***[Tab 3:]{.underline}***

**U.S. DEPARTMENT OF AGRICULTURE**

**CERTIFICATION REGARDING**

**DRUG-FREE WORKPLACE REQUIREMENTS (GRANTS)**

**ALTERNATIVE I - FOR GRANTEES OTHER THAN INDIVIDUALS**

**This certification is required by the regulations implementing Section
5151-5160 of the Drug-Free Workplace**

**Act of 1988 (Pub. L. 100-690, Title V, Subtitle D: 41 U.S.C.701 et
seq.), 7 CFR Part 3017. Subpart F, Section**

**3017.600, Purpose. The January 13, 1989, regulations were amended and
published as Part 11 of the May 25,**

**1990 Federal Register (pages 21681-21691). Copies of the regulations
may be obtained by contacting the**

**Department of Agriculture agency offering the grant.**

**(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON PAGE 3)**

**[Alternative I]{.underline}**

**A. The grantee certifies that it will provide a drug-free workplace
by:**

**(a) Publishing a statement notifying employees that the unlawful
manufacture, distribution,**

**dispensing, possession, or use of a controlled substance is prohibited
in the grantee\'s workplace and specifying the actions that will be
taken against employees for violation of such prohibition;**

**(b) Establishing a drug-free awareness program to inform employees
about \--**

> **(1) The dangers of drug abuse in the workplace;**
>
> **(2) The grantee\'s policy of maintaining a drug-free workplace;**
>
> **(3) Any available drug counseling, rehabilitation, and employee
> assistance programs; 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 ten 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**

Form AD-1049 (REV 5/90)

title, to every grant officer on whose grant activity the convicted
employee was working, unless the Federal agency has designated a central
point for the receipt of such notices. Notice shall include the
identification number(s) of each affected grant;

\(f\) 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 -

> \(1\) 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).

B. The grantee may insert in the space provided below the site(s) for
the performance of work done in connection with the specific grant:

Place of Performance (Street address, city, county, State, zip code)

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  See "Project Summary" narrative

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Check ⁪ If there are workplaces on file that are not identified here.

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  **«Applicant»**                                 §9006 Grant

  Organization Name                               Award Number or Project
                                                  Name

                                                  

  Name and Title of Authorized Representative     

                                                  November 14, 2023

  Signature                                       Date
  ----------------------------------------------- -----------------------

Form AD-1049 (REV 5/90)

**INSTRUCTIONS FOR CERTIFICATION**

**1. By signing and submitting this form, the grantee is providing the
certification set out on pages 1 and 2.**

**2. The certification set out on pages 1 and 2 is a material
representation of fact upon which reliance is placed when the agency
awards the grant. If it is later determined that the grantee knowingly
rendered a false certification, or otherwise violates the requirements
of the Drug-Free Workplace Act, the agency, in addition to any other
remedies available to the Federal Government, may take action authorized
under the Drug-Free Workplace Act.**

**3. Workplaces under grants, for grantees other than individuals, need
not be identified on the certification. If known, they may be identified
in the grant application. If the grantee does not identify the
workplaces at the time of application, or upon award, if there is no
application, the grantee must keep the identity of the workplace(s) on
file in its office and make the information available for Federal
inspection. Failure to**

**identify all known workplaces constitutes a violation of the
grantee\'s drug-free workplace - requirements.**

**4. Workplace identifications must include the actual address of
buildings (or parts of buildings) or other sites where work under the
grant takes place. Categorical descriptions may be used (e.g., all
vehicles of a mass transit authority or State highway department while
in operation, State employees in each local unemployment office,
performers in concert halls or radio studios).**

**5. If the workplace identified to the agency changes during the
performance of the grant, the grantee shall**

**inform the agency of the change(s). If it previously identified the
workplaces in question (see paragraph three).**

**6. Definitions of terms in the Nonprocurement Suspension and Debarment
common rule and Drug-Free**

**Workplace common rule apply to this certification. Grantees\'
attention is called, in particular, to the**

**following definitions from these rules:**

**\'\'Controlled substance\'\' means a controlled substance in Schedules
I through V of the Controlled**

**Substances Act (21 U.S.C. 812) and as further defined by regulation
(21 CFR 1308.11 through 1308.15);**

**\'\'Conviction\'\' means a finding of guilt (including a plea of nolo
contendere) or imposition of sentence, or**

**both, by any judicial body charged with the responsibility to
determine violations of the Federal or**

**States criminal drug statutes;**

**\'\'Criminal drug statute\'\' means a Federal or non-Federal criminal
statute involving the manufacture,**

**distribution, dispensing, use, or possession of any controlled
substance;**

**\'\'Employee\'\' means the employee of a grantee directly engaged in
the performance of work under a grant, including: (i) all \'\'direct
charge\'\' employees; (ii) all \'\'indirect charge\'\' employees unless
their impact or involvement is insignificant to the performance of the
grant; and, (iii) temporary personnel**

**and consultants who are directly engaged in the performance of work
under the grant and who are on**

**the grantee\'s payroll. This definition does not include workers not
on the payroll of the grantee (e.g. volunteers, even if used to meet a
matching requirement; consultants or independent contractors not on the
grantee\'s payroll; or employees of subrecipients or subcontractors in
covered workplaces)**

**AD-1049 (REV 5/90)**