DoD Information Assurance and Scholarship Program (IASP)

ATTACHMENT B
CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER
RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS
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. Signature of this form provides for
compliance with certification requirements under 34 CFR Part 82, "New Restrictions on Lobbying," and 34 CFR Part 85, "Governmentwide Debarment and Suspension (Nonprocurement) and Government-wide Requirements for Drug-Free Workplace (Grants)." The
certifications shall be treated as a material representation of fact upon which reliance will be placed when the Department of Education
determines to award the covered transaction, grant, or cooperative agreement.

1. LOBBYING
As required by Section 1352, Title 31 of the U.S. Code, and
implemented at 34 CFR Part 82, for persons entering into a grant or
cooperative agreement over $100,000, as defined at 34 CFR Part
82, Sections 82.105 and 82.110, 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 Form to Report Lobbying," 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 subrecipients shall certify
and disclose accordingly.

(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 (2)(b)
of this certification; and
(d) Have not within a three-year period preceding this application
had one or more public transaction (Federal, State, or local)
terminated for cause or default; and
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.

3. DRUG-FREE WORKPLACE
(GRANTEES OTHER THAN INDIVIDUALS)
As required by the Drug-Free Workplace Act of 1988, and
implemented at 34 CFR Part 85, Subpart F, for grantees, as defined
at 34 CFR Part 85, Sections 85.605 and 85.610 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:

2. DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS

(1) The dangers of drug abuse in the workplace;

As required by Executive Order 12549, Debarment and Suspension,
and implemented at 34 CFR Part 85, for prospective participants in
primary covered transactions, as defined at 34 CFR Part 85,
Sections 85.105 and 85.110--

(2) The grantee's policy of maintaining a drug-free workplace;

A. The applicant certifies that it and its principals:

(4) The penalties that may be imposed upon employees for drug
abuse violations occurring in the workplace;

(a) Are not presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded from covered
transactions by any Federal department or agency;
(b) Have not within a three-year period preceding this application
been convicted of or had a civil judgement 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;

(e) Notifying the agency, in writing, within 10 calendar days after
receiving notice under subparagraph (d)(2) from an employee or

(3) Any available drug counseling, rehabilitation, and employee
assistance programs; and

(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;

otherwise receiving actual notice of such conviction. Employers
of convicted employees must provide notice, including position

title, to: Director, Grants Policy and Oversight Staff, U.S.
Department of Education, 400 Maryland Avenue, S.W. (Room
3652, GSA Regional Office Building No. 3), Washington, DC
20202-4248. 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).

DRUG-FREE WORKPLACE
(GRANTEES WHO ARE INDIVIDUALS)
As required by the Drug-Free Workplace Act of 1988, and
implemented at 34 CFR Part 85, Subpart F, for grantees, as
defined at 34 CFR Part 85, Sections 85.605 and 85.610A. As a condition of the grant, I certify that I will not engage in
the unlawful manufacture, distribution, dispensing, possession,
or use of a controlled substance in conducting any activity with
the grant; and
B. If convicted of a criminal drug offense resulting from a
violation occurring during the conduct of any grant activity, I will
report the conviction, in writing, within 10 calendar days of the
conviction, to: Director, Grants Policy and Oversight Staff,
Department of Education, 400 Maryland Avenue, S.W. (Room
3652, GSA Regional Office Building No. 3), Washington, DC
20202-4248. Notice shall include the identification number(s) of
each affected grant.

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)

Check [ ] if there are workplaces on file that are not identified
here.

As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications.

NAME OF APPLICANT

PR/AWARD NUMBER AND / OR PROJECT NAME

DoD Information Assurance Scholarship Program
PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

SIGNATURE

ED 80-0013

DATE

12/98

The following will be included in any grant award:
MILITARY RECRUITING ON CAMPUS
As of 25 January 1995, DoD Grant and Agreement Regulations Part 23.1 “Military
Recruiting on Campus” is to be added to DoD grants. The full text of the interim rule published
in the Federal Register [at 60 FR 4544-4] is as follows:
“As a condition for receipt of funds available to the Department of Defense (DoD) under
this award, the recipient agrees that it is not an institution that has a policy of denying and that it
is not an institution that effectively prevents the Secretary of Defense from obtaining for military
purposes: (A) entry to campuses or access to students on campuses; or (B) access to directory
information pertaining to students. If the recipient is determined, using procedures established by
the Secretary of Defense to implement section 558 of Public Law 103-337 (1994), to be such an
institution during the period of performance of this agreement, and therefore to be in breach of
this clause, the Government will cease all payments of DoD funds under this agreement and all
other DoD grants and cooperative agreements, and it may suspend or terminate such grants and
agreements unilaterally for material failure to comply with the terms and conditions of award.”