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State of California Office of Traffic SafetyGRANT AGREEMENT GRANT NUMBERMC240031.GRANT TITLEMotorcyclist Safety Education and Training Program2.NAME OF AGENCY 3.Grant PeriodChinoFrom:To:10/01/202309/30/20244.AGENCY UNIT TO ADMINISTER GRANTChino Police Department5.GRANT DESCRIPTIONBest practice strategies will be conducted to reduce the number of persons killed and injured in crashes involving motorcycles. The funded strategies may include hands-on motorcyclist safety courses, motorcyclist helmet usage training, classroom education, community outreach and public awareness campaigns, educational presentations, and workshops. These countermeasures should be conducted in communities with a high number of motorcycle related crashes.6.Federal Funds Allocated Under This Agreement Shall Not Exceed:$26,000.007.TERMS AND CONDITIONS: The parties agree to comply with the terms and conditions of the following which are bythis reference made a part of the Agreement:Schedule A Problem Statement, Goals and Objectives and Method of ProcedureSchedule B Detailed Budget Estimate and Sub-Budget Estimate (if applicable) Schedule B-1 Budget Narrative and Sub-Budget Narrative (if applicable)Exhibit A Certifications and AssurancesExhibit B* OTS Grant Program ManualExhibit C Grant Electronic Management System (GEMS) Access*Items shown with an asterisk (*), are hereby incorporated by reference and made a part of this agreement as if attached hereto. These documents can be viewed at the OTS home web page under Grants: www.ots.ca.gov.We, the officials named below, hereby swear under penalty of perjury under the laws of the State of California that we are duly authorized to legally bind the Grant recipient to the above described Grant terms and conditions.IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.8.Approval SignaturesA.GRANT DIRECTORB.AUTHORIZING OFFICIALNAME:TITLE:EMAIL:PHONE:ADDRESS:Kyle [email protected](909) 334-31485450 Guardian WayChino, CA 91710ADDRESS: Linda ReichCity [email protected](909) 334-349113220 Central AvenueChino, CA 91710{{_es_signer2_signature}} {{_es_signer2_date}}{{_es_signer4_signature}} {{_es_signer4_date}}(Signature) (Date) (Signature) (Date)C.FISCAL OFFICIALD.AUTHORIZING OFFICIAL OF OFFICE OF TRAFFIC SAFETYADDRESS: Ria MedinaManagement [email protected](909) 334-30625450 Guardian WayChino, CA 91710ADDRESS: Barbara [email protected](916) 509-30302208 Kausen Drive, Suite 300Elk Grove, CA 95758{{_es_signer3_signature}} {{_es_signer3_date}}{{_es_signer6_signature}} {{_es_signer6_date}}(Signature) (Date) (Signature) (Date)
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E. ACCOUNTING OFFICER OF OFFICE OF TRAFFIC SAFETY9. SAM INFORMATIONNAME: Carolyn Vu SAM #:REGISTERED ADDRESS: CITY: ZIP+4: RGVNGHJR3NV513220 Central Ave Chino 91710-4127 ADDRESS: 2208 Kausen Drive, Suite 300Elk Grove, CA 95758 10.PROJECTED EXPENDITURES FUND CFDA ITEM/APPROPRIATION F.Y. CHAPTER STATUTE PROJECTED EXPENDITURES 405f MC- 20.616 0521-0890-101 2022 43/22 BA/22 $8,840.00 405f MC-24 20.616 0521-0890-101 2023 12/23 BA/23 $17,160.00 AGREEMENT TOTAL $26,000.00 AMOUNT ENCUMBERED BY THIS DOCUMENT I CERTIFY upon my own personal knowledge that the budgeted funds for the current budget year are available for the period and purpose of the expenditure stated above. $26,000.00 PRIOR AMOUNT ENCUMBERED FOR THIS AGREEMENT $ 0.00 OTS DATE SIGNED TOTAL AMOUNT ENCUMBERED TO DATE {{_es_signer5_signature}} {{_es_signer5_date}} $26,000.00 10/6/2023 7:39:14 AM Page 3 of 16
State of California Office of Traffic SafetyGRANT AGREEMENT Schedule A GRANT NUMBERMC24003 1. PROBLEM STATEMENT The City of Chino is approximately 30 square miles with 261 miles of roadway in the city. We are in the middle of major freeway and highways used for commuting traffic. State Route (SR) 60 runs through the north end of our city and SR 71 borders on the west side of the city. SR 83/Euclid Ave. is a major street that connects Chino with Chino Hills to the south and Ontario and Upland to the north. It also provides direct access to SR 71, SR 60, I-10 and mountain communities. Just to the east of Chino is Eastvale that is bordered by I-15. Chino is a mix of residential and industrial properties with heavily used arterial streets gaining access to the above-mentioned highways. There is a residential population of 92,000 people and an estimated 7,000 people entering the city daily for work. Eastvale and the south end of Ontario, referred to as Ontario Ranch, are developing master planned communities that bring thousands of commuters through Chino on a daily basis. One such roadway, which is used as an arterial route to Euclid Ave. and SR 71, was surveyed in April 2021, when Covid-19 was limiting some commuters. This roadway saw 45,000 commuters on a single day. One of our motorcycle fatalities occurred on this roadway during the commuting hours. Chino has seen an increase in motorcycle traffic in the last two years. It is uncertain if it is because of the fuel prices, traffic congestion or for lower vehicle payments. We have found, with the crash investigations we have conducted, many of the riders we encounter are not properly trained or endorsed for motorcycle riding. Many of the crashes involve riders who recently purchased their motorcycles, or even borrowed a From 2016-2020, there were only four fatal crashes that involved a motorcyclist. That amounted to one in seven. In calendar year 2021 and 2022 the city had a total of eight fatal crashes and five of them were motorcyclists. Three of the five crashes involved a motorcyclist hitting a parked vehicle or fixed object and one additional crash where the rider panicked and laid the bike down to avoid a crash before impacting a very slow-moving vehicle. There were several other motorcycle crashes where the rider suffered severe injuries, but the mechanism of injury or advanced medical care prevented fatalities. Many of these crashes were from inexperienced riders that did not use good judgement or were unable to effectively avoid an avoidable crash. Based on real world statistics in the city of Chino, it is evident that the citizens would benefit from the instruction that can be provided by trained officers. A curriculum that can offer experiences and statistics, coupled with practical riding training to improve not only the abilities of the rider, but their mindset as well. 2. PERFORMANCE MEASURES A. Goals: 1. Reduce the number of persons killed in traffic crashes. 2. Reduce the number of persons injured in traffic crashes. 3. Reduce the number of motorcyclists injured in traffic crashes. 4. Reduce the number of motorcyclists killed in traffic crashes. B. Objectives: Target Number 1. Issue a press release announcing the kick-off of the grant by November 15. The kick-off press releases and media advisories, alerts, and materials must be emailed to the OTS Public Information Officer at [email protected], and copied to your OTS Coordinator, for approval 14 days prior to the issuance date of the release. 1 2. Conduct free to the public motorcycle safety and training courses throughout the grant year. 4 3. Participate in Motorcycle Safety Month in May. 1 4. Participate in traffic safety fairs and/or community events with effort to reach individuals. 2 5. Send law enforcement officers to advanced motorcycle training. 2 6. Updates all department social media sites to further promote the "Ride to Live" program to the public and to promote educational goals of safe motorcycle riding. 4 10/6/2023 7:39:14 AM Page 4 of 16
3.METHOD OF PROCEDUREA. Phase 1 Program Preparation (1st Quarter of Grant Year) section.All training needed to implement the program should be conducted in the first quarter. All grant related purchases needed to implement the program should be made in the first quarter. Media Requirements Issue a press release approved by the OTS PIO announcing the kick-off of the grant by November 15, but no sooner than October 1. The kick-off release must be approved by the OTS PIO and only distributed after the grant is fully signed and executed. If you are unable to meet the November 15 deadline to issue a kick-off press release, communicate reasons to your OTS coordinator and OTS PIO. B. Phase 2 Program Operations (Throughout Grant Year) Media Requirements The following requirements are for all grant-related activities: Send all media advisories, alerts, videos, graphics, artwork, posters, radio/PSA/video scripts, storyboards, digital and/or print educational materials for grant-related activities to the OTS PIO at [email protected] for approval and copy your OTS coordinator. Optimum lead time would be 7 days before the scheduled release but at least 3 business days prior to the scheduled release date for review and approval is appreciated. The OTS PIO is responsible for the approval of the design and content of materials. The agency understands OTS PIO approval is not authorizing approval of budget expenditure or cost. Any cost approvals must come from the Coordinator. Pre-approval is not required when using any OTS-supplied template for media advisories, press releases, social media graphics, videos or posts, or any other OTS-supplied educational material. However, copy the OTS PIO at [email protected] and your OTS coordinator when any material is distributed to the media and public, such as a press release, educational material, or link to social media post. The OTS-supplied kick-off press release templates and any kickoff press releases are an exception to this policy and require prior approval before distribution to the media and public. If an OTS-supplied template, educational material, social media graphic, post or video is substantially changed, the changes shall be sent to the OTS PIO at [email protected] for approval and copy to your OTS Coordinator. Optimum lead time would be 7 days prior to the scheduled release date, but at least 3 business days prior to the scheduled release date for review and approval is appreciated. Press releases, social media posts and alerts on platforms such as NextDoor and Nixle reporting immediate and time-sensitive grant activities (e.g. enforcement operations, day of event highlights or announcements, event invites) are exempt from the OTS PIO approval process. The OTS PIO and your Coordinator should still be notified when the grant-related activity is happening (e.g. car seat checks, bicycle rodeos, community presentations, DUI checkpoints, etc.). Enforcement activities such as warrant and probation sweeps, court stings, etc. that are embargoed or could impact operations by publicizing in advance are exempt from the PIO approval process. However, announcements and results of activities should still be copied to the OTS PIO at [email protected] and your Coordinator with embargoed date and time or with Any earned or paid media campaigns for TV, radio, digital or social media that are part of a specific grant objective, using OTS grant funds, or designed and developed using contractual services by a subgrantee, requires prior approval. Please send to the OTS PIO at [email protected] for approval and copy your grant coordinator at least 3 business days prior to the scheduled release date. Social media posts highlighting state or national traffic safety campaigns (Distracted Driving Month, Motorcycle Safety Awareness Month, etc.), enforcement operations (DUI checkpoints, 10/6/2023 7:39:14 AM Page 5 of 16
etc.), or any other grant-related activity such as Bicycle rodeos, presentations, or events, are highly encouraged but do not require prior approval.Submit a draft or rough-cut of all digital, printed, recorded or video material (brochures, posters, scripts, artwork, trailer graphics, digital graphics, social posts connected to an earned or paid media campaign grant objective) to the OTS PIO at [email protected] and copy your OTS Coordinator for approval prior to the production or duplication. Use the following standard language in all press, media, and printed materials, space permitting: Funding for this program was provided by a grant from the California Office of Traffic Safety, through the National Highway Traffic Safety Administration. Space permitting, include the OTS logo on all grant-funded print materials, graphics and paid or earned social media campaign grant objective; consult your OTS Coordinator for specifics, format-appropriate logos, or if space does not permit the use of the OTS logo. Email the OTS PIO at [email protected] and copy your OTS Coordinator at least 21 days in advance, or when first confirmed, a short description of any significant grant-related traffic safety event or program, particularly events that are highly publicized beforehand with anticipated media coverage so OTS has sufficient notice to arrange for attendance and/or participation in the event. If unable to attend, email the OTS PIO and coordinator brief highlights and/or results, including any media coverage (broadcast, digital, print) of event within 7 days following significant grant-related event or program. Media and program highlights are to be reflected in QPRs. Any press releases, work plans, scripts, storyboards, artwork, graphics, videos or any educational or informational materials that received PIO approval in a prior grant year needs to be resubmitted for approval in the current grant year. Contact the OTS PIO or your OTS Coordinator for consultation when changes from any of the above requirements might be warranted. C. Phase 3 Data Collection & Reporting (Throughout Grant Year) 1. Prepare and submit grant claim invoices (due January 30, April 30, July 30, and October 30) 2. Prepare and submit Quarterly Performance Reports (QPR) (due January 30, April 30, July 30, and October 30) Collect and report quarterly, appropriate data that supports the progress of goals and objectives. Provide a brief list of activity conducted, procurement of grant-funded items, and significant media activities. Include status of grant-funded personnel, status of contracts, challenges, or special accomplishments. Provide a brief summary of quarterly accomplishments and explanations for objectives not completed or plans for upcoming activities. Collect, analyze and report statistical data relating to the grant goals and objectives. 4. METHOD OF EVALUATION the fourth/final Quarterly Performance Report (QPR). The Final Evaluation should provide a brief summary whether goals and objectives were met, exceeded, or an explanation of why objectives were not completed. 5. ADMINISTRATIVE SUPPORT This program has full administrative support, and every effort will be made to continue the grant activities after grant conclusion. 10/6/2023 7:39:14 AM Page 6 of 16
State of California Office of Traffic SafetyGRANT AGREEMENT Schedule B GRANT NUMBERMC24003 FUND NUMBERCATALOG NUMBER (CFDA) FUND DESCRIPTIONTOTAL AMOUNT405f MC-24 20.616 Motorcyclist Safety Grants $26,000.00 COST CATEGORY FUND NUMBER UNIT COST OR RATE UNITS TOTAL COST TO GRANT A.PERSONNEL COSTS Straight Time $0.00 Overtime Motorcycle Training Instruction 405f MC-24 $5,040.00 4 $20,160.00 Motorcycle Safety Presentation 405f MC-24 $1,050.00 2 $2,100.00 Category Sub-Total $22,260.00 B.TRAVEL EXPENSES $0.00 $0.00 Category Sub-Total $0.00 C.CONTRACTUAL SERVICES $0.00 Category Sub-Total $0.00 D.EQUIPMENT $0.00 Category Sub-Total $0.00 E. OTHER DIRECT COSTS Motorcycle Training Supplies 405f MC-24 $1,740.00 1 $1,740.00 Display Booth 405f MC-24 $2,000.00 1 $2,000.00 Category Sub-Total $3,740.00 F.INDIRECT COSTS $0.00 Category Sub-Total $0.00 GRANT TOTAL $26,000.00 10/6/2023 7:39:14 AM Page 7 of 16
State of California Office of Traffic SafetyGRANT AGREEMENT Schedule B-1GRANT NUMBERMC24003 BUDGET NARRATIVE PERSONNEL COSTS Motorcycle Training Instruction - Overtime for grant funded motorcycle safety education classes conducted by appropriate department personnel. Motorcycle Safety Presentation - Overtime for grant funded traffic safety education at fairs and/or community events conducted by appropriate department personnel. TRAVEL EXPENSES -CONTRACTUAL SERVICES -EQUIPMENT -OTHER DIRECT COSTS Motorcycle Training Supplies - Costs to include cones, delineators, and barriers. Additional items may be purchased with OTS approval. Display Booth - Display/information booth or pop-up tent at venues such as conferences, state and local fairs, and community events. Costs may include fees and supplies such as lighting, fans, displays, banners, tablecloths and rental of the following: tables, chairs, generators and electrical service. Costs may not include furniture such as but not limited to tables and chairs. Additional items may be purchased if approved by OTS. INDIRECT COSTS -STATEMENTS/DISCLAIMERS There will be no program income generated from this grant. 10/6/2023 7:39:14 AM Page 8 of 16
State of California Office of Traffic SafetyGRANT AGREEMENT Exhibit A GRANT NUMBERMC24003 Certifications and Assurances for Fiscal Year 2024 Highway Safety Grants (23 U.S.C. Chapter 4 or Section 1906, Public Law 109-59, as amended by Section 25024, Public Law 117-58) The officials named on the grant agreement, certify by way of signature on the grant agreement signature page, that the Grantee Agency complies with all applicable Federal statutes, regulations, and directives and State rules, guidelines, policies, and laws in effect with respect to the periods for which it receives grant funding. Applicable provisions include, but are not limited to, the following: GENERAL REQUIREMENTS The State will comply with applicable statutes and regulations, including but not limited to: 23 U.S.C. Chapter 4Highway Safety Act of 1966, as amended; Sec. 1906, Public Law 109-59, as amended by Sec. 25024, Public Law 117-58; 23 CFR part 1300Uniform Procedures for State Highway Safety Grant Programs; 2 CFR part 200Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards; 2 CFR part 1201Department of Transportation, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. NONDISCRIMINATION (applies to all subrecipients as well as States) The State highway safety agency [and its subrecipients] will comply with all Federal statutes and implementing regulations relating to Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq., 78 stat. 252), (prohibits discrimination on the basis of race, color, national origin); 49 CFR part 21 (entitled Non-discrimination in Federally-Assisted Programs of the Department of TransportationEffectuation of Title VI of the Civil Rights Act of 1964); 28 CFR 50.3 (U.S. Department of Justice Guidelines for Enforcement of Title VI of the Civil Rights Act of 1964); The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C. 4601), (prohibits unfair treatment of persons displaced or whose property has been acquired because of Federal or Federal-aid programs and projects); Federal-Aid Highway Act of 1973, (23 U.S.C. 324 et seq.), and Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683 and 1685-1686) (prohibit discrimination on the basis of sex); Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. 794 et seq.), as amended, (prohibits discrimination on the basis of disability) and 49 CFR part 27; The Age Discrimination Act of 1975, as amended, (42 U.S.C. 6101 et seq.), (prohibits discrimination on the basis of age); The Civil Rights Restoration Act of 1987, (Pub. L. 100-209), (broadens scope, coverage, and applicability of Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975 and Section 504 of the Rehabilitation Act of 1973, by expanding the definition aid recipients, subrecipients and contractors, whether such programs or activities are Federally-funded or not); Titles II and III of the Americans with Disabilities Act (42 U.S.C. 12131-12189) (prohibits discrimination on the basis of disability in the operation of public entities, public and private transportation systems, places of public accommodation, and certain testing) and 49 CFR parts 37 and 38; Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations (preventing discrimination against minority populations by discouraging programs, policies, and activities with disproportionately high and adverse human health or environmental effects on minority and low-income populations); Executive Order 13166, Improving Access to Services for Persons with Limited English Proficiency (requiring that recipients of Federal financial assistance provide meaningful access for applicants and beneficiaries who have limited English proficiency (LEP)); Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities through the Federal Government (advancing equity across the Federal Government); and Executive Order 13988, Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation (clarifying that sex discrimination includes discrimination on the grounds of gender identity or sexual orientation). GENERAL ASSURANCES 10/6/2023 7:39:14 AM Page 9of 16
In accordance with the Acts, the Regulations, and other pertinent directives, circulars, policy, memoranda, and/or guidance, the Recipient hereby gives assurance that it will promptly take any measures necessary to ensure that:be denied the benefits of, or be otherwise subjected to discrimination under any program or activity, for which the Recipient receives Federal The Civil Rights Restoration Act of 1987 clarified the original intent of Congress, with respect to Title VI of the Civil Rights Act of 1964 and other non-discrimination requirements (the Age Discrimination Act of 1975, and Section 504 of the Rehabilitation Act of 1973), by restoring the broad, institutional-wide scope and coverage of these nondiscrimination statutes and requirements to include all programs and activities of the Recipient, so long as any portion of the program is Federally assisted.SPECIFIC ASSURANCESMore specifically, and without limiting the above general Assurance, the Recipient agrees with and gives the following Assurances with respect to its Federally assisted Highway Safety Grant Program:1. 49 CFR part 21will be (with regard to anfacilitated,in compliance with all requirements imposed by, or pursuant to the Acts and the Regulations.2.The Recipient will insert the following notification in all solicitations for bids, Requests For Proposals for work, or material subject to the Acts and the Regulations made in connection with all Highway Safety Grant Programs and, in adapted form, in all proposals for negotiated agreements regardless of funding source:U.S.C 2000d to 2000d-4) and the Regulations, hereby notifies all bidders that it will affirmatively ensure that in any contract entered into pursuant to this advertisement, disadvantaged business enterprises will be afforded full and fair opportunity to submit bids in response to this invitation and will not be discriminated against on the grounds of race, color, or national origin3.The Recipient will insert the clauses of appendix A and E of this Assurance (also referred in every contract or agreement subject to the Acts and the Regulations.4.The Recipient will insert the clauses of appendix B of DOT Order 1050.2A, as a covenant running with the land, in anydeed from the United States effecting or recording a transfer of real property, structures, use, or improvements thereon or interest therein to a Recipient.5.That where the Recipient receives Federal financial assistance to construct a facility, or part of a facility, the Assurancewill extend to the entire facility and facilities operated in connection therewith.6.That where the Recipient receives Federal financial assistance in the form of, or for the acquisition of, real property or aninterest in real property, the Assurance will extend to rights to space on, over, or under such property.7.That the Recipient will include the clauses set forth in appendix C and appendix D of this DOT Order 1050.2A, as a covenant running with the land, in any future deeds, leases, licenses, permits, or similar instruments entered into by the Recipient with other parties:a.for the subsequent transfer of real property acquired or improved under the applicable activity, project, or program; andb.for the construction or use of, or access to, space on, over, or under real property acquired or improved under the applicable activity, project, or program.8.That this Assurance obligates the Recipient for the period during which Federal financial assistance is extended to the program, except where the Federal financial assistance is to provide, or is in the form of, personal property, or real property, or interest therein, or structures or improvements thereon, in which case the Assurance obligates the Recipient, or any transferee for the longer of the following periods:a.the period during which the property is used for a purpose for which the Federal financial assistance is extended,or for another purpose involving the provision of similar services or benefits; orb.the period during which the Recipient retains ownership or possession of the property.9.The Recipient will provide for such methods of administration for the program as are found by the Secretary ofTransportation or the official to whom he/she delegates specific authority to give reasonable guarantee that it, other recipients, sub-recipients, sub- grantees, contractors, subcontractors, consultants, transferees, successors in interest, and other participants of Federal financial assistance under such program will comply with all requirements imposed or pursuant to the Acts, the Regulations, and this Assurance.10.The Recipient agrees that the United States has a right to seek judicial enforcement with regard to any matter arising under the Acts, the Regulations, and this Assurance.By signing this ASSURANCE, the State highway safety agency also agrees to comply (and require any sub-recipients, sub-grantees, contractors, successors, transferees, and/or assignees to comply) with all applicable provisions governing NHTSA's access to records, accounts, documents, information, facilities, and staff. You also recognize that you must comply with any program or compliance reviews, and/or complaint investigations conducted by NHTSA. You must keep records, reports, and submit the material for review
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upon request to NHTSA, or its designee in a timely, complete, and accurate way. Additionally, you must comply with all other reporting, data collection, and evaluation requirements, as prescribed by law or detailed in program guidance. The State highway safety agency gives this ASSURANCE in consideration of and for obtaining any Federal grants, loans, contracts, agreements, property, and/or discounts, or other Federal-aid and Federal financial assistance extended after the date hereof to the recipients by the U.S. Department of Transportation under the Highway Safety Grant Program. This ASSURANCE is binding on the State highway safety agency, other recipients, sub-recipients, sub-grantees, contractors, subcontractors and their subcontractors', transferees, successors in interest, and any other participants in the Highway Safety Grant Program. The person(s) signing below is/are authorized to sign this ASSURANCE on behalf of the Recipient. THE DRUG-FREE WORKPLACE ACT OF 1988 (41 U.S.C. 8103) The Subgrantee will provide a drug-free workplace by: a.Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the grantee's workplace, and specifying the actions that will be taken against employees for violation of such prohibition; b.Establishing a drug-free awareness program to inform employees about: 1. The dangers of drug abuse in the workplace; 2. The grantee's policy of maintaining a drug-free workplace; 3. Any available drug counseling, rehabilitation, and employee assistance programs; 4. The penalties that may be imposed upon employees for drug violations occurring in the workplace; 5. Making it a requirement that each employee engaged in the performance of the grant be given a copy of the statement required by paragraph (a); c.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; 2. Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction; d.Notifying the agency within ten days after receiving notice under subparagraph (c)(2) from an employee or otherwise receiving actual notice of such conviction; e.Taking one of the following actions, within 30 days of receiving notice under subparagraph (c)(2), with respect to any employee who is so convicted 1. Taking appropriate personnel action against such an employee, up to and including termination; 2. Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; f.Making a good faith effort to continue to maintain a drug-free workplace through implementation of all of the paragraphs above. POLITICAL ACTIVITY (HATCH ACT) (applies to all subrecipients as well as States) The State will comply with provisions of the Hatch Act (5 U.S.C. 1501-1508), which limits the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. CERTIFICATION REGARDING FEDERAL LOBBYING (applies to all subrecipients as well as States) CERTIFICATION FOR CONTRACTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: 1.No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement; 2.If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, with its instructions; 3.The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, subgrants, and contracts under grant, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. 10/6/2023 7:39:14 AM Page 11 of 16
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. RESTRICTION ON STATE LOBBYING (applies to subrecipients as well as States) None of the funds under this program will be used for any activity specifically designed to urge or influence a State or local legislator to favor or oppose the adoption of any specific legislative proposal pending before any State or local legislative body. Such activities official whose salary is supported with NHTSA funds from engaging in direct communications with State or local legislative officials, in accordance with customary State practice, even if such communications urge legislative officials to favor or oppose the adoption of a specific pending legislative proposal. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION (applies to all subrecipients as well as States) INSTRUCTIONS FOR PRIMARY TIER PARTICIPANT CERTIFICATION (STATES) 1.By signing and submitting this proposal, the prospective primary tier participant is providing the certification set out below and agrees to comply with the requirements of 2 CFR parts 180 and 1200. 2.The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective primary tier participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary tier participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3.The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default or may pursue suspension or debarment. 4.The prospective primary tier participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary tier participant learns its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 5.The terms covered transaction, civil judgment, debarment, suspension, ineligible, participant, person, principal, and voluntarily excluded, as used in this clause, are defined in 2 CFR parts 180 and 1200. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations. 6.The prospective primary tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. 7.The prospective primary tier participant further agrees by submitting this proposal that it will include the clause titled ent, Suspension, Ineligibility and Voluntary ExclusionLower Tier Covered provided by the department or agency entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions and will require lower tier participants to comply with 2 CFR parts 180 and 1200. 8.A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any prospective lower tier participants, each participant may, but is not required to, check the System for Award Management Exclusions website (https://www.sam.gov/). 9.Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 10. Except for transactions authorized under paragraph 6 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency may terminate the transaction for cause or default. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERSPRIMARY TIER COVERED TRANSACTIONS 10/6/2023 7:39:14 AM Page 12 of 16
1.The prospective primary tier participant certifies to the best of its knowledge and belief, that it and its principals: a.Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excludedfrom participating in covered transactions by any Federal department or agency;b. Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of 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 (1)(b) of this certification; and d. Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. 2.Where the prospective primary tier participant is unable to certify to any of the Statements in this certification, such prospective participant shall attach an explanation to this proposal. INSTRUCTIONS FOR LOWER TIER PARTICIPANT CERTIFICATION 1.By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below and agrees to comply with the requirements of 2 CFR parts 180 and 1200. 2.The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension or debarment. 3.The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4.The terms covered transaction, civil judgment, debarment, suspension, ineligible, participant, person, principal, and voluntarily excluded, as used in this clause, are defined in 2 CFR parts 180 and 1200. You may contact the person to whom this proposal is submitted for assistance in obtaining a copy of those regulations. 5.The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6.The prospective lower tier participant further agrees by submitting this proposal that it will include the clause titled Ineligibility and Voluntary ExclusionLower Tier Covered tier covered transactions and in all solicitations for lower tier covered transactions and will require lower tier participants to comply with 2 CFR parts 180 and 1200. 7.A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any prospective lower tier participants, each participant may, but is not required to, check the System for Award Management Exclusions website ( https://www.sam.gov/). 8.Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9.Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension or debarment. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSIONLOWER TIER COVERED TRANSACTIONS 1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in covered transactions by any Federal department or agency. 10/6/2023 7:39:14 AM Page 13 of 16
2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. BUY AMERICA (applies to subrecipients as well as States) The State and each subrecipient will comply with the Buy America requirement (23 U.S.C. 313) when purchasing items using Federal funds. Buy America requires a State, or subrecipient, to purchase with Federal funds only steel, iron and manufactured products produced in the United States, unless the Secretary of Transportation determines that such domestically produced items would be inconsistent with the public interest, that such materials are not reasonably available and of a satisfactory quality, or that inclusion of domestic materials will increase the cost of the overall project contract by more than 25 percent. In order to use Federal funds to purchase foreign produced items, the State must submit a waiver request that provides an adequate basis and justification for approval by the Secretary of Transportation. CERTIFICATION ON CONFLICT OF INTEREST (applies to subrecipients as well as States) GENERAL REQUIREMENTS No employee, officer, or agent of a State or its subrecipient who is authorized in an official capacity to negotiate, make, accept, or approve, or to take part in negotiating, making, accepting, or approving any subaward, including contracts or subcontracts, in connection with this grant shall have, directly or indirectly, any financial or personal interest in any such subaward. Such a financial or personal interest would arise when the employee, officer, or agent, any member of his or her immediate family, his or her partner, or an organization which employs or is about to employ any of the parties indicated herein, has a financial or personal interest in or a tangible personal benefit from an entity considered for a subaward. Based on this policy: 1.The recipient shall maintain a written code or standards of conduct that provide for disciplinary actions to be applied for violations of such standards by officers, employees, or agents. a. The code or standards shall provide that the recipient's officers, employees, or agents may neither solicit nor accept gratuities, favors, or anything of monetary value from present or potential subawardees, including contractors or parties to subcontracts. b. The code or standards shall establish penalties, sanctions, or other disciplinary actions for violations, as permitted by State or local law or regulations. 2.The recipient shall maintain responsibility to enforce the requirements of the written code or standards of conduct. DISCLOSURE REQUIREMENTS No State or its subrecipient, including its officers, employees, or agents, shall perform or continue to perform under a grant or cooperative agreement, whose objectivity may be impaired because of any related past, present, or currently planned interest, financial or otherwise, in organizations regulated by NHTSA or in organizations whose interests may be substantially affected by NHTSA activities. Based on this policy: 1.The recipient shall disclose any conflict of interest identified as soon as reasonably possible, making an immediate and full disclosure in writing to NHTSA. The disclosure shall include a description of the action which the recipient has taken or proposes to take to avoid or mitigate such conflict. 2.NHTSA will review the disclosure and may require additional relevant information from the recipient. If a conflict of interest is found to exist, NHTSA may (a) terminate the award, or (b) determine that it is otherwise in the best interest of NHTSA to continue the award and include appropriate provisions to mitigate or avoid such conflict. 3.Conflicts of interest that require disclosure include all past, present, or currently planned organizational, financial, contractual, or other interest(s) with an organization regulated by NHTSA or with an organization whose interests may be substantially affected by NHTSA activities, and which are related to this award. The interest(s) that require disclosure include those of any recipient, affiliate, proposed consultant, proposed subcontractor, and key personnel of any of the above. Past interest shall be limited to within one year of the date of award. Key personnel shall include any person owning more than a 20 percent interest in a recipient, and the officers, employees or agents of a recipient who are responsible for making a decision or taking an action under an award where the decision or action can have an economic or other impact on the interests of a regulated or affected organization. PROHIBITION ON USING GRANT FUNDS TO CHECK FOR HELMET USAGE (applies to all subrecipients as well as States) The State and each subrecipient will not use 23 U.S.C. Chapter 4 grant funds for programs to check helmet usage or to create checkpoints that specifically target motorcyclists. 10/6/2023 7:39:14 AM Page 14 of 16
POLICY ON SEAT BELT USEIn accordance with Executive Order 13043, Increasing Seat Belt Use in the United States, dated April 16, 1997, the Grantee is encouraged to adopt and enforce on-the-job seat belt use policies and programs for its employees when operating company-owned, rented, or personally-owned vehicles. The National Highway Traffic Safety Administration (NHTSA) is responsible for providing leadership and guidance in support of this Presidential initiative. For information and resources on traffic safety programs and policies for employers, please contact the Network of Employers for Traffic Safety (NETS), a public-private partnership dedicated to improving the traffic safety practices of employers and employees. You can download information on seat belt programs, costs of motor vehicle crashes to employers, and other traffic safety initiatives at www.trafficsafety.org. The NHTSA website (www.nhtsa.gov) also provides information on statistics, campaigns, and program evaluations and references. POLICY ON BANNING TEXT MESSAGING WHILE DRIVING In accordance with Executive Order 13513, Federal Leadership On Reducing Text Messaging While Driving, and DOT Order 3902.10, Text Messaging While Driving, States are encouraged to adopt and enforce workplace safety policies to decrease crashes caused by distracted driving, including policies to ban text messaging while driving company-owned or rented vehicles, Government-owned, leased or rented vehicles, or privately-owned vehicles when on official Government business or when performing any work on or behalf of the Government. States are also encouraged to conduct workplace safety initiatives in a manner commensurate with the size of the business, such as establishment of new rules and programs or re-evaluation of existing programs to prohibit text messaging while driving, and education, awareness, and other outreach to employees about the safety risks associated with texting while driving. 10/6/2023 7:39:14 AM Page 15 of 16
INSTRUCTIONS FOR ADDING OR UPDATING GEMS USERS 1. Each agency is allowed a total of FIVE (5) GEMS Users. 2. GEMS Users listed on this form will be authorized to login to GEMS to complete and submit Quarterly Performance Reports (QPRs) and reimbursement claims. 3. Complete the form if adding, removing or editing a GEMS user(s). 4. The Grant Director must sign this form and return it with the Grant Agreement. CURRENT GEMS USER(S) 1. Kyle Baas Title: Corporal Media Contact: No Phone: (909) 334-3148 Email: [email protected] 2. Chris Corbin Title: Professional Services Manager Media Contact: No Phone: (909) 334-3120 Email: [email protected] 3. Ria Medina Title: Management Analyst Media Contact: No Phone: (909) 334-3062 Email: [email protected] 4. Scott Trosper Title: Sergeant Media Contact: No Phone: 909 334-3153 Email: [email protected] State of California Office of Traffic SafetyOTS-55 Grant Electronic Management System (GEMS) AccessExhibit C GRANT NUMBERMC24003 GRANT DETAILS Grant Number: MC24003 Agency Name: Chino Police Department Grant Title: Motorcyclist Safety Education and Training Program Agreement Total: $26,000.00 Authorizing Official: Linda Reich Fiscal Official: Ria Medina Grant Director: Kyle Baas 10/6/2023 7:39:14 AM Page 16 of 16
Complete the below information if adding, removing or editing a GEMS user(s) GEMS User 1Add/Change {{[]c11_es_:signer1}} Remove Access {{[] c12_es_:signer1}} Add as a media contact? Yes {{[]c1_es_:signer1}} No{{[]c2_es_:signer1}} {{UserName1_es_:signer1 }} {{UserTitle1_es_:signer1 }} Name Job Title {{UserEmail1_es_:signer1 }} {{UserPhone1_es_:signer1 }} Email address Phone number GEMS User 2 Add/Change {{[]c13_es_:signer1}} Remove Access {{[]c14_es_:signer1}} Add as a media contact? Yes {{[]c3_es_:signer1}}No {{[]c4_es_:signer1}} {{UserName2_es_:signer1 }} {{UserTitle2_es_:signer1 }} Name Job Title {{UserEmail2_es_:signer1 }} {{UserPhone2_es_:signer1 }} Email address Phone number GEMS User 3 Add/Change {{[]c15_es_:signer1}} Remove Access {{[]c16_es_:signer1}} Add as a media contact? Yes {{[]c5_es_:signer1}}No {{[]c6_es_:signer1}} {{UserName3_es_:signer1 }} {{UserTitle3_es_:signer1 }} Name Job Title {{UserEmail3_es_:signer1 }} {{UserPhone3_es_:signer1 }} Email address Phone number GEMS User 4 Add/Change {{[]c17_es_:signer1}} Remove Access {{[]c18_es_:signer1}} Add as a media contact? Yes {{[]c8_es_:signer1}}No {{[]c7_es_:signer1}} {{UserName4_es_:signer1 }} {{UserTitle4_es_:signer1 }} Name Job Title {{UserEmail4_es_:signer1 }} {{UserPhone4_es_:signer1 }} Email address Phone number GEMS User 5 Add/Change {{[]c19_es_:signer1}} Remove Access {{[]c20_es_:signer1}} Add as a media contact? Yes {{[]c9_es_:signer1}}No {{[]c10_es_:signer1}} {{UserName5_es_:signer1 }} {{UserTitle5_es_:signer1 }} Name Job Title {{UserEmail5_es_:signer1 }} {{UserPhone5_es_:signer1 }} Email address Phone number Form completed by: {{Sig_es_:signer1:signature}} Date: {{Dte1_es_:signer1:date}} As a signatory I hereby authorize the listed individual(s) to represent and have GEMS user access. {{Sig_es_:signer2:signature}} {{Name1_es_:signer2:fullname }} Signature Name {{Dte2_es_:signer2:date}} Grant Director Date Title