Highway safety grants rescinded by MAP-21 are governed by the applicable implementing regulations at the time of grant award.
Sec. Appendix A to Part 1200--Certification and Assurances for Highway
Safety Grants (23 U.S.C. Chapter 4) State:__________________________________________________________________Fiscal Year:--------
Each fiscal year the State must sign these Certifications and Assurances that it complies with all requirements including applicable Federal statutes and regulations that are in effect during the grant period. (Requirements that also apply to subrecipients are noted under the applicable caption.)
In my capacity as the Governor's Representative for Highway Safety, I hereby provide the following certifications and assurances:
GENERAL REQUIREMENTS
To the best of my personal knowledge, the information submitted in the Highway Safety Plan in support of the State's application for Section 402 and Section 405 grants is accurate and complete. (Incomplete or incorrect information may result in the disapproval of the Highway Safety Plan.)
The Governor is the responsible official for the administration of the State highway safety program through a State highway safety agency that has adequate powers and is suitably equipped and organized (as evidenced by appropriate oversight procedures governing such areas as procurement, financial administration, and the use, management, and disposition of equipment) to carry out the program. (23 U.S.C. 402(b)(1)(A))
The State will comply with applicable statutes and regulations, including but not limited to:
23 U.S.C. Chapter 4--Highway Safety Act of 1966, as amended
49 CFR Part 18--Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments
23 CFR Part 1200--Uniform Procedures for State Highway Safety Grant Programs
The State has submitted appropriate documentation for review to the single point of contact designated by the Governor to review Federal programs, as required by Executive Order 12372 (Intergovernmental Review of Federal Programs).
FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA)
The State will comply with FFATA guidance, OMB Guidance on FFATA Subward and Executive Compensation Reporting, August 27, 2010, (https:// www. fsrs. gov/ documents/ OMB-- Guidance-- on-- FFATA-- Subaward-- and-- Executive-- Compensation-- Reporting-- 08272010. pdf) by reporting to FSRS.gov for each sub-grant awarded:
Name of the entity receiving the award;
Amount of the award;
Information on the award including transaction type, funding agency, the North American Industry Classification System code or Catalog of Federal Domestic Assistance number (where applicable), program source;
Location of the entity receiving the award and the primary location of performance under the award, including the city, State, congressional district, and country; and an award title descriptive of the purpose of each funding action;
A unique identifier (DUNS);
The names and total compensation of the five most highly compensated officers of the entity if:
(i) the entity in the preceding fiscal year received--
(I) 80 percent or more of its annual gross revenues in Federal awards;
(II) $25,000,000 or more in annual gross revenues from Federal awards; and
(ii) the public does not have access to information about the compensation of the senior executives of the entity through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986;
Other relevant information specified by OMB guidance.
NONDISCRIMINATION
(applies to subrecipients as well as States)
The State highway safety agency will comply with all Federal statutes and implementing regulations relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), which prohibits discrimination on the basis of race, color or national origin (and 49 CFR Part 21); (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683 and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), and the Americans with Disabilities Act of 1990 (Pub. L. 101-336), as amended (42 U.S.C. 12101, et seq.), which prohibits discrimination on the basis of disabilities (and 49 CFR Part 27); (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. 6101-6107), which prohibits discrimination on the basis of age; (e) the Civil Rights Restoration Act of 1987 (Pub. L. 100-259), which requires Federal-aid recipients and all subrecipients to prevent discrimination and ensure nondiscrimination in all of their programs and activities; (f) the Drug Abuse Office and Treatment Act of 1972 (Pub. L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (g) the comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (Pub. L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (h) Sections 523 and 527 of the Public Health Service Act of 1912, as amended (42 U.S.C. 290dd-3 and 290ee-3), relating to confidentiality of alcohol and drug abuse patient records; (i) Title VIII of the Civil Rights Act of 1968, as amended (42 U.S.C. 3601, et seq.), relating to nondiscrimination in the sale, rental or financing of housing; (j) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and (k) the requirements of any other nondiscrimination statute(s) which may apply to the application.
THE DRUG-FREE WORKPLACE ACT OF 1988 (41 U.S.C. 8103)
The State will provide a drug-free workplace by:
Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition;
Establishing a drug-free awareness program to inform employees about:
[cir] The dangers of drug abuse in the workplace.
[cir] The grantee's policy of maintaining a drug-free workplace.
[cir] Any available drug counseling, rehabilitation, and employee assistance programs.
[cir] The penalties that may be imposed upon employees for drug violations occurring in the workplace.
[cir] Making it a requirement that each employee engaged in the performance of the grant be given a copy of the statement required by paragraph (a).
Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant, the employee will--
[cir] Abide by the terms of the statement.
[cir] Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction.
Notifying the agency within ten days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction.
Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted--
[cir] Taking appropriate personnel action against such an employee, up to and including termination.
[cir] 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.
Making a good faith effort to continue to maintain a drug-free workplace through implementation of all of the paragraphs above.
BUY AMERICA ACT
(applies to subrecipients as well as States)
The State will comply with the provisions of the Buy America Act (49 U.S.C. 5323(j)), which contains the following requirements:
Only steel, iron and manufactured products produced in the United States may be purchased with Federal funds unless the Secretary of Transportation determines that such domestic purchases 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. Clear justification for the purchase of non-domestic items must be in the form of a waiver request submitted to and approved by the Secretary of Transportation.
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:
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 Certification
1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below.
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 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 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 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.
4. The prospective primary participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary participant learns its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.
5. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meaning set out in the Definitions and coverage sections of 49 CFR Part 29. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations.
6. The prospective primary 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 participant further agrees by submitting this proposal that it will include the clause titled ``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.
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 may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the list of Parties Excluded from Federal Procurement and Non-procurement Programs.
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 this transaction for cause or default. Certification Regarding Debarment, Suspension, and Other Responsibility
Matters-Primary Covered Transactions
(1) The prospective primary participant certifies to the best of its knowledge and belief, that its principals:
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded 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 performing 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 record, 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 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 Certification
1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below.
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 and/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 transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definition and Coverage sections of 49 CFR Part 29. 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 ``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. (See below)
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 may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Non-procurement Programs.
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 and/or debarment.
Certification Regarding Debarment, Suspension, Ineligibility 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 participation in this transaction 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.
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 on how to implement such a program, or statistics on the potential benefits and cost-savings to your company or organization, please visit the Buckle Up America section on NHTSA's Web site at www.nhtsa.dot.gov. Additional resources are available from the Network of Employers for Traffic Safety (NETS), a public-private partnership headquartered in the Washington, DC metropolitan area, and dedicated to improving the traffic safety practices of employers and employees. NETS is prepared to provide technical assistance, a simple, user-friendly program kit, and an award for achieving the President's goal of 90 percent seat belt use. NETS can be contacted at 1 (888) 221-0045 or visit its Web site at www.trafficsafety.org.
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 crashed 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 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.
ENVIRONMENTAL IMPACT
The Governor's Representative for Highway Safety has reviewed the State's Fiscal Year highway safety planning document and hereby declares that no significant environmental impact will result from implementing this Highway Safety Plan. If, under a future revision, this Plan is modified in a manner that could result in a significant environmental impact and trigger the need for an environmental review, this office is prepared to take the action necessary to comply with the National Environmental Policy Act of 1969 (42 U.S.C. 4321, et seq.) and the implementing regulations of the Council on Environmental Quality (40 CFR Parts 1500-1517).
SECTION 402 REQUIREMENTS
The political subdivisions of this State are authorized, as part of the State highway safety program, to carry out within their jurisdictions local highway safety programs which have been approved by the Governor and are in accordance with the uniform guidelines promulgated by the Secretary of Transportation. (23 U.S.C. 402(b)(1)(B))
At least 40 percent (or 95 percent, as applicable) of all Federal funds apportioned to this State under 23 U.S.C. 402 for this fiscal year will be expended by or for the benefit of the political subdivision of the State in carrying out local highway safety programs (23 U.S.C. 402(b)(1)(C), 402(h)(2)), unless this requirement is waived in writing.
The State's highway safety program provides adequate and reasonable access for the safe and convenient movement of physically handicapped persons, including those in wheelchairs, across curbs constructed or replaced on or after July 1, 1976, at all pedestrian crosswalks. (23 U.S.C. 402(b)(1)(D))
The State will provide for an evidenced-based traffic safety enforcement program to prevent traffic violations, crashes, and crash fatalities and injuries in areas most at risk for such incidents. (23 U.S.C. 402(b)(1)(E))
The State will implement activities in support of national highway safety goals to reduce motor vehicle related fatalities that also reflect the primary data-related crash factors within the State as identified by the State highway safety planning process, including:
Participation in the National high-visibility law enforcement mobilizations;
Sustained enforcement of statutes addressing impaired driving, occupant protection, and driving in excess of posted speed limits;
An annual statewide seat belt use survey in accordance with 23 CFR Part 1340 for the measurement of State seat belt use rates;
Development of statewide data systems to provide timely and effective data analysis to support allocation of highway safety resources;
Coordination of Highway Safety Plan, data collection, and information systems with the State strategic highway safety plan, as defined in 23 U.S.C. 148(a).
(23 U.S.C. 402(b)(1)(F))
The State will actively encourage all relevant law enforcement agencies in the State to follow the guidelines established for vehicular pursuits issued by the International Association of Chiefs of Police that are currently in effect. (23 U.S.C. 402(j))
The State will not expend Section 402 funds to carry out a program to purchase, operate, or maintain an automated traffic enforcement system. (23 U.S.C. 402(c)(4))
I understand that failure to comply with applicable Federal statutes and regulations may subject State officials to civil or criminal penalties and/or place the State in a high risk grantee status in accordance with 49 CFR 18.12.
I sign these Certifications and Assurances based on personal knowledge, after appropriate inquiry, and I understand that the Government will rely on these representations in awarding grant funds.________________________________________________________________________Signature Governor's Representative for Highway Safety Date________________________________________________________________________Date________________________________________________________________________Printed name of Governor's Representative for Highway Safety
Sec. Appendix B to Part 1200--Highway Safety Program Cost Summary (HS-
217) State ----------Number ----------Date ---------- ----------------------------------------------------------------------------------------------------------------
Federally funded programs
Approved State/ ------------------------------------------ Federal
Program area program local Previous Increase/ Current share to
costs funds balance (Decrease) Balance local----------------------------------------------------------------------------------------------------------------Total NHTSA ............ .......... ............ .............. ..........Total FHWA ............ .......... ............ .............. ..........
Total NHTSA & FHWA ............ .......... ............ .............. .......... ..........----------------------------------------------------------------------------------------------------------------
State Official Authorized Signature: Name:Title:Date:
Federal Official Authorized Signature: NHTSA Name:Title:Date:
Effective Date: This form is to be used to provide funding documentation for grant programs under Title 23, United States Code. A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is --------------. Public reporting for this collection of information is estimated to be approximately 30 minutes per response, including the time for reviewing instructions and completing the form. All responses to this collection of information are required to obtain or retain benefits. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Avenue SE., Washington DC 20590.
INSTRUCTIONS FOR PROGRAM COST SUMMARY
State--The State submitting the HS Form-217
Number--Each HS-217 will be in sequential order by fiscal year (e.g., 99-01, 99-02, etc.)
Date--The date of occurrence of the accounting action(s) described.
Program Area--The code designating a program area (e.g., PT-99, where PT represents the Police Traffic Services and 99 represents the Federal fiscal year). Funds should be entered only at the program area level, not at the task level or lower.
Approved Program Costs--The current balance of Federal funds approved (but not obligated) under the HSP or under any portion of or amendment to the HSP.
State/local Funds--Those funds which the State and its political subdivisions are contributing to the program, including both hard and soft match.
Previous Balance--The balance of Federal funds obligated and available for expenditure by the State in the current fiscal year, as of the last Federally-approved transaction. The total of this column may not exceed the sum of the State's current year obligation limitation and prior year funds carried forward. (The column is left blank on the updated Cost Summary required to be submitted under 23 CFR 1200.11(e). For subsequent submissions, the amounts in this column are obtained from the ``Current Balance'' column of the immediately preceding Cost Summary.)
Increase/(Decrease)--The amount of change in Federal funding, by program area, from the funding reflected under the ``Previous Balance''.
Current Balance--The net total of the ``Previous Balance'' and the ``Increase/(Decrease)'' amounts. The total of this column may not exceed the sum of the State's current year obligation limitation and prior year funds carried forward. Sec. Appendix C to Part 1200--Assurances for Teen Traffic Safety Program State:__________________________________________________________________ Fiscal Year:____________________________________________________________
The State has elected to implement a Teen Traffic Safety Program--a statewide program to improve traffic safety for teen drivers--in accordance with 23 U.S.C. 402(m).
In my capacity as the Governor's Representative for Highway Safety, I have verified that--
The Teen Traffic Safety Program is a separately described Program Area in the Highway Safety Plan, including a specific description of the strategies and projects, and appears in HSP page number(s) --------------------------.
as required under 23 U.S.C. 402(m), the statewide efforts described in the pages identified above include peer-to-peer education and prevention strategies the State will use in schools and communities that are designed to--
[cir] increase seat belt use;
[cir] reduce speeding;
[cir] reduce impaired and distracted driving;
[cir] reduce underage drinking; and
[cir] reduce other behaviors by teen drivers that lead to injuries and fatalities.________________________________________________________________________Signature Governor's Representative for Highway SafetyDate --------------------________________________________________________________________________Printed name of Governor's Representative for Highway Safety Sec. Appendix D to Part 1200--Certifications and Assurances for National
Priority Safety Program Grants (23 U.S.C. 405) State:__________________________________________________________________Fiscal Year: ------
Each fiscal year the State must sign these Certifications and Assurances that it complies with all requirements, including applicable Federal statutes and regulations that are in effect during the grant period.
In my capacity as the Governor's Representative for Highway Safety, I:
certify that, to the best of my personal knowledge, the information submitted to the National Highway Traffic Safety Administration in support of the State's application for Section 405 grants below is accurate and complete.
understand that incorrect, incomplete, or untimely information submitted in support of the State's application may result in the denial of an award under Section 405.
agree that, as condition of the grant, the State will use these grant funds in accordance with the specific requirements of Section 405(b), (c), (d), (e), (f) and (g), as applicable.
agree that, as a condition of the grant, the State will comply with all applicable laws and regulations and financial and programmatic requirements for Federal grants.________________________________________________________________________Signature Governor's Representative for Highway Safety________________________________________________________________________Date________________________________________________________________________Printed name of Governor's Representative for Highway Safety
Instructions: Check the box for each part for which the State is applying for a grant, fill in relevant blanks, and identify the attachment number or page numbers where the requested information appears in the HSP. Attachments may be submitted electronically.
[squ] Part 1: Occupant Protection (23 CFR 1200.21)
All States: [Fill in all blanks below.]
The State will maintain its aggregate expenditures from all State and local sources for occupant protection programs at or above the average level of such expenditures in fiscal years 2010 and 2011. (23 U.S.C. 405(a)(1)(H))
The State will participate in the Click it or Ticket national mobilization in the fiscal year of the grant. The description of the State's planned participation is provided as HSP attachment or page ----.
The State's occupant protection plan for the upcoming fiscal year is provided as HSP attachment or page ----.
Documentation of the State's active network of child restraint inspection stations is provided as HSP attachment or page ----.
The State's plan for child passenger safety technicians is provided as HSP attachment or page ----.
Lower Seat belt Use States: [Check at least 3 boxes below and fill in all blanks under those checked boxes.]
[squ] The State's primary seat belt use law, requiring all occupants riding in a passenger motor vehicle to be restrained in a seat belt or a child restraint, was enacted on ----/----/---- and last amended on ----/----/----, is in effect, and will be enforced during the fiscal year of the grant.Legal citation(s):________________________________________________________________________________________________________________________________________________
[squ] The State's occupant protection law, requiring occupants to be secured in a seat belt or age-appropriate child restraint while in a passenger motor vehicle and a minimum fine of $25, was enacted on ----/----/---- and last amended on ----/----/----, is in effect, and will be enforced during the fiscal year of the grant.
Legal citations:
-------------------- Requirement for all occupants to be secured in seat belt or age appropriate child restraint
-------------------- Coverage of all passenger motor vehicles
-------------------- Minimum fine of at least $25
-------------------- Exemptions from restraint requirements
[squ] The State's seat belt enforcement plan is provided as HSP attachment or page ----.
[squ] The State's comprehensive occupant protection program is provided as HSP attachment ----.
[Check one box below and fill in any blanks under that checked box.]
[squ] The State's NHTSA-facilitated occupant protection program assessment was conducted on ----/----/----;
OR
[squ] The State agrees to conduct a NHTSA-facilitated occupant protection program assessment by September 1 of the fiscal year of the grant. (This option is available only for fiscal year 2013 grants.)
[squ] Part 2: State Traffic Safety Information System Improvements (23
CFR 1200.22)
The State will maintain its aggregate expenditures from all State and local sources for traffic safety information system programs at or above the average level of such expenditures in fiscal years 2010 and 2011.
[Fill in at least one blank for each bullet below.]
A copy of [check one box only] the [square] TRCC charter or the [square] statute legally mandating a State TRCC is provided as HSP attachment ---- or submitted electronically through the TRIPRS database on ----/----/----.
A copy of meeting schedule and all reports and other documents promulgated by the TRCC during the 12 months preceding the application due date is provided as HSP attachment ---- or submitted electronically through the TRIPRS database on ----/----/----.
A list of the TRCC membership and the organization and function they represent is provided as HSP attachment ---- or submitted electronically through the TRIPRS database on ----/----/----.
The name and title of the State's Traffic Records Coordinator is________________________________________________________________________________________________________________________________________________
A copy of the State Strategic Plan, including any updates, is provided as HSP attachment ---- or submitted electronically through the TRIPRS database on ----/----/----.
[Check one box below and fill in any blanks under that checked box.]
[squ] The following pages in the State's Strategic Plan provides a written description of the performance measures, and all supporting data, that the State is relying on to demonstrate achievement of the quantitative improvement in the preceding 12 months of the application due date in relation to one or more of the significant data program attributes: pages ----------.
OR
[squ] If not detailed in the State's Strategic Plan, the written description is provided as HSP attachment ----.
The State's most recent assessment or update of its highway safety data and traffic records system was completed on ----/----/----.
[squ] Part 3: Impaired Driving Countermeasures (23 CFR 1200.23)
All States:
The State will maintain its aggregate expenditures from all State and local sources for impaired driving programs at or above the average level of such expenditures in fiscal years 2010 and 2011.
The State will use the funds awarded under 23 U.S.C. 405(d) only for the implementation of programs as provided in 23 CFR 1200.23(i) in the fiscal year of the grant.
Mid-Range State:
[Check one box below and fill in any blanks under that checked box.]
[squ] The statewide impaired driving plan approved by a statewide impaired driving task force was issued on ----/----/---- and is provided as HSP attachment ----.
OR
[squ] For this first year of the grant as a mid-range State, the State agrees to convene a statewide impaired driving task force to develop a statewide impaired driving plan and submit a copy of the plan to NHTSA by September 1 of the fiscal year of the grant.
A copy of information describing the statewide impaired driving task force is provided as HSP attachment ----.
High-Range State:
[Check one box below and fill in any blanks under that checked box.]
[squ] A NHTSA-facilitated assessment of the State's impaired driving program was conducted on ----/----/----;
OR
[squ] For the first year of the grant as a high-range State, the State agrees to conduct a NHTSA-facilitated assessment by September 1 of the fiscal year of the grant;
[Check one box below and fill in any blanks under that checked box.]
[squ] For the first year of the grant as a high-range State, the State agrees to convene a statewide impaired driving task force to develop a statewide impaired driving plan addressing recommendations from the assessment and submit the plan to NHTSA for review and approval by September 1 of the fiscal year of the grant;
OR
[squ] For subsequent years of the grant as a high-range State, the statewide impaired driving plan developed or updated on ----/----/---- is provided as HSP attachment ----.
A copy of the information describing the statewide impaired driving task force is provided as HSP attachment ----.
Ignition Interlock Law: [Fill in all blanks below.]
The State's ignition interlock law was enacted on ----/----/---- and last amended on ----/----/----, is in effect, and will be enforced during the fiscal year of the grant.
Legal citation(s):._______________________________________________________________________
[squ] Part 4: Distracted Driving (23 CFR 1200.24)
[Fill in all blanks below.]
Prohibition on Texting While Driving
The State's texting ban statute, prohibiting texting while driving, a minimum fine of at least $25, and increased fines for repeat offenses, was enacted on ----/----/---- and last amended on ----/----/----, is in effect, and will be enforced during the fiscal year of the grant.
Legal citations:
-------------------- Prohibition on texting while driving
-------------------- Definition of covered wireless communication devices
-------------------- Minimum fine of at least $25 for first offense
-------------------- Increased fines for repeat offenses
-------------------- Exemptions from texting ban
Prohibition on Youth Cell Phone Use While Driving
The State's youth cell phone use ban statute, prohibiting youth cell phone use while driving, driver license testing of distracted driving issues, a minimum fine of at least $25, increased fines for repeat offenses, was enacted on ----/----/---- and last amended on ----/----/----, is in effect, and will be enforced during the fiscal year of the grant.
Legal citations:
-------------------- Prohibition on youth cell phone use while driving
-------------------- Driver license testing of distracted driving issues
-------------------- Minimum fine of at least $25 for first offense
-------------------- Increased fines for repeat offenses
-------------------- Exemptions from youth cell phone use ban
[squ] Part 5: Motorcyclist Safety (23 CFR 1200.25)
[Check at least 2 boxes below and fill in any blanks under those checked boxes.]
[squ] Motorcycle riding training course:
Copy of official State document (e.g., law, regulation, binding policy directive, letter from the Governor) identifying the designated State authority over motorcyclist safety issues is provided as HSP attachment ----.
Document(s) showing the designated State authority approving the training curriculum that includes instruction in crash avoidance and other safety-oriented operational skills for both in-class and on-the-motorcycle is provided as HSP attachment ----.
Document(s) regarding locations of the motorcycle rider ----.
Document showing that certified motorcycle rider training instructors teach the motorcycle riding training course is provided as HSP attachment ----.
Description of the quality control procedures to assess motorcycle rider training courses and instructor training courses and actions taken to improve courses is provided as HSP attachment ----.
[ballot] Motorcyclist awareness program:
Copy of official State document (e.g., law, regulation, binding policy directive, letter from the Governor) identifying the designated State authority over motorcyclist safety issues is provided as HSP attachment ----.
Letter from the Governor's Representative for Highway Safety regarding the development of the motorcyclist awareness program is provided as HSP attachment ----.
Data used to identify and prioritize the State's motorcyclist safety program areas is provided as HSP attachment or page ----.
Description of how the State achieved collaboration among agencies and organizations regarding motorcycle safety issues is provided as HSP attachment or page ----.
Copy of the State strategic communications plan is provided as HSP attachment ----.
[ballot] Reduction of fatalities and crashes involving motorcycles:
Data showing the total number of motor vehicle crashes involving motorcycles is provided as HSP attachment or page ----.
Description of the State's methods for collecting and analyzing data is provided as HSP attachment or page ----.
[ballot] Impaired driving program:
Data used to identify and prioritize the State's impaired driving and impaired motorcycle operation problem areas is provided as HSP attachment or page ----.
Detailed description of the State's impaired driving program is provided as HSP attachment or page ----.
The State law or regulation defines impairment. Legal citation(s):________________________________________________________________________
[ballot] Reduction of fatalities and accidents involving impaired motorcyclists:
Data showing the total number of reported crashes involving alcohol-impaired and drug-impaired motorcycle operators is provided as HSP attachment or page ----.
Description of the State's methods for collecting and analyzing data is provided as HSP attachment or page ----.
The State law or regulation defines impairment. Legal citation(s):________________________________________________________________________
[ballot] Use of fees collected from motorcyclists for motorcycle programs: [Check one box below and fill in any blanks under the checked box.]
[ballot] Applying as a Law State--
The State law or regulation requires all fees collected by the State from motorcyclists for the purpose of funding motorcycle training and safety programs are to be used for motorcycle training and safety programs. Legal citation(s):________________________________________________________________________
AND
The State's law appropriating funds for FY ---- requires all fees collected by the State from motorcyclists for the purpose of funding motorcycle training and safety programs be spent on motorcycle training and safety programs. Legal citation(s):________________________________________________________________________
[ballot] Applying as a Data State--
Data and/or documentation from official State records from the previous fiscal year showing that all fees collected by the State from motorcyclists for the purpose of funding motorcycle training and safety programs were used for motorcycle training and safety programs is provided as HSP attachment ----.
[ballot] Part 6: State Graduated Driver Licensing Laws (23 CFR 1200.26)
[Fill in all applicable blanks below.]
The State's graduated driver licensing statute, requiring both a learner's permit stage and intermediate stage prior to receiving a full driver's license, was enacted on ----/----/---- and last amended on ----/----/----, is in effect, and will be enforced during the fiscal year of the grant.
Learner's Permit Stage--requires testing and education, driving restrictions, minimum duration, and applicability to novice drivers younger than 21 years of age.
Legal citations:
-------------------- Testing and education requirements
-------------------- Driving restrictions
-------------------- Minimum duration
-------------------- Applicability to notice drivers younger than 21 years of age
-------------------- Exemptions from graduated driver licensing law
Intermediate Stage--requires driving restrictions, minimum duration, and applicability to any driver who has completed the learner's permit stage and who is younger than 18 years of age.
Legal citations:
-------------------- Driving restrictions
-------------------- Minimum duration
-------------------- Applicability to any driver who has completed the learner's permit stage and is younger than 18 years of age
-------------------- Exemptions from graduated driver licensing law
Additional Requirements During Both Learner's Permit and Intermediate
Stages
Prohibition enforced as a primary offense on use of a cellular telephone or any communications device by the driver while driving, except in case of emergency. Legal citation(s):________________________________________________________________________
Requirement that the driver who possesses a learner's permit or intermediate license remain conviction-free for a period of not less than six consecutive months immediately prior to the expiration of that stage. Legal citation(s):________________________________________________________________________
License Distinguishability (Check one box below and fill in any blanks under that checked box.)
[ballot] Requirement that the State learner's permit, intermediate license, and full driver's license are visually distinguishable. Legal citation(s):________________________________________________________________________________________________________________________________________________
OR
[ballot] Sample permits and licenses containing visual features that would enable a law enforcement officer to distinguish between the State learner's permit, intermediate license, and full driver's license, are provided as HSP attachment --------.
OR
[ballot] Description of the State's system that enables law enforcement officers in the State during traffic stops to distinguish between the State learner's permit, intermediate license, and full driver's license, are provided as HSP attachment --------.
Sec. Appendix E to Part 1200--Participation by Political Subdivisions
(a) Policy. To ensure compliance with the provisions of 23 U.S.C. 402(b)(1)(C) and 23 U.S.C. 402(h)(2), which require that at least 40 percent or 95 percent of all Federal funds apportioned under Section 402 to the State or the Secretary of Interior, respectively, will be expended by political subdivisions of the State, including Indian tribal governments, in carrying out local highway safety programs, the NHTSA Approving Official will determine if the political subdivisions had an active voice in the initiation, development and implementation of the programs for which funds apportioned under 23 U.S.C. 402 are expended.
(b) Terms.
Local participation refers to the minimum 40 percent or 95 percent (Indian Nations) that must be expended by or for the benefit of political subdivisions.
Political subdivision includes Indian tribes, for purpose and application to the apportionment to the Secretary of Interior.
(c) Determining local share.
(1) In determining whether a State meets the local share requirement in a fiscal year, NHTSA will apply the requirement sequentially to each fiscal year's apportionments, treating all apportionments made from a single fiscal year's authorizations as a single entity for this purpose. Therefore, at least 40 percent of each State's apportionments (or at least 95 percent of the apportionment to the Secretary of Interior) from each year's authorizations must be used in the highway safety programs of its political subdivisions prior to the period when funds would normally lapse. The local participation requirement is applicable to the State's total federally funded safety program irrespective of Standard designation or Agency responsibility.
(2) When Federal funds apportioned under 23 U.S.C. 402 are expended by a political subdivision, such expenditures are clearly part of the local share. Local highway safety-project-related expenditures and associated indirect costs, which are reimbursable to the grantee local governments, are classifiable as local share. Illustrations of such expenditures are the costs incurred by a local government in planning and administration of highway safety project-related activities, such as occupant protection, traffic records system improvements, emergency medical services, pedestrian and bicycle safety activities, police traffic services, alcohol and other drug countermeasures, motorcycle safety, and speed control.
(3) When Federal funds apportioned under 23 U.S.C. 402 are expended by a State agency for the benefit of a political subdivision, such funds may be considered as part of the local share, provided that the political subdivision has had an active voice in the initiation, development, and implementation of the programs for which such funds are expended. A State may not arbitrarily ascribe State agency expenditures as ``benefitting local government.'' Where political subdivisions have had an active voice in the initiation, development, and implementation of a particular program or activity, and a political subdivision which has not had such active voice agrees in advance of implementation to accept the benefits of the program, the Federal share of the cost of such benefits may be credited toward meeting the local participation requirement. Where no political subdivisions have had an active voice in the initiation, development, and implementation of a particular program, but a political subdivision requests the benefits of the program as part of the local government's highway safety program, the Federal share of the cost of such benefits may be credited toward meeting the local participation requirement. Evidence of consent and acceptance of the work, goods or services on behalf of the local government must be established and maintained on file by the State until all funds authorized for a specific year are expended and audits completed.
(4) State agency expenditures which are generally not classified as local are within such areas as vehicle inspection, vehicle registration and driver licensing. However, where these areas provide funding for services such as driver improvement tasks administered by traffic courts, or where they furnish computer support for local government requests for traffic record searches, these expenditures are classifiable as benefitting local programs.
(d) Waivers. While the local participation requirement may be waived in whole or in part by the NHTSA Administrator, it is expected that each State program will generate political subdivision participation to the extent required by the Act so that requests for waivers will be minimized. Where a waiver is requested, however, it must be documented at least by a conclusive showing of the absence of legal authority over highway safety activities at the political subdivision levels of the State and must recommend the appropriate percentage participation to be applied in lieu of the local share.
Sec. Appendix F to Part 1200--Planning and Administration (P&A;) Costs
(a) Policy. Federal participation in P&A; activities shall not exceed 50 percent of the total cost of such activities, or the applicable sliding scale rate in accordance with 23 U.S.C. 120. The Federal contribution for P&A; activities shall not exceed 13 percent of the total funds the State receives under 23 U.S.C. 402. In accordance with 23 U.S.C. 120(i), the Federal share payable for projects in the U.S. Virgin Islands, Guam, American Samoa and the Commonwealth of the Northern Mariana Islands shall be 100 percent. The Indian country, as defined by 23 U.S.C. 402(h), is exempt from these provisions. NHTSA funds shall be used only to finance P&A; activities attributable to NHTSA programs.
(b) Terms.
Direct costs are those costs identified specifically with a particular planning and administration activity or project. The salary of an accountant on the State Highway Safety Agency staff is an example of a direct cost attributable to P&A.; The salary of a DWI (Driving While Intoxicated) enforcement officer is an example of direct cost attributable to a project.
Indirect costs are those costs (1) incurred for a common or joint purpose benefiting more than one cost objective within a governmental unit and (2) not readily assignable to the project specifically benefited. For example, centralized support services such as personnel, procurement, and budgeting would be indirect costs.
Planning and administration (P&A;) costs are those direct and indirect costs that are attributable to the management of the Highway Safety Agency. Such costs could include salaries, related personnel benefits, travel expenses, and rental costs specific to the Highway Safety Agency.
Program management costs are those costs attributable to a program area (e.g., salary and travel expenses of an impaired driving program manager/coordinator of a State Highway Safety Agency).
(c) Procedures. (1) P&A; activities and related costs shall be described in the P&A; module of the State's Highway Safety Plan. The State's matching share shall be determined on the basis of the total P&A; costs in the module. Federal participation shall not exceed 50 percent (or the applicable sliding scale) of the total P&A; costs. A State shall not use NHTSA funds to pay more than 50 percent of the P&A; costs attributable to NHTSA programs. In addition, the Federal contribution for P&A; activities shall not exceed 13 percent of the total funds in the State received under 23 U.S.C. 402 each fiscal year.
(1) P&A; activities and related costs shall be described in the P&A; module of the State's Highway Safety Plan. The State's matching share shall be determined on the basis of the total P&A; costs in the module. Federal participation shall not exceed 50 percent (or the applicable sliding scale) of the total P&A; costs. A State shall not use NHTSA funds to pay more than 50 percent of the P&A; costs attributable to NHTSA programs. In addition, the Federal contribution for P&A; activities shall not exceed 13 percent of the total funds in the State received under 23 U.S.C. 402 each fiscal year.
(2) A State at its option may allocate salary and related costs of State highway safety agency employees to one of the following:
(i) P&A;
(ii) Program management of one or more program areas contained in the HSP; or
(iii) Combination of P&A; activities and the program management activities in one or more program areas.
(3) If an employee works solely performing P&A; activities, the total salary and related costs may be programmed to P&A.; If the employee works performing program management activities in one or more program areas, the total salary and related costs may be charged directly to the appropriate area(s). If an employee is working time on a combination of P&A; and program management activities, the total salary and related costs may be charged to P&A; and the appropriate program area(s) based on the actual time worked under each area(s). If the State Highway Safety Agency elects to allocate costs based on actual time spent on an activity, the State Highway Safety Agency must keep accurate time records showing the work activities for each employee. The State's recordkeeping system must be approved by the appropriate NHTSA Approving Official.
SUBCHAPTER B_GUIDELINES
PARTS 1204 1206 [RESERVED]