOBBYING Certification for Contracts, Grants, Loans, and Cooperative 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 any 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 sub­ award at all tiers (including subcontracts, subgrants, and contracts under grant, 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. Certification and Assurances 08/12, Attachment 1 Page 3 of 6 ---PAGE BREAK--- RESTRICTION ON STATE LOBBYING None of the funds under this program will be used for any activity specifically designed to urge or influence a State or local legislator to favor or oppose the adoption of any specific legislative proposal pending before any State or local legislative body. Such activities include both direct and indirect "grassroots") lobbying activities, with one exception. This does not preclude a State official whose salary is supported with NHTSA funds from engaging in direct communications with State or local legislative officials, in accordance with customary State practice, even if such communications urge legislative officials to favor or oppose the adoption of a specific pending legislative proposal. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION Instructions for Primary Certification 1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. 2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. 4. The prospective primary participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary participant learns its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 5. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meaning set out in the Definitions and coverage sections of 49 CFR Part 29. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations. 6. The prospective primary participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 CFR Part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. 7. The prospective primary participant further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction," provided by the department or agency entering into this covered transaction, without modification , in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 8. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 CFR Part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the list of Parties Excluded from Federal Procurement and Non-procurement Programs. 9. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 10. Except for transactions authorized under paragraph 6 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR Part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. Certification Regarding Debarment. Suspension, and Other Responsibility Matters-Primary Covered Transactions The prospective primary participant certifies to the best of its knowledge and belief, that its principals: Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency; Certification and Assurances 08/12, Attachment 1 Page 4 of 6 ---PAGE BREAK--- Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission 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 record, making false statements, or receiving stolen property; Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or Local) with commission of any of the offenses enumerated in paragraph of this certification; and 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. 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. Instructions for Lower Tier Certification 1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definition and Coverage sections of 49 CFR Part 29. You may contact the person to whom this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 CFR Part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this proposal that is it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. (See below) 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 CFR Part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Non-procurement Programs. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR Part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions: 1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. Certification and Assurances 08/12, Attachment 1 Page 5 of 6 ---PAGE BREAK--- 2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. POLICY TO BAN TEXT MESSAGING WHILE DRIVING In accordance with Executive Order 13513, Federal Leadership On Reducing Text Messaging While Driving, and DOT Order 3902.10, Text Messaging While Driving, States are encouraged to: Adopt and enforce workplace safety policies to decrease crashed caused by distracted driving including policies to ban text messaging while driving- a. Company-owned or -rented vehicles, or Government-owned, leased or rented vehicles; or b. Privately-owned when on official Government business or when performing any work on or behalf of the Government. Conduct workplace safety iniatives in a manner commensurate with the size of the business, such as - a. Establishment of new rules and programs or re-evaluation of existing programs to prohibit text messaging while driving; and b. Education, awareness, and other outreach to employees about the safety risks associated with texting while driving. ENVIRONMENTAL IMPACT The Governor's Representative for Highway Safety has reviewed the State's Fiscal Year highway safety planning document and hereby declares that no significant environmental impact will result from implementing this Highway Safety Plan. If, under a future revision, this Plan will be modified in such a manner that a project would be instituted that could affect environmental quality to the extent that a review and statement would be necessary, this office is prepared to take the action necessary to comply with the National Environmental Policy Act of 1969 {42 USC 4321 et seq.) and the implementing regulations of the Council on Environmental Quality (40 CFR Parts 1500-1517). Certification and Assurances 08/12, Attachment 1 Page 6 of 6