HomeMy WebLinkAbout03D COPS Hiring Program Grant AcceptanceCity Council Action Request
Meeting Date
Department
Agenda Category
Title
Staff
Recommendation
Budget Implication
Attachments
7/22/2020
Public Safety
Agenda Item
COPS Hiring Program Grant Acceptance
Authorize acceptance of the COPS Grant Award
2021 Public Safety Department $27,580
2022 Public Safety Department $30,125
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COPS Office Award Application
MN08207
Cottage Grove Department of Public Safety
COP49
Community Oriented Policing Services
U.S. Department of Justice
SECTION 1: COPS OFFICE AWARD PROGRAM REQUEST
Federal assistance is being requested under the following COPS Office program:
Verify the COPS Office award program for which you are requesting federal assistance. A separate application must be completed for each COPS Office
program for which you are applying. Please ensure that you read, understand, and agree to comply with the applicable award terms and conditions as
outlined in the COPS Office Application Guide before finalizing your selection.
The program you have selected is: COPS Hiring Program
SECTION 2: AGENCY ELIGIBILITY INFORMATION
A. Type of Agency (select one)
Law Enforcement
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Non -Law Enforcement
From the list below, please select the type of agency which best describes the applicant.
Please indicate if your jurisdiction is primarily considered rural, urban or suburban.
Suburban v
2A. CHP Eligibility Questions
In this section, we will ask you several questions about your law enforcement agency operations and authority to determine your eligibility to apply for a
COPS Hiring Program (CHP) award. Please note that CHP applicants must have a police department that is operational as of January 09, 2020, or receive
services through a new or existing contract for law enforcement services. Applicants must also maintain primary law enforcement authority for the
population to be served.
In addition, if funds under this program are to be used as part of a written contracting arrangement for law enforcement services (e.g., a town which
contracts with a neighboring sheriff's department to receive services), the government agency wishing to receive law enforcement services must be the
legal applicant in this application (although we will ask you to supply some information about the contract service provider later).
Part 1. Law Enforcement Agency Operations
A law enforcement agency is established and operational if the jurisdiction has passed authorizing legislation and it has a current operating budget.
Q1) Is your agency established and currently operational?
Yes
Part II. Contracting to Receive Law Enforcement Services
Q1) If awarded, does your agency plan to use funds awarded under this award to establish or supplement a written contract for law enforcement services
(e.g., a town contracting for services with a nearby sheriffs department)?
No r
Part III. Law Enforcement Agency Authority
An agency with primary law enforcement authority is defined as the first responder to calls for service for all types of criminal incidents within its jurisdiction.
Agencies are not considered to have primary law enforcement authority if they only: respond to or investigate specific type(s) of crime(s), respond to or
investigate crimes within a correctional institution, serve warrants, provide courthouse security, transport prisoners, have cases referred to them for
investigation or investigational support or only some combination of these.
Q1) Based on the definition above, does your agency have primary law enforcement authority? [Or, if contracting to receive services, does the agency that
will be providing law enforcement services have primary law enforcement authority for the population to be served?]
Yes v
SECTION 3: GENERAL AGENCY INFORMATION
A. Applicant ORI Number MN08207
The ORi number is assigned by the FBI and is your agency's unique identifier. The COPS Office uses the first seven characters of this number. The first two
letters are your state abbreviation, the next three numbers are your county's code, and the next two numbers identify your jurisdiction within your county. if
you do not currently have an ORI number, the COPS Office will assign one to your agency for the purpose of tracking your award. ORI numbers assigned to
agencies by the COPS Office may end in "ZZ."
B. Applicant Data Universal Numbering System (DUNS) Number: 10765095040000
A Data Universal Numbering System (DUNS) number is required prior to submitting this application. A DUNS number is a unique nine or thirteen digit
sequence recognized as the universal standard for identifying and keeping track of entities receiving federal funds. For more information about how to
obtain a DUNS number, please refer to the "How to Apply" section of the COPS Office Application Guide.
Applicant Data Universal Numbering System (DUNS) Name:
Cottage Grove, City of (inc)
If your registered name in DUNS is different from your COPS legal name, please enter the registered name. For more information about how to obtain a
DUNS name, please refer to https:IAvvvw.dt)b.com/duns-numberlloo/fup.htmi.
C. System for Award Management (SAM)
The System for Award Management (SAM) replaces the Central Contractor Registration (CCR) database as the repository for standard information about
federal financial assistance applicants, recipients, and sub recipients. The U. S. Department of Justice requires that all applicants (other than individuals) for
federal financial assistance maintain current registrations in the SAM database. Please note that applicants must update or renew their SAM registration at
least once a year to maintain active status.
Applicants that were previously registered in the CCR database must, at a minimum:
Create a SAM account
Log into SAM and migrate permissions to the SAM account (all the entity registrations and records should already have been migrated).
Applicants that were not previously registered in the CCR database must register in SAM prior to registering in Grants.gov Information about SAM
Registration procedures can be accessed at https://www.sam.gov/.
For more information about how to register with SAM, please refer to the "How to Apply" section of the COPS Office Application Guide.
Your SAM Registration is set to expire on: 01/15/2021 —�
Please enter date in MM/DD/YYYY format.
Note: If your SAM registration is set to expire prior to September 30, 2020, please renew your SAM Registration prior to completing this application. Contact
the SAM Service Desk at 866-606-8220 or view/update your registration information at https://www.sam.gov/
E. Cognizant Federal Agency: Department of Justice
Select the legal applicant's Cognizant Federal Agency. A Cognizant Federal Agency, generally, is the federal agency from which your jurisdiction receives
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the most federal funding. Your Cognizant Federal Agency also may have been previously designated by the Office of Management and Budget. Applicants
that have never received federal funding should select "Department of Justice" as the Cognizant Federal Agency.
F. Fiscal Year: From 01/01/2020 to 12/31/2020
Please enter date in MM/DD/YYYY format.
G. U.S District Attorney Question
a. Indicate your U.S. Attorney's Office District by selecting your state and then selecting U.S. Attorney's Office District in b.
Minnesota
b. Indicate your U.S. Attorney's Office District by selecting from the drop -down.
Minnesota v
H. Law Enforcement Agency Sworn Force Information
1. Enter the Fiscal Year Budgeted Sworn Force Strength for the current fiscal year below. The budgeted number of sworn officer positions is the number of
sworn positions funded in your agency's budget, including funded but frozen positions, as well as state, Bureau of Indian Affairs, or locally funded
vacancies. Do not include unfunded vacancies or unpaid/reserve officers.
a. Number of officers funded in agency's current fiscal year budget:
Full -Time: 42
Part -Time:
I. Civilian Staffing
1. Enter the number of civilian positions funded in agency's current fiscal year budget:
a. Number of civilian positions funded in agency's current fiscal year budget:
Full -Time:
Part -Time:
J. U.S. Department of Justice and Other Federal Funding
Applicants are required to disclose whether they have pending applications for federally funded assistance or active federal awards that support the same
or similar activities or services for which funding is being requested under this application.
Be advised that as a general rule COPS Office funding may not be used for the same item or service funded through another funding source. However,
leveraging multiple funding sources in a complementary manner to implement comprehensive programs or projects is encouraged and is not seen as
inappropriate. To aid the COPS Office in the prevention of awarding potentially duplicative funding, please indicate whether your agency has a pending
application and/or an active award with any other federal funding source (e.g. direct federal funding or indirect federal funding through State sub -awarded
federal funds) which supports the same or similar activities or services as being proposed in this COPS Office application. (complete the tables below):
Summary of Current/Active Non -COPS Office Awards that Support the Same or Similar Activities or Services as being Proposed in the COPS
Office Application
Federal Awarding
Agency or State
Agency for Sub-
Award
Number
Program Name
Award Start
Date
(mm/dd/yyyy)
Award End
Date(mm/dd/y
Award
ount
Describe How This Project Differs
From The Application For COPS
Office Funding
N/A
Fu
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Office Application
Federal Awarding Program Name Project items Describe How This Project Differs
Agency or State iLength Requested From The Application For COPS
Agency for Sub- Office Funding
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SECTION 4: EXECUTIVE INFORMATION
Note: Listing individuals without ultimate programmatic and financial authority for the award could delay the review of your application, or remove your
application from consideration.
A. Law Enforcement Executive/Agency Executive Information:
For Law Enforcement Agencies: This is the highest ranking law enforcement official within your jurisdiction (e.g., Chief of Police, Sheriff, or equivalent).
The section below has been pre -populated from the information listed in your COPS Office Agency Portal Account. If this information is no longer correct,
please log in to your COPS Office Agency Portal account and make the necessary corrections before proceeding with this application. For assistance,
please call the COPS Office Response Center at 800-421-6770.
For Non -Law Enforcement Agencies: This is the highest ranking individual in the applicant agency (e.g., chief executive officer, president, chairperson,
director) who has the authority to apply for this award on behalf of the applicant agency. If the award is awarded, this position will ultimately be responsible
for the programmatic implementation of the award. The section below has been pre -populated from the information listed in your COPS Office Agency
Portal Account. If this information is no longer correct, please log in to your COPS Office Agency Portal account and make the necessary corrections before
proceeding with this application. For assistance, please call the COPS Office Response Center at 800-421-6770.
Title: Director of Public Safety
First Name: Peter MI: Last Name: Koerner Suffix:
Agency Name: Cottage Grove Department of Public Safety
Streetl: 12800 Ravine Parkway S.
Street2:
City: Cottage Grove State: MN Zip / Postal Code: 55016
Telephone Number: 6124586003 Fax: 6514582820 Email: pkoerner@cottagegrovemn.gov
Edit Contact Information
If your agency previously indicated in Section 2, that if awarded, this award would be used in a written contracting arrangement to receive law enforcement
services (e.g., a town which is contracting with a neighboring sheriff's department to receive services), then question 4A, should display the executive
information for the agency which will be providing the law enforcement services under this award (e.g., Sheriff). Question 4B should display the executive
information for the government agency which will be receiving the law enforcement services under this award (i.e., Mayor, City Manager, etc.). Before
proceeding with this application, we ask that you please log onto the COPS Office Agency Portal to update the agency providing law enforcement services
as your Law Enforcement Executive/Agency Executive Information. This information will be used to populate Section 4 of this application, so please ensure
its accuracy.
B. Government Executive/Financial Official Information:
For Government Agencies: This is the highest ranking government official within yourjurisdiction (e.g., mayor, city administrator, or equivalent). The
section below has been pre -populated from the information listed in your COPS Office Agency Portal Account. If this information is no longer correct, please
log in to your COPS Office Agency Portal account and make the necessary corrections before proceeding with this application. For assistance, please call
the COPS Office Response Center at 800-421-6770.
For Non -Government Agencies: This is the financial official who has the authority to apply for this award on behalf of the applicant agency (e.g., chief
financial officer, treasurer). If the award is awarded, this position will ultimately be responsible for the financial management of the award. Please note that
information for non -executive positions (e.g., clerks, trustees) is not acceptable. The section below has been pre -populated from the information listed in
your COPS Office Agency Portal Account. If this information is no longer correct, please log in to your COPS Office Agency Portal account and make the
necessary corrections before proceeding with this application. For assistance, please call the COPS Office Response Center at 800-421-6770.
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Title: Administrator
First Name: Jennifer MI: Last Name: Levitt Suffix:
Agency Name: Cottage Grove Department of Public Safety
Streetl: 12800 Ravine Parkway S.
Street2:
City: Cottage Grove State: MN Zip / Postal Code: 55016
Telephone Number: 6514582890 Fax: 6514582897 Email: jlevitt@cottagegrovemn.gov
Edit Contact Information
C. Application Contact Information:
Application Contact: Enter the application contact's name and contact information.
Title: Icaptain
First Name: IRandy I MI: � Last Name: IMcAlister Suffix: Select One... r
Agency Name: I Cottage Grove Department of Public Safety
Streetl : 112800 Ravine Parkway S.
Street2:
City: I Cottage Grove I State: MN ,rZip / Postal Code: 55016
Telephone Number: 16514586017 ] Fax: 165145828 Email: rmcalister@cottagegrovemn.gov
SECTION 5A: COPS HIRING PROGRAM OFFICER REQUEST
Part I
Enter the Fiscal Year Actual Sworn Force Strength as of the date of this application. The actual number of sworn officer positions is the actual number of
sworn positions employed by your agency as of the date of this application. Do not include funded but currently vacant positions or unpaid positions.
Number of officers employed by your agency as of the date of this application:
Full -Time:
40
Part -Time:
0
What is the actual population your department serves as the primary law enforcement entity?
38702
This may or may not be the same as your census population. For example, a service population may be the census population minus incorporated towns
and cities that have their own police department within your geographic boundaries or estimates of ridership (e.g., transit police) or visitors (e.g., park
police). An agency with primary law enforcement authority is defined as having first responder responsibility to calls for service for all types of criminal
incidents within its jurisdiction.
For FY 2020 COPS Hiring Program (CHP) applicants are eligible to apply for the number of officer positions necessary to support their proposed community
policing strategy. Please keep in mind that there is a minimum 25 percent local cash match and a 12-month retention requirement for each officer position
funded. The COPS Office will fund as many positions as possible for successful applicants; however, the number of officer positions requested by an
agency may be reduced based on the availability of funding and other programmatic considerations.
FY 2020 CHP award funds cover 75 percent of the approved entry-level salary and fringe benefits of each newly -hired and/or rehired, full-time sworn career
law enforcement officer for three years (36 months) up to $125,000 per officer position. CHP award funding will be based on your agency's current entry-
level salaries and fringe benefits for full-time sworn officers.
If your agency requests officers to be deployed as school resource officers (SRO), ALL OF THE OFFICER POSITIONS REQUESTED BELOW MUST BE
USED TO DEPLOY FULL-TIME school resource officers. Do not request more officer positions than your agency can expect to deploy in this capacity. A
"school resource officer" is a career law enforcement officer, with sworn authority, who is engaged in community policing activities and is assigned by the
employing agency to work in collaboration with schools. If awarded an award for SRO position(s), please note that the COPS Office requires that the
officer(s) deployed into the SRO position(s) spend a minimum of 75 percent of their time in and around primary and secondary schools working on school
and youth -related activities. The placement of law enforcement officers in school carries a risk of contributing to a "school -to -prison pipeline" process where
students are arrested or cited for minor, non-violent behavioral violations and then diverted to the juvenile court system. This pipeline wastes community
resources and can lead to academic failure and greater recidivism rates for these students. If awarded, the recipient will agree that any officers deployed
while implementing School -based Policing under the COPS Hiring Program award may not be involved in the administrative discipline of the students.
There must be an increase in the level of community policing activities performed in and around primary or secondary schools in the agency's jurisdiction as
a result of the award. The time commitment of the funded officers must be above and beyond the amount of time that the agency devoted to the schools
before receiving the award. Recipients using CHP funding to hire or deploy school resource officers into schools must submit to the COPS Office a signed
memorandum of understanding (MOU) between the law enforcement agency and the school partner(s) before obligating or drawing down funds under this
award. An MOU is not required at time of application; however, if the law enforcement agency already has an MOU in place that is applicable to the
partnership, the MOU can be submitted as an attachment in Section 13 of the award application. The MOU must contain the following; the purpose of the
MOU, clearly defined roles and responsibilities of the school district and the law enforcement agency focusing officers' roles on safety, information sharing,
supervision responsibility, and chain of command for the SRO and signatures. If awarded, a recipient must submit an MOU to the COPS Office within 90
days from the date shown on the award congratulatory letter. Implementation of the COPS Hiring Program award without submission and acceptance of the
required MOU may result in expenditures not being reimbursed by the COPS Office and/or award de -obligation.
In addition, in Section 6B, you must select "School Based Policing through School Resource Officers" under "School Based Policing" as your focus area
Is your agency requesting that all of these officer positions be deployed as school resource officers (SROs)?
No s
How many officers are you requesting?
In FY 2020, agencies may request the number of officer positions necessary to support their proposed community policing strategy. Please keep in mind,
there is a minimum 25 percent local cash match and a 12 month retention period for each officer position funded. The COPS Office will fund as many
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positions as possible for successful applicants; however, the number of officer positions requested by an agency may be reduced based on the availability
of funding and other programmatic considerations. How many entry-level, full-time officer positions is your agency requesting in this application?
IMPORTANT: If you later return to this section of the application and change the above number of officers you are requesting, you must then go to Section
14A, Part 1 to allow the application to recalculate your budget figures. You will also need to adjust your projection of your Federal/Local share costs in the
chart located in Section 14A, Part 3. Failure to do this will cause a conflict in your budget submission. Next, your agency must allocate the number of
positions requested under each of the three hiring categories described below based on your agency's current needs at the time of this application. Please
be mindful of the initial three-year award period, and your agency's ability to fill and retain the officer positions awarded, while following your agency's
established hiring policies and procedures. CHP awards will be made for officer positions requested in each of the three hiring categories, and recipients are
required to use awarded funds for the specific categories awarded.
It is imperative that your agency understand that the COPS Office statutory nonsupplanting requirement mandates that award funds may only be used to
supplement (increase) a recipient's law enforcement budget for sworn officer positions and may not supplant (replace) state, local, or tribal funds that a
recipient otherwise would have spent on officer positions if it had not received an award. This means that if your agency plans to
(a) hire new officer positions (including filling existing vacancies that are no longer funded in your agency's budget); It must hire these new additional
positions on or after the official award start date, above its current budgeted (funded) level of sworn officer positions, and otherwise comply with the
nonsupplanting requirement as described in detail in the award owner's manual.
(b) rehire officers who have been laid off by any- jurisdiction as a result of state, local, or tribal budget reductions: It must rehire the officers on or after the
official award start date, maintain documentation showing the date(s) that the positions were laid off and rehired, and otherwise comply with the
nonsupplanting requirement as described in detail in the award owner's manual.
(c) Rehire officers who are (at the time of application) currently scheduled to be laid off (by -your jurisdiction) on a specific future date as a result of state,
local, or tribal budget reductions: It must continue to fund the officers with its own funds from the award start date until the date of the scheduled lay-off (for
example, if the CHP award start date is September 1 and the lay-offs are scheduled for November 1, then the CHP funds may not be used to fund the
officers until November 1, the date of the scheduled lay-off); identify the number and date(s) of the scheduled lay-off(s) in this application (see below);
maintain documentation showing the date(s) and reason(s) for the lay-off; and otherwise comply with the nonsupplanting requirement as described in detail
in the award owner's manual, [Please note that as long as your agency can document the date that the lay-off(s) would occur if CHP funds were not
available, it may transfer the officers to the CHP funding on or immediately after the date of the lay-off without formally completing the administrative steps
associated with a lay-off for each individual officer.]
Documentation that may be used to prove that scheduled lay-offs are occurring for local economic reasons that are unrelated to the availability of CHP
award funds may include (but are not limited to) council or departmental meeting minutes, memoranda, notices, or orders discussing the lay-offs; notices
provided to the individual officers regarding the date(s) of the lay-offs; or budget documents ordering departmental or jurisdiction -wide budget reductions.
These records must be maintained with your agency's CHP award records during the award period and for three years following the date of the submission
of the final expenditure report in the event of an audit, monitoring, or other evaluation of your award compliance.
If your agency's request is funded, your agency will have the opportunity after the award announcement to request an award modification to move awarded
funding into the category or categories that meet your agency's law enforcement needs at that time (including updating the dates of future scheduled lay-
offs).
If you need additional information regarding requesting a modification, please contact the COPS Office Response Center at 1-800-421-6770.
Category A: New, additional officer positions (including filling existing vacancies no longer funded in your agency's budget).
Category A Request:
Category B: Rehire officers laid off (from any jurisdiction) as a result of state or local budget reductions.
Category B Request:
F
Category C: Rehire officers scheduled to be laid off (at the time of the application) on a specific future date as a result of state or local budget reductions.
We also need some information about when the layoff of officers in this category is scheduled to occur. In the space below, please indicate when the
officer(s) specified in this category are scheduled to be laid off.
To enter your information, click "Add a New Officer Layoff'. To save your submission, click "Save" before moving to the next section.
Pdumher of Orficers Dai:o these officers are scheduled to be laid off Action
Add a New Officer Layoff
Total Category C Request: 0
Part 3
1. Under the 2020 COPS Hiring Program, applicants are not required to hire military veterans as new hires. However, the COPS Office supports the
Attorney General's commitment to hiring military veterans whenever possible. Please note that if your agency checks "yes" to the question below, your
agency will be required to maintain documentation that it made every effort possible (consistent with your internal procedures and policies) to hire at least
one military veteran.
Does your agency commit to hire and/or rehire at least one military veteran (as defined in the Application Guide) for the officer position(s) you have
requested?
J Yes
No
Part 4
The following questions will help Congress and the U.S. Department of Justice identify potential gaps in training.
1. On average how many hours of IN-SERVICE (non recruit) training (e.g. FTO, continuing professional education, roll call, standard) are required annually
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for each of your agency's officers/deputies in the following categories (if none, please indicate 0 hours)?
Use of force (hours) 24
De-escalation of conflict (hours) �p
Racial and ethnic bias that includes elements of implicit/unconscious bias (hours) 0
Gender bias in response to domestic violence and sexual assault (hours) 0
Bias towards lesbian, gay, bisexual, and transgender (LGBT) individuals (hours) p�
Community engagement ( e.g., community policing and problem solving )(hours) 0
2. Does your agency administer a police training academy?
No v
SECTION 613: LAW ENFORCEMENT & COMMUNITY POLICING STRATEGY
Community Policing Strategy
COPS Office funding must be used to reorient the mission and activities of law enforcement agencies through initiating community policing or enhancing
their involvement in community policing with the officers hired under this award program or an equal number of veteran officers who have been redeployed
to implement this plan after hiring the entry-level COPS Office -funded officers. If awarded funds, your responses to sections II(a) and II(b) that follow will
constitute your agency's community policing strategy under this award. Your organization may be audited or monitored to ensure that it is initiating or
enhancing community policing in accordance with this strategy. The COPS Office may also use this information to understand the needs of the field, and
potentially provide for training, technical assistance, problem solving and community policing implementation tools. Please note that the COPS Office
recognizes that your COPS Office -funded officer(s) (or an equal number of veteran officers who are redeployed after hiring the entry-level COPS Office -
funded officers) will engage in a variety of community policing activities and strategies, including participating in some or all aspects of your identified
community policing strategy. Your community -policing strategy may be influenced and impacted by others within and outside of your organization; this is
considered beneficial to your community policing efforts.
At any time during -your award period,youu should be prepared to demonstrate (1) the community_policing activities engaged in prior to the award that are
detailed in section I of this application and (2) how the award funds and award -funded officers (or an equal number of redeployed veteran officers) were
liecn ificaliy used to enhance (increase) or initiate community_ olici g activities according,lQyour community -policing stra egy contained in sections II (g) and
II (b) of this application.
Finally, we also understand that your community policing needs may change during the life of your award. Minor changes to this strategy may
be made without prior approval of the COPS Office; however, recipients will be required to report on progress and changes to the community
policing strategy (if any) through required progress reports. If your agency's community policing strategy changes significantly, you must
submit those changes to the COPS Office for approval. Changes are significant if they deviate from the specific crime problems(s) originally
identified and approved in the community policing strategy submitted with the application. In some cases, changes to the approved community
policing approaches may also be deemed significant and may require approval of a modified community policing strategy by the COPS Office,
depending on the scope and nature of those changes as identified in the quarterly progress reports.
The following is the COPS Office definition of community policing that emphasizes the primary components of community partnerships, organizational
transformation, and problem solving. Please refer to the COPS Office web site (https://cops.usdoj.gov/) for further information regarding this definition.
Community policing is a philosophy that promotes organizational strategies that support the systematic use of partnerships and problem solving techniques
to proactively address the immediate conditions that give rise to public safety issues, such as violent crime, non-violent crime, and fear of crime.
The COPS Office has completed the development of a comprehensive community policing self -assessment tool for use by law enforcement agencies.
Based on this work, we have developed the following list of primary sub -elements of community policing. Please refer to the COPS Office web site
(https://cops.usdoj.gov< for further information regarding these sub -elements.
Community Partnerships:
Collaborative partnerships between the law enforcement agency and the individuals and organizations they serve to both develop solutions to problems and
increase trust in police.
Other Government Agencies
Community Members/Groups
Non-Profits/Service Providers
Private Businesses
Media
Organizational Transformation:
The alignment of organizational management, structure, personnel and information systems to support community partnerships and proactive problem -
solving efforts.
Agency Management
Climate and culture
Leadership
Labor relations
Decision -making
Strategic planning
Policies
Organizational evaluations
Transparency
Organizational Structure
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Geographic assignment of officers
Despecialization
Resources and finances
Personnel
Recruitment, hiring and selection
Personnel supervision/evaluations
Training
Information Systems (Technology)
Communication/access to data
Quality and accuracy of data
Problem Solving:
The process of engaging in the proactive and systematic examination of identified problems to develop effective responses that are rigorously evaluated.
Scanning: Identifying and prioritizing problems
Analysis: Analyzing problems
Response: Responding to problems
Assessment: Assessing problem -solving initiatives
Using the Crime Triangle to focus on immediate conditions (Victim/Offender/Location)
1. Current Organizational Commitment to Community Policing
1) For each of the following statements, please answer in terms of existing agency policies and practices as they relate to collaborative
nartnershins and nroblem solvina activities. Please check all that apply.
ACTIVITY
Community Partnerships
Problem Solving
Q1 a. The agency mission statement, vision, or goals includes
references to:
(
❑
Q1 b. The agency strategic plan includes specific goals or objectives
relating to:
U IdJ
71c. The agency recruitment, selection and hiring processes include
elements relating to:
[) fd1
Q1d. Annual line officers evaluations assess performance in:
C✓]
dJ
Q1 e. Line officers receive regular (at least once every two years)
training in:
O
91
2) Which of the following internal management practices does your agency currently employ? Please check all that apply.
I) Assignment of officers to specific neighborhoods or areas for longer periods of time to enhance customer service and facilitate more contact between
police and citizens
tvi Assignment of officers to geographic hot spots that are defined statistically by creating incident maps to identify geographic clustering of crime and
disorder
r] In-service training for officers on basic and advanced community policing principles
di Early Intervention Systems that help identify officers who may be showing signs of stress, personal problem, and questionable work conduct
(-J None of the above
3) Which of the following do you count/measure to annual y. assess your agency's overall performance? Please check all that apply.
IdJ Response times
Reported crimes
fd1 Reported incidents
(�) Arrests and citations
I- I Problem solving outcomes
t-1 Department employee satisfaction
O Clearance rates
[J Complaints of officer behavior
i Reduction of crime in identified hot spots
(,ol Repeat calls for service
[ ] Social disorder/nuisance problems (e.g., graffiti, panhandling, loitering)
l-) Satisfaction with police services
f-1 Fear of crime
[41 Victimization (Le, non -reported crime)
CI Community meetings held/attended
iv] Use of force incidents
❑ Meeting the priorities as identified in your agency strategic plan
CJ My agency does not conduct annual assessments of overall performance
4) Through which of the following does your agency routine y. share information with community members? Please check all that apply.
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(dJ Neighborhood, beat, and/or school meetings
Wj Local media outlets
I Agency newsletter
(=j Neighborhood newsletters
IdJ Agency website
(✓J Social networking (Blogs, Twitter feeds, Facebook pages, etc.)
Fe] Citizen alert system (telephone, email, text, etc.)
(J Citizen alert system that is geographically targeted, based on updated hot spots
R) Public access television/radio
W1 Community organization board membership
C✓i Public forums with chief/sheriff/command staff
Posters, billboards, flyers
(] None of the above
5) Through which of the following ways does your agency formally, involve community members in influencing agency practices and operations? Please
check all that apply.
(dJ Citizen police academies
YJ Volunteer activities
(�ei Auxiliary police programs
Civilian review boards (i.e. disciplinary review boards)
Yj Citizen advisory groups (i.e. informal advisory function)
✓1 Involvement in hiring decisions (interview panels, selection boards, etc.)
Involvement in contributing to annual line officer performance reviews
fv; Representation on promotional boards
(J Participation in accountability and performance reporting and tracking meetings
C) Participation in complaint resolution process (formal mediation, disciplinary boards, etc.)
O None of the above
il(a) Proposed Community Policing Strategy: Problem Solving and Partnerships
COPS Office awards must be used to initiate or enhance community policing activities with either the newly hired officers funded by this award program or
an equivalent number of veteran officers who are redeployed to implement this community policing strategy after hiring the additional entry-level officers
with COPS Office award funds. In this section you will be asked to identify the crime and disorder problem/focus area and the partners to be engaged
through your requested COPS Office funding. Identifying the specific problem/focus area and partnerships that your agency plans to focus on is important to
ensure that you satisfy the requirements for COPS Office funding under this program and to ensure that ultimately the additional award -funded officers (or
equivalent number of redeployed veteran officers) will initiate or enhance your agency's capacity to implement community policing strategies and
approaches.
6) Using the following list, select a problem/focus area that will be addressed by the officers requested in this application. Please choose the option that best
fits your problem. You may select one problem/focus area to address through this award funding.
When identifying a problem, it is important to think about the nature of similar incidents that taken together comprise the problem and accordingly describe
it in precise, specific terms (e.g. "burglary of retail establishments", rather than just "burglary"). In doing this, it can be helpful to consider all aspects of the
problem, including the likely offenders, the suitable targets/victims, and how these come together in time and space.
School Based Policing
i J Child Sexual Predators and Internet Safety
f i Children Exposed to Violence
j Youth Crime and Delinquency
School Based Policing
School Based Policing through School Resource Officers
By selecting this focus area, your agency is committing that if awarded, all officer positions requested in this application (or an equivalent number of
redeployed veteran officers) will be used to deploy school resource officers and address problems in and around primary and secondary schools.
Please specify the areas the school resource officer(s) would address (check all that apply):
j Address crime problems, gangs, and drug activities affecting or occurring in or around an elementary or secondary school;
j Develop or expand crime prevention efforts for students;
1 Educate youth in crime prevention and safety;
f_j Develop or expand community justice initiatives for students;
I I Train students in conflict resolution, restorative justice, and crime awareness;
1 11 Assist in the identification of physical changes in the environment that may reduce crime in or around the school;
( j Assist in developing school policy that addresses crime and to recommend procedural changes to enhance school safety.
C_) Other Area
(Please Specify Other Area)
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(1 Other School Based Policing (please specify)
Opioid Education, Prevention, and Intervention
n Education, Prevention, and Intervention
Homeland & Border Security Problems
l7 Partnering with Federal Law Enforcement to Combat Illegal Immigration (e.g., information sharing, 287(g) partnerships, taskforces, and honoring
detainers)
0 Protecting Critical Infrastructure Problems
-] Information or Intelligence Problems
[] Other Homeland Security Problem (please specify)
Non -Violent Crime Problems and Quality -of -Life Policing
[] Burglary
Fraud
O Larceny/Theft (Non -Motor Vehicle)
O Motor Vehicle Theft/Theft from Motor Vehicle
0 Vandalism
Q Social Disorder
O Quality of Life Problem
0 Prostitution
Ii Misdemeanor Crimes
I_ i Disorderly Activity
O Traffic and Pedestrian Safety
Idej Other Non -Violent Crime Problem (please specify)
Severe and persistent mental illness
Building Trust and Respect
(_-) Building Trust and Respect
Violent Crime Problems
[ Assault
i_] Homicide
i Rape
i i Robbery
17 Domestic Violence
i J Human Trafficking
I ] Gun Violence
_J Criminal Gangs
[] Drug Manufacturing, Drug Dealing, Drug Trafficking
i__) Other Violent Crime Problem (please specify)
6a) Briefly describe the problem/focus area that you will address with these award funds and your approach to the problem. [2,000 characters or less]
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Our agency has noticed a tremendous increase in mental illness -related 'calls over the past decade. These
calls include crisis response, suicides, suicide -by -cop, untreated psychotic behavior, and sometimes violence
against Others. Many of these calls result in a police use -Of -force incident.
As the incidence of mass shootings and violence have become common headlines in America, we have also become'
acutely; aware of the fact that these kinds of incidents oftentimes have a component of mental illness. We
also know from behavioral threatassessment research that, to the extent `mental 'illness 'is a factor, it can
be identified early and intervened upon; thus, preventing any future acts of violence towards self or others.
Helping folks struggling with mental illness and keeping; the public safe requires,a proactive approach to
manage access to community resources and preventing people from falling through the myriad cracks of "the'
system."
We hope to fund three new police officer positions so that we can fully engage a'patrol-based proactive and
long-term and collaborative management' approach to persons suffering with mental illness. The new hires would
allow us to redeploy veteran officers into a hybrid additional duty known as the Case Management Unit (CMU).
These specially trained officers would work much` more closely with our county -based adult mental health
program: in a co -response model (where a CIT trained officer responds With a mental health' clinician). By j
necessity, management in these situations requires the manager to spend lots of time on telephones
coordinating interventions, on in -person' visits' with sufferers and family members, and on in -person meetings
with service providers and resources in the community.` Adding staffing` capacity' to our patrol division would
allow our'CMU officers to spend important time on managing these cases.
7) Which of the following information sources did you use to prioritize this problem/focus area as a problem/focus area to address through this award
program (please check all that apply):
(v, Police department data (e.g. police reports, calls for service, crime data, citizen complaints)
vi Agency personnel (e.g. officer feedback, command staff priorities)
i ,i Other local non -law enforcement government agency data
Community based organizations (e.g. faith based, non -profits, social service providers)
f . Local businesses
i i Individual community members/community meetings
(.j Community survey
O Local government officials
koi The media
I None of the above
8) If awarded funds, my agency will improve our understanding of this problem/focus area by examining (please check all that apply):
Iv, Routinely collected law enforcement data/information related to the problem (e.g. arrest, incident reports, calls for service)
I j The location and/or time aspects of the problem/focus area (e.g. mapping)
Yi The conditions and environmental factors related to the problem/focus area
N,, The strengths and limitations of current responses to the problem/focus area
( ( Non -law enforcement data/information related to the problem/focus area (e.g. insurance crash data, other government agency data, census data,
survey data)
l Existing research and best practices related to the problem/focus area
C_l Data/information from the community related to the problem/focus area (e.g. resident associations, business groups, non-profit community service
organizations)
( J Information about offenders contributing to the problem/focus area (e.g. offender interview, arrest records)
(vi Information about victims affected by the problem/focus area (e.g. crime reports, victim interviews)
f i Strengths and weaknesses of previous responses to the problem/focus area
CI None of the above
9) If awarded funds my agency will use the following information sources to assess our response to this problem/focus area to determine whether the
response was implemented and achieved the desired outcomes(please check all that apply):
(d: Routinely collected law enforcement data/information related to the problem/focus area (e.g. arrests, incident reports, calls for service)
vi Data/information regarding whether the response was implemented as planned
Police data collected for this specific problem/focus area (e.g. problem -specific surveys, field interview contact cards)
vi Non -police data/information related to the problem/focus area(e.g, insurance crash data, other government agency data, census data, survey data)
C l Data/information from the community related to the problem/focus area (e.g. resident associations, business groups, non-profit community service
organizations)
( ; Information about offenders contributing to the problem/focus area (e.g. offender interview, arrest records, probation/parole data)
(vi Information about victims and/or stake holders affected by the problem/focus area (e.g. crime reports, victim interviews)
Cl None of the above
10) To the best of your ability at this time, please select from the below list what your primary -goals are in responding to your selected problem/focus area
(please select up to 3):
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O Eliminating the problem/focus area
(d) Reducing the number of incidents
CJ Increasing public trust in your agency
O Reducing the seriousness of the incidents or the amount of harm
O Reducing the number of victims and repeat victims
O Reducing the number of offenders and repeat offenders
LJ Moving the problem/focus area to another area
(-J Getting other agencies and stake holders to assume responsibility for the problem/focus area
Iv) Improving the response to the problem/focus area (i.e, more comprehensive and coordinated way of dealing with the problem/focus area, providing
better services to victims, or greater efficiency in dealing with the problem/focus area)
CJ Improving citizen perceptions of the problem/focus area
�-] Increasing the number of arrests/citations
(_-) Reducing the number of calls for service
0 None of the above
11) An important part of a comprehensive community policing strategy is the formation of partnerships, such as working with other public agencies, private
organizations, or participation in regional law enforcement partnerships. If awarded funds, will your agency and the award funded officers or an equivalent
number of redeployed veteran officers) initiate or enhance a partnership with an external group/organization to develop responses to this problem/focus
area?
n Yes
No
11a) If awarded funds, how many external groups/organizations will your agency initiate or enhance a partnership with to develop responses to
this problem/focus area?
11 b) Name the most important external groups/organizations that your agency will initiate or enhance a partnership with to develop responses to this
problem/focus area (maximum of three partners). Note: you may attach optional letters of this support from any or all of these prospective partners in
Section 13 of the application. You will be limited to listing no more than three partners per public safety problem/focus area.
Partner Nurnber Partner Name IF 11011d Action
11c) For this partner, please indicate the statement that best characterizes this
partner:
O Local government agencies (non -law enforcement, e.g., probation/parole, parks and
recreation, code enforcement)
Community based organizations (e.g., faith based, community redevelopment groups,
social service providers, resident associations)
Washington County Adult Mental I Businesses operating in the community Edit Delete
Tribal law enforcement agencies
( ) Federal, state, or local law enforcement agencies (non -tribal) including through multi-
jurisdictional/regional partnerships
O Local educational institutions (schools/colleges/universities)
( - ) Individual stakeholders (persons residing, working, or with an interest in the community
or problem
11c) For this partner, please indicate the statement that best characterizes this
partner:
O Local government agencies (non -law enforcement, e.g., probation/parole, parks and
recreation, code enforcement)
() Community based organizations (e.g., faith based, community redevelopment groups,
social service providers, resident associations)
2 Washington County Community C
O Businesses operating in the community Edit Delete
Tribal law enforcement agencies
O Federal, state, or local law enforcement agencies (non -tribal) including through multi-
jurisdictional/regional partnerships
Local educational institutions (schools/colleges/universities)
Individual stakeholders (persons residing, working, or with an interest in the community
or problem
3 Tubman 11c) For this partner, please indicate the statement that best characterizes this Edit Delete
partner:
(-' Local government agencies (non -law enforcement, e.g., probation/parole, parks and
recreation, code enforcement)
G Community based organizations (e.g., faith based, community redevelopment groups,
social service providers, resident associations)
Businesses operating in the community
O Tribal law enforcement agencies
(-) Federal, state, or local law enforcement agencies (non -tribal) including through multi-
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jurisdictional/regional partnerships
Local educational institutions (schools/colleges/universities)
Individual stakeholders (persons residing, working, or with an interest in the community
or problem
II(b) Proposed Community Policing Strategy: Organizational Transformation
COPS Office awards must be used to initiate or enhance community policing activities. In this section you will be asked to identify the organizational
change(s) that your agency plans to focus on through your requested COPS Office funding. Identifying the specific organizational change(s) that your
agency plans to focus on is important to ensure that you satisfy the requirements for COPS Office funding under this program, and to ensure that ultimately
the use of these funds will initiate or enhance your agency's capacity to implement community policing approaches.
12) If awarded funds, will your agency initiate or enhance any of the following internal changes to personnel management? (Select no more than 2 internal
changes to personnel management that will be addressed with these award funds.)
tdi Flexibility in officer shift assignments to facilitate addressing specific problems
Please provide a narrative for each internal change to personnel management identified (2,000 characters or less)
Our police department has identified and trained five sworn officers in 'mental health response (Crisis
Intervention Team training), behavioral threat assessment, and long-term;` proactive case management. These
are -frequently at minimum staffing levels. If awarded funds through the COPS grant, we would be able to hire
three additionalentry level police officers for patrol duties. This would increase our current patrol
staffing; for the shifts which our mental; health officers are assigned to; thus making it,easier 'for these
officers to conduct follow-up and to do so out of town,', if required, as the shifts will more frequently be
staffed above minimums. Additionally,` when patrol staffing is above minimums, the CMU'officers could flex'
their shift start and end times, to work on their CMU cases
I_) Assignment of officers to specific neighborhoods or areas for longer periods of time to enhance customer service and facilitate more contact between
police and citizens
I I Recruitment and hiring practices that reflect an orientation towards problem solving and community engagement
.I In-service training for officers on basic and advanced community policing principles
i I Field training officer (FTO) programs that teach and test problem solving, community engagement, and critical thinking skills
I I Measure and include non -enforcement proactive community engagement efforts as part of officer performance evaluations
wi Provide de-escalation training to sworn personnel and promote de-escalation as an important strategy to diffuse potentially volatile situations
Please provide a narrative for each internal change to personnel management identified (2,000 characters or less)
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anagement Unit (CMU) officers have been trained; in, or will be trained in, Crisis Management Team
is the nationally recognized "gold standard" mental health/crisis response training for police
The CIT course :is a 40`hour course that trains officers in identifying mental illness, recognizing
tanding the different kinds of mental health diagnoses, ;finding ;community resources to assist
fering;with mental illnesses and providing officers with verbal -de-escalation skills. The de -
skills taught in the course focus on developing officer's "active listening" skills in order to
e agitated and/or violent individuals in the community.
ficers will be providing the primary response to crisis calls when they are on shift. More
v ani 'i,n,nnply nnr rmii rvffird`nc refill hp --h rtina lnna-tarn fnllnw-un and racp manaoamant -For
as possible, our CMU officers will be co -responding with our county mental health
closely with them than we have historically.
gill be expected to be ambassadors of de-escalation and mental health care which may,
raining to the regular patrol officers.
program will be earlier identification of people in our 'community who are not
ent for their mental illness, coordinating interventions and community referrals,
ie number and severity of mental health crisis calls in our communities.'
O Early intervention systems that help identify officers who may be showing early signs of stress, personal problems, and questionable work conduct
O Career development and/or promotional processes (i.e. sergeant exams) that reinforce problem solving and community engagement
L I Implement specific programs to improve the safety and wellness of personnel throughout your organization
L) None of the above
13) If awarded funds, will your agency initiate or enhance any of the following internal changes to agency management? (Select up to 2 internal changes to
agency management that will be addressed with these award funds.)
O Agency mission statement, vision, and/or goals that reflect the core values of community policing
vol Agency strategic plan that outlines the goals and objectives around community policing and other departmental priorities
Please provide a narrative for each internal change to agency management identified (2,000 characters or less)
If awarded funds, our agency expects to create a long-term culture and expectation of improving public safety
and community peace through proactive case management. This community -oriented approach to dealing with the
lientallylill in our community will be built into our strategic plan and objectives through the formal
adoption of a Case Management Unit policy so that it becomes part of our policing culture for years to come.
Additionally, a formal turn -key training program will be built for future CMU officers. The experience of
adding a'robust and effective proactive mental illness program will also give us experience and the needed
infrastructure to implement similar proactive and collaborative approaches in other areas of policing
C I Organizational performance measurement systems that include community policing metrics, and conduct annual assessments of agency performance
i Technology systems that provide officers, analysts, and the community better and more timely access to data and information
J Mediation strategies to resolve citizen complaints
wl Collection, analysis, and use of crime data and information in support of problem solving goals
Please provide a narrative for each internal change to agency management identified (2,000 characters or less)
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O Formal accreditation process
LJ System to capture and track problem solving and partnership efforts and activities
C) An organizational assessment of community policing
(, J None of the above
III. General Community Support and Engagement
14) Did your agency consult with any of the following groups/organizations on the develo men of this community policing strategy? Please check all that
apply.
(di Local government agencies (non -law enforcement, e.g.n probation/parole, parks and recreation, code enforcement)
() Community based organizations (e.g. faith based, community redevelopment groups, social service providers, resident associations)
f 1 Businesses operating in the community
I J Tribal law enforcement agencies (outside your jurisdiction)
[4 Other Federal, state, or local law enforcement agencies
C_i Multi -jurisdictional or regional task forces/partnerships
❑ Local educational institutions (schools/colleges/universities)
i i Local government officials
f J Individual stakeholders residing, working or with an interest in the community and/or problem
i_ i None of the above
15) To what extent are there related governmental and/or community initiatives that complement your agency's proposed community policing strategy?
O a) There are a significant number of related initiatives
b) There are a moderate number of related initiatives
c) There are a minimal number of related initiatives
d) There are no related initiatives
16) To what extent is there community support in your jurisdiction for implementing the proposed community policing strategy?
a) High level of support
-� b) Moderate level of support
c) Minimum level of support
17) If awarded funds, to what extent will the community policing strategy impact the other components of the criminal justice system in your jurisdiction?
u a) Potentially decreased impact
- b) No change in impact
c) Potentially increased impact
SECTION 7: NEED FOR FEDERAL ASSISTANCE
A. Explanation of Need for Federal Assistance
All applicants are required to explain their inability to address the need for this award without federal assistance. Please do so in the space below, [Please
limit your response to a maximum of 1,000 characters.]
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B. Service Population
1. Enter the total population of the government entity applying for this award using the latest census estimate available in the American Fact Finder at
http://factfinder2.census.gov/.
37208
L) 2. Check here if the population of the entity applying for this award is not represented by U.S. Census figures (e.g., colleges, special agencies, school
police departments, etc.).
3. What is the actual population your department serves as the primary law enforcement entity? 38702
This may or may not be the same as the population specified above. For example, a service population may be the census population minus incorporated
towns and cities that have their own police department within your geographic boundaries or estimates of ridership (e.g., transit police) or visitors (e.g., park
police). An agency with primary law enforcement authority is defined as having first responder responsibility to calls for service for all types of criminal
incidents within its jurisdiction.
3a. If applicable, please explain why the service population differs from the census population:
Because we've seen considerable residential growth in just the past 2 years.
C. Fiscal Health
Enter your law enforcement agency's total operating budget for the current AND previous two fiscal years. Please note: All figures must be rounded to the
nearest whole dollar.
CURRENT FISCAL YEAR (2020) $ 17215290
PREVIOUS FISCAL YEAR (2019) $ (6842150
PREVIOUS FISCAL YEAR (2018) $ 16690067
The U.S. Census Bureau American Community Survey (ACS) provides multi -year poverty rate estimates for communities. Please go to the U.S.
Census Bureau's American Fact Finder (http://factfinder2.consus.gov/) to determine the percentage of individuals in poverty in your jurisdiction.
For jurisdictions not included in the census (e.g., schools, universities, transit, parks), please check the box for "Not Applicable." Please see the program
Application Guide for additional information and help in using the American Fact Finder. Please note: All figures must be rounded to the nearest whole
percent.
a. Percentage of individuals in poverty %
[_) Not Applicable:
The Bureau of Labor Statistics' Local Area Unemployment Statistics (LAUS) program provides monthly estimates of unemployment for
communities. Please go to the Bureau of Labor Statistics' LAUS website (http://www.bis.govilauldata.htm) to find detailed instructions for
looking up your local area's unemployment rate. It may be necessary to select the nearest best match to your jurisdiction (for example, a city of fewer
than 25,000 people may report their county level rate). Please see the program application guide for additional information and help in using the LAUS data.
For jurisdictions not included in the census (e.g., schools, universities, transit, parks), please check the box for "Not Applicable". Please note: All figures
must be rounded to the nearest whole percent.
a. Percentage Unemployed for December 2019 0
Not Applicable:
Since January 1, 2020, has your agency taken on additional law enforcement duties and responsibilities resulting from an agency merger or the disbanding
of a neighboring law enforcement agency (which did not result in a new or supplemented funded contract to provide these law enforcement services)?
No v
In addition to the data collected elsewhere in this application, the COPS Office would like to capture information from jurisdictions that may have faced an
unanticipated catastrophic event that had a significant impact on the delivery of law enforcement services or have experienced an unusually large increase
in the number of homicides in the past year. Examples of unanticipated catastrophic events include mass shootings, terrorist attacks, natural disasters, or
other events leading to mass casualties that would not necessarily be reflected in the UCR crime statistics previously reported. Please note that if your
jurisdiction is faced with an unanticipated catastrophic event (e.g., mass shooting, terrorist attack, other mass casualty event) after submission of this
application, but before the application closing date, you should contact the COPS Office immediately at 800-421-6770 to update your application to include
this information.
C) If your agency experienced a major disaster or catastrophic event in the time period from January 1, 2019 to present, check this box.
D. PropertylViolent Crime
Please select at least one statement below:
yl My agency can report crime data for all 3 years (please input in table below:).
i I My agency cannot report crime data for 2019.
i_j My agency cannot report crime data for 2018.
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U My agency cannot report crime data for 2017.
1) Using UCR crime definitions, enter the actual number of incidents reported to your agency in the previous three calendar years (2019, 2018,
2017) for the following crime types. Note that only those incidents for which your agency had primary response authority should be provided. Please
enter 0 (zero) to indicate no incidents in a particular year/type. Leave blanks only where data is unavailable.
UCR Data 2019
Criminal Homicide I In
Forcible Rape 1 118
Aggravated Assault
Burglary
Larceny (except motor vehicle
Motor Vehicle Theft
0
9
3
16
64
497
2018 1 2017
47
If awarded funds, will your agency commit to regularly collect, analyze and report incidents of hate crimes to the FBI as part of their annual Uniform Crime
Reporting?
U Yes
0 No
Agency Profile Questions (these questions are for information purposes only and will not be scored):
1.Does your agency have a wellness policy or program for officers?
Yes v
2.Does your agency report crime data to the National Incident -Based Reporting System (NIBRS)?
No v
3.Does your agency utilize the National Integrated Ballistic Information Network (NIBIN)?
Yes .
4.Does your agency have a dedicated or specific investigator to investigate reported hate crimes?
No v
SECTION 8: CONTINUATION OF PROJECT AFTER FEDERAL FUNDING ENDS
If you are applying for a COPS Office award with a post -award retention plan requirement, please complete A. If you are applying for a COPS
Office award without a post -award retention plan requirement, please complete B.
A. Continuation of Project after Federal Funding Ends (for COPS Office awards with a retention plan requirement)
Applicants must plan to retain all sworn officer positions awarded under your COPS Office hiring award for a minimum of 12 months at the conclusion of 36
months of federal funding for each position. The retained COPS Office -funded positions should be added to your agency's law enforcement budget with
state and/or local funds at the end of award funding, over and above the number of locally -funded sworn officer positions that would have existed in the
absence of the award. These additional position(s) must be retained using state, local, or other nonfederal funding only. You may not use funds awarded by
other federal awards to cover the costs of retention. At the time of award application, applicants must affirm that they plan to retain the positions and identify
the planned source(s) of retention funding. We understand that your agency's source(s) of retention funding may change during the life of the award. Your
agency should maintain proper documentation of any changes in the event of an audit, monitoring or other evaluation of your award compliance. Please
refer to the frequently asked questions on retention which can be found here https:Hcops.usdoj.gov/clip .
1. Will your agency plan to retain any additional positions awarded under this award for a minimum of 12 months at the conclusion of federal funding for
each position?
Yes v
Note: Agencies that do not plan to retain all the positions awarded under this award are ineligible to receive CHP funding
2. Please identify the source(s) of funding that your agency plans to utilize to cover the costs of retention: (check all that apply)
di General funds
CI Raise bond/tax issue
I 1 Private sources/donations
r i Nonfederal asset forfeiture funds (subject to approval from the state or local oversight agency)
i ; Fundraising efforts
f ) State, local, or other nonfederal award funding
U Other
If other, please provide a brief description of the source(s) of funding not to exceed 500 characters.
SECTION 12: OFFICIAL PARTNER(S) CONTACT INFORMATION
An official "partner' under the award may be a governmental, private, school district, or other applicable entity that has established a legal, contractual, or
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other agreement with the applicant for the purpose of supporting and working together for mutual benefits of the award. Please see the COPS Office
application guide for more information on official partners that may be required.
t=!rst Nartre Last Name Agency Name Action
Title:
First Name: Middle Name: Last Name:1 Suffix: Select One... v
Name of Partner Agency (e.g.,Smithville High School):
17
Type of Partner Agency (e.g., School District):
Street1:
Street2:
City:1 State: Select One... I Zip/ Postal Code:
Telephone Number: Fax: Ema!I:
Important! Please click "Add Partner' below to add a partner to the list.
Reminder! If you have modified (edit, update, or delete) the list of partners in any way, please click "Save" to store your changes before moving to the
next section.
Add Partner
SECTION 13: APPLICATION ATTACHMENTS
This section should be used to attach any required or applicable attachments to your award applications (e.g. memorandum of understanding)
If awarded, recipient's using CHP funding to hire and/or deploy school resource officers into schools must submit to the COPS Office a signed
Memorandum of Understanding (MOU) between the law enforcement agency and the school partner(s) before obligating or drawing down funds under this
award. An MOU is not required at time of application; however, if the law enforcement agency already has an MOU in place that is applicable to the
partnership, the MOU can be submitted as an attachment in section 13 of the award application. The MOU must contain the following; the purpose of the
MOU, clearly defined roles and responsibilities of the school district and the law enforcement agency; focusing officers' roles on safety, information sharing,
supervision responsibility and chain of command for the SRO and signatures. If awarded, recipient will agree that the MOU must be submitted to the COPS
Office 90 days from date on the award congratulatory letter. The implementation of the COPS Hiring Program award without submission and acceptance of
the required MOU may result in expenditures not being reimbursed by the COPS Office and/or award de -obligation. Please refer to the program -specific
Application Guide to determine if an MOU or other application attachments are required. The guide will also specify if optional attachments are permitted for
submission. Please use appropriately descriptive file names (e.g. Program Narrative, Budget Detail Worksheet and Budget Narrative, Timelines,
Memoranda of Understanding, Resumes) for all attachments. Please do not submit executable file types as application attachments. These disallowed file
types include, but are not limited to, the following extensions:.com, .bat, .exe, .vbs, .cfg, .dat, Ab, AV, All, .ini, .log, .ora, .sys, and .zip. The system may
reject applications with files that use these extensions.
Current Attachments
Upload attachments using "Browse..." and "Upload...". File names may only contain:
• a-z
• 0-9
• period(.), underscore(_), hyphen(-)
• Characters other than these will be replaced by a hyphen(-).
• After clicking the "Upload..." button, please wait for the page to refresh. The uploaded file will automatically appear in the file list.
Form COPS _Sh_ApplicationAttachment_2_5-V2.5.pdf SF-424 Delete
Form SF424_2_1-V2.1.pdf SF-424 Delete
CMU Concept - draft guide.docx After Action Reports/Assessments Delete
Choose File No file chosen After Action Reports/Assessments r Upload File ...
SECTION 14: BUDGET DETAIL WORKSHEETS
Instructions for Completing the Budget Detail Worksheets
The following Budget Detail Worksheets are designed to allow all COPS Office award and cooperative agreement applicants to use the same budget forms
to request funding. Allowable and unallowable costs vary widely and depend upon the type of COPS Office program. The maximum federal funds that can
be requested and the federal/local share breakdown requirements also vary.
Please refer to the program -specific application guide to determine the allowable/unallowable costs, the maximum amount of federal funds that can be
requested, and the federal/local share requirements for the COPS Office program for which your agency is applying (see https:Hcops.usdoj.gov/grants). To
assist you, sample Budget Detail Worksheets are included in each application guide.
Please complete each section of the Budget Detail Worksheets applicable to the program for which you are applying (see https:Hcops.usdoj.gov/grants for
requirements). If you are not requesting anything under a particular budget category, please check the appropriate box in that category indicating that no
positions or items are requested.
Final calculations will be rounded to the nearest whole dollar. Once the budget for your proposal has been completed, a budget summary page will reflect
the total amounts requested in each category, the total project costs, and the total federal and local shares.
If you need assistance in completing the Budget Detail Worksheets, please call the COPS Office Response Center at 800-421-6770.
SECTION 14A: BUDGET DETAIL WORKSHEETS
Instructions: This worksheet will assist your agency in reporting your agency's current entry-level salary and benefits and identifying the total salary and
benefits request per officer position for the length of the award term. Please list the current entry-level base salary and fringe benefits rounded to the
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nearest whole dollar for one full-time sworn officer position within your agency. Do not include employee contributions. (Please refer to
https://cops.usdoj.gov/grants for information on the length of the award term for the program under which you are applying.)
Special note regarding sworn officer fringe benefits: For agencies that do not include fringe benefits as part of the base salary costs and typically calculate
these separately, the allowable expenditures may be included under Part 1, Section B. Any fringe benefits that are already included as part of the
agency's base salary (Part 1, Section A of the Sworn Officer Budget Worksheet) should not also be included in the separate fringe listing (Part 1
Section B). Please refer to https:Hcops.usdoj.gov/grants for information about allowable and unallowable fringe benefits for sworn officer positions
requested under the program to which your agency is applying.
A. SWORN OFFICER POSITIONS
Full -Time Entry -Level Sworn Officer Base Salary Information
Part 1: Instructions: Please complete the questions below based on your agency's entry-level salary and benefits package for one locally -funded officer
position. As applicable per the program -specific application guide, you may also be required to project Year 2 and Year 3 salaries.
Sworn Officer Position
A. Base Salary Information
Year 1 Salary
Year 2 Salary
Year 3 Salary
Enter the first
Enter the second
Enter the third
year entry-level
year entry-level
year entry-level
base salary for
base salary for
base salary for
one sworn officer
one sworn officer
one sworn officer
position.
position.
position.
7004.0000
84620.0000
93870.0000
No ♦ Does the base Np
♦ Does the base Np
♦ Does the base
salary include
salary include
salary include
Vacation costs?
Vacation costs?
Vacation costs?
Please select Yes
Please select Yes
Please select Yes
or No,
or No,
or No.
No vDoes the base o
N
v Does the base Np
♦ Does the base
salary include
salary Include
salary include
Sick Leave costs?
Sick Leave costs?
Sick Leave costs?
Please select Yes
Please select Yes
Please select Yes
or No,
or No,
or No.
B. Fringe Benefit costs should be calculated for each year of the award term.
FRINGE BENEFITS:
Year 1 Fringe Benefits
Year 2 Fringe Benefits
Year 3 Fringe Benefits
COST % OF
BASE SALARY
COST % OF
BASE SALARY
COST % OF
BASE SALARY
Social security
expenses
cannot exceed Yj Exempt %-J 6.20% 11 Fixed Rate
6.2%
Medicare
expenses
1116.560 1.45
1226.99 1.45
1361.12 1.45
cannot ( I Exempt Wj 1.45% L-1 Fixed Rate
exceed
1.45%
Health Insurance (Family Coverage)
13679.0 17.7640
14362.0 16.9723
15081.0 16.0658
Life Insurance
348.000 .4519
348.000 .4113
348.000 .3707
Vacation Number of Hours Annually: 144
Fo___1 0.0000
Fo I .0Eo
IT-_-I.0000
Sick Number of Hours Annually:
Leave
F ,0000
0.0000
0.0000
Retirement
13398.7 17.4000
14723.8 17.4000
16333, 3 17.4000
Worker's Compensation I ) Exempt
250.62 5.5200
671.02 5.5200
5181.62 5.5200
Unemployment fdiExempt
Insurance
o��
��
Other Dental Insurance °
529.000 .6870
545.000 .6441
561.000 .5976
Other Select One °
Fo 0.0000
Fo___1 .0000
1T___1 .0000
Other Select One °
F--] ,0000
F7 .0000
F7 .0000
Benefits Sub -Total Per Year (1 Position)
33321.8800
35876.8900
38866.1200
C. Total Salary + Benefits Per Year (1 Position)
110325.8800
120496.8900
132736.1200
D. Total Salary and Benefits for Years 1, 2,
and 3 (1 Position):
363558.8900
X 0 # of Positions
1090676.6700
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SALARY DETAILS
Part 2 : Sworn Officer Salary Information
1. If your agency's second or third -year costs for salaries and/or fringe benefits increase after the first year, check the reasons(s) why in the space below. If
these costs do not increase, please select "Not Applicable".
[) Cost of Living Adjustment (COLA)
Y7 Step Raises
(_) Change in Benefit Costs
L3 Not Applicable
Part 3: Federal/Local Share Costs (for Hiring Awards)
As part of the local matching requirement for the 2020 COPS Hiring Program, recipients must assume a progressively larger share of the cost of the award
with local funds over the three-year award period. This means that your local match must increase each year, while the federal share must decrease,
1090676.67 Total Salary and Benefits for year 1, 2, & 3 (all positions):
375000.0o Total Federal Share:
34.3823252472 Total Federal Percentage:
15676.67 Total local share required:
5.6176747527�7 Total Local Percentage:
Please project in the chart below how your agency plans to assume a progressively larger share of the award costs during each year of the program. The
chart is only a projection of your plans; while your agency may deviate from these specific projections during the award period, it must still ensure that the
federal share decreases and the local share increases. For more details on local matching requirements for this program, please refer to
https://cops.usdoj.gov/grants.
Please use the Recalculate button below after any changes to the benefit table above before moving forward.
Percent of the "Total Local Share Required" your agency plans to assume in Year 1
31 Percent of the "Total Local Share Required" your agency plans to assume in Year 2
Percent of the "Total Local Share Required" your agency plans to assume in Year 3
10o Percent Total
152058.47 Federal Share Year 1
139631.0o Federal Share Year 2
83310.53 Federal Share Year 3
37500o Federal Total
178919.17 Local Share Year 1
21659.77 Local Share Year 2
314897.73 Local Share Year 3
15676.67 Local Total
1090676.67 Recalculate
S. BUDGET SUMMARY
Instructions: Please review the category totals and the total project costs below. If the category totals and project amounts shown are correct, please
continue with the submission of your application. Should you need to make revisions to a budget category, please return to the Budget Detail Worksheet.
Section
Budget Category
Category Total
A. Sworn Officers
$1090676.6700
B. Civilian and Non -Sworn Personnel
$0.0000
C. Equipment and Technology
$0.0000
D. Supplies
$0.0000
E. Travel, Training, and Conferences
$0.0000
F. Contracts and Consultants
$0.0000
G. Other Costs
$0.0000
H. Indirect Costs
$0.0000
Total Project Amount:
$1090676.6700
Total Federal Share Amount:
(Total Project Amount X Federal Share Percentage Allowable)
$375000
34.3823%
I I I I
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Total Local Share Amount (If applicable): $715677 65.6177%
(Total Project Amount - Total Federal Share Amount)
If your application is funded, but for a reduced number of officer positions, the percentage of the local share provided above will be applied to the total
project cost of the awarded officers.
Waiver of Local Match
The COPS Office may waive some or all of a recipient's local match requirement based on severe fiscal distress. During the application review process,
your agency's waiver request will be evaluated based on the availability of funding, a demonstration of severe fiscal distress as reflected through the fiscal
health data in section 7 of this application, and a comparison of your fiscal health data with that of the overall applicant pool.
Q1: Are you requesting a waiver of the local match based on severe fiscal distress?
No
Contact Information for Budget Questions
Please provide contact information of the financial official that the COPS Office may contact with questions related to your budget submission.
First Name:
Robin
Last Name:
Roland
Title:
Finance Director
Telephone Number:
6514582832
Fax:
6514582897
Email Address:
rroland@cottagegro
SECTION 15A: U.S. DEPARTMENT OF JUSTICE CERTIFIED STANDARD ASSURANCES
On behalf of the Applicant, and in support of this application for a grant or cooperative agreement, I certify under penalty of perjury to the U.S. Department
of Justice ("Department"), that all of the following are true and correct:
(1) 1 have the authority to make the following representations on behalf of myself and the Applicant. I understand that these representations will be relied
upon as material in any Department decision to make an award to the Applicant based on its application.
(2) 1 certify that the Applicant has the legal authority to apply for the federal assistance sought by the application, and that it has the institutional, managerial,
and financial capability (including funds sufficient to pay any required non-federal share of project costs) to plan, manage, and complete the project
described in the application properly.
(3) 1 assure that, throughout the period of performance for the award (if any) made by the Department based on the application --
a. the Applicant will comply with all award requirements and all federal statutes and regulations applicable to the award;
b, the Applicant will require all subrecipients to comply with all applicable award requirements and all applicable federal statutes and regulations; and
c. the Applicant will maintain safeguards to address and prevent any organizational conflict of interest, and also to prohibit employees from using their
positions in any manner that poses, or appears to pose, a personal or financial conflict of interest.
(4) The Applicant understands that the federal statutes and regulations applicable to the award (if any) made by the Department based on the application
specifically include statutes and regulations pertaining to civil rights and nondiscrimination, and, in addition --
a. the Applicant understands that the applicable statutes pertaining to civil rights will include section 601 of the Civil Rights Act of 1964 (42 U.S.C. § 2000d);
section 504 of the Rehabilitation Act of 1973 (29 U.S.C. § 794); section 901 of the Education Amendments of 1972 (20 U.S.C. § 1681); and section 303 of
the Age Discrimination Act of 1975 (42 U.S.C. § 6102);
b. the Applicant understands that the applicable statutes pertaining to nondiscrimination may include section 809(c) of Title I of the Omnibus Crime Control
and Safe Streets Act of 1968 (34 U.S.C. § 10228(c)); section 1407(e) of the Victims of Crime Act of 1984 (34 U.S.C. § 20110(e)); section 299A(b) of the
Juvenile Justice and Delinquency Prevention Act of 2002 (34 U.S.C. § 11182(b)); and that the grant condition set out at section 40002(b)(13) of the Violence
Against Women Act (34 U.S.C. § 12291(b)(13)), which will apply to all awards made by the Office on Violence Against Women, also may apply to an award
made otherwise;
c. the Applicant understands that it must require any subrecipient to comply with all such applicable statutes (and associated regulations); and;
d. on behalf of the Applicant, I make the specific assurances set out in 28 C.F.R. §§ 42.105 and 42.204.
(5) The Applicant also understands that (in addition to any applicable program -specific regulations and to applicable federal regulations that pertain to civil
rights and nondiscrimination) the federal regulations applicable to the award (if any) made by the Department based on the application may include, but are
not limited to, 2 C.F.R. Part 2800 (the DOJ "Part 200 Uniform Requirements") and 28 C.F.R. Parts 22 (confidentiality - research and statistical information),
23 (criminal intelligence systems), 38 (regarding faith -based or religious organizations participating in federal financial assistance programs), and 46
(human subjects protection).
(6) 1 assure that the Applicant will assist the Department as necessary (and will require subrecipients and contractors to assist as necessary) with the
Department's compliance with section 106 of the National Historic Preservation Act of 1966 (54 U.S.C. § 306108), the Archeological and Historical
Preservation Act of 1974 (54 U.S.C. §§ 312501-312508), and the National Environmental Policy Act of 1969 (42 U.S.C. §§ 4321-4335), and 28 C.F.R. Parts
61 (NEPA) and 63 (floodplains and wetlands).
(7) 1 assure that the Applicant will give the Department and the Government Accountability Office, through any authorized representative, access to, and
opportunity to examine, all paper or electronic records related to the award (if any) made by the Department based on the application.
(8) 1 assure that, if the Applicant is a governmental entity, with respect to the award (if any) made by the Department based on the application--
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a. it will comply with the requirements of the Uniform Relocation Assistance and Real Property Acquisitions Act of 1970 (42 U.S.C. §§ 4601-4655), which
govern the treatment of persons displaced as a result of federal and federally -assisted programs; and
b. it will comply with requirements of 5 U.S.C. §§ 1501-1508 and 7324-7328, 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.
(9) If the Applicant applies for and receives an award from the Office of Community Oriented Policing Services (COPS Office), I assure that as required by
34 U.S.C. § 10382(c)(11), it will, to the extent practicable and consistent with applicable law —including, but not limited to, the Indian Self- Determination and
Education Assistance Act —seek, recruit, and hire qualified members of racial and ethnic minority groups and qualified women in order to further effective
law enforcement by increasing their ranks within the sworn positions, as provided under 34 U.S.C. § 10382(c)(11).
(10) If the Applicant applies for and receives a DOJ award under the STOP School Violence Act program, I assure as required by 34 U.S.C. § 10552(a)(3),
that it will maintain and report such data, records, and information (programmatic and financial) as DOJ may reasonably require.
I acknowledge that a materially false, fictitious, or fraudulent statement (or concealment or omission of a material fact) in this certification, or in the
application that it supports, may be the subject of criminal prosecution (including under 18 U.S.C. §§ 1001 and/or 1621, and/or 34 U.S.C. §§ 10271-10273),
and also may subject me and the Applicant to civil penalties and administrative remedies for false claims or otherwise (including under 31 U.S.C. §§ 3729-
3730 and 3801-3812). 1 also acknowledge that the Department's awards, including certifications provided in connection with such awards, are subject to
review by the Department, including by its Office of the Inspector General.
Signature of Law Enforcement Executive/Agency Executive (For your electronic signature, please type in your name) Peter Koerner
Peter Koerner —�
Date:
03/09/2020
Signature of Government Executive/Financial Official (For your electronic signature, please type in your name) Jennifer Levitt
I
Date:
I
SECTION 1513: U. S. DEPARTMENT OF JUSTICE 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. The certifications shall be treated as a material representation of fact
upon which reliance will be placed when the U.S. Department of Justice ("Department") determines to award the covered transaction, grant, or cooperative
agreement.
1. Lobbying
As required by 31 U.S.C. § 1352, as implemented by 28 C.F.R. Part 69, the Applicant certifies and assures (to the extent applicable) the following:
(a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the Applicant, 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, or the extension, continuation, renewal, amendment, or modification
of any Federal grant or cooperative agreement;
(b) If the Applicant's request for Federal funds is in excess of $100,000, and 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 Applicant shall complete and submit Standard
Form - LLL, "Disclosure of Lobbying Activities" in accordance with its (and any DOJ awarding agency's) instructions; and
(c) The Applicant shall require that the language of this certification be included in the award documents for all subgrants and procurement contracts (and
their subcontracts) funded with Federal award funds and shall ensure that any certifications or lobbying disclosures required of recipients of such subgrants
and procurement contracts (or their subcontractors) are made and filed in accordance with 31 U.S.C. § 1352.
2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS
A. Pursuant to Department regulations on nonprocurement debarment and suspension implemented at 2 C.F.R. Part 2867, and to other related
requirements, the Applicant certifies, with respect to prospective participants in a primary tier "covered transaction," as defined at 2 C.F.R. § 2867.20(a), that
neither it nor any of its principals —
(a) is presently debarred, suspended, proposed for debarment, declared ineligible, sentenced to a denial of Federal benefits by a State or Federal court, or
voluntarily excluded from covered transactions by any Federal department or agency;
(b) has within a three-year period preceding this application been convicted of a felony criminal violation under any Federal law, or been convicted or had a
civil judgment rendered against it for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public
(Federal, State, tribal, or local) transaction or private agreement or transaction; violation of Federal or State antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion or receiving stolen property, making false
claims, or obstruction of justice, or commission of any offense indicating a lack of business integrity or business honesty that seriously and directly affects its
(or its principals') present responsibility;
(c) is presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, tribal, or local) with commission of any of the
offenses enumerated in paragraph (b) of this certification; and/or
(d) has within a three-year period preceding this application had one or more public transactions (Federal, State, tribal, or local) terminated for cause or
default.
B. Where the Applicant is unable to certify to any of the statements in this certification, it shall attach an explanation to this application. Where the Applicant
or any of its principals was convicted, within a three-year period preceding this application, of a felony criminal violation under any Federal law, the Applicant
also must disclose such felony criminal conviction in writing to the Department (for OJP Applicants, to OJP at mailto:Ojpcompliancereporting@usdoj.gov ;
for OVW Applicants, to OVW at mailto:OVW.GFMD@usdoj.gov; or for COPS Applicants, to COPS at mailto:AskCOPSRC@usdoj.gov), unless such
disclosure has already been made.
3. FEDERAL TAXES
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A. If the Applicant is a corporation, it certifies either that (1) the corporation has no unpaid Federal tax liability that has been assessed, for which all judicial
and administrative remedies have been exhausted or have lapsed, that is not being paid in a timely manner pursuant to an agreement with the authority
responsible for collecting the tax liability, or (2) the corporation has provided written notice of such an unpaid tax liability (or liabilities) to the Department (for
OJP Applicants, to OJP at mailto:Ojpcompliancereporting@usdoj.gov; for OVW Applicants, to OVW at mailto:OVWGFMD@usdoj.gov; or for COPS
Applicants, to COPS atmailto:AskCOPSRC@usdoj.gov).
B. Where the Applicant is unable to certify to any of the statements in this certification, it shall attach an explanation to this application.
4. DRUG -FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS)
As required by the Drug -Free Workplace Act of 1988, as implemented at 28 C.F.R. Part 83, Subpart F, for grantees, as defined at 28 C.F.R. §§ 83.620 and
83.650:
A. The Applicant certifies and assures 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 its 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—
(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;
(c) Making it a requirement that each employee to be engaged in the performance of the award 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 award, the employee will—
(1) Abide by the terms of the statement; and
(2) Notify the employer in writing of the employee's conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar
days after such conviction;
(e) Notifying the Department, in writing, within 10 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 of any such convicted employee to the
Department, as follows:
For COPS award recipients - COPS Office, 145 N Street, NE, Washington, DC, 20530;
For OJP and OVW award recipients - U.S. Department of Justice, Office of Justice Programs, ATTN: Control Desk, 810 7th Street, N.W., Washington, D.C.
20531.
Notice shall include the identification number(s) of each affected award;
(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; and
(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)
5. COORDINATION REQUIRED UNDER PUBLIC SAFETY AND COMMUNITY POLICING PROGRAMS
As required by the Public Safety Partnership and Community Policing Act of 1994, at 34 U.S.C. § 10382(c)(5), if this application is for a COPS award, the
Applicant certifies that there has been appropriate coordination with all agencies that may be affected by its award. Affected agencies may include, among
others, Offices of the United States Attorneys; State, local, or tribal prosecutors; or correctional agencies.
I acknowledge that a materially false, fictitious, or fraudulent statement (or concealment or omission of a material fact) in this certification, or in the
application that it supports, may be the subject of criminal prosecution (including under 18 U.S.C. §§ 1001 and/or 1621, and/or 34 U.S.C. §§ 10271-10273)
and also may subject me and the Applicant to civil penalties and administrative remedies for false claims or otherwise (including under 31 U.S.C. §§ 3729-
3730 and 3801-3812). 1 also acknowledge that the Department's awards, including certifications provided in connection with such awards, are subject to
review by the Department, including by its Office of the Inspector General.
Signature of Law Enforcement Executive/Agency Executive (For your electronic signature, please type in your name) Peter Koerner
Date:
Signature of Government Executive/Financial Official (For your electronic signature, please type in your name) Jennifer Levitt
I
Date:
f I Where the Applicant is unable to certify to any of the statements in this certification, it shall attach an explanation to this application in Section 13.
SECTION 16A: DISCLOSURE OF LOBBYING ACTIVITIES
This section duplicates OMB's Instructions for Completion of SF-LLL, Disclosure of Lobbying Activities
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered
Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. § 1352, The filing of a form is required for each payment or agreement to
make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or
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employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Complete all items that apply for both the
initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter
the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal
action.
4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District number, if known. Check the appropriate
classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first
subawardee of the prime is the 1 st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under awards.
5. If the organization filing the report in item 4 checks "Subawardee," then enter the full name, address, city, state and zip code of the prime Federal
recipient. Include Congressional District, if known.
6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For
example, U.S. Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance
(CFDA) number for grants, cooperative agreements, loans and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number;
Invitation for Bid (IFB) number; award announcement number; the contract, grant, or loan award number; the application/proposal control number assigned
by the Federal agency). Include prefixes, e.g., "RFPD E-90-001."
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan
commitment for the prime entity identified in item 4 or 5.
10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting registrant identified in item 4 to influence the
covered Federal action.
(b) Enter the full name(s) of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and Middle
Initial (MI).
11. The certifying official shall sign and date the form, print his/her name, title and telephone number.
According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB
control number. The valid OMB control number for this information collection is OMB No. 4040-0013 Public reporting burden for this collection of information
is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (4040-
0013), Washington, DC 20503.
Disclosure of Lobbying Activities
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. § 1352.
U Not Applicable
1. Type of Federal Action:
�> a. contract
b. grant
O c. cooperative agreement
O d.loan
e. loan guarantee
f. loan insurance
2. Status of Federal Action:
a. bid/offer/application
<) b. initial award
c. post -award
3. Report Type:
a. initial filing
C� b. material change
For Material Change Only: if you select "b. material change" above, the following three fields are required.
4. Name and Address of Reporting Entity:
Congressional District, if known:
rI
a. Prime
O b. Subawardee
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6. Federal Department/Agency:
7. Federal Program Name/Description:
CFDA Number, if applicable:
8. Federal Action Number, if known:
9. Award Amount, if known:
1
10. a. Name and Address of Lobbying Registrant (if individual):
10 b. Individuals Performing Services (including address if different from No.10a):
11. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying activities is a material
representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is
required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection.
Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for
each such failure.
Signature (For your electronic signature, please type in your name):
Title:
Telephone Number:
0
DATE:
0
Federal Use Only:
Authorized for Local Reproduction, Standard Form - LLL
SECTION 16 C: CERTIFICATION OF 287(G) PARTNERSHIP AND CERTIFICATION OF
ILLEGAL IMMIGRATION COOPERATION
State and local law enforcement agency applicants have the opportunity to receive additional points based on their cooperation with federal
immigration officials to address illegal immigration.
A. State or local law enforcement agency applicants may receive additional points if the agency has a 287(g) partnership, defined for this purpose as a
partnership with the U.S. Department of Homeland Security ("DHS") under 8 U.S.C. § 1357(g)(1) whereby officers of the applicant entity are delegated
limited immigration officer authority to identify and process for removal aliens in the custody of the entity named below under the direction and supervision of
DHS, documented with the official 287(g) Memorandum of Agreement with the Department of Homeland Security Immigration and Customs Enforcement.
To receive these additional points, please complete the following:
I J By checking this box I certify that this law enforcement agency applicant has a 287(g) Partnership documented with the official 287(g) Memorandum of
Agreement with the Department of Homeland Security Immigration and Customs Enforcement as of the date that this application is submitted.
B. State and local law enforcement agency applicants may be eligible to receive additional points by certifying willingness to cooperate with federal
immigration officials within their detention or correctional facilities. To be eligible to receive these additional points, your agency must operate a detention or
correctional facility, defined for this purpose as a prison or jail in which individuals are fingerprinted and detained for periods of 24 hours or longer. To
determine whether your agency is eligible to receive these additional points, please complete the following:
i I Yes, my agency operates its own detention or correctional facility (a prison or jail in which individuals are fingerprinted and detained for periods of 24
hours or longer).
O No, my agency does not operate a detention or correctional facility (a prison or jail in which individuals are fingerprinted and detained for periods of 24
hours or longer).
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SECTION 17: REVIEWS AND CERTIFICATIONS
1) Federal Civil Rights and Award Reviews:
Please be advised that an application may not be funded and, if awarded, a hold may be placed on the award if it is deemed that the applicant is not in
compliance with federal civil rights laws, and/or is not cooperating with an ongoing federal civil rights investigation, and/or is not cooperating with a U.S.
Department of Justice award review or audit.
2) Certification of Review of 28 C.F.R. Part 23/Criminal Intelligence Systems:
Please review the COPS Office application guide: Legal Requirements Section for additional information.
Please check one of the following, as applicable to your agency's intended use of this award:
No, my agency will not use these COPS Office funds (if awarded) to operate an interjurisdictional criminal intelligence system.
Yes, my agency will use these COPS Office funds (if awarded) to operate an interjurisdictional criminal intelligence system. By signing below, we assure
that our agency will comply with the requirements of 28 C.F.R. Part 23.
3) Certification of Review and Representation of Compliance with Requirements:
The signatures of the Law Enforcement Executive/Agency Executive, Government Executive/Financial Official, and the Person Submitting this Application
on the Reviews and Certifications represent to the COPS Office that:
a) the signatories have been legally and officially authorized by the appropriate governing body to submit this application and act on behalf of the applicant
entity;
b) the applicant will comply with all legal, administrative, and programmatic requirements that govern the applicant for acceptance and use of federal funds
as outlined in the applicable COPS Office application guide, the COPS Office award owner's manual, Assurances, Certifications and all other applicable
program regulations, laws, orders, and circulars;
c) the applicant understands that false statements or claims made in connection with COPS Office programs may result in fines, imprisonment, debarment
from participating in federal awards, cooperative agreements, or contracts, or any other remedy available by law to the Federal Government;
d) the information provided in this application, including any amendments, shall be treated as material representations of fact upon which reliance will be
placed when the U.S. Department of Justice determines to fund the covered award;
e) the applicant understands that as a general rule COPS Office funding may not be used for the same item or service funded through another funding
source; and
f) the applicant and any required or identified official partner(s) listed in section 12 are partners in this award project and mutually agreed to this partnership
prior to this application.
The signatures of the Law Enforcement Executive/Agency Executive and the Government Executive/Financial Official on this application must be the same
as those identified in Section 4 of this application. Applications with missing, incomplete, or inaccurate signatories or responses may not be considered for
funding.
Signature of Law Enforcement Executive/Agency Executive (For your electronic signature, please type in your name) Peter Koerner
Date:
Signnature of Government Executive/Financial Official (For your electronic signature, please type in your name) Jennifer Levitt
I
Date:
Signature of Person Submitting This Application (For your electronic signature, please type in your name)
Date:
By clicking this box, the applicant understands that the use of typed names in this application and the required forms, including the Assurances,
Certifications, and Disclosure of Lobbying Activities form, constitute electronic signatures and that the electronic signatures are the legal equivalent of
handwritten signatures.
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