VOCA FFY 2024 COMBINED GRANT AWARD DOCUMENTS FOR SIGNATURE.PDF
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ARIZONA DEPARTMENT OF PUBLIC SAFETY
VICTIMS OF CRIME ACT (VOCA) VICTIM ASSISTANCE GRANT PROGRAM
SUBGRANT AWARD AGREEMENT
General Conditions
1.0
Definition of Terms. As used in this subgrant award agreement, the terms listed below
are defined as follows:
1.1
“Agreement” means a written online Request for Grant Application (RFGA) approved by
the Arizona Department of Public Safety.
1.2
“Agreement Amendment” means a written online document requested by the subrecipient
agency for the purpose of making changes in the agreement and approved by the Arizona
Department of Public Safety.
1.3
“Application” means a written online Request for Grant Application (RFGA).
1.4
“Days” means calendar days unless otherwise specified.
1.5
“Direct Service” means supportive services provided through direct contact with a victim
in-person, by phone or hotline, or by email.
1.6
“Director” means the Director of the Arizona Department of Public Safety, or his/her
designee, who is duly authorized by the State to enter into grant agreements and make
written determinations with respect to those agreements.
1.7
“DPS” means the Arizona Department of Public Safety.
1.8
“Grant” means the furnishing of financial or other assistance, including state or federal
grant funds, by the Department of Public Safety to any person for the purpose of supporting
or stimulating educational, cultural, social or economic quality of life.
1.9
“Gratuity” means a payment, loan, subscription, advance, deposit of money, services, or
anything of more than nominal value, present or promised, unless consideration of
substantially equal or greater value is received.
1.10
“Match” means additional resources (cash or in-kind) provided by the subrecipient to
support the DPS VOCA funded project. Cash match shall be from a non-Federal source.
1.11
“Project” means activities and services supported by Victims of Crime Act (VOCA) funds
plus required match, relating to this subgrant award agreement only.
1.12
“Services” means the furnishing of labor, time or effort by a subrecipient which does not
involve the delivery of a specific end product other than required reports and performance.
Allowable services include those efforts that (1) respond to the emotional and physical
needs [healing] of crime victims; (2) assist primary and secondary victims of crime to
stabilize [restitution/economic restabilization] their lives after a victimization; (3) assist
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victims to understand and participate in the criminal [justice] system; and (4) provide
victims of crime with a measure of [safety] and security.
1.13
“State” means the State of Arizona and Department or Agency of the State that executes
the subgrant award agreement.
1.14 “Subgrant award agreement” means a written signed agreement between the Arizona
Department of Public Safety and the grant recipient for the award of DPS VOCA funds.
1.15
“Subrecipient” means the legal entity to which a subaward is made and which is
accountable to DPS for the use of the funds provided.
1.16
“VOCA” means Victims of Crime Act of 1984, as amended, 34 U.S.C. § 20101, et seq.
2.0
Subgrant award agreement interpretation.
2.1
Arizona Law. Arizona law applies to this grant award agreement, including the Solicitation
and Award of Grants, Arizona Revised Statutes (A.R.S.) Title 41, Chapter 24, and its
implementing rules.
2.2
Subgrant Award Agreement Order of Precedence. In the event of a conflict in the
provisions of the subgrant award agreement, the following shall prevail in the order set
forth below:
2.2.1 Special Conditions;
2.2.2 General Conditions;
2.2.3 DPS / VOCA Guidelines;
2.2.4 Federal VOCA Guidelines; DOJ Grants Financial Guide; and Uniform Administrative
Requirements, Cost Principles, and Audit Requirements in 2 CFR Part 200.
2.3
Relationship of parties. The subrecipient under this subgrant award agreement is an
independent subrecipient. Neither party to this subgrant award agreement shall be deemed
to be the employee or agent of the other party to the subgrant award agreement.
2.4
Severability. The provisions of this subgrant award agreement are severable. Any
condition deemed illegal or invalid shall not affect any other condition of the subgrant
award agreement.
2.5
No parole evidence. This subgrant award agreement is intended by the parties as a final
and complete expression of their agreement. No prior dealings between the parties shall
supplement or explain any terms used in this document and no other understanding either
oral or in writing shall be binding.
2.6
No waiver. Either party’s failure to insist on strict performance of any condition of the
subgrant award agreement shall not be deemed a waiver of that condition even if the party
accepting or acquiescing in the nonconforming performance knows of the nature of the
performance and fails to object to it.
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3.0
Subgrant award agreement administration and operation.
3.1
Non-Discrimination. The subrecipient shall comply with State Executive Order No. 2023-
01 and all other applicable Federal and State laws, rules and regulations related to the
prohibition against discrimination, including A.R.S. § 41-1461, et seq., Title VI of the Civil
Rights Act of 1964, as amended, the Indian Civil Rights Act, Section 504 of the
Rehabilitation Act of 1973, the Age Discrimination Act of 1975, Title IX of the Education
Amendments of 1972, the Omnibus Crime Control and Safe Streets Act of 1968, the
Juvenile Justice and Delinquency Prevention Act of 1974, as amended, the Victims of
Crime Act of 1984, the Americans with Disabilities Act of 1990, Department of Justice
implementing regulations and Partnerships with Faith-Based and Other Neighborhood
Organizations.
If in the three years prior to the date of the grant award, a federal or state court or
administrative agency makes an adverse finding of discrimination after a due process
hearing against the subrecipient agency on the grounds of race, color, national origin,
religion, sex, or disability, the subrecipient shall forward a copy of the finding to the
Department of Justice, Office of Justice Programs, Office for Civil Rights and DPS.
3.1.1 Providing Services to Limited English Proficiency (LEP) Individuals. In accordance with
Department of Justice guidance, recipients (and subrecipients) of Federal financial
assistance shall take reasonable steps to provide meaningful access to their programs and
activities for persons with limited English proficiency (LEP).
3.1.2 Faith-Based Organizations. Department of Justice regulations prohibit faith-based
organizations from using financial assistance from the Department of Justice to fund
explicitly religious activities. While faith-based organizations can engage in non-funded
explicitly religious activities, they shall be held separately from the Department of Justice
funded program, and customers or beneficiaries cannot be compelled to participate in them.
Regulation also makes clear that organizations participating in programs funded by the
Department of Justice are not permitted to discriminate in the provision of services on the
basis of a beneficiary’s religion.
3.1.3 Equal Employment Opportunity Plan. The subrecipient acknowledges that failure to
submit an acceptable Equal Employment Opportunity Plan (if required to submit one
pursuant to 28 CFR Section 42.302) that is approved by the Office for Civil Rights is a
violation of its Standard Assurances and may result in suspension or termination of
funding, until such time as the subrecipient is in compliance.
3.1.4 Civil Rights Compliance Review. The subrecipient shall provide relevant information
regarding civil rights policies and procedures during the DPS-VOCA Civil Rights
Compliance Review process.
3.2
Certification Regarding Lobbying. Subrecipients entering into a VOCA grant or
cooperative agreement over $100,000 shall certify that no Federal funds have been paid or
will be paid, by or on behalf of the subrecipient, to any persons for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an
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officer or employee of Congress, or an employee of a Member of Congress in connection
with the making of any Federal grant, the entering into of any cooperative agreement, and
the extension, continuation, renewal, amendment, or modification of any Federal grant or
cooperative agreement. Federal funds include but are not limited to such grants as Victims
of Crime Act (VOCA), Violence Against Women Act (VAWA), Family Violence
Prevention and Services Act (Rural Safe Home Network Program), and the Children’s
Justice Act, which may be administered through a State or other local governmental
agency. Additionally, subrecipients shall disclose to DPS any lobbying activities that have
been paid or will be paid with any funds other than Federal funds.
3.2.1 Lobbying Activities. The subrecipient understands and agrees that it cannot use any
federal funds, either directly or indirectly, to support or oppose the enactment, repeal,
modification or adoption of any law, regulation, or policy, at any level of government.
Furthermore, the subrecipient understands and agrees that it cannot use any federal funds
to pay any person to influence (or attempt to influence) a federal agency, a Member of
Congress, or Congress (or an official or employee of any of them) with respect to the
awarding of a federal grant or cooperative agreement, subgrant, contract, subcontract, or
loan, or with respect to actions such as renewing, extending, or modifying any such award.
Should any question arise as to whether a particular use of Federal funds by the subrecipient
would or might fall within the scope of this prohibition, the subrecipient shall contact DPS
for guidance, and may not proceed without the express prior written approval of DPS.
3.3
Required reports. The subrecipient will submit reports on such data in such form and at
such times as required by DPS, to include:
3.3.1 Subgrant Award Report is due no later than October 30th of Year 2 and Year 3 of the grant
cycle;
3.3.2 Monthly financial reports are due no later than the 15th of each month;
3.3.3 Quarterly statistical and programmatic reports are due no later than 30 days following the
close of each quarter (the subrecipient agrees to collect and maintain data that measure the
performance and effectiveness of work under this award);
3.3.4 Final Request to Reprogram Funds (if necessary) is due no later than June 30th of each
fiscal year within the grant cycle;
3.3.5 Year-end amendment is due in conjunction with the final Monthly Financial Report which
is due no later than October 15th; and
3.3.6 All obligations properly incurred by September 30th of each fiscal year within the grant
cycle must be liquidated no later than November 30th. Any funds not liquidated by
November 30th will revert to DPS;
3.3.7 the Annual Report is due no later than October 30th of each fiscal year within the grant
cycle.
Failure to submit complete, accurate and timely reports may result in a reduction of the
current award. Any three combined occurrences of monthly or quarterly reports submitted
over 15 days late and/or three combined occurrences relating to the submission of
incomplete or inaccurate monthly or quarterly reports may result in up to a 10% award
reduction as determined by DPS.
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3.4
Disclosure of High Risk Status. If the subrecipient is designated “high risk” by a federal
or state grant-making agency outside of DPS, currently or at any time during the course of
the period of performance under this award, the recipient must disclose the fact and certain
related information to DPS. For the purposes of this disclosure, high risk includes any
status under which a federal or state awarding agency provides additional oversight due to
the subrecipient’s past performance, or other programmatic or financial concerns with the
subrecipient. If the subrecipient is designated high risk by another federal or state awarding
agency, the subrecipient must provide the following information: (1) the federal or state
awarding agency that designates the subrecipient high risk; (2) the date the subrecipient
was designated high risk; (3) the high risk point of contact at that federal or state awarding
agency (name, phone number, and email address); (4) the reasons for the high risk status,
as set out by the federal or state awarding agency.
In the event DPS determines that the subrecipient has failed to meet the acceptable standard
for maintaining financial and/or programmatic documentation or is identified as a high risk
subrecipient, additional financial or programmatic documentation may be required.
3.5
Records. The subrecipient shall retain all financial records, supporting documentation,
statistical records and all other records pertinent to this award until March 31, 2029. In
addition, with a 24-hour notice, the subrecipient will allow DPS and the Department of
Justice’s Office for Victims of Crime and/or the Office of the Chief Financial Officer (or
its representatives) to review all of the subrecipient’s records concerning this grant project.
3.6
Capital equipment. Any purchase of capital equipment shall be approved by DPS prior to
purchase to include submission of the subrecipient’s procurement or purchasing policies
and procedures and related quote(s) for item purchase. The subrecipient shall maintain all
capital equipment and furniture (costs in excess of $5,000 per unit) purchased through this
subgrant award agreement in accordance with the DOJ Grants Financial Guide. The
subrecipient shall submit documentation relevant to the purchase as required by DPS. All
capital equipment and furniture shall be used for victim services as identified in the
subrecipient’s application and this subgrant award agreement. Any deviation from this
provision shall be approved in writing by DPS.
3.7
Client Assistance, Emergency Financial Assistance, Transitional Housing, and Relocation.
Subrecipients receiving VOCA funds for client assistance, emergency financial assistance,
transitional housing, and relocation services must submit the policies, procedures and rules
governing the provision of the assistance for review and approval. The subrecipient agrees
to revise any policy, procedure or rule DPS determines to be unallowable or does not
conform to appropriate internal controls for suitable use of the funds and protection from
fraud, waste or abuse.
3.8
Contracts for Professional Services. Subrecipients receiving VOCA funds for contracting
for specialized professional services that are not available within the subrecipient
organization must maintain signed agreements for consultant/contractual services and
provide copies of the agreements to DPS prior to the use of VOCA funds for such services.
3.9
Noncompetitive approach in procurement contracts. The subrecipient must comply with
all applicable requirements to obtain specific advance approval to use a noncompetitive
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approach in any procurement contract that would exceed the Simplified Acquisition
Threshold (currently, $150,000).
The details of the requirement for advance approval to use a noncompetitive approach in a
procurement contract under an OJP award are posted on the OJP website at
https://ojp.gov/funding/Explore/NoncompetitiveProcurement.htm.
3.10
Authorization of use. DPS reserves a royalty-free, non-exclusive, and irrevocable license
to reproduce, publish or otherwise use, and authorize others to use for government
purposes, the copyright of any work developed under this award and any rights of copyright
to which a subrecipient purchases ownership with support through this subgrant award
agreement.
3.11
Research or statistical information. The subrecipient shall not use or reveal any research
or statistical information under this project that is identifiable to any specific person except
for the purpose for which the information was obtained, in accordance with VOCA.
3.12
Non-Disclosure of Confidential or Private Information. The subrecipient shall, to the
extent permitted by law, reasonably protect the confidentiality and privacy of persons
receiving services under this program and shall abide by the Non-Disclosure of
Confidential or Private Information rules as outlined in the DPS-VOCA Guidelines.
3.13
Site inspections. The continuance of the subrecipient’s subgrant award agreement is
contingent upon successful completion of random or for-cause inspections. Failure to
satisfactorily comply with Required Action items identified during the site inspection can
result in termination of the subgrant award agreement.
3.14
Audit requirements. The subrecipient shall comply with the audit requirements of Title 2
C.F.R. Subpart F (§ 200.500 et seq.) of the Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards and the DPS VOCA guidelines. If
an audit is required, a copy of the audit report shall be sent to DPS.
The subrecipient understands and agrees that DPS may withhold award funds, or may
impose other related requirements, if (as determined by DPS) the subrecipient does not
satisfactorily and promptly address outstanding issues from audits required by the Part 200
Uniform Requirements (or by the terms of this award), or other outstanding issues that arise
in connection with audits, investigations, or reviews of DOJ awards.
3.15
Financial statement availability. The nonprofit subrecipient shall make its financial
statements available online (either on the subrecipient’s or another publicly available
website). Subrecipient organizations that have Federal 501(c)(3) tax status are considered
in compliance with this requirement to the extent that such organizations file IRS Form
990 or similar tax documents (e.g., 990-EZ), as several sources already provide searchable
online databases of such financial statements.
3.16
Certification of nonprofit status. The nonprofit subrecipient shall certify its nonprofit status
by submitting a statement to DPS affirmatively asserting that the subrecipient is a nonprofit
organization, and by providing either 1) a copy of its 501(c)(3) designation letter; 2) a letter
from the Arizona Department of Revenue or Arizona Attorney General’s Office stating
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that the subrecipient is a nonprofit organization operating within Arizona; or 3) a copy of
the agency’s Arizona certificate of incorporation that substantiates its nonprofit status.
Subrecipients that are local nonprofit affiliates of Arizona or national nonprofits should
have available proof of (1), (2) or (3), and a statement by the Arizona or national parent
organization that the subrecipient is a local nonprofit affiliate.
3.17
Potential fraud, waste, abuse or misconduct. The subrecipient shall promptly notify the
DOJ Office of the Inspector General (OIG) and DPS in writing of any credible evidence
that a principal, employee, agent, contractor, subcontractor, or other person has in
connection with funds under this award either (1) submitted a false claim for grant funds
under the False Claims Act; or (2) committed a criminal or civil violation of laws pertaining
to fraud, conflict of interest, bribery, gratuity, or similar misconduct.
Potential fraud, waste, abuse, or misconduct involving or relating to funds under this award
shall be reported to the OIG by (1) online submission accessible via the OIG webpage at
https://oig.justice.gov/hotline/contact-grants.htm (select “Submit Report Online”); (2) mail
directed to: Office of the Inspector General, U.S. Department of Justice, Investigations
Division, 1425 New York Avenue, N.W. Suite 7100, Washington, DC 20530; and/or (3)
facsimile directed to the DOJ OIG Fraud Detection Office (Attn: Grantee Reporting) at
(202) 616-9881 (fax).
Additional
information
is
available
from
the
DOJ
OIG
website
at
https://oig.justice.gov/hotline.
3.18
Restrictions and certifications regarding non-disclosure agreements and related matters.
No subrecipient under this award may require any employee or contractor to sign an
internal confidentiality agreement or statement that prohibits or otherwise restricts, or
purports to prohibit or restrict, the reporting (in accordance with law) of waste, fraud, or
abuse to an investigative or law enforcement representative of a federal department or
agency authorized to receive such information. The foregoing is not intended to contravene
requirements applicable to Standard Form 312 (which relates to classified information),
Form 4414 (which relates to sensitive compartmented information), or any other form
issued by a federal department or agency governing the nondisclosure of classified
information.
3.19
Compliance with 41 U.S.C. § 4712 (including prohibitions on reprisal; notice to
employees). The subrecipient must comply with, and is subject to, all applicable provisions
of 41 U.S.C. § 4712, including all applicable provisions that prohibit under specified
circumstances, discrimination against an employee as reprisal for the employee’s
disclosure of information related to gross mismanagement of a federal grant, a gross waste
of federal funds, an abuse of authority relating to a federal grant, a substantial and specific
danger to public health or safety, or a violation of law, rules, or regulation related to a
federal grant.
The subrecipient also must inform its employees, in writing (and in the predominant native
language of the workforce), of employee rights and remedies under 41 U.S.C. § 4712.
Should a question arise as to the applicability of the provisions of 41 U.S.C. § 4712 to this
award, the subrecipient is to contact the OJP and DPS for guidance.
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3.20
Prohibited activities. The following activities are prohibited under this subgrant award
agreement: 1. New construction. 2. Any renovation or remodeling of a property either (a)
listed on or eligible for listing on the National Register of Historical Places or (b) located
within a 100-year floodplain, a wetland, or habitat for an endangered species. 3. A
renovation which will change the basic prior use of a facility or significantly change its
size. 4. Research and technology whose anticipated and future application could be
expected to have an effect on the environment. 5. Implementation of a program involving
the use of chemicals (including the identification, seizure, or closure of clandestine
methamphetamine laboraties).
3.21
Subgrant award agreement renewal. DPS has the option to renew this project for a
specified additional time period. The renewal of this project is contingent upon satisfactory
performance, availability of funds, and demonstrated need.
3.22
System for Award Management. The subrecipient agrees to comply with applicable
requirements regarding registration with the System for Award Management (SAM). After
the initial registration, subrecipients are required to review and update the information at
least annually and more frequently if required by changes in the subrecipient’s information
or another award item. Additional information about registration procedures may be found
at the SAM website (www.sam.gov).
3.23
Employment eligibility verification for hiring under the award.
1. The subrecipient must:
A. Ensure that, as part of the hiring process for any position within the United States
that is or will be funded (in whole or in part) with award funds, the subrecipient
properly verifies the employment eligibility of the individual who is being hired,
consistent with the provisions of 8 U.S.C. 1324a(a)(1) and (2), A.R.S. § 41-4401
and A.R.S. § 23-214.
B. Notify all persons associated with the subrecipient who are or will be involved
in activities under this subaward of both (1) this award requirement for verification
of employment eligibility, and (2) the associated provisions in 8 U.S.C. 1324a(a)(1)
and (2) that, generally speaking, make it unlawful, in the United States, to hire (or
recruit for employment) certain aliens.
C. Provide training (to the extent necessary) to those persons required by this
condition to be notified of the subaward requirement for employment eligibility
verification and of the associated provisions of 8 U.S.C. 1324a(a)(1) and (2).
D. As part of the recordkeeping for the subaward (including pursuant to the Part
200 Uniform Requirements), maintain records of all employment eligibility
verifications pertinent to compliance with this award condition in accordance with
Form I-9 record retention requirements, as well as records of all pertinent
notifications and trainings.
2. Monitoring – DPS is responsible for monitoring subrecipient compliance with this
condition.
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3. Allowable costs - To the extent that such costs are not reimbursed under any other federal
program, DPS may allow subrecipients to use VOCA funds, if awarded for the reasonable,
necessary, and allocable costs (if any) of actions designed to ensure compliance with this
condition.
4. Rules of construction
A. Staff involved in the hiring process - For purposes of this condition, persons "who are
or will be involved in activities under this award" specifically includes (without limitation)
any and all subrecipient officials or other staff who are or will be involved in the hiring
process with respect to a position that is or will be funded (in whole or in part) with award
funds.
B. Employment eligibility confirmation with E-Verify - For purposes of satisfying the
requirement of this condition regarding verification of employment eligibility, the
subrecipient may choose to participate in, and use, E-Verify (www.e-verify.gov), provided
an appropriate person authorized to act on behalf of the subrecipient uses E-Verify and
follows the proper E-Verify procedures, including in the event of a "Tentative
Nonconfirmation" or a "Final Nonconfirmation" to confirm employment eligibility for
each hiring for a position in the United States that is or will be funded (in whole or in part)
with award funds.
C. "United States" specifically includes the District of Columbia, Puerto Rico, Guam, the
Virgin Islands of the United States, and the Commonwealth of the Northern Mariana
Islands.
D. Nothing in this condition shall be understood to authorize or require any subrecipient at
any tier, or any person or other entity, to violate any federal law, including any applicable
civil rights or nondiscrimination law.
E. Nothing in this condition, including in paragraph 4.B., shall be understood to relieve any
subrecipient at any tier, or any person or other entity, of any obligation otherwise imposed
by law, including 8 U.S.C. 1324a(a)(1) and (2). Questions about E-Verify should be
directed to the Department of Homeland Security (DHS). For more information about E-
Verify visit the E-Verify website (https://www.e-verify.gov/) or email E-Verify at E-
Verify@dhs.gov.
E-Verify
employer
agents
can
email
E-Verify
at
E-
VerifyEmployerAgent@dhs.gov.
Questions about the meaning or scope of this condition should be directed to DPS, before
award acceptance.
3.24
Requirement of report actual or imminent breach of personally identifiable information
(PII). The subrecipient must have written procedures in place to respond in the event of an
actual or imminent "breach" (OMB M-17-12) if it-- 1) creates, collects, uses, processes,
stores, maintains, disseminates, discloses, or disposes of "personally identifiable
information (PII)" (2 CFR 200.1) within the scope of an OJP grant-funded program or
activity, or 2) uses or operates a "Federal information system" (OMB Circular A-130). The
subrecipient's breach procedures must include a requirement to report actual or imminent
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breach of PII to DPS no later than 24 hours after an occurrence of an actual breach, or the
detection of an imminent breach.
3.25
Unreasonable restrictions on competition under the award; association with federal
government.
SCOPE. This condition applies with respect to any procurement of property or services
that is funded (in whole or in part) by this subaward, whether by the recipient (DPS) or by
any subrecipient at any tier, and regardless of the dollar amount of the purchase or
acquisition, the method of procurement, or the nature of any legal instrument used. The
provisions of this condition must be among those included in any subaward (at any tier).
1. No discrimination, in procurement transactions, against associates of the federal
government Consistent with the (DOJ) Part 200 Uniform Requirements -- including as set
out at 2 C.F.R. 200.300 (requiring awards to be "manage[d] and administer[ed] in a manner
so as to ensure that Federal funding is expended and associated programs are implemented
in full accordance with U.S. statutory and public policy requirements") and
200.319(a) (generally requiring "[a]ll procurement transactions [to] be conducted in a
manner providing full and open competition" and forbidding practices "restrictive of
competition," such as "[p]lacing unreasonable requirements on firms in order for them to
qualify to do business" and taking "[a]ny arbitrary action in the procurement process") –
no recipient (or subrecipient, at any tier) may (in any procurement transaction) discriminate
against any person or entity on the basis of such person or entity's status as an "associate
of the federal government" (or on the basis of such person or entity's status as a parent,
affiliate, or subsidiary of such an associate), except as expressly set out in 2 C.F.R.
200.319(a) or as specifically authorized by USDOJ.
2. Monitoring - The DPS’s monitoring responsibilities include monitoring of subrecipient
compliance with this condition.
3. Allowable costs - To the extent that such costs are not reimbursed under any other federal
program, DPS may allow subrecipients to use VOCA funds, if awarded for the reasonable,
necessary, and allocable costs (if any) of actions designed to ensure compliance with this
condition.
4. Rules of construction
A. The term "associate of the federal government" means any person or entity engaged or
employed (in the past or at present) by or on behalf of the federal government -- as an
employee, contractor or subcontractor (at any tier), grant recipient or -subrecipient (at
any tier), agent, or otherwise -- in undertaking any work, project, or activity for or on
behalf of (or in providing goods or services to or on behalf of) the federal government,
and includes any applicant for such employment or engagement, and any person or
entity committed by legal instrument to undertake any such work, project, or activity
(or to provide such goods or services) in future.
B. Nothing in this condition shall be understood to authorize or require any recipient, any
subrecipient at any tier, or any person or other entity, to violate any federal law,
including any applicable civil rights or nondiscrimination law.
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4.0
Cost and Payments.
4.1
Available funds. Any award is dependent upon receipt of the VOCA Assistance funds
from the U.S. Department of Justice, and there is no obligation on the part of DPS to award
funds other than the federal VOCA Assistance funds.
4.2
Match waiver. Any award made with a match waiver pending approval from DPS, in
accordance with the U.S. Department of Justice’s match waiver approval process, is subject
to reduction if the match waiver is not approved.
4.3
Compliance. Failure of the subrecipient to utilize DPS VOCA funds for direct services to
crime victims or for training purposes as stated in the approved budget may be subject to
immediate cancellation. The subrecipient shall not utilize VOCA funds for projects which
serve perpetrators of crime or crime prevention, and/or for any other non-allowable cost or
activity in accordance with DPS / VOCA guidelines. The subrecipient agrees to reimburse
DPS for any VOCA funds the subrecipient expends that are not in full compliance with
this subgrant award agreement.
4.4
No charge to victims. Subrecipients shall provide services to crime victims, at no charge,
through the VOCA-funded project. The purpose of the VOCA victim assistance grant
program is to provide services to all crime victims regardless of their ability to pay for
services rendered or availability of insurance or other third-party payment resources.
4.5
Non-supplantation. VOCA crime victim assistance funds will be used to enhance or
expand services and shall not be used to supplant state and local funds that would otherwise
be available for crime victim services. See Section 1404(a)(2)(c), codified at 42 USC §
10603(a)(2)(C).
4.6
Mandated services. The subrecipient shall not utilize VOCA funds to support legally
mandated services.
4.7
Funds management. The subrecipient shall provide appropriate accounting and monitoring
procedures to ensure fiscal control and efficient management of funds, in accordance with
the U.S. Department of Justice, Office of Justice Programs, Grants Financial Guide,
effective edition.
4.8
Unexpended funds. The subrecipient shall immediately contact DPS to make arrangements
to amend its budget to expend remaining funds or to reduce the contracted amount when it
becomes apparent that not all VOCA grant funds will be expended by the end of the grant
period. Any VOCA funds not expended or encumbered prior to the end of the award period
shall be reverted to DPS within 30 days of the close of the grant period. Any funds not
matched as required shall be reverted to DPS within 30 days of receipt of written
notification from DPS.
4.9
Matching funds. The subrecipient shall commit, track and report matching funds at
approximately the same percentage rate as VOCA expenditures. The subrecipient may
commit, track and report match funds at a higher percentage rate each month, not to exceed
12
the total required match amount. If the rate of VOCA expenditures reported surpasses the
rate of match expenditures reported by more than 10%, the subgrant award agreement is
subject to cancellation.
4.10
Training and conference expense. The subrecipient agrees to comply with all applicable
laws, regulations, policies, and Official DOJ guidance (including specific cost limits, prior
approval and reporting requirements, where applicable) governing the use of federal funds
for expenses related to conferences (as that term is defined by DOJ), meetings, training,
and other events, including the provision of food and/or beverage and costs of attendance
at such events.
4.11
Training or training materials. The subrecipient understands and agrees that any training
or training materials developed or delivered with funding provided under this award shall
adhere to the OJP Training Guiding Principles for Grantees and Subgrantees, available at
https://ojp.gov/funding/Implement/TrainingPrinciplesForGrantees-Subgrantees.htm.
4.12
Duplicate funding. The subrecipient agrees that if it currently has an open award of federal
or state funds or if it receives an award of federal or state funds other than this award, and
those award funds have been, are being, or are to be used, in whole or in part, for one or
more of the identical cost items for which funds are being provided under this award, the
subrecipient shall promptly notify DPS and, if so requested by DPS, seek an agreement
amendment request to eliminate any duplication of funding.
5.0
Subgrant Award Agreement Changes.
5.1
Agreement Amendment. This subgrant award agreement is issued under the authority of
the Director of the Arizona DPS and may be modified only through an Agreement
Amendment, approved by DPS.
5.2
Assignment of duties. The subrecipient shall not assign or transfer any of its duties under
this agreement without express written permission of DPS.
5.3
Scope of work. Awards are based on information presented in the subrecipient’s on-line
application. Any deviation from the scope of the project as stated in subrecipient’s
application shall be approved in writing by DPS prior to the use of such funds.
5.4
Subcontracts. The subrecipient shall not enter into any subcontract under this subgrant
award agreement without the advance written approval of DPS. The subrecipient shall
clearly list any proposed subcontractors and the subcontractor’s proposed responsibilities
in the application for funding or agreement amendment. The subcontract shall incorporate
by reference the terms and conditions of this subgrant award agreement.
6.0
Indemnification.
Subrecipient Indemnification. To the fullest extent permitted by law, Contractor (as
“Indemnitor”) shall defend, indemnify, and hold harmless the State of Arizona, and its
departments, agencies, boards, commissions, universities, officers, officials, agents, and
13
employees (as “Indemnitee”) from and against any and all claims, actions, liabilities,
damages, losses, or expenses (including court costs, attorneys’ fees, and costs of claim
processing, investigation and litigation) (hereinafter referred to as “Claims”) for bodily
injury or personal injury (including death), or loss or damage to tangible or intangible
property caused, or alleged to be caused, in whole or in part, by the negligent or willful
acts or omissions of Contractor or any of its owners, officers, directors, agents, employees
or subcontractors. This indemnity includes any claim or amount arising out of, or recovered
under, the Workers’ Compensation Law or arising out of the failure of such Contractor to
conform to any federal, state, or local law, statute, ordinance, rule, regulation, or court
decree. It is the specific intention of the parties that the Indemnitee shall, in all instances,
except for Claims arising solely from the negligent or willful acts or omissions of the
Indemnitee, be indemnified by Contractor from and against any and all claims. It is agreed
that Contractor will be responsible for primary loss investigation, defense, and judgment
costs where this indemnification is applicable. In consideration of the award of this
contract, the Contractor agrees to waive all rights of subrogation against the State of
Arizona, its officers, officials, agents, and employees for losses arising from the work
performed by the Contractor for the State of Arizona.
This indemnity shall not apply if the contractor or sub-contractor(s) is/are an agency, board,
commission or university of the State of Arizona.
7.0
Grant Remedies.
7.1
Requirements of the award; remedies for non-compliance or for materially false
statements. The conditions of this award are material requirements of the award.
Compliance with any certifications or assurances submitted by or on behalf of the
subrecipient that relate to conduct during the period of performance also is a material
requirement of this award. By signing and accepting this subaward on behalf of the
subrecipient, the authorized subrecipient official accepts all material requirements of the
subaward, and specifically adopts all such assurances or certifications as if personally
executed by the authorized subrecipient official.
Failure to comply with any one or more of these award requirements—whether a condition
set out in full, a condition incorporated by reference, or a certification or assurance related
to conduct during the award period—may result in DPS taking appropriate action with
respect to the subrecipient and the award. Among other things, DPS may withhold award
funds, disallow costs, or suspend or terminate the award. DPS, the Department of Justice
(DOJ), including the Office of Justice Programs, also may take other legal action as
appropriate.
Any materially false, fictitious, or fraudulent statement to DPS or DOJ (or concealment or
omission of a material fact) may be the subject of criminal prosecution (including under 18
U.S.C. §§ 1001 and/or 1621, and/or 34 U.S.C. § 10271-10273), and also may lead to civil
penalties and administrative remedies for false claims or otherwise (including under 31
U.S.C. §§ 3729-3730 and 3801-3812).
Should any provision of a requirement of this award be held to be invalid or unenforceable
by its terms, that provision shall first be applied with a limited construction so as to give it
14
the maximum effect permitted by law. Should it be held, instead, that the provision is
utterly invalid or unenforceable, such provision shall be deemed severable from this award.
7.2
Right to Assurance. If DPS in good faith has reason to believe that the subrecipient does
not intend to, or is unable to perform or continue performing under this subgrant award
agreement, DPS may demand in writing that the subrecipient give a written assurance of
intent to perform. Failure by the subrecipient to provide written assurance within the
number of days specified in the demand may, at DPS’s option, be the basis for terminating
the subgrant award agreement under the General Conditions or other rights and remedies
available by law or provided by the subgrant award agreement.
7.3
Project implementation. If a project is not operational within 60 days of the original start
date of the project period, the subrecipient shall submit written documentation to DPS
explaining steps taken to initiate the project, the reasons for the delay, and the expected
start date. If a project is not operational within 90 days of the original start date of the
project period, the subrecipient shall submit a second written statement explaining the
implementation delay. DPS reserves the right to cancel the agreement if the proposed
project is not operational within 90 days of the original start date.
8.0
Grant Termination.
8.1
Cancellation for conflict of interest. Pursuant to A.R.S. § 38-511, the State may cancel this
agreement without penalty or further obligation if any person significantly involved in
initiating, negotiating, securing, drafting or creating the agreement on behalf of the State is
or becomes at any time while the agreement or an extension of the agreement is in effect
an employee of or a consultant to any other party to this agreement with respect to the
subject matter of the agreement. The cancellation shall be effective when the subrecipient
receives written notice of the cancellation unless the notice specifies a later time. If the
subrecipient is a political subdivision of the State, it may also cancel this agreement as
provided in A.R.S. § 38-511. In the event of cancellation under this paragraph, any
unexpended funds received by the subrecipient shall be reverted within 30 days of the
cancellation notification.
8.2
Gratuities. DPS may, by written notice, terminate this subgrant award agreement, in whole
or in part, if DPS determines that employment or a gratuity was offered or made by the
subrecipient or a representative of the subrecipient to any officer or employee of the state
for the purpose of influencing the outcome of the grant award or in securing the subgrant
award agreement, an amendment to the subgrant award agreement, or favorable treatment
concerning the subgrant award agreement, including the making of any determination or
decision about subgrant award agreement performance. DPS, in addition to any other
rights or remedies, shall be entitled to recover exemplary damages in the amount of three
times the value of the gratuity offered by the subrecipient.
8.3
Suspension or Debarment. DPS may, by written notice to the subrecipient, immediately
terminate this subgrant award agreement if DPS determines that the subrecipient has been
debarred, suspended or otherwise lawfully prohibited from or ineligible for participation
in federal assistance programs or activities, including but not limited to, being disapproved
as a subcontractor of any public procurement unit or other governmental body. Submittal
15
of an application for funding or execution of a subgrant award agreement shall attest that
the subrecipient is not currently suspended or debarred. If the subrecipient becomes
suspended or debarred, the subrecipient shall immediately notify DPS.
8.4
Termination for convenience. DPS reserves the right to terminate the subgrant award
agreement, in whole or in part any time, when in the best interest of DPS without penalty
or recourse. Upon receipt of the written notice, the subrecipient shall stop all work as
directed in the notice and minimize all further costs to DPS. In the event of termination
under this paragraph, any unexpended funds received by the subrecipient shall be reverted
within 30 days of the termination notification.
8.5
Termination for default. In addition to the rights reserved in the contract, DPS may
terminate the subgrant award agreement in whole or in part due to the failure of the
subrecipient to comply with any term or condition of the subgrant award agreement or to
make satisfactory progress in performing the subgrant award agreement. DPS shall provide
a 30-day written notice of termination and the reasons for termination to the subrecipient.
In the event of termination under this paragraph, any unexpended funds received by the
subrecipient shall be reverted within 30 days of the termination notification. The
subrecipient has the option to appeal within 20 calendar days of the date of the written
notice of termination. The final decision will be at the discretion of the Director or his
designee.
8.6
Continuation of performance through termination. The subrecipient shall continue to
perform, in accordance with the requirements of the subgrant award agreement, up to the
date of termination, as directed in the termination notice.
8.7
Termination by subrecipient. Upon written notice to DPS, the subrecipient may cancel this
subgrant award agreement. Any unexpended funds shall immediately be reverted to DPS.
9.0
Arbitration.
The parties to this subgrant award agreement agree to resolve all disputes arising out of or
relating to this subgrant award agreement through arbitration, after exhausting applicable
administrative review, to the extent required by A.R.S. § 12-1518 except as may be
required by other applicable statutes (Title 41, Chapter 23).
10.0
Other Service Requirements and Prohibited Activities.
10.1
Collaboration. The subrecipient agrees to continually and proactively participate in
developing partner relationships among other service providers in the effort to aid crime
victims within the community served.
10.2
Demographics. The subrecipient agrees to collect and maintain information on race, sex,
national origin, age, and disability of victims receiving assistance through this project,
where such information is voluntarily furnished by the victim.
16
10.3
Key staff changes. The subrecipient agrees to promptly notify DPS of changes in key staff
members identified in the grant application, to include Project Contact, Civil Rights
Contact, Crime Victim Compensation Coordinator, Project Director, Financial Contact,
Authorizing Official, and VOCA funded staff and/or staff used as match.
10.4
Vacancies. The subrecipient agrees to promptly notify DPS in writing when any VOCA
funded or match employee position is vacated and when any VOCA funded or match
employee position is filled.
10.5
Surveys. The subrecipient agrees to utilize customer feedback surveys to assist the agency
with contracted project outcome and quality measures. Feedback and satisfaction surveys
will utilize the Likert Scale of Measurement (Strongly Agree, Agree, Neither Agree or
Disagree, Disagree, Strongly Disagree).
10.6
Victim Compensation. The subrecipient agrees to assist eligible victims in seeking
available crime victim compensation benefits provided by the state victim compensation
program. The subrecipient shall designate a Victim Compensation Coordinator within its
agency. The Victim Compensation Coordinator shall receive victim compensation training
from his/her county attorney’s office or complete the Arizona Criminal Justice
Commission (ACJC) on-line Introduction to Crime Victim Compensation training module.
If training has not been received, the subrecipient shall arrange for and attend training
within 90 days from the first day of this subgrant award agreement or 90 days after
reassignment of new staff in this role.
10.7
Victims’ Rights. The subrecipient agrees to notify victims of Victims’ Rights (A.R.S. Title
13, Chapter 40 Crime Victims’ Rights; and A.R.S. Title 8, Chapter 3, Article 7 Victims’
Rights for Juvenile Offenses) and to offer to connect the victim with a representative from
the prosecutor’s or county attorney’s office if the victim so chooses. Subrecipients shall
ensure that all DPS-VOCA funded and match staff and their first line supervisor have
attended a victims’ rights presentation from the Arizona Attorney General’s Office.
10.8
Civil Rights. The subrecipient shall designate a Civil Rights Contact Person within its
agency. This person shall complete the on-line civil rights training program offered by the
Office for Civil Rights (OCR), Office of Justice Programs (OJP), Department of Justice
(DOJ) via the Arizona Criminal Justice Commission (ACJC) website. The subrecipient
shall ensure the Civil Rights Contact Person completes the training within 90 days from
the first day of this subgrant award agreement or 90 days after reassignment of new staff
in this role.
10.9
Volunteers. The subrecipient agrees to incorporate the use of volunteers to assist in
carrying out the agency’s mission. The use of volunteers is a current and ongoing
requirement for all projects.
10.10 Text messaging policy. Pursuant to Executive Order 13513, “Federal Leadership on
Reducing Text Messaging While Driving,” 74 Fed. Reg. 51225 (October 1, 2009), the
Department of Justice (DOJ) encourages subrecipients to adopt and enforce policies
banning employees from text messaging while driving any vehicle during the course of
performing work funded by this grant, and to establish workplace safety policies and
17
conduct education, awareness, and other outreach to decrease crashes caused by distracted
drivers.
10.11 Human Trafficking. The subrecipient must comply with all applicable requirements
(including requirements to report allegations) pertaining to prohibited conduct related to
the trafficking of persons. The details of the subrecipient’s obligations related to prohibited
conduct related to trafficking in persons are posted on the OJP website at
https://ojp.gov/funding/Explore/ProhibitedConduct-Trafficking.htm.
10.12 Consolidated Appropriations Act. The subrecipient shall comply with all applicable
restrictions on the use of federal funds set out in federal appropriations statutes. Pertinent
restrictions, including from various “general provisions” in the Consolidated
Appropriations Act, 2022, are set forth below.
Should a question arise as to whether a particular use of federal funds by a subrecipient
would or might fall within the scope of a restriction set out in this award condition, the
recipient is to contact DPS for guidance, and may not proceed without the express prior
written approval of DPS.
Publicity or Propaganda. Federal funds are not legally available, and may not be used
(whether directly or indirectly, including by private contractors), for publicity or
propaganda purposes not authorized by Congress.
Employee Trainings. Federal funds are not legally available, and may not be used, for any
employee training that:
1. does not meet identified needs for knowledge, skills, and abilities bearing directly upon
the performance of official duties;
2. contains elements likely to induce high levels of emotional response or psychological
stress in some participants;
3. does not require prior employee notification of the content and methods to be used in
the training and written end-of-course evaluation;
4. contains any methods or content associated with religious or quasi-religious belief
systems or “new age” belief systems as defined in Equal Employment Opportunity
Commission Notice N-915.022, dated September 2, 1988; or
5. is offensive to, or designed to change, participants’ personal values or lifestyle outside
the workplace.
Nothing in this provision prohibits, restricts, or otherwise precludes an agency from
conducting training bearing directly upon the performance of official duties.
Nondisclosure policies, forms, and agreements. Federal funds are not legally available, and
may not be used, to implement or enforce any nondisclosure policy, form, or agreement, if
such policy, form, or agreement does not contain the following provisions:
“These provisions are consistent with and do not supersede, conflict with,
or otherwise alter the employee obligations, rights, or liabilities created by
existing federal statute or Executive Order relating to 1) classified
information; 2) communications to Congress; 3) the reporting to an
Inspector General of a violation of any law, rule, or regulation, or
18
mismanagement, a gross waste of funds, an abuse of authority, or a
substantial and specific danger to public health or safety; or 4) any other
whistleblower protection. The definitions, requirements, obligations,
rights, sanctions, and liabilities created by controlling Executive Orders and
federal statutory provisions are incorporated into this agreement and are
controlling.”
Acorn and related organizations. Absent express prior written approval from OJP, federal
funds may not be provided to the Association of Community Organizers for Reform Now
(ACORN), or any of its affiliates, subsidiaries, allied organizations, or successors.
Nondiscrimination in programs involving students. Funds appropriated under the
Department of Justice Appropriations Act, 2022, and awarded by OJP are not legally
available, and may not be used, to discriminate against or denigrate the religious or moral
beliefs of students who participate in programs for which financial assistance is provided
from those funds, or those of their parents or legal guardians.
Blocking of pornography on computer networks. Funds appropriated under the Department
of Justice Appropriations Act, 2022, and awarded by OJP are not legally available and,
may not be used, to maintain or establish a computer network unless such network blocks
the viewing, downloading, and exchanging of pornography. Nothing in this provision
limits the use of funds necessary for any federal, State, tribal, or local law enforcement
agency or any other entity carrying out criminal investigations, prosecution, adjudication,
or other law enforcement or victim assistance-related activity.
Award or incentive fees to contractors. Funds appropriated under the Department of Justice
Appropriations Act, 2022, and awarded by OJP are not legally available, and may not be
used, to pay award or incentive fees for contractor performance that has been judged to be
below satisfactory performance or for performance that does not meet the basic
requirements of a contract.
Use of funds in connection with abortion. Fund appropriated under the Department of
Justice Appropriations Act, 2022, and awarded by OJP are not legally available, and may
not be used – (1) to pay for an abortion, except where the life of the mother would be
endangered if the fetus were carried to term, or in the case of rape or incest; or (2) to require
any person to perform, or facilitate in any way the performance of, any abortion.
“Pay-to-stay” at local jails. Funds appropriated to the Department of Justice through an
annual appropriations statute and awarded by OJP are not legally available to, and may not
be provided to, any local jail that runs a “pay-to-stay” program. (Monies in the Crime
Victims Fund are not appropriated through an annual appropriations statute.)
10.13 Israel Boycott Divestments. Subrecipient warrants it is not engaged in a boycott of Israel
as defined by A.R.S. § 35-393.01.
19
As the duly authorized representative of the applicant, I hereby certify that the applicant will
comply with the above general conditions.
Subrecipient (organization) Name: _________________________________________________
Signature: __________________________________________ Date: __________________
Authorizing Official
______________________________________________________________
Printed Name and Title of Authorizing Official
Maricopa County Attorney's Office
SIGN
Clint Hickman, Chairman, Maricopa County Board of Supervisors
Equal Employment Opportunity Certification Form
Arizona Department of Public Safety
Victims of Crime Act (VOCA) Administration Unit
Please read the instructions below carefully and complete the sections as indicated.
Subrecipient Agency Name:
Address:
Name of Contact Person:
Title of Contact Person:
Telephone # and Email Address of Contact Person:
Date form completed:
Select the relevant Organizational Category and then the relevant Organizational Type
Non-Government
Nonprofit Organization
Health Care or Hospital Facility
Faith-based/Religious Organization
Educational Institution
Other
Government Law Enforcement
County/Municipal Corrections
State Corrections
County/Municipal Law Enforcement
State Law Enforcement
Tribal Law Enforcement
Special Jurisdiction Law Enforcement
Government – Non-Law
Enforcement
County/Municipal Court
State Court
County/Municipal Prosecutor
Attorney General
County/Municipal Government
State Government
Tribe or Tribal Government
Health Care or Hospital Facility
Education Institution
Complete either Section A or Section B (depending on the subrecipient’s exemption status)
Section A: Declaration Claiming Complete Exemption from the EEOP Requirement - Check all that apply:
Less than 50 employees
Nonprofit Organization
Indian Tribe
Educational Institution
Medical Institution
Receiving a single award(s) less
than $25,000
I, [name of responsible official] certify that
[subrecipient agency name] is not required to
prepare an EEOP for the reason(s) checked above. I further certify that
[subrecipient agency name] will comply with all applicable federal civil rights laws that prohibit discrimination in
employment and in the delivery of services.
______________________________________________________ ____________________________________
Print Name and Title of Responsible Official
Signature
Section B: Non-Exempt Organizations
If the subrecipient agency is not exempt based on Section A above, then the most recent EEOP and Utilization
Report must be submitted to the Arizona Department of Public Safety with the Subgrant Award Agreement package.
VOCA subrecipients are no longer required to submit the EEOP and Utilization Report to the Federal Office for Civil
Rights (unless you are a Direct Recipient of funds from DOJ). I certify that the most recent EEOP and Utilization
Report have been uploaded to SAGE.
______________________________________________________ ____________________________________
Print Name and Title of Responsible Official Signature
Signature
Maricopa County DBA County Attorney's Office
225 W Madison
Sherry Rindels-Larsen
Grant Administrator
602-882-0720
10/16/2023
SIGN
Sherry Rindels-Larsen, Grant Administrator
Digitally signed by Sherry Rindels-Larsen
DN: C=US, CN=Sherry Rindels-Larsen,
E=rindelss@mcao.maricopa.gov
Reason: I have reviewed this document
Location: your signing location here
Date: 2023.10.27 08:10:11-07'00'
Foxit PhantomPDF Version: 10.1.12
Sherry
Rindels-Larsen
JEFFREY GLOVER
Director
U.S. Department of Justice
Office of Justice Programs
Office of the Chief Financial Officer
Certifications Regarding Lobbying; Debarment,
Suspension and Other Responsibility Matters
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 form. Acceptance of this form provides for compliance
with certification requirements under 28 CFR Part 69, "New Restrictions on Lobbying," 2 CFR
Part 2867, "DOJ Implementation of OMB Guidance on Nonprocurement Debarment and
Suspension," 28 CFR Part 83, "Government-wide Debarment and Suspension."
The certifications shall be treated as a material representation of fact upon which reliance will be
placed when the Department of Justice determines to award the covered transaction, grant, or
cooperative agreement.
Certification Regarding Lobbying
As required by Section 1352, Title 31 of the U.S. Code, and implemented at 28 CFR Part 69, for
persons entering into a grant or cooperative agreement over $100,000, as defined at 28 CFR
Part 69, the applicant certifies that:
(a) 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 making of any Federal grant, the entering
into of any cooperative agreement, and the extension, continuation, renewal, amendment, or
modification of any Federal grant or cooperative agreement;
(b) 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 grant or cooperative agreement, the undersigned
shall complete and submit Standard Form - LLL, "Disclosure of Lobbying Activities," in
accordance with its instructions;
(c) The undersigned shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subgrants, contracts under grants
and cooperative agreements, and subcontracts) and that all sub-recipients shall certify and
disclose accordingly.
KATIE HOBBS
Governor
ARIZONA DEPARTMENT OF PUBLIC SAFETY
2102 WEST ENCANTO BLVD. P.O. BOX 6638 PHOENIX, ARIZONA 85005-6638 (602) 223-2000
“Courteous Vigilance”
Certification Regarding Debarment, Suspension and Other Responsibility Matters
Pursuant to Executive Order 12549, Debarment and Suspension, implemented at 2 CFR Part
2867, for prospective participants in primary covered transactions, as defined at 2 CFR Section
2867.20(a), and other requirements:
A. The applicant certifies that it and its principals:
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible,
sentenced to a denial of Federal benefits by a State or Federal court, or voluntarily excluded
from covered transactions by any Federal department or agency;
(b) Have not within a three-year period preceding this application 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 records, making false statements, or receiving stolen property;
(c) 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 (b) of this certification; and
(d) Have not within a three-year period preceding this application had one or more public
transactions (Federal, State, or local) terminated for cause or default.
B. Where the applicant is unable to certify to any of the statements in this certification, he or she
shall attach an explanation to this application.
Federal Taxes
A. If the applicant is a corporation, the applicant certifies that either (1) the corporation has no
unpaid Federal tax liability that has been assessed, for which all judicial and administrative
remedies have been exhausted or have lapsed, that is not being paid in a timely manner
pursuant to an agreement with the authority responsible for collecting the tax liability, or (2) the
corporation has provided written notice of such an unpaid tax liability (or liabilities) to OJP at
Ojpcompliancereporting@usdoj.gov, and, after such disclosure, the applicant has received a
specific written determination from OJP that neither suspension nor debarment of the applicant
is necessary to protect the interests of the Government in this case.
B. Where the applicant is unable to certify to any of the statements in this certification, he or she
shall attach an explanation to this application.
As the duly authorized representative of the applicant, I hereby certify that the applicant will
comply with the above certification.
Subrecipient (organization) name:
Address:
_______________________________________
Signature of Authorizing Official
Date
Printed Name & Title of Authorizing Official
Maricopa County Attorney's Office
225 W Madison
Clint Hickman, Chairman, Maricopa County Board of Supervisors
SIGN
DISCLOSURE OF LOBBYING ACTIVITIES
Approved by OMB
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352
0348-0046
(See reverse for public burden disclosure.)
1. Type of Federal Action:
2. Status of Federal Action:
3. Report Type:
a. contract
a. bid/offer/application
a. initial filing
b. grant
b. initial award
b. material change
c. cooperative agreement
c. post-award
For Material Change Only:
d. loan
year _________ quarter _________
e. loan guarantee
date of last report ______________
f. loan insurance
4. Name and Address of Reporting Entity:
5. If Reporting Entity in No. 4 is a Subawardee, Enter Name
and Address of Prime:
Tier ______, if known :
Congressional District, if known :
Congressional District, if known :
6. Federal Department/Agency:
7. Federal Program Name/Description:
CFDA Number, if applicable: _____________
8. Federal Action Number, if known :
9. Award Amount, if known :
$
10. a. Name and Address of Lobbying Registrant
b. Individuals Performing Services (including address if
(if individual, last name, first name, MI):
different from No. 10a)
(last name, first name, MI):
11.
Signature:
Print Name:
Title:
Telephone No.: _______________________
Authorized for Local Reproduction
Standard Form LLL (Rev. 7-97)
Information requested through this form is authorized by title 31 U.S.C. section
1352. This disclosure of lobbying activities is a material representation of fact
upon which reliance was placed by the tier above when this transaction was made
or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This
information will be available for public inspection.
required disclosure shall be subject to a
not more than $100,000 for each such failure.
Prime
Subawardee
Federal Use Only:
Date:
who fails to file the
Any person
$10,000 and
than
civil penalty of not less
Not Applicable
Clint Hickman
Chairman, Maricopa County Board of Supervisors
PRINT
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal
action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreementto make
payment to any lobbying entity for influencing or attempting to influence an officer or employeeof any agency, a Member of Congress, an officer or employeeof
Congress, or an employeeof a Member of Congress in connectionwith a coveredFederalaction. Completeall items that apply for both the initial filing and material
change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriateclassification of this report. If this is a followup report caused by a material change to the information previously reported, enter
the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal
action.
4. Enter the full name, address, city, State and zip code of the reportingentity. Include CongressionalDistrict, if known. Check the appropriateclassification
of the reportingentity that designatesif it is, or expects to be, a prime or subawardrecipient. Identify the tier of the subawardee,e.g., the first subawardee
of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks "Subawardee," then enter the full name, address, city, State and zip code of the prime Federal
recipient. Include Congressional District, if known.
6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizationallevel below agency name, if known. For
example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance
(CFDA) number for grants, cooperative agreements, loans, and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number;
Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number
assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001."
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan
commitment for the prime entity identified in item 4 or 5.
10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting
entity identified in item 4 to influence the covered Federal action.
(b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and
Middle Initial (MI).
11. The certifying official shall sign and date the form, print his/her name, title, and telephone number.
According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control
Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is
estimated to average 10 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 other aspect of this collection of
information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington,
DC 20503.
JEFFREY GLOVER
Director
Complying with Federal Civil Rights Program Requirements
Ensuring Access to Federally Assisted Programs
Federal laws prohibit recipients (and subrecipients) of federal financial assistance from
discrimination on the basis of race, color, national origin, religion, sex, or disability in funded
program or activities, not only in respect to employment practices but also in the delivery of
services or benefits. Federal law also prohibits funded programs or activities from discriminating
on the basis of age in the delivery of services or benefits.
Providing Services to Limited English Proficiency (LEP) Individuals
In accordance with Department of Justice Guidance pertaining to Title VI of the Civil Rights Act
of 1964, 42 U.S.C. § 2000d, recipients (and subrecipients) of federal financial assistance must
take reasonable steps to provide meaningful access to their programs and activities for persons
with limited English proficiency (LEP). For more information on the civil rights responsibilities that
recipients have in providing language services to LEP individuals, please refer to
http://www.lep.gov.
Ensuring Equal Treatment of Faith-Based Organizations and Safeguarding Constitutional
Protections Related to Religion
The United States Department of Justice (DOJ) regulation below has been modified and now
applies not just to faith-based organizations but includes all VOCA subrecipients.
The DOJ regulation, Partnerships with Faith-Based and Other Neighborhood Organizations, 28
C.F.R. pt. 38, prohibits all recipient organizations, whether they are law enforcement agencies,
governmental agencies, educational institutions, houses of worship, or faith-based organizations,
from using financial assistance from the DOJ to fund explicitly religious activities. Explicitly
religious activities include worship, religious instruction, or proselytization. While funded
organizations may engage in non-funded explicitly religious activities (e.g., prayer), they must
hold them separately from the activities funded by the DOJ, and recipients cannot compel
beneficiaries to participate in them. The regulation also makes clear that organizations
participating in programs funded by the DOJ are not permitted to discriminate in the provision of
services on the basis of a beneficiary’s religion, religious belief, a refusal to hold a religious belief,
or a refusal to attend or participate in a religious practice. Funded faith-based organizations must
also provide written notice to beneficiaries, advising them that if they should object to the religious
character of the funded faith-based organization, the funded faith-based organization will take
reasonable steps to refer the beneficiary to an alternative service provider. For more information
on the regulation, please see the DOJ, Office of Justice Programs, Office for Civil Rights’ (OCR)
website at https://ojp.gov/about/ocr/partnerships.htm.
Faith-based organizations should also note that the Omnibus Crime Control and Safe Streets Act
(Safe Streets Act) of 1968, as amended, 34 U.S.C. §10228(c); the Victims of Crime Act of 1984,
as amended, 34 U.S.C. § 20110(e); the Juvenile Justice and Delinquency Prevention Act of 1974,
as amended, 34 U.S.C. § 11182(b); and VAWA, as amended, 34 U.S.C. § 12291(b)(13), contain
KATIE HOBBS
Governor
ARIZONA DEPARTMENT OF PUBLIC SAFETY
2102 WEST ENCANTO BLVD. P.O. BOX 6638 PHOENIX, ARIZONA 85005-6638 (602) 223-2000
“Courteous Vigilance”
prohibitions against discrimination on the basis of religion in employment. Despite these
nondiscrimination provisions, the DOJ has concluded that it may construe the Religious Freedom
Restoration Act (RFRA) on a case-by-case basis to permit some faith-based organizations to
receive DOJ funds while taking into account religion when hiring staff, even if the statue that
authorizes the funding program generally forbids recipients from considering religion in
employment decisions. Please consult with the OCR if you have any questions about the
regulation or the application of RFRA to the statutes that prohibit discrimination in employment.
Nondiscrimination Notification
DPS VOCA subrecipient agencies must have a method of notifying employees, clients,
customers, or program participants that the subrecipient agency does not discriminate in
employment practices or delivery of services and must have a written policy that includes the
procedures for filing a complaint, and the names and contact information for the agencies that
receive complaints.
Discrimination Complaints
Employees, clients, customers, or program participants of a DPS VOCA subrecipient who wish to
file a complaint of discrimination, may file a complaint directly with the subrecipient; or with the
Arizona Department of Public Safety VOCA Administration Unit (VOCACivilRights@azdps.gov);
the Arizona Office of the Attorney General, Office for Civil Rights (http://azag.gov/civil-rights/); or
the Office for Civil Rights (OCR), Office of Justice Programs, Department of Justice
(https://www.ojp.gov/program/civil-rights-office/filing-civil-rights-complaint).
Submitting Findings of Discrimination
If in the three years prior to the date of the grant award, a federal or state court or administrative
agency makes an adverse finding of discrimination after a due process hearing against the
subrecipient agency on the grounds of race, color, national origin, religion, sex, or disability, the
subrecipient shall forward a copy of the finding to the Department of Justice, Office of Justice
Programs, Office for Civil Rights and DPS VOCA.
I,
(printed name of authorizing
official), certify that _
(name of subrecipient
organization) will comply with the Federal Civil Rights Program requirements as outlined above.
_______________
Signature of Authorizing Official
Date
Printed Name and Title of Authorizing Official
Clint Hickman
Maricopa County Attorney's Office
SIGN
Clint Hickman, Chairman, Maricopa County Board of Supervisors
JEFFREY GLOVER
Director
Proof of Nonprofit Status
Nonprofit subrecipients shall demonstrate nonprofit status by any of the following means:
(1) Provide proof that the Internal Revenue Service recognizes the organization as being tax
exempt under 501(c)(3) of the Internal Revenue Code;
(2) A statement from a state taxing body or state secretary of state certifying that the
organization is a nonprofit organization and that no part of the organization’s net
earnings may benefit any private shareholder or individual;
(3) A certified copy of a certificate of incorporation or similar document establishing nonprofit
status; or
(4) Any of the above, if it applies to a state or national parent organization, with a statement
by the state or national parent organization that the applicant is a local nonprofit affiliate.
This documentation shall be returned to DPS with the signed Award Agreement.
I certify
(name of subrecipient
organization) is a nonprofit agency and attached is documentation demonstrating proof of
nonprofit status according to the requirements outlined in item number
listed above.
________________
Signature of Authorizing Official
Date
Printed Name and Title of Authorizing Official
KATIE HOBBS
Governor
ARIZONA DEPARTMENT OF PUBLIC SAFETY
2102 WEST ENCANTO BLVD. P.O. BOX 6638 PHOENIX, ARIZONA 85005-6638 (602) 223-2000
“Courteous Vigilance”
Maricopa County Attorney's Office
2
Clint Hickman, Chairman, Maricopa County Board of Supervisors
SIGN
JEFFREY GLOVER
Director
Certification regarding eligibility for de minimis rate of 10% of Modified Total Direct Costs
(MTDC)
Pursuant to § 200.414 Indirect (F&A) Costs of the Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards, any non-Federal entity that does not have
a current negotiated (including provisional) indirect cost rate, except for those non-Federal entities
described in Appendix VII to Part 200 – States and Local Government and Indian Tribe Indirect
Cost Proposals, paragraph (d)(1)(B), may elect to charge a de minimis rate of 10% of modified
total direct costs (MTDC) which may be used indefinitely. As described in § 200.403 Factors
affecting allowability of costs, costs must be consistently charged as either indirect or direct costs
but may not be double charged or inconsistently charged as both. If chosen, this methodology
once elected must be used consistently for all Federal awards until such time as a non-Federal
entity chooses to negotiate for a rate, which the non-Federal entity may apply to do at any time.
Additionally, pursuant to § 200.414(g), any non-Federal entity that has a federally negotiated
indirect cost rate may apply for a one-time extension of a current negotiated indirect cost rate for
a period of up to four years. This extension will be subject to the review and approval of the
cognizant agency for indirect costs. If an extension is granted the non-Federal entity may not
request a rate review until the extension period ends. At the end of the 4-year extension, the non-
Federal entity must re-apply to negotiate a rate.
I certify
(name of subrecipient organization):
does not have a current negotiated (including provisional) indirect cost rate
agreement and elects to charge a de minimis rate of 10% of modified total direct
costs.
has a current negotiated (including provisional) indirect cost rate agreement, of
which will be provided to the Arizona Department of Public Safety.
______________
Signature of Authorizing Official
Date
Printed Name and Title of Authorizing Official
KATIE HOBBS
Governor
ARIZONA DEPARTMENT OF PUBLIC SAFETY
2102 WEST ENCANTO BLVD. P.O. BOX 6638 PHOENIX, ARIZONA 85005-6638 (602) 223-2000
“Courteous Vigilance”
Maricopa County Attorney's Office
Clint Hickman, Chairman, Maricipa County Board of Supervisors
SIGN
JEFFREY GLOVER
Director
Certification regarding Non-Supplanting
As outlined in the U.S. Department of Justice, Office of Justice Programs, Federal Financial
Guide,
Federal funds must be used to supplement existing State and local funds for program activities
and must not supplant those funds that have been appropriated for the same purpose.
Furthermore, supplanting is defined as “to deliberately reduce State or local funds because of the
existence of Federal funds. For example, when State funds are appropriated for a stated purpose
and Federal funds are awarded for that same purpose, the State replaces its State funds with
Federal funds, thereby reducing the total amount available for the stated purpose.”
The following example is provided in the Federal Financial Guide to help clarify the difference
between supplementing and supplanting:
State funds are appropriated to hire 50 new police officers, and Federal funds are
awarded for hiring 60 new police officers. At the end of the year, the State has
hired 60 new police officers, and the Federal funds have been exhausted. The
State has not used its funds towards hiring new officers, but instead reduced its
appropriation for that purpose and assigned or appropriated the funds to another
purpose. In this case, the State has supplanted its appropriation with the Federal
funds. If supplanting had not occurred, 110 new officers would have been hired
using Federal funds for 60 officers and State funds for 50 officers.
As a subrecipient of Victims of Crime Act (VOCA) Assistance funds, each agency shall
certify its understanding of and adherence to the prohibition against supplanting of State
or local funds with Federal funds.
I certify that the
(name of
subrecipient organization) will comply with the prohibition against supplanting as outlined above.
___________
Signature of Authorizing Official
Date
Printed Name and Title of Authorizing Official
KATIE HOBBS
Governor
ARIZONA DEPARTMENT OF PUBLIC SAFETY
2102 WEST ENCANTO BLVD. P.O. BOX 6638 PHOENIX, ARIZONA 85005-6638 (602) 223-2000
“Courteous Vigilance”
Maricopa County Attorney's Office
Clint Hickman, Chairman, Maricipa County Board of Supervisors
SIGN
U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
Approved: OMB No. 1121-0329
Expires 12/31/2023
Background
Recipients’ financial management systems and internal controls must meet certain requ
uding those
set out in the “Part 200 Uniform Requirements” (2.C.F.R. Part 2800).
Including at a minimum, the financial management system of each
OJP award recipient must provide
for the following:
(1)
Identification, in its accounts, of all Federal awards received and expended and the Federal programs under
which they were received. Federal program and Federal award identification must include, as applicable, the
CFDA title and number, Federal award identification number and year, and the name of the Federal agency.
(2) Accurate, current, and complete disclosure of the financial res
ults of each Federal award or program.
(3) Records that identify adequately the source and application of funds for Federally-funded activities. These
records must contain information pertaining to Federal awards, authorizations, obligations, unobligated
balances, assets, expenditures, income, and interest, and be supported by source documentation.
(4) Effective control over, and accountability for, all funds, prop
erty, and other assets. The recipient must
adequately safeguard all assets and assure that they are used s
olely for authorized purposes.
(5) Comparison of expenditures with budget amounts for each Federal award.
(6) Written procedures to document the receipt and disbursement of
Federal funds including procedures to
minimize the time elapsing between the transfer of funds from the United States Treasury and the disbursement
by the OJP recipient.
(7) Written procedures for determining the allowability of costs in accordance with both the terms and conditions of
the Federal award and the cost principles to apply to the Federal award.
(8) Other important requirements related to retention requirements for records, use of open and machine readable
formats in records, and certain Federal rights of access to awa
rd-related records and recipient personnel.
irements, incl
1. Name of Organization and Address:
Organization Name:
Street1:
Street2:
City:
State:
Zip Code:
2. Authorized Representative’s Name and Title:
Prefix:
First Name:
Middle Name:
Last Name:
Suffix:
Title:
3. Phone:
4. F ax:
5. E mail:
6. Year Established:
7. Employer Identification Number (EIN):
8. Unique Entity Identifier (UEI) Number:
9. a) Is the applicant entity a nonprofit organization (including a nonprofit institution of higher education) as
described in 26 U.S.C. 501(c)(3) and exempt from taxation under 26 U.S.C. 501(a)?
Yes
No
If "No" skip to Question 10.
If "Yes", complete Questions 9. b) and 9. c).
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Maricopa County Attorney's Office
225 W Madison St.
Phoenix
AZ
85003-2163
Clint
Hickman
Chairman, Maricopa County Board of Supervisors
(602) 506-7642
chickman@mail.maricopa.gov
1871
866000472
DP5UNAV7S2L7
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U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
Approved: OMB No. 1121-0329
Expires 12/31/2023
AUDIT INFORMATION
9. b) Does the applicant nonprofit organization maintain offshore accounts for
the purpose of avoiding paying the tax described in 26 U.S.C. 5
11(a)?
9. c) With respect to the most recent year in which the applicant nonprofit
organization was required to file a tax return, does the applicant nonprofit
organization believe (or assert) that it satisfies the requirements of 26 C.F.R.
53.4958-6 (which relate to the reasonableness of compensation of certain
individuals)?
If "Yes", refer to “Additional Attachments” under “What An Application Should
Include” in the OJP solicitation (or application guidance) unde
r which the
applicant is submitting its application. If the solicitation/guidance describes the
“Disclosure of Process related to Executive Compensation,” the
applicant
nonprofit organization must provide -- as an attachment to its application -- a
disclosure that satisfies the minimum requirements as described by OJP.
For purposes of this questionnaire, an “audit” is conducted by an independent, external auditor using generally
accepted auditing standards (GAAS) or Generally Governmental Au
diting Standards (GAGAS), and results in an
audit report with an opinion.
10. Has the applicant entity undergone any of the following types of audit(s)(Please check all that apply):
“Single Audit” under OMB A-133 or Subpart F of 2 C.F.R. Part 200
Financial Statement Audit
Defense Contract Agency Audit (DCAA)
Other Audit & Agency (list type of audit):
None (if none, skip to question 13)
11. Most Recent Audit Report
Issued:
Within the last
Within the last
Over 2 years ago
N/A
12 months
2 years
Name of Audit Agency/Firm:
AUDITOR'S OPINION
Unqualified Opinion
Qualified Opinion
Disclaimer, Going Concern
N/A: No audits as
or Adverse Opinions
described above
Enter the number of findings (if none, enter "0":
Enter the dollar amount of questioned costs (if none, enter "$0"):
Were material weaknesses noted in the report or opinion?
Yes
No
13. Which of the following best describes the applicant entity's accounting system:
ACCOUNTING SYSTEM
Manual
Automated
Combination of manual and automated
14. Does the applicant entity's accounting system have the capability to
Yes
No
Not Sure
identify the receipt and expenditure of award funds separately for each
Federal award?
15. Does the applicant entity's accounting system have the capability to
Yes
No
Not Sure
record expenditures for each Federal award by the budget cost categories
shown in the approved budget?
16. Does the applicant entity's accounting system have the capability to
Yes
No
Not Sure
record cost sharing ("match") separately for each Federal award, and
maintain documentation to support recorded match or cost share?
Yes
No
Yes
No
12. On the most recent audit, what was the auditor’s opinion?
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Arizona Auditor General
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U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
Approved: OMB No. 1121-0329
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17. Does the applicant entity's accounting system have the capability to
Yes
Not Sure
accurately track employees actual time spent performing work for each federal
award, and to accurately allocate charges for employee salaries and wages
for each federal award, and maintain records to support the actual
time spent
and specific allocation of charges associated with each applicant e
mployee?
18. Does the applicant entity’s accounting system include budgetary
controls
Yes
No
Not Sure
to preclude the applicant entity from incurring obligations or costs that exceed
the amount of funds available under a federal award (the total amount of the
award, as well as the amount available in each budget cost cate
gory)?
19. Is applicant entity familiar with the "cost principles" that apply to recent
No
Not Sure
and future federal
awards, including
the general and specific principles set out
in 2 C.F.R Part 200?
Yes
No
PROPERTY STANDARDS AND PROCUREMENT STANDARDS
20. Does the applicant entity’s property management system(s) maintain the
No
Not Sure
following information on property purchased with federal
award funds (1) a
Yes
description of the property; (2) an identification number; (3) the source of
funding for the property, including the award number; (4) who holds title; (5)
acquisition date; (6) acquisition cost; (7) federal share of the acquisition cost;
(8) location and
condition of the property; (9) ultimate disposition information?
21. Does the appl
icant entity maintain written policies and
procedures for
Not Sure
procurement transactions that -- (1) are designed to avoid unnecessary or
duplicative purchases; (2) provide for analysis of lease versus purchase
alternatives;
(3) set out a process for soliciting goods and services, and (4)
include standards of conduct that address conflicts of interest
?
22. a) Are the applicant entity’s procurement policies and procedures
Yes
No
Not Sure
designed to ensure that procurements are conducted in a manner that
provides full and open competition to the extent practicable, and to avoid
practices that restrict competition?
22. b) Do the applicant entity's procurement policies and procedure
s require
Yes
No
Not Sure
documentation of the history of a procurement, including the ra
tionale for the
method of procurement, selection of contract type, selection or rejection of
contractors, and basis for the contract price?
23. Does the applicant entity have written policies and procedures designed
Yes
No
Not Sure
to prevent the applicant entity from entering into a procurement contract
under a federal award with any entity or individual that is suspended or
debarred from such contracts, including provisions for checking the “Excluded
Parties List” system (www.sam.gov) for suspended or debarred sub-grantees
and contractors, prior to award?
Yes
No
TRAVEL POLICY
24. Does the applicant entity:
No
(a) maintain a standard travel policy?
Yes
(b) adhere to the Federal Travel Regulation (FTR)?
Yes
SUBRECIPIENT MANAGEMENT AND MONITORING
No
Yes
No
Not Sure
N/A - Applicant does not make
25. Does the applicant entity have written policies, procedures, and/or
guidance designed to ensure that any subawards made by the applicant
entity under a federal award -- (1) clearly document applicable federal
requirements, (2) are appropriately monitored by the applicant, and (3)
comply with the requirements in 2 CFR Part 200 (see 2 CFR 200.331)?
subawards under any OJP
awards
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U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
Approved: OMB No. 1121-0329
Expires 12/31/2023
26. Is the applicant entity aware of the differences between subawards under
No
Not Sure
federal awards and procurement contracts under federal awards, including
the different roles and responsibilities associated with each?
N/A - Applicant does not make
subawards under any OJP
awards
27. Does the applicant entity have written policies and procedures designed
Yes
Not Sure
to prevent the applicant entity from making a subaward under a federal
award to any entity or individual is suspended or debarred from such
N/A - Applicant does not make
subawards?
subawards under any OJP
awards
Yes
No
DESIGNATION AS 'HIGH-RISK' BY OTHER FEDERAL AGENCIES
28. Is the applicant entity designated “high risk” by a federal grant-making
Yes
No
Not Sure
agency outside of DOJ? (High risk includes any status under which a federal
awarding agency provides additional oversight due to the applicant's past
performance, or other programmatic or financial concerns with the applicant.)
If "Yes", provide the following:
(a) Name(s) of the federal awarding agency:
(b) Date(s) the agency notified the applicant entity of the "high risk" designation:
(c) Contact information for the "high risk" point of contact at the federal agency:
Name:
Phone:
Email:
(d) Reason for "high risk" status, as set out by the federal agency:
CERTIFICATION ON BEHALF OF THE APPLICANT ENTITY
(Must be made by the chief executive, executive director, chief financial officer, designated authorized
representative ("AOR"), or other official with the requisite knowledge and authority)
On behalf of the applicant entity, I certify to the U.S. Department of Justice that the information provided above is
complete and correct to the best of my knowledge. I have the requisite authority and information to make this
certification on behalf of the applicant entity.
Name:
Date:
Title:
Executive Director
Chief Financial Officer
Chairman
Other:
Phone:
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602-506-7642
JEFFREY GLOVER
Director
Applicant Disclosure of High-Risk Status
The subrecipient must disclose whether it, currently or at any time during the course of the period
of performance under this award, is designated “high risk” by a federal or state grant-making
agency outside of the Arizona Department of Public Safety (DPS). For purposes of this
disclosure, high risk includes any status under which a federal or state awarding agency provides
additional oversight due to the subrecipient’s past performance, or other programmatic or financial
concerns with the subrecipient. If the subrecipient is, currently or at any time during the course
of the period of performance under this award, designated high risk by another federal or state
awarding agency, the subrecipient must provide the following information:
(1) The federal or state awarding agency that currently designates the subrecipient high risk.
(2) The date the subrecipient was designated high risk.
(3) The high-risk point of contact at that federal or state awarding agency (name, phone
number, and email address)
(4) The reasons for the high risk status, as set out by the federal or state awarding agency.
DPS seeks this information to help ensure appropriate oversight of DPS awards. A subrecipient
that is considered “high risk” by another federal awarding agency is not automatically disqualified
from receiving an award. DPS may, however, may impose additional oversight of the award.
Complete the section below by responding as appropriate:
I certify
(name of subrecipient
organization)
has not been notified as having been designated high-risk by any federal or state grant
making agency, nor has it been placed under any status requiring additional oversight by a federal
or state agency due to past programmatic or financial concerns.
has been notified as having been designated high-risk by a federal or state grant making
agency, and the information to be provided as described in 1-4 above is attached to this
disclosure.
___________
Signature of Authorizing Official
Date
Printed Name and Title of Authorizing Official
KATIE HOBBS
Governor
ARIZONA DEPARTMENT OF PUBLIC SAFETY
2102 WEST ENCANTO BLVD. P.O. BOX 6638 PHOENIX, ARIZONA 85005-6638 (602) 223-2000
“Courteous Vigilance”
Maricopa County Attorney's Office
Clint Hickman, Chairman, Maricopa County Board of Supervisors
SIGN
JEFFREY GLOVER
Director
DRUG-FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS)
As required by the Drug-Free Workplace Act of 1988, and implemented at 28 CFR Part 83,
Subpart F, for grantees, as defined at 28 CFR Sections 83.620 and 83.650:
A. The applicant certifies that it will or will continue to 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 an on-going 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; and
(4) The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
(c) 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 (a);
(d) Notifying the employee in the statement required by paragraph (a) that, as a condition
of employment under the grant, the employee will
(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 conviction;
(e) Notifying the agency, in writing, within 10 calendar days after receiving notice under
subparagraph (d)(2) from an employee or otherwise receiving actual notice of such
conviction. Employers of convicted employees must provide notice, including position
title, to:
Arizona Department of Public Safety
VOCA Administration, MD 1335
P. O. Box 6638
Phoenix, AZ 85005-6638
(f) Taking one of the following actions, within 30 calendar days of receiving notice under
subparagraph (d)(2), with respect to any employee who is so convicted.
KATIE HOBBS
Governor
ARIZONA DEPARTMENT OF PUBLIC SAFETY
2102 WEST ENCANTO BLVD. P.O. BOX 6638 PHOENIX, ARIZONA 85005-6638 (602) 223-2000
“Courteous Vigilance”
(1) 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
(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 (a), (b), (c), (d), (e), and (f).
As the duly authorized representative of the applicant agency, I hereby certify that the applicant
will comply with the above certifications.
__________________
Signature of Authorizing Official
Date
Printed Name and Title of Authorizing Official
Clint Hickman, Chairman, Maricopa County Board of Supervisors
SIGN
JEFFREY GLOVER
Director
Determination of Suitability Required, In Advance, For Certain Individuals
Who May Interact with Participating Minors
The VOCA subrecipient, subrecipient contractors, subcontractors and consultants providing
services to minors must make determinations of suitability before certain individuals may interact
with participating minors. This requirement applies regardless of an individual’s employment
status.
This certified assurance requires that subrecipients prepare determinations of suitability to interact
with minors in advance of any individual being permitted to interact with minors as part of the
VOCA-funded program. In order to aid the subrecipient programs in complying with this certified
assurance, the DPS will provide a Determination of Suitability to Interact with Minors form that
can be uploaded with each VOCA grant.
The details of this requirement are summarized below and are posted on the Office of Justice
Programs website at: https://www.ojp.gov/funding/explore/interact-minors.
1. Advance determination regarding suitability. The subrecipient may not permit any covered
individual to interact with any participating minor in the course of activities under the award,
unless the recipient or subrecipient first has made a written determination of the suitability of that
individual to interact with participating minors.
2. Updates and reexaminations. The subrecipient must, at least every five years, update the
criminal background searches and reexamine the covered individual's suitability determination in
light of those search results, and, if appropriate, modify or withdraw that determination. The
subrecipient also must reexamine a covered individual's suitability determination upon learning of
information that reasonably may suggest unsuitability and, if appropriate, modify or withdraw that
determination.
3. Definitions – a) "Covered individual" means any individual (other than a participating minor, as
defined in this condition, or a client of the subrecipient) who is expected, or reasonably likely, to
interact with any participating minor (other than the individual's own minor children). A covered
individual need not have any particular employment status or legal relationship with the
subrecipient. Such an individual might be an employee of a subrecipient, but also might be (for
example) a consultant, contractor, employee of a contractor, trainee, volunteer, or teacher. b)
"Participating minor" means all individuals under 18 years of age receiving services under the
VOCA-funded project. c) "Interaction" includes physical contact, oral and written
communication, and the transmission of images and sound, and may be in person or by electronic
(or similar) means. Interaction does not include brief, unexpected or unintentional contact and
those contacts where there is another adult present, pursuant to written policies and procedures of
the subrecipient, that are designed to ensure that –throughout the contact—an appropriate adult
who has been determined to be suitable pursuant to this condition will closely and personally
KATIE HOBBS
Governor
ARIZONA DEPARTMENT OF PUBLIC SAFETY
2102 WEST ENCANTO BLVD. P.O. BOX 6638 PHOENIX, ARIZONA 85005-6638 (602) 223-2000
“Courteous Vigilance”
accompany, and remain continuously within view and earshot of, the covered individual. d)
"Activities under the award" mean activities carried out under the VOCA award, using VOCA
funds, matching funds, or program income. Activities also include actions taken by an entity or
individual pursuant to a procurement contract under the subaward at any tier. e) "Current and
appropriate information" means, in addition to information resulting from checks or screening
required by applicable federal, state, tribal, or local law, and/or by the subrecipient's own written
policies and procedures, current and appropriate information includes the results of all required
searches listed below, each of which must be completed no earlier than six months before the
determination regarding suitability.
(1) Public sex offender and child abuse websites/registries. A search (by current name, and,
if applicable, by previous name(s) or aliases), of the pertinent and reasonably- accessible
federal, state, and (if applicable) local and tribal sex offender and child abuse
websites/public registries, including (a) the Dru Sjodin National Sex Offender Public
Website (www.nsopw.gov);
(b) the website/public registry for each state (and/or tribe, if applicable) in which the
individual lives, works, or goes to school, or has lived, worked, or gone to school at any
time during the past five years; and (c) the website/public registry for each state (and/or
tribe, if applicable) in which the individual is expected to, or reasonably likely to, interact
with a participating minor in the course of activities under the award.
(2) Criminal history registries and similar repositories of criminal history records. For each
individual at least 18 years of age who is a covered individual under the VOCA subaward,
a fingerprint search (or, if the subrecipient documents that a fingerprint search is not legally
available, a name-based search, using current and, if applicable, previous names and
aliases) encompassing at least the time period beginning five calendar years preceding
the date of the search request
of pertinent state (and, if applicable, local and tribal)
criminal history registries or similar repositories, including (a) the criminal history
registry for each state in which the individual lives, works, or goes to school, or has lived,
worked, or gone to school at any time during the past five years; and (b) the criminal history
registry for each state in which he or she is expected to, or reasonably likely to, interact
with a participating minor in the course of activities under the award.
4. Factors and considerations in determinations regarding suitability. In addition to the factors
and considerations that must or may be considered under applicable federal, state, tribal, or local
law, and under the subrecipient's written policies and procedures, in making a determination
regarding suitability, the subrecipient must consider the results of all required searches listed
below, each of which must be completed no earlier than six months before the determination
regarding suitability.
In particular (unless applicable law precludes it), with respect to either an initial determination of
suitability or a subsequent reexamination, the subrecipient may not determine that a covered
individual is suitable to interact with participating minors in the course of activities under the
award if the covered individual—
A) Withholds consent to a criminal history search required by this condition;
B) Knowingly makes (or made) a false statement that affects, or is intended to affect, any
search required by this condition;
C) Is listed as a registered sex offender on the Dru Sjodin National Sex Offender Public
Website;
D) To the knowledge of the recipient (or subrecipient), has been convicted whether as a
felony or misdemeanor under federal, state, tribal, or local law of any of the following
crimes (or any substantially equivalent criminal offense, regardless of the specific
words by which it may be identified in law):
(1) sexual or physical abuse, neglect, or endangerment of an individual under the
age of 18 at the time of the offense;
(2) rape/sexual assault, including conspiracy to commit rape/sexual assault;
(3) sexual exploitation, such as through child pornography or sex trafficking;
(4) kidnapping;
(5) voyeurism; or
E) Is determined by a federal, state, tribal, or local government agency not to be suitable.
5. Administration; rule of construction. a) The requirements of this condition will be monitored
by DPS. These requirements apply as of the date of acceptance of the subaward, and throughout
the remainder of the period of performance. b) The subrecipient is to contact DPS with any
questions regarding the requirements of this condition and must not allow a covered individual to
interact with a participating minor until such questions are answered. c) DPS may allow awarded
funds to be used, in part, for the reasonable, necessary, and allocable costs (if any) of actions
designed to ensure compliance with this condition, provided that such funds would not supplant
non-federal funds that would otherwise be available for such costs. d) Nothing in this condition
shall be understood to authorize or require any subrecipient at any tier, or any person or other
entity, to violate any federal, state, tribal, or local law, including any applicable civil rights or
nondiscrimination law.
6. Written policies and procedures. Subrecipients are required to prepare written policies and
procedures pertaining to this certified assurance and provide those written policies and procedures
to DPS by October 1, 2020. The procedures should identify the sources of information the
subrecipient organization intends to use to support the determination of suitability to interact with
minors (e.g. the National Sex Offender Registry).
7. Advising Covered Individuals. All employees, volunteers, contractors and consultants who are
deemed to be a covered individual, should be properly advised of this new certified assurance and
the need for a determination of suitability by the subrecipient organization. This may require
subrecipient organizations to develop a form to be completed by covered individuals that would
ask certain questions necessary to aid the subrecipient in making the determination of suitability.
At a minimum, the notice should request names and aliases used by the covered person in the
immediate 5 years prior to the request, and all cities and states the covered individual has lived,
worked or gone to school in the 5 years prior to the request.
8. Determination of suitability to interact with participating minors form. This form will be
provided by DPS and should be submitted to DPS annually. The form should list all covered
individuals deemed suitable to interact with participating minors, the date the covered individual(s)
received the designation of suitability by the subrecipient organization, when the next review will
be initiated, and the screening(s) to be performed. This determination must be made very five
years for each covered individual. Those individuals deemed not suitable to provide services to
minors should not be listed on the form and should not be permitted to interact with participating
minors under the VOCA subaward.
I,
(printed name of authorizing
official), certify that the
(name
of subrecipient organization) will comply with the Determination of Suitability to Interact With
Participating Minors requirements as outlined above.
_________________
Signature of Authorizing Official
Date
Title of Authorizing Official
Clint Hickman
Maricopa County Attorney's Office
SIGN
Chairman, Maricopa County Board of Supervisors
JEFFREY GLOVER
Director
Victims of Crime Act (VOCA) Victim Assistance Grant Program
Boycott of Israel Disclosure
Pursuant to A.R.S. §35-393.01, public entities are prohibited from entering into contracts
“unless the contract includes a written certification that the company is not currently
engaged in, and agrees for the duration of the contract to not engage in, a boycott of goods
or services from Israel.”
Under A.R.S. §35-393:
1. "Boycott" means engaging in a refusal to deal, terminating business activities or performing
other actions that are intended to limit commercial relations with entities doing business in
Israel or in territories controlled by Israel, if those actions are taken either:
(a) Based in part on the fact that the entity does business in Israel or in territories controlled
by Israel.
(b) In a manner that discriminates on the basis of nationality, national origin or religion and
that is not based on a valid business reason.
2. "Company" means an organization, association, corporation, partnership, joint venture, limited
partnership, limited liability partnership, limited liability company or other entity or business
association, including a wholly owned subsidiary, majority-owned subsidiary, parent company
or affiliate, that engages in for-profit activity and that has ten or more full-time employees.
…
5. "Public entity" means this State, a political subdivision of this State or an agency, board,
commission or department of this State or a political subdivision of this State.
The certification below does not include boycotts prohibited by 50 United States Code Section 4842
or a regulation issued pursuant to that section. See A.R.S. §35-393.03.
In compliance with A.R.S. §§35-393 et seq., all subrecipients must select one of the
following:
The Subrecipient (Company) does not participate in, and agrees not to participate in during
the term of the contract, a boycott of Israel in accordance with A.R.S. §§35-393 et seq. I
understand that my entire response will become public record in accordance with A.A.C. R2-
7-C317.
The Subrecipient (Company) does participate in a boycott of Israel as described in A.R.S.
§§35-393 et seq.
KATIE HOBBS
Governor
ARIZONA DEPARTMENT OF PUBLIC SAFETY
2102 WEST ENCANTO BLVD. P.O. BOX 6638 PHOENIX, ARIZONA 85005-6638 (602) 223-2000
“Courteous Vigilance”
Exempt Contract or Subrecipient.
Indicate which of the following statements applies to this Contract:
Contract has an estimated value of less than $100,000;
Subrecipient is a sole proprietorship;
Subrecipient has fewer than ten (10) employees; and/or
Subrecipient is a non-profit organization.
Subrecipient Organization (Company):
Name:
Address:
City:
State:
Zip Code:
Authorizing Official:
Printed Name:
Title:
Signature: _
Date: _
Maricopa County Attorney's Office
225 W Madison
Clint Hickman
SIGN
Chairman, Maricopa County Board of Supervisors