OMB Number: 4040-0004

Expiration Date: 12/31/2022

Application for Federal Assistance SF-424

* 1. Type of Submission: * 2. Type of Application: * If Revision, select appropriate letter(s):

Preapplication New

Application Continuation * Other (Specify):

Changed/Corrected Application Revision

* 3. Date Received: 4. Applicant Identifier:

Completed by Grants.gov upon submission.

5a. Federal Entity Identifier: 5b. Federal Award Identifier:

State Use Only:

6. Date Received by State: 7. State Application Identifier: Choose State...

8. APPLICANT INFORMATION:

* a. Legal Name: City of San Mateo

* b. Employer/Taxpayer Identification Number (EIN/TIN): * c. UEI:

94-6000422 R92YFGVKF6B4

d. Address:

* Street1: 330 W. 20th Avenue

Street2:

* City: San Mateo

County/Parish: San Mateo
* State: CA: California
Province:

* Country: USA: UNITED STATES

* Zip / Postal Code: 94403-1338

e. Organizational Unit:

Department Name: Division Name:

San Mateo Police Department Support Services

f. Name and contact information of person to be contacted on matters involving this application:

Prefix: * First Name: Tricia

Middle Name:

* Last Name: Toomey

Suffix:

Title: Business Manager

Organizational Affiliation:
City of San Mateo

* Telephone Number: 6505227623 Fax Number:

* Email: [email protected]
Application for Federal Assistance SF-424

* 9. Type of Applicant 1: Select Applicant Type:

C: City or Township Government

Type of Applicant 2: Select Applicant Type:

Type of Applicant 3: Select Applicant Type:

* Other (specify):

* 10. Name of Federal Agency:

Bureau of Justice Assistance

11. Catalog of Federal Domestic Assistance Number:

16.738
CFDA Title:
Edward Byrne Memorial Justice Assistance Grant Program

* 12. Funding Opportunity Number:

O-BJA-2022-171368

* Title:
BJA FY 22 Edward Byrne Memorial Justice Assistance Grant Program - Local Solicitation

13. Competition Identification Number:

C-BJA-2022-00154-PROD
Title:

Category 1 - Applicants with eligible allocation amounts of less than $25,000

14. Areas Affected by Project (Cities, Counties, States, etc.):

Add Attachment Delete Attachment View Attachment

* 15. Descriptive Title of Applicant's Project:

San Mateo Police Department Customer Service for Public Safety Software Project

Attach supporting documents as specified in agency instructions.

Add Attachments Delete Attachments View Attachments

Application for Federal Assistance SF-424

16. Congressional Districts Of:

* a. Applicant CA14 * b. Program/Project CA14

Attach an additional list of Program/Project Congressional Districts if needed.

Add Attachment Delete Attachment View Attachment

17. Proposed Project:

* a. Start Date: 07/01/2022 * b. End Date: 06/30/2023

18. Estimated Funding ($):

* a. Federal 21,088.00
* b. Applicant 0.00
* c. State 0.00
* d. Local 0.00
* e. Other 0.00

* f. Program Income 0.00

* g. TOTAL 21,088.00

* 19. Is Application Subject to Review By State Under Executive Order 12372 Process?

a. This application was made available to the State under the Executive Order 12372 Process for review on 08/02/2022 .

b. Program is subject to E.O. 12372 but has not been selected by the State for review.

c. Program is not covered by E.O. 12372.

* 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.)
Yes No

If "Yes", provide explanation and attach

Add Attachment Delete Attachment View Attachment

21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to
comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may
subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 18, Section 1001)

** I AGREE

** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency
specific instructions.

Authorized Representative:

Prefix: * First Name: Tricia

Middle Name:

* Last Name: Toomey

Suffix:

* Title: Business Manager

* Telephone Number: 6505227623 Fax Number:

* Email: [email protected]

* Signature of Authorized Representative: Completed by Grants.gov upon submission. * Date Signed: Completed by Grants.gov upon submission.
PROPOSAL NARRATIVE

Grant: Edward Byrne Memorial Justice Assistance Grant Program 2022

Applicant: City of San Mateo, California
Project Title: San Mateo Police Department Customer Service for Public Safety
Software Project
Project Contract: Tricia Toomey, Business Manager
650-522-7623 [email protected]

BACKGROUND
The City of San Mateo is applying for funds from the Edward Byrne Memorial Justice
Assistance (JAG) program FY2022 Local Solicitation to fund a project titled the San Mateo
Police Department Customer Service for Public Safety Software Project The amount of funding
allocated for this application is $21,088.

Funds will be used to purchase software to modernize our customer service efforts. As a law
enforcement agency, our relationship with our community begins with our customers. The
software will optimize our operations with an automated customer service platform designed
specifically for public safety. The desired product will help determine the best way to engage
with the victim or caller (i.e. email or text); will automatically send a custom message to
reporting parties and 911 callers, keeping them updated on the status of their call; and will
collect subsequent feedback through mobile-friendly surveys. The intent is to increase trust,
enhance communication and ultimately improve service.

PERFORMANCE MEASURES AND GRANT REPORTING

The applicant will submit all quarterly financial status reports, semiannual progress reports, final
financial and progress reports, and will provide performance data on the OJP’s performance
measurement platform as required.

The City will establish a separate account to track and record all expenditures related to this
grant and will comply with all reporting requirements as outlined.
BUDGET NARRATIVE

Grant: Edward Byrne Memorial Justice Assistance Grant Program 2022

Applicant: City of San Mateo, California
Project Title: San Mateo Police Department Customer Service for Public Safety
Software Project
Project Contract: Tricia Toomey, Business Manager
650-522-7623 [email protected]

The City is eligible for $21,088 through the 2022 JAG program, and anticipates expending all
grant funds by June 30, 2023. The proposed budget is as follows:

EXPENDITURES
Item Description Cost
PERSONNEL $0
FRINGE BENEFITS $0
EQUIPMENT/TRAINING $0
SUPPLIES $0
CONSULTANTS/ $0
CONTRACTS
OTHER Customer Service for Public Safety $21,088
Software
TOTAL EXPENDITURES $21,088
FUNDING SOURCES
2022 JAG GRANT FUNDS $21,088
PROJECT TOTAL $21,088

The total expenses are estimated to cost approximately $21,088. The final cost for the Customer
Service for Public Safety Software will be known upon an assessment of our professional needs
for the software, and subsequent quotation/procurement processes have been conducted
according to local policies

A separate account to track and record all expenditures related to this grant will be established to
comply with all reporting requirements as outlined.
 Purpose Area #4

Budget Detail ‐ Year 1
Does this budget contain conference costs which is defined broadly to include meetings, retreats, seminars, symposia, and training activities? ‐ Y/N No
(DOJ Financial Guide, Section 3.10)
A. Personnel
Name Position Computation
List each name, if known. List each position, if known. Show annual salary rate & amount of time devoted to the project for each name/position.

Time Worked Percentage of  Non‐Federal  Federal 

Salary  Rate (# of hours, days, months,  Total Cost
Time Contribution Request
years)

$0 $0

Total(s) $0 $0 $0
Narrative

B. Fringe Benefits
Name Computation
List each grant‐supported position receiving fringe benefits. Show the basis for computation.

Non‐Federal  Federal 
Base Rate Total Cost
Contribution Request

$0 $0

Total(s) $0 $0 $0
Narrative

1
 Purpose Area #4

C. Travel
Purpose of Travel Location Type of Expense Basis Computation

Indicate the purpose of each trip  Per day, 
or type of trip (training, advisory  Indicate the travel destination. Lodging, Meals, Etc. mile, trip,  Compute the cost of each type of expense X the number of people traveling.
group meeting) Etc.

# of  Non‐Federal  Federal 

Cost Quantity # of Staff Total Cost
Trips Contribution Request

N/A $0 $0

Total(s) $0 $0 $0
Narrative

D. Equipment

2
 Purpose Area #4

Item Computation
List and describe each item of equipment that will be purchased Compute the cost (e.g., the number of each item to be purchased X the cost per item)

Non‐Federal  Federal 
# of Items Unit Cost Total Cost
Contribution Request

$0 $0

Total(s) $0 $0 $0
Narrative

E. Supplies
Supply Items Computation
Provide a list of the types of items to be purchased with grant funds. Describe the item and the compute the costs. Computation: The number of each item to be purchased X the cost per item.

Non‐Federal  Federal 
# of Items Unit Cost Total Cost
Contribution Request
$0 $0

Total(s) $0 $0 $0
Narrative

3
 Purpose Area #4

F. Construction
Purpose Description of Work Computation
Provide the purpose of the 
Describe the construction project(s) Compute the costs (e.g., the number of each item to be purchased X the cost per item)
construction
Non‐Federal  Federal 
# of Items Cost Total Cost
Contribution Request
$0 $0

Total(s) $0 $0 $0
Narrative

G. Subawards (Subgrants)
Description Purpose Consultant?

4
 Purpose Area #4

Is the subaward for a 
consultant? If yes, use 
Provide a description of the activities to be carried out by  the section below to 
Describe the purpose of the subaward (subgrant)
subrecipients. explain associated 
travel expenses 
included in the cost.

Non‐Federal  Federal 
Total Cost
Contribution Request
$0

Total(s) $0 $0 $0
Consultant Travel (if necessary)
Purpose of Travel Location Type of Expense Computation
Indicate the purpose of each trip 
or type of trip (training, advisory  Indicate the travel destination. Hotel, airfare, per diem Compute the cost of each type of expense X the number of people traveling.
group meeting)
Duration 
# of  Non‐Federal  Federal 
Cost or  Total Cost
Staff Contribution Request
Distance
$0 $0

Total $0 $0 $0
Narrative

H. Procurement Contracts
Description Purpose Consultant?

5
 Purpose Area #4

Is the subaward for a 
Provide a description of the products or services to be procured by 
consultant? If yes, use 
contract and an estimate of the costs.  Applicants are encouraged to 
the section below to 
promote free and open competition in awarding contracts.  A  Describe the purpose of the contract
explain associated 
separate justification must be provided for sole source procurements 
travel expenses 
in excess of the Simplified Acquisition Threshold (currently $150,000). 
included in the cost.

Non‐Federal  Federal 
Total Cost
Contribution Request

$0

Total(s) $0 $0 $0
Consultant Travel (if necessary)
Purpose of Travel Location Type of Expense Computation
Indicate the purpose of each trip 
or type of trip (training, advisory  Indicate the travel destination. Hotel, airfare, per diem Compute the cost of each type of expense X the number of people traveling.
group meeting)
Duration 
# of  Non‐Federal  Federal 
Cost or  Total Cost
Staff Contribution Request
Distance
$0 $0

Total $0 $0 $0
Narrative

I. Other Costs
Description  Computation
List and describe items that will be paid with grants funds (e.g. rent, 
reproduction, telephone, janitorial, or security services, and  Show the basis for computation
investigative or confidential funds).

6
 Purpose Area #4

Non‐Federal  Federal 
Quantity Basis Cost Length of Time Total Cost
Contribution Request

Customer Service for Public Safety Software 1 ea $21,088.00 1 $21,088 $21,088

$0 $0

$0 $0

Total(s) $21,088 $0 $21,088

Narrative
Funds will be used to purchase software to modernize our customer service efforts as well as build trust and enhance our relationship with our community.  

J. Indirect Costs
Description Computation
Describe what the approved rate is and how it is applied. Compute the indirect costs for those portions of the program which allow such costs.

Non‐Federal  Federal 
Base Indirect Cost Rate Total Cost
Contribution Request

$0 $0

Total(s) $0 $0 $0
Narrative

7
Purpose Area #4

8
CERTIFICATION AND ASSURANCES – LOCAL GOVERNING BODY REVIEW

Grant: Edward Byrne Memorial Justice Assistance Grant Program 2022

Applicant: City of San Mateo, California
Project Title: San Mateo Police Department Customer Service for Public Safety
Software Project
Project Contract: Tricia Toomey, Business Manager
650-522-7623 [email protected]

This 2022 JAG application will be made available to the local governing body, the San Mateo
City Council, as well as to citizens for public comment for a period of 30 days, after which time
the San Mateo City Council will review the 2022 JAG application at a public meeting where the
public will have an opportunity to comment on the application. After that time, the Chief
Executive or his/her designee will be able to execute the “Certification and Assurances.” As the
application will be submitted prior to the completion of the required 30 day review period, the
applicant understands a “Witholding Special Condition” will be placed on the award. The
applicant will subsequently submit the required certification that the public and City Council
have completed the requisite 30 day review period prior to any disbursement of grant funds.
DISCLOSURE OF PENDING APPLICATIONS/DISCLOSURE OF DUPLICATION IN
COST ITEMS

Grant: Edward Byrne Memorial Justice Assistance Grant Program 2022

Applicant: City of San Mateo, California
Project Title: San Mateo Police Department Customer Service for Public Safety
Software Project
Project Contract: Tricia Toomey, Business Manager
650-522-7623 [email protected]

The City of San Mateo does not have pending applications submitted within the last 12 months
for federally funded assistance that includes the request for funding to support the same project
being proposed under this solicitation and will cover the identical cost items outlined in the
budget narrative and worksheet in the application under this solicitation.
 1-800-518-4726
WORKSPACE FORM [email protected]

This Workspace form is one of the forms you need to complete prior to submitting your Application Package. This form can be completed in its entirety offline using
Adobe Reader. You can save your form by clicking the "Save" button and see any errors by clicking the “Check For Errors” button. In-progress and completed forms
can be uploaded at any time to Grants.gov using the Workspace feature.

When you open a form, required fields are highlighted in yellow with a red border. Optional fields and completed fields are displayed in white. If you enter invalid or
incomplete information in a field, you will receive an error message. Additional instructions and FAQs about the Application Package can be found in the Grants.gov
Applicants tab.
OPPORTUNITY & PACKAGE DETAILS:
Opportunity Number: O-BJA-2022-171368

Opportunity Title: BJA FY 22 Edward Byrne Memorial Justice Assistance Grant Program - Local
Solicitation

Opportunity Package ID: PKG00275143

CFDA Number: 16.738

CFDA Description: Edward Byrne Memorial Justice Assistance Grant Program

Competition ID: C-BJA-2022-00154-PROD

Competition Title: Category 1 - Applicants with eligible allocation amounts of less than $25,000

Opening Date: 06/22/2022

Closing Date: 08/03/2022

Agency: Bureau of Justice Assistance

Contact Information: National Criminal Justice Reference Service Response Center

APPLICANT & WORKSPACE DETAILS:
Workspace ID: WS00953188

Application Filing Name: San Mateo Police Department Customer Service for Public Safety Software Project

UEI: R92YFGVKF6B4

Organization: SAN MATEO, CITY OF

Form Name: Disclosure of Lobbying Activities (SF-LLL)

Form Version: 2.0

Requirement: Mandatory

Download Date/Time: Aug 02, 2022 04:04:48 PM EDT

Form State: No Errors

FORM ACTIONS:

CHECK FOR ERRORS SAVE PRINT

 DISCLOSURE OF LOBBYING ACTIVITIES
Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352 OMB Number: 4040-0013
Expiration Date: 02/28/2025
Review Public Burden Disclosure Statement
1. * Type of Federal Action: 2. * Status of Federal Action: 3. * Report Type:
a. contract a. bid/offer/application a. initial filing
b. grant b. initial award b. material change
c. cooperative agreement c. post-award
d. loan

e. loan guarantee

f. loan insurance

4. Name and Address of Reporting Entity:

Prime SubAwardee
* Name
City of San Mateo
* Street 1 Street 2
330 W. 20th Avenue
* City State Zip
San Mateo CA: California 94403-1338

Congressional District, if known: CA14

5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime:

6. * Federal Department/Agency: 7. * Federal Program Name/Description:

US Department of Justice Edward Byrne Memorial Justice Assistance Grant Program

CFDA Number, if applicable: 16.738

8. Federal Action Number, if known: 9. Award Amount, if known:

O-BJA-2022-171368 $ 21,088.00

10. a. Name and Address of Lobbying Registrant:

Prefix * First Name Middle Name
Smith
* Last Name Suffix
Dawson & Andrews

* Street 1 Street 2
1150 Connecticut Avenue NW Suite 730
* City State Zip
Washington DC: District of Columbia 20036

b. Individual Performing Services (including address if different from No. 10a)

Prefix * First Name Middle Name
Robert

* Last Name Suffix

Gaines
* Street 1 Street 2
1150 Connecticut Avenue NW Suite 730
* City State Zip
Washington DC: District of Columbia 20036

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 the 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: Completed on submission to Grants.gov

*Name: Prefix * First Name Middle Name

Tricia
* Last Name Suffix
Toomey

Title: Business Manager Telephone No.: 6505227623 Date: Completed on submission to Grants.gov

Authorized for Local Reproduction

Federal Use Only: Standard Form - LLL (Rev. 7-97)
 U.S. DEPARTMENT OF JUSTICE Approved: OMB No. 1121-0329
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Background
Recipients’ financial management systems and internal controls must meet certain requirements, including those
set out in the “Part 200 Uniform Requirements” (2.C.F.R. Part 2800).
Including at a minimum, the financial management system of each OJP award recipient must provide
for the following:
(1) Identification, in its accounts, of all Federal awards received and expended and the Federal programs under
which they were received. Federal program and Federal award identification must include, as applicable, the
CFDA title and number, Federal award identification number and year, and the name of the Federal agency.
(2) Accurate, current, and complete disclosure of the financial results of each Federal award or program.
(3) Records that identify adequately the source and application of funds for Federally-funded activities. These
records must contain information pertaining to Federal awards, authorizations, obligations, unobligated
balances, assets, expenditures, income, and interest, and be supported by source documentation.
(4) Effective control over, and accountability for, all funds, property, and other assets. The recipient must
adequately safeguard all assets and assure that they are used solely for authorized purposes.
(5) Comparison of expenditures with budget amounts for each Federal award.
(6) Written procedures to document the receipt and disbursement of Federal funds including procedures to
minimize the time elapsing between the transfer of funds from the United States Treasury and the disbursement
by the OJP recipient.
(7) Written procedures for determining the allowability of costs in accordance with both the terms and conditions of
the Federal award and the cost principles to apply to the Federal award.
(8) Other important requirements related to retention requirements for records, use of open and machine readable
formats in records, and certain Federal rights of access to award-related records and recipient personnel.

1. Name of Organization and Address:

Organization Name: City of San Mateo
Street1: 330 W. 20th Avenue
Street2:
City: San Mateo
State: CA
Zip Code: 94403
2. Authorized Representative’s Name and Title:
Prefix: Mr First Name: Richard Middle Name:
Last Name: Lee Suffix:
Title: Finance Director
3. Phone: 650-522-7102 4. Fax: 650-522-7101
5. Email: [email protected]
6. Year Established: 7. Employer Identification Number (EIN): 8. DUNS Number:
1894 94-6000422 085845147

9. a) Is the applicant entity a nonprofit organization (including a nonprofit institution of higher education) as
described in 26 U.S.C. 501(c)(3) and exempt from taxation under 26 U.S.C. 501(a)? Yes ■ No
If "No" skip to Question 10.
If "Yes", complete Questions 9. b) and 9. c).

Page 1 of 4
 U.S. DEPARTMENT OF JUSTICE Approved: OMB No. 1121-0329
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AUDIT INFORMATION

9. b) Does the applicant nonprofit organization maintain offshore accounts for

Yes No
the purpose of avoiding paying the tax described in 26 U.S.C. 511(a)?
9. c) With respect to the most recent year in which the applicant nonprofit
organization was required to file a tax return, does the applicant nonprofit Yes No
organization believe (or assert) that it satisfies the requirements of 26 C.F.R.
53.4958-6 (which relate to the reasonableness of compensation of certain
individuals)?

If "Yes", refer to “Additional Attachments” under “What An Application Should

Include” in the OJP solicitation (or application guidance) under which the
applicant is submitting its application. If the solicitation/guidance describes the
“Disclosure of Process related to Executive Compensation,” the applicant
nonprofit organization must provide -- as an attachment to its application -- a
disclosure that satisfies the minimum requirements as described by OJP.

For purposes of this questionnaire, an “audit” is conducted by an independent, external auditor using generally
accepted auditing standards (GAAS) or Generally Governmental Auditing Standards (GAGAS), and results in an
audit report with an opinion.
10. Has the applicant entity undergone any of the following types of audit(s)(Please check all that apply):
■ “Single Audit” under OMB A-133 or Subpart F of 2 C.F.R. Part 200
Financial Statement Audit
Defense Contract Agency Audit (DCAA)
Other Audit & Agency (list type of audit):

None (if none, skip to question 13)

11. Most Recent Audit Report Issued: Within the last ■ Within the last Over 2 years ago N/A
12 months 2 years
Name of Audit Agency/Firm: Badawi and Associates
AUDITOR'S OPINION
12. On the most recent audit, what was the auditor’s opinion?
■ Unqualified Opinion Qualified Opinion Disclaimer, Going Concern N/A: No audits as
or Adverse Opinions described above
Enter the number of findings (if none, enter "0": 0
Enter the dollar amount of questioned costs (if none, enter "$0"):$0
Were material weaknesses noted in the report or opinion? Yes ■ No
ACCOUNTING SYSTEM
13. Which of the following best describes the applicant entity's accounting system:
Manual ■ Automated Combination of manual and automated
14. Does the applicant entity's accounting system have the capability to
identify the receipt and expenditure of award funds separately for each
■ Yes No Not Sure
Federal award?
15. Does the applicant entity's accounting system have the capability to ■ Yes No Not Sure
record expenditures for each Federal award by the budget cost categories
shown in the approved budget?

16. Does the applicant entity's accounting system have the capability to ■ Yes No Not Sure
record cost sharing ("match") separately for each Federal award, and
maintain documentation to support recorded match or cost share?

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 U.S. DEPARTMENT OF JUSTICE Approved: OMB No. 1121-0329
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17. Does the applicant entity's accounting system have the capability to Yes No Not Sure
accurately track employees actual time spent performing work for each federal
award, and to accurately allocate charges for employee salaries and wages
for each federal award, and maintain records to support the actual time spent
and specific allocation of charges associated with each applicant employee?
18. Does the applicant entity’s accounting system include budgetary controls
■ Yes No Not Sure
to preclude the applicant entity from incurring obligations or costs that exceed
the amount of funds available under a federal award (the total amount of the
award, as well as the amount available in each budget cost category)?
19. Is applicant entity familiar with the "cost principles" that apply to recent ■ Yes No Not Sure
and future federal awards, including the general and specific principles set out
in 2 C.F.R Part 200?

PROPERTY STANDARDS AND PROCUREMENT STANDARDS

20. Does the applicant entity’s property management system(s) maintain the Yes No Not Sure
following information on property purchased with federal award funds (1) a
■
description of the property; (2) an identification number; (3) the source of
funding for the property, including the award number; (4) who holds title; (5)
acquisition date; (6) acquisition cost; (7) federal share of the acquisition cost;
(8) location and condition of the property; (9) ultimate disposition information?

21. Does the applicant entity maintain written policies and procedures for
procurement transactions that -- (1) are designed to avoid unnecessary or
■ Yes No Not Sure
duplicative purchases; (2) provide for analysis of lease versus purchase
alternatives; (3) set out a process for soliciting goods and services, and (4)
include standards of conduct that address conflicts of interest?
22. a) Are the applicant entity’s procurement policies and procedures
■ Yes No Not Sure
designed to ensure that procurements are conducted in a manner that
provides full and open competition to the extent practicable, and to avoid
practices that restrict competition?
22. b) Do the applicant entity's procurement policies and procedures require
■ Yes No Not Sure
documentation of the history of a procurement, including the rationale for the
method of procurement, selection of contract type, selection or rejection of
contractors, and basis for the contract price?
23. Does the applicant entity have written policies and procedures designed
to prevent the applicant entity from entering into a procurement contract ■ Yes No Not Sure
under a federal award with any entity or individual that is suspended or
debarred from such contracts, including provisions for checking the “Excluded
Parties List” system (www.sam.gov) for suspended or debarred sub-grantees
and contractors, prior to award?

TRAVEL POLICY
24. Does the applicant entity:
(a) maintain a standard travel policy? ■ Yes No
(b) adhere to the Federal Travel Regulation (FTR)? ■ Yes No

SUBRECIPIENT MANAGEMENT AND MONITORING

25. Does the applicant entity have written policies, procedures, and/or
Yes No Not Sure
guidance designed to ensure that any subawards made by the applicant
entity under a federal award -- (1) clearly document applicable federal
requirements, (2) are appropriately monitored by the applicant, and (3) ■ N/A - Applicant does not make
comply with the requirements in 2 CFR Part 200 (see 2 CFR 200.331)? subawards under any OJP
awards

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 U.S. DEPARTMENT OF JUSTICE Approved: OMB No. 1121-0329
OFFICE OF JUSTICE PROGRAMS Expires 12/31/2023

26. Is the applicant entity aware of the differences between subawards under Yes No Not Sure
federal awards and procurement contracts under federal awards, including
the different roles and responsibilities associated with each? ■ N/A - Applicant does not make
subawards under any OJP
awards

27. Does the applicant entity have written policies and procedures designed Yes No Not Sure
to prevent the applicant entity from making a subaward under a federal
award to any entity or individual is suspended or debarred from such ■ N/A - Applicant does not make
subawards? subawards under any OJP
awards

DESIGNATION AS 'HIGH-RISK' BY OTHER FEDERAL AGENCIES

28. Is the applicant entity designated “high risk” by a federal grant-making
Yes ■ No Not Sure
agency outside of DOJ? (High risk includes any status under which a federal
awarding agency provides additional oversight due to the applicant's past
performance, or other programmatic or financial concerns with the applicant.)

If "Yes", provide the following:

(a) Name(s) of the federal awarding agency:

(b) Date(s) the agency notified the applicant entity of the "high risk" designation:

(c) Contact information for the "high risk" point of contact at the federal agency:
Name:
Phone:
Email:

(d) Reason for "high risk" status, as set out by the federal agency:

CERTIFICATION ON BEHALF OF THE APPLICANT ENTITY

(Must be made by the chief executive, executive director, chief financial officer, designated authorized
representative ("AOR"), or other official with the requisite knowledge and authority)
On behalf of the applicant entity, I certify to the U.S. Department of Justice that the information provided above is
complete and correct to the best of my knowledge. I have the requisite authority and information to make this
certification on behalf of the applicant entity.

Name: Richard Lee Date: 07/15/2022

Title: Executive Director ■ Chief Financial Officer Chairman

Other:

Phone: 650-522-7102

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OMB APPROVAL NUMBER 1121-0140

EXPIRES 05/31/2019

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) I 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) I 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) I 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) I 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) I 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) If this application is for an award from the National Institute of Justice or the Bureau of Justice
Statistics pursuant to which award funds may be made available (whether by the award directly or by any
subaward at any tier) to an institution of higher education (as defined at 34 U.S.C. § 10251(a)(17)), I
assure that, if any award funds actually are made available to such an institution, the Applicant will
require that, throughout the period of performance--

a. each such institution comply with any requirements that are imposed on it by the First
Amendment to the Constitution of the United States; and
b. subject to par. a, each such institution comply with its own representations, if any,
concerning academic freedom, freedom of inquiry and debate, research independence,
and research integrity, at the institution, that are included in promotional materials, in
official statements, in formal policies, in applications for grants (including this award
application), for accreditation, or for licensing, or in submissions relating to such grants,
accreditation, or licensing, or that otherwise are made or disseminated to students, to
faculty, or to the general public.

(9) I assure that, if the Applicant is a governmental entity, with respect to the award (if any) made by the
Department based on the application--

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.
(10) 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).

(11) 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). I 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.
U.S. DEPARTMENT OF JUSTICE

CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY

MATTERS; DRUG-FREE WORKPLACE REQUIREMENTS; LAW ENFORCEMENT AND COMMUNITY
POLICING

Applicants should refer to the regulations and other requirements 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 or other cited requirements 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 [email protected]; for OVW Applicants, to OVW at
[email protected]; or for COPS Applicants, to COPS at [email protected]), unless such
disclosure has already been made.

3. FEDERAL TAXES
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
[email protected]; for OVW Applicants, to OVW at [email protected]; or for
COPS Applicants, to COPS at [email protected]).
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. LAW ENFORCEMENT AGENCY CERTIFICATION REQUIRED UNDER DEPARTMENT OF JUSTICE

DISCRETIONARY GRANT PROGRAMS (“SAFE POLICING CERTIFICATION”)
If this application is for a discretionary award pursuant to which award funds may be made available
(whether by the award directly or by any subaward at any tier) to a State, local, college, or university law
enforcement agency, the Applicant certifies that any such law enforcement agency to which funds will
be made available has been certified by an approved independent credentialing body or has started the
certification process. To become certified, a law enforcement agency must meet two mandatory
conditions:
(a) the agency’s use of force policies adhere to all applicable federal, State, and local laws; and
(b) the agency’s use of force policies prohibit chokeholds except in situations where use of deadly force
is allowed by law.
For detailed information on this certification requirement, see https://cops.usdoj.gov/SafePolicingEO .

The Applicant acknowledges that compliance with this safe policing certification requirement does not
ensure compliance with federal, state, or local law, and that such certification shall not constitute a
defense in any federal lawsuit. Nothing in the safe policing certification process or safe policing
requirement is intended to be (or may be) used by third parties to create liability by or against the
United States or any of its officials, officers, agents or employees under any federal law. Neither the safe
policing certification process nor the safe policing certification requirement is intended to (or does)
confer any right on any third-person or entity seeking relief against the United States or any officer or
employee thereof. No person or entity is intended to be (or is) a third-party beneficiary of the safe
policing certification process, or, with respect to the safe policing certification requirement, such a
beneficiary for purposes of any civil, criminal, or administrative action.

6. 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). I 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.