HomeMy WebLinkAboutFlorida Department Of Law Enforcement - Justice Assistance Grant Certification Form 2011-JAGD- 1086 2011 01 19 CERTIFICATION FORM
Recipient Name and Address: City of Winter Springs, 1126 E. SR 434, Winter Springs, Florida
Grant Title: Citizens on Patrol Grant Number: 201 I—JAGD—.1086Award Amount:$5,809
.................................
Contact Person Name and Title: Lt- DojA&__Segj .......... _____Phone Number: (407).327-7977
Federal regulations require recipients of financial assistance from the Office of Justice Programs(OJP),its component agencies,and the
Office of Community Oriented Policing Services(COPS)to prepare,maintain on file,submit to OJP for review,and implement an Equal
Employment Opportunity Plan(EEOP)in accordance with 28 C.F.R §§ 42.301-.308. The regulations exempt some recipients from all of
the EEOP requirements. Other recipients,according to the regulations,must prepare,maintain on file and implement an EEOP,but they
do not need to submit the EEOP to OJP for review. Recipients that claim a complete exemption from the EEOP requirement must
complete Section A below. Recipients that claim the limited exemption from the submission requirement,must complete Section B
below. A recipient should complete either Section A or Section B,not both. If a recipient receives multiple OJP or COPS grants,
please complete a form for each grant,ensuring that any EEOP recipient certifies as completed and on file(if applicable)has been
prepared within two years of the latest grant. Please send the completed form(s)to the Office for Civil Rights,Office of Justice Programs,
U.S.Departme4t of Justice, 810 7hStreet,N.W.,Washington,D.C. 20531. For assistance in completing this form,please call(202)307-
0690 or TTY (202)307-2027. 1
Section A- Declaration Claiming Coml-ilete Exemption from the EEOP Requirement. Please check all the boxes that
apply-
El Recipient has less than 50 employees, 0 Recipient is an Indian tribe,
1:1 Recipient is a non-profit organization, El Recipient is an educational institution,or
El Recipient is a medical institution, 1�1 Recipient is receiving an award less than$25,000
Charles Lacey,, official], certify that
11' '1111-1 "1',""-" 7......................... [responsible offl
The City,of Y.3..-..nter Springs ........... [recipient] is not required to
..............
prepare an EEOP for the reason(s)ch6cked above,pursuant to 28 C.F.R §42.302. 1 further certify that ,,
The City of Winter Springs
............... .......... ............."I.... ....... ............. [recipient] will comply with applicable Federal civil rights
laws that prohibit discrimination in employment and in the delivery of services.
Charles Lacedjor of Winter Sr
ins w
Print or type Name and Title Signature .......... D7a;e
Section B-Declaration Claiming Exemption from the EEOP Submission Requirement and Ceitffying That an
EEOP Is on File for Review.
If a recipient agency has 50 or more employees and is receiving a single award or subaward for$25,000 or more,but less than$50,000,
then the recipient agency does not have to submit an EEOP to OJP for review as long as it certifies the following(42 C.F.R., § ?2.305):
11 ... .......... [responsible official], certify that
the ,,. ....... [recipient],which has 50 or more
employees and is receiving a single award or subaward for$25,000 or more,but less than$500,000,has formulated an
EEOP in accordance A1128 CFR§42.301,etseq., subpart E. I further certify that the EEOP has been formulated and
signed into effect within the past two years by the proper authority and that it is available for review. The EEOP is on file in
the office of: [organization],
at [address],for review by the public and
employees sofor review or audit by officials of the relevant state planning agency or the Office for Civil Rights, Office of
Justice Programs,U. S. Department of Justice,as required by relevant laws and regulations.
Print or type Name and Title Signature Date
OMB Approval No. 1121-0140 Expiration Date:12/31/12