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FY 2021 COPS Hiring Program (CHP) <br />Declaration and Certification to the U.S.Department of Justice as to Acceptance <br />By checking the declaration and certification box 1-- <br />A to the U.S. Depar Iment of Justice (DOJ), under penalty of perjury, that I have <br />authority to make this declaration and certification on behalf of the applicant. <br />B. Certify to DOJ, under penalty of perjury, on behalf of myself and the applicant, to the <br />best of my knowledge and belief, that the following are true as of the date of this award <br />acceptance: (1) I have conducted or there was conducted (including by applicant's legal <br />counsel as appropriate and made available to me) a diligent review of all terms and <br />conditions of, and all supporting materials submitted in connection with, this award, <br />including any assurances and certifications (including anything submitted in connection <br />therewith by a person on behalf of the applicant before, after, or at the time of the <br />application submission and any materials that accompany this acceptance and <br />certification); and (2) I have the legal authority to accept this award on behalf of the <br />applicant. <br />C. Accept this award on behalf of the applicant. <br />D. Declare the followingto DOJ, under penalty of perjury, on behalf of myself and the <br />applicant: (1) I understand that, in taking (or not taking) any action pursuant to this <br />declaration and certification, DOJ will rely upon this declaration and certification as a <br />material representation; and (2) I understand that any materially false, fictitious, or <br />fraudulent information or statement in this declaration and certification (or concealment or <br />omission of a material fact as to either) may be the subject of criminal prosecution <br />(including under 18 U.S.C. §§ 1001 and/or 1621, and/or 34 U.S.C. §§ 10271-10273), and <br />also may subject me and the applicant to civil penalties and administrative remedies under <br />the federal False Claims Act (including under 31 U.S.C. §§ 3729-3730 and/or §§ 3801-3812) <br />or otherwise. <br />Authorized Representatives Acceptance o f Award <br />Eric Dreyer <br />Law Enforcement Executive/Program Official <br />Printed Name <br />Chief of Police <br />Law Enforcement Executive/Program Official <br />Law E <br />Signature <br />cement Executive/Program Official <br />2 <br />Allan Ekberg <br />Governm ent Executive/Financial Official <br />Printed Name <br />City of Tukwila Mayor <br />Governm ent Executive/Financial Official <br />Title <br />Government Executive/Financial Official <br />Signature <br />Date <br />