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<br />Washington State
<br />Health Care Authority Page 34 of 53 Contract # 2747
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<br />(1) Abide by the terms of the statement; and
<br />(2) Notify the employer in writing of his or her
<br />conviction for a violation of a criminal drug
<br />statute occurring in the workplace no later than
<br />five calendar days after such conviction;
<br />
<br />e) Notifying the agency in writing within ten
<br />calendar days after receiving notice under
<br />paragraph (d)(2) from an employee or
<br />otherwise receiving actual notice of such
<br />conviction. Employers of convicted employees
<br />must provide notice, including position title, to
<br />every contract officer or other designee on
<br />whose contract activity the convicted employee
<br />was working, unless the Federal agency has
<br />designated a central point for the receipt of
<br />such notices. Notice shall include the
<br />identification number(s) of each affected grant;
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<br />f) Taking one of the following actions, within 30
<br />calendar days of receiving notice under
<br />paragraph (d) (2), with respect to any employee
<br />who is so convicted—
<br />(1) Taking appropriate personnel action
<br />against such an employee, up to and
<br />including termination, consistent with
<br />the requirements of the Rehabilitation
<br />Act of 1973, as amended; or
<br />(2) Requiring such employee to participate
<br />satisfactorily in a drug abuse
<br />assistance or rehabilitation program
<br />approved for such purposes by a
<br />Federal, State, or local health, law
<br />enforcement, or other appropriate
<br />agency;
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<br />g) Making a good faith effort to continue to
<br />maintain a drug-free workplace through
<br />implementation of paragraphs (a), (b), (c), (d),
<br />(e), and (f).
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<br />For purposes of paragraph (e) regarding agency
<br />notification of criminal drug convictions, Authority
<br />has designated the following central point for
<br />receipt of such notices:
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<br />Legal Services Manager
<br />WA State Health Care Authority
<br />PO Box 42700
<br />Olympia, WA 98504-2700
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<br />3. CERTIFICATION REGARDING LOBBYING
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<br />Title 31, United States Code, Section 1352, entitled
<br />"Limitation on use of appropriated funds to
<br />influence certain Federal contracting and financial
<br />transactions," generally prohibits recipients of
<br />Federal grants and cooperative agreements from
<br />using Federal (appropriated) funds for lobbying the
<br />Executive or Legislative Branches of the Federal
<br />Government in connection with a SPECIFIC grant
<br />or cooperative agreement. Section 1352 also
<br />requires that each person who requests or receives
<br />a Federal grant or cooperative agreement must
<br />disclose lobbying undertaken with non-Federal
<br />(nonappropriated) funds. These requirements
<br />apply to grants and cooperative agreements
<br />EXCEEDING $100,000 in total costs (45 CFR Part
<br />93).
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<br />The undersigned (authorized official signing for the
<br />contracting organization) certifies, to the best of his
<br />or her knowledge and belief, that:
<br />
<br />(1) No Federal appropriated funds have been paid
<br />or will be paid, by or on behalf of the
<br />undersigned, to any person for influencing or
<br />attempting to influence an officer or employee
<br />of any agency, a Member of Congress, an
<br />officer or employee of Congress, or an
<br />employee of a Member of Congress in
<br />connection with the awarding of any Federal
<br />contract, the making of any Federal grant, the
<br />making of any Federal loan, the entering into
<br />of any cooperative agreement, and the
<br />extension, continuation, renewal, amendment,
<br />or modification of any Federal contract, grant,
<br />loan, or cooperative agreement.
<br />
<br />(2) If any funds other than Federally appropriated
<br />funds have been paid or will be paid to any
<br />person for influencing or attempting to
<br />influence an officer or employee of any
<br />agency, a Member of Congress, an officer or
<br />employee of Congress, or an employee of a
<br />Member of Congress in connection with this
<br />Federal contract, grant, loan, or cooperative
<br />agreement, the undersigned shall complete
<br />and submit Standard Form -LLL, "Disclosure of
<br />Lobbying Activities," in accordance with its
<br />instructions. (If needed, Standard Form-LLL,
<br />"Disclosure of Lobbying Activities," its
<br />instructions, and continuation sheet are
<br />included at the end of this application form.)
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<br />(3) The undersigned shall require that the
<br />language of this certification be included in the
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