AGR-7016 - STATE OF CALIFORNIA OFFICE OF TRAFFIC SAFETY - TRAFFIC RECORDS IMPROVEMENT PROJECT 10-1-20 THRU 9-30-21A R-701 b
State of California—Office of Traffic Safety GRANT NUMBER
GRANT AGREEMENT TR21032
1. GRANT TITLE
Traffic Records Improvement Project
2. NAME OF AGENCY 3. Grant Period
Orange From: 10/01/2020
4. AGENCY UNIT TO ADMINISTER GRANT To: 09/30/2021
Orange Police Department
5. GRANT DESCRIPTION
State and local agencies need timely, accurate, complete, accessible, and uniform traffic records to identify
and prioritize traffic safety issues, to choose appropriate safety countermeasures and evaluate their
effectiveness. Traffic records improvement grants provide traffic safety stakeholders with the ability to plan
and initiate traffic records improvement projects such as the purchase and implementation of traffic crash
re ortin s stems as well as electronic citation e ui ment and software.
6. Federal Funds Allocated Under This Agreement Shall Not Exceed:24,800.00
7. TERMS AND CONDITIONS: The parties agree to comply with the terms and conditions of the following which are by
this reference made a part of the Agreement:
Schedule A—Problem Statement, Goals and Objectives and Method of Procedure
Schedule B—Detailed Budget Estimate and Sub-Budget Es4imate(if applicable)
Schedule B-1 —Budget Narrative and Sub-Budget Narrative (if applicable)
Exhibit A—Certifications and Assurances
Exhibit B*—OTS Grant Program Manual
Exhibit C—Grant Electronic Management System (GEMS)Access
Items shown with an asterisk("), are hereby incorporated by reference and made a part of this agreement as if
attached hereto.
These documents can be viewed at the OTS home web page under Grants: www.ots.ca.gov.
We, the officials named below, hereby swear under penalty of perjury under the laws of the State of California that we
are duly authorized to legally bind the Grant recipient to the above described Grant terms and conditions.
IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.
8. Approval Signatures
A. GRANT DIRECTOR B. AUTHORIZING OFFICIAL
Na,Me: Trevor Cullen ADDRESS: RICI(OttO
Tir e: Sergeant City Manager
Ennai: tcullen@orangepd.org rotto@cityoforange.org
PHONe: (714)744-7323 714-744-2203
AooRess: 1107 N.Batavia St. 300 E. Chapman Avenue
Orange, CA 92866 Orange, CA 92866
l'R-'- Aug 12,2020 Au 12 2020
N,,,,,„,..,o,,::n x,.:o,:,h g ,
Signature) Date) Signature) Date)
C. FISCAL OFFICIAL D. AUTHORIZING OFFICIAL OF OFFICE OF TRAFFIC SAFETY
Ao Ress: Hilda Montoya AooRess: Barbara Rooney
Administrative Analyst Director
hmontoya@orangepd.org barbara.rooney@ots.ca.gov
714-744-7522 916)509-3030
1107 N.Batavia Street 2208 Kausen Drive Suite 300
Orange, CA 92867 Elk Grove, CA 95758
h`il fa loh oKa Aug 12,2020 Aug 14,2020Hud,uo i y,i.w:v.?.:,n o•.,ron
Signature) Date) Signature) Date)
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E. ACCOUNTING OFFICER OF OFFICE OF TRAFFIC SAFETY 9. DUNS INFORMATION
NnMe: Carolyn Vu DUNS#: 089140982
AooRess: 2208 Kausen Drive,Suite 300 REGISTERED
Elk Grove,CA 95758 A oRess: 1107 N.Batavia Street,Orange, CA 92867
CiTv: Orange
ZiP+4: 92867-4615
10. PROJECTED EXPENDITURES
FUND CFDA ITEM/APPROPRIATION F.Y. CHAPTER STATUTE
PROJECTED
EXPENDITURES
405c TR-21 20.616 0521-0890-101 2020 2020 BA/20 24,800.00
AGREEMENT
24,800.00
TOTAL
AMOUNT ENCUMBERED BY THIS DOCUMENT
24,800.00
I CERTIFY upon my own personal knowledge that the budgeted
PRIOR AMOUNT ENCUMBERED FOR THIS
funds for the current budget year are available for the period and
AGREEMENT
purpose of the expenditure stated above.
0.00
OTS ACCOUNTING OFFICER'S SIGNATURE DATE SIGNED TOTAL AMOUNT ENCUMBERED TO DATE
caro4/vn u g , 24 800.00
iarv ynvu(nugP.lovo'l:scnn
1U 12 2 20
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State of California—Office of Traffic Safety GRANT NUMBER
GRANT AGREEMENT TR21032
Schedule A
1. PROBLEM STATEMENT
State and local agencies need timely, accurate, complete, accessible, and uniform traffic records to identify
and prioritize traffic safety issues, to choose appropriate safety countermeasures and evaluate their
effectiveness. Currently, the California Highway Patrol collects this data via the Statewide Integrated Traffic
Records System (SWITRS)from law enforcement agencies throughout the state. The Orange Police
Department utilizes the CHP 555 traffic collision form to collect local traffic collision data for input into
SWITRS. In 2018, the department purchased Crossroads Collision Report Writer software to improve
efficiency and accuracy in its collision reporting. This system, however, does not communicate directfy with
SWITRS. In order to get Orange PD's collision data into SWITRS, records personnel have to physically print
a copy of the collision report and then mail it to CHP where it must be manually entered into the database.
Considering the police department takes over a thousand traffic collision reports a year, this is not only labor
intensive, but it creates unnecessa dela s and backlo s with accessin collision data and statistics.
2. PERFORMANCE MEASURES
A. Goals:
1. Reduce the number of persons injured in traffic crashes.
2. Reduce the number of persons killed in traffic crashes.
B. Objectives: Target Number
1. Upgrade existing electronic crash reporting program to the latest version available 1
that includes the capability of exporting complete crash report records to a
departmental records management system and the California Highway Patrol's
Statewide Integrated Traffic Records S stem.
3. METHOD OF PROCEDURE
A. Phase 1 — Proaram Preparation (15t Quarter of Grant Year)
The department will develop operational plans to implement the interface as outlined in the
objectives section.
The department will work with internal IT staff to coordinate and prepare for the implementation
of the interface.
All training needed to implement the interface should be conducted in the first quarter.
All grant related purchases needed to implement the interface should be made in the first quarter.
B. Phase 2— Proqram Operations (Throughout Grant Year)
Implementation of the Crossroads interface#o upload Collision Report Data and documents to
the California Highwa Patrol SWITRS system.
C. Phase 3—Data Collection 8 Reportinq (Throughout Grant Year)
1. Prepare and submit invoice claims (due January 30, April 30, July 30, and October 30).
Successful project completion and confirmation of successful transmission by the
California Highway Patrol is required before submission of invoice claims seeking
reimbursement from OTS:
2. Prepare and submit quarterly performance reports (due January 30, April 30, July 30, and
October 30).
Collect and report quarterly appropriate data that supports the progress of goals and
objectives.
Provide a summary of quarterly accomplishments and explanations for objectives not
completed.
Collect, anal ze, and re ort statistical data relatin to the rant oals and ob'ectives
4. METHOD OF EVALUATION
Using the data compiled during the grant, the Grant Director will complete the"Final Evaluation" section in
the fourth/final Quarterly Performance Report(QPR). The Final Evaluation should provide a brief summary
of the grant's accomplishments, challenges and significant activities. This narrative should also include
whether goals and objectives were met, exceeded, or an explanation of why objectives were not completed.
5. ADMINISTRATIVE SUPPORT
This program has full administrative support, and every effort will be made to continue the grant activities
after grant conclusion.
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i
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State of California—Office of Traffic Safety GRANT NUMBER
GRANT AGREEMENT TR21032
Schedule B
FUND NUMBER CATALOG FUND DESCRIPTION TOTAL AMOUNT
NunnBeR(CFDA
405c TR-21 20.616 State Traffic Safety Information 24,800.00
S stem Improvements
COST CATEGORY FUND UNIT COST OR UNITS TOTAL COST TO
NUMBER RATE GRANT
A. PERSONNEL COSTS
Positions and Salaries
Straight Time
0.00
Overtime
0.00
Category Sub-Total 0.00
B. TRAVEL EXPENSES
0.00
0.00
Category Sub-Total 0.00
C. CONTRACTUAL SERVICES
Traffic Crash Database System Update 405c TR-21 24,800.00 1 24,800.00
Category Sub-Total 24,800.00
D. EQUIPMENT
0.00
Category Sub-Total 0.00
E. OTHER DIItECT COSTS
0.00
Category Sub-Total 0.00
F. INDIItECT COSTS
0.00
Category Sub-Total 0.00
GRaivT ToTaL 24,800.00
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State of California—Office of Traffic Safety GRANT NUMBER
GRANT AGREEIVIENT TR21032
Schedule B-1
BUDGET NARRATIVE
PERSONNEL COSTS
TRAVEL EXPENSES
CONTRACTUAL SERVICES
Traffic Crash Database System Update -An update to the traffic crash database and geographic information
system (GIS)to the most current forms, operating system, and version. Costs may include software,
licenses, training, accessories, and associated shipping and taxes.
EQUIPMENT
OTHER DIRECT COSTS
INDIRECT COSTS
STATEMENTS/DISCLAIMERS
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State of California—Office of Traffic Safety GRANT NUMBER
GRANT AGREEMENT TR21032
Exhibit A
CERTIFICATIONS AND ASSURANCES
HIGHWAY SAFETY GRANTS
23 U.S.C. CHAPTER 4 AND SEC. 1906, PUB. L. 109-59,AS AMENDED
Failure to comply with applicable Federal statutes,regulations, and directives may subject Grantee Agency
officials to civil or criminal penalties and/or place State in a high-risk grantee status in accordance with 49 CFR
18.12.
The Officials named on the grant agreement signature page, that the Grantee Agency complies with all
applicable Federal statutes,regulations, and directives and State rules, guidelines,policies and laws in effect
with respect to the periods for which it receives grant funding. Applicable provisions include but are not limited
to the following:
GENERAL REQUIREMENTS
23 U.S.C. Chapter 4— Highway Safety Act of 1966, as amended
2 CFR part 200—Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards
49 CFR Part 18- Uniform Administrative Requirements for Grants and Cooperative Agreements to State
and Local Governments.
23 CFR part 1300— Uniform Procedures for State Highway Safety Grant Programs
NONDISCRINIINATION
applies to subrecipients as well as States)
The State highway safety agency will comply with all Federal statutes and implementing regulations relating to
nondiscrimination("Federal Nondiscrimination Authorities"). These include but are not limited to:
Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq., 78 stat. 252), (prohibits discrimination on
the basis of race, color, national origin) and 49 CFR part 21;
The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C. 4601),
prohibits unfair treatment of persons displaced or whose property has been acquired because of Federal or
Federal-aid programs and projects);
Federal-Aid Highway Act of 1973, (23 U.S.C. 324 et seq.), and Title IX of the Education Amendments of
1972, as amended(20 U.S.C. 1681-1683 and 1685-1686) (prohibit discrimination on the basis of sex);
Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. 794 et seq.), as amended, (prohibits discrimination
on the basis of disability) and 49 CFR part 27;
The Age Discrimination Act of 1975, as amended, (42 U.S.C. 6101 et seq.), (prohibits discrimination on the
basis of age);
The Civil Rights Restoration Act of 1987, (Pub. L. 100-209), (broadens scope, coverage and applicability of
Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975 and Section 504 of the
Rehabilitation Act of 1973,by expanding the definition of the terms "programs or activities"to include all of the
programs or activities of the Federal aid recipients, subrecipients and contractors,whether such programs or
activities are Federally-funded or not);
Titles II and III of the Americans with Disabilities Act(42 U.S.C. 12131-12189) (prohibits discrimination
on the basis of disability in the operation of public entities, public and private transportation systems,places of
public accommodation, and certain testing) and 49 CFR parts 37 and 38;
Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and
Low-Income Populations (prevents discrimination against minority populations by discouraging programs,
policies, and activities with disproportionately high and adverse human health or environmental effects on
minority and low-income populations); and
Executive Order 13166, Improving Access to Services for Persons with Limited English Proficiency
guards against Title VI national origin discrimination/discrimination because of limited English proficiency(LEP)
by ensuring that funding recipients take reasonable steps to ensure that LEP persons have meaningful access
to programs (70 FR 74087-74100).
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The State highway safety agency—
Will take all measures necessary to ensure that no person in the United States shall, on the grounds of race,
color, national origin, disability, sex, age, limited English proficiency, or membership in any other class
protected by Federal Nondiscrimination Authorities, be excluded from participation in, be denied the benefits of,
or be otherwise subjected to discrimination under any of its programs or activities, so long as any portion of the
program is Federally-assisted;
Will administer the program in a manner that reasonably ensures that any of its subrecipients, contractors,
subcontractors, and consultants receiving Federal financial assistance under this program will comply with all
requirements of the Non-Discrimination Authorities identified in this Assurance;
Agrees to comply(and require its subrecipients, contractors, subcontractors, and consultants to comply)with
all applicable provisions of law or regulation governing US DOT's or NHTSA's access to records, accounts,
documents, information, facilities, and staff, and to cooperate and comply with any program or compliance
reviews, and/or complaint investigations conducted by US DOT or NHTSA under any Federal Nondiscrimination
Authority;
Acknowledges that the United States has a right to seek judicial enforcement with regard to any matter arising
under these Non-Discrimination Authorities and this Assurance;
Agrees to insert in all contracts and funding agreements with other State or private entities the following
clause:
During the performance of this contract/funding agreement, the contractor/funding recipient agrees—
a. To comply with all Federal nondiscrimination laws and regulations, as may be amended from time to time;
b. Not to participate directly or indirectly in the discrimination prohibited by any Federal non-discrimination law
or regulation, as set forth in appendix B of 49 CFR part 21 and herein;
c. To permit access to its books, records, accounts, other sources of information, and its facilities as required by
the State highway safety office, US DOT or NHTSA;
d. That, in event a contractor/funding recipient fails to comply with any nondiscrimination provisions in this
contract/funding agreement, the State highway safety agency will have the right to impose such
contract/agreement sanctions as it or NHTSA determine are appropriate, including but not limited to withholding
payments to the contractor/funding recipient under the contract/agreement until the contractor/funding recipient
complies; and/or cancelling, terminating, or suspending a contract or funding agreement, in whole or in part;
and
e. To insert this clause, including paragraphs (a)through (e), in every subcontract and subagreement and in
every solicitation for a subcontract or sub-agreement, that receives Federal funds under this program.
POLITICAL ACTIVITY (HATCH ACT)
applies to subrecipients as well as States)
The state will comply with provisions of the Hatch Act(5 U.S.C. 1501-1508),which limits the political activities
of employees whose principal employment activities are funded in whole or in part with Federal funds.
CERTIFICATION REGARDING FEDERAL LOBBYING
applies to subrecipients as well as States)
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
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1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress,
an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding
of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of
any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal contract, grant, loan, or cooperative agreement;
2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer
or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract,
grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL,
Disclosure Form to Report Lobbying," in accordance with its instructions;
3. The undersigned shall require that the language of this certification be included in the award documents for
all sub-award at all tiers (including subcontracts, subgrants, and contracts under grant, loans, and cooperative
agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification
shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
RESTRICTION ON STATE LOBBYING
applies to subrecipients as well as States)
None of the funds under this program will be used for any activity specifically designed to urge or influence a
State or local legislator to favor or oppose the adoption of any specific legislative proposal pending before any
State or local legislative body. Such activities include both direct and indirect(e.g., "grassroots") lobbying
activities, with one exception. This does not preclude a State official whose salary is supported with NHTSA
funds from engaging in direct communications with State or local legislative officials, in accordance with
customary State practice, even if such communications urge legislative officials to favor or oppose the adoption
of a specific pending legislative proposal.
CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
applies to subrecipients as well as States)
Instructions for Primary Tier Participant Certification (States)
1. By signing and submitting this proposal, the prospective primary tier participant is providing the certification
set out below and agrees to comply with the requirements of 2 CFR parts 180 and 1200.
2. The inability of a person to provide the certification required below will not necessarily result in denial of
participation in this covered transaction. The prospective primary tier participant shall submit an explanation of
why it cannot provide the certification set out below. The certification or explanation will be considered in
connection with the department or agency's determination whether to enter into this transaction. However,
failure of the prospective primary tier participant to furnish a certification or an explanation shall disqualify such
person from participation in this transaction.
3. The certification in this clause is a material representation of fact upon which reliance was placed when the
department or agency determined to enter into this transaction. If it is later determined that the prospective
primary tier participant knowingly rendered an erroneous certification, in addition to other remedies available to
the Federal Government, the department or agency may terminate this transaction for cause or default or may
pursue suspension or debarment.
4. The prospective primary tier participant shall provide immediate written notice to the department or agency to
which this proposal is submitted if at any time the prospective primary tier participant learns its certification was
erroneous when submitted or has become erroneous by reason of changed circumstances.
5. The terms covered transaction, civil judgment, debarment, suspension, ineligible, participant, person,
principal, and volunfarily excluded, as used in this clause, are defined in 2 CFR parts 180 and 1200. You may
contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of
those regulations.
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6. The prospective primary tier participant agrees by submitting this proposal that, should the proposed covered
transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person
who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction, unless authorized by the department or
agency entering into this transaction.
7. The prospective primary tier participant further agrees by submitting this proposal that it will include the
clause titled "Instructions for Lower Tier Participant Certification" including the "Certification Regarding
Debarment, Suspension, Ineligibility and Voluntary Exclusion—Lower Tier Covered Transaction," provided by
the department or agency entering into this covered transaction, without modification, in all lower tier covered
transactions and in all solicitations for lower tier covered transactions and will require lower tier participants to
comply with 2 CFR parts 180 and 1200.
8. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier
covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred,
suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification
is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or
otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the
eligibility of any prospective lower tier participants, each participant may, but is not required to, check the
System for Award Management Exclusions website (https://www.sam.gov/).
9. Nothing contained in the foregoing shall be construed to require establishment of a system of records in
order to render in good faith the certification required by this clause. The knowledge and information of a
participant is not required to exceed that which is normally possessed by a prudent person in the ordinary
course of business dealings.
10. Except for transactions authorized under paragraph 6 of these instructions, if a participant in a covered
transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment
under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in
this transaction, in addition to other remedies available to the Federal government, the department or agency
may terminate the transaction for cause or default.
Certification Regarding Debarment, Suspension, and Other Responsibilify Mafters-Primary Tier Covered
Transactions
1)The prospective primary tier participant certifies to the best of its knowledge and belief, that it and its
principals:
a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded
from participating in covered transactions by any Federal department or agency;
b) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment
rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to
obtain, or pertorming a public (Federal, State or local) transaction or contract under a public transaction;
violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery,
falsification or destruction of records, making false statements, or receiving stolen property;
c)Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity(Federal,
State or Local)with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and
d) Have not within a three-year period preceding this application/proposal had one or more public transactions
Federal, State, or local)terminated for cause or default.
2)Where the prospective primary tier participant is unable to certify to any of the Statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Instructions for Lower Tier Participant Certification
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1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set
out below and agrees to comply with the requirements of 2 CFR parts 180 and 1200.
2. The certification in this clause is a material representation of fact upon which reliance was placed when this
transaction was entered into. If it is later determined that the prospective lower tier participant knowingly
rendered an erroneous certification, in addition to other remedies available to the Federal government, the
department or agency with which this transaction originated may pursue available remedies, including
suspension or debarment.
3. The prospective lower tier participant shall provide immediate written notice to the person to which this
proposal is submitted if at any time the prospective lower tier participant learns that its certification was
erroneous when submitted or has become erroneous by reason of changed circumstances.
4. The terms covered fransaction, civil judgment, debarment, suspension, ineligible, participant, person,
principal, and voluntarily excluded, as used in this clause, are defined in 2 CFR parts 180 and 1200. You may
contact the person to whom this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered
transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person
who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction, unless authorized by the department or
agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will include the clause
titled "Instructions for Lower Tier Participant Certification" including the "Certification Regarding Debarment,
Suspension, Ineligibility and Voluntary Exclusion— Lower Tier Covered Transaction,"without modification, in all
lower tier covered transactions and in all solicitations for lower tier covered transactions and will require lower
tier participants to comply with 2 CFR parts 180 and 1200.
7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier
covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred,
suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification
is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or
otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the
eligibility of any prospective lower tier participants, each participant may, but is not required to, check the
System for Award Management Exclusions website (https://www.sam.gov/).
8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in
order to render in good faith the certification required by this clause. The knowledge and information of a
participant is not required to exceed that which is normally possessed by a prudent person in the ordinary
course of business dealings.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered
transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment
under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in
this transaction, in addition to other remedies available to the Federal government, the department or agency
with which this transaction originated may pursue available remedies, including suspension or debarment.
Certification Regarding Debarment, Suspension, Ineligibilify and Voluntary Exclusion --Lower Tier Covered
Transactions:
1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals
is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participating in covered transactions by any Federal department or agency.
2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification,
such prospective participant shall attach an explanation to this proposal.
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BUY AMERICA ACT
applies to subrecipients as well as States)
The State and each subrecipient will comply with the Buy America requirement(23 U.S.C. 313) when
purchasing items using Federal funds. Buy America requires a State, or subrecipient, to purchase with Federal
funds only steel, iron and manufactured products produced in the United States, unless the Secretary of
Transportation determines that such domestically produced items would be inconsistent with the public interest,
that such materials are not reasonably available and of a satisfactory quality, or that inclusion of domestic
materials will increase the cost of the overall project contract by more than 25 percent. In order to use Federal
funds to purchase foreign produced items, the State must submit a waiver request that provides an adequate
basis and justification for approval by the Secretary of Transportation.
PROHIBITION ON USING GRANT FUNDS TO CHECK FOR HELMET USAGE
applies to subrecipients as well as States)
The State and each subrecipient will not use 23 U.S.C. Chapter 4 grant funds for programs to check helmet
usage or to create checkpoints that specifically target motorcyclists.
POLICY ON SEAT BELT USE
In accordance with Executive Order 13043, Increasing Seat Belt Use in the United States, dated April 16, 1997,
the Grantee is encouraged to adopt and enforce on-the job seat belt use policies and programs for its
employees when operating company-owned, rented, or personally-owned vehicles. The National Highway
Traffic Safety Administration (NHTSA) is responsible for providing leadership and guidance in support of this
Presidential initiative. For information and resources on traffic safety programs and policies for employers,
please contact the Network of Employers for Traffic Safety(NETS), a public-private partnership dedicated to
improving the traffic safety practices of employers and employees. You can download information on seat belt
programs, costs of motor vehicle crashes to employers, and other traffic safety initiatives at
www.trafficsafety.org. The NHTSA website (www.nhtsa.gov) also provides information on statistics, campaigns,
and program evaluations and references.
POLICY ON BANNING TEXT MESSAGING WHILE DRIVING
In accordance with Executive Order 13513, Federal Leadership On Reducing Text Messaging While Driving,
and DOT Order 3902.10, Text Messaging While Driving, States are encouraged to adopt and enforce
workplace safety policies to decrease crashes caused by distracted driving, including policies to ban text
messaging while driving company-owned or rented vehicles, Government-owned, leased or rented vehicles, or
privately-owned vehicles when on official Government business or when performing any work on or behalf of
the Government. States are also encouraged to conduct workplace safety initiatives in a manner commensurate
with the size of the business, such as establishment of new rules and programs or re-evaluation of existing
programs to prohibit text messaging while driving, and education, awareness, and other outreach to employees
about the safety risks associated with texting while driving.
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State of California—Office of Traffic Safety GRANT NUMBER
OTS-55 Grant Electronic Management System (GEMS) Access TR21032
Exhibit C
INSTRUCTIONS FOR ADDING OR UPDATING GEMS USERS
1. Each agency is allowed a total of FIVE (5) GEMS Users.
2. GEMS Users listed on this form will be authorized to login to GEMS to complete and submit Quarterly
Performance Reports (QPRs) and reimbursement claims.
3. Complete the form if adding, removing or editing a GEMS user(s).
4. The Grant Director must sign this form and return it with the Grant Agreement.
GRANT DETAILS
Grant Number: TR21032
Agency Name: Orange Police Department
Grant Title: Traffic Records Improvement Project
Agreement Total: 24,800.00
Authorizing Official: Rick Otto
Fiscal Official:Hilda Montoya
Grant Director: Trevor Cullen
CURRENT GEMS USER(S)
1. Trevor Cullen
Title: Sergeant Media Contact: Yes
Phone: (714) 744-7323
Email: tcullen@orangepd.org
2. Phillip McMullin
Title: Sergeant Media Contact: Yes
Phone: (714) 744-7323
Email: pmcmullin@orangepd.org
3. Hilda Montoya
Title: Administrative Analyst Media Contact: No
Phone: 714-744-7522
Email: hmontoya@orangepd.org
7/20/2020 4:27:45 PM Page 13 of 14
Complete the below information if adding, removing or editing a GEMS user(s)
GEMS User 1 Add as a media contact? Yes No0
Add/Change Remove Access
Name Job Title
Email address Phone number
GEMS User 2 Add as a media contact? Yes No
Add/Change Remove Access
Name Job Title
Email address Phone number
GEMS User 3 Add as a media contact? Yes No
Add/Change Remove Access
Name Job Title
Email address Phone number
GEMS User 4 Add as a media contact? Yes No
Add/Change Remove Access
Name Job Title
Email address Phone number
GEMS User 5 Add as a media contact? Yes No
Add/Change Remove Access
Name Job Title
Email address Phone number
Form completed by: r e or u,n Date: Aug 12 2020u,,o.c nwn In o iz u:o ca:or vnn
As a signatory I hereby authorize the listed individual(s) to represent and have GEMS user access.
i2e, Z%oo.- Trevor Cullen
r zvo c uz„tn s r.=oao oxi:ro i
Signature Name
Aug 12,2020 Grant Director .
Date Title
7/20/2020 4:27:45 PM Page 14 of 14
Grant greernen - T 21032
Final Audit Report 2020-08-14
Created: 2020-07-20
By: Kristen Mickey(Kristen.mickey@ots.ca.gov)
Status: Signed
Transaction ID: CBJCHBCAABAA3V3KIDhr8yGv31TkgWsM1c-GI4u1yqLF
Grant Agreement - TR21032" History
Document created by Kristen Mickey(Kristen.mickey@ots.ca.gov)
2020-07-20-11:27:55 PM GMT-IP address:96.43.153.8
C'w Document emailed to Trevor Cullen (tcullen@orangepd.org)for signature
2020-07-20-11:28:01 PM GMT
Email viewed by Trevor Cullen (tcullen@orangepd.org)
2020-07-20-11:29:01 PM GMT-IP address:54.151.74.199
Email viewed by Trevor Cullen (tcullen@orangepd.org)
2020-07-28-1:36:02 AM GMT-IP address:13.52.101.64
Email viewed by Trevor Cullen (tcullen@orangepd.org)
2020-08-04-7:15:17 PM GMT-IP address:18.144.169.134
Email viewed by Trevor Cullen (tcullen@orangepd.org)
2020-08-12-4:06:04 PM GMT-IP address:54.241.143.192
6'o Document e-signed by Trevor Cullen (tcullen@orangepd.org)
Signature Date:2020-08-12-4:07:10 PM GMT-Time Source:server-IP address:67.52.125.42
C'o Document emailed to Trevor Cullen(tcullen@orangepd.org)for signature
2020-08-12-4:07:12 PM GMT
Email viewed by Trevor Cullen (tcullen@orangepd.org)
2020-08-12-4:10:19 PM GMT-IP address:67.52.125.42
do Document e-signed by Trevor Cullen (tcullen@orangepd.org)
Signature Date:2020-OS-12-4:12:00 PM GMT-Time Source:server-IP address:67.52.125.42
C'- Document emailed to Hilda Montoya(hmontoya@orangepd.org)for signature
2020-08-12-4:12:02 PM GMT
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TRAFFI AdOb£SIQ,I'l
S4FET'
Email viewed by Hilda Montoya (hmontoya@orangepd.org)
2020-08-12-4:12:23 PM GMT-IP address:54.241.143.192
b, Document e-signed by Hilda Montoya (hmontoya@orangepd.org)
Signature Date:2020-08-12-4:37:38 PM GMT-Time Source:server-IP address:67.52.125.42
C'y Document emailed to Rick Otto(rotto@cityoforange.org)for signature
2020-08-12-4:37:40 PM GMT
Email viewed by Rick Otto(rotto@cityoforange.org)
2020-08-13-0:05:34 AM GMT-IP address:67.52.190.252
rS'o Document e-signed by Rick Otto (rotto@cityoforange.org)
Signature Date:2020-08-13-0:06:02 AM GMT-Time Source:server-IP address:67.52.190.252
a Document emailed to Carolyn Vu (carolyn.vu@ots.ca.gov)for signature
2020-08-13-0:06:04 AM GMT
Email viewed by Carolyn Vu (carolyn.vu@ots.ca.gov)
2020-08-13-0:24:53 AM GMT-IP address:104.47.64.254
CP5' Document e-signed by Carolyn Vu (carolyn.vu@ots.ca.gov)
Signature Date:2020-08-13-0:25:02 AM GMT-Time Source:server-IP address:76.20.59.121
r pocument emailed to Barbara Rooney(barbara.rooney@ots.ca.gov)for signature
2020-08-13-0:25:04 AM GMT
Email viewed by Barbara Rooney(barbara.rooney@ots.ca.gov)
2020-08-14-7:31:29 PM GMT-IP address:104.47.65.254
t, Document e-signed by Barbara Rooney(barbara.rooney@ots.ca.gov)
Signature Date:2020-08-14-7:32:44 PM GMT-Time Source:server-IP address:74.46.253.92
Signed document emailed to Kristen Mickey(Kristen.mickey@ots.ca.gov), Barbara Rooney
barbara.rooney@ots.ca.gov), Hilda Montoya(hmontoya@orangepd.org), Carolyn Vu (carolyn.vu@ots.ca.gov),
and 3 more
2020-08-14-7:32:44 PM GMT
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