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Home My WebLink AboutFEDERAL REENTRY INITIATIVE GRANT SVORI Sep 13 2006 1:04PM CJCC' 4045594960 p. 1 State of Georgia Criminal Justice Coordinating Council Facsimile Cover Sheet Date: Monday, September 11, 2006 ilumber of pages incl~ding cover sheet: 24 To: 'feD &)tG''-l IUS Donna Williams, Director Augusta Finance Office 530 Greene Street Augusta, GA 30911 Phone: 706-821-2429 Fax Phone: 706-821-2520 cc: From: James Banks Consultant Grants Administration Phone: 404-559-4949 ext. 135 Fax. Phone: 404-559-4960 Email: ;banks(ci)cjcc.state.ga.us Remarks: Accompanying this fax is the application kit, along with a copy of the Special Conditions, for the Serious and Violent Offender Re-entry Initiative that I promised to send to you. Feel free to contact me at the telephone number and extension listed above or Eden Freeman at the above number-extension 118. Please be advised that the Augusta Re-entry Steering Committee has already completed steps 7,10, 11 and 12 of the Special Conditions to the satisfaction of the Criminal Justice Coordinating Council. Augusta will not have to take any action in those areas. CONFIDENTIALITY WARNING: The information contained in, or attached to, this fax message is inte.nded only for tbe personal and confidential Dse of the designated recipients named above. If the reader of this message is Dot the intended recipient or an agent responsible for deliverini 1t to the intended recipient, your are bereby notified that you have received this document in error, and that any review, dissemination, distribution or duplication of this message is strictly prohibited. Any applicable crlmillal and or civil Sep 13 2006 1:04PM CJCC 4045594960 p.2 CR!." 1:\':\1. JUSTICE COOHD) 1\.-\ TINe CO('i\(,11. OFFICE OF THE GOVEW\OR he Serious and Violent Offender Reentry Initiative (SVORI) program was created as a collaborative response by various federal agencies to address the needs of offenders returning to their home communities. Because this is a discretionary grant program, applications are only accepted from the targeted communities of Savannah, Albany, Macon arid Augusta. S03 Oak Place Suite 540 Atlanta, Georgia 30349 404.559-4949 Fax: 404-559-4960 www.g-aDet.or~q;ccl Directed Application Kit for: THE SERIOUS AND VIOLENT OFFENDER REENTRY INITIATIVE ALBANY, AUGUSTA AND MACON. .........O...................G.............................. ApDHcation Process The application for the SVORI project has been greatly simplified and only requires the completion of the forms attached to this package. This kit is designed to guide you through the process. If you have questions or desire assistance, please do not hesitate to contact James Banks, Consultant, at ibanks@cicc.state.ga.us or Eden Freeman, Program Director, at efreeman@cicc.state.ga.us or by calling CJCC directly at (404) 559-4949. Sep. 13.2006 1:04PM CJCC 4045594960 . p.3 COMPLETE THE GRANT APPLICATION. COVER SHEET ...............................ea......................~............ Applicant Information - Boxes 1. 2. and 3 For local government agencies, the legal name must be the city or the county government, not a subdivision. Also enter the mailing address and the name of any subdivision that will administer the grant. if funded. Prolect Descriptors - Box 4 List the Purpose Areas that best descnbe the project you are applying for and its targets and focuses. Contact Information - Box 5 Ch~e a person who is very familiar with the grant application as the contact person and enter their name. title, address. telephOlle number, fax number. and e-mail address. if available. This will be the person who CJCC staff members will contact with questions about the application. Federal Emolover Identlficatlon (FEn Number - Box 6 Please enter the employer identification number as assigned by the Internal Revenue Service. This is used to process all awards and/or payments. Debts - Box 7 If your agency is currently delinquent on a state or federal debt, check yes and attach an explanation. CICC will not award a grant to an applicant checking yes, unless they can show mitigating circumstances and CICC approves these circmnstances. Reouested Fundine: Amounts - Box 8 Enter the amounts requested for CJCC funds (i.e. Federal Funds) and cash match as you recorded on the Budget Summary. Proiect TItle - Box 9 Enter a title for your project that generally describes what the project does. If a continuation project, use the same project title each year. Fund Twe - Box 10 Pre-filled. Countv Where Project is Based - Boxes 11 and 12 Enter the county where the project's headquarters are located. Also enter the population for the county. Geoe:raphic: Areas - Box 13 Enter the names of the county (or counties) that will be served by the project and the populations of each. If the project intends to serve only part of any county or group of counties, then name the city or cities that will be served along with the county name. Grant Start Date - Box 14 Enter the start date for the grant, if funded. Grants are generally available for a 12-month period. Fun.d Year - Box 15 Answer whether this application is for a new or for a continuation grant. If for a continuation application, enter the year of funding that this application. if funded, will be. Also enter the sub grant number for the current grant. CODl!ressioDal Districts Served bv Proiect - Box 16 List the Congressional Districts that will be served by the project, if funded. Chane:e of Service Area - Box 1 , Please indicate whether your service area has changed since the last application. Also, please indicate if this a reduction or addition to the service area. SVORI Grant Program - Page 2 Sep 13 2006 1:04PM. CJCC 4045594960 p.4 GRANT APPLICATION COVER SHEET 1. Legal name of orvanizalion app~ing (NAME of GOVER/lH:NT ;NT1lY): Augusta, Georgia 2. Division orunn within ilia apprrcant organization to adminlslel'tle project SVORI Sterring Committee . 3.. Offk:ial appicanl olganJza1ioo maDlng address: 53) Greene Street, Augusta, GA:rBll 4. List1he Purposa Araa(li) lbatyour project falls under:: Education - GED Program Employment Life Skills Substance Abuse Mental Health Counseling Police Correction Liaison Servic Information Management Case Management 5. Pallon 1:0110 call answer spaclrcques1ions about this application. "-' Name: Ted Wiggins TIlle: Rentr Coordinator Address: GA 30901 706.721-8030 Te:iephoneNumber. (706) 721-8071 F~oomoor. po23~augmpo dcor.state.ga.us e-mai' address: 6. Agency'S Slate Payee ldenlifJCaIion Number. 58-2204274 7. Is the applicant orvanization delinquent on any sia!e orfederaJ debt? DYes Of Yes, altact1 explanation) 0 No 8. R uesl8d Funds Amount R uested CJCC Funds' CashMa1d1 TarAL To !he best of my icnOW\edga, aU Infonnation in this appJica1ion is true and correct. . The application has been duly authorized by the govemlng body of the applicant and agrees to comply with all CJCC roles. inclOOing the aUached assurances. If awaRlEid. ~1% j ~() David S. Copenhaver, Mayor T~U!i:j' Signat1Jre of Authortz:e<.! Offlcral . I /04 Data Sgned Offe'nder Reen ry Serious and Violent ~ffender Reentry Grant Program 11. County where headquarters are based: Richmond 12. Populalkin of the county where 1f1e headquarters are based: 200,000 . 13. All clUes and counties In file service a'rea of1he projacllWilhe population of ~~: . A~-Qsta-Richmond County-200,000 14. Grant start Dale: 15. Is !his an application for Iirst-vear funding? ~Yes 0 No If "No'. complete 1he foJIowing. Year offundj~ for Ibis appficafion (check ona): OYeari o Year 3 o Year 4 o YearS OYear_ Current Suligranl it: 16, ConqressionaJDis!Jict(s)servalibyProiect. 12 John Barrow - Ulstrlct Charlie Norwood - District 9 17. Foran existing project. has your seMce area challf1ed? DYES DNO If YES, is this a reducfiJn or additbo in your service am? D REDUCTION 0 ADDrnON SVORI Grant Program - Page 3 ' Sep 13 2006 1:05PM CJCC 4045594960 p.5 DESIGNATE THE . GRANT OFFICIALS .*.....0.............................................._ On the following page, complete the Da111e, title, address, and phone number for the project director. the financial officer, and the authoriud official for the grant. No two officials can be the same person. Following are the rules for selecting each. Profect Director This official must be an em.ployee oftbe applicant agency or from a contractor organization, at the applicant's option, who will be directly responsible for operation of the project Financial Officer This person must be the chief financial officer of the applicant agency such as the county auditor, city treasurer, comptroller, or treasurer of the nonprofit corporation's board. Authorized Official This person is the official who is authorized to apply for, accept. decline, or cancel the grant for the applicant agency. This perron must be the executive director of a state agency, chairperson of the county Board of Commissioners, mayor. or chairperson of the City Council. All official correspondence regarding the grant and the application (assurances, disclosures, certifications, award documentation, subgrant expenditure reports, subgrant adjustment reports) must be signed by the authorized official. However, if the authorized official wishes to designate someone to sign this documentation, the authorized official may submit a letter on agency letterhead designating the person responsible for this duty. SVORI Grant Program - Page 4 . Sep 13 200S1:0SPM CJCC 40455949S0 . p'.S DESIGNATION OF GRANT OFFICIALS (page 1 of 1) LEGAL NAME OF AGENCY: Augusta, Georgia PROJECT TITLE: Serious and Violent Offender Reentry Initiative )&Mr. OMs. Ted Wiggins PROJECT DIRECTOR NAME (Type or Print) Reentry Coordinator, SVORI Title and Agency 901 Greene Street. Augusta. Official Agency Mailing Address (706) 721-8030 Daytime Telephone Number po23-augmpo@dcor.state.ga.us E-Mail Address Georgia 30901 City . (706) 721-807~ Fax Number Zip o Mr. '~Ms. Donna Williams l ~~~g~E~~~:r~~ector, Augusta, Georgial Title and Agency 530 Greene Street, Room Official Agency Mailing Address (706) 821-2338 Daytime Telephone Number dwilliams@augustaga.gov E-Mail Address I 105, Augusta, Georgia Ci ' (706) 821-2855 Fax. Number 30911 Zip )g( Mr. OMs. David S. Copenhaver AUTHORIZED OFFICIAL (Type or Print) Mayor,' Augusta, Georgia Title and Agency 530 Greene Street, Room Official Agency Mailing Address (706) 821-1831 Daytime Telephone Number mavordeke@augustaga.gov E-Mail Address 806, Augusta, GeorJia 30911 City : Zip (706) 821-1835 Fax Number I I SVORI Grant Program - Page 5 Sep 13 200S 1:0SPM. CJCC 40455949S0 p.? "3 . COMPLETE THE REQUIRED ATTACHMENTS .................................................................... The applicant must submit the various required attachments 'with the grant application. If the applicant cannot submit an attachment with the application, then they should include a note indicating the reason in place of the form. If an attachment is not in the application, cree will identify it as an item in need of resolution and will provide the applicant with a deadline by which to resolve it.lfall of these items are not cleared by the deadline, CJCe may either deny or postpone funding to the applicant or attach a special condition to the award' affecting the grantee's ability to access funds. CJee will advise grantees ofspeciaJ conditions on the Statement of Grant Award. Attachments Without Forms Some required attachments do not have accompanying foIDlS, Following are each of these along with the circumstances under which it must be submitted. Use the checklist below to determine which attachments you must submit .:J All applicants must include a fully executed Memorandum of Understanding/Agreement/Cooperation between the affected parties. Q Applicants are strongly encouraged to attach support letters from the appropriate stakeholders in the community (i.e. Sheriffs, Chiefs of Police, Judges, Representatives, Senators, etc.). Attachments With Forms c All applications must include the Civil Rights Requirements form. c All applications must include a copy of the Assurances,' signed by the Authorized Official. c All applications must include a copy of the Certifications Regarding Lobbying, Debannent, Suspension and other Responsibility Matters, signed by the Authorized Official. C All applications must include a copy of the Disclosure of Lobbying Activities signed by the Authorized Official. o InstrudioDS for completing the required forms follow the blank forms. SVORI Grant Program - Page 6 Sep 13 200S 1:0SPM CJCC 4045594960 p.s REQUIRED ATTACHMENTS SVORI Grant Program - Page 7 Sep 13 200S 1: OSPM 'CJCC.,... 40455949S0 '.' p.9 CIVIL RIGHTS REQIDREMENTS SVORI Grant Program - Page 8 '." Sep 13 200S 1:0SPM CJCC 40455949S0' . . p. 10 CIVIL RIGHTS REQUIREMENTS Frank Thomas (1) Civil Rights Contact Person: (2) Title/Address: Executive Director Human Relations Commission 360 Bay Street, Suite 204 Augusta, Georgia 30901 (3) Telephone Number: (706) 821-2506 (4) .. Number of persons employed by the organizational unit (agency) responsible for administering the subgrant: 2500:!: Questions regarding the EEOP compliance requirements in connection with funding under this program should be addressed directly to: Office for Civil Rights, Office of Justice Programs 810 7th Street, NW Washington, DC 20531 Phone: FAX: Web: 202-307 -0690 202-616-9865 http://www.oip.usdoi.gov/ocr SVORI Grant Program. - Page 9 . Sep' 13 200S 1: OSPM CJCC ASSURANCES 40455949S0 p ~ 11 SVORI Grant Program - Page 10 Sep13200S 1:0SPM CJ.CC 40455949S0 p.12 OMB APPROVAL NO. 1121-0140 EXPIRES 0113112006 STANDARD ASSURANCES The Applicant hereby assures and certifies compliance with all applicable Federal statutes, regulations, policies, guidelines, andrequirements, including OMB Circulars A-21. A-87. A-I02, A-I to. A-122, A- 133; Ex. Order 12372 (intergovernmental review of federal programs); and 28 C.F.R. pts. 66 or 70 (administrative requirements for grants and cooperative agreements). The applicant also specifically assures and certifies that: 1. It has the legal au~rity to apply for federal assistance and the institutional, managerial, and financial capability (including fimds sufficient to pay any required non-federal share ofproject cost) to ensure proper planning, management, and completion of the project descnbed in this application. 2. It will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 3. It will give the awarding agency or the General Accounting Office, through any authorized representative. access to and the right to examine all paper or electronic records related to the financial assistance. 4. It will comply with allla:wful requirements imposed by the awarding agency, specifically including any applicable regulations, such as 28 C.F.R. pts. 18,22, 23,30,35. 38.42.61, and 63. 5. It will assist the awarding agency (if necessary) in assuring compliance ",ith section 106 oftbe National Historic Preservation Act of 1966 (16 U.S.C. ~ 470). Ex. Order 11593 (identification and protection of historic properties), the Archeological and Historical Preservation Act of 1974 (16 U.S.C.~ 469 a-I m ~.), and the National Environmental Policy Act of 1969 (42 V.S.C. ~ 4321). 6. It will comply (and will require any subgrantees or contractors to comply) with any applicable statutorily-imposed nondiscrimination requirements, which may include the Omnibus Crime Control and Safe Streets Act of 1968 (42 V.S.C. ~ 3789d); the Victims of Crime Act (42 V.S.C. gl0604(e)); The Juvenile Justice and Delinquency Prevention Act of2002 (42 V.S.C. ~ S672(b)); the Civil Rights Act of 1964 (42 U.S.C. ~ 2OO0d); the Rehabilitation Act of 1973 (29 V.S.C. ~7 94); the Americans with Disabilities Act of1990 (42 U.S.C.~ 12131-34); the Education Amendments of 1972 (20 U.S.C. Ul681, 1683, 1685-86); and the Age Discrimination Act of 1975 (42 V.S.C. ~~ 6101-07); see Ex. Order 13279'- (equal protection of the laws for faith-based and community organizations). 7. If a governmental entity- a) it will comply with the requirements of the UnifollD Reloct\tion Assistance and Real. Property Acquisitions Act of 1970 (42 U.S.C.~ 4601 ~!S:.9..). which govern the treatment of persons displaced as a result of federal and federally-assisted programs; and b) it will comply with requirements ofS U.S.C.~~ 1501-08 and ~~7324-28, which limit certain political activities of State or local government employees whose principal employment is in connection with an activity financed in whole or in part by federal assistance. cY<14,. ~ Signature M. ~ ~0fr l (; / a-C; /0 G Date . Sep 13 200S1.:07PM CJCC 40455949S0 p.13- CERTIFICATIONS REGARDING LOBBYING, DEBARMENT, SUSPENSION AND OTHER RESPONSffiILITY MATTERS SVORI Grant Program - Page 12 Sep 13 200S '1: 07PM .CJCC .40455949S0 p.14 U.S. DEPARTMENT OF JUSTICE OFFICE OF JUSTICE PROGRAMS OFFICE OF THE COMPTROLLER CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER RESPONSlBIUTY 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 28 CFR Part 69, .New Restrictions on Lobbying" and 28 CFR Part 67. "Government-wide Debarment and Suspension (Nonpro-curement) and Government-wide Requirements for Drug-Free Workplace (Grants): The certlffcations 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. . 1, LOBBYING As required by Seellon 1352, TItle 31 of !he U.S. Code. and Implemented at 28 CFR Part 69, for persona entering Into a grant or cooperative agreement over $1 OO.OOO. as defined at 28 CFR Part 89. the applicant certllles that: (1I) No Federal approprlsted funds have been paid or will be pakf. by or on behalf or the undersigned, to any person for In. fluenclng 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 s Member of Congress In con. . nectlon with the making of any Federal grant, ttIe entering Into of any cooperative agreement, and the extension. continuation. renewal. amendment, or modification of any Federel grent or cooperetive agreement; (b) If any funds other than Federal approprIated funds have been paid or will be paid to any peraon for Influencing or at- tempting to Influence an officer or employee of any agency, a Member of Con9r.... 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 cClmplets and submit Slandllfd Form - LLL, "DIsclosure of Lobbying Activities," In accordanoe with lis Instructions: (c) The undersigned shall require that the language of this cer. tlfication be included in the award documents for all sub awards at all tiers (Including subgranls, contracts under grants and cooperative agreements. and subcontracts) and Ihat all sub. recipients shall cerllfy and disclose accordingly. 2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS (DIRECT RECIPIENT) As required by Executive Order 12549. Debarment and Suspenslcn, and Implemented at 28 CFR Part 87, for prospec- live participants In primary covered transactions. as defined at 28 CFR Part 67, Section 67.510- A.The applicant certifies that it and lts principals: eel Are not presently debarred. suspended, proposed for debar. ment. declared Ineligible. sentenced to a denial of Federal benefits by a State or Federal court, cr voluntarily exclude<! from covared transactions by any Federal department or agency; (bJ Have nol within 8 three-year period preceding this applica- tion been convicted of or had II civil judgment rendered against them for commission of fraud or a criminal offanse In connec- tion with obtaining, altempUng to obtain. or performing 8 public (Federal, State, or local) transaction or contract ~nder a public transaction; violation of Federal or State antitrust statutGS or commission of embezzlement. theft, forgery. bribery, falsification or destruction of records, making false slatements. Of' receiving stolen property; (c) Are not presently indicted for or otherwise criminally or c(vJlly charge<! by a goverrvnental enlity (Federal. State, or local) with commission of any of the offenses enumerated in paragraph (1 )(b) of Ihls certification; and (d) Have not within e three-year periOd preceding this appllca- lion had one or more public transactions (Federal, State. or local) terminated for cause or default; and Bo Where the applicant Is unable to certify to any of the statements in this certJficallon, he or she shalf atta~h an explanallon to this application. 3. DRUG-FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS) As required by the Drug-Free Workplace A1;t of t 988, and Implemented at 28 CFR Part 67, Subpart F, for grantees. 88 defined at 28 CFR Par167 Sections 67.615 and 67.620- A. The applicant certifies that it will or will continue to provide a drug.(ree workplace by: (e) Publishing a statement notifying employees that the unlawful manufacture, distribution. dispensing. possession, or use of a controlled substance Is prohibited In the granlee's workplace and specifying the actions that will be taken against employees forvloiallon ohuch prohibition: (b) Establishing an on-going drug-tree awareness program to inform employees about- (1) The dangers of drug sbuse in the workplace; (2l The grantee's polley of maintaining a drug-free workplace; (3) Any available drug counseling, rehabllltatlon, and employee assistance programs; and (4) The penelUes that may be Imposed upon employees for drug abuse \(Iolatlons occurring In the workplace; (c) Making It II reqUirement that each employee to be engaged In the performance of the grant be given a copy of the slatc- ment required by paragraph (a); (d) Notifying the employee in the statement required by para. graph (a) that. as a condillon of employment under the grant, the employee will- OJ!" FORII1408118 (3-01) REPLACES OJP FORMS -4061/2. -4ll8113 AND 4061/4 WHICH ARE OBSOLETE. Sep 13 200S 1:08PM 'CJCC. (1) Abide by the terms of the statement; and (2) Nollfy the employer in writing of his or her conviction for a violation or a criminal drug statute occurring In the workplace no later than five calendar days after such conviction; (e) Nottfying the agenc;y.ln writing, within 10 calendar days after receiving notk:e under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such convlc-tlon. Employers of convicted employees must provide nolice. Including position tltle,to: Department of Justice, Office of Justice Programs, ATIN: Control Desk, 633 Indiana Avenue. N.W.. Washington, D,C. 20531. Notice shall Include the Iden- tification number(s) of each affected grant; (1) Taking one of the klllowing aclions. within 30 ceJendar days of receiving notice under subparagraph (d)(2). with respect to any employee who Is 80 convlcted- (1) Taking appropriale porsonnel aellon against such an employee, up to and including termination. consistent with the requirements of the Rehablfltation Act of 1973, as ameoded; or (2) Requiring such employee to participate sallsfactorlly in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State. or local health. law enforce- ment, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug- free workplace through implementation of paragraphs (al. (bl, (e). (d), (e), and {f}. B. The grantee may Imlert in the space provided below the site(s) for the performance of work done in connection with the speclflc grant: Place of Performance (Street address, city, county. state, zip code) 40'455949S0 '. p. 15 Cheek 0 If there are workplaces on file that are not indentlfied here. Seelion 67. 630 of the regulations provides that a grantee thet is a State may elect to make one certifICation in each Federal fiscal year. A copy of which should be Included with each ap- plication for Department of Justice funding. States and State agenCies may elect to use OJP Form 4061n. Check 0 If the State has elected tc> complete OJP Form 406117. DRUG-FREE WORKPLACE (GRANTEES WHO ARE INDIVIDUALS) As reqUired by the Drug-Free Workplace Act of 1988, and Implemented at 28 CFR Part 67. Subpart F, for graJ"ltees. as defined at 28 CFR Pan 67; Sections 67.615 and 67.620- A. As a condition of the grant, I certify that I will not engage in lhe unlawful manufacture, distribution. dispensing. posses- sion. 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 l1f the conviction. to: Oepar1ment of Justice, OffICe of Justice Programs, ATTN: Centrol Desk. 633 Indiana Avenue, N.W.. Washington, D.C. 20531. As the duly 8uthorlzecl representalllle of the applicant, I hereby certify that the applicant will comply wfth the above certifications. 1. Grantee Name end Address: Augusta, Georgia 530 Greene Street Augusta, Georgia 30911 2. Application Number and/or Project Name Serious and Violent Offender Reentry Initiative (SVORI) 4. Typed Name and Title of Authorized Representative D~d_b C~haver, . L c/C~ ____ 5. Signature Mayor 3. Grantee IRSNcndor Number 58-2204274 {a/K.foc 6. Date "U.s. GcNemrn.'" PrlnUng 0lIlce: ,we. 4050031/40014 Sep 13 200S 1~08PM CJCC. . . 40455949S0. -'. DISCLOSURE OF LOBBYING ACTIVITIES SVORl Grant Program - Page 15 p.1S Sep 13 200S 1:08PM' CJCC 4045-5949S0,' p.17 Disclosure of Lcbbylng Activities Approved by OMS 0348-0046 CQ~te this form to disclose lobbying actlvlties purausrrt to 31 U.S.C. 1352 (See rwetW aide for lnllWl:tiona.) Pub/lc Reporting 8urden for lhl& collecllon oIlnformalan I; eatlmatad to average 90 rnnutln per Alspanse"InducIi"9 .. lime tor rflVl8Wlng Inswollons, Hatch1r'G eXIsting dala liOUrces. gathering and mllinlalnl~ II. data l1IIedad. and c:ompletln; MIl reviewing ~ colleolon of lnIormldan. Send conmenta rll9an:1lrG Ills burden esllmalB or IIII~ oilier aspecf of Ills coll8Cttcln of InformatIDn.lncludll'lg sugg41lllollS brreG.lchfl tIU ~, tl Il. OfIoe of ManIlOWi*'rt and Budget. Paperwork Re<<lcQon Prqect (03411-(1046). WaehltWtcn. D.C. 2D503. 1. T~ ~f Feder.. Ac:tfon: 2. Statu, of ~ Ac1Ion; O a. contract 0 a bldlofterlappl!catlon b. gtanl b. InllaJ award c. cooperative agreement e. post-award d. loan 8, ban guarantee I. loan Insurance 4. Nerne and Add,.. of ~9 Entl1y: o Prime 0 Subawardee TIer S. Report l)pe: O L InlllalfiUng b. rtIabl1l1a1 d1~e For M...... a.qa Only: Y881 quAr18r datD of last report I I. If ReportIng Entity In No. 41a SU~", e,*" Neat. and Acfdn.. of , Pm.: . II MOM!: Augusta, Georgia 530 Greene Street Augusta, Georgia 30911 \'S\ <QvA ~ I ~ngteMIanaI DfftIct," known: I 7. FecIem Program NenlelDeaadplloa: I Serious and Violent Offender i Reentry Initiative (SVORI) I I i CFDA NumIMr. If eppIlc:able: '8. :_dAmount,lfknown: b. JndMd..... PnrmII1lJ s.moe. (IndudInglldllmslt dlllerentfrom Ho. loa.) (Iesl rwne, Iftt...,.., MI): . CongI1lMlonIl DJstrIot.1I known: 2 2 and 2 3 II. Federal DepartmlllnClAg.nq: S. FHend ACIIon Number ,1I1cnc1wn: 10& Herne and Add.-. of Lobbying Regts1rant (If fndlvldLllll. last name. first name, U):. . 11. Information requested through 1hls form Is aU1l1crtzed by Sec:.319, , Pub. L 1 01-121. 103 Stat. 750. asamendedby,sec. 10;Pub. L 104. I Signature: 65, Stat. 700 (31 U.S.C. 1352). This CUsclosure at lobbying acrlvhles I' Is a material representatIon of fact upon which reliance was placed by the above when this transaction was made or entered Into. This Print Nun.: disclosure Is required pursuant to 31 U.S.C. 1352. ThIs Information wi. be reported to the Congress &8ITi' annually and will be available 10r public inspection. Any person who tails to tfte 1he required nUe: disclosure shaH be subject to a civil penalty of not less than $10,000 I'. and not more than $100,000 for each such failure. I TlIIePh_ No.: (7Ch) 821-1831 ~zt ~~ -(?J 1.. D...: ~ gr./o{.l Autllorfad far Loc.I ReproducUon 81IInd1lld FonaoLU /'H) David S. Copenhaver Mayor ~~ifdJ}kil~t111j,i~~iI~;~~;~~~~~{'i~tff~~1Yi~~iJirit!~i!C~;~~fii~i.ij~j;.ri[~:~ Sep 13 200S 1:09PM CJCC' 40455949S0 INSTRUCTIONS FOR COMPLETING THE REQUIRED FORMS SVORl Grant Program - Page 17 p. 18 Sep 13 2006 1:09PM CJCC 40455949S0 p.19 INSTRUCTIONS FOR COMPLETING REQUIRED FORMS AssURANCES This is a standard federal assurances form. Please review carefully to insure that there are no apparent conflicts. Finally, have the authorized agency official sign and date. CERTIFICATIONS REGARDING LoBBYING: DEBARMENT. SUSPENSION AND OTHER RESPONSmILITY MATIERS: AND DRUG-FREE WORKPLACE REOUIREMENTS In order to execute this document, the subgrantee should do the follo\ving: · Carefully review the infonnation about each of the certifications listed on this document; . Type or write in the name and address of the Subgrantee; · Type or write in the Subgrant Number and/or Project Title; · Type or write in the Subgrantee's Employer Tax Identification Number (BIN); · Type or write in the name and the title of the Authorized Official executing the document; · Have the Authorized Official [i.e., County Board of Commissioners Chairperson, Mayor, State Department Head, Executive Director; City Council ChaiIperson, etc.] sign and date this document; an4. · Make a copy of the certifications for the project file and return the signed original to CJCC. DISCLOSURE OF LOBBYING ACTIVITIES This doCument is a standard federal form that is used to certify that the subgrantee does not actively lobby on the federal level. Federal requirements demand that this form be completed twice: at the initial application and the actual awarding of the project. In order to execute the document, the following boxes should be completed. . Box 1: Please mark letter "B. J) This signifies that the action is a grant. · Box 2: Please mark letter "B:' This demonstrates that you are completing this form at the time of the award. · Box 3: Please mark letter "A." This indicates that this is an initial filing of the document for this award. SVORI Grant Program - Page 18 Sep 13 200S 1:09PM CJCC 40455949S0 p.20. · Box 4: Please check Prime and fiU in with State of Georgia Criminal Justice Coordinating Council 503 Oak Place Suite 540 Atlanta, GA 30349-5974 · Box 5: Please leave blank. · Box 6: Please fill in with U.S. Department of Justice, Office of Justice Programs. · Box 7: Complete with "Serious and Violent Offender Reentry Initiative (SVORI) Grant Program. .. . Box 8: Please leave blank. · Box 9: Please leave blank. · Box 10a: Please:fill in with "The (insert name of sub grantee) does not conduct lobbying activities." If your agency does lobby on the federal level, please contact CJCC as soon as possible to determine eligibility for this award. · Box lOb: Please leave blank. · Box 11: Please have the authorized official sign and date. SVORJ Grant Program - Page 19 AUGUSTA-RICHMOND COUNTY COMMI~SION STEPHEN E. SHEPARD County Attorney Augusta Law Department DAVID S. COPENHAVER Mayor STAFF ATIORNEY Vanessa Flournoy Betty Beard Marion Williams Joe Bowles Calvin Stevenson. Jr. Calvin Holland, Sr. Andy Cheek Jerry Brigham Jimmy Smith 1. R. Hatney Don Grantham Marion Williams Mayor Pro Tern TO: Deke Copenhaver, MaYOr/, 0/ StephenE. Shepard i~ October 26, 2006 Frederick L. Russell Administrator FROM: Please Reply to: 70 I Greene Street, Suite 104 Augusta, Georgia 30901 DATE: RE: Augusta SVORl Reentry Program Enclosed is the application for the Serious and Violent Offender Reentry Initiative Grant that was delivered to my office Wednesday, October 25,2006. My staff contacted Ted Wiggins, Reentry Coordinator, and completed it substantively to the extent information was available to my office. The application is also approved as to form. SES:mdh Enclosure F: \ Users'SShepard'STEVEICITYlcity. 2006. doc Augusta Law Department 501 Greene Street, Suite 302, Augusta, Georgia 30901 (706) 842-5550 - Fax (706) 842-5556 County Attorney 701 Greene Street, Suite 104, Augusta, Georgia 30901 (706) 724-6597 - Fax (706) 722-4817