HUD 50070 Certification for a Drug Free Workplace

Applicant: Saint Louis County Project Applicant
Project: FY2020_New_Application_Test1

MO-500 Project Applicant
136785

1H. HUD 50070

HUD 50070 Certification for a Drug Free Workplace
Applicant Name: Saint Louis yahoo
Program/Activity Receiving Federal Grant CoC Program
Funding:
Acting on behalf of the above named Applicant as its Authorized Official, I
make the following certifications and agreements to the Department of
Housing and Urban Development (HUD) regarding the sites listed below:
I certify that the above named Applicant will or will continue to
provide a drug-free workplace by:
a.

Publishing a statement notifying employees that the unlawful
e.
manufacture, distribution, dispensing, possession, or use of a
controlled substance is prohibited in the Applicant's workplace
and specifying the actions that will be taken against employees
for violation of such prohibition.

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

b.

Establishing an on-going drug-free awareness program to
f.
inform employees --(1) The dangers of drug abuse in the workplace
(2) The Applicant'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.

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;

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.;

Making a good faith effort to continue to maintain a drugfree
workplace through implementation of paragraphs a. thru f.

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;

g.

2. Sites for Work Performance.
The Applicant shall list (on separate pages) the site(s) for the performance of work done in
connection with the HUD funding of the program/activity shown above: Place of Performance
shall include the street address, city, county, State, and zip code. Identify each sheet with the
Applicant name and address and the program/activity receiving grant funding.)
Workplaces, including addresses, entered in the attached project application.
Refer to addresses entered into the attached project application.

I certify that the information provided on this
form and in any accompanying
New Project Application FY2020

X
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03/24/2020

Applicant: Saint Louis County Project Applicant
Project: FY2020_New_Application_Test1

MO-500 Project Applicant
136785

documentation is true and accurate. I
acknowledge that making, presenting,
submitting, or causing to be submitted a
false, fictitious, or fraudulent statement,
representation, or certification may result in
criminal, civil, and/or administrative
sanctions, including fines, penalties, and
imprisonment.
WARNING: Anyone who knowingly submits a false claim or makes a false statement is subject
to criminal and/or civil penalties, including confinement for up to 5 years, fines, and civil and
administrative penalties. (18 U.S.C. §§ 287, 1001, 1010, 1012; 31 U.S.C. §3729, 3802)

Authorized Representative
Prefix: Mr.
First Name: Steven
Middle Name V
Last Name: Stenger
Suffix:
Title: County Executive
Telephone Number: (314) 615-7016
(Format: 123-456-7890)
Fax Number: (314) 615-3727
(Format: 123-456-7890)
Email: [email protected]
Signature of Authorized Representative: Considered signed upon submission in e-snaps.
Date Signed: 03/24/2020

New Project Application FY2020

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