INFORMATION SR 11-07-1994
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COPS FAST Ap'plication
U.S. Department of Justice
Office of Community Oriented Policing Services
This FAST Application is for jurisdictions serving populations of under
50,000. This grant pays only for salaries and benefits of new or rehired
police officers. Complete the information below, read the assurances on
the back and the enclosed Certifications, and sign below. By signing this
application you also acknowledge that COPS FAST hiring grants provide
a maximum federal contribution of75% of the salary and benefits of
each officer over three years, up to a cap of $75,000 per officer, with the
federal share decreasing from year to year.
633 Indiana Avenue, NW, 3rd Floor (202) 514-2058
Washington, DC 20531 FAX (202) 514-9272
Applicant Organization's Legal Name J:::. ( K -R; V ~ r Po I ~ c.e ~.
Law Enforcement Executive's Name Ihr::.W\qS j) . Lere....Jo.. S. pr':) 1;(' e C h; e..r
Address I 30"~ 0 r 0 IV 0 P t?. r ~ yY a. "" '
City ~ It( f2...lver- State ( /IV) J J. Zip Code S S 330
Telephone I:" 61 d. - L{I.//- ;;3;). L.{ FAX /- ~ l~ - i./I.//- gq 37
Government Executive's Name P (\ -1-r; c..k t=;:J a~ rS
Address l..3.o.b~ nrt;;:;)jo.Jn Po..rkc.....L~ .
City ~/"" ~;~ec:.., State . /VIr.! Zip Code _~~.33o
Telephone t - bl ;J - l.fL/ /-74;;) 0 FAX I-fp!d - lI'-Il- tel 3 7
Number of Officers Requested Through FAST
Actual Number of Sworn Officers Performing Law
Enforcement Functions as of 10/1/94
I TWD
(d)
I$?
Area of Jurisdiction (square miles)
Entry Level Annual Salary Per Officer
L/4
I -;271 ~Q:).0(:)1
Number of 1993 UCR Part I Crimes
Entry Level Annual Fringe Benefits Cost Per Officer
.L(K3
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\ I, 000, CC I
Current Population Served (per most recent U.S.
census data)
Is the applicant organization delinquent on any federal
debt? (If answer is yes, please attach an explanation.)
11/143
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Yes
No
I certify that the information provided on this form is true and accurate to the best of my knowledge. I understand that the applicant
must comply with the assurances on the reverse side if the assistance is awarded. On behalf of the applicant, I certify compliance
with the apPlicable requirements of the Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility
Matters; Drug-Free Workplace Requirements; and Non-Supplanting.
Law En. forcement ~ecuti~.s Signature Zz)j ~J.--
Government Executive's Signature -
Return this form postmarked by December 31,1994 to: COPS Office, P.O. Box 14440, Washington, DC 20044. Overnight mail:
633 Indiana Avenue, NW, Third Floor, Washington, DC 20531. FAX: (202) 514-9272.
Public reporting burden for this collection of infonnation is estimated at 55 minutes per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the collection of infonnation. Send comments regarding this burden estimate or any other
aspects of this collection of infonnation, including suggestions for reducing this burden to the Office of Community Oriented Policing Services, U.S. Department of Justice,
633 Indiana Ave., Nw, Third Floor, Washington, DC 20531; and to the Public Use Reports Project, 1105-0061, Office oflnforniation and Regulatory Affairs, Office of
Management and Budget, Washington,. DC 20503. COPS 001101
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Assurances
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Several provisions of federal law and policy apply to all grant programs. We (the Offic~ of
Community Oriented Policing Services) need to secure your assurance that you (the
applicant) will comply with these provisions. If you would like further information about
any of the matters on which we seek your assurance, please contact us.
By your authorized representative's signature, you assure us and certify to us that, if the
. grant is awarded, you will comply with all legal and administrative requirements that
govern the acceptance and use of federal grant funds. In particular, you assure us that:
1. You have been legally and official,ly authorized by the
appropriate governing body (for example, mayor or city
council) to apply for this grant and that the persons signing
the application and these assurances on your behalf are
authorized to do so and to act on your behalf with respect to.
any issues that may arise during processing of this applica-
tion.
2. You will comply with the provisions of federal law which
limit certain political activities of your employees whose
principal employment is in connection with an activity
financed in whole or in part with this grant. These restric-
tions are set forth in 5 U.S.C. ~ 1501, ~.
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3. You will comply with the minimum wage and maximum
hours provisions of the Federal Fair Labor Standards Act, if
they apply to you.
4. You will establish safeguards, if you have not done so
already, to prohibit employees from using their positions for
a purpose that is, or gives the appearance of being, moti-
vated by a desire for private gain for themselves or others,
particularly those with whom they have family, business, or
other ties.
5. You will give us or the Comptroller General access to
and the right to examine records and documents related to
the grant.
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6. You will comply with all requirements imposed by us as a
condition or administrative requirement of the grant, with the
requirements of OMB Circulars A-87 (goveming cost
calculations) and A-128 (governing audits), with the appli-
cable provisions of the Omnibus Crime Control and Safe
Streets Act of 1968, as amended, with 28 CFR Part 66
(Uniform Administrative Requirements), with the provisions
of the current edition of the Office of Justice Programs
Financial and Administrative Guide for Grants, and with all
other applicable laws, orders, regulations, or circulars.
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7. You will, to the extent practicable, seek, recruit, and hire
members of racial and ethnic minority groups and women in
order to increase their ranks within the sworn positions in
your agency.
8. You will not, on the ground of race, color, religion,
national,origin, gender, disability or age, unlawfully
exclude 'any person rromparticipation in, deny the
benefits or employment to any person, or subject any
, person to discrimination in connection with any programs
or activities funded in whole or in part with federal funds.
These civil rights requirements are found in the nondis-
crimination provisions of the Omnibus Crime Control and
Safe Streets Act of 1968, as amended (42 U.S.C.
~ 3789(d)); Title VI of the Civil Rights Act of 1964, as
amended (42 U.S.C. ~ 2000d); the Indian Civil
Rights Act (25 U.S.C. ~~ 1301-1303); Section 504 of
the Rehabilitation Act of 1973, as amended (29
U.S.C. ~ 794); Title II, Subtitle A of the Americans
with Disabilities Act (ADA) (42 U.S.C. ~ 12101, ~
gg.); the Age Discrimination Act of 1975 (42 U.S.C.
~ 6101, ~.); and Department of Justice Non-
Discrimination Regulations contained in Title 28, Parts 35
and 42 (subparts C, D, E and G) of the Code of Federal
Regulations.
A. In the event that any court or administrative
agency makes a finding of discrimination on grounds of
race, color, religion, national origin or sex against you
after a due process hearing, you agree to forward a copy
of the finding to the Office of General Counsel, COPS,
P.O. Box 14440, Washington, DC 20044.
B. If you are applying for a grant of $500,000 or
more and Department regulations (28.CFR 42.301 m
gg.) require you to submit an Equal Opportunity Employ-
ment Plan, you will do so at the time of this application, if
you have not done so in the past.
9. You will insure that the facilities under your ownership,
lease or supervision which shall be utilized in the
accomplishment of the project are not listed on the
Environmental Protection Agency's (EPA) list of Violating
Facilities and that you will notify us if you are advised by
the EPA indicating that a facility to be used in this grant is
under consideration for listing by EPA.
10. If your state has established a review and comment
procedure under Executive Order 12372 and has
selected this program for review, you have made this
application available for review by the State Single Point
of Contact.
coPS 001101 (Back)