HomeMy WebLinkAboutAgreement A-25-516 with OTS.pdf Agreement No. 25-516
State of California — Office of Traffic Safety GRANT NUMBER
GRANT AGREEMENT OP26007
1. GRANT TITLE
Child Passenger Safety Program
2. NAME OF AGENCY 3. Grant Period
Fresno County From: 10/01/2025
4. AGENCY UNIT To ADMINISTER GRANT To: 09/30/2026
Fresno County Public Health Department
s. GRANT DESCRIPTION
Best practice strategies will be conducted to reduce the number of persons killed and injured in crashes
involving children under the age of eight years old. The funded strategies may include education, child safety
seat check-ups, community events, presentations, and training. Other countermeasures may include properly
fitting child safety seats, providing educational materials, and the distribution of child safety seats. Efforts
should be conducted in underserved communities and coordinated in collaboration with community-based
organizations.
6. Federal Funds Allocated Under This Agreement Shall Not Exceed: $187,317.00
Allocation is contingent upon availability of federal funds.
7. TERMS AND CONDITIONS: The parties agree to comply with the terms and conditions of the following which are by
this reference made a part of the Agreement:
• Schedule A—Problem Statement, Goals and Objectives and Method of Procedure
• Schedule B—.Detailed Budget Estimate and Sub-Budget Estimate(if applicable)
• Schedule B-1 —Budget Narrative and Sub-Budget Narrative(if applicable)
• Exhibit A—Certifications and Assurances
• Exhibit B•—OTS Grant Program Manual
• Exhibit C—Grant Electronic Management System (GEMS)Access
'Items shown with an asterisk(`),are hereby incorporated by reference and made a part of this agreement as if
attached hereto. These documents can be viewed at the OTS home web page under Grants: www.ots.ca.-gov.
We,the officials named below, hereby swear under penalty of perjury under the laws of the State of California that we are
duly authorized to legally bind the Grant recipient to the above described Grant terms and conditions.
IN WITNESS WHEREOF,this Agreement has been executed by the parties hereto.
8. Approval Signatures
A. GRANT DIRECTOR B. AUTHORIZING OFFICIAL
NAME: Ge Vue NAME: Ernest Buddy Mendes
TITLE: Director of Public Health Nursing TITLE: Chairman
EMAIL: gevue@fresnocountyca.gov EMAIL: district4@fresnocountyca.gov
PHONE: (559)600-3330 PHONE: (559)600-6456
ADDRESS: 1221 Fulton Street ADDRESS: 1221 Fulton Street
Fresno,CA 93721 Fresno, CA 93721
(Signature) (Date) (Signat e) (Date)
C. FISCAL OFFICIAL D. AUTHORIZING OFFICIAL OF OFFICE OF TRAFFIC SAFETY
NAME: Irene Parade NAME: Stephanie Dougherty
TITLE: Division Manager TITLE: Director
EMAIL: jparada@fresnocountyca.gov EMAIL: stephanie.dougherty@ots.ca,gov
PHONE: (559)600-6438 PHONE: (916)509-3030
ADDRESS: 1221 Fulton Street ADDRESS: 2208 Kausen Drive Suite 300
Fresno,C 3721 Sacramento,CA 95758
(Signature) (Date) (Signature) (Date)
ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
COLmty of Fresno,State of California
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Agreement Between the County of Fresno and the Office of Traffic Safety
Allocation Name: Child Passenger Safety Program
Fund/Subclass: 0001/10000
Organization: 56201617
Revenue Account #: 4380
E. ACCOUNTING OFFICER OF OFFICE OF TRAFFIC SAFETY 9. SAM INFORMATION
NAME: Carolyn Vu SAM#: GLP5PZLWSZE1
ADDRESS: 2208 Kausen Drive, Suite 300 REGISTERED
Elk Grove, CA 95758 ADDRESS: 1221 Fulton Street#3
CITY: Fresno
Zip+4: 93721-1915
10. PROJECTED EXPENDITURES
FUND CFDA ITEM/APPROPRIATION F.Y. CHAPTER STATUTE PROJECTED
EXPENDITURES
405b OP-26 20.616 0521-0890-101 2025 04/25 BA/25 $187,317.00
AGREEMENT $187,317.00
TOTAL
AMOUNT ENCUMBERED BY THIS DOCUMENT
$187,317.00
I CERTIFY upon my own personal knowledge that the budgeted PRIOR AMOUNT ENCUMBERED FOR THIS
funds for the current budget year are available for the period and AGREEMENT
purpose of the expenditure stated above.
$ 0.00
OTS ACCOUNTING OFFICER'S SIGNATURE DATE SIGNED TOTAL AMOUNT ENCUMBERED TO DATE
$187,317.00
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State of California—Office of Traffic Safety GRANT NUMBER
GRANT AGREEMENT OP26007
Schedule A
1. PROBLEM STATEMENT
Describe the city, county, or jurisdiction this grant will impact.
Fresno County, located in California's San Joaquin Valley, is home to a growing and diverse population of
over 1 million residents as of July 2023, reflecting a 0.8% increase since 2020 (U.S. Census Bureau). The
county's demographic composition underscores its rich cultural diversity, with 54.9% of residents identifying
as Hispanic or Latino, 12.2% as Asian, 6.0% as Black or African American, and 3.2% as American Indian or
Alaska Native. Significant Armenian and Hmong communities further enhance Fresno's cultural fabric,
necessitating culturally and linguistically tailored outreach to address critical public health issues such as
child passenger safety. With a youthful population of 27.5% under the age of 18—child safety is a priority.
However, socioeconomic disparities persist, as 19.5% of residents live below the poverty line despite a
median household income of$67,756 in 2022 (U.S. Census Bureau). These challenges are particularly
acute in underserved rural areas such as Mendota and Firebaugh, where families have limited access to
child safety resources.
The county's educational attainment reflects additional barriers, with 78.3% of individuals holding at least a
high school diploma and only 23.4% earning a bachelor's degree or higher (U.S. Census Bureau). These
statistics highlight the importance of accessible and understandable education on child passenger safety,
particularly for parents and caregivers who may lack exposure to safety regulations and best practices.
Moreover, Fresno County's 12.7% of children with special health care needs (CSHCN) face unique
challenges requiring adaptive car seats, anti-escape devices, and specialized CPS Technician training
(California Department of Public Health). Rural families, in particular, often struggle to access these
specialized resources due to geographic and financial constraints.
A child passenger safety program in Fresno County will address these pressing issues by providing
equitable access to free car seats, bilingual education, and hands-on car seat installation to support
underserved urban and rural areas. Tailored outreach will engage diverse communities with culturally
appropriate education in their language and address specific needs of families with CSHCN. By bridging
socioeconomic and geographic disparities, promoting community collaboration, and direct distribution
statistics, we will significantly reduce preventable injuries and fatalities, creating a safer environment for
Fresno County (California Office of Traffic Safety, U.S. Census Bureau, California Department of Public
Health).
Describe the problem(s) to be addressed, supported by current and relevant crash data. (most
recent calendar year data/stats).
Fresno County faces significant challenges in ensuring child passenger safety, as evidenced by data from
multiple sources. According to the California Office of Traffic Safety (OTS) and the Statewide Integrated
Traffic Records System (SWITRS), the county reported alarming rates of fatalities and injuries among
children under eight involved in motor vehicle crashes. Between 2021-2023, 39 children under the age of
eight were killed, and 1,274 were injured in such crashes. According to the OTS Crash Rankings in 2022,
Fresno County ranked 3rd out of 15 cities of similar size for crashes in which the victims killed or injured
were a pedestrian under the age of 15. Furthermore, in 2022, Fresno County had 301 non-fatal injury
emergency room visits related to being an occupant in a motor vehicle crash.
The problem is further compounded by widespread misuse of car seats. Data from Safe Kids Central
California highlights that during 10 car seat check-up events between 2022 and 2024, 97% of car seats
inspected were either installed incorrectly or the children were not properly restrained. While efforts reduced
the misuse rate to 94% in 2024, it remains far above the national average of 74-78%. Common issues
included improper installation methods, particularly in forward-facing and rear-facing car seats for children
aged 1-6, and incorrect use of seat belts versus LATCH systems.
Adding to these challenges, Fresno County has a shortage of certified Child Passenger Safety Technicians
CPSTs . According to Safe Kids Worldwide, there are only 19 certified CPSTs serving the entire county,
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with only three being Spanish-speaking. Given that over 54.9% of the population identifies as Hispanic or
Latino, this shortage presents a significant barrier to providing adequate outreach and education to families
in need of proper car seat guidance. Many rural and underserved areas, where transportation-related
injuries are prevalent, have little to no access to trained technicians, leaving many families without the
necessary resources to ensure their children's safety. This lack of available technicians limits the county's
capacity to conduct inspections, distribute free car seats, and deliver culturally appropriate education.
Expanding the number of certified technicians, particularly those who are bilingual and represent
underserved communities, will be critical to addressing the ongoing misuse of car seats and the
disproportionate impact of transportation injuries on vulnerable populations. By increasing access to trained
professionals, Fresno County will be better positioned to reduce preventable injuries and fatalities and
improve child passenger safety outcomes for its diverse population.
Define the target population the grant intends to serve and how they are affected by the problem(s).
The child passenger safety program in Fresno County will target children under the age of eight and their
families, particularly those in underserved communities. Motor vehicle crashes are a leading cause of injury
and death for this age group in the county, with seven fatalities and 465 injuries reported in 2023 alone.
These alarming statistics highlight the urgent need to improve child passenger safety and reduce the risks
faced by young passengers.
The program will address the needs of low-income families, who often face economic barriers that limit their
ability to access high-quality car seats or professional installation assistance. According to the U.S. Census
Bureau, nearly 20% of Fresno County residents live below the poverty line, leaving many children
unprotected during travel, particularly in urban areas like southwest Fresno and rural regions such as
Mendota and Firebaugh. Additionally, the program would focus on Fresno County's diverse population,
which includes 54.9% identifying as Hispanic or Latino and significant Hmong and Armenian communities.
Language and cultural differences in these communities often hinder awareness and proper use of child
safety restraints, increasing the likelihood of misuse or non-use.
Children with special healthcare needs (CSHCN) will also be a key focus of the program. Approximately
12.7% of children in Fresno County require adaptive car seats or additional safety measures, yet resources
and trained professionals to support these families are scarce (California Department of Public Health,
2022). Moreover, geographic disparities in the county exacerbate the problem for families in rural areas,
where access to car seat inspection stations and educational resources is limited.
By providing free car seats, bilingual education, and access to certified Child Passenger Safety Technicians,
the program will address economic, cultural, and geographic barriers. This targeted approach aims to
reduce preventable injuries and fatalities, creating a safer environment for Fresno County's youngest and
most vulnerable residents.
2. PERFORMANCE MEASURES
A. Goals:
1. Reduce the number of persons killed in traffic crashes.
2. Reduce the number of persons injured in traffic crashes.
3. Reduce the number of vehicle occupants killed under age eight.
4. Reduce the number of vehicle occupants injured under age eight.
5. Increase child safety seat usage.
B. Objectives: Target Number
1. Issue a news release announcing the kick-off of the grant by December 31 st. The 1
kick-off news releases and media advisories, alerts, and materials must be
emailed to the OTS Public Information Officer at pio@ots.ca.gov, and copied to
your OTS Coordinator, for approval 7 days prior to the issuance date of the
release.
2. Participate in National Child Passenger Safety Week and National Heatstroke 2
Prevention Day.
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3. Conduct highly publicized child safety seat checkups at community locations such 2
as shopping centers, car dealerships or preschools to educate and empower
parents and caregivers to properly install and use an appropriate car seat for their
child. Car seat checkers must: be NHTSA-certified Child Passenger Safety
Technicians (CPST); check for car seat recalls, use a standardized form to collect
child safety seat misuse data, record corrections made, record seats installed, and
have access to car seat instructions and resource materials.
4. Conduct NHTSA Child Passenger Safety Technician Certification courses. 1
5. Certify, recertify or renew staff as NHTSA Child Passenger Safety Technicians. 6
6. Conduct child safety seat education classes with an effort to reach low-income 6
residents, professionals transporting children, caregivers, and parents.
7. Participate in traffic safety fairs and/or community events with an effort to reach 2
individuals.
8. Distribute OTS funded child safety seats at no-cost to families in need who receive 250
child safety seat education.
9. Purchase OTS funded child safety seats. 250
10. Participate in quarterly meetings with countywide child passenger safety 4
stakeholders to collaborate on events, share best practices, and leverage
resources.
11. Conduct individual child safety seat checkup by appointment to promote correct 100
usage, with an effort to reach parents or caregivers. Car seat checkers must be
NHTSA-Certified Child Passenger Safety Technicians (CPST).
12. Identify grant funded, straight time personnel. Include any vacancies or staff 4
changes that have occurred. For any vacancies, include the status of filling the
vacancy.
13. Participate in highly publicized child safety seat checkups hosted by other 3
agencies at community locations such as shopping centers, car dealerships or
preschools to educate and empower parents and caregivers to properly install and
use an appropriate car seat for their child. Car seat checkers must: be NHTSA-
certified Child Passenger Safety Technicians (CPST); check for car seat recalls,
use a standardized form to collect child safety seat misuse data, record
corrections made, record seats installed, and have access to car seat instructions
and resource materials.
14. Conduct paid Media Outreach Campaign and other media posts to reach target 1
audiences. The objective is to reach at least 1,000,000 impressions through this
mixed media approach with the target audience to include parents and caregivers
of children under 8 years old, families in Fresno County with the emphasis on the
underserved and rural areas, and non-English speaking families. When reporting,
include date/platform and potential number of individuals reached. Upload posts,
including number of views and reactions, to GEMS. All content requires OTS
approval.
15. Distribute OTS funded adaptive child restraints and accessories at no-cost to 1
families in need who receive child safety seat education.
3. METHOD OF PROCEDURE
A. Phase 1 — Program Preparation (1st Quarter of Grant Year)
• Develop operational plans to implement the "best practice" strategies outlined in the objectives
section.
• Conduct all training needed to implement the program, in the first quarter.
• Purchase all grant related supplies and materials to implement the program, in the first quarter.
• Items with a unit cost of$5,000 or more (including tax and shipping) must comply with Buy
America.
Media Requirements
• Issue a news release approved by the OTS PIO announcing the kick-off of the grant by
December 31 and after the grant is signed and executed, but no sooner than October 1, the start
of the grant year. The kick-off release must be approved by the OTS PIO. If you are unable to
meet the December 31 deadline to issue a kick-off press release, communicate reasons to your
OTS grant coordinator and OTS PIO.
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Phase 1 - Program Preparation Addendum
• Finalize agreement with key partner, Safe Kids Central California.
• Develop car seat distribution protocol with Safe Kids Central California.
• Develop plan for car seat check events with Safe Kids Central California.
• Plan logistics for Child Passenger Safety Technicians (CPST) certification course.
• Schedule and coordinate CPS certification course through Safe Kids Central California.
• Identify CPST training candidates.
• Enroll three internal staff and three community-based representatives in Child Passenger Safety
(CPS) Technician certification course.
• Develop and conduct pre-program training for public health educators on community outreach,
cultural competence, and data collection method.
• Order child safety seats, booster seats, and adaptive car seats to accommodate children with
special healthcare needs.
• Purchase training materials, including car seat demonstration models, instructional videos, and
printed educational materials in multiple languages.
• Acquire program supplies such as tents, tables, signage, and promotional materials for outreach
events.
• Set up a digital tracking system for inventory management and distribution of car seats.
• Develop culturally and linguistically appropriate educational materials for parents and caregivers.
• Design pre- and post-test assessments for car seat safety classes and technician trainings.
• Establish data collection tools to track program impact, including event attendance, car seat
installations, and knowledge retention.
• Define key performance indicators (KPIs) for program evaluation and reporting.
• Develop a reporting structure for grant compliance, including financial tracking and progress
reports.
• Issue a news release approved by the Office of Traffic Safety (OTS) Public Information Officer
(PIO) announcing the kickoff of the grant by December 31 st or after the grant agreement is
signed and executed.
By executing these Phase 1 activities, the Fresno County Department of Public Health will establish a
strong foundation for the successful implementation of the Child Passenger Safety Program, ensuring
broad community engagement, measurable safety improvements, and compliance with all grant
requirements.
B. Phase 2 — Program Operations (Throughout Grant Year)
Media Requirements
The following requirements are for all grant-related activities:
• Send all media advisories, alerts, videos, graphics, artwork, posters, radio/PSA/video scripts,
storyboards, digital and/or print educational materials for grant-related activities to the OTS PIO
at pio(a�ots.ca.gov for approval and copy your OTS grant coordinator. Optimum lead time would
be 7 days before the scheduled release but at least 3 business days prior to the scheduled
release date for review and approval is appreciated.
• Send all PowerPoint presentations, online presentations and trainings for grant-related activities
to the OTS PIO at pio ots.ca.gov for approval and copy your OTS grant coordinator. Certified
training courses are EXEMPT from the approval process.
• The OTS PIO is responsible for the approval of the design and content of materials. The agency
understands OTS PIO approval is not authorizing approval of budget expenditure or cost. Any
cost approvals must come from the OTS grant coordinator.
• Pre-approval is not required when using any OTS-supplied template for media advisories, news
releases, social media graphics, videos or posts, or any other OTS-supplied educational material.
However, copy the OTS PIO at pio ots.ca.gov and your OTS grant coordinator when any
material is distributed to the media and public, such as a news release, educational material, or
link to social media post.
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• If an OTS-supplied template, educational material, social media graphic, post or video is
substantially changed, the changes shall be sent to the OTS PIO at pio(a)_ots.ca.gov for approval
and copy your OTS grant coordinator.
• News releases, social media posts and alerts on platforms such as NextDoor and Nixle reporting
immediate and time-sensitive grant activities (e.g. enforcement operations, day of event
highlights or announcements, event invites) are EXEMPT from the OTS PIO approval process.
The OTS PIO and your OTS grant coordinator should still be notified when the grant-related
activity is happening (e.g. car seat checks, bicycle rodeos, community presentations, DUI
checkpoints, etc.).
• Enforcement activities such as warrant and probation sweeps, court stings, etc. that are
embargoed or could impact operations by publicizing in advance are EXEMPT from the PIO
approval process. However, announcements and results of activities should still be copied to the
OTS PIO at pio(@ots.ca.gov and your OTS grant coordinator with the embargoed date and time
or with "INTERNAL ONLY: DO NOT RELEASE" message in subject line of email.
• Any earned or paid media campaigns for TV, radio, digital or social media that are part of a
specific grant objective, using OTS grant funds, or designed and developed using contractual
services by a subgrantee, requires prior approval.
• Social media posts highlighting state or national traffic safety campaigns (Distracted Driving
Month, Motorcycle Safety Awareness Month, etc.), enforcement operations (DUI checkpoints,
etc.), or any other grant-related activity such as Bicycle rodeos, presentations, or events, are
highly encouraged but do not require prior approval.
• Submit a draft or rough-cut of all digital, printed, recorded or video material (brochures, posters,
scripts, artwork, trailer graphics, digital graphics, social posts connected to an earned or paid
media campaign grant objective) to the OTS PIO at pio(@ots.ca.gov and copy your OTS grant
coordinator for approval prior to the production or duplication.
• Use the following standard language in all press, media, and printed materials, space permitting:
Funding for this program was provided by a grant from the California Office of Traffic Safety,
through the National Highway Traffic Safety Administration.
• Space permitting, include the OTS logo on all grant-funded print materials, graphics and paid or
earned social media campaign grant objective; consult the OTS PIO and copy your OTS grant
coordinator for specifics, format-appropriate logos, or if space does not permit the use of the OTS
logo.
• Email the OTS PIO at pio(a ots.ca.gov and copy your OTS grant coordinator at least 21 days in
advance, or when first confirmed, a short description of any significant grant-related traffic safety
event or program, particularly events that are highly publicized beforehand with anticipated media
coverage so OTS has sufficient notice to arrange for attendance and/or participation in the event.
If unable to attend, email the OTS PIO and coordinator brief highlights and/or results, including
any media coverage (broadcast, digital, print) of event within 7 days following significant grant-
related event or program. Media and program highlights are to be reflected in APRs.
• Any news releases, work plans, scripts, storyboards, artwork, graphics, videos or any educational
or informational materials that received OTS PIO approval in a prior grant year needs to be
resubmitted for approval in the current grant year.
• For additional guidance, refer to the OTS Grants Materials Approval Process
Guidelines and OTS Grants Media Approval Process FAQs on the OTS website.
• Contact the OTS PIO or your OTS grant coordinator for consultation when changes from any of
the above requirements might be warranted.
Phase 2 - Program Operations Addendum
• Conduct monthly parent education classes in partnership with Safe Kids Central California in
both English and Spanish to teach proper car seat installation and usage with hands on
demonstration.
• Use pre- and post-tests to measure participants' knowledge and understanding of child
passenger safety.
• Attend quarterly Safe Kids Central California meetings.
• Host/participate in quarterly car seat check events at community locations such as schools,
churches, and community centers.
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• Staff events with certified Child Passenger Safety (CPS) Technicians to inspect car seats and
provide guidance to families on proper installation and usage.
• Distribute free car seats to families in need during check events, focusing on underserved and
rural areas.
• Track data from events, including the number of car seats checked, distributed, and corrected, to
assess impact and effectiveness.
• Register for local health fairs and community events to promote the program and engage directly
with families.
• Set up interactive booths staffed by CPS Technicians and educators to provide safety information
and answer questions.
• Distribute educational materials in multiple languages and promote upcoming car seat classes
and check events.
• Partner with event organizers to identify and prioritize participation in high-traffic or underserved
areas.
• Develop a comprehensive event calendar, scheduling car seat checks, education classes, and
health fair participation in advance.
• Collaborate with community-based organizations to identify locations and dates that maximize
program accessibility.
• Promote events through social media, local radio, community partners, and flyers distributed in
schools and healthcare settings.By integrating these operational activities, the program will
effectively increase awareness, provide direct assistance to families, and improve child
passenger safety outcomes across Fresno County.
C. Phase 3 — Data Collection & Reporting (Throughout Grant Year)
1. Prepare and submit grant claim invoices (due January 30, April 30, July 30, and October 30)
2. Prepare and submit Quarterly Performance Reports (QPR) (due January 30, April 30, July 30, and
October 30)
• Collect and report quarterly, appropriate data that supports the progress of goals and objectives.
• Provide a brief list of activity conducted, procurement of grant-funded items, and significant
media activities. Include status of grant-funded personnel, status of contracts, challenges, or
special accomplishments.
• Provide a brief summary of quarterly accomplishments and explanations for objectives not
completed or plans for upcoming activities.
• Collect, analyze and report statistical data relating to the grant goals and objectives.
Phase 3 - Data Collection Addendum
• Document all car seat checkup events with detailed records, including participant names, dates,
and locations.
• Maintain course rosters and pre- and post-test results for each participant to measure knowledge
gained.
• Record the number and types of car seats inspected, installed, or distributed during each event.
• Collect data on common misuse issues identified and corrective actions taken to inform future
training and outreach.
• Track attendance for all parent education classes using course rosters.
• Administer pre- and post-tests to evaluate participant knowledge and understanding of child
passenger safety.
• Record feedback from participants to improve the content and delivery of future classes.
• Document the number of educational materials distributed, including multilingual resources.
• Document CPS Technician training course with course roster, date, and location.
• Record certifications achieved, including the number of new CPS Technicians trained and
certified.
• Track demographic information of trainees to ensure equitable representation and outreach.
• Maintain records of health fairs and community outreach events, including locations, dates, and
participation levels.
• Track the number of families engaged and materials distributed during these events.
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• Collect feedback from community members and event partners to evaluate the program's impact
and identify areas for improvement.
• Compile data from all program activities, including car seat checkups, education classes, and
training courses, into a centralized database.
• Analyze trends, such as reductions in car seat misuse rates or increases in community
knowledge, to assess the program's effectiveness.
• Report key performance indicators (KPls) to funding agencies, including the Office of Traffic
Safety (OTS), as required.
• Develop periodic reports summarizing program activities, achievements, and lessons learned to
guide future program planning.
By implementing comprehensive data collection and documentation practices, the program will ensure
accountability, measure its impact, and continuously refine its activities to better serve Fresno County's
communities.
4. METHOD OF EVALUATION
Using the data compiled during the grant, the Grant Director will complete the "Final Evaluation" section in
the fourth/final Quarterly Performance Report (QPR). The Final Evaluation should provide a brief summary
of the grant's accomplishments, challenges and significant activities. This narrative should also include
whether goals and objectives were met, exceeded, or an explanation of why objectives were not completed.
5. ADMINISTRATIVE SUPPORT
This program has full administrative support, and every effort will be made to continue the grant activities
after grant conclusion.
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State of California—Office of Traffic Safety GRANT NUMBER
GRANT AGREEMENT OP26007
Schedule B
FUND NUMBER CATALOG FUND DESCRIPTION TOTAL AMOUNT
NUMBER(CFDA)
405b OP-26 20.616 Occupant Protection $187,317.00
COST CATEGORY FUND UNIT COST OR UNITS TOTAL COST TO
NUMBER RATE GRANT
A. PERSONNEL COSTS
Straight Time
Health Education Specialist 405b OP- $33.60 2,080 $69,888.00
26
Benefits - Health Education Specialist @ 405b OP- $57,497.00 1 $57,497.00
82.27 % 26
Overtime
$0.00
Category Sub-Total $127,385.00
B. TRAVEL EXPENSES
In State Travel 405b OP- $2,000.00 1 $2,000.00
26
$0.00
Category Sub-Total $2,000.00
C. CONTRACTUAL SERVICES
$0.00
Category Sub-Total $0.00
D. EQUIPMENT
$0.00
Category Sub-Total $0.00
E. OTHER DIRECT COSTS
Child Safety Seats 405b OP- $112.00 250 $28,000.00
26
Adaptive Child Restraints and Accessories 405b OP- $1,000.00 1 $1,000.00
26
CPS Instruction, Inspection and Training 405b OP- $4,000.00 1 $4,000.00
Supplies 26
CPS Technician/Instructor Fees 405b OP- $95.00 6 $570.00
26
Educational Materials 405b OP- $3,000.00 1 $3,000.00
26
Office Supplies 405b OP- $1,000.00 1 $1,000.00
26
Media Outreach Campaign 405b OP- $9,000.00 1 $9,000.00
26
Translation/Interpretation Services 405b OP- $2,000.00 1 $2,000.00
26
Category Sub-Total $48,570.00
F. INDIRECT COSTS
Indirect 405b OP- $9,362.00 1 $9,362.00
26
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Category Sub-Total $9,362.00
GRANT TOTAL $187,317.00
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State of California—Office of Traffic Safety GRANT NUMBER
GRANT AGREEMENT OP26007
Schedule B-1
BUDGET NARRATIVE
PERSONNEL COSTS
Health Education Specialist - The proposed budget will support the training and certification of a Health
Education Specialist (HES) as a Child Passenger Safety Technician (CPST)to oversee and implement
Fresno County's child passenger safety program. The HES will coordinate car seat inspection events,
provide educational trainings for caregivers in partnership with Safe Kids Central California, and manage the
no-cost contract with Safe Kids to ensure seamless collaboration and program success. Additionally, the
HES will oversee the procurement, distribution, and tracking of program supplies, including car seats and
educational materials, while maintaining detailed records of program activities and outcomes. These efforts
will ensure efficient management, accountability, and impactful delivery of the program's objectives,
ultimately enhancing child passenger safety across Fresno County. Claim should reflect actual costs up to
the rate specified.
Benefits - Health Education Specialist @ 82.27 % - Claimed amounts must reflect actual benefit costs for
straight time hours charged to the grant.
TRAVEL EXPENSES
In State Travel - Costs are included for appropriate staff to attend conferences and training events
supporting the grant goals and objectives and/or traffic safety. Local mileage for grant activities and
meetings is included. All conferences, seminars or training not specifically identified in the Budget Narrative
must be approved by OTS. All travel claimed must be at the agency approved rate. Per Diem may not be
claimed for meals provided at conferences when registration fees are paid with OTS grant funds. Allocation
for mileage costs for roundtrip travel to partner agencies, classes, outreach events, check-up events, and
meetings.
CONTRACTUAL SERVICES
EQUIPMENT
OTHER DIRECT COSTS
Child Safety Seats - Unit cost not to exceed $125 per seat (including booster seats) including sales tax,
shipping and handling. Seats to be distributed at no cost during CPS checkups, appointments, fitting stations
and traffic safety presentations. Infant only seats are not an allowable expense.
Adaptive Child Restraints and Accessories - Adaptive child restraints and accessories for community
members in need. Restraints and accessories may include travel vests meeting applicable NHTSA
standards, anti-escape accessories such as lockable chest clips, and belt cutters to be used on restraints
with locking features in the event of a crash. Unit costs in excess of$200 including sales tax, shipping and
handling may be allowable if approved by the OTS. When reporting, include date/location, and number of
individuals reached.
CPS Instruction, Inspection and Training Supplies - Supplies to conduct child passenger safety seat
education, training, and inspections at check-up events, classes, and individual appointments. Costs may
include LATCH manuals, demonstration dolls, traffic cones, pop-up tents, pool noodles, child safety seat
clips, tote carriers, Personal Protective Equipment, and event signage. Costs may not include furniture such
as but not limited to tables and chairs. Additional items may be purchased if approved by OTS.
CPS Technician/Instructor Fees - Certification, recertification or renewal fees for technicians who
successfully complete the NHTSA Child Passenger Safety Technician Certification or Renewal course or
biennial requirements to re-certify.
Educational Materials - Costs of purchasing, developing, or printing brochures, pamphlets, fliers, coloring
books, posters, signs, banners, and training materials associated with grant activities. Items shall include a
traffic safety message and if space is available, the OTS logo. Draft materials must be submitted to OTS for
approval. Additional items may be purchased if approved by OTS.
Office Supplies - Used for standard office supplies to support grant related activities, grant monitoring and
reporting. Costs may include paper, toner, ink cartridges, CDs/DVDs, flash drives, and desk top supplies
such as pens, pencils, binders, folders, flip charts, easels, and clips. Excludes office furnishings and fixtures
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such as but not limited to the following: desk, chair, table, shelving, coat rack, credenza, book, filing cabinet,
floor covering, office planter, storage cabinet, portable partition, picture, wall clock, draperies and hardware,
and fixed lighting/lamp. Additional items may be purchased if approved by OTS.
Media Outreach Campaign - Costs included to conduct a Media Outreach campaign utilizing FCDH's
vendor, HYPHEN Marketing, in alignment with grant cycle to raise awareness and promote Fresno County's
Child Passenger safety program to diverse and underserved communities, ensuring families are informed
about the car sear inspection events, educational events, and free car seats. This will include a mix of media
channels to effectively reach our target audience across Fresno County including social media ads
(Facebook, Instagram) to target local parents and caregivers, radio spots during commute hours to reach
broader community audiences, and digital banners or online display ads on local news websites and
parenting resources to be distributed with bilingual content (English and Spanish).
Translation/Interpretation Services - Costs dedicated to translation or interpretation services for grant-funded
educational material content and activities. All costs must be approved by OTS.
INDIRECT COSTS
Indirect - 7.35% of Salary and Benefits Indirect Cost Rate of 7.35% - De Minimis Rate of 7.35% applied to
Personnel costs.
STATEMENTS/DISCLAIMERS
There will be no program income generated from this grant.
Salaries may include wages, salaries, special compensations, or authorized absences such as annual leave
and sick leave provided the cost for the individual employee is (a) reasonable for the services rendered, and
(b) follows an appointment made in accordance with state or local laws and rules and meets federal
requirements.
Any non-grant funded vacancies created by reassignment to a grant-funded position must be filled at the
expense of the grantee agency.
Benefits for personnel costs can only be applied to straight time or overtime hours charged to the grant.
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State of California—Office of Traffic Safety GRANT NUMBER
GRANT AGREEMENT OP26007
Exhibit A
Appendix A to Part 1300—Certifications and Assurances for Highway Safety Grants
(23 U.S.C. Chapter 4 or Section 1906, Public Law 109-59, as amended by Section 25024, Public Law 117-
58)
The officials named on the grant agreement, certify by way of signature on the grant agreement signature page,
that the Grantee Agency complies with all applicable Federal statutes, regulations, and directives and State
rules, guidelines, policies, and laws in effect with respect to the periods for which it receives grant funding.
Applicable provisions include, but are not limited to, the following:
GENERAL REQUIREMENTS
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;
• Sec. 1906, Public Law 109-59, as amended by Sec. 25024, Public Law 117-58;
• 23 CFR part 1300—Uniform Procedures for State Highway Safety Grant Programs;
• 2 CFR part 200—Uniform Administrative Requirements, Cost Principles, and Audit Requirements
for Federal Awards;
• 2 CFR part 1201—Department of Transportation, Uniform Administrative Requirements, Cost Principles,
and Audit Requirements for Federal Awards.
NONDISCRIMINATION
(applies to subrecipients as well as States)
The State highway safety agency [and its subrecipients] will comply with all Federal statutes and implementing
regulations relating to nondiscrimination ("Federal Nondiscrimination Authorities"). These include but are not
limited to:
• Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq., 78 stat. 252), (prohibits discrimination
on the basis of race, color, national origin);
• 49 CFR part 21 (entitled Non-discrimination in Federally-Assisted Programs of the Department of
Transportation—Effectuation of Title VI of the Civil Rights Act of 1964);
• 28 CFR 50.3 (U.S. Department of Justice Guidelines for Enforcement of Title VI of the Civil Rights Act
of 1964);
• The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C.4601),
(prohibits unfair treatment of persons displaced or whose property has been acquired because of Federal
or Federal-aid programs and projects);
• Federal-Aid Highway Act of 1973, (23 U.S.C. 324 et seq.), and Title IX of the Education Amendments
of 1972, as amended (20 U.S.C. 1681-1683 and 1685-1686) (prohibit discrimination on the basis of
sex);
• Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. 794 et seq.), as amended, (prohibits
discrimination on the basis of disability) and 49 CFR part 27;
The Age Discrimination Act of 1975, as amended, (42 U.S.C. 6101 et seq.), (prohibits discrimination
on the basis of age);
The Civil Rights Restoration Act of 1987, (Pub. L. 100-209), (broadens scope, coverage, and
applicability of Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975 and Section
504 of the Rehabilitation Act of 1973, by expanding the definition of the terms "programs or activities" to
include all of the programs or activities of the
Federal aid recipients, subrecipients and contractors, whether such programs or activities are Federally-
funded or not);
• Titles II and 111 of the Americans with Disabilities Act(42 U.S.C. 12131-12189) (prohibits
discrimination on the basis of disability in the operation of public entities, public and private
transportation systems, places of public accommodation, and certain testing) and 49 CFR parts 37
and 38
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The preceding statutory and regulatory cites hereinafter are referred to as the "Acts" and "Regulations,"
respectively.
GENERAL ASSURANCES
In accordance with the Acts, the Regulations, and other pertinent directives, circulars, policy, memoranda,
and/or guidance, the Recipient hereby gives assurance that it will promptly take any measures necessary to
ensure that:
"No person in the United States shall, on the grounds of race, color, or national origin, be excluded from
participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity, for which the Recipient receives Federal financial assistance from
DOT, including NHTSA."
The Civil Rights Restoration Act of 1987 clarified the original intent of Congress, with respect to Title VI of the
Civil Rights Act of 1964 and other non-discrimination requirements (the Age Discrimination Act of 1975, and
Section 504 of the Rehabilitation Act of 1973), by restoring the broad, institutional-wide scope and coverage of
these nondiscrimination statutes and requirements to include all programs and activities of the Recipient, so
long as any portion of the program is Federally assisted.
SPECIFIC ASSURANCES
More specifically, and without limiting the above general Assurance, the Recipient agrees with and gives the
following Assurances with respect to its Federally assisted Highway Safety Grant Program:
1. The Recipient agrees that each "activity," "facility," or"program," as defined in § 21.230) and (c) of
49 CFR part 21 will be (with regard to an "activity") facilitated, or will be (with regard to a "facility")
operated, or will be (with regard to a "program") conducted in compliance with all requirements
imposed by, or pursuant to the Acts and the Regulations.
2. The Recipient will insert the following notification in all solicitations for bids, Requests For
Proposals for work, or material subject to the Acts and the Regulations made in connection with all
Highway Safety Grant Programs and, in adapted form, in all proposals for negotiated agreements
regardless of funding source:
"The[name of Recipient], in accordance with the provisions of Title VI of the Civil Rights Act of
1964 (78 Stat. 252, 42 U.S.C 2000d to 2000d-4) and the Regulations, hereby notifies all bidders
that it will affirmatively ensure that in any contract entered into pursuant to this advertisement,
disadvantaged business enterprises will be afforded full and fair opportunity to submit bids in
response to this invitation and will not be discriminated against on the grounds of race, color, or
national origin in consideration for an award."
3. The Recipient will insert the clauses of appendix A and E of this Assurance (also referred to as DOT
order 1050.2A) 111 in every contract or agreement subject to the Acts and the Regulations.
4. The Recipient will insert the clauses of appendix B of DOT Order 1050.2A, as a covenant running
with the land, in any deed from the United States effecting or recording a transfer of real property,
structures, use, or improvements thereon or interest therein to a Recipient.
5. That where the Recipient receives Federal financial assistance to construct a facility, or part of a
facility, the Assurance will extend to the entire facility and facilities operated in connection therewith.
6. That where the Recipient receives Federal financial assistance in the form of, or for the acquisition
of, real property or an interest in real property, the Assurance will extend to rights to space on,
over, or under such property.
7. That the Recipient will include the clauses set forth in appendix C and appendix D of this DOT Order
1050.2A, as a covenant running with the land, in any future deeds, leases, licenses, permits, or
similar instruments entered into by the Recipient with other parties:
a. for the subsequent transfer of real property acquired or improved under the applicable
activity, project, or program; and
b. for the construction or use of, or access to, space on, over, or under real property acquired
or improved under the applicable activity, project, or program.
8. That this Assurance obligates the Recipient for the period during which Federal financial assistance
is extended to the program, except where the Federal financial assistance is to provide, or is in the
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form of, personal property, or real property, or interest therein, or structures or improvements
thereon, in which case the Assurance obligates the Recipient, or any transferee for the longer of the
following periods:
a. the period during which the property is used for a purpose for which the Federal financial
assistance is extended, or for another purpose involving the provision of similar services or
benefits; or
b. the period during which the Recipient retains ownership or possession of the property.
9. The Recipient will provide for such methods of administration for the program as are found by the
Secretary of Transportation or the official to whom he/she delegates specific authority to give
reasonable guarantee that it, other recipients, sub-recipients, sub- grantees, contractors,
subcontractors, consultants, transferees, successors in interest, and other participants of Federal
financial assistance under such program will comply with all requirements imposed or pursuant to
the Acts, the Regulations, and this Assurance.
10. The Recipient agrees that the United States has a right to seek judicial enforcement with regard to
any matter arising under the Acts, the Regulations, and this Assurance.
By signing this ASSURANCE, the State highway safety agency also agrees to comply (and require any sub-
recipients, sub-grantees, contractors, successors, transferees, and/or assignees to comply) with all applicable
provisions governing NHTSA's access to records, accounts, documents, information, facilities, and staff. You
also recognize that you must comply with any program or compliance reviews, and/or complaint investigations
conducted by NHTSA. You must keep records, reports, and submit the material for review upon request to
NHTSA, or its designee in a timely, complete, and accurate way. Additionally, you must comply with all other
reporting, data collection, and evaluation requirements, as prescribed by law or detailed in program guidance.
The State highway safety agency gives this ASSURANCE in consideration of and for obtaining any Federal
grants, loans, contracts, agreements, property, and/or discounts, or other Federal-aid and Federal financial
assistance extended after the date hereof to the recipients by the U.S. Department of Transportation under the
Highway Safety Grant Program. This ASSURANCE is binding on the State highway safety agency, other
recipients, sub-recipients, sub-grantees, contractors, subcontractors and their subcontractors', transferees,
successors in interest, and any other participants in the Highway Safety Grant Program. The person(s) signing
below is/are authorized to sign this ASSURANCE on behalf of the Recipient.
THE DRUG-FREE WORKPLACE ACT OF 1988 (41 U.S.C. 8103)
The Subgrantee will 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 the grantee's workplace, and
specifying the actions that will be taken against employees for violation of such prohibition;
b. Establishing a drug-free awareness program to inform employees about:
1. The dangers of drug abuse in the workplace;
2. The grantee's policy of maintaining a drug-free workplace;
3. Any available drug counseling, rehabilitation, and employee assistance programs;
4. The penalties that may be imposed upon employees for drug violations occurring in the
workplace;
5. 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);
c. Notifying the employee in the statement required by paragraph (a) that, as a condition of
employment under the grant, the employee will-
1. Abide by the terms of the statement;
2. Notify the employer of any criminal drug statute conviction for a violation occurring in
the workplace no later than five days after such conviction;
d. Notifying the agency within ten days after receiving notice under subparagraph (c)(2)from an
employee or otherwise receiving actual notice of such conviction;
e. Taking one of the following actions, within 30 days of receiving notice under
subparagraph (c)(2), with respect to any employee who is so convicted-
1. Taking appropriate personnel action against such an employee, up to and including
termination;
2. Requiring such employee to participate satisfactorily in a drug abuse assistance or
9/19/2025 11:52:19 AM Page 16 of 21
rehabilitation program approved for such purposes by a Federal, State, or local health, law
enforcement, or other appropriate agency;
f. Making a good faith effort to continue to maintain a drug-free workplace through
implementation of all of the paragraphs above.
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-awards at all tiers (including subcontracts, subgrants, and contracts under
grant, loans, and cooperative agreements) and that all subrecipients shall certify and disclose
accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making or
entering into this transaction imposed by section 1352, title 31,
U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of
not less than $10,000 and not more than $100,000 for each such failure.
RESTRICTION ON STATE LOBBYING
(applies to subrecipients as well as States)
None of the funds under this program will be used for any activity specifically designed to urge or influence a
State or local legislator to favor or oppose the adoption of any specific legislative proposal pending before any
State or local legislative body. Such activities include both direct and indirect (e.g., "grassroots") lobbying
activities, with one exception. This does not preclude a State official whose salary is supported with NHTSA
funds from engaging in direct communications with State or local legislative officials, in accordance with
customary State practice, even if such communications urge legislative officials to favor or oppose the adoption
of a specific pending legislative proposal.
CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
(applies to subrecipients as well as States)
INSTRUCTIONS FOR PRIMARY TIER PARTICIPANT CERTIFICATION(STATES)
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1. By signing and submitting this proposal, the prospective primary tier participant is providing the
certification set out below and agrees to comply with the requirements of 2 CFR parts 180 and
1200.
2. The inability of a person to provide the certification required below will not necessarily result in
denial of participation in this covered transaction. The prospective primary tier participant shall
submit an explanation of why it cannot provide the certification set out below. The certification or
explanation will be considered in connection with the department or agency's determination
whether to enter into this transaction. However, failure of the prospective primary tier participant to
furnish a certification or an explanation shall disqualify such person from participation in this
transaction.
3. The certification in this clause is a material representation of fact upon which reliance was placed
when the department or agency determined to enter into this transaction. If it is later determined that
the prospective primary tier participant knowingly rendered an erroneous certification, in addition to
other remedies available to the Federal Government, the department or agency may terminate this
transaction for cause or default or may pursue suspension or debarment.
4. The prospective primary tier participant shall provide immediate written notice to the department
or agency to which this proposal is submitted if at any time the prospective primary tier participant
learns its certification was erroneous when submitted or has become erroneous by reason of
changed circumstances.
5. The terms covered transaction, civil judgment, debarment, suspension, ineligible,
participant, person, principal, and voluntarily excluded, as used in this clause, are defined in
2 CFR parts 180 and 1200. You may contact the department or agency to which this proposal is
being submitted for assistance in obtaining a copy of those regulations.
6. The prospective primary tier participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter into any lower tier
covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4,
debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered
transaction, unless authorized by the department or agency entering into this transaction.
7. The prospective primary tier participant further agrees by submitting this proposal that it will include
the clause titled "Instructions for Lower Tier Participant Certification" including the "Certification
Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion—Lower Tier Covered
Transaction," provided by the department or agency entering into this covered transaction, without
modification, in all lower tier covered transactions and in all solicitations for lower tier covered
transactions and will require lower tier participants to comply with 2 CFR parts 180 and 1200.
8. A participant in a covered transaction may rely upon a certification of a prospective participant in a
lower tier covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart
9_4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it
knows that the certification is erroneous. A participant is responsible for ensuring that its principals
are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify
the eligibility of its principals, as well as the eligibility of any prospective lower tier participants, each
participant may, but is not required to, check the System for Award Management Exclusions
website
( https://www.sam.go0.
9. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge and
information of a participant is not required to exceed that which is normally possessed by a prudent
person in the ordinary course of business dealings.
10. Except for transactions authorized under paragraph 6 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or
voluntarily excluded from participation in this transaction, in addition to other remedies available to
the Federal Government, the department or agency may terminate the transaction for cause or
default.
CERTIFICATION REGARDING DEBARMENT,SUSPENSION,AND OTHER RESPONSIBILITY MATTERS—PRIMARY TIER
COVERED TRANSACTIONS
1. The prospective primary tier participant certifies to the best of its knowledge and belief, that it and
9/19/2025 11:52:19 AM Page 18 of 21
its principals:
a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participating in covered transactions by any Federal department
or agency;
b. Have not within a three-year period preceding this proposal been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection
with obtaining, attempting to obtain, or 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
records, making false statements, or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a
governmental entity (Federal, State, or local) with commission of any of the offenses
enumerated in paragraph (1)(b) of this certification; and
d. Have not within a three-year period preceding this application/proposal had one or more
public transactions (Federal, State, or local) terminated for cause or default.
2. Where the prospective primary tier participant is unable to certify to any of the Statements in this
certification, such prospective participant shall attach an explanation to this proposal.
INSTRUCTIONS FOR LOWER TIER PARTICIPANT CERTIFICATION
1. By signing and submitting this proposal, the prospective lower tier participant is providing the
certification set out below and agrees to comply with the requirements of 2 CFR parts 180 and
1200.
2. The certification in this clause is a material representation of fact upon which reliance was placed
when this transaction was entered into. If it is later determined that the prospective lower tier
participant knowingly rendered an erroneous certification, in addition to other remedies available to
the Federal Government, the department or agency with which this transaction originated may
pursue available remedies, including suspension or debarment.
3. The prospective lower tier participant shall provide immediate written notice to the person to
which this proposal is submitted if at any time the prospective lower tier participant learns that
its certification was erroneous when submitted or has become erroneous by reason of
changed circumstances.
4. The terms covered transaction, civil judgment, debarment, suspension, ineligible, participant,
person, principal, and voluntarily excluded, as used in this clause, are defined in 2 CFR parts
180 and 1200. You may contact the person to whom this proposal is submitted for assistance in
obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed
covered transaction be entered into, it shall not knowingly enter into any lower tier covered
transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4,
debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered
transaction, unless authorized by the department or agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will include
the clause titled "Instructions for Lower Tier Participant Certification" including the "Certification
Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion—Lower Tier Covered
Transaction," without modification, in all lower tier covered transactions and in all solicitations for
lower tier covered transactions and will require lower tier participants to comply with 2 CFR parts
180 and 1200.
7. A participant in a covered transaction may rely upon a certification of a prospective participant in a
lower tier covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart
9_4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it
knows that the certification is erroneous. A participant is responsible for ensuring that its principals
are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify
the eligibility of its principals, as well as the eligibility of any prospective lower tier participants, each
participant may, but is not required to, check the System for Award Management Exclusions
website
( https://www.sam.go0.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of
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records in order to render in good faith the certification required by this clause. The knowledge and
information of a participant is not required to exceed that which is normally possessed by a prudent
person in the ordinary course of business dealings.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or
voluntarily excluded from participation in this transaction, in addition to other remedies available to
the Federal Government, the department or agency with which this transaction originated may
pursue available remedies, including suspension or debarment.
CERTIFICATION REGARDING DEBARMENT,SUSPENSION,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 participating in covered transactions by any Federal department or
agency.
2. Where the prospective lower tier participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
BUY AMERICA
(applies to subrecipients as well as States)
The State and each subrecipient will comply with the Buy America requirement (23 U.S.C. 313) when
purchasing items using Federal funds. Buy America requires a State, or subrecipient, to purchase with Federal
funds only steel, iron and manufactured products produced in the United States, unless the Secretary of
Transportation determines that such domestically produced items would be inconsistent with the public
interest, that such materials are not reasonably available and of a satisfactory quality, or that inclusion of
domestic materials will increase the cost of the overall project contract by more than 25 percent. In order to use
Federal funds to purchase foreign produced items, the State must submit a waiver request that provides an
adequate basis and justification for approval by the Secretary of Transportation.
CERTIFICATION ON CONFLICT OF INTEREST
(applies to subrecipients as well as States)
GENERAL REQUIREMENTS
No employee, officer, or agent of a State or its subrecipient who is authorized in an official capacity to
negotiate, make, accept, or approve, or to take part in negotiating, making, accepting, or approving any
subaward, including contracts or subcontracts, in connection with this grant shall have, directly or indirectly,
any financial or personal interest in any such subaward. Such a financial or personal interest would arise when
the employee, officer, or agent, any member of his or her immediate family, his or her partner, or an
organization which employs or is about to employ any of the parties indicated herein, has a financial or
personal interest in or a tangible personal benefit from an entity considered for a subaward. Based on this
policy:
1. The recipient shall maintain a written code or standards of conduct that provide for disciplinary
actions to be applied for violations of such standards by officers, employees, or agents.
a. The code or standards shall provide that the recipient's officers, employees, or agents
may neither solicit nor accept gratuities, favors, or anything of monetary value from
present or potential subawardees, including contractors or parties to subcontracts.
b. The code or standards shall establish penalties, sanctions, or other disciplinary actions
for violations, as permitted by State or local law or regulations.
2. The recipient shall maintain responsibility to enforce the requirements of the written code or
standards of conduct.
DISCLOSURE REQUIREMENTS
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No State or its subrecipient, including its officers, employees, or agents, shall perform or continue to perform
under a grant or cooperative agreement, whose objectivity may be impaired because of any related past,
present, or currently planned interest, financial or otherwise, in
organizations regulated by NHTSA or in organizations whose interests may be substantially affected by NHTSA
activities. Based on this policy:
1. The recipient shall disclose any conflict of interest identified as soon as reasonably possible,
making an immediate and full disclosure in writing to NHTSA. The disclosure shall include a
description of the action which the recipient has taken or proposes to take to avoid or mitigate such
conflict.
2. NHTSA will review the disclosure and may require additional relevant information from the recipient.
If a conflict of interest is found to exist, NHTSA may (a) terminate the award, or(b) determine that it
is otherwise in the best interest of NHTSA to continue the award and include appropriate provisions
to mitigate or avoid such conflict.
3. Conflicts of interest that require disclosure include all past, present, or currently planned
organizational, financial, contractual, or other interest(s) with an organization regulated by NHTSA
or with an organization whose interests may be substantially affected by NHTSA activities, and
which are related to this award. The interest(s) that require disclosure include those of any
recipient, affiliate, proposed consultant, proposed subcontractor, and key personnel of any of the
above. Past interest shall be limited to within one year of the date of award. Key personnel shall
include any person owning more than a 20 percent interest in a recipient, and the officers,
employees or agents of a recipient who are responsible for making a decision or taking an action
under an award where the decision or action can have an economic or other impact on the
interests of a regulated or affected organization.
PROHIBITION ON USING GRANT FUNDS TO CHECK FOR HELMET USAGE
(applies to subrecipients as well as States)
The State and each subrecipient will not use 23 U.S.C. Chapter 4 grant funds for programs to check helmet
usage or to create checkpoints that specifically target motorcyclists.
POLICY ON SEAT BELT USE
In accordance with Executive Order 13043, Increasing Seat Belt Use in the United States, dated April 16, 1997,
the Grantee is encouraged to adopt and enforce on-the-job seat belt use policies and programs for its
employees when operating company-owned, rented, or personally-owned vehicles. The National Highway
Traffic Safety Administration (NHTSA) is responsible for providing leadership and guidance in support of this
Presidential initiative. For information and resources on traffic safety programs and policies for employers,
please contact the Network of Employers for Traffic Safety (NETS), a public-private partnership dedicated to
improving the traffic safety practices of employers and employees. You can download information on seat belt
programs, costs of motor vehicle crashes to employers, and other traffic safety initiatives at
www.trafficsafety.org. The NHTSA website ( www.nhtsa.gov) also provides information on statistics,
campaigns, and program evaluations and references.
POLICY ON BANNING TEXT MESSAGING WHILE DRIVING
In accordance with Executive Order 13513, Federal Leadership On Reducing Text Messaging While Driving,
and DOT Order 3902.10, Text Messaging While Driving, States are encouraged to adopt and enforce
workplace safety policies to decrease crashes caused by distracted driving, including policies to ban text
messaging while driving company-owned or rented vehicles, Government-owned, leased or rented vehicles, or
privately-owned vehicles when on official Government business or when performing any work on or behalf of
the Government. States are also encouraged to conduct workplace safety initiatives in a manner
commensurate with the size of the business, such as establishment of new rules and programs or re-
evaluation of existing programs to prohibit text messaging while driving, and education, awareness, and other
outreach to employees about the safety risks associated with texting while driving.
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